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A fairly consistent finding in research on trust in physicians is that racial and ethnic minorities cite lower levels than whites. This research typically samples only health care users, which limits our understanding of what underlies distrust. It remains unclear whether the distrust is generalized, which is distrust that is unrelated to using health care regularly or recently.

Using data from the Health Information National Trends Survey, multivariable logistic regressions assessed whether racial and ethnic differences in distrust (1) are equivalent among health care users and non-users; (2) regardless of respondents’ health and socio-economic status; and (3) manifest in other health information sources.

Racial and ethnic minorities are less likely than whites to trust physicians as health information sources. These racial and ethnic differences are equivalent among health care users and non-users, regardless of respondents’ health and socio-economic status. The racial and ethnic patterns do not manifest when predicting trust in other health information sources (Internet, family or friends, government health agencies, charitable organizations).

Data are derived from a cross-sectional survey, which makes it difficult to account comprehensively for self-selection into being a health care user. Despite the limitations, this research suggests that racial and ethnic minorities possess a generalized distrust in physicians, necessitating interventions that move beyond improving health care experiences.

Many researchers have surmised that a generalized distrust in physicians exists among racial and ethnic minorities. This chapter is the first to explicitly examine the existence of such distrust.

This study aims to provide a comprehensive review of electric tugboat deployment in maritime transportation, including an in-depth assessment of its advantages and disadvantages. Along with the identification of advantages and disadvantages of electric tugboat deployment, the present research also aims to provide managerial insights into the economic viability of different tugboat alternatives that can guide future investments in the following years.

A detailed literature review was conducted, aiming to gain broad insights into tugboat operations and focusing on different aspects, including tugboat accidents and safety issues, scheduling and berthing of tugboats, life cycle assessment of diesel tugboats and their alternatives, operations of electric and hybrid tugboats, environmental impacts and others. Moreover, a set of interviews was conducted with the leading experts in the electric tugboat industry, including DAMEN Shipyards and the Port of Auckland. Econometric analyses were performed as well to evaluate the financial viability and economic performance of electric tugboats and their alternatives (i.e. conventional tugboats and hybrid tugboats).

The advantages of electric tugboats encompass decreased emissions, reduced operating expenses, improved energy efficiency, lower noise levels and potential for digital transformation through automation and data analytics. However, high initial costs, infrastructure limitations, training requirements and restricted range need to be addressed. The electric tugboat alternative seems to be the best option for scenarios with low interest rate values as increasing interest values negatively impact the salvage value of electric tugboats. It is expected that for long-term planning, the electric and hybrid tugboat alternatives will become preferential since they have lower annual costs than conventional diesel tugboats.

The outcomes of this research provide managerial insights into the practical deployment of electric tugboats and point to future research needs, including battery improvements, cost reduction, infrastructure development, legislative and regulatory changes and alternative energy sources. The advancement of battery technology has the potential to significantly impact the cost dynamics associated with electric tugboats. It is essential to do further research to monitor the advancements in battery technology and analyze their corresponding financial ramifications. It is essential to closely monitor the industry’s shift toward electric tugboats as their prices become more affordable.

The maritime industry is rapidly transforming and facing pressing challenges related to sustainability and digitization. Electric tugboats represent a promising and innovative solution that could address some of these challenges through zero-emission operations, enhanced energy efficiency and integration of digital technologies. Considering the potential of electric tugboats, the present study provides a comprehensive review of the advantages and disadvantages of electric tugboats in maritime transportation, extensive evaluation of the relevant literature, interviews with industry experts and supporting econometric analyses. The outcomes of this research will benefit governmental agencies, policymakers and other relevant maritime transportation stakeholders.

Existing descriptions of trust in health care largely assume a straightforward association between a patient’s relationship with a regular provider and his or her trust in health care. I extend status characteristics theory (SCT) and social identity theory (SIT) to suggest greater variability in this association by investigating the role of social differences between patients and their regular providers. Whereas the SIT extension predicts lower trust in dissimilar than similar dyads, the predictions from the SCT extension depend on status in dissimilar dyads. Further, research examining how social differences in patient–provider dyads shape trust largely emphasizes racial differences, but the theories implicate gender differences too.

I analyze a longitudinal dataset of patient–provider dyads offering a conservative test of the extensions.

Results generally support predictions from the SCT extension. Specifically, patients’ status based on differences in either race or gender: (1) is inversely related to their trust in health care and (2) influences the resiliency of their trust, whereby the degree health care met prior expectations matters less (more) for the trust of low (high) status patients than equal status patients.

When patients and providers differ on both race and gender, findings sometimes depart from predictions. This indicates differences in two social categories is a unique situation where the contributions of each category are distinct from that of the other.

This research extends SCT to explain greater variability in the connection between patient–provider dyads and trust in health care, while also showing how gender compares to race.

The paper aims to critically review four recently published books, each of which aims to explain the disproportionate representation of men and women in science careers, and to understand gender differences in achievements and productivity.

This is a thematic book review and conceptual analysis and development.

The review shows that in order to reduce and eliminate gender inequality in science careers, it is naïve to assume that changing women's attitudes alone will solve the problem. This position in‐itself indicates the unspoken presumption that the male model of work is the norm to which women must adapt.

The review shows there is a need for policy actions and initiatives that eliminate the structural barriers in SET career trajectories which currently favour the working preferences of male scientists.

It should be noted that the (inland waterway transport) IWT in Ukraine currently is in its infancy in comparison with other land based transport means (rail and road) and with other countries that possess navigable rivers. This paper is an extension of the research initiated by Grushevska and Notteboom (2015) where the concepts of intermediacy and centrality were introduced in order to assess the role of Ukraine in the global and regional transport networks. The list of key obstacles for Ukraine’s intermediacy function included IWT related barriers such as: (i) deficient inland waterway infrastructure, (ii) high IWT costs (fees for bridges, locks etc.) and (iii) pilotage charges. To date the transportation to/from ports is mainly fulfilled by road or by rail based multimodal transport solutions. We present the unutilized potential of Ukrainian IWT that needs to be efficiently exploited for the benefit of the national economy and national transport system. This study intends to enrich the limited academic research on IWT systems in a transition stage, as exemplified by the case of Ukraine.

We explored how clinicians assisting low-income US Latino patients with diabetes and limited English proficiency (LEP) made sense of language-discordant care in the context of the social determination of health.

We interviewed 14 physicians in an urban teaching hospital, recorded and transcribed the interviews, and read transcripts to identify themes and interpret meanings. We used a mixed qualitative approach and drew from the Marxian tradition that illuminates how the dynamic of the clinical encounter tends to reproduce the social order by excluding its critical appraisal.

Participants believed that language barriers undermine the quality of the clinical encounter and diabetes outcomes, were eager to serve disadvantaged patients, and were well schooled in the social determination of health and its role in diabetes inequalities. However, they appeared unable to conceptualize macro-level changes that may achieve greater health equity.

The structure of medical discourse appears to limit the ability of individual clinicians to conceptualize and engage in social change on behalf patients. Recent debates in primary care indicate that this limitation is currently being challenged. Health services for persons with diabetes and limited English proficiency in the United States and elsewhere require significant improvements in interpreter services. At a broader level, clinicians should consider stepping beyond the limited, traditional role of medical/behavioral advisor to engage in political action toward greater social equity, which would result in better health.

Research in the various dimensions of language discordance is largely quantitative thus the need for qualitative studies to inform practice and policy.

IN a series of articles entitled “Tailless Aircraft and Flying Wings”, concluded last month, the evolution of the tailless aeroplane and the flying wing was treated. The different trends of the development were classified, and a short discussion of the difficulties which had been experienced during experimental work given.

The purpose of this chapter is to advance existing literature on crisis management by critically analysing the impact of crisis on tourism performance within a developing world context, with a specific focus on South Africa as a case study area. Crime, xenophobic attacks and the Day Zero water crisis form the basis for discussion as significant crisis affecting the country's tourism industry.

Utilising qualitative content analysis as a methodological approach, the study analysis strategic policy documents, newspaper reports, press conferences, and campaigns to discover policies, strategies and plans that have been applied to alleviate the impacts of catastrophic events on tourism performance.

The interpretation of literature reveals that factors affecting the South Africa tourism industry stem from mainly human-caused disasters, this being crime and violence, and inadequate water management strategies.

Results discussed in this study were framed through a systemic review of existing literature To gain an in-depth understanding of crisis-related matters in the Global South, future research can apply empirical data-gathering procedures.

The study proposes that proactive crisis management planning and inclusion of non-tourism stakeholders in crisis management planning is essential to combat crisis' impact on tourism performance.

In the Global South, studies that interrogate the effects of crises on tourism performance generally focus on a single case of a disaster or crisis, therefore lacks a study that comprehensively discusses events that deter tourism performance. Thus, this study bridges the existing literature gap by focussing on South Africa as a case study area.