Article Summaries

This article was published on July 6, 2023 on Behavioral Sciences journal.

We’ll start with the Abstract:
Demand for foreign nurses and medical staff is rapidly increasing due to the severe labor shortage in U.S. hospitals triggered by the Covid-19 pandemic. However, empirical studies on the effect of the racial diversity of medical staff on hospital operations are still lacking. This research gap is thus investigated based on the foreign medical staff working in 3870 U.S. hospitals.

Results show that workforce racial diversity has a significantly positive relationship with hospital operational efficiency regarding occupancy rate, manpower productivity, capacity productivity, and case mix index. Notably, this study empirically supports that increasing the ratio of foreign nurses positively affects the overall operational efficiency of hospitals. In addition, the study results also indicate that the hospital location, size, ownership, and teaching status act as significant control variables for the relationship between racial diversity and hospital efficiency.

These results imply that hospitals with these specific operating conditions need to pay more attention to racial diversity in the workplace, as they are structurally more sensitive to the relationship between racial diversity and operational efficiency. In short, the findings of this study suggest that hospital efficiency can be operationally improved by implementing workforce ethnic diversity. For this reason, hospital stakeholders and healthcare policymakers are expected to benefit from this study’s findings.

Above all, the results of this study imply that if an organization adapts to extreme external environmental changes through appropriate organizational restructuring (i.e., expanding the workforce racial diversity by hiring foreign medical staff), the organization can gain a competitive advantage, a claim that is supported by contingency theory. Further, investors are increasingly interested in ESG, especially companies that embody ethical and socially conscious workplaces, including a diverse and inclusive workforce.

Thereby, seeking racial diversity in the workforce is now seen as a fundamental benchmark for organizational behavior that predicts successful ESG business practices, a claim that is supported by stakeholder theory. Therefore, in conclusion, the findings of this study suggest that workforce racial diversity is no longer an optional consideration but should be considered as one of the essential determinants of competitive advantage in organizations, particularly in the healthcare sector.

The conclusion of the article:
This study aims to answer the research question of how workforce racial diversity affects hospital operational efficiency. The empirical evidence from this study strongly supports a positive relationship between the racial diversity of medical staff and the efficiency of healthcare operations in the context of U.S. hospitals. The findings of this study suggest that hospital efficiency can be operationally improved by implementing workforce racial diversity. For this reason, hospital stakeholders and healthcare policymakers are expected to benefit from this study's findings. In fact, investors and stakeholders have been increasingly interested in ESG management. Socially conscious investors look for companies that embody an ethical and socially conscious work environment, from subcontractors to top management, and these claims can be supported by the stakeholder theory.

As such, seeking racial diversity in the workforce is now seen as a fundamental barometer of organizational behavior that predicts successful ESG business practices. In particular, the Covid 19 pandemic has forced healthcare to innovate to adapt to the changing public health landscape. The severe nurse shortage caused by the Covid 19 pandemic also requires changes in federal healthcare policy to be more flexible and inclusive in hiring foreign medical staff. In this context, the findings of this study provide additional evidence for increasing funding to strengthen DEI policies in the healthcare industry.

Therefore, in conclusion, we propose that the racial diversity of the workforce should no longer be an optional consideration but should be considered as one of the essential determinants of competitive advantage in organizations, particularly in the healthcare sector.

This article was published on June 30, 2023 on Behavioral Sciences journal and was written by Amapola De Sales-Millán, José Félix Aguirre-Garrido , Rina María González-Cervantes and José Antonio Velázquez-Aragón.

We’ll start with the Abstract:
Autism Spectrum Disorder – ASD, is a complex neurodevelopmental disorder characterized by deficits in social interaction and communication, as well as restricted and stereotyped interests.

Due of the high prevalence of gastrointestinal disorders in individuals with ASD, researchers have investigated the gut microbiota as a potential contributor to its aetiology. The relationship between the microbiome, gut, and brain (microbiome–gut–brain axis) has been acknowledged as a key factor in modulating brain function and social behaviour, but its connection to the aetiology of ASD is not well
understood. Recently, there has been increasing attention on the relationship between the immune system, gastrointestinal disorders and neurological issues in ASD, particularly in relation to the loss of specific species or a decrease in microbial diversity. It focuses on how gut microbiota dysbiosis can affect gut permeability, immune function and microbiota metabolites in ASD. However, a very complete study suggests that dysbiosis is a consequence of the disease and that it has practically no effect on autistic manifestations. This is a review of the relationship between the immune system, microbial diversity and the microbiome–gut–brain axis in the development of autistic symptoms severity and a proposal of a novel role of gut microbiome in ASD, where dysbiosis is a consequence of ASD-related behaviour and where dysbiosis in turn accentuates the autistic manifestations of the patients via the microbiome–gut–brain axis in a feedback circuit.

The conclusion of the article:
The mode of delivery at birth, caesarean section or vaginal, will determine the type of microbiota that will colonise the intestine of the new-born. The colonisation process during the first days of life helps configure a correct immunological and cognitive development in the neonate. Subsequently, the type of diet, breast milk or milk formula, will shape the alpha diversity of the infant. During the first months of life, alpha diversity is low, and its diversity increases gradually when solid foods are introduced to the baby for the first time - approximately 6 months.

During a disease process, the composition, from a dynamic and functional viewpoint, of the microbiome can vary. The changes in this dynamic system can generate the deregulation of the production of microbial metabolites, generating an imbalance, as reported under the term “dysbiosis”. Gastrointestinal problems are mostly linked to intestinal dysbiosis.

Alterations in the microbiota–gut–brain axis are the main cause of the most frequent gastrointestinal motility disorders in psychiatric disorders, such as depression and anxiety and, neurodevelopmental diseases, such as ASD. Neuroinflammation produced by the different metabolites of a dysbiotic microbiota may be a pathogenic factor in severe neurodegenerative disorders, such as Alzheimer’s disease and Parkinson’s disease. Children with ASD have unique bacterial biomarkers, and Bacteroides may contribute to the severity of autism symptoms. Despite these findings, there are inconsistencies regarding the phenotypic signature of the gut microbiome of children with ASD, and a reason for these inconsistent results is that the composition of the microbiome is influenced by several factors, such as diet, lifestyle, medical history and genetic variations. For this reason, there are controversies between the microbiome and the restrictive diet as possible causes of gastrointestinal comorbidities and autistic symptoms in ASD. However, with the model proposed in this review, it is intended to expand knowledge of the role of gut microbiota in the patients with ASD.

The intercommunication between immune-mediated neurological and gastrointestinal disorders, leading to the proposition of a novel microbiome–gut–mucosa–immuno–brain axis, termed neuroimmunogastroenterology, in individuals with ASD. We postulate that this axis plays a significant role in a vicious cycle that contributes to the exacerbation of autistic manifestations. To gain insights into this phenomenon, large-scale clinical cohort studies involving early diagnosed ASD patients are essential to assess the potential prevention of dysbiosis and avoidance of accentuated autistic behaviour. Identifying therapeutic interventions to restore a healthy gut microbiome, thereby alleviating autistic manifestations, is paramount. Strategies, such as diversifying food intake with sensory feeding therapy, along with targeted administration of development stage-specific pre and probiotics to restore beneficial intestinal bacteria, are potential approaches. Furthermore, exploring the promising long-term positive effects of faecal microbiome transplantation is warranted.