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In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.

The objective of the chapter is to provide an integrative appraisal of recent participatory research projects with children on violence and maltreatment conducted by members of the COST Action CA 19106 working group on children's participation (WG3) and their colleagues to identify what is working well and what needs to change in future research. The evaluation of research examples clustered around four key questions: Why, when, how and how much do children participate in research? Data were collected using a unified tool designed to characterise participatory research, which was distributed among WG3 members. In addition, chapters of the current book were another source of data about participatory research. Overall, data on 19 studies involving 46,761 children were collected and analysed using Shier's matrix. Findings show that most studies (n = 10) engaged children as consultants to adults in data collection, whereas a few studies (n = 5) demonstrated a more children-led research approach. The analysis uncovered specific areas where more progress is required, including engaging children in decisions about the research topic, involving young children, utilising methods that are more natural and familiar to children, and gaining children's reflective accounts about their participation experience. The authors encourage scholars to publish their work to advance evidence-based knowledge and skills in participatory research with children about sensitive topics.

This chapter looks at the discursive dimension of the working environment in research and higher education organizations; more specifically at neoliberal managerial discourse and at how it participates in shaping the way researchers, teachers and support staff perceive themselves and their experiences. It is based on a multiple case study and combines an intersectional and a socio-clinical approach. The empirical data is constituted by in-depth interviews with women conducted in Ireland and Chile, and includes some observations made in France. A thematic analysis of individual narratives of self-ascribed experiences of being bullied enables to look behind the veil drawn by managerial discourse, thus providing insights into power vectors and power domains contributing to workplace violence. It also shows that workplace bullying may reinforce identification to undervalued social categories. This contribution argues that neoliberal managerial discourse, by encouraging social representations of “neutral” individuals at work, or else celebrating their “diversity,” conceals power relations rooting on different social categories. This process influences one’s perception of one’s experience and its verbalization. At the same time, feeling assigned to one or more of undervalued social category can raise the perception of being bullied or discriminated against. While research has shown that only a minority of incidents of bullying and discrimination are reported within organizations, this contribution suggests that acknowledging the multiplicity and superposition of categories and their influence in shaping power relations could help secure a more collective and caring approach, and thus foster a safer work culture and atmosphere in research organizations.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Background – Disorders of sex development (DSDs) also known as “intersex” are congenital conditions in which chromosomal, gonadal, and anatomical development mismatch. One in 4,500 infants is born with abnormalities of external genitalia, which are mostly unexplained in molecular terms. Androgen insensitivity syndrome (AIS) is a common cause of DSDs.

Objective – One of the three broad subdivided phenotypes of AIS are partial androgen insensitivity syndrome (PAIS). Feminization (i.e., undermasculinization) of the exterior genitalia at birth, secondary abnormal secondary sexual development at puberty, and infertility in individuals with 46, XY karyotype are the proof. In males, PAIS is common to observe a micropenis, hypospadias, and cryptorchidism. Women who have clitoromegaly and fused labia during puberty are characterized as individuals with PAIS.

Case – We reported a 13-year-old child with the chief complaint of primer amenorrhea. The patient was a girl but not yet got her menstruation. Patient was referred by a Endocrinology Fertility and Reproductive Consultant of OBGYN who had done chromosomal and hormonal analysis. We performed a laparoscopic explorative study where we did not find uterus, fallopian tubal, and ovaries. But, we found testis in the inguinal canal.

Conclusion – Decisions regarding gender assignment are still confronted between patient’s family and medical staff. The ambiguity of genital, physical, and psychosocial adjustment for sex assignment can determine the prognosis.

The TARGET approach aims at establishing a reflexive gender equality policy in research performing and research funding organisations. Monitoring has enormous potential to support reflexivity at both the institutional and the individual levels in the gender equality plan (GEP) development and implementation context. To exploit this potential, the monitoring system has to consist of meaningful indicators, which adequately represent the complex construct of gender equality and refer to the concrete objectives and policies of the GEP. To achieve this, we propose an approach to indicator development that refers to a theory of change for the GEP and its policies. Indicator development thus becomes a reflexive endeavour and monitoring a living tool. This requires constant reflection on data gaps, validity of indicators and the further development of indicators. Furthermore, we recommend the creation of space for reflexivity to discuss monitoring results with the community of practice.