Contextualizing sociocultural beliefs about cleft, knowledge of the treatments, and factors associated with delay of treatment in Eastern Indonesia

INTRODUCTION

Indonesia is a multicultural Asian country with a high incidence of cleft. This study contextualizes how patients' sociocultural backgrounds hinder cleft management in a diverse nation.

MATERIAL AND METHODS

This study involved 202 families of cleft patients attending six tertiary care hospitals in South Sulawesi between 2021 and 2022. A mixed-methods, descriptive cross-sectional study employed semi-structured interviews and focus group discussions. Thematic content analysis was done using Murdock's causal attribution of illness. Knowledge of the treatments and surgery expectations used open coding. We held medical team focus group discussions to validate education on treatments. Cleft management education was thematically analyzed based on Indonesia's Minister of Health Decree.

RESULTS

Two hundred-two families and ten medical teams participated. Thematic content analysis revealed common beliefs and factors that hinder medical treatments. The participants were 109 Buginese, 57 Makassarese, 16 Durinese, 8 Luwunese, 8 Torajanese, and 4 Mandarese. 22.3 % were unaware of causation, while 29.2 % attributed it to natural causes. About half of the interviewees believed in supernatural attribution. Even though 40 % of participants knew little about the surgery, they agreed that surgery improves appearance and speech. Medical treatments are delayed due to a lack of treatment knowledge, parents' concerns about surgical safety, and beliefs about causes.

DISCUSSION

Indigenous societies in South Sulawesi believe in supernatural causes of cleft. Most had incomplete surgical treatment information. An intensive educational health program about causes, treatments, medical specialists, and treatment goals is warranted to enhance patient compliance with medical treatment, ultimately leading to improved health outcomes.

Normalized "medical inferiority bias" and cultural racism against international medical graduate physicians in academic medicine

Socio-historical barriers remain a concern in Academic Medicine. Regrettably, despite the modern cultural era defined by increased recognition and response to such issues, widespread covert barriers and misperceptions continue to limit the advancement of many, in particular, international medical graduate physicians (IMGs) who represent a significant proportion of the US physician workforce. Adversity is experienced in the form of cultural racism, affinity bias, and underrepresentation in distinct specialties as well as in leadership roles. Often, these unnecessary hardships exacerbate pre-existing discrimination in Academic Medicine, further marginalizing IMGs. In this article, we discuss the prevalence of "medical inferiority bias" and the resulting impact on US healthcare, specifying considerations to be made from a policy perspective.

Online professional development across institutions and borders

Professional development (PD) is a key element for enhancing the quality of academic teaching. An increasing number of PD activities have moved to blended and online formats, especially since the COVID-19 pandemic. Due to the desire, potential, and need for collaboration among educators to learn from innovative and best practices, several institutions have started to pool their resources and expertise together and have started to implement cross-institutional and cross-national online professional development (OPD). The questions of what type of a (cross-)institutional OPD educators might prefer, and whether educators learn effectively from (and with) peers in such cross-cultural context have not been adequately explored empirically. In this case-study across three European countries, we explored the lived experiences of 86 educators as a result of a cross-institutional OPD. Using a mixed methods design approach our pre-post findings indicated that, on average, participants made substantial gains in knowledge. In addition, several cultural differences were evident in the expectations and lived experiences in ODP, as well as the intention to transfer what had been learned into one's own practice of action. This study indicates that while substantial economic and pedagogical affordances are provided with cross-institutional OPD, cultural differences in context might impact the extent to which educators implement lessons learned from OPD.

Cultural Competence and Humility

The increasing diversification of the United States has led to more racially and ethnically discordant visits between health care providers and patients; this is especially true in dermatology due to the lack of diversity in the field. Diversifying the health care workforce has been shown to reduce health care disparities and is an ongoing goal of dermatology. Improving cultural competence and humility among physicians is an important part of addressing health care inequities. This article reviews cultural competence, cultural humility, and practices dermatologists can incorporate to address this challenge.

Central and Eastern European migrants' experiences of mental health services in the UK: A qualitative study post-Brexit

OBJECTIVE

Central and Eastern European (CEE) migrants are a large minority group in the UK who are vulnerable to experiencing mental health problems. However, due to their shared 'whiteness' with the majority population, health service disparities may be overlooked. This is the first study exploring CEE-born people's experiences of mental health services post-Brexit.

METHOD

Thirteen CEE migrants who had received mental health services in the UK were interviewed and data was thematically analysed.

RESULTS

Barriers and facilitators to engagement reflected: 1) attitudes towards help-seeking; 2) cultural in/visibility; and 3) professional-service user communication. Some barriers were unique to the CEE community and not shared by other minority groups, such as the 'invisibility' of ethnic identity and this framed the way participants navigated interactions with services.

CONCLUSIONS

Cultural differences and mental health stigma were reported to influence understanding of mental health, attitudes to help-seeking, and experiences of services. Flexible ethnic identity and majority group "passing" could conceal inequalities in healthcare.

PRACTICE IMPLICATIONS

The need for culturally informed approaches, professional upskilling, strengthened inter-agency working, and collaboration with CEE communities. The need to build on pre-existing strengths, for self-directed and self-care activities, for appropriate pacing and confidentiality discussions, and the use of web-based resources.

Colostrum avoidance practice and associated factors among mothers of infants less than six months in Chencha District: cross-sectional study

BACKGROUND

Colostrum avoidance is failure to feed first breast milk to a newborn baby for the first 2 to 3 days after delivery. The problem of avoiding colostrum is prevalent in Ethiopia. But it is not adequately addressed yet. Therefore, the purpose of this study was to assess prevalence of colostrum avoidance practices and associated factors among mothers of infants aged less than six months; and to explore barriers for colostrum feeding in ChenchaZuria District.

METHODS

A community-based cross-sectional study supplemented with a qualitative study was conducted in August 2020. The quantitative data were collected from 674 mothers selected by systematic sampling using a structured questionnaire. Both bi-variable and multi-variable binary logistic regression analysis was used to identify factors associated with the colostrum avoidance practices. The statistical significance was declared at a p-value < 0.05. The qualitative data were collected using in-depth interviews from breastfeeding mothers and thematic analysis was done manually.

RESULT

The prevalence of the colostrum avoidance practice was 15.3% (95% CI: 11.4%- 18.2%). Late initiation of breastfeeding (AOR 4.15 95% CI 2.51-6.84), giving pre-lacteal feeding (AOR 3.16 95% CI 1.93-5.15), not using of postnatal care (PNC) service (AOR 1.79 95% CI 1.05-3.04), and having poor maternal knowledge regarding colostrum. (AOR 1.88 95% CI 1.14-3.08) were factors significantly associated with the colostrum avoidance practices. And in the qualitative part, cultural beliefs and misconceptions, community influence, and complementary feeding practices were found to be facilitators for the colostrum avoidance.

CONCLUSION

About one in seven mothers practiced colostrum avoidance. Factors that contributed to the colostrum avoidance practices were breastfeeding initiation, pre-lacteal feeding, PNC utilization, and maternal knowledge regarding colostrum. Thus, efforts to prevent colostrum avoidance practices should focus on strengthening and promoting PNC services utilization, timely initiation of breastfeeding, and improving awareness creation activities on the importance of colostrum feeding and risks of pre-lacteal feeding.

Culture, church, and collective: a qualitative study about gambling harm prevention and reduction in Aotearoa/New Zealand-a Tongan male perspective

BACKGROUND

In New Zealand, Pacific people continue to be more at risk of gambling harm than the general population, despite increasing public health efforts and treatment service provisions introduced to address this social and health issue. In looking at why this is so, our first concern was to ask why the delivery of the prevailing gambling-focussed programmes was not influencing Pacific gambling behaviours. In seeking to answer this question, it was important to explore ethnic-Pacific-specific factors of gambling harm prevention and reduction.

METHODS

The research design was interpretivist/constructivist and phenomenological, applied through the lens of a Tongan worldview. Participants comprised Tongan male elders and youth. Recruitment of participants was through snowball sampling from churches and kava-drinking circles. A total of 28 elders and 18 youth participated through focus group talanoa and individual talanoa. This study employed descriptive thematic analysis.

RESULTS

Participants were not aware of any policy document or problem-gambling preventative programmes. Four key themes were raised, which include raising the awareness of existing gambling harm treatment providers, the church influence in addressing gambling harm, community-based strategies, and cultural-based approaches.

CONCLUSIONS

This study proposes several recommendations such as more awareness of gambling harm providers in community, increasing cultural spaces and church engagements, and calls for further research in addressing the prevention and reduction of gambling harm amongst the Tongan community in New Zealand.

Effect of a culturally sensitive DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in China: A quasi-experimental study

BACKGROUND

Existing educational programmes for building capacity in dementia care are developed in the Western culture; their applicability and cultural relevancy to other cultures is questionable. There is a dearth of culturally specific dementia-care educational programme for Chinese communities.

OBJECTIVES

To evaluate a culturally specific DEmentia Competence Education for Nursing home Taskforce (DECENT) programme in mainland China.

DESIGN

A multi-site quasi-experimental study.

METHODS

Nursing homes were pair-matched and allocated into intervention (n = 5) and control group (n = 5). The DECENT programme was delivered face-to-face using multiple pedagogies for 60-90 min per session by a trained educator once per week over 8 weeks. The primary outcome was the sense of competence in dementia care. The secondary outcomes were dementia knowledge, attitudes towards people with dementia, person-centred care in nursing homes and the severity of behavioral and psychological symptoms of dementia of residents with dementia and staff-perceived disturbance. They were measured at baseline (T0), immediately post-intervention (T1) and 3 months after the intervention (T2).

RESULTS

The intervention group has significantly greater improvement than control group in sense of competence both at T1 (B = 5.24, p < .001) and T2 (B = 4.43, p = .013). Regarding dementia knowledge and person-centred care, intervention group only showed greater improvement than control group at T1 (B = 3.18, p = .001; B = 5.75, p = .018, respectively), but not at T2 (p = .089 and .104, respectively). Group differences in attitudes and severity of behavioral and psychological symptoms of dementia and staff-perceived disturbance were not significant at both time points.

CONCLUSIONS

The DECENT programme is applicable and beneficial in improving staff's sense of competence in dementia care in Chinese communities, but reinforcement strategies are needed to sustain the effect for maintaining the learnt knowledge and changed person-centred care practice.

Ecocultural attributes are important components of perceptions of the importance of coastal beaches of conservation concern

Sandy beaches along coasts and bays are prime real estate for houses and condominiums, marinas, recreation, and tourism for people living in urban and suburban areas within a hundred km of coasts. Human encroachment and disturbance can be a determinant of success of animals in human-impacted systems, particularly shorebirds. Understanding perceptions of people visiting critical habitats can aid in conservation of shorebirds and associated ecosystems, as well as improving the human experience. This paper examines valuation of ecological resources and ecocultural attributes of visitors to 9 beaches on the New Jersey shore of Delaware Bay during a shorebird migratory stopover period. Ecocultural attributes are those cultural activities or experiences that require an intact ecosystem to be optimal, including activities of recreational, aesthetic or spiritual importance. Using a Likert scale, interviewees (N = 279) rated the importance of shorebirds and/or horseshoe crabs Limulus polyphemus, ambiance, existence, aesthetics, the beach itself, and recreational activities (photography, birding, and fishing) to the Bay and to their experience. Although shorebirds/crabs were rated as most important (mean rating well over 4.0 out of 5); ecocultural attributes (ambience, existence, aesthetics, the beach itself) were rated higher (rating well over 3) than recreation, hardcore or casual birding, photography (mean rating around 3) and fishing (rating less than 2). Although some ratings of these resources and attributes were positively correlated, many values for birds and/or crabs were not correlated with the ecocultural attributes. Women rated most resources and ecocultural attributes higher than did men, and older people rated them higher than younger interviewees. It was unexpected that the ecocultural attributes played so heavily in the attractiveness of the beach. The importance and implication of these findings are discussed for management and conservation of these beaches, including the importance of ecocultural resources within a context of local community involvement.

Social media and body image: Modulating effects of social identities and user characteristics

Social media use and exposure, in particular to highly visual and appearance-focused content, has shown a relationship with poorer body image with small to moderate effect sizes. The aim here was to provide an overview of the theoretical and empirical evidence of the relationships between social media use and body image may vary across individuals. Although evidence exists to support variations in these relationships across different groups, to date, data are scarce and a number of theoretically important groups have largely been overlooked. The available evidence suggests that age may be an important moderating factor of vulnerability to exposure to highly-visual social media content, with younger adolescents most likely to experience negative outcomes. In addition, women and other groups for whom appearance is strongly tied to attractiveness and self-worth may be at heightened risk. Moving forward further research should aim to focus on understanding the relationships between social media use and body image concerns among underrepresented groups, and to expand the focus of to include different aspects of social media use and more sophisticated methodological approaches.

Quantitative remote sensing of forest ecosystem services in sub-Saharan Africa's urban landscapes: a review

A dearth of information on urban ecosystem services in the past decades has led to little consolidation of such information for informed planning, decision-making and policy development in sub-Saharan African cities. However, the increasing recognition of the value of urban ecological processes and services as well as their contribution to climate change adaptation and mitigation has recently become an area of great research interest. Specifically, the emerging geospatial analytical approaches like remote sensing have led to an increase in the number of studies that seek to quantify and map urban ecosystem services at varying scales. Hence, this study sought to review the current remote sensing trends, challenges and prospects in quantifying urban ecosystem services in sub-Saharan Africa cities. Literature shows that consistent modelling and understanding of urban ecosystem services using remotely sensed approaches began in the 1990s, with an average of five publications per year after around 2010. This is mainly attributed to the approach's ability to provide fast, accurate and repeated spatial information necessary for optimal and timely quantification and mapping of urban ecosystem services. Although commercially available high spatial resolution sensors (e.g. the Worldview series, Quickbird and RapidEye) with higher spatial and spectral properties have been valuable in providing highly accurate and reliable data for quantification of urban ecosystem services, their adoption has been limited by high image acquisition cost and small spatial coverage that limits regional assessment. Thus, the newly launched sensors that provide freely and readily available data (i.e. Landsat 8 and 9 OLI, Sentinel-2) are increasingly becoming popular. These sensors provide data with improved spatial and spectral properties, hence valuable for past, current and future urban ecosystem service assessment, especially in developing countries. Therefore, the study provides guidance for future studies to continuously assess urban ecosystem services in order to achieve the objectives of Kyoto Protocol and Reducing Emissions from Deforestation and forest Degradation (REDD +) of promoting climate-resilient and sustainable cities, especially in developing world.

A qualitative focus group study concerning perceptions and experiences of Nigerian mothers on stillbirths

Objective

To explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria.

Design

Qualitative, interpretative.

Setting

Tertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria.

Sample

Mothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth.

Methods

Semi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day.

Results

Our findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby.

Conclusions

As access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-04207-4.

Contributing factors to suicide: Political, social, cultural and economic

This review summarizes recent research in four environmental areas affecting risk of deaths by suicide. Politically, the weight of the evidence suggests that laws increasing social welfare expenditures and other policies assisting persons with low incomes (e.g., minimum wage) tend to lower suicide rates. Other legal changes such as those restricting firearms and alcohol availability can also prevent suicides. The social institutions of marriage, as well as parenting, continue to serve as protective factors against suicide, although the degree of protection is often gendered. Religiousness tends to be inversely associated with suicide deaths at the individual level of analysis, but the mediators need exploration to determine what accounts for the association: social support, better mental health, better physical health, less divorce, or other covariates. Cultural definitions of the traditional male role (e.g., breadwinner culture) continue to help explain the high male to female suicide ratio. New work on the "culture of suicide" shows promise. The degree of approval of suicide is sometimes the single most important factor in predicting suicide. At the individual level of analysis, two of the strongest predictors of suicide are economic ones: unemployment and low socio-economic status. Attention is drawn to enhancing the minimum wage as a policy known to lower state suicide rates. Limitations of research include model mis-specification, conflicting results especially when ecological data are employed, and a need for more research exploring moderators of established patterns such as that between religiousness and suicide.

Motivators and barriers to adoption of Improved Land Management Practices. A focus on practice change for water quality improvement in Great Barrier Reef catchments

To protect and improve water quality in the Great Barrier Reef, the Queensland Government's Reef 2050 Water Quality Improvement Plan targets that 90% of sugarcane, horticulture, cropping and grazing lands in priority areas be managed using best management practices for sediment, nutrient and pesticides by 2025. Progress towards this target is insufficient and variable across catchments and industries. The motivation to adopt improvements in management practices is heavily influenced by social, economic, cultural and institutional dimensions. In this paper we synthesise the literature on how these human dimensions influence decision making for land management practice and highlight where future investment could be focussed. We highlight that focussing on -1) investigating systems to support landholder decision making under climate uncertainty (risk); 2) generating a better understanding of the extent and drivers of landholder transaction cost; 3) understanding if there are competing 'right' ways to farm; and 4) improving understanding of the social processes, trust and power dynamics within GBR industries and what these means for practice change- could improve practice change uptake in the future.

Based cultural and religion to education of exclusive breastfeeding for bride

OBJECTIVE

This study aims to design and apply modules that are developed based on culture and religion in the event of "mappatemme' Qur'an" in Exclusive Breastfeeding Education for prospective bride.

METHOD

The research methodology is qualitative with ethnographic approaches. The study was conducted at the Darul Istiqamah Islamic Boarding School. The informants were 32 participants consisting of 2 community leader, 18 Young Women, 6 Ustadz, and 6 bride. The informants were selected based on purposive sampling. Data was collected through in-depth interviews, Focus Group Discussion, and Observation. Test of data validity uses source triangulation and method. The data was analyzed by using content analysis.

RESULTS

The results show that in the Mappatemme' Qur'an ustadz used interpersonal communication in delivering module content interspersed with cultural jokes and religious lectures. The contents of the modules that have been developed encompass notion of exclusive breastfeeding, risk of not giving exclusive breastfeeding, steps of breastfeeding, and management of lactation from pregnancy to birth. Toma and young women interested and understood the contents of the module so that they strongly agreed to use it to educate prospective brides. Mothers became more aware of Exclusive Breastfeeding after Ustadz explained the contents of the module based on cultural and religious approaches.

CONCLUSION

The development of this module at the Mappatemme' Qur'an' program was very effective in giving bride an understanding of Exclusive Breastfeeding.

The experiences of Aboriginal and Torres Strait Islander Bachelor of Midwifery students: An integrative literature review

ISSUE

There is an underrepresentation of Aboriginal and Torres Strait Islander midwives across Australia and an inadequate number of graduating midwives to redress this. A major pillar for the Birthing on Country Model is maternity care workforce development.

AIM

The purpose of this review is to examine the enablers and barriers that Aboriginal students experience while undertaking the Bachelor of Midwifery degree in Australia.

METHODS

A search of the literature was undertaken through electronic databases. When only three papers were found looking at the experiences of Aboriginal midwifery students the search was broadened to include Aboriginal undergraduate health students.

FINDINGS

The literature review reported a strong need for cultural safety in both the clinical and education systems. Students with access to cultural supports, relationships with Aboriginal mentors and academics and Aboriginal clinical placements felt empowered and were able to navigate the 'two worlds' in a meaningful way.

DISCUSSION

This review highlights a significant gap in the literature. Despite the expanded search terms to include Aboriginal health students, a relatively narrow range of papers were found. Interestingly, the combined search revealed similar themes: kinship, personal factors, and cultural issues.

CONCLUSION

Empowering and supporting Aboriginal Peoples to become midwives is essential. While systems and societies aim for cultural safety, this review shows there is still a way to go. Further research is essential to decolonise higher education and health care systems, and provide strong, well supported pathways for Aboriginal midwifery students.

Gender identity: A psychosocial primer for providing care to patients with a disorder/difference of sex development and their families [individualized care for patients with intersex (Disorders/differences of sex development): Part 2]

INTRODUCTION/BACKGROUND

Many parents of infants born with a DSD describe the process of initial sex assignment at birth as highly stressful. Parents of children with a DSD also note high distress when their children engage in behaviors that are not considered typical for their gender.

OBJECTIVE

The goal of this article is to provide members of the health care team a brief overview of psychosocial facets of gender and gender identity particularly relevant to DSD for the purposes of enhancing shared decision-making and optimizing support for individuals with a DSD and their families.

DISCUSSION

Gender identity is a multidimensional construct involving related but distinct concepts such as gender typicality, gender contentedness and felt pressure for gender differentiation, and can be assessed via standardized measures. Gender dysphoria is associated with poor psychological adjustment, and is mitigated by family and peer support. Family influences on gender identity include parental modeling of gender behavior and family composition (e.g., same-sex children vs both sons and daughters in a family). Cultural factors that may influence sex assignment include societal views on gender, and gender-related differential resource allocation within a society. In addition, religious beliefs and the presence of a "third-sex" category within a culture may also influence parental gender ideology.

CLINICAL APPLICATION

Health care providers who work with patients with a DSD must have a strong grasp on the construct of gender identity, and must be able to clearly and consistently communicate with patients and families about gender beliefs in order to optimize family support and gender-related decisions.

Patients experience of living with cancer associated thrombosis in France (Le PELICAN)

INTRODUCTION

Previous research in the United Kingdom and Spain has identified several areas of unmet clinical and support need for cancer patients diagnosed with cancer associated thrombosis (CAT). These included lack of information, which was directly associated with distress. Appropriate information has been shown to improve tolerance and compliance with self-injecting low molecular weight heparin (LMWH). It is not known whether such experiences are restricted to those particular countries healthcare systems and/or cultures.

METHODS

Purposive sampling of patients with CAT were recruited from an academic hospital in Colombes, France. Semi structured interviews were audio recorded and transcribed. Transcripts were coded using Invivo software. Analysis was undertaken using framework analysis.

RESULTS

Twenty four patients participated. Three major themes with associated subthemes were identified: Patients received minimal information regarding risks of CAT or how to treat it once diagnosed. However, this was not associated with distress. Patients adopted a passive role whereby the doctor was always right. They were intolerant injections and found it inconvenient to await community nurses.

CONCLUSION

The doctor patient relationship in France differs from other countries, with patients adopting a passive role with respect to information requirements. This dynamic appears to be a "two edged sword" whereby distress around CAT was minimal yet a lack of knowledge impacted on acceptability of LMWH. This has implications for the choice of anticoagulant particularly now that the DOACS have been evaluated for this indication.

Materialising contexts: virtual soundscapes for real-world exploration

This article presents the results of a study based on a group of participants' interactions with an experimental sound installation at the National Science and Media Museum in Bradford, UK. The installation used audio augmented reality to attach virtual sound sources to a vintage radio receiver from the museum's collection, with a view to understanding the potentials of this technology for promoting exploration and engagement within museums and galleries. We employ a practice-based design ethnography, including a thematic analysis of our participants' interactions with spatialised interactive audio, and present an identified sequence of interactional phases. We discuss how audio augmented artefacts can communicate and engage visitors beyond their traditional confines of line-of-sight, and how visitors can be drawn to engage further, beyond the realm of their original encounter. Finally, we provide evidence of how contextualised and embodied interactions, along with authentic audio reproduction, evoked personal memories associated with our museum artefact, and how this can promote interest in the acquisition of declarative knowledge. Additionally, through the adoption of a functional and theoretical aura-based model, we present ways in which this could be achieved, and, overall, we demonstrate a material object's potential role as an interface for engaging users with, and contextualising, immaterial digital audio archival content.

Preliminary Findings of Culturally Responsive Consultation with Educators

Behavior analysts are increasingly called to serve culturally and linguistically diverse populations. The culture of a population can provide context in which to identify behaviors likely to be reinforced by the client's social environment, stimuli established as reinforcers for client behavior, and behavioral repertoires shaped by the client's social environment. One of the largest and fastest growing minority groups in the United States is the Latinx population. This article offers preliminary evidence of incorporating cultural adaptations into the context of behavioral consultation for the Latinx population. Cultural adaptation of behavioral consultation can lead to improved outcomes for educators. In this study, 5 educators received behavioral consultation consisting of behavioral skills training to implement culturally responsive class-wide behavior management procedures. All 5 educators improved their treatment fidelity of the culturally responsive behavior management practices. Implications for practitioners and future research are discussed.

The cultural practices of Bamar diabetic patients: An ethnographic study

Background

Many qualitative studies on the feelings and lived experiences of diabetic patients have already been conducted in European and Asian countries. However, little is known about the cultural practices of diabetic patients among the Bamar population of Myanmar.

Aim

The aim of this study was to explore the cultural practices of Bamar diabetic patients in Myanmar.

Methods

The conceptual framework of this ethnographic study was based on Spradley's ethnographic theory and Leininger's cultural care theory. Seven participants who met the preset criteria were purposively selected from Anawmar quarter, Tharkayta Township, Yangon. Their cultural practices were studied through participant observations, ethnographic interviews and writing field notes. Collected data were analyzed step-by-step using Creswell's data analysis method.

Findings

The nine main themes that emerged were: reasons for late awareness of diabetes, misconceptions, cultural beliefs and practices, non-adherence, cultural influences on controlling diet, limitations in physical activities, suffering of living with diabetes, emotional reactions and coping by way of religious or spiritual beliefs. Fourty-six subthemes support the main themes.

Discussion

It was found that Bamar diabetics in this study were being strongly influenced by cultural beliefs and practices on treatment choice and controlling diet. They believed that diabetes is a curable disease, and its cause is due to cultural factors such as karma from either a previous or their current life. Bamar diabetic patients in this study used a variety of medicinal plants and traditional medicines due to availability at affordable prices.

Conclusion

Although some cultural beliefs are not harmful, some have detrimental effects on these patients' health. Hopefully, this study may provide information which can reduce cultural influences on Bamar diabetic patients. The results of this study highlight patients' needs for nursing personnel when it comes to providing effective culturally-tailored care.

Intended and Unintended Consequence in the Digital Age of Psychiatry: The Interface of Culture and Technology in Psychiatric Treatments

Culture plays a critical role in shaping the structure, content, and process of psychiatric treatment and influences the use of technology. Mental health providers and health care systems should account for the impact of the interface of technology and culture on clinical processes. Psychiatrists need to assess and monitor the impact of this interface on therapeutic processes. Health care systems should attend to these issues as they develop, adapt, and deploy technologies. As a field, psychiatry needs to develop frameworks for formally evaluating the use of existing and innovating technologies for use in mental health treatment.

Cultural adaptation for country diversity: A systematic review of injury prevention interventions caused by domestic accidents in children under five years old

Background: Children under five years old are the most vulnerable in home-injuries. More than half of the accident happens at home. Intervention programs are effective ways to reduce the risk of injuries. The use of cultural strategies has been recommended for effective interventions. The aim of this study was to evaluate cultural adaptability in interventional studies which were performed to prevent injuries caused by domestic accidents in children under five years old in all countries.

Methods: This systematic review has been conducted from June to July 2016. Iran Medex, Magiran, SID from Persian databases and Scopus, Web of Science, Science direct, Pub Med, Biomed central from English databases were employed. Available cultural adaptation guidelines were used to compare the cultural adaptation strategies. A search of studies had been conducted from the creation of databases until July 2016.

Results: Overall, 15 studies were entered into the analyses. The interventional approach in 11 studies was an educational approach. Consequently, 8 studies from 11 reported that they had significantly achieved all expected outcomes. Three studies had used behavioral change models or theories to achieve the desired changes. Seven studies had considered socio-cultural strategy in their interventions, and six studies had reported achieving outcomes. Only seven studies acquired a minimum score of cultural adaptation.

Conclusion: In this systematic review, an educational intervention was effective in preventing child injuries. If cultural strategies are taken into consideration in interventions, they will have a change in behavior in this regard. Also, theoretical frameworks and models can be effective.

Kuda Kepang: A Case Report of Javanese Cultural-Related Trance in Medan

BACKGROUND

One of the works of Javanese culture is the kuda kepang. None of the historical records explains the origin of this dance. Kuda kepang or also called kuda lumping or jathilan. In the kuda kepang dance, the trance process takes place through the calling of the spirit or called endang through the songs that are played. In the International Classification of Disease Edition (ICD-10), it is called trance and possession disorders and in the Diagnostic and Statistical Manual of Mental Disorders five editions (DSM-5) it is included into Other Specified Dissociative Disorder.

CASE REPORT

This is a case of the direct interview with the kuda kepang player, SI (30 years old), and HO (54 years old) both were the Javanese tribe as the owner of the kuda kepang art group called "Kesenian Tunas Baru" in Sukaraya Village, Kutalimbaru District. He was one of the music players in the arts.

CONCLUSION

The traditional performance of kuda kepang is a change and innovation that characterises the traditional art world where kuda kepang performances are truly sacred events and now become extraordinary and can be performed. In this case, it appears when the magical side is in the trance condition; this trance can be performed.

Testing a new interpersonal model of disordered eating between Australian and East-Asian women: The relationships between theory of mind, maladaptive schemas, and appearance-based rejection sensitivity

The current study tested a new interpersonal model of disordered eating behaviours, whereby maladaptive schemas and theory of mind decoding (ToM-decoding) were related with disordered eating attitudes (body dissatisfaction) and behaviours (binging/purging and food restriction) through the mediating variable appearance-based rejection-sensitivity. A secondary aim was to test whether this model differed between two cultural groups: Caucasian Australian women (N = 197, ages ranging 17-43, M = 19.25, SD = 3.10), and Asian women living in East-Asia (N = 195, ages ranging 18-40, M = 28.60, SD = 5.15). Participants completed an online survey assessing the variables of interest. While the model showed acceptable fit for both groups, invariance testing demonstrated that the model worked differently in each group. Appearance-based rejection-sensitivity mediated the effect of maladaptive schemas on body dissatisfaction and disordered eating in both groups, but only mediated the effect of ToM-decoding on body dissatisfaction in the East-Asian group. Overall, the significant indirect pathways were greater in strength and number for the Caucasian-Australian group. These findings indicate that while the relationships between maladaptive schemas, appearance-based rejection-sensitivity, and disordered eating attitudes and behaviours are present in both cultures, ToM-decoding may only play a role for East-Asian participants.

Field Studies to Develop Weed Management Programs for Grain Sorghum

Weed management programs to be used in grain sorghum production are best investigated in field studies with naturally occurring weed populations in their relevant growing environments. Weed control tactics to be evaluated include use of crop production practices such as row spacing and seeding rates, mechanical tools, and herbicide programs with soil- and foliar-applied products.

Italian Translation and Cross-Cultural Adaptation of a Back Pain Screening Questionnaire (Start Back Screening Tool)

BACKGROUND

Low back pain is a heterogeneous condition, from which most patients recover after a few months. However, a considerable proportion of patients develop chronic pain despite different types of treatment. Primary care evidence-based guidelines for non-specific back pain highlight the importance of identifying indicators of poor prognosis in order for treatment to be appropriately targeted. The Start Back Screening Tool Questionnaire (SBST) is a prognostic tool developed and validated to identify subgroups of patients and guide the decision-making process for the initial primary care of the acute back pain.

AIMS

The aim of this project is the translation and the cross-cultural adaptation of an Italian SBST version. The development of a reliable and validated questionnaire would be useful for different health professionals in the management of low back pain.

METHODS

The translation and validation of this tool was divided in different steps, following the guidance of questionnaire translation: contact with the SBST developers, translation from English to Italian, synthesis, retranslation from Italian to English, expert committee review, test of the pre-final version on 30 individuals with LBP, and the final version being approved by the original Author.

RESULTS

For the linguistic translation it was necessary to make some semantic variations. The interviewed participants reported a good general understanding of the questions. However, 6 subjects (14%) wondered if two questions were related to back pain or general health. After discussion within the expert committee and with the SBST developer, the wording was modified to add a reference to back pain in these two questions. The Italian version of STST is now ready for validation.

Supporting aboriginal and Torres Strait islander cultural educators and cultural mentors in Australian general practice education

BACKGROUND

Promoting cultural competence of health professionals working with Aboriginal and Torres Strait Islander communities is key to improving health outcomes. Cultural Educators and Cultural Mentors (CE/ CMs) have critical roles in Australian general practice training, yet these are not well understood.

METHODS

Guided by a CE/CM Network, our research team including experienced CE/CMs, used surveys and semi-structured interviews to explore these roles and investigate best practice in employment and support. Participants sampled from stakeholders involved in general practice education across Australia included CE/CMs, Medical Educators, General Practice Supervisors and Registrars, and representatives of Regional Training Organisations, Indigenous Health Training Posts and other key organisations. We undertook thematic analysis using a framework approach, refined further in team discussions that privileged views of CE/ CM members.

RESULTS

Participants comprised 95 interviewees and 55 survey respondents. We organised our findings under three overarching themes: understandings about cultural education and mentoring; employment and support of CE/CMs; and delivery and evaluation of cultural education and mentoring. Our findings supported a central role for Aboriginal and Torres Strait Islander CE/CMs in face-to-face Registrar education about culture and history and related impacts on health and healthcare. Cultural education was reported to provide base-line learning as preparation for clinical practice whilst cultural mentoring was seen as longitudinal, relationship-based learning. Mentoring was particularly valued by Registrars working in Aboriginal and Torres Strait Islander communities. Challenges described with employment and support included difficulties in finding people with skills and authority to undertake this demanding work. Remuneration was problematic, particularly for CMs whose work-time is difficult to quantify, and who are often employed in other roles and sometimes not paid. Other improved support recommended included appropriate employment terms and conditions, flexibility in role definitions, and professional development. Recommendations concerning implementation and evaluation included valuing of cultural education, greater provision of mentoring, partnerships with Medical Educators, and engagement of CE/CMs in rigorous evaluation and assessment processes.

CONCLUSIONS

Our research highlights the importance of the unique CE/CM roles and describes challenges in sustaining them. Professional and organisational support is needed to ensure delivery of respectful and effective cultural education within general practitioner training.

Morphological and molecular diversity of Sclerotinia sclerotiorum infecting Indian mustard

Fourteen isolates of Sclerotinia sclerotiorum were collected from different locations of mustard growing regions of India and were studied for cultural, morphological and molecular variability at CCS HAU, Hisar. Variability was observed for colony colour, type of growth, diameter of mycelial growth, sclerotia initiation, number and pattern of sclerotia formation among the isolates. Mycelial growth and sclerotia initiation were faster in Bhiwani isolate as compared to others. Bhiwani isolate was found to be the most diverse and had least similarity with Chhanibari isolate on the basis of molecular variability. Hence, morphological and cultural variability observed in the present investigation is by and large strongly correlated to molecular marker based variability.

Socioeconomic and cultural impact of tobacco in India

Tobacco consumed either in the form of smoke or smokeless is hazardous to the human body. Death toll due to tobacco globally, has risen to about 6.4 million annually, and is on a constant increase. Since long, tobacco consumption has been attributed to a variety of factors including geographical variation, cultural factors and other associated variables. Earlier tobacco was considered as a taboo, but with advent of 21^st century and commercialization of tobacco it has been prevalent among males and females. Global adult tobacco survey (GATS) in India 2016-17 revealed that there has been drop of 34.1% tobacco consumers in India, mainly due to the increasing awareness and anti-tobacco campaigns and tobacco hazards warning on the packs. Analysing the changes in trends by healthcare professionals can prove to be a valuable tool in devising strategies to control and limit the morbidity and mortality caused due to tobacco consumption.

Psycho-Socio-Cultural Determinants of Food Choice: A Qualitative Study on Adults in Social and Cultural Context of Iran

Objective: Food choice is a process through which people think, feel, and eat food. It does not only influence individuals' health and well-being, families and communities, but also it has an effect on regional, national, and global levels. This qualitative study was conducted to explore perceptions and lived experiences of Tehran adult residents on psychological, social and cultural determinants of food choice. Method: In this qualitative design, we recruited 33 adults aged 30 to 64 years from various districts of Tehran, capital of Iran, and we explored how people make decisions about food choice in practice and shape their perception, attitude, and eating practices. An individual in-depth semi-structured interview guide included major questions with follow-up probes was used to explore participants' current and past eating habits from childhood to adulthood, dietary change at different life courses, and effective psychological state on food selection in different seasons. Results: This study revealed that food choice in the studied adults (30-64 years old) was widely influenced by psychological, social, and cultural determinants, which can be categorized into 5 main themes: cultural context and patterns; social Structure and norms; information resources and media; household and family structure; and nutrition transition. Conclusion: The findings clarified the importance of social and cultural contexts, which influence the food choice of adults in a metropolis like Tehran. Many of these concepts are contextualized from childhood. These findings could serve as guideline to design socio-culturally appropriate strategies and improve dietary behaviors of Iranians.

The ties that bind - A case report about restraining a mentally unwell family member at home for over a decade

This is a case report describing a patient, with schizophrenia, who was physically chained by her mother in their house for more a decade. Illness factors, family dynamics, stigma, lack of mental health literacy and cultural roles contributed to her chaining. To our knowledge, this is the first case report that examines the prolonged use of physical restraints by family members on a patient in a developed urban setting and that explores the cultural and ethical issues surrounding this phenomenon. We have concluded that there remains a need for a national level approach to increase mental health literacy, reduce stigma and promote existing psychiatric community health services in a culturally sensitive manner.

Childhood Overweight and Obesity

Childhood overweight and obesity are increasing in prevalence and are a growing health concern. The diseases and their comorbidities have devastating consequences to children and adults as well as families, communities, and the nation. Comorbidities are cardiorespiratory, endocrinologic, gastrointestinal, orthopedic, and psychosocial. Health care providers are facing this crisis with limited medical, community, and federal resources and insufficient reimbursement. This article reviews recent trends in the assessment and treatment of this disease as well as trends in reimbursement, financial implications, and the need for further research and advocacy.

Life stage influences on U.S. South Asian women's physical activity

PURPOSE

South Asian (SA) women in the United States report extremely low rates of leisure time physical activity (PA) compared with women in other ethnic minority groups. This study explored SA women's perspectives on PA during different life stages.

DESIGN

This is a community-based participatory research study that used focus groups.

SETTING

The study setting was a community-based organization that provides social services to SA immigrants in Chicago, Illinois.

PARTICIPANTS

The study team conducted six focus groups (in English and Hindi) with 42 SA women, ages 18 to 71 years.

METHOD

A semistructured interview guide was used to foster discussion about perceptions of, barriers to/facilitators of, and suggestions for PA programs. Discussions were transcribed and independently coded by two reviewers using thematic content analysis and guided by a coding scheme that was developed a priori.

RESULTS

Participants said that different life stages strongly influenced their PA. PA decreased after marriage and having children. Chronic diseases constrained older women from more vigorous PA. Barriers to PA among younger women were family disapproval and perceptions that PA is unnecessary if you are "skinny." Women agreed that PA is not a priority within the culture, and that interventions must take into account cultural, religious, and family context.

CONCLUSION

Sociocultural norms, family constraints, and lack of awareness about the benefits of PA strongly influenced PA among SA women. Culturally salient intervention strategies might include programs in trusted community settings where women can exercise in women-only classes with their children, and targeted education campaigns to increase awareness about the benefits of PA across life stages.

The person in the disabled body: a perspective on culture and personhood from the margins

Background

Persons with disabilities (PWD) are one of the most marginalized groups in Western societies. These inequalities are manifested through various disadvantages in the psychosocial, cultural, and economic domains. Inspired by the World Health Organization's holistic conceptualization of disability, the present study examines the relation between the body and personhood in Israeli culture, through cases of newly diagnosed adults with disability.

Method

Participant observation at a rehabilitation daycare center was carried out for a period of two years. The analysis is based on field notes recorded during these observations, including interviews with individuals with disabilities, their family members, and service providers.

Results

The analysis reveals the agonizing experience of individuals who have become disabled in adulthood, who undergo symbolic diminution and social exclusion after their former acceptance as whole and normative persons. This ongoing multifaceted process includes infantilization, denial of their sexuality/sensuality, transgression of gender boundaries, and their construction as categorically different from the "healthy" people around them. At the same time, the analysis also demonstrates the ways in which daily routine at the daycare center also complicates the normative healthy-disabled binary, indicating a continuum on which attendees may attempt to reposition themselves.

Conclusions

This paper aims to make a dual contribution. We draw on anthropological understandings of“person” as a holistic category to resurrect the personhood of individuals with disabilities, as a correction tothe overwhelming tendency to reduce their humanity to their physical injury. We likewise reverse theanalytical gaze by using these individuals' experiences to understand the normative, culture-bound perception of “healthy” persons. We thus highlight Israeli culture's conditioning of normative personhood on having a perfect body, and its concomitant construction of individuals with physical disabilities as lesser persons. By opting to bring back the person into the disabled body, we aim to facilitate a less stigmatized outlook on disability and to create an opportunity for caregivers, researchers, and healthcare professionals to view disabled persons as whole and complex human beings.

BE ACTIVE: an Education Program for Chinese Cancer Survivors in Canada

The needs of cancer survivors have been well documented and tend to be higher in immigrant populations. In order to help address unmet needs of Chinese-speaking cancer survivors, we have developed a structured psycho-educational program for this group. The program development was informed by both cultural values of the population and published recommendations for cancer survivorship education and support. The program, entitled BE ACTIVE, includes topics related to key domains in cancer survivorship: psychosocial aspects, general medical management and follow up for late effects, complementary medicine, and lifestyle management through fitness and nutrition. We studied the program delivery in 2012 and 2013, where a total of 124 individuals took part. Participants reported high satisfaction, learning gains, and the willingness to recommend the program to others; they rated their understanding of the behaviors needed for wellness and their motivation for change as high. A facilitator toolkit, which includes topic content development guides and presentation examples, was developed to assist with delivery of the program by other centers. This type of program can improve access and delivery to underserved populations with unmet needs and may also benefit cancer survivors in other jurisdictions with similar concerns.

The importance of context in logic model construction for a multi-site community-based Aboriginal driver licensing program

Evidence indicates that Aboriginal people are underrepresented among driver licence holders in New South Wales, which has been attributed to licensing barriers for Aboriginal people. The Driving Change program was developed to provide culturally responsive licensing services that engage Aboriginal communities and build local capacity.

AIM

This paper outlines the formative evaluation of the program, including logic model construction and exploration of contextual factors.

METHODS

Purposive sampling was used to identify key informants (n=12) from a consultative committee of key stakeholders and program staff. Semi-structured interviews were transcribed and thematically analysed. Data from interviews informed development of the logic model.

RESULTS

Participants demonstrated high level of support for the program and reported that it filled an important gap. The program context revealed systemic barriers to licensing that were correspondingly targeted by specific program outputs in the logic model. Addressing underlying assumptions of the program involved managing local capacity and support to strengthen implementation.

DISCUSSION

This formative evaluation highlights the importance of exploring program context as a crucial first step in logic model construction. The consultation process assisted in clarifying program goals and ensuring that the program was responding to underlying systemic factors that contribute to inequitable licensing access for Aboriginal people.

Methodological Issues in Questionnaire Design

PURPOSE

The process of designing a questionnaire is complicated. Many questionnaires on nursing phenomena have been developed and used by nursing researchers. The purpose of this paper was to discuss questionnaire design and factors that should be considered when using existing scales.

METHODS

Methodological issues were discussed, such as factors in the design of questions, steps in developing questionnaires, wording and formatting methods for items, and administrations methods. How to use existing scales, how to facilitate cultural adaptation, and how to prevent socially desirable responding were discussed. Moreover, the triangulation method in questionnaire development was introduced.

RESULTS

Steps were recommended for designing questions such as appropriately operationalizing key concepts for the target population, clearly formatting response options, generating items and confirming final items through face or content validity, sufficiently piloting the questionnaire using item analysis, demonstrating reliability and validity, finalizing the scale, and training the administrator. Psychometric properties and cultural equivalence should be evaluated prior to administration when using an existing questionnaire and performing cultural adaptation.

CONCLUSION

In the context of well-defined nursing phenomena, logical and systematic methods will contribute to the development of simple and precise questionnaires.

African Cultural Concept of Death and the Idea of Advance Care Directives

An advance care directive is a person's oral or written instructions about his or her future medical care, if he or she becomes unable to communicate. It may be in written or oral form. Africans ordinarily do not encourage the contemplation of death or any discussion about their own or their loved ones’ death. According to the African belief system, life does not end with death, but continues in another realm. Becoming an ancestor after death is a desirable goal of every individual, a feat which cannot be achieved if an individual asks for an unnatural death by attempting to utilize advance care directives. Advance care directives are considered to be too individualistic for communitarian societies such as Africa. Coupled with the communitarian nature of African societies are issues such as lack of awareness of advance directives, fear of death and grief, and the African cultural belief system, which are potential barriers to the utilization of advance care directives in the African setting. Hence, the need for culture sensitivity which makes it imperative that patient's family and loved ones are carried along as far as possible, without compromising the autonomy of the patient in question when utilizing advance care directives.

Role of communication for pediatric cancer patients and their family

Background:

Communication is a key component in medical practice. The area of pediatric palliative care is emotionally distressing for families and healthcare providers. Inadequate communication can increase the stress and lead to mistrust or miscommunication.

Materials and Methods:

Reviewing the literature on communication between physicians, patients, and their family; we identified several barriers to communication such as paternalism in medicine, inadequate training in communication skills, knowledge of the grieving process, special issues related to care of children, and cultural barriers. In order to fill the gap in area of cultural communication, a study questionnaire was administered to consecutive families of children receiving chemotherapy at a large, north Indian referral hospital to elicit parental views on communication.

Results:

Most parents had a protective attitude and favored collusion; however, appreciated truthfulness in prognostication and counseling by physicians; though parents expressed dissatisfaction on timing and lack of prior information by counseling team.

Conclusion:

Training programs in communication skills should teach doctors how to elicit patients’ preferences for information. Systematic training programs with feedback can decrease physicians stress and burnout. More research for understanding a culturally appropriate communication framework is needed.

Is bad living better than good death? Impact of demographic and cultural factors on health state preference

PURPOSE

The aim of this study was to examine the impact of demographic and cultural factors on health preferences among Chinese general population.

METHODS

The Chinese EQ-5D-5L valuation study was conducted between December 2012 and January 2013. A total of 1296 participants were recruited from the general public at Beijing, Chengdu, Guiyang, Nanjing, and Shenyang. Each participant was interviewed to measure preferences for ten EQ-5D-5L health states using composite time trade-off and seven pairs of states using discrete choice experiment (data were not included in this study). At the end of the interview, each participant was also asked to provide their demographic information and answers to two questions about their attitudes towards whether bad living is better than good death (LBD) and whether they believe in an afterlife. Generalized linear model and random effects logistic models were used to examine the impact of demographic and cultural factors on health preferences.

RESULTS

Participants who had serious illness experience received college or higher education, or agree with LBD were more likely to value health states positively and have a narrower score range. Participants at Beijing were more likely to be non-traders, value health states positively, less likely to reach the lowest possible score, and have narrower score range compared with all other four cities after controlling for all other demographic and culture factors.

CONCLUSIONS

Health state preference is significantly affected by factors beyond demographics. These factors should be considered in achieving a representative sample in valuation studies in China.

Role of social, cultural and economic capitals in perceived quality of life among old age people in kerala, India

Objective:

To find out the relationship of collective social, economic, and cultural properties of a population on the perceived quality of life (QOL) among old age people.

Materials and Methods:

In a community-based cross-sectional study, we analyzed information on a representative sample of 900 old age (aged > 60 years) from 28 villages in Kollam district of Kerala. WHO-Quality of Life - BREF questionnaire was used. Ethical clearance from Institutional Ethics Committee was obtained. The mean scores for perceived QOL for domains such as physical health, psychological health, social relations, and control of environments were calculated. The three scales (social capital, cultural capital, and economic capital) were standardized using z-score transformation to make them comparable. Using multiple linear regression, we calculated the independent effect of economic capital, social capital, and cultural capital on perceived QOL among old people adjusted for age, sex, and the presence of chronic disease.

Results:

For overall QOL, only cultural capital contributed significantly. An increase of one unit z-score cultural capital led to three units increase in overall QOL score (β = 3.362; 95% CI: 2.645-4.078). Social capital and cultural capital contributed significantly to the physical health domain of QOL. With one z-score increase in social capital and cultural capital, QOL score of physical health domain increased by 0.2 units (β = 0. 227; 95% CI: 0.020-0.434), and 0.5 (β = 0. 596; 95% CI: 0.384-0.808) units, respectively. Psychological health domain and environmental domain were affected by all three capitals significantly. But, the social relations domain was significantly affected only by cultural capital (β = 0. 576; 95% CI: 0.373-0.779).

Conclusion:

Hence, the policies for old people should envision retaining our cultural and social norms along with the economic interventions for a better palliative care.

Perioperative nursing in public university hospitals: an ethnography

BACKGROUND

In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly specialized operating rooms in public university hospitals?

METHODS

An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark.

RESULTS

Patients were addressed as either human beings or objects. Likewise, the participants' technical skills were observed and described as either technical flair or a lack of technical skills/technophobia. The different ways in which the technical skills were handled and the different ways in which the patients were viewed contributed to the development of three levels of interaction between technology and nursing care: the interaction, declining interaction, and failing interaction levels.

CONCLUSION

Nursing practice at the interaction level is characterized by flexibility and excellence, while practice at the declining interaction level is characterized by inflexibility and rigidity. Nursing practice at the failing interaction level is characterized by staff members working in isolation with limited collaboration with other staff members in operating rooms. Considering that the declining and failing interaction levels are characterized by inflexibility, rigidity, and isolation in nursing practice, nurses at these two levels must develop and improve their qualifications to reach a level of flexible, excellent interaction. Nurse leaders must therefore refocus their skills on proficiency in perioperative nursing.

Intercultural comparison of patient satisfaction with physiotherapy care in Australia and Korea: an exploratory factor analysis

OBJECTIVES

The aim of this study was to conduct a cross-cultural comparison of the factors that influence patient satisfaction with musculoskeletal physiotherapy care in Australia and Korea.

METHODS

Prospective studies were conducted in Australia and Korea. Patient satisfaction data were collected using the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS) from a total of 1666 patients who were attending clinics for physiotherapy treatment of a musculoskeletal condition. Exploratory factor analysis was conducted to identify factors determining patient satisfaction in each cohort.

RESULTS

A four-factor solution for the MRPS was found for the Australian and Korean data sets, explaining 61 and 55% of the variance respectively. Communication and respect, convenience and quality time and person-focused care were factors common to both countries. One factor unique to Korea was courtesy and propriety. For both cultures, global patient satisfaction was significantly but weakly correlated with the outcome of treatment.

CONCLUSIONS

The interpersonal aspect of care, namely effective communication and respect from the therapist, appears to be the predominant and universal factor that influences patient satisfaction with physiotherapy care, although other culturally specific factors were identified. Physiotherapists can maximize patient satisfaction with care by addressing those features that uniquely contribute to patient satisfaction in the cultural context in which they are working.

The nurse's role in preventing cervical cancer: A cultural framework

This article proposes an innovative, theoretically-driven intervention to reduce risk from human papillomavirus (HPV). This lessening of HPV risk would lead to a reduction in the rate of cervical cancer. Aims of this article are to introduce a culturally appropriate model (PEN-3) that may facilitate vaccine uptake among vulnerable populations and to ascertain whether culturally appropriate health education delivered by nurses could be included in vaccine education programs.

The 'holi' dermatoses: annual spate of skin diseases following the spring festival in India

Background:

‘Holi’ is an annual spring festival celebrated all over India. The central ritual of Holi involves throwing of colors on one another. Playing with toxic industrial dyes often results in various dermatological complaints in a significant number of people immediately following the celebration.

Aims:

To describe patterns of various skin manifestations directly or indirectly related to the use of different colors in the celebration of Holi.

Methods:

Observational clinical study on consecutive patients presenting to a teaching hospital in Kolkata, India.

Results:

Forty-two patients with a mean age of 24.2 years were studied. Itching was the commonest symptom (25, 59.5%), followed by burning sensation, pain, oozing, and scaling. Eleven patients’ symptoms were attributed to activities related to preparation of colors and the removal of colors from the skin surface. Eczematous lesions were the most common pattern (24, 57.1%) followed by erosions, xerosis and scaling, erythema, urticaria, acute nail-fold inflammation, and abrasions. Thirteen (30.9%) patients reported aggravation of preexisting dermatoses (acne, eczema, and paronychia). Secondary pyoderma occurred in 3 (7.1%). Face was the commonest site affected (24, 57.1%), followed by dorsum of the hands, scalp, forearm, palms, arms, and trunk. Ocular complaints in the form of redness, watering, and grittiness occurred in 7 (16.7%) patients.

Conclusion:

Various forms of cutaneous manifestations, often associated with ocular complaints, occur commonly due to Holi colors. Public awareness and regulatory actions are needed to avoid these preventable conditions.

State of the science: a cultural view of Native Americans and diabetes prevention

The purpose of this article is to present a review of the literature on diabetes type 2 prevention interventions for Native American populations. The interrelation of the cultural role of food in Native American diets, educational policies related to food, outcomes of federal policies, and the historical background of diabetes are addressed. In addition, published studies of diabetes prevention interventions with Native American populations are examined. Lastly, exemplars of programs that represent best practices in the prevention of diabetes are described.