WorldWideScience

Sample records for cultural change health

  1. Sustaining organizational culture change in health systems.

    Science.gov (United States)

    Willis, Cameron David; Saul, Jessie; Bevan, Helen; Scheirer, Mary Ann; Best, Allan; Greenhalgh, Trisha; Mannion, Russell; Cornelissen, Evelyn; Howland, David; Jenkins, Emily; Bitz, Jennifer

    2016-01-01

    The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues. The authors conducted a literature review informed by rapid realist review methodology that examined how interventions interact with contexts and mechanisms to influence the sustainability of cultural change. Reference and expert panelists assisted in refining the research questions, systematically searching published and grey literature, and helping to identify interactions between interventions, mechanisms and contexts. Six guiding principles were identified: align vision and action; make incremental changes within a comprehensive transformation strategy; foster distributed leadership; promote staff engagement; create collaborative relationships; and continuously assess and learn from change. These principles interact with contextual elements such as local power distributions, pre-existing values and beliefs and readiness to engage. Mechanisms influencing how these principles sustain cultural change include activation of a shared sense of urgency and fostering flexible levels of engagement. The principles identified in this review, along with the contexts and mechanisms that influence their effectiveness, are useful domains for policy and practice leaders to explore when grappling with cultural change. These principles are sufficiently broad to allow local flexibilities in adoption and application. This is the first study to adopt a realist approach for understanding how changes in organizational culture may be sustained. Through doing so, this review highlights the broad principles by which organizational action may be organized within enabling contextual settings.

  2. Cultural change and mental health in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Curtis, Tine; Greenland, Population Study

    2002-01-01

    to the General Health Questionnaire (GHQ-12) and the prevalence of suicidal thoughts were studied in relation to childhood residence and father's occupation, current residence, and language. The statistical methods included logistic regression and graphical independence models. The results indicated a U...

  3. Cultural change and mental health in Greenland

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Curtis, Tine; Greenland, Population Study

    2002-01-01

    to the General Health Questionnaire (GHQ-12) and the prevalence of suicidal thoughts were studied in relation to childhood residence and father's occupation, current residence, and language. The statistical methods included logistic regression and graphical independence models. The results indicated a U......-shaped association in Greenland of GHQ-cases with age and a high prevalence of suicidal thoughts among young people; a low prevalence of GHQ-cases among those who were bilingual or spoke only Danish; and a high prevalence of suicidal thoughts among migrants who grew up in Denmark and among residents of the capital...... of Greenland. In Greenland, women were more often GHQ-cases and had suicidal thoughts more often than men. The association between language and GHQ-cases is presumed to operate through socioeconomic factors. It is necessary to modify the common notion that rapid societal development is in itself a cause...

  4. Redirecting traditional professional values to support safety: changing organisational culture in health care.

    Science.gov (United States)

    Carroll, J S; Quijada, M A

    2004-12-01

    Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to support change. We offer examples of organisations that drew upon cultural strengths to create new ways of working and gradually shifted the culture.

  5. Redirecting traditional professional values to support safety: changing organisational culture in health care

    OpenAIRE

    Carroll, J.; Quijada, M.

    2004-01-01

    Professionals in healthcare organisations who seek to enhance safety and quality in an increasingly demanding industry environment often identify culture as a barrier to change. The cultural focus on individual autonomy, for example, seems to conflict with desired norms of teamwork, problem reporting, and learning. We offer a definition and explication of why culture is important to change efforts. A cultural analysis of health care suggests professional values that can be redirected to suppo...

  6. Faith in the 'cultural fix': limits to a planned cultural change program in a rural health service.

    Science.gov (United States)

    Mahony, K

    2000-01-01

    This paper, by way of a narrative on the author's participation, explains the limits to a planned cultural change program in a large rural health service. Cultural change was identified by the CEO as crucial to the success of a major restructuring of the service, and the attitudes and beliefs of the 'old guard' were considered to be constraining progress. Advocates of cultural integration contend that shared core values across an organisation can overcome such obstacles. This is a matter of faith. An application of Habermasian theory suggests that organisational leaders are drawing on traditional/religious beliefs and practices to bolster their visions and missions at a time of motivational crisis. Though a need for cultural change in some sectors of the health services is acknowledged, the particular challenges in attempting to manipulate the traditionally embedded culture and sub-cultures of the health services is highlighted. An analysis of some of the ideas and beliefs surrounding authority, deference and discipline is undertaken. It is argued that the ritualistic reinforcement of these beliefs and the reproduction of sub-cultures along material and ideal interests militate against the implementation of objectives delineated by the CEO. While cultural analysis has revealed the irrational face of organisations and can bring to conscious awareness the taken-for-granted beliefs which inform behaviour, the cultural integrationists have a further agenda. They aim to manipulate organisational culture to subtly control employees' beliefs and hence behaviour. Cultural control is a covert form of top down authority that can be just as directive and centralizing as bureaucratic control. The author also maintains that cultural change programs alone cannot fix a problem that arose in the macro-economic sphere: a chronic lack of resources ever since the state responded to the economic crisis by cutting funds to health and welfare services.

  7. The culture of mental health in a changing Oaxaca

    OpenAIRE

    Duncan, Whitney L.

    2012-01-01

    This dissertation examines the causes and consequences of the recent growth in Euroamerican mental health practice in Oaxaca, one of Mexico's poorest and most ethnically diverse states with a thriving tradition of indigenous medicine. Based on 18 months of fieldwork in Oaxaca City and the Mixteca region, I explore how and why mental health services have grown so dramatically; what they consist of and what discourses they promote; for what problems they are being utilized; and what impacts the...

  8. Rapid socio-cultural change and health in the Arctic

    DEFF Research Database (Denmark)

    Bjerregaard, P

    2001-01-01

    The colonization of the circumpolar peoples has had a profound influence on their health. History tells about devastating epidemics and the introduction of alcohol. The last 50 years have witnessed an unprecedented societal development in Greenland and a rapid epidemiological transition. Physical...

  9. Changing health care culture: a prerequisite to improving patient safety

    Directory of Open Access Journals (Sweden)

    Azizi S

    2017-05-01

    Full Text Available Saeed Azizi, Faisal Siddiqui, Ithsham Iqbal Faculty of Medicine, St George’s Hospital Medical School, London, UKWe read the recent article by Chua et al1 with great interest. We found it thought-provoking to read how novel interventions, such as sharing errors, among the team can reduce the frequency of error recurrence in the future. We are hopeful that if such interventions were applied to other areas of health care, it would yield similar results. Having said this, we strongly believe that an important prerequisite of openness among health care workers is required for such interventions to work. View the original paper by Chua et al 

  10. How does a culture of health change? Lessons from the war on cigarettes.

    Science.gov (United States)

    Schudson, Michael; Baykurt, Burcu

    2016-09-01

    This paper focuses on one of the most dramatic changes in the culture of health in the U.S. since World War II: the reduction of adult cigarette smoking from close to half of the population to under 20 percent between the 1960s and the 1990s. What role does culture play in explaining this shift in smoking from socially accepted to socially stigmatized? After surveying how culture has been used to explain the decline in smoking in the fields of tobacco control and public health, we argue that existing concepts do not capture the complex transformation of smoking. We instead suggest a micro-sociological view which presumes that culture may change in response to spatially organized constraints, cajoling, and comradeship. By reviewing two major drivers of the transformation of smoking - the Surgeon General's Reports and the nonsmokers' rights movement - at this micro-sociological level, we show how culture works through social spaces and practices while institutionalizing collective or even legal pressures and constraints on behavior. This conclusion also seeks to explain the uneven adoption of non-smoking across classes, and to reflect on the utility of presuming that a uniform "culture" blankets a society.

  11. Implementing and sustaining a hand hygiene culture change programme at Auckland District Health Board.

    Science.gov (United States)

    Roberts, Sally A; Sieczkowski, Christine; Campbell, Taima; Balla, Greg; Keenan, Andrew

    2012-05-11

    In January 2009 Auckland District Health Board commenced implementation of the Hand Hygiene New Zealand (HHNZ) programme to bring about a culture change and to improve hand hygiene compliance by healthcare workers. We describe the implementation process and assess the effectiveness of this programme 36 months after implementation. In keeping with the HHNZ guideline the implementation was divided into five steps: roll-out and facility preparation, baseline evaluation, implementation, follow-up evaluation and sustainability. The process measure was improvement in hand hygiene compliance and the outcome measure was Staphylococcus aureus clinical infection and bacteraemia rates. The mean (95% CI; range) baseline compliance rates for the national reporting wards was 35% (95% CI 24-46%, 25-61%). The overall compliance by the 7th audit period was 60% (95% CI 46-74; range 47-91). All healthcare worker groups had improvement in compliance. The reduction in healthcare-associated S. aureus bacteraemia rates following the implementation was statistically significant (p=0.027). Compliance with hand hygiene improved following implementation of a culture change programme. Sustaining this improvement requires commitment and strong leadership at a senior level both nationally and within each District Health Board.

  12. Shifting the balance of power? Culture change and identity in an English health-care setting.

    Science.gov (United States)

    McDonald, Ruth

    2005-01-01

    A recurring theme in Government policy documents has been the need to change the culture of the NHS in order to deliver a service "fit for the twenty-first century". However, very little is said about what constitutes "culture" or how this culture change is to be brought about. This paper seeks to focus on an initiative aimed ostensibly at "empowering" staff in an English Primary Care Trust as a means of changing organisational culture. It presents findings from an ethnographic study which suggests that this attempt at "culture change" is aimed at manipulating the behaviour and values of individual employees and may be interpreted as a process of changing employee identity. Employees reacted in different ways to the empowerment initiative, with some resisting attempts to shape their identity and others actively engaging in projects to bring their unruly self into line with the ideal self to which they were encouraged to aspire. The challenges presented by the need to respond to conflicting Government policies created tensions between individuals and conflicts of allegiance and identity within individual members of staff. Alternative forms of self-hood did not merely replace existing identities, but interacted with them, often uncomfortably. The irony is that, whilst Government seeks to promote culture change, the frustrations created by its top-down target-driven regime acted to mitigate the transformational and reconstitutive effects of a discourse of empowerment aimed at achieving this change.

  13. Cultural changes in aerospace

    Science.gov (United States)

    Strobl, Bill

    1991-01-01

    Cultural changes; people and jobs; examples of cultural changes required; advanced launch system (ALS) philosophy; ALS operability capabilities; and ALS operability in design are outlined. This presentation is represented by viewgraphs.

  14. Patients-people-place: developing a framework for researching organizational culture during health service redesign and change.

    Science.gov (United States)

    Gale, Nicola K; Shapiro, Jonathan; McLeod, Hugh S T; Redwood, Sabi; Hewison, Alistair

    2014-08-20

    Organizational culture is considered by policy-makers, clinicians, health service managers and researchers to be a crucial mediator in the success of implementing health service redesign. It is a challenge to find a method to capture cultural issues that is both theoretically robust and meaningful to those working in the organizations concerned. As part of a comparative study of service redesign in three acute hospital organizations in England, UK, a framework for collecting data reflective of culture was developed that was informed by previous work in the field and social and cultural theory. As part of a larger mixed method comparative case study of hospital service redesign, informed by realist evaluation, the authors developed a framework for researching organisational culture during health service redesign and change. This article documents the development of the model, which involved an iterative process of data analysis, critical interdisciplinary discussion in the research team, and feedback from staff in the partner organisations. Data from semi-structured interviews with 77 key informants are used to illustrate the model. In workshops with NHS partners to share and debate the early findings of the study, organizational culture was identified as a key concept to explore because it was perceived to underpin the whole redesign process. The Patients-People-Place framework for studying culture focuses on three thematic areas ('domains') and three levels of culture in which the data could be organised. The framework can be used to help explain the relationship between observable behaviours and cultural artefacts, the values and habits of social actors and the basic assumptions underpinning an organization's culture in each domain. This paper makes a methodological contribution to the study of culture in health care organizations. It offers guidance and a practical approach to investigating the inherently complex phenomenon of culture in hospital organizations

  15. User-Centered Design of Health Care Software Development: Towards a Cultural Change.

    Science.gov (United States)

    Stanziola, Enrique; Uznayo, María Quispe; Ortiz, Juan Marcos; Simón, Mariana; Otero, Carlos; Campos, Fernando; Luna, Daniel

    2015-01-01

    Health care software gets better user efficiency, efficacy and satisfaction when the software is designed with their users' needs taken into account. However, it is not trivial to change the practice of software development to adopt user-centered design. In order to produce this change in the Health Informatics Department of the Hospital Italiano de Buenos Aires, a plan was devised and implemented. The article presents the steps of the plan, shows how the steps were carried on, and reflects on the lessons learned through the process.

  16. Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity.

    Science.gov (United States)

    Williams, Nathaniel J; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

    2017-03-01

    The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians' evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians' EBP adoption and use. Four hundred seventy-five mental health clinicians in 14 children's mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians' EBP adoption and use. ARC increased clinicians' EBP adoption (OR = 3.19, p = .003) and use (81 vs. 56 %, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC's effects on clinicians' EBP adoption and use. ARC increases clinicians' EBP adoption and use by creating proficient organizational cultures that increase clinicians' intentions to adopt EBPs.

  17. To Change Corporate Culture

    Institute of Scientific and Technical Information of China (English)

    尹雁

    2007-01-01

    1. Analysis of Culture and Managing change 1.1 The Two Varies of Models 1.1.1 Five-step model According to ’five-step model’, the progress of change could be divided into five stages. Firstly, manager needs to think why a culture change is necessary. Possibly due to the signals from the environment in which the company locate in, managers find the operating principles or routines are not in line with the change of the market. These elements have threatened the corporation. On this occasion, managers could start to analyze what kind of culture the organization possesses.

  18. Darwinism and cultural change.

    Science.gov (United States)

    Godfrey-Smith, Peter

    2012-08-05

    Evolutionary models of cultural change have acquired an important role in attempts to explain the course of human evolution, especially our specialization in knowledge-gathering and intelligent control of environments. In both biological and cultural change, different patterns of explanation become relevant at different 'grains' of analysis and in contexts associated with different explanatory targets. Existing treatments of the evolutionary approach to culture, both positive and negative, underestimate the importance of these distinctions. Close attention to grain of analysis motivates distinctions between three possible modes of cultural evolution, each associated with different empirical assumptions and explanatory roles.

  19. Organizational structure, leadership and readiness for change and the implementation of organizational cultural competence in addiction health services.

    Science.gov (United States)

    Guerrero, Erick G; Kim, Ahraemi

    2013-10-01

    Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Addressing mental health challenges facing the "Next America": A call for culture change.

    Science.gov (United States)

    McLeigh, Jill D; Melton, Gary B

    2015-09-01

    Provides an editorial addressing future mental health challenges. The articles in this issue highlight the need to create environments conducive to promoting the well-being of future generations. The articles build on symposia held by the American Orthopsychiatric Association in 2015, which focused on the effects on well-being of changing sociodemographics and labor market trends. Included in these pages are articles that lay out some of the challenges young people today face and strategies for helping them transition to adulthood successfully. (c) 2015 APA, all rights reserved).

  1. Cultural change that sticks.

    Science.gov (United States)

    Katzenbach, Jon R; Steffen, Ilona; Kronley, Caroline

    2012-01-01

    When a major change initiative runs aground, leaders often blame their company's culture for pushing it off course. They try to forge ahead by overhauling the culture--a tactic that tends to fizzle, fail, or backfire. Most cultures are too well entrenched to be jettisoned. The secret is to stop fighting your culture--and to work with and within it, until it evolves in the right direction. Today's best-performing companies, such as Southwest Airlines, Apple, and the Four Seasons, understand this, say the authors, three consultants from Booz & Company. These organizations follow five principles for making the most of their cultures: 1. Match strategy to culture. Culture trumps strategy every time, no matter how brilliant the plan, so the two need to be in alignment. 2. Focus on a few critical shifts in behavior. Wholesale change is hard; choose your battles wisely. 3. Honor the strengths of the existing culture. Every culture is the product of good intentions and has strengths; put them to use. 4. Integrate formal and informal interventions. Don't just implement new rules and processes; identify "influencers" who can bring other employees along. 5. Measure and monitor cultural evolution. Otherwise you can't identify backsliding or correct course. When the leaders of Aetna applied these rules while implementing a new strategy in the early 2000s, they reinvigorated the company's ailing culture and restored employee pride. That shift was reflected in the business results, as Aetna went from a $300 million loss to a $1.7 billion gain.

  2. Quality, Culture and Change

    Science.gov (United States)

    Strydom, J. F.; Zulu, N.; Murray, L.

    2004-01-01

    Higher education in South Africa has been grappling with the issue of quality assurance since the early 1990s. This paper investigates the relationships or tensions between quality, culture and change as a result of the introduction of quality assurance systems in higher education institutions in South Africa. The imperatives for the introduction…

  3. Quality, Culture and Change

    Science.gov (United States)

    Strydom, J. F.; Zulu, N.; Murray, L.

    2004-01-01

    Higher education in South Africa has been grappling with the issue of quality assurance since the early 1990s. This paper investigates the relationships or tensions between quality, culture and change as a result of the introduction of quality assurance systems in higher education institutions in South Africa. The imperatives for the introduction…

  4. 50 years of physical growth and impressive technological advances unmatched by health human resources reform and cultural change.

    Science.gov (United States)

    Scott, Graham W S

    2012-01-01

    The year 1962 was pre-medicare. The public was concerned about access and individual affordability of care. Funding involved public or private responsibility and the role of government. Physicians, the most influential providers, were concerned that government funding would result in the loss of their independence and their becoming state employees. The retrospective analysis "Looking Back 50 Years in Hospital Administration" by Graham and Sibbald is arresting as it underlines just how much progress we have made in what could be termed "hardware" in support of healthcare policy and hospital administration. From this perspective, the progress has been eye opening, given the advent of universal healthcare, the advancement in our physical facilities, the development of high-quality diagnostic equipment, the explosion of new research centres and new and complex clinical procedures. The development of this hardware has given our providers better weapons and contributed to a remarkable improvement in life expectancy. But progress in health administration and policy management involves more than hardware. If the hardware constitutes the tools, then the "software" of the healthcare system involves the human resources and the culture change that must be positioned to make maximum use of the hardware. In 2062, looking back at the 2012 experience, the legacy test may be whether we dealt with health human resources and culture change at a rate that matched our progress in hardware.

  5. Changing organizational culture: using the CEO cancer gold standard policy initiatives to promote health and wellness at a school of public health.

    Science.gov (United States)

    Towne, Samuel D; Anderson, Kelsey E; Smith, Matthew Lee; Dahlke, Deborah Vollmer; Kellstedt, Debra; Purcell, Ninfa Pena; Ory, Marcia G

    2015-09-03

    Worksite wellness initiatives for health promotion and health education have demonstrated effectiveness in improving employee health and wellness. We examined the effects of a multifaceted health promotion campaign on organizational capacity to meet requirements to become CEO Cancer Gold Standard Accredited. We conducted an online survey to assess perceived organizational values and support for the five CEO Cancer Gold Standard Pillars for cancer prevention: tobacco cessation; physical activity; nutrition; cancer screening and early detection; and accessing information on cancer clinical trials. Baseline and follow-up surveys were sent 6-months apart to faculty, staff, and students at a school of public health to test the impact of a multifaceted health promotion campaign on perceived organizational change. Descriptive analyses were used to characterize percent improvement. Multivariate logistic regression analyses were used to control for participants' university status. The current organizational culture highly supported tobacco cessation at both time points. Significant improvements (p < .05) from baseline to follow-up were observed for questions measuring organizational values for 'prevention, screening, and early detection of cancer' and 'accessing cancer treatment and clinical trials'. Health promotion and education efforts using multiple approaches were effective to improve perceived organizational values and support for cancer prevention and early detection, and increase access to information about cancer clinical trials. Future studies are needed to examine broader impacts of implementing worksite health promotion initiatives.

  6. Social Processes of Health and Physical Education Teachers' Identity Formation: Reproducing and Changing Culture

    Science.gov (United States)

    Sirna, K.; Tinning, R.; Rossi, T.

    2010-01-01

    This paper examines Initial Teacher Education students' experiences of participation in health and physical education (HPE) subject department offices and the impact on their understandings and identity formation. Pierre Bourdieu's concepts of habitus, field, and practice along with Wenger's communities of practice form the theoretical frame used…

  7. College Drinking - Changing the Culture

    Science.gov (United States)

    ... about college alcohol policies College Drinking - Changing the Culture This is your one-stop resource for comprehensive ... More about special features College Drinking - Changing the Culture This is your one-stop resource for comprehensive ...

  8. Essential conditions for the implementation of comprehensive school health to achieve changes in school culture and improvements in health behaviours of students.

    Science.gov (United States)

    Storey, Kate E; Montemurro, Genevieve; Flynn, Jenn; Schwartz, Marg; Wright, Erin; Osler, Jill; Veugelers, Paul J; Roberts, Erica

    2016-11-02

    Comprehensive School Health (CSH) is an internationally recognized framework that holistically addresses school health by transforming the school culture. It has been shown to be effective in enhancing health behaviours among students while also improving educational outcomes. Despite this effectiveness, there is a need to focus on how CSH is implemented. Previous studies have attempted to uncover the conditions necessary for successful operationalization, but none have described them in relation to a proven best practice model of implementation that has demonstrated positive changes to school culture and improvements in health behaviours. The purpose of this research was to identify the essential conditions of CSH implementation utilizing secondary analysis of qualitative interview data, incorporating a multitude of stakeholder perspectives. This included inductive content analysis of teacher (n = 45), principal (n = 46), and school health facilitator (n = 34) viewpoints, all of whom were employed within successful CSH project schools in Alberta, Canada between 2008 and 2013. Many themes were identified, here called conditions, that were divided into two categories: 'core conditions' (students as change agents, school-specific autonomy, demonstrated administrative leadership, dedicated champion to engage school staff, community support, evidence, professional development) and 'contextual conditions' (time, funding and project supports, readiness and prior community connectivity). Core conditions were defined as those conditions necessary for CSH to be successfully implemented, whereas contextual conditions had a great degree of influence on the ability for the core conditions to be obtained. Together, and in consideration of already established 'process conditions' developed by APPLE Schools (assess, vision, prioritize; develop and implement an action plan; monitor, evaluate, celebrate), these represent the essential conditions of successful CSH

  9. Increasing clinicians' EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC.

    Science.gov (United States)

    Glisson, Charles; Williams, Nathaniel J; Hemmelgarn, Anthony; Proctor, Enola; Green, Philip

    2016-01-01

    Clinician EBT exploration and preparation behavior is essential to the ongoing implementation of new EBTs. This study examined the effect of the ARC organizational intervention on clinician EBT exploration and preparation behavior and assessed the mediating role of organizational culture as a linking mechanism. Fourteen community mental health agencies that serve youth in a major Midwestern metropolis along with 475 clinicians who worked in those agencies, were randomly assigned to either the three-year ARC intervention or control condition. Organizational culture was assessed with the Organizational Social Context (OSC) measure at baseline and follow-up. EBT exploration and preparation behavior was measured as clinician participation in nine separate community EBT workshops held over a three-year period. There was 69 percent greater odds (OR = 1.69, p organizational culture mediated the positive effect of the ARC intervention on clinicians' workshop attendance (a × b = .21; 95% CI:LL = .05, UL = .40). Organizational interventions that create proficient mental health agency cultures can increase clinician EBT exploration and preparation behavior that is essential to the ongoing implementation of new EBTs in community youth mental health settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Cultural reflexivity in health research and practice.

    Science.gov (United States)

    Aronowitz, Robert; Deener, Andrew; Keene, Danya; Schnittker, Jason; Tach, Laura

    2015-07-01

    Recent public health movements have invoked cultural change to improve health and reduce health disparities. We argue that these cultural discourses have sometimes justified and maintained health inequalities when those with power and authority designated their own social practices as legitimate and healthy while labeling the practices of marginalized groups as illegitimate or unhealthy. This "misrecognition," which creates seemingly objective knowledge without understanding historical and social conditions, sustains unequal power dynamics and obscures the fact that what is deemed legitimate and healthy can be temporally, geographically, and socially relative. We use examples from research across multiple disciplines to illustrate the potential consequences of cultural misrecognition, highlight instances in which culture was invoked in ways that overcame misrecognition, and discuss how cultural reflexivity can be used to improve health research and practice.

  11. Cultural diversity and mental health.

    Science.gov (United States)

    Gopalkrishnan, Narayan; Babacan, Hurriyet

    2015-12-01

    Cultural diversity and its impact on mental health has become an increasingly important issue in a globalised world where the interactions between cultures continue to grow exponentially. This paper presents critical areas in which culture impacts on mental health, such as how health and illness are perceived, coping styles, treatment-seeking patterns, impacts of history, racism, bias and stereotyping, gender, family, stigma and discrimination. While cultural differences provide a number of challenges to mental health policy and practice they also provide a number of opportunities to work in unique and effective ways towards positive mental health. Ethno-specific approaches to mental health that incorporate traditional and community-based systems can provide new avenues for working with culturally diverse populations. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  12. SEM: A Cultural Change Agent

    Science.gov (United States)

    Barnes, Bradley; Bourke, Brian

    2015-01-01

    The authors advance the concept that institutional culture is a purposeful framework by which to view SEM's utility, particularly as a cultural change agent. Through the connection of seemingly independent functions of performance and behavior, implications emerge that deepen the understanding of the influence of culture on performance outcomes…

  13. Health communication: a media and cultural studies approach

    National Research Council Canada - National Science Library

    Lewis, Belinda; Lewis, Jeff

    2015-01-01

    "This book is about communicating for health and social change. With a clear focus on public health and health promotion practice, it provides a unique introduction to media and cultural studies perspectives on health communication...

  14. Changes in cultural consumption

    DEFF Research Database (Denmark)

    Navarrete, T.; Borowiecki, K. J.

    2016-01-01

    Visits to museums have been studied as hedonic and utilitarian forms of cultural consumption, though limited attention has been given to the access of museum collections online. We perform a unique historic analysis of the visibility of collections in a museum of ethnographic collections and comp......Visits to museums have been studied as hedonic and utilitarian forms of cultural consumption, though limited attention has been given to the access of museum collections online. We perform a unique historic analysis of the visibility of collections in a museum of ethnographic collections...

  15. Health and culture in urban planning.

    Science.gov (United States)

    Baba, S

    1994-01-01

    Rapid change, driven mainly by business and technology, has transformed our understanding of health and living conditions in recent decades. Experiments in urban development in Japan are bringing together technology, quality of life, culture and business to satisfy the needs of human health and well-being.

  16. Climate Change and Health

    Science.gov (United States)

    ... sheets Fact files Questions & answers Features Multimedia Contacts Climate change and health Fact sheet Reviewed June 2016 Key ... in improved health, particularly through reduced air pollution. Climate change Over the last 50 years, human activities – particularly ...

  17. Leadership, Culture and Organizational Change

    Directory of Open Access Journals (Sweden)

    Vladimir-Codrin Ionescu

    2014-12-01

    Full Text Available An effective leadership, an evolutionary organizational culture and permanent connection to change may ensure a company’s success within an ever more dynamic competitive environment. The scientific approach of this paper is in line with theoretical and applied research in the field by the presentation of the connections existing among leadership, organizational culture and organizational change. The paper highlights the triad “vision – motivation – momentum”, the mission and the defining coordinates of leadership, the complementarity “new – tradition” in organizational culture, the stages of the change management process and the role of managers and leaders in the preparation and implementation of change projects. Leadership is essential in building and developing an appropriate cultural model, which, in its turn, is an important vector of organizational change processes in modern companies.

  18. Understanding Culture and Influencing Change

    Science.gov (United States)

    2010-03-01

    sexes. 44 Democratic countries considered feministic tend to elect more women to political offices and government posts unless they have a large...his book Organization Change: Theory and Practice expands Gladwell’s ideas identifying areas a leader can leverage to assist with changing culture...Leading Across Cultures, 3rd Edition (Boston,MA: Nicholas Brealy Publishing, 2006), 28-29. 4 Gareth R. Jones, Organizational Theory , Design, and

  19. Climate change and human health

    DEFF Research Database (Denmark)

    Warren, John A; Berner, James E; Curtis, Tine

    2005-01-01

    or degradation of permafrost. Climate change can result in damage to sanitation infrastructure resulting in the spread of disease or threatening a community's ability to maintain its economy, geographic location and cultural tradition, leading to mental stress. Through monitoring of some basic indicators...... communities can begin to develop a response to climate change. With this information, planners, engineers, health care professionals and governments can begin to develop approaches to address the challenges related to climate change....

  20. Changing the Culture: Football

    Science.gov (United States)

    Santo, Ricky

    2015-01-01

    In this article college football coach Ricky Santo argues that in order to change the ways of the misunderstood world of racism, one needs to acknowledge the sociocultural consciousness in society today. The sociocultural consciousness is a way to understand how people think and behave which is influenced by their race/ethnicity, social class, and…

  1. Acquisition streamlining: A cultural change

    Science.gov (United States)

    Stewart, Jesse

    1992-01-01

    The topics are presented in viewgraph form and include the following: the defense systems management college, educational philosophy, the defense acquisition environment, streamlining initiatives, organizational streamlining types, defense law review, law review purpose, law review objectives, the Public Law Pilot Program, and cultural change.

  2. Medicine: in need of culture change.

    Science.gov (United States)

    Ward, S; Outram, S

    2016-01-01

    Compared with other health professionals and the general population, doctors and medical students reported higher rates of psychological distress, burnout, diagnosed mental illness, suicidal ideation and attempted suicide. Where possible, the problematic and unnecessarily stressful aspects of working as a doctor must be improved. Collectively, we must change the often toxic culture of medicine into a culture that promotes a nurturing and supportive approach to teaching and supervision. The goal should be to develop medical practices that facilitate well-being and quality of life, where sustainable medical careers can develop and better serve the community.

  3. Exploring the 'cultural' in cultural competencies in Pacific mental health.

    Science.gov (United States)

    Samu, Kathleen Seataoai; Suaalii-Sauni, Tamasailau

    2009-02-01

    Cultural competency is about the ability of individuals and systems to respond respectfully and effectively to the cultural needs of peoples of all cultures. Its general attributes include knowledge, attitudes, skills and professional judgment. In Pacific mental health, 'the cultural' is generally understood to be ethnic culture. Accordingly, Pacific cultural competencies assume ethnic specific markers. In mental health Pacific cultural competencies has seen a blending of cultural and clinical beliefs and practices. This paper provides an overview of five key theme areas arising from Auckland-based ethnic-specific Pacific workshop data: language, family, tapu relationships, skills and organisation policy. Workshop participants comprised of Pacific mental health providers, Pacific consumers, family members of Pacific consumers and members of the Pacific community members. This paper purports that identifying the perceptions of different Pacific groups on ethnic-specific elements of cultural competencies are necessary to build and strengthen the capacity and capability of mental health services to provide culturally relevant services.

  4. Climate change and human health

    DEFF Research Database (Denmark)

    Warren, John A; Berner, James E; Curtis, Tine

    2005-01-01

    In northern regions, climate change can include changes in precipitation magnitude and frequency, reductions in sea ice extent and thickness, and climate warming and cooling. These changes can increase the frequency and severity of storms, flooding, or erosion; other changes may include drought...... or degradation of permafrost. Climate change can result in damage to sanitation infrastructure resulting in the spread of disease or threatening a community's ability to maintain its economy, geographic location and cultural tradition, leading to mental stress. Through monitoring of some basic indicators...... communities can begin to develop a response to climate change. With this information, planners, engineers, health care professionals and governments can begin to develop approaches to address the challenges related to climate change....

  5. Organizational cultural competence consultation to a mental health institution.

    Science.gov (United States)

    Fung, Kenneth; Lo, Hung-Tat Ted; Srivastava, Rani; Andermann, Lisa

    2012-04-01

    Cultural competence is increasingly recognized as an essential component of effective mental health care delivery to address diversity and equity issues. Drawing from the literature and our experience in providing cultural competence consultation and training, the paper will discuss our perspective on the foundational concepts of cultural competence and how it applies to a health care organization, including its programs and services. Based on a recent consultation project, we present a methodology for assessing cultural competence in health care organizations, involving mixed quantitative and qualitative methods. Key findings and recommendations from the resulting cultural competence plan are discussed, including core principles, change strategies, and an Organizational Cultural Competence Framework, which may be applicable to other health care institutions seeking such changes. This framework, consisting of eight domains, can be used for organizational assessment and cultural competence planning, ultimately aiming at enhancing mental health care service to the diverse patients, families, and communities.

  6. Cultural Diversity and the Changing Culture of Education

    Science.gov (United States)

    Nderu-Boddington, Eulalee

    2008-01-01

    The paper will examine the change in schools brought about by cultural diversity and examines the theories that surround the topic. I will evaluate and examine ways in which schools can accommodate cultural diversity. References will be made to cultural and social changes in our schools and how education is affected by such changes. The issue of…

  7. The Cultural Geography of Health Care Delivery.

    Science.gov (United States)

    Gesler, Wilbert M.

    1987-01-01

    This article shows how health care delivery is related to cultural or human geography. This is accomplished by describing health care delivery in terms of 12 popular themes of cultural geography. (JDH)

  8. A Culture Of Health And Human Rights.

    Science.gov (United States)

    Mariner, Wendy K; Annas, George J

    2016-11-01

    A culture of health can be seen as a social norm that values health as the nation's priority or as an appeal to improve the social determinants of health. Better population health will require changing social and economic policies. Effective changes are unlikely unless health advocates can leverage a framework broader than health to mobilize political action in collaboration with non-health sector advocates. We suggest that human rights-the dominant international source of norms for government responsibilities-provides this broader framework. Human rights, as expressed in the Universal Declaration of Human Rights and enforceable treaties, require governments to assure their populations nondiscriminatory access to food, water, education, work, social security, and a standard of living adequate for health and well-being. The policies needed to realize human rights also improve population health, well-being, and equity. Aspirations for human rights are strong enough to endure beyond inevitable setbacks to specific causes. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Assessing and changing medical practice culture.

    Science.gov (United States)

    Hills, Laura

    2011-01-01

    Your medical practice has an existing culture that manifests itself daily in literally hundreds of ways. Some aspects of your culture likely support your practice's growth; others may be impeding your progress. This article describes the characteristics of medical practice culture and provides numerous examples of how culture influences behavior. It describes how culture is expressed in a medical practice through objects and artifacts, language, emotions, interactions, practice management systems, and daily work habits. It offers three techniques for assessing an existing medical practice culture and a checklist for conducting culture observations. This article also provides guidelines for identifying a desired medical practice culture and explores why changing culture is so difficult. It describes five reasons employees are likely to resist culture change and provides 12 fundamental changes that will enable a practice to improve its culture. Finally, this article explores how medical practice cultures are formed and perpetuated and provides more than a dozen questions to ask employees in a culture survey.

  10. Cultural Synergy and Organizational Change

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig; Vogt, Joachim

    2013-01-01

    This paper explores informal codes and rhythms of social behavior at work and their relation to organizational change and wellbeing. After a merger within a public service organization we organized 8 focus groups of 2-3 clerical or academic employees within a head office and a division office (N...... = 21). Word counts of ‘I’ and ‘we’ revealed that people sharing pre-merger organizational background (homogeneous groups) used ‘we’ more often than heterogeneous groups. Head office employees were concerned with workload and social code, whereas division office employees mainly discussed meetings......, commitment, and office space. Organizational background rather than office cultures guided these differences. We found that in a merged organization cultural synergies are possible to create if practical and social values for employees are offered. Thus, interesting new ways to transform problems...

  11. From a blame culture to a just culture in health care.

    Science.gov (United States)

    Khatri, Naresh; Brown, Gordon D; Hicks, Lanis L

    2009-01-01

    A prevailing blame culture in health care has been suggested as a major source of an unacceptably high number of medical errors. A just culture has emerged as an imperative for improving the quality and safety of patient care. However, health care organizations are finding it hard to move from a culture of blame to a just culture. We argue that moving from a blame culture to a just culture requires a comprehensive understanding of organizational attributes or antecedents that cause blame or just cultures. Health care organizations need to build organizational capacity in the form of human resource (HR) management capabilities to achieve a just culture. This is a conceptual article. Health care management literature was reviewed with twin objectives: (a) to ascertain if a consistent pattern existed in organizational attributes that lead to either blame or just cultures and (2) to find out ways to reform a blame culture. On the basis of the review of related literature, we conclude that (a) a blame culture is more likely to occur in health care organizations that rely predominantly on hierarchical, compliance-based functional management systems; (b) a just or learning culture is more likely to occur in health organizations that elicit greater employee involvement in decision making; and (c) human resource management capabilities play an important role in moving from a blame culture to a just culture. Organizational culture or human resource management practices play a critical role in the health care delivery process. Health care organizations need to develop a culture that harnesses the ideas and ingenuity of health care professional by employing a commitment-based management philosophy rather than strangling them by overregulating their behaviors using a control-based philosophy. They cannot simply wish away the deeply entrenched culture of blame nor can they outsource their way out of it. Health care organizations need to build internal human resource management

  12. Culture change and nursing home quality of care.

    Science.gov (United States)

    Grabowski, David C; O'Malley, A James; Afendulis, Christopher C; Caudry, Daryl J; Elliot, Amy; Zimmerman, Sheryl

    2014-02-01

    Culture change models are intended to improve the quality of life for nursing home residents, but the impact of these models on quality of care is unknown. We evaluated the impact of the implementation of nursing home culture change on the quality of care, as measured by staffing, health-related survey deficiencies, and Minimum Data Set (MDS) quality indicators. From the Pioneer Network, we have data on whether facilities were identified by experts as "culture change" providers in 2004 and 2009. Using administrative data, we employed a panel-based regression approach in which we compared pre-post quality outcomes in facilities adopting culture change between 2004 and 2009 against pre-post quality outcomes for a propensity score-matched comparison group of nonadopters. Nursing homes that were identified as culture change adopters exhibited a 14.6% decrease in health-related survey deficiency citations relative to comparable nonadopting homes, while experiencing no significant change in nurse staffing or various MDS quality indicators. This research represents the first large-scale longitudinal evaluation of the association of culture change and nursing home quality of care. Based on the survey deficiency results, nursing homes that were identified as culture change adopters were associated with better care although the surveyors were not blind to the nursing home's culture change efforts. This finding suggests culture change may have the potential to improve MDS-based quality outcomes, but this has not yet been observed.

  13. Cultural capital and social inequality in health.

    Science.gov (United States)

    Abel, T

    2008-07-01

    Economic and social resources are known to contribute to the unequal distribution of health outcomes. Culture-related factors such as normative beliefs, knowledge and behaviours have also been shown to be associated with health status. The role and function of cultural resources in the unequal distribution of health is addressed. Drawing on the work of French Sociologist Pierre Bourdieu, the concept of cultural capital for its contribution to the current understanding of social inequalities in health is explored. It is suggested that class related cultural resources interact with economic and social capital in the social structuring of people's health chances and choices. It is concluded that cultural capital is a key element in the behavioural transformation of social inequality into health inequality. New directions for empirical research on the interplay between economic, social and cultural capital are outlined.

  14. Changing cultural attitudes towards female genital cutting.

    Science.gov (United States)

    Vogt, Sonja; Mohmmed Zaid, Nadia Ahmed; El Fadil Ahmed, Hilal; Fehr, Ernst; Efferson, Charles

    2016-10-27

    As globalization brings people with incompatible attitudes into contact, cultural conflicts inevitably arise. Little is known about how to mitigate conflict and about how the conflicts that occur can shape the cultural evolution of the groups involved. Female genital cutting is a prominent example. Governments and international agencies have promoted the abandonment of cutting for decades, but the practice remains widespread with associated health risks for millions of girls and women. In their efforts to end cutting, international agents have often adopted the view that cutting is locally pervasive and entrenched. This implies the need to introduce values and expectations from outside the local culture. Members of the target society may view such interventions as unwelcome intrusions, and campaigns promoting abandonment have sometimes led to backlash as they struggle to reconcile cultural tolerance with the conviction that cutting violates universal human rights. Cutting, however, is not necessarily locally pervasive and entrenched. We designed experiments on cultural change that exploited the existence of conflicting attitudes within cutting societies. We produced four entertaining movies that served as experimental treatments in two experiments in Sudan, and we developed an implicit association test to unobtrusively measure attitudes about cutting. The movies depart from the view that cutting is locally pervasive by dramatizing members of an extended family as they confront each other with divergent views about whether the family should continue cutting. The movies significantly improved attitudes towards girls who remain uncut, with one in particular having a relatively persistent effect. These results show that using entertainment to dramatize locally discordant views can provide a basis for applied cultural evolution without accentuating intercultural divisions.

  15. Climate change and health

    Energy Technology Data Exchange (ETDEWEB)

    Last, J.M. [Ottawa Univ., ON (Canada); Chiotti, Q.P. [Environment Canada, Ottawa, ON (Canada)

    2001-12-31

    Adverse effects such as heat-related illnesses are felt on human health as a result of climate change. Those effects can also be the increased frequency and severity of extreme weather resulting in injury and death, a wider array of insect vectors for diseases, as well as increased risk of allergic, food-borne and water-borne diseases. Coastal ecosystems are altered, sea levels are rising and millions of people will need to relocate in the next century as a result of global warming. Keeping disaster plans, maintaining epidemiological monitoring and surveillance, and issuing advisory messages concerning the risks to human health are some of the responses required from public health officials. The establishment of standards, the development of policies on food and nutrition and the defining of priorities for research are important aspects that must be kept in mind. The authors indicated that multidisciplinary approaches are better suited to find solutions to the challenges encountered due to climate change than the narrow methods used in the past. refs., 4 tabs.

  16. Cultural aspects of ageing and health promotion.

    Science.gov (United States)

    Mariño, R J

    2015-03-01

    The emphasis of Australian Government policy is on the promotion of good health in later life and positive experiences with ageing. Conceptually, a new gerontology framework has replaced the study of disease, decline, loss and disability. Within this framework, health promotion offers a mechanism by which individuals can be assisted to create environments that offer better opportunities for continued participation in society and improved quality of health and self-care. Oral health is instrumental to older people's health, life satisfaction, quality of life and perception of self. Australia is culturally diverse, composed of numerous ethno-cultural groups coexisting within a larger, predominant culture, creating a multicultural and multiracial society. However, despite this cultural diversity, the well documented ageing profile of the Australian population and repeated calls for comprehensive geriatric assessment, the oral health of older adults remains a challenge for oral health providers and for society. A major challenge will be to translate existing knowledge and experience of disease prevention and health promotion into appropriate programmes for older adults. Health promotion is the key to improving oral health in later life as it encourages older adults to be proactive in regard to their health. Therefore, increased efforts should be directed towards identifying opportunities for health promotion activities and the development of community based models that encourage older people to improve and maintain their oral health. Ignoring opportunities for health promotion may increase inequalities in oral health and may lead to even greater demands for curative and oral rehabilitative services from these groups This article firstly provides a brief rationale for oral health promotion. Its second part explores the influence of culture on health beliefs, behaviours and outcomes in older adults and how oral health can relate to cultural background. The last section

  17. Changes in Health Knowledge

    Science.gov (United States)

    Silvestri, Lynette; Bonis, Marc

    2009-01-01

    Health education can improve the health of the nation. Emphasis is on promoting health, maintaining good health and preventing health problems. A segment of society that tends to ignore their health is college students. They are a large group that makes up 31% of 18-24 year olds in the U.S. (Hingson, et al, 2001). This population is considered to…

  18. Changing living conditions, life style and health

    DEFF Research Database (Denmark)

    Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

    2005-01-01

    community in Greenland, where changing environmental conditions have influenced fishing and employment opportunities to the extent that the size of the population has changed dramatically. The link between social change and health is shown with reference to studies on education, housing and occupation...... as well as life style changes. The paper further illustrates the relationship between the rapid socio-cultural and economic change and the health of the population. Psychosocial stress is reflected in problems such as alcohol abuse, violence and suicide, and these factors have been shown in studies...

  19. Changing living conditions, life style and health

    DEFF Research Database (Denmark)

    Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

    2005-01-01

    as well as life style changes. The paper further illustrates the relationship between the rapid socio-cultural and economic change and the health of the population. Psychosocial stress is reflected in problems such as alcohol abuse, violence and suicide, and these factors have been shown in studies....... The aim of the paper is to illustrate the influence of environmental change on living conditions and life style and some of the mechanisms through which such changes affect physical and mental health. The interrelationship between environmental and societal change is illustrated by an example from a small...

  20. Cultural values and health service quality in China.

    Science.gov (United States)

    Polsa, Pia; Fuxiang, Wei; Sääksjärvi, Maria; Shuyuan, Pei

    2013-01-01

    Several service quality studies show how cultural features may influence the way service quality is perceived. However, few studies specifically describe culture's influence on health service quality. Also, there are few studies that take into account patients' health service quality perceptions. This article seeks to present a first step to fill these gaps by examining patients' cultural values and their health service quality assessments. The study draws on published work and applies its ideas to Chinese healthcare settings. Data consist of hospital service perceptions in the People's Republic of China (PRC), a society that is socially, economically and culturally undergoing major changes. In total, 96 patients were surveyed. Data relationships were tested using partial least square (PLS) analysis. Findings show that Chinese patients' cultural values and their health service assessments are related and that the cultural values themselves seem to be changing. Additionally, further analyses provided interesting results pointing to which cultural values influenced service quality perceptions. The strongest service quality predictor was power distance. The sample is relatively small and collected from only one major hospital in China. Therefore, future research should extend the sample size and scope. Follow-up research could also include cross-cultural investigations of perceived health service quality to substantiate cultural influences on health service quality perceptions. In line with similar research in other contexts, the study confirms that power distance has a significant relationship with service quality perceptions. The study contributes to existing health service literature by offering patients' views on health service quality and by describing relationships between health service perceptions and cultural values--the study's main contribution.

  1. Cultural competence education for health professionals.

    Science.gov (United States)

    Horvat, Lidia; Horey, Dell; Romios, Panayiota; Kis-Rigo, John

    2014-05-05

    educational interventions for health professionals working in health settings that aimed to improve: health outcomes of patients/consumers of minority cultural and linguistic backgrounds; knowledge, skills and attitudes of health professionals in delivering culturally competent care; and healthcare organisation performance in culturally competent care. We used the conceptual framework as the basis for data extraction. Two review authors independently extracted data on interventions, methods, and outcome measures and mapped them against the framework. Additional information was sought from study authors. We present results in narrative and tabular form. We included five RCTs involving 337 healthcare professionals and 8400 patients; at least 3463 (41%) were from CALD backgrounds. Trials compared the effects of cultural competence training for health professionals, with no training. Three studies were from the USA, one from Canada and one from The Netherlands. They involved health professionals of diverse backgrounds, although most were not from CALD minorities. Cultural background was determined using a validated scale (one study), self-report (two studies) or not reported (two studies). The design effect from clustering meant an effective minimum sample size of 3164 CALD participants. No meta-analyses were performed. The quality of evidence for each outcome was judged to be low.Two trials comparing cultural competence training with no training found no evidence of effect for treatment outcomes, including the proportion of patients with diabetes achieving LDL cholesterol control targets (risk difference (RD) -0.02, 95% CI -0.06 to 0.02; 1 study, USA, 2699 "black" patients, moderate quality), or change in weight loss (standardised mean difference (SMD) 0.07, 95% CI -0.41 to 0.55, 1 study, USA, effective sample size (ESS) 68 patients, low quality).Health behaviour (client concordance with attendance) improved significantly among intervention participants compared with controls

  2. Cultural Change and the Operational Energy Strategy

    Science.gov (United States)

    2012-02-01

    CULTURAL CHANGE AND THE OPERATIONAL ENERGY STRATEGY by Colonel Steven L. Allen United States Army Dr. Richard Meinhart ...Cultural Change and the Operational Energy Strategy by Colonel Steven L. Allen United States Army United States... Army War College Class of 2012 DISTRIBUTION STATEMENT: A Approved for Public Release Distribution is Unlimited This manuscript is submitted

  3. Changing the Culture of a College.

    Science.gov (United States)

    Gorringe, Richard; And Others

    1994-01-01

    The purpose of this collection of eight essays is to demonstrate some of the ways in which the culture of British colleges of further education are being consciously changed to meet the demands of the 21st century. The essays are: (1) "Change Where Contrasting Cultures Meet," (Will Bridge) which examines the experiences of South Thames…

  4. Leading Culture Change in Global Organizations Aligning Culture and Strategy

    CERN Document Server

    Denison, Daniel; Lane, Nancy; Lief, Colleen

    2012-01-01

    Filled with case studies from firms such as GT Automotive, GE Healthcare China, Vale, Dominos, Swiss Re Americas Division, and Polar Bank, among others, this book (written by Dan Denison and his co-authors) combines twenty years of research and survey results to illustrate a critical set of cultural dynamics that firms need to manage in order to remain competitive. Each chapter uses a case as a means to illustrate an important aspect of culture change focusing on seven common culture-change dilemmas including creating a strategic alignment, keeping strategy simple, and more.

  5. Natural selection and cultural rates of change.

    Science.gov (United States)

    Rogers, Deborah S; Ehrlich, Paul R

    2008-03-04

    It has been claimed that a meaningful theory of cultural evolution is not possible because human beliefs and behaviors do not follow predictable patterns. However, theoretical models of cultural transmission and observations of the development of societies suggest that patterns in cultural evolution do occur. Here, we analyze whether two sets of related cultural traits, one tested against the environment and the other not, evolve at different rates in the same populations. Using functional and symbolic design features for Polynesian canoes, we show that natural selection apparently slows the evolution of functional structures, whereas symbolic designs differentiate more rapidly. This finding indicates that cultural change, like genetic evolution, can follow theoretically derived patterns.

  6. Culture, Personality, Health, and Family Dynamics: Cultural Competence in the Selection of Culturally Sensitive Treatments

    Science.gov (United States)

    Sperry, Len

    2010-01-01

    Cultural sensitivity and cultural competence in the selection of culturally sensitive treatments is a requisite for effective counseling practice in working with diverse clients and their families, particularly when clients present with health issues or medical problems. Described here is a strategy for selecting culturally sensitive treatments…

  7. CHANGING ORGANIZATIONAL CULTURE IN A ROMANIAN COMPANY

    Directory of Open Access Journals (Sweden)

    CRIVEANU Maria Magdalena

    2016-08-01

    Full Text Available The focus on studying the issue of change, migrated from the attention towards western countries, struggling with the growing spread of globalization, which affects all the changes in the environment, to the former socialist countries of Central and Eastern Europe, which have undergone dramatic changes since 1989. The most disturbing event was the transition from the centralized economy system to the market economy system, which led to a series of mutations at both psychological and organizational level. In this context, this article aims to identify both the dominant type of culture in the largest retail company in Romania and the dominant type of culture in other similar companies. This research project aims at studying the culture and its specificity within the company, but also its impact on society and on the organization. The issue at stake is a retail company in Romania, in which we tried to identify the dominant culture within the company and culture desired by its employees. We also conducted a parallel between the culture type identified in the Romanian company and the type of culture identified in other companies. The research results can be a starting point for the manager charged with change, as he can easily identify discrepancies between the dominant culture and culture desired by employees

  8. Creating a culture for health care quality and safety.

    Science.gov (United States)

    Roberts, Velma; Perryman, Martha M

    2007-01-01

    Approximately 67% of hospital quality indicators require some type of laboratory testing to monitor compliance. Unfortunately, in many hospitals, laboratory data information systems remain an untapped resource in eliminating medical errors and improving patient safety. Using case scenarios, this article demonstrates potential consequences for patient safety and quality of care when information sharing between medical technologists and nurses is not a part of a hospital's culture. The outcome for this patient could have been avoided if a more inclusive health care quality and safety culture existed. Creating a culture for health care quality and safety requires consensus building by clinical and administrative leaders. Consensus building occurs by managing relationships among and between a team of independent, autonomous physicians, nurses, allied health professionals, and health care administrators. These relationships are built on mutual respect and effective communication. Creating a quality culture is a challenging but necessary prerequisite for eliminating medical errors and ensuring patient safety. Physician leaders promoting and advancing cultural change in clinical care from one of exclusive decision making authority to a culture that is based on shared decision making are a necessary first step. Shared decision making requires mutual respect, trust, confidentiality, responsiveness, empathy, effective listening, and communication among all clinical team members. Physician and administrative leaders with a focus on patient safety and a willingness to change will ensure a culture of health care quality and safety.

  9. Global health language and culture competency.

    Science.gov (United States)

    Beadling, Charles; Maza, John; Nakano, Gregg; Mahmood, Maysaa; Jawad, Shakir; Al-Ameri, Ali; Zuerlein, Scott; Anderson, Warner

    2012-01-01

    This article presents findings from a survey conducted to examine the availability of foreign language and culture training to Civil Affairs health personnel and the relevance of that training to the tasks they perform. Civil Affairs forces recognize the value of cross-cultural communication competence because their missions involve a significant level of interaction with foreign governments? officials, military, and civilians. Members of the 95th Civil Affairs Brigade (Airborne) who had a health-related military occupational specialty code were invited to participate in the survey. More than 45% of those surveyed were foreign language qualified. Many also received predeployment language and culture training specific to the area of deployment. Significantly more respondents reported receiving cultural training and training on how to work effectively with interpreters than having received foreign language training. Respondents perceived interpreters as important assets and were generally satisfied with their performance. Findings from the survey highlight a need to identify standard requirements for predeployment language training that focuses on medical and health terminology and to determine the best delivery platform(s). Civil Affairs health personnel would benefit from additional cultural training that focuses on health and healthcare in the country or region of deployment. Investing in the development of distance learning capabilities as a platform for delivering health-specific language and culture training may help ease the time and resources constraints that limit the ability of Civil Affairs health personnel to access the training they need.

  10. Cultural diversity in adolescent health care.

    Science.gov (United States)

    Bennett, David L; Chown, Peter; Kang, Melissa S-L

    2005-10-17

    In Australia, where about 16% of young people are born overseas and 24% are from a non-English-speaking background, adolescent health care is a multicultural challenge. "Cultural competency" involves challenging one's own cultural assumptions and beliefs, developing empathy for people from other cultures, and applying specific communication and interaction skills in clinical encounters. For health professionals, sensitivity to the cultural, ethnic, linguistic and social diversity among young people helps to avert problems and misunderstandings, improves satisfaction for all concerned and leads to better outcomes. Engaging the family and gaining the trust of parents is critical in treating young people from cultural backgrounds in which participation in health care is a family concern rather than an individual responsibility.

  11. Culturally Sensitive Refugee Mental Health Training Programs.

    Science.gov (United States)

    Minnesota Univ., Minneapolis. Refugees Assistance Program - Mental Health Technical Assistance Center.

    This report, based on a survey conducted during the summer and fall of 1986, identifies culturally sensitive training programs for professionals, paraprofessionals, and others who provide mental health services to refugees. An introductory section discusses the language, cultural, racial, experiential, and socioeconomic factors of refugee mental…

  12. Organisational culture and change: implementing person-centred care.

    Science.gov (United States)

    Carlström, Eric D; Ekman, Inger

    2012-01-01

    The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person-centred care (PCC) for patients with chronic heart failure. Surveys were sent out to 170 nurses. The survey included two instruments--the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC). The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well-defined framework. An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes. Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units--i.e. the health workers in different hospital wards--was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.

  13. Cultural competence in correctional mental health.

    Science.gov (United States)

    Kapoor, Reena; Dike, Charles; Burns, Craig; Carvalho, Vinneth; Griffith, Ezra E H

    2013-01-01

    Cultural competence is an essential aspect of competence as a mental health professional. In this article, the framework of cultural competence developed in general psychiatry-acquiring knowledge, attitudes, and skills necessary to understand the interaction between culture and the individual-is applied to the prison setting. Race and ethnicity, extremes of age, gender, and religion are highlighted and examined as elements of the overall culture of prisons. The model of the cultural formulation from the DSM-IV is then adapted for use by clinicians in the correctional setting, with particular emphasis on the interaction between the inmate's culture of origin and the unique culture of the prison environment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Changing the Culture at CERN

    CERN Multimedia

    2002-01-01

    'Change at CERN' is a major theme of the Management's draft Mid-Term plan that Director General, Luciano Maiani, presented to the staff on 4 April. One important change is to encourage more openness and better communication between the different sectors at CERN. For its part, the Bulletin is beginning a series of articles about the proposals presented in the draft plan. This week we begin with one aspect of Industrial Services. Future articles will cover the work of all the Task Forces, including such topics as the restructuring of the Accelerator Sector, Locally Recruited Staff, and Earned Value reporting. If you have any proposals for topics that you would like to see on these pages please send your suggestions via the form on the Users' Web Page, 'Suggestions for Change'.

  15. Cultural Synergy and Organizational Change

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig; Vogt, Joachim

    2013-01-01

    This paper explores informal codes and rhythms of social behavior at work and their relation to organizational change and wellbeing. After a merger within a public service organization we organized 8 focus groups of 2-3 clerical or academic employees within a head office and a division office (N...

  16. Our Cultures Are Our Source of Health

    Centers for Disease Control (CDC) Podcasts

    2013-03-04

    Wes Studi, Hollywood actor, highlights the wisdom of cultural knowledge to promote health and prevent type 2 diabetes.  Created: 3/4/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/4/2013.

  17. Toward a multidimensional understanding of culture for health interventions.

    Science.gov (United States)

    Asad, Asad L; Kay, Tamara

    2015-11-01

    Although a substantial literature examines the relationship between culture and health in myriad individual contexts, a lack of comparative data across settings has resulted in disparate and imprecise conceptualizations of the concept for scholars and practitioners alike. This article examines scholars and practitioners' understandings of culture in relation to health interventions. Drawing on 169 interviews with officials from three different nongovernmental organizations working on health issues in multiple countries-Partners in Health, Oxfam America, and Sesame Workshop-we examine how these respondents' interpretations of culture converge or diverge with recent developments in the study of the concept, as well as how these understandings influence health interventions at three different stages-design, implementation, and evaluation-of a project. Based on these analyses, a tripartite definition of culture is built-as knowledge, practice, and change-and these distinct conceptualizations are linked to the success or failure of a project at each stage of an intervention. In so doing, the study provides a descriptive and analytical starting point for scholars interested in understanding the theoretical and empirical relevance of culture for health interventions, and sets forth concrete recommendations for practitioners working to achieve robust improvements in health outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Demystifying and improving organizational culture in health-care.

    Science.gov (United States)

    Pellegrin, Karen L; Currey, Hal S

    2011-01-01

    Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.

  19. Mergers and acquisitions: some implications of cultural change.

    Science.gov (United States)

    Cavanaugh, S J

    1996-01-01

    A result of recent National Health Service reforms is the need to investigate, and possibly change, the culture of the professional working relationship between members of staff and their employer. This is particularly the case in situations of mergers and acquisitions where staff working from different cultural environments must work together. Mergers are becoming a feature of health service provision, perhaps this becomes most obvious with the recent moves by colleges of nursing and midwifery into the higher education sector and amalgamations of some purchasing authorities. Mergers highlight the practical issues of bringing together different organizational and work cultures to deliver a high quality service. This article discusses some aspects of the nature of organizational culture, the human impact of mergers and acquisitions and offers strategies for managing these events.

  20. Climate change, conflict and health.

    Science.gov (United States)

    Bowles, Devin C; Butler, Colin D; Morisetti, Neil

    2015-10-01

    Future climate change is predicted to diminish essential natural resource availability in many regions and perhaps globally. The resulting scarcity of water, food and livelihoods could lead to increasingly desperate populations that challenge governments, enhancing the risk of intra- and interstate conflict. Defence establishments and some political scientists view climate change as a potential threat to peace. While the medical literature increasingly recognises climate change as a fundamental health risk, the dimension of climate change-associated conflict has so far received little attention, despite its profound health implications. Many analysts link climate change with a heightened risk of conflict via causal pathways which involve diminishing or changing resource availability. Plausible consequences include: increased frequency of civil conflict in developing countries; terrorism, asymmetric warfare, state failure; and major regional conflicts. The medical understanding of these threats is inadequate, given the scale of health implications. The medical and public health communities have often been reluctant to interpret conflict as a health issue. However, at times, medical workers have proven powerful and effective peace advocates, most notably with regard to nuclear disarmament. The public is more motivated to mitigate climate change when it is framed as a health issue. Improved medical understanding of the association between climate change and conflict could strengthen mitigation efforts and increase cooperation to cope with the climate change that is now inevitable. © The Royal Society of Medicine.

  1. Exhibiting health and medicine as culture

    DEFF Research Database (Denmark)

    Bencard, Adam; Tybjerg, Karin; Whiteley, Louise;

    2017-01-01

    This paper discusses the potential role of medical museums in public engagement with health and medicine, based in the work of Medical Museion at the University of Copenhagen. Rather than asking if cultural venues such as museums can directly improve the wellbeing of their visitors, we instead...... focus on how museums should communicate about health and medicine. There is increasing emphasis on the need for health communication to recognize peoples’ multiple, lived cultures. We argue that we should also recognize that medical research and practice is itself a form of culture......, and as such is multiple and historically shifting. We suggest that museums are an ideal site for doing so, and can thereby contribute to public engagement with medicine that acknowledges multiplicity on both sides. The paper describes three examples of exhibitions at Medical Museion that attempt to display medicine...

  2. Culture, Urbanism and Changing Human Biology

    OpenAIRE

    Schell, L M

    2014-01-01

    Anthropologists have long known that human activity driven by culture changes the environment. This is apparent in the archaeological record and through the study of the modern environment. Perhaps the largest change since the paleolithic era is the organization of human populations in cities. New environments can reshape human biology through evolution as shown by the evolution of the hominid lineage. Evolution is not the only process capable of reshaping our biology. Some changes in our hum...

  3. New salary system supports changing culture.

    Science.gov (United States)

    Esquibel, O; Ning, J; Sugg, J

    1990-10-01

    Changing job classification, salary administration and benefits programs for the sake of change can create considerable problems in an organization. However, as the organizational culture changes, these HR systems need to adjust to help the process. Associate involvement requires considerable planning, time and effort, but the results often prove worthwhile. As the company moves into the future, this involvement process or something similar will help shape other human resource programs.

  4. 'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health.

    Science.gov (United States)

    Harper, S L; Edge, V L; Cunsolo Willox, A

    2012-03-01

    Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

  5. Cultural adaptations to augment health and mental health services: a systematic review.

    Science.gov (United States)

    Healey, Priscilla; Stager, Megan L; Woodmass, Kyler; Dettlaff, Alan J; Vergara, Andrew; Janke, Robert; Wells, Susan J

    2017-01-05

    Membership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery. MEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients. Thirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider's behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group. Conceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies

  6. Culture Change from Tobacco Accommodation to Intolerance: Time to Connect the Dots

    Science.gov (United States)

    Livingood, William C., Jr.; Allegrante, John P.; Green, Lawrence W.

    2016-01-01

    Broad changes in normative health behavior are critical to overcoming many of the contemporary challenges to public health. Reduction in tobacco use during the last third of the 20th century--one of the greatest improvements in public health--illustrates such change. The culture change from accommodation to intolerance of smoking is irrefutable.…

  7. Real-Time Culture Change Improves Lean Success: Sequenced Culture Change Gets Failing Grades.

    Science.gov (United States)

    Kusy, Mitchell; Diamond, Marty; Vrchota, Scott

    2015-01-01

    Success with the Lean management system is rooted in a culture of stakeholder engagement and commitment. Unfortunately, many leaders view Lean as an "add-on" tool instead of one that requires a new way of thinking and approaching culture. This article addresses the "why, how, and what" to promote a Lean culture that works. We present a five-phased approach grounded in evidence-based practices of real-time culture change. We further help healthcare leaders understand the differences between traditional "sequenced" approaches to culture change and "real-time" methods--and why these real-time practices are more sustainable and ultimately more successful than traditional culture change methods.

  8. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation.

    Science.gov (United States)

    Wight, Daniel; Plummer, Mary; Ross, David

    2012-09-14

    Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief), economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action - but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change.

  9. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

    Directory of Open Access Journals (Sweden)

    Wight Daniel

    2012-09-01

    Full Text Available Abstract Background Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief, economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change.

  10. Cultural Change, Human Activity, and Cognitive Development

    Science.gov (United States)

    Gauvain, Mary; Munroe, Robert L.

    2012-01-01

    Differential cognitive performance across cultural contexts has been a standard result in comparative research. Here we discuss how societal changes occurring when a small-scale traditional community incorporates elements from industrialized society may contribute to cognitive development, and we illustrate this with an analysis of the cognitive…

  11. Cultural Change, Human Activity, and Cognitive Development

    Science.gov (United States)

    Gauvain, Mary; Munroe, Robert L.

    2012-01-01

    Differential cognitive performance across cultural contexts has been a standard result in comparative research. Here we discuss how societal changes occurring when a small-scale traditional community incorporates elements from industrialized society may contribute to cognitive development, and we illustrate this with an analysis of the cognitive…

  12. Health Effects of Climate Change

    Science.gov (United States)

    ... resulting health effects. Extreme weather events due to climate change may cause people to experience geographic displacement, damage to their property, loss of loved ones, and chronic stress—all of which can negatively affect ... change may be associated with staple food shortages, malnutrition, ...

  13. Leading change in diversity and cultural competence.

    Science.gov (United States)

    de Leon Siantz, Mary Lou

    2008-01-01

    This article describes an expanded leadership role needed in schools of nursing as the nurse of the 21st century is prepared to assume expanded roles in a diverse society. With schools of nursing becoming more global, and the diverse population of the United States rapidly growing, a critical need exists for nurses who are ready to partner in the health care that multicultural communities need locally, nationally, and globally. Diversity and cultural competence have now become central issues in nursing education, research, practice, and health policy. Diversity leadership in a school of nursing can no longer concentrate only on issues of affirmative action, recruitment, and retention. The purpose of this article is to discuss how diversity leadership must increasingly focus on building a corporate environment in schools of nursing that integrates diversity and cultural competence with the strategic plan of the School's Chief Nursing Officer, across academic programs, research, practice, and public policy to eliminate health disparities in partnership with faculty, students, staff, the University infrastructure, and the community at large. The theoretical framework that guided the strategic planning is based on the model used by the Robert Wood Johnson Executive Nurse Fellowship Program. Examples of program initiatives designed to implement the strategic plan to strengthen the diversity and cultural competence of one school of nursing environment are described.

  14. Climate Change and Human Health

    Directory of Open Access Journals (Sweden)

    Jan C. Semenza

    2014-07-01

    Full Text Available Climate change impacts on human health span the trajectory of time—past, present, and future. The key finding from the Working Group II, Fifth Assessment Report (AR5 of the Intergovernmental Panel on Climate Change (IPCC states that health impacts due to climate change have already occurred in the past, are currently occurring and will continue to occur, at least for the foreseeable future, even with immediate reductions in greenhouse gas emissions [1]. According to the IPCC, there has been increased heat-related mortality and decreased cold-related mortality in some regions as a result of warming (Box 1. Moreover, local changes in temperature and rainfall have altered the distribution of some water-borne illnesses and disease vectors. Impacts of climate-related extremes include alteration of ecosystems, disruption of food production and water supply, damage to infrastructure and settlements, morbidity and mortality, and consequences for mental health and human well-being [1]. [...

  15. Culture Negative Infective Endocarditits: a Changing Paradigm

    LENUS (Irish Health Repository)

    Daly, A

    2016-05-01

    Traditionally, the modified Duke\\'s criteria, based primarily on positive blood cultures, is used to diagnose Infective Endocarditis (IE). However, reports demonstrate that 31% of cases are diagnosed as Culture Negative Infective Endocarditis (CNIE)1. Consequently, empiric broad-spectrum antibiotics are prescribed to cover unidentified organisms and, as a result, antibiotic therapy may be compromised. Molecular diagnostic techniques aid with identifying causative organisms in cases of CNIE and we question if the increasing use of such technologies will change the local epidemiology of CNIE. We present the first case of Tropheryma whipplei Infective Endocarditis (TWIE) reported in Ireland.

  16. Culture-based literacy and Aboriginal health.

    Science.gov (United States)

    Smylie, Janet; Williams, Lewis; Cooper, Nancy

    2006-01-01

    This is a summary report of the Aboriginal content of the Language and Culture theme at the Canadian Public Health Association's Second Canadian Conference on Literacy and Health. Our key premise is that Indigenous conceptualizations of literacy need to build on Indigenous understandings and perspectives. We support this premise through a review of the relevant literature in the disciplines of Aboriginal literacy, Indigenous education, health literacy, health promotion, and knowledge translation and our synthesis of the presentations, workshops, and discussions at the meeting. Key emergent themes include: the unique and culturally determined ways in which Aboriginal peoples and their languages conceptualize learning, education, and health; and the recognition that self-determination of language and learning are human rights. Aboriginal concepts of and approaches to literacy naturally link to and overlap with Aboriginal concepts of and approaches to health. The paper includes an overview of gaps in the field and an example of the way that research and practice can be brought together in the context of one First Nations community.

  17. Interdisciplinary: Cultural competency and culturally congruent education for millennials in health professions.

    Science.gov (United States)

    Hawala-Druy, Souzan; Hill, Mary H

    2012-10-01

    The increasingly diverse multicultural and multigenerational student population in the United States requires that educators at all levels develop cultural knowledge, awareness, and sensitivity to help diverse learners fulfill their potential and to avoid cultural misunderstandings that can become obstacles or barriers to learning. The purpose of this study was to design and implement eclectic, creative, evidence-based interdisciplinary educational activities, along with culturally congruent teaching strategies, within a semester-long university course that promoted positive and culturally competent learning outcomes for culturally diverse, largely millennial students. The interdisciplinary course would prepare health professional students with the requisite knowledge and skills, through transformative learning that produces change agents, to provide culturally congruent and quality team-based care to diverse populations. This was a qualitative and quantitative study, which measured students' level of cultural awareness, competence, and proficiency pre and post the educational intervention. Instruments used for data collection included the Inventory for Assessing The Process of Cultural Competence-Student Version (IAPCC-SV) by Campinha-Bacote, course evaluations, students' feedback, and portfolio reflections. The study was conducted at a private academic institution located in the Mid-Atlantic region and the sample population included inter-professional students (N=106) from various health professions including nursing, pharmacy, and allied health sciences. Results from the pre- and post-test IAPCC-SV survey revealed that mean scores increased significantly from pre-test (60.8) to post-test (70.6). Thus, students' levels of cultural competency (awareness, knowledge, skills, desire, encounter) improved post-educational intervention, indicating that the teaching methods used in the course might be applied on a larger scale across the university system to cater to the

  18. Folk Beliefs of Cultural Changes in China

    Directory of Open Access Journals (Sweden)

    Yi eXu

    2014-09-01

    Full Text Available For the last several decades, Chinese society has experienced transformative changes. How are these changes understood among Chinese people? To examine this question, Part 1 in this research solicited folk beliefs of cultural change from a group of Chinese participants in an open-ended format, and the generated folk beliefs were rated by another group of participants in Part 2 to gauge each belief’s level of agreement. Part 3 plotted the folk beliefs retained in Part 2 using the Google Ngram Viewer in order to infer the amount of intellectual interests that each belief has received cross-temporarily. These analyses suggested a few themes in Chinese folk beliefs of cultural change (1 rising perceived importance of materialism and individualism in understanding contemporary Chinese culture and Chinese psychology relative to those of the past (2 rising perceived importance of freedom, democracy and human rights and (3 enduring perceived importance of family relations and friendship as well as patriotism. Interestingly, findings from Parts 2 and 3 diverged somewhat, illuminating possible divergence between folk beliefs and intellectual interests especially for issues related to heritage of Confucianism.

  19. Folk beliefs of cultural changes in China.

    Science.gov (United States)

    Xu, Yi; Hamamura, Takeshi

    2014-01-01

    For the last several decades, Chinese society has experienced transformative changes. How are these changes understood among Chinese people? To examine this question, Part 1 in this research solicited folk beliefs of cultural change from a group of Chinese participants in an open-ended format, and the generated folk beliefs were rated by another group of participants in Part 2 to gage each belief's level of agreement. Part 3 plotted the folk beliefs retained in Part 2 using the Google Ngram Viewer in order to infer the amount of intellectual interests that each belief has received cross-temporarily. These analyses suggested a few themes in Chinese folk beliefs of cultural change (1) rising perceived importance of materialism and individualism in understanding contemporary Chinese culture and Chinese psychology relative to those of the past (2) rising perceived importance of freedom, democracy and human rights and (3) enduring perceived importance of family relations and friendship as well as patriotism. Interestingly, findings from Parts 2 and 3 diverged somewhat, illuminating possible divergence between folk beliefs and intellectual interests especially for issues related to heritage of Confucianism.

  20. Changes In Growth Culture FDA Activity Under Changing Growth Conditions

    DEFF Research Database (Denmark)

    Jørgensen, Per Elberg; Eriksen, Thomas Juul; Jensen, Bjørn K.

    1992-01-01

    of the bacteria. The FDA activity/ATP ratio was calculated for different concentrations of autoclaved sludge. A faster decay rate of ATP relative to FDA hydrolysis activity was observed, thus causing changes in the ratio. Furthermore, comparison between values obtained from pure cultures and different soils...

  1. Development of a culture of sustainability in health care organizations.

    Science.gov (United States)

    Ramirez, Bernardo; West, Daniel J; Costell, Michael M

    2013-01-01

    This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document. This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence. With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities. Further empirical research needs to be conducted on these interrelated innovative topics. Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability. The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability. Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

  2. Cultural Journalism and Cultural Critique in a changing Media Landscape

    DEFF Research Database (Denmark)

    Nørgaard Kristensen, Nete; From, Unni

    2015-01-01

    This special issue addresses a topic of journalism studies that has previously been somewhat neglected but which has gained increasing scholarly attention since the mid-2000s: the coverage and evaluation of art and culture, or what we term “cultural journalism and cultural critique.......” In this introduction, we highlight three issues that serve to frame the study of cultural journalism and cultural critique more generally and the eight articles of this special issue more specifically: (1) the constant challenge of demarcating cultural journalism and cultural critique, including the interrelations...... of “journalism” and “critique”; (2) the dialectic of globalisation’s cultural homogenisation, on the one hand, and the specificity of local/national cultures, on the other; and (3) the digital media landscape seen in terms of the need to rethink, perhaps even redefine cultural journalism and cultural critique...

  3. Health and Borders across Time and Cultures: Introduction

    Directory of Open Access Journals (Sweden)

    Beatriz Carrillo Garcia

    2011-12-01

    Full Text Available This special issue of Portal brings together papers examining the intersection of health and borders. In this analysis health is understood not only as the absence of illness, but also as knowledge, as a right, and as the pursuit of identity and self-transformation. Similarly, borders here are used as both physical and mental constructs. The special issue represent a multidisciplinary effort that looks at health from a social science perspective through historical, socio-economic, and cultural approaches. It is also concerned with the health inequities across and within national borders, due to economic imperatives, changing technologies and environments. The articles in this special issue explore lessons learned and new ways of understanding health across time and borders, with specific reference to the cases of India, Australia, Hong Kong and China, Pakistan, and Thailand.

  4. [Demographic changes and health management].

    Science.gov (United States)

    Calero, Juan del Rey

    2006-01-01

    Since our Constitution declaration in 1978 and General Law for Health in 1986, to date, the Spanish society has undergorne marked social changes. Socio-economic and health indicators in Spain have also improved as to an increased life expectancy, important reduction in infant mortality, and favourable changes reported in the national Health Survey. Risk factors influence the main causes of death, thus it is said that "man does not die but it kills himself". Healthy health practices are specified, and there is empirical evidence of greater disability-adjusted life years, a better adherence to Mediterranean diet, no smoking, moderate consumption of alcohol, enough time of sleeping, weight control, avoiding obsity and overweight, and increased physical activity, all the above practices achieving a healthier life. At a global scale in the world we live, famine has no frontiers, and fighting against this plague can not await longer. Overall, health and poverty are correlated and it must be overcome for reasons of human dignity, universal rights (even in ius gentium), and ethical dimension as normative of new socio-economic structures. Present must be transformed to recover hope in ou global world, still hungry, and in need of justice, enlightenment and solidarity.

  5. Migrants and health: a cultural dilemma.

    Science.gov (United States)

    Eshiett, Michael U A; Parry, Eldryd H O

    2003-01-01

    Culture profoundly affects what those who come to the UK as migrants believe about disease and thus how they behave during illness. Their beliefs may be very different from the beliefs of healthcare professionals and so there can be difficulties in understanding and barriers which inhibit effective clinical management. The behaviour of healthcare professionals towards those of a different race can lead to feelings of discrimination and lack of sympathy, so that a gulf can be allowed to develop. This gulf can be bridged if simple measures are adopted: training in communication, culturally sensitive health-promotion programmes, specific programmes relevant for those of defined ethnic groups and, as a basic means to increase confidence and trust, elementary skills in the language of the migrants.

  6. [Health culture in the Statute of Lastovo].

    Science.gov (United States)

    Milovic Karic, Grozdana; Milovic, Dorde

    2013-01-01

    The aim of this article was to define the elements of health culture in the Statute of Lastovo, from its declaration in 1310 to amendments made in the 18th century. The source we used was a recently published translation of the Statute from Latin, in which we identified the lawmaker's stipulations directly or indirectly related to public health of the times. The Statute stipulates several preventive measures to keep plague at bay and to control it if it breaks out. Stipulations on communal slaughterhouses and fish markets, even if not directly intended to address healthcare issues, brought a definite improvement to public hygiene and sanitation. Penal provisions for the perpetrators included death, whipping, branding, cutting fingers off, standing on logs, and pillorying. The article concludes that even though the Statute of Lastovo is quite comprehensive and voluminous, it does not give much space to health culture, in fact, even less space than other Medieval statutes of towns along the east coast of the Adriatic.

  7. Organisational culture: pursuing a theoretical foundation within the Finnish public oral health-care context.

    Science.gov (United States)

    Kasila, Kirsti; Poskiparta, Marita

    2004-01-01

    At the moment, Finnish oral health care is undergoing many changes. Little attention has been paid to issues of organisational culture and communication in Finnish oral health care. Yet the question of culture is of primary importance for changes in an organisation and for planning and reconstructing the rational functioning of an organisation. The purpose of this paper is to examine Finnish public oral health care within a theoretical framework of organisational culture and to identify the various cultural traits that appear to characterise Finnish oral health care. Using a cultural point of view, we develop an orientation for understanding more profoundly and specifically the processes concerning the functioning and change of oral health care.

  8. Climate and culture Changes, lessons, and challenges

    Directory of Open Access Journals (Sweden)

    Yunita T. Winarto

    2010-10-01

    Full Text Available From generation to generation over the centuries, people in all parts of the world have developed adaptive social-cultural institutions and strategies of natural resource management based on the intimate relationship they had with their environment. At present, recent global warming is threatening people’s lives. Unfortunately, climate change is a natural phenomenon which is neither easy to observe, nor to predict and anticipate accurately. In many places, local people can no longer rely on earlier experiences and existing socio-cultural institutions to adjust to unprecedented changes. We are in urgent need of specific efforts to re-interpret and enrich our knowledge of this natural phenomenon. However, this is not an easy thing to do. People from all kinds of levels and entities in society are simultaneously the cause and the victims of global warming. The problem becomes even more complicated because of various mutually-affecting dimensions like ethics, politics, power, economics, and justice. These are the ultimate challenges scholars of the social sciences and humanities need to address seriously everywhere in the world, including in Indonesia. This article addresses the arguments of what scholars in the social sciences and humanities could and should do in response to climate change. Promoting a new paradigm and ethics in dealing with climate change is urgent and improvements in approaches and research methodologies are necessary. Learning from experiences gained from the way farmers in Java respond to climate change, the author argues that interdisciplinary research across social and natural sciences, and collaborative work with target groups is a promising and significant step (although scholars will have to face many challenges and constraints.

  9. [Primary health care reform and implications for the organizational culture of Health Center Groups in Portugal].

    Science.gov (United States)

    Leone, Claudia; Dussault, Gilles; Lapão, Luís Velez

    2014-01-01

    The health sector's increasing complexity poses major challenges for administrators. There is considerable consensus on workforce quality as a key determinant of success for any health reform. This study aimed to explore the changes introduced by an action-training intervention in the organizational culture of the 73 executive directors of Health Center Groups (ACES) in Portugal during the primary health care reform. The study covers two periods, before and after the one-year ACES training, during which the data were collected and analyzed. The Competing Values Framework allowed observing that after the ACES action-training intervention, the perceptions of the executive directors regarding their organizational culture were more aligned with the practices and values defended by the primary health care reform. The study highlights the need to continue monitoring results over different time periods to elaborate further conclusions.

  10. Changing the Culture of Alcohol Abuse on Campus: Lessons Learned from Secondhand Smoke

    Science.gov (United States)

    Misch, Donald A.

    2010-01-01

    Alcohol abuse is the single greatest public health hazard on American college and university campuses, but the culture of abusive alcohol consumption continues to be highly resistant to change. The author argues that secondhand smoke campaigns can be used as models to change the culture of alcohol abuse on campus. He proposes the implementation of…

  11. Changing the Culture of Alcohol Abuse on Campus: Lessons Learned from Secondhand Smoke

    Science.gov (United States)

    Misch, Donald A.

    2010-01-01

    Alcohol abuse is the single greatest public health hazard on American college and university campuses, but the culture of abusive alcohol consumption continues to be highly resistant to change. The author argues that secondhand smoke campaigns can be used as models to change the culture of alcohol abuse on campus. He proposes the implementation of…

  12. Cultural Journalism and Cultural Critique in a changing Media Landscape

    DEFF Research Database (Denmark)

    Nørgaard Kristensen, Nete; From, Unni

    2015-01-01

    This special issue addresses a topic of journalism studies that has previously been somewhat neglected but which has gained increasing scholarly attention since the mid-2000s: the coverage and evaluation of art and culture, or what we term “cultural journalism and cultural critique...

  13. Future health: coping with change.

    Science.gov (United States)

    Zaini, A; Nayan, Noor Fadhilah Mat

    2002-01-01

    WHO's Declaration of the "Health for All" (HFA) goal was pronounced in 1978 in Alma Ata, and it was planned that HFA would be achieved through primary health care programmes and approaches by 2000. However, it is now 2002 and despite the technological advancements in medicine, science, and ICT, Health for All is far from reality. Instead, more and more conflicts are emerging with lethal consequences, such as, bioterrorism, biological agent abuse, global-terrorism, and environmental destruction is occurring at a greater scale that we have witnessed before. We may have the latest technology and knowledge today, but ironically, we are using them to inflict more suffering and pain in the world. In the Asia-Pacific, the past 30 years has seen dramatic advancement and lifestyle changes. We are now paying a high price for such progress in terms of risk factors to the health of the population, such as, ageing diseases, obesity, smoking, diabetes, hypertension, and related conditions. The social, political, economic and environmental factors appeared to have deterred and negated WHO's HFA goal to attain basic human rights and health care for all. The HFA will not be achieved in the future if we do not learn from history and start taking measures now.

  14. Cultural change and support of waste minimization

    Energy Technology Data Exchange (ETDEWEB)

    Boylan, M.S. [EG and G Idaho, Inc., Idaho Falls, ID (United States). Idaho National Engineering Lab.

    1991-12-31

    The process of bringing a subject like pollution prevention to top of mind awareness, where designed to prevent waste becomes part of business as usual, is called cultural change. With Department of Energy orders and management waste minimization commitment statements on file, the REAL work is just beginning at the Idaho National Engineering Laboratory (INEL); shaping the attitudes of 11,000+ employees. The difficulties of such a task are daunting. The 890 square mile INEL site and in-town support offices mean a huge diversity of employee jobs and waste streams; from cafeteria and auto maintenance wastes to high-level nuclear waste casks. INEL is pursuing a three component cultural change strategy: training, publicity, and public outreach. To meet the intent of DOE orders, all INEL employees are slated to receive pollution prevention orientation training. More technical training is given to targeted groups like purchasing and design engineering. To keep newly learned pollution prevention concepts top-of-mind, extensive site-wide publicity is being developed and conducted, culminating in the April Pollution Prevention Awareness Week coinciding with Earth Day 1992. Finally, news of INEL pollution prevention successes is shared with the public to increase their overall environmental awareness and their knowledge of INEL activities. An important added benefit is the sense of pride the program instills in INEL employees to have their successes displayed so publicly.

  15. The culture of criticism and argument in health education.

    Science.gov (United States)

    Westwood, Barbara; Westwood, Geoffrey

    2002-03-01

    A programme to introduce skills in critical analytical reading and writing in postgraduate tertiary students in Public Health Management is described. The students had considerable professional experience, but their previous academic learning did not require a critical-analytical approach. The ability to review and analyse past theory and practice and to critically analyse and evaluate public health programmes is an essential element of the skills required by graduates. The paper describes and discusses the teaching and learning strategies used in critical analysis sessions. The personal and systemic barriers to achieving substantial change in cultures of learning are reviewed. As a limited response to a perceived problem, significant changes in the ability of students to critically analyse published material and write appropriate essays were achieved. The value of critical analysis in public health is described and the implication for medical education at all levels is considered.

  16. CANCER PATIENT’S EXPERIENCE CROSSING THE HEALTH CULTURE

    Directory of Open Access Journals (Sweden)

    Maura G. Felea

    2014-12-01

    Full Text Available Cognitive anthropology does not predict human behavior, but tries to access principles that rule behavior. Cross-cultural communication is a skill acquired through a learning process, and it can improve doctor-patient relationship and enhance the outcomes of care. The unfulfilled expectations of a patient may influence the patient self-esteem and his perceived role in the society. For some patients living with cancer, it was found as an unforeseen benefit of learning to be closer to God. Based on a narrative communication, we tried to underline cross-cultural differences in cancer patients from different countries with various backgrounds. We described the patient reactions, his way of interpreting the things that happened to him, and his actions regarding adaptive changes in behavior. The originality of the study resides in understanding cross-cultural patterns of cancer patients. The innovative element is the use of qualitative research and its application in health care.

  17. A qualitative study of the cultural changes in primary care organisations needed to implement clinical governance.

    Science.gov (United States)

    Marshall, Martin; Sheaff, Rod; Rogers, Anne; Campbell, Stephen; Halliwell, Shirley; Pickard, Susan; Sibbald, Bonnie; Roland, Martin

    2002-08-01

    It is commony claimed that changing the culture of health organisations is a fundamental prerequisite for improving the National Health Service (NHS). Little is currently known about the nature or importance of culture and cultural change in primary care groups and trusts (PCG/Ts) or their constituent general practices. To investigate the importance of culture and cultural change for the implementation of clinical governance in general practice by PCG/Ts, to identify perceived desirable and undesirable cultural attributes of general practice, and to describe potential facilitators and barriers to changing culture. Qualitative: case studies using data derived from semi-structured interviews and review of documentary evidence. Fifty senior non-clinical and clinical managers from 12 purposely sampled PCGs or trusts in England. Senior primary care managers regard culture and cultural change as fundamental aspects of clinical governance. The most important desirable cultural traits were the value placed on a commitment to public accountability by the practices, their willingness to work together and learn from each other, and the ability to be self-critical and learn from mistakes. The main barriers to cultural change were the high level of autonomy of practices and the perceived pressure to deliver rapid measurable changes in general practice. The culture of general practice is perceived to be an important component of health system reform and quality improvement. This study develops our understanding of a changing organisational culture in primary care; however, further work is required to determine whether culture is a useful practical lever for initiating or managing improvement.

  18. Advice on cultural policy matters: changing times for the Council for Culture

    NARCIS (Netherlands)

    Lelieveldt, Philomeen; Minnaert, Toine

    The central question is the changing role of advisory councils in Dutch cultural policy and the subsequent change in discourse on culture and the arts within cultural policy. Our working hypothesis is that the role of the Council for Culture (Raad voor Cultuur), the formal advisory council, is

  19. Designing Work, Family & Health Organizational Change Initiatives.

    Science.gov (United States)

    Kossek, Ellen Ernst; Hammer, Leslie B; Kelly, Erin L; Moen, Phyllis

    2014-01-01

    For decades, leaders and scholars have been advocating change efforts to improve work-life relationships. Yet most initiatives have lacked rigor and not been developed using scientific principles. This has created an evidence gap for employer support of work and personal life as a win-win for productivity and employees' well-being. This paper examines the approach used by the U.S. Work Family Health Network (WFRN) to develop an innovative workplace intervention to improve employee and family health. The change initiative was designed to reduce organizationally based work-family conflict in two contrasting contexts representative of major segments of today's U.S. workforce: health care employees and informational technology professionals. The WFRN Intervention (called STAR) had three theoretically based change elements. They were: 1) increase job control over work time and schedule; 2) increase supervisor social support for family and job effectiveness; and 3) improve organizational culture and job design processes to foster results orientation. Seven practical lessons for developing work-life interventions emerged from this groundbreaking endeavor.

  20. The Culture-Work-Health Model and Work Stress.

    Science.gov (United States)

    Peterson, Michael; Wilson, John F.

    2002-01-01

    Examines the role of organizational culture in the etiology of workplace stress through the framework of the Culture-Work- Health model. A review of relevant business and health literature indicates that culture is an important component of work stress and may be a key to creating effective organizational stress interventions. (SM)

  1. The Culture-Work-Health Model and Work Stress.

    Science.gov (United States)

    Peterson, Michael; Wilson, John F.

    2002-01-01

    Examines the role of organizational culture in the etiology of workplace stress through the framework of the Culture-Work- Health model. A review of relevant business and health literature indicates that culture is an important component of work stress and may be a key to creating effective organizational stress interventions. (SM)

  2. Building a culture of health: A new framework and measures for health and health care in America.

    Science.gov (United States)

    Trujillo, Matthew D; Plough, Alonzo

    2016-09-01

    For generations, Americans' health has been unequally influenced by income, education, ethnicity, and geography. Health care systems have operated largely apart from each other and from community life. The definition of health has been the "absence of illness," rather than the recognition that all aspects of our lives should support health. Today, a growing number of communities, regions, and states are working to redefine what it means to get and stay healthy by addressing the multiple determinants of health. The requirements of federal health care reform are changing who has access to care, how care is paid for and delivered, and how patients and providers interact. Coordinated efforts to promote wellness and prevent diseases are proliferating among a diverse set of stakeholders. These developments in health and in society present a window of opportunity for real societal transformation-a chance to catalyze a national movement that demands and supports a widely shared, multifaceted vision for a Culture of Health. To address this challenge, the Robert Wood Johnson Foundation has embarked on a strategic direction to use the tools of a large national philanthropy to catalyze a social movement which we are calling Building a Culture of Health. This article presents the Foundation's new model for a Culture of Health, the trans-disciplinary research that developed a set of metrics that tie to the model, and the community engagement activities undertaken in the development of both the model and metrics. The model and associated metrics and extensive communication, in addition to partnership, and grant funding strategies, represent a culture change strategy being implemented over 20 years. Addressing underlying inequities in health affirming life conditions and improving social cohesion across diverse groups to take action to improve theses condition lay at the heart of this strategy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Social Change and its Potential Impacts on Chinese Population Health

    Directory of Open Access Journals (Sweden)

    Wang, Hong

    2004-12-01

    Full Text Available Within the past 25 years, China has experienced transformation of its economic system from a highly centralized planned economy toward a market oriented economic system. This process has led to massive and rapid changes in all aspects of society with profound effects on the population’s health in the large parts of the country. Along with the material prosperity, the living conditions of Chinese people, such as food, shelter, and sanitation status, have been improving steadily. People have more capability to purchase health related merchandise as well as health services. Overall the health status of most Chinese has improved but there are significant exceptions to this overall conclusion. These exceptions arise from increasing inequity of income, increases in unemployment rates, the decline of health insurance coverage, changes in demography, changes in social value, culture, health related behaviors, and the changes of health care systems.

  4. Evaluation of the organizational cultural competence of a community health center: a multimethod approach.

    Science.gov (United States)

    Cherner, Rebecca; Olavarria, Marcela; Young, Marta; Aubry, Tim; Marchant, Christina

    2014-09-01

    Cultural competence is an important component of client-centered care in health promotion and community health services, especially considering the changing demographics of North America. Although a number of tools for evaluating cultural competence have been developed, few studies have reported on the results of organizational cultural competence evaluations in health care or social services settings. This article aims to fill this gap by providing a description of a cultural competence evaluation of a community health center serving a diverse population. Data collection included reviewing documents, and surveying staff, management, and the Board of Directors. The organization fully met 28 of 53 standards of cultural competence, partially met 21 standards, and did not meet 2 standards, and 2 standards could not be assessed due to missing information. The advantages and lessons learned from this organizational cultural competence evaluation are discussed. © 2014 Society for Public Health Education.

  5. Culturally Sensitive Health Care and Counseling Psychology: An Overview

    Science.gov (United States)

    Herman, Keith C.; Tucker, Carolyn M.; Ferdinand, Lisa A.; Mirsu-Paun, Anca; Hasan, Nadia T.; Beato, Cristina

    2007-01-01

    This article introduces the Major Contribution, which focuses on counseling psychologists' roles in addressing health disparities through culturally sensitive health care research and interventions. First, the authors provide a rationale for conducting research focused on culturally sensitive health care and then offer definitions of…

  6. Conceptualizing the Role of Culture in Political Change.

    Science.gov (United States)

    Aronoff, Myron J.

    Using as a point of departure anthropologist Clifford Geertz's study of culture with special emphasis on political change, the paper develops a theoretical framework for studying the relationship between culture and political change. A major objective of this anthropological approach to the study of political culture is to help political…

  7. Individual Behavior, Culture, and Social Change

    Science.gov (United States)

    Glenn, Sigrid S.

    2004-01-01

    The principle of operant selection is examined as a prototype of cultural selection, and the role of the social environment is suggested as the critical element in the emergence of cultural phenomena. Operant contingencies are compared to cultural selection contingencies, designated as metacontingencies. Both of these types of contingency…

  8. Cross-cultural School Based Encounters as Health Education

    DEFF Research Database (Denmark)

    Bruselius-Jensen, Maria; Renwick, Kerry; Aagaard-Hansen, Jens

    2016-01-01

    : Qualitative analysis of 18 focus group discussions with 72 Danish and 36 Kenyan students. Results: Cross-cultural dialogues promoted students’ engagement and reflections on their own and peers’ health condition, access to education, food cultures, gender and family structures. Conclusion: Findings indicate......Objective: Drawing on the concepts of the cosmopolitan person and democratic health education, this article explores the merits of primary school–based, cross-cultural dialogues for global health education. Design: A qualitative study of the learning outcomes of the Move|Eat|Learn (MEL) project...... the merits of cross-cultural dialogues as a means of educating students to become global health agents with a cosmopolitan outlook....

  9. Interagency Reform: Changing Organizational Culture through Education and Assignment

    Science.gov (United States)

    2007-03-30

    to focus on the people operating inside the interagency community. That takes changing basic organizational culture using an in-stride method that...capitalizes on two momentous influencers of organizational culture - education and interagency assignments.

  10. Culturally sensitive health counseling to prevent lifestyle-related diseases in Japan.

    Science.gov (United States)

    Marutani, Miki; Miyazaki, Misako

    2010-09-01

    This study explored the methods that are used by public health nurses to provide culturally sensitive health counseling to elderly Japanese farmers in order to motivate them to adopt healthy behaviors. Fourteen elderly farmers (eight men and six women) from three rural communities underwent health counseling and then changed their habits to prevent lifestyle-related diseases. Qualitative and inductive analyses were conducted to determine the effects of the culturally sensitive counseling. Five methods for providing culturally sensitive counseling were identified: (i) showing an interest in, and respect for, the local culture; (ii) stimulating the participants' awareness of the health risks inherited in their local cultural practices through the use of familiar examples; (iii) accepting and understanding the participants' ambivalence about their local culture; (iv) connecting the reasons for the participants to change their lifestyle with their local culture; and (v) adjusting the health-promoting behaviors of the participants to fit their local culture. Public health nurses should consider the pride that elderly farmers have in their background and their resistance to change and use these factors to point out the discrepancies in their lifestyle and promote more quality-of-life-oriented and practical self-care behaviors.

  11. 'Good culture, bad culture': polygyny, cultural change and structural drivers of HIV in Papua New Guinea.

    Science.gov (United States)

    Shih, Patti; Worth, Heather; Travaglia, Joanne; Kelly-Hanku, Angela

    2017-02-16

    Culture is often problematised as a key structural driver of HIV transmission in Papua New Guinea. Official HIV programmes, as well as church teachings, tend to focus on customary marital practices of polygyny and bride price payments as 'harmful traditions'. This focus can oversimplify the effects of current and historical nuances of cultural, political and economic change on sexual concurrency and gender inequality. Community-based healthcare workers in Southern Highlands Province explain that customary marital practices are now highly reconfigured from their traditional forms. A recent mining boom has financially advantaged local and travelling men, who are driving an increase of sexual concurrency, transactional sex and inflation of bride price payments. Healthcare workers suggest that the erosion of important social relationships and kinship obligations by the expanding cash economy has caused an intensification of individual male power while enhancing the vulnerability of women. Yet without the means to challenge the effects of uneven economic development, healthcare workers are left to target 'culture' as the central influence on individual behaviours. A commitment to address structural inequality by political leadership and in HIV prevention programmes and a careful contextualisation of cultural change is needed.

  12. Positive mental health: is there a cross-cultural definition?

    Science.gov (United States)

    Vaillant, George E

    2012-06-01

    SEVEN MODELS FOR CONCEPTUALIZING POSITIVE MENTAL HEALTH ARE REVIEWED: mental health as above normal, epitomized by a DSM-IV's Global Assessment of Functioning (GAF) score of over 80; mental health as the presence of multiple human strengths rather than the absence of weaknesses; mental health conceptualized as maturity; mental health as the dominance of positive emotions; mental health as high socio-emotional intelligence; mental health as subjective well-being; mental health as resilience. Safeguards for the study of mental health are suggested, including the need to define mental health in terms that are culturally sensitive and inclusive, and the need to empirically and longitudinally validate criteria for mental health.

  13. How to change organisational culture: Action research in a South African public sector primary care facility

    Science.gov (United States)

    De Sa, Angela; Christodoulou, Maria

    2016-01-01

    Background Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim To explore how to transform the organisational culture in line with the desired values. Setting Retreat Community Health Centre, Cape Town, South Africa. Methods Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Results Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group. PMID:27608671

  14. How to change organisational culture: Action research in a South African public sector primary care facility.

    Science.gov (United States)

    Mash, Robert; De Sa, Angela; Christodoulou, Maria

    2016-08-31

    Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. To explore how to transform the organisational culture in line with the desired values. Retreat Community Health Centre, Cape Town, South Africa. Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  15. Forming health culture as part of general education

    Directory of Open Access Journals (Sweden)

    Andreeva Irina

    2016-01-01

    Full Text Available The paper outlines methods of forming health culture in the content of education as a theoretical-methodological area aimed at fostering a positive attitude, sustained motivation for health and personal responsibility for its preservation.

  16. Organisational culture matters for system integration in health care.

    Science.gov (United States)

    Munir, Samina K; Kay, Stephen

    2003-01-01

    This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the 'Actual Usefulness' of the system and the 'Organisational Culture'. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated.

  17. The first study of patient safety culture in Iranian primary health centers.

    Science.gov (United States)

    Tabrizchi, Narges; Sedaghat, Mojtaba

    2012-01-01

    Although the error in health care has received attention recently, patient safety culture in health centers has been relatively neglected. To measure the patient safety culture in primary health centers. A cross-sectional study, utilizing the modified version of the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ) and a demographic questionnaire. Healthcare staffs from health centers were participated in the survey. The patient safety culture score including subscores on 11 dimensions and 39 items; patient safety grade and number of events reported. The overall positive response rate of patient safety culture was 57 ± 16.8 (CI (95)55%-59%). The dimensions that received higher positive response rate were "Teamwork across units of health center", "Teamwork within units", "Head of center support for patient safety". The lowest percentage of positive responses was "Non punitive response to error". There were no relationship between working years and patients safely culture score. Similarly, no relationship was found between professional, gender and total patients safely culture score. Statistical analysis showed discrepancies between Iranian health centers and the US hospitals in three dimensions. For improving patient safety culture in health centers, it is necessary to have enough staff and establish an environment to be open and fair with staff which helps report errors spontaneously and without any fear. The findings of this study could be used to measure changes in patient safety culture over the time.

  18. The First Study of Patient Safety Culture in Iranian Primary Health Centers

    Directory of Open Access Journals (Sweden)

    Mojtaba Sedaghat

    2012-07-01

    Full Text Available Although the error in health care has received attention recently, patient safety culture in health centers has been relatively neglected. To measure the patient safety culture in primary health centers. A cross-sectional study, utilizing the modified version of the Hospital Survey on Patient Safety Culture (HSOPSC developed by the Agency for Healthcare Research and Quality (AHRQ and a demographic questionnaire. Healthcare staffs from health centers were participated in the survey. The patient safety culture score including subscores on 11 dimensions and 39 items; patient safety grade and number of events reported. The overall positive response rate of patient safety culture was 57 ±16.8 (CI 9555%-59%. The dimensions that received higher positive response rate were "Teamwork across units of health center", "Teamwork within units", "Head of center support for patient safety". The lowest percentage of positive responses was "Non punitive response to error". There were no relationship between working years and patients safely culture score. Similarly, no relationship was found between professional, gender and total patients safely culture score. Statistical analysis showed discrepancies between Iranian health centers and the US hospitals in three dimensions. For improving patient safety culture in health centers, it is necessary to have enough staff and establish an environment to be open and fair with staff which helps report errors spontaneously and without any fear. The findings of this study could be used to measure changes in patient safety culture over the time.

  19. Child care work. Organizational culture and health and safety.

    Science.gov (United States)

    Calabro, K S; Bright, K A; Cole, F L; Mackey, T; Lindenberg, J; Grimm, A

    2000-10-01

    A nonrandom sample of child care workers was surveyed to assess whether child care work represented an "at risk" health and safety culture and to measure the organizational dimensions contributing to the health and safety culture. The child care workers in Houston, Texas, were surveyed by mail, using an instrument developed by the research team. The sample population represented 34 child care centers (n = 240 respondents). The analysis yielded five factors related to determinants of health and safety culture. The participants had a favorable perception of the five health and safety determinants. The participants also reported high levels of injury and illness in their environments, suggesting a less than favorable situation. A culture, work, and health model was useful in examining the relationship between health and safety and organizational culture.

  20. Liquid vs Solid Culture Medium to Evaluate Proportion and Time to Change in Management of Suspects of Tuberculosis-A Pragmatic Randomized Trial in Secondary and Tertiary Health Care Units in Brazil.

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Rezende Moreira

    Full Text Available The use of liquid medium (MGIT960 for tuberculosis (TB diagnosis was recommended by WHO in 2007. However, there has been no evaluation of its effectiveness on clinically important outcomes.A pragmatic trial was carried out in a tertiary hospital and a secondary health care unit in Rio de Janeiro City, Brazil. Participants were 16 years or older, suspected of having TB. They were excluded if only cerebral spinal fluid or blood specimens were available for analysis. MGIT960 technique was compared with the Lowenstein-Jensen (LJ method for laboratory diagnosis of active TB. Primary outcome was the proportion of patients who had their initial medical management changed within 2 months after randomisation. Secondary outcomes were: mean time for changing the procedure, patient satisfaction with the overall treatment and adverse events. Data were analysed by intention-to-treat. Between April 2008 and September 2011, 693 patients were enrolled (348 to MGIT, 345 to LJ. Smear and culture results were positive for 10% and 15.7% of participants, respectively. Patients in the MGIT arm had their initial medical management changed more frequently than those in the LJ group (10.1% MGIT vs 3.8% LJ, RR 2.67 95% CI 1.44-.96, p = 0.002, NNT 16, 95% CI 10-39. Mean time for changing the initial procedure was greater in LJ group at both sites: 20.0 and 29.6 days in MGIT group and 52.2 and 64.3 in LJ group (MD 33.5, 95% CI 30.6-36.4, p = 0.0001. No other important differences were observed.This study suggests that opting for the MGIT960 system for TB diagnosis provides a promising case management model for improving the quality of care and control of TB.Controlled-Trials.com ISRCTN79888843.

  1. Changing cultures, changing cuisines: Cultural transitions and dietary change in Iron Age, Roman, and Early Medieval Croatia.

    Science.gov (United States)

    Lightfoot, E; Slaus, M; O'Connell, T C

    2012-08-01

    Food is well-known to encode social and cultural values, for example different social groups use different consumption patterns to act as social boundaries. When societies and cultures change, whether through drift, through population replacement or other factors, diet may also alter despite unchanging resource availability within a region. This study investigates the extent to which dietary change coincides with cultural change, to understand the effects of large-scale migrations on the populations' diets. Through stable carbon and nitrogen isotope analysis of Iron Age, Roman, and Early Medieval human bone collagen, we show that in Croatia large-scale cultural change led to significant changes in diet. The isotopic evidence indicates that Iron Age diet consisted of C(3) foodstuffs with no isotopic evidence for the consumption of C(4) or marine resources. With the Roman conquest, marine resources were added to the diet, although C(3) foodstuffs continued to play an important role. In the Early Medieval period, this marine component was lost and varying amounts of C(4) foodstuffs, probably millet, were added to the otherwise C(3) diet. In both of these transitions it is likely that the changes in diet are related to the arrival of a new people into the area.

  2. Game-Changing Innovations: How Culture Can Change the Parameters of Its Own Evolution and Induce Abrupt Cultural Shifts.

    Science.gov (United States)

    Kolodny, Oren; Creanza, Nicole; Feldman, Marcus W

    2016-12-01

    One of the most puzzling features of the prehistoric record of hominid stone tools is its apparent punctuation: it consists of abrupt bursts of dramatic change that separate long periods of largely unchanging technology. Within each such period, small punctuated cultural modifications take place. Punctuation on multiple timescales and magnitudes is also found in cultural trajectories from historical times. To explain these sharp cultural bursts, researchers invoke such external factors as sudden environmental change, rapid cognitive or morphological change in the hominids that created the tools, or replacement of one species or population by another. Here we propose a dynamic model of cultural evolution that accommodates empirical observations: without invoking external factors, it gives rise to a pattern of rare, dramatic cultural bursts, interspersed by more frequent, smaller, punctuated cultural modifications. Our model includes interdependent innovation processes that occur at different rates. It also incorporates a realistic aspect of cultural evolution: cultural innovations, such as those that increase food availability or that affect cultural transmission, can change the parameters that affect cultural evolution, thereby altering the population's cultural dynamics and steady state. This steady state can be regarded as a cultural carrying capacity. These parameter-changing cultural innovations occur very rarely, but whenever one occurs, it triggers a dramatic shift towards a new cultural steady state. The smaller and more frequent punctuated cultural changes, on the other hand, are brought about by innovations that spur the invention of further, related, technology, and which occur regardless of whether the population is near its cultural steady state. Our model suggests that common interpretations of cultural shifts as evidence of biological change, for example the appearance of behaviorally modern humans, may be unwarranted.

  3. A change of culture: reducing blood culture contamination rates in an Emergency Department.

    Science.gov (United States)

    Bentley, James; Thakore, Shobhan; Muir, L; Baird, Alastair; Lee, Jennifer

    2016-01-01

    Blood cultures are an important investigation to help tailor effective management for patients with severe sepsis. Frequent contaminated samples increase laboratory workload and can delay or cause incorrect changes to patient management. This can prolong patient hospitalisation, increase the risk of harm and increase cost to health boards. Current guidelines advocate a contamination rate of 2-3%. From January 2013 to November 2014 inclusive, the contamination rate was 4.74% in our Emergency Department, responsible for initial management and investigation of over 40 cases of sepsis per month. A Quality Improvement team was created to try to reduce contamination rates to the recommended target. An initial baseline survey of local staff showed good understanding of when to obtain a blood culture but there was variability in the methods and equipment used. A project was then conducted which focused on rationalising and standardising equipment and technique for blood culture sampling along with staff education to support this change. A simple department target of 30 days free from a contaminated blood culture was created which, if achieved, would ensure a contamination rate of less than 3%. This was supported by ongoing surveillance of contamination rates and investigation of contaminated sample cases. We were able to then identify high risk patients and factors which increased the chance of blood culture contamination. This allowed us to formulate solutions to help reduce the risks of contamination. Department achievements and learning points to help prevent further contamination were fed back positively to all staff. This project operated for 12-months and successfully reduced local contamination rates to 2.0%.

  4. Taking action on overuse: Creating the culture for change.

    Science.gov (United States)

    Parchman, Michael L; Henrikson, Nora B; Blasi, Paula R; Buist, Diana S; Penfold, Robert; Austin, Brian; Ganos, Emily H

    2016-11-10

    Unnecessary care contributes to high costs and places patients at risk of harm. While most providers support reducing low-value care, changing established practice patterns is difficult and requires active engagement in sustained behavioral, organizational, and cultural change. Here we describe an action-planning framework to engage providers in reducing overused services. The framework is informed by a comprehensive review of social science theory and literature, published reports of successful and unsuccessful efforts to reduce low-value care, and interviews with innovators of value-based care initiatives in twenty-three health care organizations across the United States. A multi-stakeholder advisory committee provided feedback on the framework and guidance on optimizing it for use in practice. The framework describes four conditions necessary for change: prioritize addressing low-value care; build a culture of trust, innovation and improvement; establish shared language and purpose; and commit resources to measurements. These conditions foster productive sense-making conversations between providers, between providers and patients, and among members of the health care team about the potential for harm from overuse and reflection on current frequency of use. Through these conversations providers, patients and team members think together as a group, learn how to coordinate individual behaviors, and jointly develop possibilities for coordinated action around specific areas of overuse. Organizational efforts to engage providers in value-based care focused on creating conditions for productive sense-making conversations that lead to change. Organizations can use this framework to enhance and strengthen provider engagement efforts to do less of what potentially harms and more of what truly helps patients. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Exploring the Cultural Dimensions of the Right to the Highest Attainable Standard of Health

    Directory of Open Access Journals (Sweden)

    Yvonne Donders

    2015-07-01

    . The article concludes that various cultural dimensions of the right to health are recognised and elaborated upon in recommendations by treaty monitoring bodies both at UN and African level. These bodies have endorsed the idea that health facilities, goods and services must be respectful of the culture of individuals, peoples and communities. At the same time, the right to health should be protected against the negative impact that cultural values, patterns or practices may have, such as on access to health goods and services and on the health of people as such. The latter issue has received most attention at the UN as well as at African level, and there appears to be a clear consensus on several practices that are considered harmful. It is also realised, however, that the identification of a certain practice as harmful by an international body, even if agreed to by the State Party, is not sufficient to eradicate it. Cultural communities are crucial in promoting social and behavioural changes that may be needed to eradicate harmful practices. It is therefore important to involve the cultural communities concerned in the drafting, implementation and evaluation of health laws and policies. This could be more emphasised by the monitoring bodies. The involvement of the cultural community is also crucial to respecting and promoting the more positive cultural dimensions of the right to health. By consulting the cultural communities and individuals concerned, States can implement the right to the enjoyment of the highest attainable standard of health in a culturally sensitive, appropriate and responsible way.

  6. Dental Health Care Models of Southwest Cultures. Final Report.

    Science.gov (United States)

    Pettibone, Timothy J.; Solis, Enrique, Jr.

    The major goal of this research was the development and validation of cultural models of dental health practices. The specific objectives were to determine if 3 cultural groups (American Indians, Mexican Americans, and Anglo Americans) differ in the dental health hygiene indices, characteristics, psychological factors, or social factors; to…

  7. Technological Education as a Means of Developing Students' Health Culture

    Science.gov (United States)

    Masalimova, Alfiya R.; Luchinina, Anastasia O.; Ulengov, Ruslan A.

    2016-01-01

    The urgency of the research is due to the fact that health of school-age children in Russia is deteriorating. The development of health culture has become an integral part of students' general cultural development. The purpose of this article is to reveal the potential of "Technology" as a school subject for the development of students'…

  8. Population change and socio-cultural values.

    Science.gov (United States)

    1982-06-01

    The developing countries of the world in general, and those of Asia and the Pacific in particular, recognize that unplanned population growth is a stumbling block to socioeconomic development. Discussion here focuses on population growth and social, economic, and institutional forces, which are referred to as sociocultural values. Generally, sociocultural values change sluggishly over time. The rate at which a country's sociocultural values change depends on several factors such as the stage of economic development and modernization and whether a country has an open or closed door policy. "The Value of Children Study: A Crossnational Study" by Fred Arnold et al. shows that there are positive and negative values attributed to children in the Asian countries. These are: positive general values--emotional benefits, economic benefits and security, self enrichment and development, identification with children, and family cohesiveness and continuity; negative general values--emotional costs, economic costs, restrictions on opportunity costs, physical demands, and family costs; large family values--sibling relationships, sex preferences, child survival; and small family values--maternal health and societal costs. Possibly the most formidable obstacle to the success of antinatalist population policies is that of religious values. It appears that the Muslim world is divided on the issue of fertility control. Conflicting views regarding fertility control is perhaps aggravated by the fact that there is no central international religious official hierarchy that issues out edicts. Despite the presence of a centralized religious hierarchy and a network of churches from the Vatican to the village levels among the Catholics, and a clearer elucidation of the Humanae Vitae, a liberal attitude to population regulation and family planning has emerged, largely because of the declining quality of life of the people resulting from unplanned births. Economic benefits of children include

  9. Promoting cultural competence through a health policy course.

    Science.gov (United States)

    Kaplan, Louise

    2010-01-01

    A healthcare system designed to support a culturally competent work force can contribute to the elimination of health disparities. Various courses were revised as part of a multicultural transformation of a college of nursing curricula. The author discusses a health policy course revised to promote development of cultural competencies. Examples of topics, teaching strategies, and assignments for integrating concepts and content related to cultural competencies as well as comments from students that reflect their learning experiences are provided.

  10. Climate change: the public health response.

    Science.gov (United States)

    Frumkin, Howard; Hess, Jeremy; Luber, George; Malilay, Josephine; McGeehin, Michael

    2008-03-01

    There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations.

  11. Climate Change, Health, and Communication: A Primer.

    Science.gov (United States)

    Chadwick, Amy E

    2016-01-01

    Climate change is one of the most serious and pervasive challenges facing us today. Our changing climate has implications not only for the ecosystems upon which we depend, but also for human health. Health communication scholars are well-positioned to aid in the mitigation of and response to climate change and its health effects. To help theorists, researchers, and practitioners engage in these efforts, this primer explains relevant issues and vocabulary associated with climate change and its impacts on health. First, this primer provides an overview of climate change, its causes and consequences, and its impacts on health. Then, the primer describes ways to decrease impacts and identifies roles for health communication scholars in efforts to address climate change and its health effects.

  12. Planned health change in an emerging nation. Maternal/child health programme in the Peruvian Andes.

    Science.gov (United States)

    Levine, M A

    1990-04-01

    Professional skills developed in providing maternal and child care in the industrialised world can be applied to the provision of appropriate services to emerging nations. Understanding local mores and values, one can more effectively convey the essential elements of maintenance and promotion of health. By volunteering to work with a locally based relief organisation in Arequipa, Peru, I helped to facilitate cross-cultural planned health change in the maternal/child health programme.

  13. Do TQM interventions change management culture? Findings and implications.

    Science.gov (United States)

    Gerowitz, M B

    1998-01-01

    This study assesses the impact of TQM/CQI interventions on the culture and performance of top management teams. The findings suggest culture is related to performance but that TQM/CQI interventions are not associated with either performance or culture change. Implications for additional research and for practice are discussed.

  14. Climate Change and Public Health Policy.

    Science.gov (United States)

    Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock

    2017-03-01

    Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

  15. 10 Facts on Climate Change and Health

    Science.gov (United States)

    World health organization 10 facts on climate change and health Next UNEP/Still Pictures Previous 1 2 3 4 5 6 7 8 9 10 Next Over the last 50 ... more heat in the lower atmosphere. The resulting changes in the global climate bring a range of risks to health, from ...

  16. Jedi Public Health: Co-creating an Identity-Safe Culture to Promote Health Equity.

    Science.gov (United States)

    Geronimus, Arline T; James, Sherman A; Destin, Mesmin; Graham, Louis A; Hatzenbuehler, Mark; Murphy, Mary; Pearson, Jay A; Omari, Amel; Thompson, James Phillip

    2016-12-01

    The extent to which socially-assigned and culturally mediated social identity affects health depends on contingencies of social identity that vary across and within populations in day-to-day life. These contingencies are structurally rooted and health damaging inasmuch as they activate physiological stress responses. They also have adverse effects on cognition and emotion, undermining self-confidence and diminishing academic performance. This impact reduces opportunities for social mobility, while ensuring those who "beat the odds" pay a physical price for their positive efforts. Recent applications of social identity theory toward closing racial, ethnic, and gender academic achievement gaps through changing features of educational settings, rather than individual students, have proved fruitful. We sought to integrate this evidence with growing social epidemiological evidence that structurally-rooted biopsychosocial processes have population health effects. We explicate an emergent framework, Jedi Public Health (JPH). JPH focuses on changing features of settings in everyday life, rather than individuals, to promote population health equity, a high priority, yet, elusive national public health objective. We call for an expansion and, in some ways, a re-orienting of efforts to eliminate population health inequity. Policies and interventions to remove and replace discrediting cues in everyday settings hold promise for disrupting the repeated physiological stress process activation that fuels population health inequities with potentially wide application.

  17. Does cultural integration explain a mental health advantage for adolescents?

    Science.gov (United States)

    Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie

    2012-06-01

    A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a 'total difficulties score' and by classification as a 'probable clinical case'. A total of 6643 pupils in first and second years of secondary school (ages 11-13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005-06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Cultural integration was associated with better mental health, independent of the mental health advantage found among specific ethnic groups: Black Caribbean and

  18. Parenting and child mental health: a cross-cultural perspective.

    Science.gov (United States)

    Bornstein, Marc H

    2013-10-01

    In its most general instrumental sense, parenting consists of care of the young in preparing them to manage the tasks of life. Parents provide childhood experiences and populate the environments that guide children's development and so contribute to child mental health. Parenting is expressed in cognitions and practices. However, parents do not parent, and children do not grow up, in isolation, but in multiple contexts, and one notable context of parenting and child mental health is culture. Every culture is characterized, and distinguished from other cultures, by deep-rooted and widely acknowledged ideas about how one needs to feel, think, and act as an adequately functioning member of the culture. Insofar as parents subscribe to particular conventions of a culture, they likely follow prevailing "cultural scripts" in childrearing. Broadening our definition, it is therefore the continuing task of parents also to enculturate children by preparing them for the physical, psychosocial, and educational situations that are characteristic of their specific culture. Cross-cultural comparisons show that virtually all aspects of parenting children are informed by culture: culture influences when and how parents care for children, what parents expect of children, and which behaviors parents appreciate, emphasize and reward or discourage and punish. Thus, cultural norms become manifest in the mental health of children through parenting. Furthermore, variations in what is normative in different cultures challenge our assumptions about what is universal and inform our understanding of how parent-child relationships unfold in ways both culturally universal and specific. This essay concerns the contributions of culture to parenting and child mental health. No study of a single society can address this broad issue. It is possible, however, to learn lessons about parenting and child mental health from the study of different societies.

  19. Cultural changes (1986-96) in a Norwegian airline company.

    Science.gov (United States)

    Mjøs, Kjell

    2002-02-01

    The purpose of the study was to investigate cultural changes in a Norwegian airline company over a time span of 10 years. A questionnaire including parameters characterizing culture was administered to air crews in 1986 (n = 137) and in 1996 (n = 50). The performance part of a simulator study in 1996 indicated a significant reduction in operational failures compared with the 1986 study. The data further demonstrated significant changes in cultural variables, such as reduced Dominance and Masculinity, and improved Social climate and Communication. The direction of change in scores on the cultural variables corresponded with the principles on which the remedial actions were based.

  20. Directional cultural change by modification and replacement of memes.

    Science.gov (United States)

    Cardoso, Gonçalo C; Atwell, Jonathan W

    2011-01-01

    Evolutionary approaches to culture remain contentious. A source of contention is that cultural mutation may be substantial and, if it drives cultural change, then current evolutionary models are not adequate. But we lack studies quantifying the contribution of mutations to directional cultural change. We estimated the contribution of one type of cultural mutations--modification of memes--to directional cultural change using an amenable study system: learned birdsongs in a species that recently entered an urban habitat. Many songbirds have higher minimum song frequency in cities, to alleviate masking by low-frequency noise. We estimated that the input of meme modifications in an urban songbird population explains about half the extent of the population divergence in song frequency. This contribution of cultural mutations is large, but insufficient to explain the entire population divergence. The remaining divergence is due to selection of memes or creation of new memes. We conclude that the input of cultural mutations can be quantitatively important, unlike in genetic evolution, and that it operates together with other mechanisms of cultural evolution. For this and other traits, in which the input of cultural mutations might be important, quantitative studies of cultural mutation are necessary to calibrate realistic models of cultural evolution.

  1. DIRECTIONAL CULTURAL CHANGE BY MODIFICATION AND REPLACEMENT OF MEMES

    Science.gov (United States)

    Cardoso, Gonçalo C.; Atwell, Jonathan W.

    2017-01-01

    Evolutionary approaches to culture remain contentious. A source of contention is that cultural mutation may be substantial and, if it drives cultural change, then current evolutionary models are not adequate. But we lack studies quantifying the contribution of mutations to directional cultural change. We estimated the contribution of one type of cultural mutations—modification of memes—to directional cultural change using an amenable study system: learned birdsongs in a species that recently entered an urban habitat. Many songbirds have higher minimum song frequency in cities, to alleviate masking by low-frequency noise. We estimated that the input of meme modifications in an urban songbird population explains about half the extent of the population divergence in song frequency. This contribution of cultural mutations is large, but insufficient to explain the entire population divergence. The remaining divergence is due to selection of memes or creation of new memes. We conclude that the input of cultural mutations can be quantitatively important, unlike in genetic evolution, and that it operates together with other mechanisms of cultural evolution. For this and other traits, in which the input of cultural mutations might be important, quantitative studies of cultural mutation are necessary to calibrate realistic models of cultural evolution. PMID:20722726

  2. Climate Change: Science, Health and the Environment

    Centers for Disease Control (CDC) Podcasts

    2007-04-10

    Climate Change: Science, Health and the Environment Howard Frumkin, MD, DrPH, Director of CDC's National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, discusses the science of climate change, the potential for shifts in the natural world to affect our wellbeing, and the challenges of emerging issues in environmental health.  Created: 4/10/2007 by CDC National Center for Environmental Health.   Date Released: 4/13/2007.

  3. Climate change and health in Earth's future

    Science.gov (United States)

    Bowles, Devin C.; Butler, Colin D.; Friel, Sharon

    2014-02-01

    Threats to health from climate change are increasingly recognized, yet little research into the effects upon health systems is published. However, additional demands on health systems are increasingly documented. Pathways include direct weather impacts, such as amplified heat stress, and altered ecological relationships, including alterations to the distribution and activity of pathogens and vectors. The greatest driver of demand on future health systems from climate change may be the alterations to socioeconomic systems; however, these "tertiary effects" have received less attention in the health literature. Increasing demands on health systems from climate change will impede health system capacity. Changing weather patterns and sea-level rise will reduce food production in many developing countries, thus fostering undernutrition and concomitant disease susceptibility. Associated poverty will impede people's ability to access and support health systems. Climate change will increase migration, potentially exposing migrants to endemic diseases for which they have limited resistance, transporting diseases and fostering conditions conducive to disease transmission. Specific predictions of timing and locations of migration remain elusive, hampering planning and misaligning needs and infrastructure. Food shortages, migration, falling economic activity, and failing government legitimacy following climate change are also "risk multipliers" for conflict. Injuries to combatants, undernutrition, and increased infectious disease will result. Modern conflict often sees health personnel and infrastructure deliberately targeted and disease surveillance and eradication programs obstructed. Climate change will substantially impede economic growth, reducing health system funding and limiting health system adaptation. Modern medical care may be snatched away from millions who recently obtained it.

  4. Organizational change management in mental health.

    Science.gov (United States)

    Callaly, Tom; Arya, Dinesh

    2005-06-01

    To discuss change management as applicable to mental health. As mental health care grows increasingly complex, and the network of accountability widens, change is both inevitable and necessary. Strategies to introduce change effectively are essential. Resistance by medical staff to change often has a sound basis and must be acknowledged and explored. Change in clinical systems and practice is facilitated by careful planning and preparation, and by engaging clinicians in all phases of the change process; change will fail if this is not achieved. A number of management models facilitate the understanding and process of change.

  5. "Shattering culture": perspectives on cultural competence and evidence-based practice in mental health services.

    Science.gov (United States)

    Good, Mary-Jo DelVecchio; Hannah, Seth Donal

    2015-04-01

    The concept of culture as an analytic concept has increasingly been questioned by social scientists, just as health care institutions and clinicians have increasingly routinized concepts and uses of culture as means for improving the quality of care for racial and ethnic minorities. This paper examines this tension, asking whether it is possible to use cultural categories to develop evidenced-based practice guidelines in mental health services when these categories are challenged by the increasing hyperdiversity of patient populations and newer theories of culture that question direct connection between group-based social identities and cultural characteristics. Anthropologists have grown concerned about essentializing societies, yet unequal treatment on the basis of cultural, racial, or ethnic group membership is present in medicine and mental health care today. We argue that discussions of culture-patients' culture and the "culture of medicine"-should be sensitive to the risk of improper stereotypes, but should also be sensitive to the continuing significance of group-based discrimination and the myriad ways culture shapes clinical presentation, doctor-patient interactions, the illness experience, and the communication of symptoms. We recommend that mental health professionals consider the local contexts, with greater appreciation for the diversity of lived experience found among individual patients. This suggests a nuanced reliance on broad cultural categories of racial, ethnic, and national identities in evidence-based practice guidelines. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Impact of organisational change on mental health

    DEFF Research Database (Denmark)

    Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia

    2012-01-01

    Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowle......Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web...

  7. Cultural diversity and conflict in the health care workplace.

    Science.gov (United States)

    Lowenstein, A J; Glanville, C

    1995-01-01

    Cultural diversity issues affect the health care workplace and nursing practice. The Lowenstein-Glanville conflict model can be used for assessing and intervening in racial and status conflict in hospital settings. Implications for nursing practice include recognizing that cultural diversity will continue to grow in the health care workplace. Nurses must increase sensitivity, become aware of cultural nuances and issues, and make cultural assessment a routine part of their assessment and planning, not only for patient care, but also with their co-workers and subordinates.

  8. Food and Health: Individual, Cultural, or Intellectual Matters?

    DEFF Research Database (Denmark)

    Coff, Christian Eyde; Nordström, Karin; Jönsson, Håkan

    2013-01-01

    In personalized nutrition, food is a tool for good health, implying an instrumental relationship between food and health. Food receives a secondary value, while health would appear to be a descriptive biological concept. This article gives an introduction to cultural understandings of food and he...

  9. Why culture matters in health interventions: lessons from HIV/AIDS stigma and NCDs.

    Science.gov (United States)

    Airhihenbuwa, Collins O; Ford, Chandra L; Iwelunmor, Juliet I

    2014-02-01

    Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. We argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. We conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.

  10. Changing living conditions, life style and health

    National Research Council Canada - National Science Library

    Curtis, Tine; Kvernmo, Siv; Bjerregaard, Peter

    2005-01-01

    .... The aim of the paper is to illustrate the influence of environmental change on living conditions and life style and some of the mechanisms through which such changes affect physical and mental health...

  11. Impact of culture on health outcomes.

    Science.gov (United States)

    Kagawa-Singer, Marjorie

    2011-10-01

    The diagnosis of cancer creates anticipatory grief and fear for the patient and the family, and the x cancer care experience is fraught with physical, emotional and spiritual challenges. The palliative care literature in Europe and North American is rapidly growing, but such literature is sparse in other parts of the world. Translating the findings from the West however, may be problematic in non-Western, and particularly, non-Christian cultures, for many of the assumptions that underlie the approach to suffering and death in the West are culturally based in the values and beliefs of western European society. Therefore this paper provides a means to explore how such translation across cultures might occur by: (1) providing a definition of culture so that the context for the subsequent discussion is framed, (2) describing how culture impacts the cancer experience, (3) how culture affects communication to relieve suffering and improve quality of life for patients and families. The paper closes with 8 recommended steps to improve communication cross-culturally to provide effective quality palliative care for patients and families from diverse backgrounds.

  12. Culture Change From Tobacco Accommodation to Intolerance: Time to Connect the Dots.

    Science.gov (United States)

    Livingood, William C; Allegrante, John P; Green, Lawrence W

    2016-04-01

    Broad changes in normative health behavior are critical to overcoming many of the contemporary challenges to public health. Reduction in tobacco use during the last third of the 20th century-one of the greatest improvements in public health-illustrates such change. The culture change from accommodation to intolerance of smoking is irrefutable. The role of health communication in predisposing, enabling, and reinforcing the normative social changes that ensued, however, has been less well documented with the linear, cause-and-effect methods of controlled intervention research. We examine the role of mass communication in the cultural transformation that reduced tobacco use, concluding that its influence on reduction in tobacco use follows a pathway as much through secondary transmissions within groups of people as through direct influence on individuals.

  13. The impact of organisational change and fiscal restraint on organisational culture.

    Science.gov (United States)

    Dark, Frances; Whiteford, Harvey; Ashkanasy, Neal M; Harvey, Carol; Harris, Meredith; Crompton, David; Newman, Ellie

    2017-01-01

    Strategies to implement evidence-based practice have highlighted the bidirectional relationship of organisational change on organisational culture. The present study examined changes in perceptions of organisational culture in two community mental health services implementing cognitive therapies into routine psychosis care over 3 years. During the time of the study there were a number of shared planned and unplanned changes that the mental health services had to accommodate. One service, Metro South, had the additional challenge of embarking on a major organisational restructure. A survey of organisational culture was administered to clinical staff of each service at yearly intervals over the 3 years. At baseline assessment there was no significant difference between the two services in organisational culture. At the midpoint assessment, which was conducted at the time the Metro South restructure was operationalized, there were less positive ratings of organisational culture recorded in Metro South compared to the other service. Organisational culture returned to near-baseline levels at endpoint assessment. These findings are consistent with the literature that organisational culture is relatively robust and resilient. It is also consistent with the literature that, at any one time, a service or organisation may have a finite capacity to absorb change. Consequently this limitation needs to be taken into account in the timing and planning of major service reform where possible. The results also extend the literature, insofar as external factors with a high impact on the operation of an organisation may impact upon organisational culture albeit temporarily.

  14. ON HEALTH PROTECTION AND HEALTH RELATED PHYSICAL CULTURE TRAININGS OF FIRST YEAR STUDENTS

    Directory of Open Access Journals (Sweden)

    V.G. Fotynyuk

    2017-01-01

    Full Text Available Purpose: to assess health protection and health related physical culture trainings of first year students. Material: in the research first year students (n=121; 86 boys and 35girls of age 16 - 19 years, participated. Results: components of students’ individual health were found. Situation with health related physical culture trainings, ensuring students’ sound health and optimal functional potentials of their organisms were determined. It was found that leading role shall be played by formation of health world vision values, knowledge about formation of practical skills in healthy life style. Motivation tendency for realization of intentions and practicing of health related physical culture trainings were found in students. Conclusions: the received results prove students’ tendency to pay insufficient attention to individual health. It was found that health related physical culture trainings require modern renewal of education’s content, forms and methods of physical education. The basis of such trainings shall be health related orientation.

  15. Will Boeing Change Health Care?

    Science.gov (United States)

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate.

  16. Understanding and managing organizational change: implications for public health management.

    Science.gov (United States)

    Thompson, Jon M

    2010-01-01

    Managing organizational change has become a significant responsibility of managers. Managing the change process within public health organizations is important because appropriately and systematically managing change is linked to improved organizational performance. However, change is difficult and the change process poses formidable challenges for managers. Managers themselves face increased pressure to respond to environmental influences and provide the necessary leadership to their organizations in the change process. In fact, managing organizational change has become a key competency for healthcare managers. This article addresses the important topic of organizational change in public health organizations. It provides a conceptual foundation for understanding organizational change and its relationship to healthcare organizational performance, and then discusses the types and nature of change, using some examples and evidence from those organizations that have successfully managed change. A framework for guiding public health managers in the change management process is provided. The article concludes with suggested management competencies to establish a change-oriented organization with the culture and capacity for change.

  17. A multilevel model of organizational health culture and the effectiveness of health promotion.

    Science.gov (United States)

    Lin, Yea-Wen; Lin, Yueh-Ysen

    2014-01-01

    Organizational health culture is a health-oriented core characteristic of the organization that is shared by all members. It is effective in regulating health-related behavior for employees and could therefore influence the effectiveness of health promotion efforts among organizations and employees. This study applied a multilevel analysis to verify the effects of organizational health culture on the organizational and individual effectiveness of health promotion. At the organizational level, we investigated the effect of organizational health culture on the organizational effectiveness of health promotion. At the individual level, we adopted a cross-level analysis to determine if organizational health culture affects employee effectiveness through the mediating effect of employee health behavior. The study setting consisted of the workplaces of various enterprises. We selected 54 enterprises in Taiwan and surveyed 20 full-time employees from each organization, for a total sample of 1011 employees. We developed the Organizational Health Culture Scale to measure employee perceptions and aggregated the individual data to formulate organization-level data. Organizational effectiveness of health promotion included four dimensions: planning effectiveness, production, outcome, and quality, which were measured by scale or objective indicators. The Health Promotion Lifestyle Scale was adopted for the measurement of health behavior. Employee effectiveness was measured subjectively in three dimensions: self-evaluated performance, altruism, and happiness. Following the calculation of descriptive statistics, hierarchical linear modeling (HLM) was used to test the multilevel hypotheses. Organizational health culture had a significant effect on the planning effectiveness (β = .356, p organizational health culture on three dimensions of employee effectiveness were completely mediated by health behavior. The construct connections established in this multilevel model will help in

  18. Climate change and human health: a One Health approach.

    Science.gov (United States)

    Patz, Jonathan A; Hahn, Micah B

    2013-01-01

    Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.

  19. Components of cultural competence in three mental health programs.

    Science.gov (United States)

    Siegel, Carole; Haugland, Gary; Reid-Rose, Lenora; Hopper, Kim

    2011-06-01

    The aim of this study was to identify components of cultural competence in mental health programs developed for cultural groups by community and mental health professionals from these groups. Three programs were studied: a prevention program primarily serving African-American and Afro-Caribbean youth, a Latino adult acute inpatient unit, and a Chinese day treatment program in a community-based agency. Nine study-trained field researchers used a semistructured instrument that captures program genealogy, structure, processes, and cultural infusion. Program cultural elements were identified from field notes and from individual and group interviews of consumers and staff (N=104). A research-group consensus process with feedback from program staff was used to group elements by shared characteristics into the program components of cultural competence. Components included communication competencies (with use of colloquialisms and accepted forms of address); staff in culturally acceptable roles; culturally framed trust building (such as pairing youths with mentors), stigma reduction, friendly milieus (such as serving culturally familiar foods and playing music popular with the culture), and services; and peer, family, and community involvement (including use of peer counselors and mentors, hosting parent weekends, and linking clients with senior center and community services). Incorporating these components into any program in which underserved cultural populations are seen is recommended for improving cultural competence.

  20. Health coaching: holistically empowering change.

    Science.gov (United States)

    Gorman, Becky

    2013-05-01

    It's no secret that the rate and magnitude of stress in daily life, both at work and at home, are drastically affecting the health and well-being of people in our communities and around the world. People are desperate to find ways to improve their lives and feel happier, healthier, and more vibrant. Likewise, industry is clamoring to find resources to improve the health and well-being of their staff and their teams.(1) (,) (2) With the aging population and rapidly growing demands of modern life, this need is expanding exponentially. Billions of dollars are spent annually on complementary and integrative care resources. Many people seek to combine allopathic medical care with proactive self-initiated choices and behaviors to prevent or manage illness and to increase their overall health and well-being.

  1. Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice.

    Science.gov (United States)

    Aarons, Gregory A; Sawitzky, Angelina C

    2006-02-01

    Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice.

  2. Parenting and child mental health: a cross‐cultural perspective

    National Research Council Canada - National Science Library

    Bornstein, Marc H

    2013-01-01

    .... Parenting is expressed in cognitions and practices. However, parents do not parent, and children do not grow up, in isolation, but in multiple contexts, and one notable context of parenting and child mental health is culture...

  3. Climate Change, Individual Responsibilities and Cultural Frameworks

    National Research Council Canada - National Science Library

    Thomas Heyd

    2010-01-01

    .... On the assumption that, in the light of accelerating climate change, individuals have both ethical and prudential responsibilities, the limited advances in mitigation and adaptation of international...

  4. DESCRIPTIVE ANALYSIS OF CORPORATE CULTURE FOLLOWING THE CHANGES

    Directory of Open Access Journals (Sweden)

    Elenko Zahariev

    2016-09-01

    Full Text Available Corporate culture more sensibly makes additions to the economic knowledge, accompanies the strategy and tactics in management. It feels in manners and overall activity of the organization - it is empathy and tolerance, respect and responsibility. The new corporate culture transforms each participant, changes his/her mind in the general collaborations and working habits. The new corporate culture requires improving the management style. It is no longer necessary the leader only to rule, to administer and control, but to lead and inspire. The leader sets challenging targets, optimizes the performance of the teams, fuels an optimistic mood and faith, gains agreement between workers, monitors and evaluate the work in a fair way. Current study raises the problem of interpreting cultural profiles in modern organizations and analyzes corporate culture after the changes during the transition period in Bulgaria. The descriptive analysis of corporate culture allows the relatively precise identification of its various types based on the accepted classification signs.

  5. Not all cultural values are created equal: Cultural change in China reexamined through Google books.

    Science.gov (United States)

    Zhang, Rui; Weng, Liping

    2017-06-20

    Given its major transformations in recent decades, China has figured prominently in research on cultural change. Previous research converges in showing a general trend towards individualism in contemporary China while noting that rising individualism tends to coexist with enduring collectivism. To further understand this, we tested whether perceived traditional importance of cultural values would modulate the trajectory of cultural change reflected in word usage frequencies in published books. We re-analysed Google's Chinese corpus since 1980 based on a broad sample of words associated with individualism-collectivism. We replicated the pattern of rising individualism and declining collectivism among words of modest and low perceived traditional importance. Most important, however, collectivistic words of high perceived traditional importance increased in usage frequencies with time, thus departing from the general trend towards individualism. Overall, our research underscores the role of core culture in cultural maintenance during times of rapid cultural change. © 2017 International Union of Psychological Science.

  6. Cultural Dance and Health: A Review of the Literature

    Science.gov (United States)

    Olvera, Anna E.

    2008-01-01

    Physical activity has many physical and mental health outcomes. However, physical inactivity continues to be common. Dance, specifically cultural dance, is a type of physical activity that may appeal to some who are not otherwise active and may be a form of activity that is more acceptable than others in certain cultures. The purpose of this paper…

  7. Culture clash: alcohol marketing and public health aspirations.

    Science.gov (United States)

    Munro, Geoffrey; de Wever, Johanna

    2008-03-01

    It is of no coincidence that a number of recent Harm Reduction Digests have addressed the issue of the reduction of alcohol-related harm. Despite the dominant focus on illicit drug use in the popular discourse, alcohol remains Australia's number one drug problem, as it is in many other developed countries. In this Digest Munro and de Wever use the 'four Ps' of marketing: product, price, place and promotion, to critique the two decades industry self-regulation of alcohol marketing. They conclude that if we are going to develop policies which effectively change Australian drinking culture to reduce alcohol-related harm, we need first to accept that the alcohol industry and the health field have separate and conflicting interests.

  8. Health services and the political culture of Saudi Arabia.

    Science.gov (United States)

    Gallagher, E B; Searle, C M

    1985-01-01

    Health services occupy a high priority in the development agenda of Saudi Arabia, Saudi culture--devotion to Islam, extended-family values, the segregated status of females and the Al Saud monarchic hegemony--is being formulated in an increasingly deliberate fashion, constituting a new 'political culture' which acts as a screen to insure that technological and human progress remain within acceptable bounds. There is a general disposition on the part of the Saudi populace to use modern health services as these become available, largely under governmental auspice. The role of the government in providing health care for pilgrims during the hajj to Mecca is of particular culture importance. Cultural sensitivities concerning male physicians and female patients will be minimized by the training of a substantial number of Saudi female physicians, whose efforts will be directed toward female patients. At present, most health care in the Kingdom is delivered by male expatriate physicians, as part of the general massive reliance upon expatriate workers: although the expatriates will eventually be replaced by Saudi physicians, this dependency, which is felt to threaten Saudi culture, will continue for a decade or more. Private medicine is rapidly increasing though not on the same scale as government medicine. The provision of government health services is a source of legitimation for the Al Saud regime. In general, health services appear to constitute a form of modernization which meets the test of cultural compatibility.

  9. Performance measurement of workplace change: in two different cultural contexts

    Directory of Open Access Journals (Sweden)

    Chaiwat Riratanaphong

    2014-01-01

    in different contexts. Two organisations in Thailand and one organisation in The Netherlands were selected to serve as case studies. The impact of culture was explored as a contextual background.Research methodsBased on literature review an overview of performance measurement systems and measures has been developed. The list of corporate real estate performance measures has been classified in six categories according to Bradley (2002 and subsequently compared with the findings from the case studies. The six categories include: 1 stakeholder perception, 2 financial health, 3 organisational development, 4 productivity, 5 environmental responsibility and 6 cost efficiency. The impact of workplace change was examined using the work environment diagnosis instrument (WODI questionnaire which evaluates employees’ responses to the changed work environment in three areas: employee satisfaction, perceived productivity support and prioritised aspects (Maarleveld, et al., 2009. The Organisational Culture Assessment Instrument (OCAI; Cameron and Quinn, 2006 was used to assess organisational culture. National culture was measured by using the Value Survey Module 94 (VSM94; Hofstede, 1997.Research findingsThe conceptual framework that came to the fore from the literature review showed to be useful for both theoretical understanding of performance measurement and practical applications. Proposed performance measures have been applied in all three case studies but in different ways. The three case studies showed that performance measurement of an organisation is multi-dimensional. It includes several performance criteria and performance measures beyond cost efficiency. All seven performance criteria mentioned by Sink and Tuttle (1989 have been applied in all three cases including effectiveness, efficiency, quality, productivity, quality of worklife, innovation and profitability. The four perspectives of the Balanced Scorecard (financial, customer, internal business process

  10. Changing culture - the experience of TU Delft Library

    NARCIS (Netherlands)

    Heijne, M.; Van der Sar, E.

    2004-01-01

    When seeking to introduce change into an organisation, it is usually the organisational structure that is the main focus of attention. A reorganisation, however, does not necessarily resolve underlying cultural problems. It can, in fact, be just these cultural problems that prevent the organisation

  11. The Trials of Culture--Law, Conflict, and Change.

    Science.gov (United States)

    Bliss, Pam, Ed.; Kaplan, Howard, Ed.

    2002-01-01

    This magazine aims to help high school teachers of civics, government, history, and law and law-related education program developers educate students about legal issues. This volume focuses on culture, law, conflict, and change. The first article, "Trying Beliefs: The Law of Cultural Orthodoxy and Dissent" (J. H. Landman), demonstrates…

  12. Working Together To Change the Rape and Violence Culture.

    Science.gov (United States)

    Abrams, Julie M.; And Others

    This publication is a collection of 20 supporting documents for a conference program, "Working Together To Change the Rape and Violence Culture." Contents include: (1) "Presenter Contact Information"; (2) "Characteristics of Rape-Prone versus Rape-Free Cultures"; (3) "Dater's Bill of Rights"; (4)…

  13. Cross cultural aspects of health interpreting

    Institute of Scientific and Technical Information of China (English)

    昝婷

    2014-01-01

    In today’s society, the migrant phenomenon occurs easily and frequently. In the host society, they will meet language difficulties in different sectors, for example, in the medical context. In this case we need the medical interpreters. As it has been known, medical interpretation is extremely challenging. For medical interpreters, how to overcome language and cultural obstacles becomes very important.

  14. Technology Change And Working Conditions – A Cultural Perspective

    DEFF Research Database (Denmark)

    Sørensen, Ole Henning

    2004-01-01

    When technology change improves working conditions, the success is often attributed to skilful change agents. When it is not, the blame is on “resistance to change” and “resilient cultures”. How can these failures be understood differently? A cultural perspective on technology change might be a way...

  15. Health-related quality of life and culture.

    Science.gov (United States)

    Kagawa-Singer, Marjorie; Padilla, Geraldine V; Ashing-Giwa, Kimlin

    2010-02-01

    To clarify the relationship between quality of life (QOL) and culture. Journal articles, proceedings, and clinical experience. QOL is a subjective, multidimensional experience of well-being that is culturally constructed as individuals seek safety and security, a sense of integrity and meaning in life, and a sense of belonging in one's social network. In a society where health disparities between diverse groups are known to exist, it is incumbent upon nurses to consider the impact of ethnicity/culture on the health care they deliver and on the QOL of their patients. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  16. Organisational Change, Health and the Labour Market

    DEFF Research Database (Denmark)

    Bhatti, Yosef; Gørtz, Mette; Holm Pedersen, Lene

    This research examines the effects of organisational change on employee health and labour market outcomes. Previous studies looking into organisational change in the private sector indicate that the larger the size and depth of organisational change, the larger the detrimental consequences...... of causal effects of organisational change by exploiting a large scale public sector reform which can be considered as a quasi-experiment. Third, given that the reform was exogenous and implemented simultaneously in a number of Danish municipalities, we also have an objective measure of organisational...... change. And fourth, we have access to objective measures of health outcomes from register data. The results show that the effects of organisational change on health outcomes are limited and heterogeneous. Change per se does not necessarily lead to worsened employee outcomes. However, the degree...

  17. Technology Change And Working Conditions – A Cultural Perspective

    DEFF Research Database (Denmark)

    Sørensen, Ole Henning

    2004-01-01

    When technology change improves working conditions, the success is often attributed to skilful change agents. When it is not, the blame is on “resistance to change” and “resilient cultures”. How can these failures be understood differently? A cultural perspective on technology change might be a way...... to facilitate technology change processes that lead to improved working conditions. The research based project described here has developed a special homepage that explains how this might be achieved. The homepage is targeted at working life professionals. The homepage presents theoretical explanations...... of the concept of organizational culture, a model for analysis and several practical case stories. This paper explains how the project tries to reach a broad spectrum of professionals in order to facilitate their use of a cultural perspective. It also discusses the ethical consequences of the cultural...

  18. Effecting IT infrastructure culture change: management by processes and metrics

    Science.gov (United States)

    Miller, R. L.

    2001-01-01

    This talk describes the processes and metrics used by Jet Propulsion Laboratory to bring about the required IT infrastructure culture change to update and certify, as Y2K compliant, thousands of computers and millions of lines of code.

  19. Effecting IT infrastructure culture change: management by processes and metrics

    Science.gov (United States)

    Miller, R. L.

    2001-01-01

    This talk describes the processes and metrics used by Jet Propulsion Laboratory to bring about the required IT infrastructure culture change to update and certify, as Y2K compliant, thousands of computers and millions of lines of code.

  20. How to change organisational culture: Action research in a South African public sector primary care facility

    Directory of Open Access Journals (Sweden)

    Robert Mash

    2016-03-01

    Full Text Available Background: Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA and had 6 months of coaching. Results: Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion: Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  1. How to change organisational culture: Action research in a South African public sector primary care facility

    Directory of Open Access Journals (Sweden)

    Robert Mash

    2016-03-01

    Full Text Available Background: Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA and had 6 months of coaching. Results: Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion: Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  2. [Changes necessary for continuing health reform: II. The "internal" change].

    Science.gov (United States)

    Martín Martín, J; de Manuel Keenoy, E; Carmona López, G; Martínez Olmos, J

    1990-01-01

    The article desired organizational and managerial changes in Primary Health Care, so as to develop a sound and feasible social marketing strategy. Key elements that should be changed are: 1. Rigid and centralized administrative structures and procedures. 2. Incentives system centralized and dissociated from the managerial structure. 3. Primary Health Care management units immersed in political conflict. 4. Absence of alternative in the margin. Users cannot choose. 5. Lack of an internal marketing strategy. Several ways of internal markets simulation are assessed as potential means for internal change. The need for an administration reform leading to a less inflexible system in the Spanish national and regional health services in reviewed too. Three changes are considered essential: a) Payment systems in Primary Health Care. b) Modifications in the personnel contracts. c) Reform of the budgeting processes. Specific strategies in each of these issues are suggested, making emphasizing the need of their interrelationship and coherence.

  3. Assessing Cultural Change in the United States Army Recruiting Command

    Science.gov (United States)

    2008-11-10

    market research and analysis .27 Given these characteristics there is a clear distinction from the clan culture where NCOs come to their new environment as a recruiter in a market culture. This transition must be difficult. Cameron and Quinn suggest that “if an organization’s culture has gravitated toward the lower quadrants (hierarchy and market) it is very difficult to enact change to move the culture toward the higher quadrants (clan and adhocracy).”28 Conversely, it must be just as difficult to move in the opposite direction,

  4. [The new culture of dematerialized health].

    Science.gov (United States)

    Moruzzi, Mauro

    2014-11-01

    With the Electronic Health Record, which has been provided by law by the Italian State, all health data and information regarding the citizens are dematerialized and move within regional networking eHealth graphs, which are interoperable at the national and then European level. Data generated by the interaction between a patient and a doctor - through a visit, a diagnostic exam or a hospitalization - are shared at the speed of light among all the professionals who are interested in the patient's care pathway, and then with the citizen, in a process producing his/her empowerment.This personalized information, stored and enriched online throughout one's life, makes it possible to reconstruct and actualize the clinical history of the assisted person's, through the demolition of space and time barriers. The interaction between the doctor and the assisted user is thus supported by the communicational power of Health networks, generating powerful data fluxes along the care pathway and serving the purposes of assistential continuity.

  5. Cultural Competence and Children's Mental Health Service Outcomes

    Science.gov (United States)

    Mancoske, Ronald J.; Lewis, Marva L.; Bowers-Stephens, Cheryll; Ford, Almarie

    2012-01-01

    This study describes the relationships between clients' perception of cultural competency of mental health providers and service outcomes. A study was conducted of a public children's mental health program that used a community-based, systems of care approach. Data from a subsample (N = 111) of families with youths (average age 12.3) and primarily…

  6. Assumptions about culture in discourse on ethnic minority health.

    Science.gov (United States)

    Jaeger, Kirsten

    2013-01-01

    This paper is interested in the way the concept of culture is deployed in documents aimed at investigating, informing on and promoting aspects of ethnic minority health. Within a health-political discourse focusing increasingly on individual lifestyles, ethnic minority health became subject to increased political and professional interest in the last decades of the twentieth and the first decade of the twenty-first century. Analysis of the discourse on ethnic minority health emerging in five texts addressing health professionals shows that the culture of ethnic minority citizens is primarily seen as contributing to low levels of knowledge about health and to adverse health behavior. Thus, the texts present cultural beliefs and practices as contributing to the high prevalence of lifestyle diseases among ethnic minority population groups. The analysis, however, demonstrates that a more nuanced discourse is evolving, taking the complexity of the culture concept into account. In accordance with Danish health-political priorities, the most recent text analyzed in this study promotes an individualistic approach to both ethnic minority and Danish ethnic majority citizens.

  7. Food and Health: Individual, Cultural, or Intellectual Matters?

    DEFF Research Database (Denmark)

    Coff, Christian Eyde; Nordström, Karin; Jönsson, Håkan

    2013-01-01

    In personalized nutrition, food is a tool for good health, implying an instrumental relationship between food and health. Food receives a secondary value, whilehealth would appear to be a descriptive biological concept.This article gives an introduction to cultural understandings of food and heal...

  8. Research culture in allied health: a systematic review.

    Science.gov (United States)

    Borkowski, Donna; McKinstry, Carol; Cotchett, Matthew; Williams, Cylie; Haines, Terry

    2016-06-07

    Research evidence is required to guide optimal allied health practice and inform policymakers in primary health care. Factors that influence a positive research culture are not fully understood, and nor is the impact of a positive research culture on allied health professionals. The aim of this systematic review was to identify factors that affect allied health research culture and capacity. An extensive search of 11 databases was conducted in June 2015. Studies were included if they were published in English, had full-text availability and reported research findings relating to allied health professions. Study quality was evaluated using the McMaster Critical Review Forms. Fifteen studies were eligible for inclusion. A meta-analysis was not performed because of heterogeneity between studies. Allied health professionals perceive that their individual research skills are lower in comparison to their teams and organisation. Motivators for conducting research for allied health professionals include developing skills, increasing job satisfaction and career advancement. Barriers include a lack of time, limited research skills and other work roles taking priority. Multilayered strategies, such as collaborations with external partners and developing research leadership positions, aimed at addressing barriers and enablers, are important to enhance allied health research culture and capacity.

  9. Assumptions on culture in discourse on ethnic minority health

    DEFF Research Database (Denmark)

    Jæger, Kirsten

    2014-01-01

    as contributing to low levels of knowledge about health and to adverse health behavior. Thus, the texts present cultural beliefs and practices as contributing to the high prevalence of lifestyle diseases among ethnic minority population groups. The analysis, however, demonstrates that a more nuanced discourse...

  10. Burmese culture, personality and mental health.

    Science.gov (United States)

    Way, R T

    1985-09-01

    As Australia, shaped by new policies of immigration and multiculturalism, grows more cosmopolitan, the challenge for psychiatry is to gain greater familiarity with the new ethnic minority groups, including their cultural personalities and backgrounds. The problem faced by the Burmese group in Australia is distinctive and poignant. Some 20,000 Burmese immigrated following World War II, chiefly to Western Australia in the first place, uniting and consolidating their families. Following the military coup and the Revolutionary Council Government of the early 60s, further emigration from Burma was cut off. This meant that the Burmese in Australia, already under stress arising from cultural differences, were prevented from developing the extensive internal social support systems that characterise other major ethnic groups. The author, a Burmese doctor working in a psychiatric setting in Sydney, draws attention to aspects of his country and its people which should be helpful for psychiatric and related professions.

  11. Cross cultural aspects of health interpreting

    Institute of Scientific and Technical Information of China (English)

    昝婷

    2014-01-01

    In today’s society,the migrant phenomenon occurs easily and frequently.In the host society,they will meet language difficulties in different sectors,for example,in the medical context.In this case we need the medical interpreters.As it has been known,medical interpretation is extremely challenging.For medical interpreters,how to overcome language and cultural obstacles becomes very important.

  12. Phenotypic changes in satellite glial cells in cultured trigeminal ganglia.

    Science.gov (United States)

    Belzer, Vitali; Shraer, Nathanael; Hanani, Menachem

    2010-11-01

    Satellite glial cells (SGCs) are specialized cells that form a tight sheath around neurons in sensory ganglia. In recent years, there is increasing interest in SGCs and they have been studied in both intact ganglia and in tissue culture. Here we studied phenotypic changes in SGCs in cultured trigeminal ganglia from adult mice, containing both neurons and SGCs, using phase optics, immunohistochemistry and time-lapse photography. Cultures were followed for up to 14 days. After isolation virtually every sensory neuron is ensheathed by SGCs, as in the intact ganglia. After one day in culture, SGCs begin to migrate away from their parent neurons, but in most cases the neurons still retain an intact glial cover. At later times in culture, there is a massive migration of SGCs away from the neurons and they undergo clear morphological changes, and at 7 days they become spindle-shaped. At one day in culture SGCs express the glial marker glutamine synthetase, and also the purinergic receptor P2X7. From day 2 in culture the glutamine synthetase expression is greatly diminished, whereas that of P2X7 is largely unchanged. We conclude that SGCs retain most of their characteristics for about 24 h after culturing, but undergo major phenotypic changes at later times.

  13. [Climate change and health. SESPAS report 2010].

    Science.gov (United States)

    Tirado Blázquez, María Cristina

    2010-12-01

    To present the available evidence on the impacts of climate change on health, to analyze the situation in Spain in relation to the European context, to discuss barriers to and catalysts for climate change, and to recommend policy options to reduce the effects of climate change on health. We reviewed the literature on the impact of climate change on health. The proposals for adaptation to climate change identified in the framework of the European project coordinated by the WHO/Europe on "Climate, Environment and Health action plans and information systems" were analyzed. The effects of climate change on health include: 1) an increase in the impacts of extreme weather events; 2) an increase of the frequency of respiratory diseases due to changes in air quality and pollen distribution; 3) an increase in the incidence of food-borne, zoonotic and waterborne diseases; and 4) a change in the distribution of infectious diseases and/or their vectors. In Spain, the morbidity and mortality due to heat waves are expected to increase. The main impact related to atmospheric contamination is a predicted increase in fine particles and ozone. There is also a risk of an increase in the geographical distribution of vector borne diseases that are already established in Spain or the establishment of new subtropical vectors. Spain is one of the first European countries to have developed a climate change adaptation plan. This plan provides a framework for coordination among public institutions on activities to evaluate the impacts of climate change, as well as vulnerability and adaptation to this phenomenon, and makes reference to the health sector. Policy options to reduce the impacts of climate change on health include: 1) integrating health in all policies, strategies and interventions to mitigate and adapt to climate change; 2) strengthening health systems and public health systems to improve their ability to prevent, prepare and respond to the impacts of climate change; 3) raising

  14. Challenging financial Institutions in the region on organizational culture change

    Directory of Open Access Journals (Sweden)

    Dritan Abazi

    2013-02-01

    Full Text Available The father of modern management, Peter Drucker, concluded that “We are in one of those great historical periods that occur every 200 ore 300 years when people don’t understand the world anymore, and the past is not sufficient to explain the future”. We think that organizational culture is equal to quality management. At the same time, we think that quality management is determinant in the organizational performance. If management understands the preferred corporate culture of its organization, it can take steps to create or maintain that culture. Importantly, the people-management policies and procedures should be adjusted to align with and support the desired culture. Eventually, the competition for capital in the banking sectors will increase. This will push banks to look for ways to improve ROE or share price, depending on the markets. In other markets, this has led banks to get into risk areas that are not well understood by many, leading to losses. Our research also highlights an important potential competitive advantage for banks in the region. Increasing creativity should lead to new business opportunities. Creating a culture of creativity in banks in the region would be a challenging. Changing organizational culture is a challenging process and should not be influenced only by external environmental factors or the decision-making of the management, strengthening the organizational culture should be a process that must involve the entire organization by taking into account the preferred culture that is affected by local cultures and environmental changes.

  15. 120 Years of Changing Images of Danish Cultural Journalism

    DEFF Research Database (Denmark)

    Kristensen, Nete Nørgaard

    became cultural products for consumers, which could out-compete the cultural experiences (e.g., visits to an art exhibit) that the stories describe. A content analysis of two national morning papers, a tabloid newspaper, and a free-of-charge newspaper points to ever greater distinction among......The visualization of cultural journalism has changed in Danish printed newspapers during the 20th century. The alternations reflect structural transformations of the Danish media system – from a political party press at the turn of the 20th century, through an omnibus press during most of the 20th...... century, to commercial media institutions with differentiated media- cultural profiles at the turn of the 21st century. Quantitative and qualitative analysis of the long-term changes in the form and content of Danish cultural journalism, from 1890 to 2008, point to an increasing prominence and complexity...

  16. Creating a Culture of Prevention in Occupational Safety and Health Practice.

    Science.gov (United States)

    Kim, Yangho; Park, Jungsun; Park, Mijin

    2016-06-01

    The incidence of occupational injuries and diseases associated with industrialization has declined markedly following developments in science and technology, such as engineering controls, protective equipment, safer machinery and processes, and greater adherence to regulations and labor inspections. Although the introduction of health and safety management systems has further decreased the incidence of occupational injuries and diseases, these systems are not effective unless accompanied by a positive safety culture in the workplace. The characteristics of work in the 21(st) century have given rise to new issues related to workers' health, such as new types of work-related disorders, noncommunicable diseases, and inequality in the availability of occupational health services. Overcoming these new and emerging issues requires a culture of prevention at the national level. The present paper addresses: (1) how to change safety cultures in both theory and practice at the level of the workplace; and (2) the role of prevention culture at the national level.

  17. Creating a Culture of Prevention in Occupational Safety and Health Practice

    Directory of Open Access Journals (Sweden)

    Yangho Kim

    2016-06-01

    Full Text Available The incidence of occupational injuries and diseases associated with industrialization has declined markedly following developments in science and technology, such as engineering controls, protective equipment, safer machinery and processes, and greater adherence to regulations and labor inspections. Although the introduction of health and safety management systems has further decreased the incidence of occupational injuries and diseases, these systems are not effective unless accompanied by a positive safety culture in the workplace. The characteristics of work in the 21st century have given rise to new issues related to workers' health, such as new types of work-related disorders, noncommunicable diseases, and inequality in the availability of occupational health services. Overcoming these new and emerging issues requires a culture of prevention at the national level. The present paper addresses: (1 how to change safety cultures in both theory and practice at the level of the workplace; and (2 the role of prevention culture at the national level.

  18. A conceptual model for culture change evaluation in nursing homes.

    Science.gov (United States)

    Hartmann, Christine W; Snow, A Lynn; Allen, Rebecca S; Parmelee, Patricia A; Palmer, Jennifer A; Berlowitz, Dan

    2013-01-01

    This article describes the development and particulars of a new, comprehensive model of nursing home culture change, the Nursing Home Integrated Model for Producing and Assessing Cultural Transformation (Nursing Home IMPACT). This model is structured into four categories, "meta constructs," "care practices," "workplace practices," and "environment of care," with multiple domains under each. It includes detailed, triangulated assessment methods capturing various stakeholder perspectives for each of the model's domains. It is hoped that this model will serve two functions: first, to help practitioners guide improvements in resident care by identifying particular areas in which culture change is having positive effects, as well as areas that could benefit from modification; and second, to emphasize the importance in culture change of the innumerable perspectives of residents, family members, staff, management, and leadership. Published by Mosby, Inc.

  19. Climate Change, Health, and Populations of Concern

    Science.gov (United States)

    This page contains communication materials that summarize key points from the U.S. Climate and Health Assessment for eight different populations that are disproportionately affected by climate change impacts.

  20. 'I still believe...' Reconstructing spirituality, culture and mental health across cultural divides.

    Science.gov (United States)

    Mayer, Claude-Hélène; Viviers, Rian

    2014-06-01

    Whilst striving to create a balanced and healthy life, individuals experience challenges across their life span. Spirituality can contribute to mental health and well-being, as can cultural constructs. In South Africa, apartheid categories are still vivid, which affect spiritual, cultural and racial mental constructs and impact on the mental health of individuals across cultural groups. This article focuses on the long-term development of spiritual and cultural concepts within a selected individual in Cape Town, South Africa, during 11 years of field work. It also explores the impact of spirituality and culture on the researcher-researched relationship. A mixed-method approach was used, including various qualitative methods of data collection as well as content analysis to analyse the data and intersubjective validation to interpret them. Findings show a strong intrapersonal interlinkage of spirituality, culture and mental health and the researcher-researched relationship having a strong impact on spiritual, cultural and mental health constructions. We are not human beings having a spiritual experience. We are spiritual beings having a human experience. (Pierre Teilhard de Chardin, 1976).

  1. Cultural Health Capital on the margins: Cultural resources for navigating healthcare in communities with limited access.

    Science.gov (United States)

    Madden, Erin Fanning

    2015-05-01

    Communities struggling with access to healthcare in the U.S. are often considered to be disadvantaged and lacking in resources. Yet, these communities develop and nurture valuable strategies for healthcare access that are underrecognized by health scholars. Combining medical sociology and critical race theory perspectives on cultural capital, this paper examines the health-relevant cultural resources, or Cultural Health Capital, in South Texas Mexican American border communities. Ethnographic data collected during 2011-2013 in Cameron and Hidalgo counties on the U.S.-Mexico border provide empirical evidence for expanding existing notions of health-relevant cultural capital. These Mexican American communities use a range of cultural resources to manage healthcare exclusion and negotiate care in alternative healthcare spaces like community clinics, flea markets and Mexican pharmacies. Navigational, social, familial, and linguistic skills and knowledge are used to access doctors and prescription drugs in these spaces despite social barriers to mainstream healthcare (e.g. cost, English language skills, etc.). Cultural capital used in marginalized communities to navigate limited healthcare options may not always fully counteract healthcare exclusion. Nevertheless, recognizing the cultural resources used in Mexican American communities to facilitate healthcare challenges deficit views and yields important findings for policymakers, healthcare providers, and advocates seeking to capitalize on community resources to improve healthcare access. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Yogurt, living cultures, and gut health.

    Science.gov (United States)

    Morelli, Lorenzo

    2014-05-01

    Bacteria used to ferment milk to obtain yogurt belong to thermophilic, bile-sensitive species of lactic acid bacteria, which are not ideally suited for survival into the human gut. However, assessing the viability of these bacteria through the digestive tract may be relevant to evaluate their potential to deliver some beneficial effects for the well-being of the consumer. The well-known reduction in the symptoms caused by lactose maldigestion is not the only benefit provided by yogurt starter cultures; some additional effects will be reviewed here, with special attention paid to data that may suggest a strain-dependent effect, features that are not present with lactose hydrolysis.

  3. Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice.

    Science.gov (United States)

    Young, Susan; Guo, Kristina L

    2016-01-01

    The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

  4. Towards an occupational safety and health culture

    NARCIS (Netherlands)

    Zwetsloot, G.I.J.M.; Steijger, N.

    2014-01-01

    Occupational safety and health (OSH) is a highly regulated area that appears to be based on rational planning and logical management approaches, e.g. OSM Management Systems: employers and employees of organisations should be aware of OSH risks, assess these risks systematically, provide the necessar

  5. Cultural and socio-economic factors in health, health services and prevention for indigenous people

    Directory of Open Access Journals (Sweden)

    SHEIKH MASHHOOD AHMED

    2010-12-01

    Full Text Available Indigenous people across the world experience more health related problems as compared to the population at large. So, this review article is broadly an attempt to highlight the important factors for indigenous peoples’ health problems, and to recommend some suggestions to improve their health status. Standard database for instance, Pubmed, Medline, Google scholar, and Google book searches have been used to get the sources. Different key words, for example, indigenous people and health, socio-economic and cultural factors of indigenous health, history of indigenous peoples’ health, Australian indigenous peoples’ health, Latin American indigenous peoples’ health, Canadian indigenous peoples’ health, South Asian indigenous peoples’ health, African indigenous peoples’ health, and so on, have been used to find the articles and books. This review paper shows that along with commonplace factors, indigenous peoples’ health is affected by some distinctive factors such as indigeneity, colonialand post-colonial experience, rurality, lack of governments’ recognition etc., which nonindigenous people face to a much lesser degree. In addition, indigenous peoples around the world experience various health problems due to their varied socio-economic and cultural contexts. Finally, this paper recommends that the spiritual, physical, mental, emotional, cultural, economic, socio-cultural and environmental factors should be incorporated into the indigenous health agenda to improve their health status.

  6. Preparing culture change agents for academic medicine in a multi-institutional consortium: the C - change learning action network.

    Science.gov (United States)

    Pololi, Linda H; Krupat, Edward; Schnell, Eugene R; Kern, David E

    2013-01-01

    Research suggests an ongoing need for change in the culture of academic medicine. This article describes the structure, activities and evaluation of a culture change project: the C - Change Learning Action Network (LAN) and its impact on participants. The LAN was developed to create the experience of a culture that would prepare participants to facilitate a culture in academic medicine that would be more collaborative, inclusive, relational, and that supports the humanity and vitality of faculty. Purposefully diverse faculty, leaders, and deans from 5 US medical schools convened in 2 1/2-day meetings biannually over 4 years. LAN meetings employed experiential, cognitive, and affective learning modes; innovative dialogue strategies; and reflective practice aimed at facilitating deep dialogue, relationship formation, collaboration, authenticity, and transformative learning to help members experience the desired culture. Robust aggregated qualitative and quantitative data collected from the 5 schools were used to inform and stimulate culture-change plans. Quantitative and qualitative evaluation methods were used. Participants indicated that a safe, supportive, inclusive, collaborative culture was established in LAN and highly valued. LAN members reported a deepened understanding of organizational change, new and valued interpersonal connections, increased motivation and resilience, new skills and approaches, increased self-awareness and personal growth, emotional connection to the issues of diversity and inclusion, and application of new learnings in their work. A carefully designed multi-institutional learning community can transform the way participants experience and view institutional culture. It can motivate and prepare them to be change agents in their own institutions. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical

  7. Muslim American adolescents' explanations of changing religious practices: Cultural tools in cultural contexts.

    Science.gov (United States)

    Cain, Kathleen M; Schiro, Isabella N; Gregory, Wesley E; Westberg, Lindsay M; Lee, Samantha R; Boyle, Colleen D

    2017-03-01

    To examine the culturally embedded nature of religious practices, we conducted a mixed-methods study in which Muslim American adolescents described how and why their religious practices had changed in recent years (see Etengoff & Daiute, 2013, J. Adolesc. Res., 28, 690). Participants included 201 Muslim adolescents (ages 13-19) from predominantly immigrant families; all were contestants in a Muslim Inter-Scholastic Tournament regional competition. Participants completed surveys including an item regarding whether their religious practices had changed, and for those who answered affirmatively, open-ended questions about the change. Additional measures assessed ethnic identity and perceived discrimination. As hypothesized, the 60% of participants who reported a change in religious practices described this shift as a response to new contexts, people, and religious knowledge. Those who reported a change also reported higher levels of ethnic identity exploration and perceived discrimination. Overall, Muslim American adolescents' descriptions portrayed religious practices as developing through reciprocal interactions with culture. More generally, participants' descriptions point to the viability of a model in which religious practices change and in turn are changed by cultural contexts. Statement of contribution What is already known on this subject? Religious development is viewed as taking place in relational systems with reciprocity between individuals and surrounding contexts. Variations in contexts predict variations in religious development, but mechanisms of development are not well understood. Muslim Americans, including adolescents, show high levels of religious involvement and experience unique cultural and religious contexts. Muslim American emerging adults describe their religious practices as responsive to sociocultural contexts. What does the study add? This study focuses on Muslim American adolescents, a group that has received little research attention

  8. Relationships between change and organizational culture in hospitals.

    Science.gov (United States)

    Seren, Seyda; Baykal, Ulku

    2007-01-01

    To define organizational culture in hospitals that have received quality certificates and to identify attitudes of healthcare personnel toward change. The population was all physicians and nurses (N=3,067) employed at four private hospitals that have received accreditation or the "ISO" certificate, and four public hospitals, all of which were located within Istanbul city limits. A proportional sample of 570 participants were selected from the eight hospitals. Data-gathering tools were information form, culture scale, and Attitude Against Change Scale (AACS). Data were evaluated by using descriptive statistics, Cronbach alpha coefficient, Chi-square test, and by t test for dependent groups, one-way variance analysis (ANOVA), and Tukey test. The lowest score averages on the AACS were found in those employed in public hospitals, in those who perceived top executives as autocrats, and in those who were unwilling to participate in quality studies. Participants in a power culture were least open to change. A collaborative culture was the most evident culture in private hospitals, but in public hospitals the most dominant culture was a power culture.

  9. Culture and religious beliefs in relation to reproductive health.

    Science.gov (United States)

    Arousell, Jonna; Carlbom, Aje

    2016-04-01

    An increasing number of contemporary research publications acknowledge the influence of religion and culture on sexual and reproductive behavior and health-care utilization. It is currently hypothesized that religious influences can partly explain disparities in sexual and reproductive health outcomes. In this paper, we will pay particular attention to Muslims in sexual and reproductive health care. This review reveals that knowledge about devout Muslims' own experience of sexual and reproductive health-care matters is limited, thus providing weak evidence for modeling of efficient practical guidelines for sexual and reproductive health care directed at Muslim patients. Successful outcomes in sexual and reproductive health of Muslims require both researchers and practitioners to acknowledge religious heterogeneity and variability, and individuals' possibilities to negotiate Islamic edicts. Failure to do so could lead to inadequate health-care provision and, in the worst case, to suboptimal encounters between migrants with Muslim background and the health-care providers in the receiving country.

  10. Organizational and cultural changes for providing safe patient care.

    Science.gov (United States)

    Odwazny, Richard; Hasler, Scott; Abrams, Richard; McNutt, Robert

    2005-01-01

    To describe an approach and experience with fostering a culture of patient safety. (1) Organizational Change-The Department of Medicine established a patient safety committee (PSC) and charged it with reviewing adverse events. (2) Cultural Change-PSC sponsors and participants work to promote a culture of collaboration, study, learning, and prevention versus a culture of blame. (3) Collaboration-The PSC includes chief residents and members from medical informatics, nursing, pharmacy, quality assurance, risk management, and utilization management. (4) Evolution-The duties of the PSC progressed from merely learning from adverse event reports to implementing patient safety and quality improvement projects. (5) Standardization-The PSC uses standard definitions and procedures when reviewing cases of adverse events, and when conducting patient safety and quality improvement projects. (1) Developed an online adverse event reporting system, shortening the average report collection time by 2 days and increasing the number of adverse events reported. (2) Established a model for change using (a) safety rounds with residents, (b) e-mail safety alerts, and, in some cases, (c) decision alerts using electronic order entry. These changes in culture and capability led to improvements in care and improved financial results. Senior management support of a culture of learning and prevention and an organizational structure that promotes collaboration has provided an environment in which patient safety initiatives can flourish by providing not only safer and higher quality patient care but also a positive financial return on investment.

  11. Stories and Scripts as "Cultural Constraints" on Change in Organisations

    Science.gov (United States)

    Amundsen, Oscar

    2014-01-01

    This paper explores narratives and scripts as possible "cultural constraints" on change in an organisation. The empirical basis is a study of employee's perceptions of change processes in a Norwegian finance group. "Narrative" and "script" are key theoretical concepts in the paper, including their potential to grasp…

  12. Stories and Scripts as "Cultural Constraints" on Change in Organisations

    Science.gov (United States)

    Amundsen, Oscar

    2014-01-01

    This paper explores narratives and scripts as possible "cultural constraints" on change in an organisation. The empirical basis is a study of employee's perceptions of change processes in a Norwegian finance group. "Narrative" and "script" are key theoretical concepts in the paper, including their potential to grasp…

  13. Women who fly: Gender and cultural change in Cuetzalan

    Directory of Open Access Journals (Sweden)

    Eugenia Rodríguez Blanco

    2011-07-01

    Full Text Available This article puts forward a feminist analysis of the dynamics of cultural change in indigenous contexts. We intend to document the processes of cultural change that are concomitant to overcoming exclusion or marginalization of women, and to analyze the factors that cause such transformations. In this study we look for signs that can prove whether these changes are a consequence of a transformation in the gender relations — and an increase in the empowerment of women—or if they are the result of other factors and interests which have the secondary effect of reducing the marginalization of women. The specific case presented here is the participation of women in the "danza de los voladores", a recent phenomenon that suggests a cultural change in relation to gender.

  14. A Cultural Competence Organizational Review for Community Health Services: Insights From a Participatory Approach.

    Science.gov (United States)

    Truong, Mandy; Gibbs, Lisa; Pradel, Veronika; Morris, Michal; Gwatirisa, Pauline; Tadic, Maryanne; de Silva, Andrea; Hall, Martin; Young, Dana; Riggs, Elisha; Calache, Hanny; Gussy, Mark; Watt, Richard; Gondal, Iqbal; Waters, Elizabeth

    2017-05-01

    Cultural competence is an important aspect of health service access and delivery in health promotion and community health. Although a number of frameworks and tools are available to assist health service organizations improve their services to diverse communities, there are few published studies describing organizational cultural competence assessments and the extent to which these tools facilitate cultural competence. This article addresses this gap by describing the development of a cultural competence assessment, intervention, and evaluation tool called the Cultural Competence Organizational Review (CORe) and its implementation in three community sector organizations. Baseline and follow-up staff surveys and document audits were conducted at each participating organization. Process data and organizational documentation were used to evaluate and monitor the experience of CORe within the organizations. Results at follow-up indicated an overall positive trend in organizational cultural competence at each organization in terms of both policy and practice. Organizations that are able to embed actions to improve organizational cultural competence within broader organizational plans increase the likelihood of sustainable changes to policies, procedures, and practice within the organization. The benefits and lessons learned from the implementation of CORe are discussed.

  15. In the right words: addressing language and culture in providing health care.

    Science.gov (United States)

    2003-08-01

    As part of its continuing mission to serve trustees, executives, and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of experts from philanthropy, research, health care practice, and policy on April 4, 2003, to discuss the roles of language and culture in providing effective health care. During this Issue Dialogue, In the Right Words: Addressing Language and Culture in Providing Health Care, health grantmakers and experts from policy and practice participated in an open exchange of ideas and perspectives on language access and heard from fellow grantmakers who are funding innovative programs in this area. Together they explored ways to effectively support comprehensive language services, including the use of interpreters and translation of written materials. This Issue Brief synthesizes key points from the day's discussion with a background paper previously prepared for Issue Dialogue participants. It focuses on the challenges and opportunities involved with ensuring language access for the growing number of people who require it. Sections include: recent immigration trends and demographic changes; the effect of language barriers on health outcomes and health care processes; laws and policies regarding the provision of language services to patients, including an overview of public financing mechanisms; strategies for improving language access, including enhancing access in delivery settings, promoting advocacy and policy change, improving interpreter training, and advancing research; and roles for foundations in supporting improved language access, including examples of current activities. The Issue Dialogue focused mainly on activities and programs that ensure linguistic access to health care for all patients. Although language and culture are clearly inseparable, a full exploration of the field of cultural competence and initiatives that promote its application to the health care setting are beyond the scope

  16. Anthropology, health and illness: an introduction to the concept of culture applied to the health sciences.

    Science.gov (United States)

    Langdon, Esther Jean; Wiik, Flávio Braune

    2010-01-01

    This article presents a reflection as to how notions and behavior related to the processes of health and illness are an integral part of the culture of the social group in which they occur. It is argued that medical and health care systems are cultural systems consonant with the groups and social realities that produce them. Such a comprehension is fundamental for the health care professional training.

  17. Systems Thinking for Transformational Change in Health

    Science.gov (United States)

    Willis, Cameron D.; Best, Allan; Riley, Barbara; Herbert, Carol P.; Millar, John; Howland, David

    2014-01-01

    Incremental approaches to introducing change in Canada's health systems have not sufficiently improved the quality of services and outcomes. Further progress requires 'large system transformation', considered to be the systematic effort to generate coordinated change across organisations sharing a common vision and goal. This essay draws on…

  18. Mental health effects of climate change

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Padhy

    2015-01-01

    Full Text Available We all know that 2014 has been declared as the hottest year globally by the Meteorological department of United States of America. Climate change is a global challenge which is likely to affect the mankind in substantial ways. Not only climate change is expected to affect physical health, it is also likely to affect mental health. Increasing ambient temperatures is likely to increase rates of aggression and violent suicides, while prolonged droughts due to climate change can lead to more number of farmer suicides. Droughts otherwise can lead to impaired mental health and stress. Increased frequency of disasters with climate change can lead to posttraumatic stress disorder, adjustment disorder, and depression. Changes in climate and global warming may require population to migrate, which can lead to acculturation stress. It can also lead to increased rates of physical illnesses, which secondarily would be associated with psychological distress. The possible effects of mitigation measures on mental health are also discussed. The paper concludes with a discussion of what can and should be done to tackle the expected mental health issues consequent to climate change.

  19. Maintenance culture and management of change - Intermediate report 2004

    Energy Technology Data Exchange (ETDEWEB)

    Reiman, T.; Oedewald, P.; Kettunen, J. [VTT Industrial Systems (Finland); Rollenhagen, C.; Kahlbom, U. [Maelardalen University (Sweden)

    2005-04-01

    Change management has emerged as an important topic in safety-critical organisations. A lot of knowledge on change management exists, but still lot of projects fail and the safety consequences of various changes are unclear. It seems that the problems of change management are interdisciplinary, but still solutions tend to only from one perspective (e.g. technical or personnel management). There also exists empirical evidence that change has been experienced as stressful in the nuclear power plants. The cultural perspective taken in this paper strives to combine technical approaches to human resources approaches. It raises new questions that are not usually explicitly taken into account in change management. Financial pressures, change of generation and other changes in the environment have forced many organisations to reorganise their practices (e.g. downsize, outsource, and develop team-based organisations). These changes have had an impact on the culture of the organisation (and the organisational culture has mediated these changes in the first phase). (au)

  20. Climate change, water resources and child health.

    Science.gov (United States)

    Kistin, Elizabeth J; Fogarty, John; Pokrasso, Ryan Shaening; McCally, Michael; McCornick, Peter G

    2010-07-01

    Climate change is occurring and has tremendous consequences for children's health worldwide. This article describes how the rise in temperature, precipitation, droughts, floods, glacier melt and sea levels resulting from human-induced climate change is affecting the quantity, quality and flow of water resources worldwide and impacting child health through dangerous effects on water supply and sanitation, food production and human migration. It argues that paediatricians and healthcare professionals have a critical leadership role to play in motivating and sustaining efforts for policy change and programme implementation at the local, national and international level.

  1. Organizational culture, intersectoral collaboration and mental health care.

    Science.gov (United States)

    Mitchell, Penelope Fay; Pattison, Philippa Eleanor

    2012-01-01

    This study aims to investigate whether and how organizational culture moderates the influence of other organizational capacities on the uptake of new mental health care roles by non-medical primary health and social care services. Using a cross-sectional survey design, data were collected in 2004 from providers in 41 services in Victoria, Australia, recruited using purposeful sampling. Respondents within each service worked as a group to complete a structured interview that collected quantitative and qualitative data simultaneously. Five domains of organizational capacity were analyzed: leadership, moral support and participation; organizational culture; shared concepts, policies, processes and structures; access to resource support; and social model of health. A principal components analysis explored the structure of data about roles and capacities, and multiple regression analysis examined relationships between them. The unit of analysis was the service (n = 41). Organizational culture was directly associated with involvement in two types of mental health care roles and moderated the influence of factors in the inter-organizational environment on role involvement. Congruence between the values embodied in organizational culture, communicated in messages from the environment, and underlying particular mental health care activities may play a critical role in shaping the emergence of intersectoral working and the uptake of new roles. This study is the first to demonstrate the importance of organizational culture to intersectoral collaboration in health care, and one of very few to examine organizational culture as a predictor of performance, compared with other organizational-level factors, in a multivariate analysis. Theory is developed to explain the findings.

  2. A quality improvement evaluation case study: impact on public health outcomes and agency culture.

    Science.gov (United States)

    Livingood, William C; Sabbagh, Radwan; Spitzfaden, Steve; Hicks, Angela; Wells, Lucy; Puigdomenech, Suzannah; Kramer, Dale F; Butterfield, Ryan; Riley, William; Wood, David L

    2013-05-01

    Quality improvement (QI) is increasingly recognized as an important strategy to improve healthcare services and health outcomes, including reducing health disparities. However, there is a paucity of evidence documenting the value of QI to public health agencies and services. The purpose of this project was to support and assess the impact on the outcomes and organizational culture of a QI project to increase immunization rates among children aged 2 years (4:3:1:3:3:1 series) within a large public health agency with a major pediatric health mission. The intervention consisted of the use of a model-for-improvement approach to QI for the delivery of immunization services in public health clinics, utilizing plan-do-study-act cycles and multiple QI techniques. A mixed-method (qualitative and quantitative) model of evaluation was used to collect and analyze data from June 2009 to July 2011 to support both summative and developmental evaluation. The Florida Immunization Registry (Florida SHOTS [State Health Online Tracking System]) was used to monitor and analyze changes in immunization rates from January 2009 to July 2012. An interrupted time-series application of covariance was used to assess significance of the change in immunization rates, and paired comparison using parametric and nonparametric statistics were used to assess significance of pre- and post-QI culture items. Up-to-date immunization rates increased from 75% to more than 90% for individual primary care clinics and the overall county health department. In addition, QI stakeholder scores on ten key items related to organizational culture increased from pre- to post-QI intervention. Statistical analysis confirmed significance of the changes. The application of QI combined with a summative and developmental evaluation supported refinement of the QI approach and documented the potential for QI to improve population health outcomes and improve public health agency culture. Copyright © 2013 American Journal of

  3. Conceptual apparatus of synergetics and study of cultural changes

    Directory of Open Access Journals (Sweden)

    K. A. Ivanova

    2015-04-01

    The second kind of cultural consciousness of researchers of cosmos and nature is analyzed in the article. This group has such features as involvement into revolution ideology and loyalty to the ideals of Enlightenment, faith in the future, confidence in science and its unlimited possibilities to change human nature. Carriers of second kind of cultural consciousness have negative attitude to any attempts of humanitarians to establish prohibition of intervention to human nature.

  4. Rethinking arts marketing in a changing cultural policy context

    OpenAIRE

    Lee, Hye-Kyung

    2005-01-01

    This paper investigates recent changes in British cultural policy and their implications for arts marketing. It first points out the decisive role of the policy in shaping the environment of the nonprofit arts and argues that arts marketing developed as an organisational strategy within the context of marketisation policy since the 1980s. This is followed by an analysis of the current cultural policy, where ‘social impacts’ of the arts are highly emphasised and state intervention intensifies....

  5. Attitude change among health educators studying abroad.

    Science.gov (United States)

    Weinstein, S

    1983-01-01

    This study examined change in attitudes about international health efforts among health educators who participated in graduate study-abroad programs in Japan and Jamaica. No statistically significant changes were found in levels of hostility toward other nations or attitude toward international health cooperation. However, correlations found between individual attitude change and measures of dogmatism and tolerance for ambiguity suggest that participants may vary in their receptiveness to the messages of such programs, and that openness of participant's belief systems may have some role in the success of such programs. The nature of this role is unclear since more dogmatic participants in the Japan group reported greater attitude change than their more open minded peers. This result was opposite to that expected and was not found for the Jamaica group.

  6. Culture and healthcare in medical education: migrants' health and beyond.

    Science.gov (United States)

    Knipper, Michael; Akinci, Secil; Soydan, Nedim

    2010-01-01

    One of the main challenges for teaching programs on immigration, ethnic diversity and health is to transform the commonplace notion of "culture" into a helpful tool for medical training and practice. This paper presents the teaching approach of an interdisciplinary course on "migrants' health" established at the University of Giessen since 2004, which has recently been complemented by a thematically related collaboration with two universities in Latin America (Ecuador, Peru). The overall goal is to translate the abstract philosophy of "think global and teach local" into medical practice, and to provide students with the insights, attitudes and skills needed for a fruitful use of concepts like "culture", "ethnicity" and "migration background". A key feature of the course is the strong commitment to ethnography as an important means for looking under the surface of superficial attributions to culture, and for grasping the interplay of medicine and health with cultural, social, religious, economic and legal aspects in its particular local and/or individual shape. Three elements of the course are presented to illustrate this approach: First, a unit on Islam and Medicine, as important parts of the local immigrant community are Muslims. The second one deals with psychosomatic aspects, because in case of immigrants, complex symptoms and disease representations like somatisation are easily misinterpreted as "cultural". The third element consists of a unit with specialized social workers form outside the university, who provide direct insights into the living conditions and health problems of local immigrant communities.

  7. SOCIAL AND HEALTH-IMPROVING SERVICES AS A FACTOR OF CULTURE HEALTH ORGANIZATION

    Directory of Open Access Journals (Sweden)

    Olga Alekseevna Zaplatina

    2015-02-01

    Full Text Available At present time mankindis entering upon a new information age, and therefore the foundations of culture health organization is considered as the perspective to distribute intellectual and information resources as ecologically sustainable development and modernizing of Russian society. Great attention in this regard is given to a higher education system, the aim of which is to prepare a specialist with fundamental knowledge, professionally important qualities, environmental culture and culture of health.Though information resources in the sphere of continuous environmental and valeological education, from the point of their socio-philosophical justification, are varied and quite extensional, these trends are just beginning to penetrate in all areas of social life (including the educational environment and are not sufficiently reflected in continuing professional education, especially technical and, as it is know, technical education is preparing professionals of new type, adequate to changing conditions.In this regard, the ecologization аnd valeologization of continuous training acquires the greatest relevance in modernization of higher education. Also one of the urgent tasks is training of specialists, having high level of ecological and valeological consciousness development and ecological thinking; all these determine the functioning of the system «society-production-environment». According to these facts, it is possible to mention the necessity to solve the problems of environmental and valeological education in professional training of specialists, by means of global process modeling directly and indirectly related to this field.Since ecological and valeological education in higher schools must be based on regulatory support, as an important tool, used by the state in order to preserve the national health, as well as balances environmental management, it is necessary to note that at the state level the most important task is to promote

  8. Living in the tide of change: explaining Japanese subjective health from the socio-demographic change

    Science.gov (United States)

    Hitokoto, Hidefumi; Tanaka-Matsumi, Junko

    2014-01-01

    Today, countries around the world are caught in the tide of change toward Gesellshaft, or individualistic socio-demographic condition. Recent investigations in Japan have suggested negative impacts of change on emotional and motivational aspects of the Japanese self (Norasakkunkit et al., 2012; Ogihara and Uchida, 2014). Building on previous findings, in Study 1, we measured socio-demographic change toward individualistic societal condition during 1990–2010—two decades marked by great economic recession—at the levels of prefecture and city using archival data. In Study 2, we tested whether Japanese adults' general health, satisfaction with life, self-esteem, and perceived social support were negatively predicted by the change using social survey. Results of hierarchical linear modeling showed small but unique negative effects of the change on several health measures, suggesting that this change had an impact on health, above and beyond individual personality traits, and demographics. Additionally, interdependent happiness, the type of cultural happiness grounded in interdependence of the self (Hitokoto and Uchida, 2014), showed an independent positive relationship with all aspects of health examined. Implications for health studies in changing socio-demographic condition are discussed in the context of Japanese society after economic crisis. PMID:25400604

  9. An assessment of cultural values and resident-centered culture change in U.S. nursing facilities.

    Science.gov (United States)

    Banaszak-Holl, Jane; Castle, Nicholas G; Lin, Michael; Spreitzer, Gretchen

    2013-01-01

    Culture change initiatives propose to improve care by addressing the lack of managerial supports and prevalent stressful work environments in the industry; however, little is known about how culture change facilities differ from facilities in the industry that have not chosen to affiliate with the resident-centered care movements. The aim of this study was to evaluate representation of organizational culture values within a random sample of U.S. nursing home facilities using the competing values framework and to determine whether organizational values are related to membership in resident-centered culture change initiatives. We collected reports of cultural values using a well-established competing values framework instrument in a random survey of facility administrators and directors of nursing within all states. We received responses from 57% of the facilities that were mailed the survey. Directors of nursing and administrators did not differ significantly in their reports of culture and facility measures combined their responses. Nursing facilities favored market-focused cultural values on average, and developmental values, key to innovation, were the least common across all nursing homes. Approximately 17% of the facilities reported that all cultural values were strong within their facilities. Only high developmental cultural values were linked to participation in culture change initiatives. Culture change facilities were not different from non-culture change facilities in the promotion of employee focus as organizational culture, as emphasized in group culture values. Likewise, culture change facilities were also not more likely to have hierarchical or market foci than non-culture change facilities. Our results counter the argument that culture change facilities have a stronger internal employee focus than facilities more generally but do show that culture change facilities report stronger developmental cultures than non-culture change facilities, which

  10. CULTURAL CHANGE IN TELECOMMUNICATIONS COMPANIES: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Cristiane Alves Anacleto

    2014-09-01

    Full Text Available This work aims to propose a model for the conduct of cultural change in the IT department of a company in the telecommunications industry. To achieve the goal proposed exploratory, technical procedures used were the case study and literature review. The techniques of data collection in the case study were: participant observation, unstructured interview and document analysis. The proposed model consists of five steps: analysis of the company's strategic planning, cultural diagnosis of the IT department, brainstorming with the staff and managers, compared to the case studies surveyed and proposed actions for the conduct of cultural change. We conclude that a receptive environment, employees not only understand why the changes are necessary, but engage with the process and faithfully executes the steps required, favoring the strategic positioning of the company.

  11. Culture change, leadership and the grass-roots workforce.

    Science.gov (United States)

    Edwards, Mark; Penlington, Clare; Kalidasan, Varadarajan; Kelly, Tony

    2014-08-01

    The NHS is arguably entering its most challenging era. It is being asked to do more for less and, in parallel, a cultural shift in response to its described weaknesses has been prescribed. The definition of culture, the form this change should take and the mechanism to achieve it are not well understood. The complexity of modern healthcare requires that we evolve our approach to the workforce and enhance our understanding of the styles of leadership that are required in order to bring about this cultural change. Identification of leaders within the workforce and dissemination of a purposeful and strategic quality improvement agenda, in part defined by the general workforce, are important components in establishing the change that the organisation currently requires. We are implementing this approach locally by identifying and developing grassroots networks linked to a portfolio of safety and quality projects.

  12. [Sexual development in the light of socio-cultural changes].

    Science.gov (United States)

    Strauss, Bernhard

    2007-01-01

    This article briefly summarizes central components of theories of sexual development and outlines that these components depend largely on socio-cultural factors. A cultural change of human sexuality is reflected by several phenomena such as the public debate about sexual violence and its consequences, a diminuation of gender differences and a turn away from monosexuality, tremendous changes within the world of partner relationships and a mediatization of sexuality. This mediatization is paralleled by a public sexualization as well as a de-sexualization of the private sphere together with an increase of a loss of sexual desire reflecting well-known problems of human sexuality. Finally, it has to be stated that sexuality has experienced a demystification as a consequence of socio-cultural changes following the sexual liberalization.

  13. Universal health care: the changing international discourse.

    Science.gov (United States)

    Bisht, Ramila

    2013-01-01

    Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world's populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to "Health for All" was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC). It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited.

  14. Universal health care: The changing international discourse

    Directory of Open Access Journals (Sweden)

    Ramila Bisht

    2013-01-01

    Full Text Available Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world′s populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to "Health for All" was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC. It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited.

  15. Overcoming health care disparities via better cross-cultural communication and health literacy.

    Science.gov (United States)

    Misra-Hebert, Anita D; Isaacson, J Harry

    2012-02-01

    Health care disparities have multiple causes; the dynamics of the physician-patient encounter is one of the causes that can be modified. Here, we discuss specific recommendations related to cross-cultural communication and health literacy as practical steps to providing more equitable health care to all patients.

  16. Culture Shock—A Review of Vietnamese Culture and Its Concepts of Health and Disease

    OpenAIRE

    1985-01-01

    Misunderstandings of Vietnamese culture and beliefs have led to many unfortunate incidents in the United States, including court cases for child abuse and even suicide. These can be avoided by an awareness of the cultural background of the Vietnamese, their philosophy of life and the influence of religion and beliefs on their personalities, both as individual persons and as members of extended family units. The Vietnamese concepts of health and disease are presented, along with brief descript...

  17. Innovations in public health education: promoting professional development and a culture of health.

    Science.gov (United States)

    Levy, Marian; Gentry, Daniel; Klesges, Lisa M

    2015-03-01

    As the field of public health advances toward addressing complex, systemic problems, future public health professionals must be equipped with leadership and interprofessional skills that support collaboration and a culture of health. The University of Memphis School of Public Health has infused innovative strategies into graduate education via experiential learning opportunities to enhance leadership, collaboration, and professional development. Novel training programs such as Day One, Public Health Interdisciplinary Case Competition, and Memphis Healthy U support Association of Schools and Programs of Public Health cross-cutting competencies and prepare Master of Public Health and Master of Health Administration graduates to function effectively at the outset of their careers and become catalysts for creating a culture of health.

  18. The ethical self-fashioning of physicians and health care systems in culturally appropriate health care.

    Science.gov (United States)

    Shaw, Susan J; Armin, Julie

    2011-06-01

    Diverse advocacy groups have pushed for the recognition of cultural differences in health care as a means to redress inequalities in the U.S., elaborating a form of biocitizenship that draws on evidence of racial and ethnic health disparities to make claims on both the state and health care providers. These efforts led to federal regulations developed by the U.S. Office of Minority Health requiring health care organizations to provide Culturally and Linguistically Appropriate Services. Based on ethnographic research at workshops and conferences, in-depth interviews with cultural competence trainers, and an analysis of postings to a moderated listserv with 2,000 members, we explore cultural competence trainings as a new type of social technology in which health care providers and institutions are urged to engage in ethical self-fashioning to eliminate prejudice and embody the values of cultural relativism. Health care providers are called on to re-orient their practice (such as habits of gaze, touch, and decision-making) and to act on their own subjectivities to develop an orientation toward Others that is "culturally competent." We explore the diverse methods that cultural competence trainings use to foster a health care provider's ability to be self-reflexive, including face-to-face workshops and classes and self-guided on-line modules. We argue that the hybrid formation of culturally appropriate health care is becoming detached from its social justice origins as it becomes rationalized by and more firmly embedded in the operations of the health care marketplace.

  19. Parenting and child mental health: a cross-cultural perspective

    OpenAIRE

    Bornstein, Marc H.

    2013-01-01

    In its most general instrumental sense, parenting consists of care of the young in preparing them to manage the tasks of life. Parents provide childhood experiences and populate the environments that guide children's development and so contribute to child mental health. Parenting is expressed in cognitions and practices. However, parents do not parent, and children do not grow up, in isolation, but in multiple contexts, and one notable context of parenting and child mental health is culture. ...

  20. Smoke free health care: an organisational change to increase effective intervention for tobacco.

    Science.gov (United States)

    Kia, Annie M; van Beurden, Eric K; Dart, Gavin S; Barrack, Cecily M; Mitchell, Mark D

    2008-01-01

    In 1999, the NSW Health Smoke Free Workplace Policy directed that grounds of health sites would become smoke free, in addition to the existing policy requiring smoke-free buildings. This was one of the first attempts by any health service to exclude tobacco entirely from health sites. This task required the adoption of evidence-based management of tobacco dependence and changing the culture of smoking in the health service. There were many barriers to implementation.

  1. Creating quality improvement culture in public health agencies.

    Science.gov (United States)

    Davis, Mary V; Mahanna, Elizabeth; Joly, Brenda; Zelek, Michael; Riley, William; Verma, Pooja; Fisher, Jessica Solomon

    2014-01-01

    We conducted case studies of 10 agencies that participated in early quality improvement efforts. The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

  2. Cross-cultural equivalence in translations of the oral health impact profile.

    Science.gov (United States)

    MacEntee, Michael I; Brondani, Mario

    2016-04-01

    The Oral Health Impact Profile (OHIP) has been translated for comparisons across cultural boundaries. This report on a systematic search of literature published between 1994 and 2014 aims to identify an acceptable method of translating psychometric instruments for cross-cultural equivalence, and how they were used to translate the OHIP. An electronic search used the keywords 'cultural adaptation', 'validation', 'Oral Health Impact Profile' and 'OHIP' in MEDLINE and EMBASE databases supplemented by reference links and grey literature. It included papers on methods of cross-cultural translation and translations of the OHIP for dentulous adults and adolescents, and excluded papers without translational details or limited to specific disorders. The search identified eight steps to cross-cultural equivalence, and 36 (plus three supplemental) translations of the OHIP. The steps involve assessment of (i) forward/backward translation by committee, (ii) constructs, (iii) item interpretations, (iv) interval scales, (v) convergent validity, (vi) discriminant validity, (vii) responsiveness to clinical change and (viii) pilot tests. Most (>60%) of the translations involved forward/backward translation by committee, item interpretations, interval scales, convergence, discrimination and pilot tests, but fewer assessed the underlying theory (47%) or responsiveness to clinical change (28%). An acceptable method for translating quality of life-related psychometric instruments for cross-cultural equivalence has eight procedural steps, and most of the 36 OHIP translations involved at least five of the steps. Only translations to Saudi Arabian Arabic, Chinese Mandarin, German and Japanese used all eight steps to claim cultural equivalence with the original OHIP.

  3. Framing the impact of culture on health: a systematic review of the PEN-3 cultural model and its application in public health research and interventions.

    Science.gov (United States)

    Iwelunmor, Juliet; Newsome, Valerie; Airhihenbuwa, Collins O

    2014-02-01

    This paper reviews available studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. We search electronic databases and conducted a thematic analysis of empirical studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. Studies were mapped to describe their methods, target population and the health behaviors or health outcomes studied. Forty-five studies met the inclusion criteria. The studies reviewed used the PEN-3 model as a theoretical framework to centralize culture in the study of health behaviors and to integrate culturally relevant factors in the development of interventions. The model was also used as an analysis tool, to sift through text and data in order to separate, define and delineate emerging themes. PEN-3 model was also significant with exploring not only how cultural context shapes health beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes. Finally, the studies reviewed highlighted the utility of the model with examining cultural practices that are critical to positive health behaviors, unique practices that have a neutral impact on health and the negative factors that are likely to have an adverse influence on health. The limitations of model and the role for future studies are discussed relative to the importance of using PEN-3 cultural model to explore the influence of culture in promoting positive health behaviors, eliminating health disparities and designing and implementing sustainable public health interventions.

  4. Instructional design strategies for health behavior change.

    Science.gov (United States)

    Kinzie, Mable B

    2005-01-01

    To help health educators build upon the best of different health behavior change theories, this paper offers a unified set of instructional design strategies for health education interventions. This set draws upon the recommendations of Rosenstock (Health Belief Model), Bandura (Social Cognitive Theory), and Dearing (Diffusion Theory), and uses a modified Events of Instruction framework (adapted from Robert Gagne): gain attention (convey health threats and benefits), present stimulus material (tailor message to audience knowledge and values, demonstrate observable effectiveness, make behaviors easy-to-understand and do), provide guidance (use trustworthy models to demonstrate), elicit performance and provide feedback (to enhance trialability, develop proficiency and self-efficacy), enhance retention and transfer (provide social supports and deliver behavioral cues). Sample applications of these strategies are provided. A brief review of research on adolescent smoking prevention enables consideration of the frequency with which these strategies are used, and possible patterns between strategy use and behavioral outcomes.

  5. Climate change and human health: impacts, vulnerability and public health.

    Science.gov (United States)

    Haines, A; Kovats, R S; Campbell-Lendrum, D; Corvalan, C

    2006-07-01

    It is now widely accepted that climate change is occurring as a result of the accumulation of greenhouse gases in the atmosphere arising from the combustion of fossil fuels. Climate change may affect health through a range of pathways, for example as a result of increased frequency and intensity of heat waves, reduction in cold related deaths, increased floods and droughts, changes in the distribution of vector-borne diseases and effects on the risk of disasters and malnutrition. The overall balance of effects on health is likely to be negative and populations in low-income countries are likely to be particularly vulnerable to the adverse effects. The experience of the 2003 heat wave in Europe shows that high-income countries may also be adversely affected. Adaptation to climate change requires public health strategies and improved surveillance. Mitigation of climate change by reducing the use of fossil fuels and increasing a number of uses of the renewable energy technologies should improve health in the near-term by reducing exposure to air pollution.

  6. Managing equality and cultural diversity in the health workforce.

    Science.gov (United States)

    Hunt, Beverley

    2007-12-01

    This article offers practical strategies to managers and others for supporting overseas trained nurses and managing cultural diversity in the health workforce. Widespread nursing shortages have led managers to recruit nurses from overseas, mainly from developing countries. This paper draws on evidence from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study reported elsewhere in this issue, which indicates that overseas trained nurses encountered widespread discriminatory practices including an overuse of complaints and grievances against them. The researchers also found that the overseas trained nurses responded to their experiences by using various personal strategies to resist or re-negotiate and overcome such discriminatory practices. A research workshop was held in June 2005 at the midpoint of the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study. Twenty-five participants attended the workshop. They were the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals study researchers, advisory group members, including the author of this paper and other researchers in the field of migration. The overall aim of the workshop was to share emerging research data from the Researching Equal Opportunities for Internationally Recruited Nurses and Other Health Professionals and related studies. The final session of the workshop on which this paper is based, was facilitated by the author, with the specific aim of asking the participants to discuss and determine the challenges to managers when managing a culturally diverse workforce. The discussion yielded four main themes collated by the author from which a framework of strategies to facilitate equality and cultural diversity management of the healthcare workers may be developed. The four themes are: assumptions and expectations; education and training to include

  7. Navigating the ethics of cross-cultural health promotion research.

    Science.gov (United States)

    Haintz, Greer Lamaro; Graham, Melissa; McKenzie, Hayley

    2015-12-01

    Health promotion researchers must consider the ethics of their research, and are usually required to abide by a set of ethical requirements stipulated by governing bodies (such as the Australian National Health and Medical Research Council) and human research ethics committees (HRECs). These requirements address both deontological (rule-based) and consequence-based issues. However, at times there can be a disconnect between the requirements of deontological issues and the cultural sensitivity required when research is set in cultural contexts and settings etic to the HREC. This poses a challenge for health promotion researchers who must negotiate between meeting both the requirements of the HREC and the needs of the community with whom the research is being conducted. Drawing on two case studies, this paper discusses examples from cross-cultural health promotion research in Australian and international settings where disconnect arose and negotiation was required to appropriately meet the needs of all parties. The examples relate to issues of participant recruitment and informed consent, participants under the Australian legal age of consent, participant withdrawal when this seemingly occurs in an ad hoc rather than a formal manner and reciprocity. Although these approaches are context specific, they highlight issues for consideration to advance more culturally appropriate practice in research ethics and suggest ways a stronger anthropological lens can be applied to research ethics to overcome these challenges.

  8. Our Cultures Are Our Source of Health PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-03-04

    In this 60 second Public Service Announcement, Wes Studi, Hollywood actor, highlights the wisdom of cultural knowledge to promote health and prevent type 2 diabetes.  Created: 3/4/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/4/2013.

  9. Our Cultures Are Our Source of Health PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2013-03-04

    In this 30 second Public Service Announcement, Wes Studi, Hollywood actor, highlights the wisdom of cultural knowledge to promote health and prevent type 2 diabetes.  Created: 3/4/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/4/2013.

  10. Individualization of forming health culture in schoolchildren of Polish schools

    Directory of Open Access Journals (Sweden)

    Yermakova T.S.

    2015-01-01

    Full Text Available The aim is to highlight the issues of gender education and individual characteristics of schoolchildren in the formation of their health culture due to school conditions. Material: content analysis of domestic and foreign authors. Results . Determined that the peculiarities of forming health culture of schoolchildren make for the specifics of school age (primary school age - 6/7 - 10/11 years; teen school age - 12/13 - 15/16 years. It is found that the level of formation of health culture in childhood will depend on the next person’s lifestyle, the level of his personal potential. Gender approach in pedagogy can overcome entrenched negative gender stereotypes, to develop a set of approaches aimed at helping children to easily go through the process of socialization and gender identity. Conclusions: information about formation schoolchildren health culture should be provided necessarily considering age and individual characteristics of schoolchildren, because otherwise it can be confusing for them and as a consequence is not only beneficial, but also harm.

  11. Culture, history, and health in an Australian aboriginal community: the case of utopia.

    Science.gov (United States)

    Anderson, Heather; Kowal, Emma

    2012-01-01

    The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia.

  12. Global Climate Change and Children's Health.

    Science.gov (United States)

    2015-11-01

    Rising global temperatures are causing major physical, chemical, and ecological changes in the planet. There is wide consensus among scientific organizations and climatologists that these broad effects, known as "climate change," are the result of contemporary human activity. Climate change poses threats to human health, safety, and security, and children are uniquely vulnerable to these threats. The effects of climate change on child health include: physical and psychological sequelae of weather disasters; increased heat stress; decreased air quality; altered disease patterns of some climate-sensitive infections; and food, water, and nutrient insecurity in vulnerable regions. The social foundations of children's mental and physical health are threatened by the specter of far-reaching effects of unchecked climate change, including community and global instability, mass migrations, and increased conflict. Given this knowledge, failure to take prompt, substantive action would be an act of injustice to all children. A paradigm shift in production and consumption of energy is both a necessity and an opportunity for major innovation, job creation, and significant, immediate associated health benefits. Pediatricians have a uniquely valuable role to play in the societal response to this global challenge.

  13. Social change, migration and sexual health: Chilean women in Chile and Australia.

    Science.gov (United States)

    Dawson, Maria Teresa; Gifford, Sandra Margaret

    2003-01-01

    Cultural beliefs, norms and values regarding sexuality and gender roles forge people's sexual behaviour and understanding of sexual health risk. Acknowledging a person's cultural background is a key challenge for the promotion of sexual health programs and strategies for the prevention of sexually transmitted diseases (STDs) and HIV/AIDS. This challenge acquires larger dimensions when health promotion programs are directed towards migrant communities. This article examines narratives about past and present life experiences of Chilean women living in Australia and Chilean women in Chile. We inquire about social changes and exposure to education women experienced in their own country and in Australia and the ways in which migrant women define and articulate their experiences in relation to sexual health prevention. In comparing these experiences, we raise a number of questions about sexual health promotion and programs, including the prevention of STDs and HIV/AIDS targeted to specific migrant communities in Australia. Very few sexual health policies and strategies in Australia take into account the impact that the social and cultural background of migrants, social changes and the 'settlement process' has on the cultural construction of gender identity of migrants in the new country. We propose that these cultural constructs are key in the formulation of migrants' beliefs and attitudes towards sexuality and sexual health. We suggest that there is a need to build effective and culturally appropriate sexual health promotion and prevention strategies that build upon the social and cultural background and the present and past life experiences of migrant women and men.

  14. Smart health and innovation: facilitating health-related behaviour change.

    Science.gov (United States)

    Redfern, J

    2017-08-01

    Non-communicable diseases (NCD) are the leading cause of death globally. Smart health technology and innovation is a potential strategy for increasing reach and for facilitating health behaviour change. Despite rapid growth in the availability and affordability of technology there remains a paucity of published and robust research in the area as it relates to health. The objective of the present paper is to review and provide a snapshot of a variety of contemporary examples of smart health strategies with a focus on evidence and research as it relates to prevention with a CVD management lens. In the present analysis, five examples will be discussed and they include a physician-directed strategy, consumer directed strategies, a public health approach and a screening strategy that utilises external hardware that connects to a smartphone. In conclusion, NCD have common risk factors and all have an association with nutrition and health. Smart health and innovation is evolving rapidly and may help with diagnosis, treatment and management. While on-going research, development and knowledge is needed, the growth of technology development and utilisation offers opportunities to reach more people and achieve better health outcomes at local, national and international levels.

  15. Ethanol induces MAP2 changes in organotypic hippocampal slice cultures

    DEFF Research Database (Denmark)

    Noraberg, J; Zimmer, J

    1998-01-01

    Microtubule-associated protein 2 (MAP2) and neuron-specific protein (NeuN) immunostains were used to demonstrate neurotoxic effects in mature hippocampal slice cultures exposed to ethanol (50, 100, 200 mM) for 4 weeks. At the low dose the density of MAP2 immunostaining in the dentate molecular...... layer was 118% of the control cultures, with no detectable changes in CA1 and CA3. At 100 mM no changes were detected, while 200 mM ethanol significantly reduced the MAP2 density in both dentate (19%) and hippocampal dendritic fields (CA3, 52%; CA1, 55%). At this dose NeuN staining showed considerable...... loss of CA3 pyramidal cells and moderate loss of dentate granule cells, as seen in vivo. The results indicate that brain slice cultures combined with immunostaining for cytoskeleton and neuronal markers can be used for studies of ethanol and organic solvent neurotoxicity....

  16. Ethanol induces MAP2 changes in organotypic hippocampal slice cultures

    DEFF Research Database (Denmark)

    Noraberg, J; Zimmer, J

    1998-01-01

    loss of CA3 pyramidal cells and moderate loss of dentate granule cells, as seen in vivo. The results indicate that brain slice cultures combined with immunostaining for cytoskeleton and neuronal markers can be used for studies of ethanol and organic solvent neurotoxicity.......Microtubule-associated protein 2 (MAP2) and neuron-specific protein (NeuN) immunostains were used to demonstrate neurotoxic effects in mature hippocampal slice cultures exposed to ethanol (50, 100, 200 mM) for 4 weeks. At the low dose the density of MAP2 immunostaining in the dentate molecular...... layer was 118% of the control cultures, with no detectable changes in CA1 and CA3. At 100 mM no changes were detected, while 200 mM ethanol significantly reduced the MAP2 density in both dentate (19%) and hippocampal dendritic fields (CA3, 52%; CA1, 55%). At this dose NeuN staining showed considerable...

  17. An evolutionary framework for cultural change: selectionism versus communal exchange.

    Science.gov (United States)

    Gabora, Liane

    2013-06-01

    Dawkins' replicator-based conception of evolution has led to widespread mis-application of selectionism across the social sciences because it does not address the paradox that necessitated the theory of natural selection in the first place: how do organisms accumulate change when traits acquired over their lifetime are obliterated? This is addressed by von Neumann's concept of a self-replicating automaton (SRA). A SRA consists of a self-assembly code that is used in two distinct ways: (1) actively deciphered during development to construct a self-similar replicant, and (2) passively copied to the replicant to ensure that it can reproduce. Information that is acquired over a lifetime is not transmitted to offspring, whereas information that is inherited during copying is transmitted. In cultural evolution there is no mechanism for discarding acquired change. Acquired change can accumulate orders of magnitude faster than, and quickly overwhelm, inherited change due to differential replication of variants in response to selection. This prohibits a selectionist but not an evolutionary framework for culture and the creative processes that fuel it. The importance non-Darwinian processes in biological evolution is increasingly recognized. Recent work on the origin of life suggests that early life evolved through a non-Darwinian process referred to as communal exchange that does not involve a self-assembly code, and that natural selection emerged from this more haphazard, ancestral evolutionary process. It is proposed that communal exchange provides an evolutionary framework for culture that enables specification of cognitive features necessary for a (real or artificial) societies to evolve culture. This is supported by a computational model of cultural evolution and a conceptual network based program for documenting material cultural history, and it is consistent with high levels of human cooperation.

  18. An evolutionary framework for cultural change: Selectionism versus communal exchange

    Science.gov (United States)

    Gabora, Liane

    2013-06-01

    Dawkins' replicator-based conception of evolution has led to widespread mis-application of selectionism across the social sciences because it does not address the paradox that necessitated the theory of natural selection in the first place: how do organisms accumulate change when traits acquired over their lifetime are obliterated? This is addressed by von Neumann's concept of a self-replicating automaton (SRA). A SRA consists of a self-assembly code that is used in two distinct ways: (1) actively deciphered during development to construct a self-similar replicant, and (2) passively copied to the replicant to ensure that it can reproduce. Information that is acquired over a lifetime is not transmitted to offspring, whereas information that is inherited during copying is transmitted. In cultural evolution there is no mechanism for discarding acquired change. Acquired change can accumulate orders of magnitude faster than, and quickly overwhelm, inherited change due to differential replication of variants in response to selection. This prohibits a selectionist but not an evolutionary framework for culture and the creative processes that fuel it. The importance non-Darwinian processes in biological evolution is increasingly recognized. Recent work on the origin of life suggests that early life evolved through a non-Darwinian process referred to as communal exchange that does not involve a self-assembly code, and that natural selection emerged from this more haphazard, ancestral evolutionary process. It is proposed that communal exchange provides an evolutionary framework for culture that enables specification of cognitive features necessary for a (real or artificial) societies to evolve culture. This is supported by a computational model of cultural evolution and a conceptual network based program for documenting material cultural history, and it is consistent with high levels of human cooperation.

  19. Public health, cultural norms and the criminal law: an inconvenient union? A case study of female genital cutting.

    Science.gov (United States)

    Iyioha, Ireh

    2012-09-01

    Social and cultural stereotypes held about women and their health needs constitute a significant barrier to the enforcement of laws protecting women's health. While the promulgation of remedial legislation to address the problem is a positive step towards protecting women's health, these laws are promulgated in a cultural milieu that remains unwelcoming to women's rights. The clash between long-held cultural perceptions and health laws, such as those affecting women's reproductive health, engenders more problems for women's health because the laws sometimes fail to produce the desired behavioural changes. This paper attempts to debunk the uncritical assumption that legislative reforms without more are positive instruments of change in protecting women's health. In outlining this thesis, the paper examines the legal prohibition of Female Genital Cutting ('FGC') as a case study. To determine whether FGC prohibition laws are likely to be effective in achieving the public health agenda of protecting women's health, the paper analyzes FGC laws against the normative and instrumental theories of legal compliance, as well as against the socio-cultural worldviews underlying the practice. It concludes that legislative efforts to protect women's health may remain ineffective without structured efforts between health systems, governments or legal institutions and the cultural society.

  20. Changing the Cultural Paradigm to Meet Emerging Requirements

    Science.gov (United States)

    Robbins, William W.

    2007-01-01

    This viewgraph presentation reviews changes that are required in Space Transportation. This new transportation paradigm from the reliance on the Space Shuttle to a mixture of space transportation vehicles, i.e., the Russian Progress, vehicle, the Japanese HTV, the European ATV and other commercial orbital transportation systems, requires a new cultural paradigm. This new paradigm is outlined, and reviewed.

  1. Instituting Cultural Change at a Major Organization: A Case Study

    Science.gov (United States)

    Dulek, Ronald E.

    2015-01-01

    This article examines the development and implementation of a strategic cultural change program from a case study perspective. Initially, the article describes how the program was developed, including an explanation as to how a communication component was integrated into the program from inception. This integration helped reduce the anxiety that…

  2. German financial media's responsiveness to Deutsche Bank's cultural change

    NARCIS (Netherlands)

    Strauß, N.

    2015-01-01

    Based on first-order and second-order agenda building theory, this study analyzes the responsiveness of German financial media to frames of the "cultural change" proclaimed in the banking industry, exemplified by Deutsche Bank. Findings suggest a difference between the two major German financial med

  3. Transforming Cultures of Care: A Case Study in Organizational Change

    Science.gov (United States)

    Purvis, Karyn; Cross, David; Jones, Daren; Buff, Gary

    2012-01-01

    The authors report on a small organizational case study highlighting the dimensions of trauma-informed care, the processes of organizational change, and the growth of caregiver expertise. The article is framed by the notion of caregiving cultures, which refers to the beliefs, languages, and practices of caregivers and caregiving organizations.…

  4. The socio-cultural implications of climate change in Cameroon ...

    African Journals Online (AJOL)

    ... ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... Climate change impact has remained a serious threat to man and more particularly in the water-stressed environment of north Cameroon where in most cases, man ... In this region, the socio-cultural impacts can be devastating as has been ...

  5. Office Review: Managing Successful Change in an Overwork Culture

    Science.gov (United States)

    Child, Christine; Lander, Rachel

    2008-01-01

    The increase in student numbers and the decline in the average unit of resource since the 1990s together with the changes brought about by rising student expectations are familiar circumstances to anyone working in higher education. The authors perceive this as part of the move towards a consumer culture in the public sector. This paper gives an…

  6. Transforming Cultures of Care: A Case Study in Organizational Change

    Science.gov (United States)

    Purvis, Karyn; Cross, David; Jones, Daren; Buff, Gary

    2012-01-01

    The authors report on a small organizational case study highlighting the dimensions of trauma-informed care, the processes of organizational change, and the growth of caregiver expertise. The article is framed by the notion of caregiving cultures, which refers to the beliefs, languages, and practices of caregivers and caregiving organizations.…

  7. Sustainable Lifeways: Cultural Persistence in an Ever-Changing Environment

    Directory of Open Access Journals (Sweden)

    Monica Ramsey

    2013-07-01

    Full Text Available Book review of Sustainable Lifeways: Cultural Persistence in an Ever-Changing Environment. Naomi F. Miller, Katherine M. Moore, Kathleen Ryan, editors. 2011. University of Pennsylvania Press, Philadelphia. Pp. 352, 73 illustrations. $65.00 (cloth. ISBN 9787934536193.

  8. Health care provider and consumer understandings of cultural safety and cultural competency in health care: an Australian study.

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2007-01-01

    There is increasing recognition in Australia that racial and ethnic minority groups experience significant disparities in health and health care compared with the average population and that the Australian health care system needs to be more responsive to the health and care needs of these groups. The paper presents the findings of a year long study that explored what providers and recipients of health care know and understand about the nature and implications of providing culturally safe and competent health care to minority racial and ethnic groups in Victoria, Australia. Analysis of the data obtained from interviewing 145 participants recruited from over 17 different organizational sites revealed a paucity of knowledge and understanding of this issue and the need for a new approach to redress the status quo.

  9. Changing health behaviors with social marketing.

    Science.gov (United States)

    Suarez-Almazor, M E

    2011-08-01

    Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.

  10. Cellular Changes of Stem Cells in 3-Dimensional Culture.

    Science.gov (United States)

    Green, Matthew P; Hou, Bo

    2017-06-12

    During various operations and procedures, such as distraction osteogenesis and orthodontics, skeletal tissues use mechanotransduction. Mechanotransduction is important for maintaining bone health and converting mechanical forces into biochemical signals. We hypothesized that cells put under mechanical stress would adapt and change morphologically and respond with a decrease in cellular proliferation to accommodate the stress differences. These differences will be measured at the molecular and genetic level. We also wanted to test the practicality of an in vitro 3-dimensional gel model system. We implemented a 3-dimensional cell culture model. The sample was composed of isolated mouse mesenchymal prefibroblast bone marrow cells from the femurs and tibias of 6- to 8-week-old wild-type C57BL6 mice. The cells were seeded on fibronectin-coated hydrogels along with fibrin and nodulin growth factors. The variables tested were a no-force model (control) and a force model. The force model required two 0.1-mm suture pins put through one 0.25-cm length of cell-gel matrix. After the experiments were run to completion, the samples were fixed with 4% paraformaldehyde and embedded in paraffin. Serial sections were cut at a thickness of 5 μm along the long axis for the force construct and encompassing the entire circular area of the control construct. Descriptive and bivariate statistics were computed, and the P value was set at 5%. There was a statistically significant difference between the 2 models. The force model had longer and straighter primary cilia, less apoptosis, and an increase in cell proliferation. In addition, the shape of the cells was markedly different after the experiment. The results of the study suggest cells put under tensile stress have the ability to mechanically sense the environment to provide improved adaptation. Our work also confirms the usefulness of the in vitro 3-dimensional gel model system to mimic in vivo applications. Published by Elsevier

  11. [Cultural diversity in Montreal: a range of public health challenges].

    Science.gov (United States)

    Vissandjee, B; Hemlin, I; Gravel, S; Roy, S; Dupéré, S

    2005-09-01

    Increasing immigration to Quebec has brought to the surface the need for adapting its public health systems and services, particularly in the area of primary care. The challenge is to take the heterogeneous nature of the population into account and to integrate diverse values, experience and know-how into the development of programmes and delivery of services, whilst simultaneously respecting the values of the various care providers and the norms of the institutions in the host country. This article addresses the question of adaptation strategies for health services, and namely the development of prevention and heath promotion programmes in public health within the framework of primary health care services within the intercultural context of Montreal. The issue of adaptation falls within the perspective and mandate of the Quebec government's policy on health and well-being (La politique de santé et du bien-être, 1992). Furthermore, it is a response to frequent demands from various health professionals and groups concerned with the adaptation of public services with respect to intercultural relationships confronted with the emerging realities associated with immigration. The article provides a reflection on specific ways of adapting prevention and health promotion initiatives targeting cultural communities and those who are undergoing immigration procedures or transitions. It also examines the development of ethno-cultural or other indicators which make it possible to capture migration experiences and their health impact. Since the Quebec health and social services system is currently in the process of major reform, it is hoped that it will seize this opportunity in order to make health and social service centres accountable for the adaptation of their programmes and services to the diversity of the populations they serve.

  12. Has solar variability caused climate change that affected human culture?

    Science.gov (United States)

    Feynman, Joan

    If solar variability affects human culture it most likely does so by changing the climate in which the culture operates. Variations in the solar radiative input to the Earth's atmosphere have often been suggested as a cause of such climate change on time scales from decades to tens of millennia. In the last 20 years there has been enormous progress in our knowledge of the many fields of research that impinge on this problem; the history of the solar output, the effect of solar variability on the Earth's mean climate and its regional patterns, the history of the Earth's climate and the history of mankind and human culture. This new knowledge encourages revisiting the question asked in the title of this talk. Several important historical events have been reliably related to climate change including the Little Ice Age in northern Europe and the collapse of the Classical Mayan civilization in the 9th century AD. In the first section of this paper we discus these historical events and review the evidence that they were caused by changes in the solar output. Perhaps the most important event in the history of mankind was the development of agricultural societies. This began to occur almost 12,000 years ago when the climate changed from the Pleistocene to the modern climate of the Holocene. In the second section of the paper we will discuss the suggestion ( Feynman and Ruzmaikin, 2007) that climate variability was the reason agriculture developed when it did and not before.

  13. Performance measures of cultural competency in mental health organizations.

    Science.gov (United States)

    Siegel, C; Davis-Chambers, E; Haugland, G; Bank, R; Aponte, C; McCombs, H

    2000-11-01

    The authors utilized numerous documents created by advisory groups, expert panels and multicultural focus groups to develop performance measures for assessing the cultural competency of mental health systems. Competency was measured within three levels of organizational structure: administrative, provider network, and individual caregiver. Indicators, measures and data sources for needs assessment, information exchange, services, human resources, plans and policies, and outcomes were identified. Procedures for selection and implementation of the most critical measures are suggested. The products of this project are broadly applicable to the concerns of all cultural groups.

  14. Building a Culture of Health Informatics Innovation and Entrepreneurship: A New Frontier.

    Science.gov (United States)

    Househ, Mowafa; Alshammari, Riyad; Almutairi, Mariam; Jamal, Amr; Alshoaib, Saleh

    2015-01-01

    Entrepreneurship and innovation within the health informatics (HI) scientific community are relatively sluggish when compared to other disciplines such as computer science and engineering. Healthcare in general, and specifically, the health informatics scientific community needs to embrace more innovative and entrepreneurial practices. In this paper, we explore the concepts of innovation and entrepreneurship as they apply to the health informatics scientific community. We also outline several strategies to improve the culture of innovation and entrepreneurship within the health informatics scientific community such as: (I) incorporating innovation and entrepreneurship in health informatics education; (II) creating strong linkages with industry and healthcare organizations; (III) supporting national health innovation and entrepreneurship competitions; (IV) creating a culture of innovation and entrepreneurship within healthcare organizations; (V) developing health informatics policies that support innovation and entrepreneurship based on internationally recognized standards; and (VI) develop an health informatics entrepreneurship ecosystem. With these changes, we conclude that embracing health innovation and entrepreneurship may be more readily accepted over the long-term within the health informatics scientific community.

  15. Human rights, cultural pluralism, and international health research.

    Science.gov (United States)

    Marshall, Patricia A

    2005-01-01

    In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry.

  16. Organisational Change, Health and the Labour Market

    DEFF Research Database (Denmark)

    Bhatti, Yosef; Gørtz, Mette; Holm Pedersen, Lene

    This research examines the effects of organisational change on employee health and labour market outcomes. Previous studies looking into organisational change in the private sector indicate that the larger the size and depth of organisational change, the larger the detrimental consequences...... to the employees. This study contributes to the literature on four main dimensions. First, we extend the analysis of organisational change to a public sector setting. Second, while previous findings remain inconclusive regarding causal effects due to problems of endogeneity, our analysis contributes to research...... of causal effects of organisational change by exploiting a large scale public sector reform which can be considered as a quasi-experiment. Third, given that the reform was exogenous and implemented simultaneously in a number of Danish municipalities, we also have an objective measure of organisational...

  17. Change management with the electronic health record.

    Science.gov (United States)

    Schmucker, DeeAnn

    2009-01-01

    Many medical organizations have already changed to, are implementing, or are contemplating implementing an electronic health record (EHR) system. As in all change, some people accept the switch from paper to EHRs much easier and with more enthuiasm than others. It is common for organizations to overlook the importance of including change management properties as they create the overall plan for the change from paper to paperless. Often the result of this is anger, frustration, and lack of cooperation or even sabotage from physicians and office staff who are the recipients of the training on the EHR system. This article examines the steps for, opportunities for, and positive results from incorporating change management principles from the very beginning, and the benefits accrued by understanding and utilizing the concepts of good choices, relationships, planning, and feedback.

  18. CULTURE OF HEALTH OF TEACHERS OF INCLUSIVE SCHOOLS

    Directory of Open Access Journals (Sweden)

    E. L. Kutseeva

    2016-01-01

    Full Text Available The article discusses the role of teachers’ health culture in inclusive educational environments. The special attention is given to a definition of the term «health». The objective and subjective reasons of professional deformations, their manifestations in the behavior of the teacher are shown. Deformations in the professional consciousness, thinking and behavior lead to disadaptation of the teaching profession, have a negative impact on the quality of the work with the pupils. The article analyses the difficulties in the pedagogical activity of teachers of inclusive school. The contents and technology of  the  methodological  and  psychological support of teachers shown briefly. The article discusses the methods of optimization (reduction of occupational stress: physical, biochemical and psychological. The author emphasizes the importance of harmonization of the individual teacher in the rehabilitation and restoration of mental and physical resources. Main content and technological aspects of formation of future teachers’ health culture at the pedagogical University are disclosed. Рrofessional-pedagogical readiness in inclusive educational conditions is formed in the education and upbringing of the specialists on the basis of competence assessment. Competence of the future teachers of inclusive education is a set of professional knowledge and skills in the fields of teaching, education and correctional-educational work with children with disabilities. Building a culture of health of future specialists is carried out from the position of a systemic approach to the physical, psychological, social and spiritual levels. Of great importance is the harmonization and humanization of the identity of the future teachers. The author emphasizes the role of interactive technologies in creating a culture of health students.

  19. Public health in a rapidly changing world

    Directory of Open Access Journals (Sweden)

    Tatiana I. Andreeva

    2014-06-01

    Full Text Available Several months in 2013 and 2014 have been a hardly predictable time in Ukraine, and the situation is still far from being stable. This made the editorial team of TCPHEE based in Ukraine postpone publishing consecutive issues. However, while the situation still requires practical steps, many aspects including those related to public health require analysis and debate. Thus we invite opinion pieces and studies addressing all different spheres of how public health should function under changing social circumstances. There might be a wide range of such related topics. The most obvious ones are those linked to changing living conditions. Many studies have been undertaken and published with regard to health threats to refugees, people involved in natural or technical disasters (Noji, 2005. Along with environmental health threats, there might be mental health disturbances (World Health Organization, 1992 resulting from long-term strain, losses et cetera. Another important focus is related to changes in health services provision. Crimea, which is a former Ukrainian territory now occupied by the Russian Federation, was among those in Ukraine highly affected with HIV (Dehne, Khodakevich, Hamers, & Schwartlander, 1999. This was responded by several NGOs actively providing harm reduction services to high-risk groups along with methadone substitution therapy to opiate users and antiretroviral medicines to those HIV-infected (Curtis, 2010. However, there are news reports that Russia is going to stop provision of methadone (kommersant.ru, 2014. As opiate substitution programs have been shown an effective approach towards preventing HIV transmission among people who inject drugs (MacArthur et al., 2012, such change in public health policies might affect not only most at risk populations but their partners and population as a whole as well resulting in a rapid spread of HIV. Yet another related topic is that of how health services can be organized at times of

  20. Learning, changing and managing in mental health.

    Science.gov (United States)

    Henderson, J

    2001-11-01

    This paper draws on research which considers the implications for practitioners and managers of implementing new ideas for practice gained from learning and education in mental health in the UK. Using a questionnaire survey followed by eight semi-structured interviews, the research set out to identify the issues facing workers trying to implement change in the workplace as a result of new learning gained from study of an Open University mental health course. The paper argues that much management literature on change within organisations is problematic in this specific context. This is largely because it takes insufficient account of the complexities surrounding work within social care (particularly mental health). Findings show that workers who have undertaken learning in mental health often feel disempowered and isolated when attempting to introduce new ideas for practice into the workplace. The first line manager operates at the intersection of practice and learning and has a key role in enabling and supporting staff through practice as well as service change and professional development. This paper locates the distance learning experience within a wider framework of student/practitioner support, and explores the role of the first line manager in supporting and enabling staff.

  1. [Air pollution, climate change and health].

    Science.gov (United States)

    Ballester, Ferran

    2005-01-01

    Emissions into the atmosphere related to the climate change may further worsen the effects which air pollution has on the health of our citizens, not only indirectly due to the impact of weather phenomenon, but directly, due to the direct effects pollutants have on health. However, the efforts throughout most of the world have been aimed at dealing with these two problems separately for too many years. In fact, it is very often believed that the climate's health-safeguarding benefits would be achieved in the long term. To the contrary, what has become obvious over recent years is that the actions for reducing the emissions of polluting gases could redound in beneficial effects in the short term due to the reduction of the impact of air pollutants on the health of our citizens. This article presents the possible risks of the pollutants most closely related to climate changes, such as ozone and fine particles. Bearing in mind the uncertainties and unknowns related to this subject, the main implications for the policies related to this matter in Spain, as well as the needs for research are set out herein. In this regard, both from the standpoint of monitoring as well as research, it is considered necessary for an epidemiological monitoring system of the effects of air pollution and the relationship thereof to global changes to be established.

  2. A culturally appropriate intervention to improve health behaviors in Hispanic mother-child dyads.

    Science.gov (United States)

    Bender, Melinda S; Nader, Philip R; Kennedy, Christine; Gahagan, Sheila

    2013-04-01

    Obesity interventions targeting Hispanic preschool children are still nascent, and few are culturally appropriate. We evaluated the feasibility of a culturally relevant 9-month intervention program to improve health behaviors in low-income Mexican mothers with 3- to 5-year-old children. A community engagement approach was used to culturally and linguistically tailor an intervention program that was pilot tested with 33 mother-child dyads enrolled from a large California urban health center. A one-group, pretest-posttest design assessed changes in children's consumption of sugar-sweetened beverages (SSB), mothers' pedometer steps, and BMI. Data were collected at baseline, postintervention and at 6 months postintervention. At postintervention, SSB consumption had significantly decreased for soda and other sugary drinks with a modest reduction for 100% juice. Consumption of water had significantly increased, whereas milk had an increased trend. Maternal step counts significantly increased for weekdays by 69% and weekend days by 49%. Overall, maternal BMI decreased while children's BMI% remained stable. At 6 months postintervention, children's soda and juice consumption reverted toward baseline levels, as did maternal step counts, but children's consumption of sugary drinks remained lower, while water and milk remained higher. Findings suggest that a culturally relevant intervention was feasible for improving target health behaviors in a low-income Mexican community. Future work should assess an enhanced intervention including a maintenance phase for long-term adherence to health behavior changes and influence on maternal and child BMI.

  3. Cultural competence in mental health care: a review of model evaluations

    Directory of Open Access Journals (Sweden)

    McKenzie Kwame

    2007-01-01

    Full Text Available Abstract Background Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. Methods A systematic review that included evaluated models of professional education or service delivery. Results Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. Conclusion There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes.

  4. Political Culture and Covalent Bonding. A Conceptual Model of Political Culture Change

    Directory of Open Access Journals (Sweden)

    Camelia Florela Voinea

    2015-01-01

    Full Text Available Our class of models aims at explaining the dynamics of political attitude change by means of the dynamic changes in values, beliefs, norms and knowledge with which it is associated. The model constructs a political culture perspective over the relationship between macro and micro levels of a society and polity. The model defines the bonding mechanism as a basic mechanism of the political culture change by taking inspiration from the valence bonding theory in Chemistry, which has inspired the elaboration of the mechanisms and processes underlying the political culture emergence and the political culture control over the relationship between macro-level political entities and the micro-level individual agents. The model introduces operational definitions of the individual agent in political culture terms. The simulation model is used for the study of emergent political culture change phenomena based on individual interactions (emergent or upward causation as well as the ways in which the macro entities and emergent phenomena influence in turn the behaviors of individual agents (downward causation. The model is used in the ongoing research concerning the quality of democracy and political participation of the citizens in the Eastern European societies after the Fall of Berlin Wall. It is particularly aimed at explaining the long-term effect of the communist legacy and of the communist polity concept and organization onto the political mentalities and behaviors of the citizens with respect to democratic institutions and political power. The model has major implications in political socialization, political involvement, political behavior, corruption and polity modeling.

  5. Organizational Identity and Culture in the Context of Managed Change

    DEFF Research Database (Denmark)

    Hatch, Mary Jo; Schultz, Majken; Skov, Anne-Marie

    2015-01-01

    This article presents top and middle managers’ experiences and understandings of how organizational identity and culture were entangled with transformational change as it unfolded over a 5-year period in Carlsberg Group. Combining ethnography and grounded theory methods with engaged scholarship...... their organization’s identity led middle managers and employees both to support and resist new organizational identity claims made by top management. Within these identity activation processes we found frequent references relating new identity claims to organizational culture. Further analysis of the data revealed......, our work sits between research and practice, speaking directly to the experience of managers at the same time that it researches both the content and processes of organizational identity and culture. The study shows that engaging in processes of reflecting, questioning, and debating about...

  6. Culture change in care homes: development and facilitation.

    Science.gov (United States)

    Wild, Deidre; Kydd, Angela

    2016-09-29

    This article is the second of a two-part series that explores a programme of culture change in care homes. In this article, the authors describe their independent development and facilitation of a flexible learning programme for care homes, designed to meet a quality improvement request made by a care home company. The two selected care homes' staff conducted a review of their care culture, as a precursor to their creation of a new care philosophy. These activities provided a firm foundation from which the homes could, in theory, become a Remedial Enterprise Active Learning care home. Although the learning programme was not completed due to unavoidable circumstances, the staff's experiences highlight some of the challenges and successes that may be experienced when seeking to improve care homes' learning culture and practice.

  7. Health care in a changing society: the health services of Israel.

    Science.gov (United States)

    Margolis, E

    1975-11-01

    In the pre-State era, Israeli society displayed an "ascetic" orientation with emphasis on austerity and egalitarianism. The medical profession was influenced by the basic philosophy of the country and coped successfully with the country's health problems, mainly by lowering morbidity and mortality rates. With the emergence of the State of Israel, mass immigration of people with different backgrounds, cultures, and values occurred, and health problems of the disability, dissatisfaction, and discomfort type arose. The existing medical organizations were unable to handle them. The story of three such organizations is detailed in brief: the first medical school in Jerusalem, the greatest supplier of curative services--the workers' sick fund (Kupa Holim), and the Ministry of Health. Their impact on the health services of the country is described. These services are splintered into numerous self-contained authorities and an understanding of the overall needs is lacking. This state of affairs reflects the antagonistic interests of the political powers behind the various health agencies. A concensus within the health field on the nature of the problems and their solution could be reached if the health organizations accepted a broader philosophy of health, comprising its somatic, mental, and social aspects, and if they commit themselves to applying this philosophy in their activities. This may lead to considerable changes in medical education, more attention being focused on the social functions of medicine than on medical technology; health care would become more comprehensive and would cover all aspects of health in its preventive, curative, and rehabilitative stages. Failure to meet the health needs of the changing society will constitute a false reading of the public pulse. Of late, the voices demanding the conquest of social diseases and the attainment of health in its broadest sense are becoming more and more audible.

  8. Recognition rights, mental health consumers and reconstructive cultural semantics

    Directory of Open Access Journals (Sweden)

    Radden Jennifer H

    2012-01-01

    Full Text Available Abstract Introduction Those in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness. Results First person accounts of psychiatric diagnosis and mental health care (shown here to represent 'counter stories' to the powerful 'master narrative' of biomedical psychiatry, offer indications about how experiences of mental disorder might be reframed and redefined as part of efforts to acknowledge and honor recognition rights and epistemic justice. However, the task of cultural semantics is one for the entire culture, not merely consumers. These new meanings must be negotiated. When they are not the result of negotiation, group-wrought definitions risk imposing a revision no less constraining than the mis-recognizing one it aims to replace. Contested realities make this a challenging task when it comes to cultural meanings about mental disorder. Examples from mental illness memoirs about two contested realities related to psychosis are examined here: the meaninglessness of symptoms, and the role of insight into illness. They show the magnitude of the challenge involved - for consumers, practitioners, and the general public - in the reconstruction of these new meanings and realities. Conclusion To honor recognition rights and epistemic justice acknowledgement must be made of the heterogeneity of the effects of, and of responses to, psychiatric diagnosis and care, and the extent of the challenge of the reconstructive cultural semantics involved.

  9. Climate Change, Soils, and Human Health

    Science.gov (United States)

    Brevik, Eric C.

    2013-04-01

    According to the Intergovernmental Panel on Climate Change, global temperatures are expected to increase 1.1 to 6.4 degrees C during the 21st century and precipitation patterns will be altered by climate change (IPCC, 2007). Soils are intricately linked to the atmospheric/climate system through the carbon, nitrogen, and hydrologic cycles. Altered climate will, therefore, have an effect on soil processes and properties. Studies into the effects of climate change on soil processes and properties are still incomplete, but have revealed that climate change will impact soil organic matter dynamics including soil organisms and the multiple soil properties that are tied to organic matter, soil water, and soil erosion. The exact direction and magnitude of those impacts will be dependent on the amount of change in atmospheric gases, temperature, and precipitation amounts and patterns. Recent studies give reason to believe at least some soils may become net sources of atmospheric carbon as temperatures rise; this is particularly true of high latitude regions with permanently frozen soils. Soil erosion by both wind and water is also likely to increase. These soil changes will lead to both direct and indirect impacts on human health. Possible indirect impacts include temperature extremes, food safety and air quality issues, increased and/or expanded disease incidences, and occupational health issues. Potential direct impacts include decreased food security and increased atmospheric dust levels. However, there are still many things we need to know more about. How climate change will affect the nitrogen cycle and, in turn, how the nitrogen cycle will affect carbon sequestration in soils is a major research need, as is a better understanding of soil water-CO2 level-temperature relationships. Knowledge of the response of plants to elevated atmospheric CO2 given limitations in nutrients like nitrogen and phosphorus and how that affects soil organic matter dynamics is a critical

  10. Repositioning through Culture: Testing Change in Connectivity Patterns

    Directory of Open Access Journals (Sweden)

    Beatriz Plaza

    2016-12-01

    Full Text Available Symbolic knowledge-driven innovations can play an important role in the economic development of cities and regions. Cultural events and infrastructures can act as powerful connectivity engines, generating new connections, rewiring links, and repositioning institutions/cities/regions on the Internet map. Within this framework, this paper aims to contribute to the analytical understanding of culture-led repositioning. For this purpose we perform regression analysis with cultural networks (observational cross-sectional network data from digital media for a specific cultural case study: the Basque Culinary Center (BCC, a higher education faculty of haute cuisine promoted by the University of Mondragon along with a group of Michelin-starred chefs. Results show that a cultural sector, such as haute cuisine, can contribute to structural changes in connectivity patterns, putting an institution/city/region on the media map. It is the connection (in the online press of the BCC to the influential Michelin-starred chefs that can fuel the accumulation of press articles (media items on the BCC; and it is precisely this accumulation of press articles that can impact BCC revenues. Put differently, the co-branding between the influential Michelin chefs and the BCC may have put the BCC on the press map, promoting new student registrations and fostering Basque haute cuisine. The main contribution of this article is a prototype of regression analysis to test repositioning with network data.

  11. Rates of cultural change and patterns of cultural accumulation in stochastic models of social transmission.

    Science.gov (United States)

    Aoki, Kenichi; Lehmann, Laurent; Feldman, Marcus W

    2011-06-01

    Cultural variation in a population is affected by the rate of occurrence of cultural innovations, whether such innovations are preferred or eschewed, how they are transmitted between individuals in the population, and the size of the population. An innovation, such as a modification in an attribute of a handaxe, may be lost or may become a property of all handaxes, which we call "fixation of the innovation." Alternatively, several innovations may attain appreciable frequencies, in which case properties of the frequency distribution-for example, of handaxe measurements-is important. Here we apply the Moran model from the stochastic theory of population genetics to study the evolution of cultural innovations. We obtain the probability that an initially rare innovation becomes fixed, and the expected time this takes. When variation in cultural traits is due to recurrent innovation, copy error, and sampling from generation to generation, we describe properties of this variation, such as the level of heterogeneity expected in the population. For all of these, we determine the effect of the mode of social transmission: conformist, where there is a tendency for each naïve newborn to copy the most popular variant; pro-novelty bias, where the newborn prefers a specific variant if it exists among those it samples; one-to-many transmission, where the variant one individual carries is copied by all newborns while that individual remains alive. We compare our findings with those predicted by prevailing theories for rates of cultural change and the distribution of cultural variation.

  12. The Dubai Community Psychiatric Survey: II. Development of the Socio-cultural Change Questionnaire.

    Science.gov (United States)

    Bebbington, P; Ghubash, R; Hamdi, E

    1993-04-01

    The Dubai Community Psychiatric Survey was carried out to assess the effect of very rapid social change on the mental health of women in Dubai, one of the United Arab Emirates. In order to measure social change at an individual level, we developed a questionnaire covering behaviour and attitudes in a wide range of situations, the Socio-cultural Change Questionnaire (ScCQ). In this paper we give an account of the considerations that determined the form of the ScCQ, its structural characteristics, and its validity.

  13. A culture-centered exploration of health: constructions from rural Bangladesh.

    Science.gov (United States)

    Jamil, Raihan; Dutta, Mohan J

    2012-01-01

    The traditional approach in health communication has historically adopted a linear model to explore and study health, without considering the voices of the subaltern sectors in academic discourse. Such linear models prescribe one-way knowledge, information, and transmission of beliefs from the core health sectors to the subalterns at the margins. The culture-centered approach to health focuses on co-constructing meanings of health through dialogic engagement with communities that are situated at the margins of mainstream discursive spaces. This co-constructive research investigates how members of a Bangladeshi rural community define, construct, and negotiate health issues in their everyday lives through their narratives of health, illness, and healing. The findings explicate how the community participants negotiate their health in terms of poverty, work, and structure, and highlights how the participants negotiate their marginalization through communicative practices. The in-depth narratives on their construction of health underscore possible entry points into constructing culture-centered praxis, pointing toward spaces of change.

  14. [Urban culture and mental health: an anthropological perspective].

    Science.gov (United States)

    Andrès, Cédric

    2012-01-01

    This article is an anthropological reflection on the trans-cultural issues specific to large urban centers. The author questions how can a person develop and create an identity in this context. He then examines how proximity and isolation relative to urban settings contribute to the mental health of urban populations. Finally, he examines how characteristics of city life conditions assistance to people with mental disorders in urban settings.

  15. Behaviour change for better health: nutrition, hygiene and sustainability

    Science.gov (United States)

    2013-01-01

    As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled ‘Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability’. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today’s environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes – particularly in developing and emerging countries – imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public

  16. Behaviour change for better health: nutrition, hygiene and sustainability.

    Science.gov (United States)

    Newson, Rachel S; Lion, Rene; Crawford, Robert J; Curtis, Valerie; Elmadfa, Ibrahim; Feunekes, Gerda I J; Hicks, Cheryl; van Liere, Marti; Lowe, C Fergus; Meijer, Gert W; Pradeep, B V; Reddy, K Srinath; Sidibe, Myriam; Uauy, Ricardo

    2013-01-01

    As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled 'Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability'. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today's environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes - particularly in developing and emerging countries - imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public-private partnerships.

  17. Italian Family Business Cultures Involved in the Generational Change

    Directory of Open Access Journals (Sweden)

    Ruggero Ruggieri

    2014-02-01

    Full Text Available In family firms, the business and the family are two arenas in which processes significantly overlap and influence management. The present paper investigates the overlap of the family system and the business through the use of culture. Adopting an idiographic approach and recognising the unique psychodynamic process of family business (FB, this study aims to identify the cultural patterns within the FB, starting from what families define as a family, b business and, c the generational change. Twenty-five family firms were considered during the generational change. The results show how and when this overlap takes shape pointing out how the role of family tradition can became a critical or success factor for the business.

  18. Organizational Change to Improve Health Literacy: workshop summary

    National Research Council Canada - National Science Library

    French, Melissa; Hernandez, Lyla M

    2013-01-01

    Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy...

  19. Culture change in a museum: An action research analysis

    OpenAIRE

    Dennehy, Robert F.; Morgan, Sandra; Lehrburger, Karen J.

    2004-01-01

    The move of a museum in the western United States to larger quarters resulted in an increase in visitors and requests for tours. To respond to the greater number of tours, new volunteers (docents) were recruited and trained. But conflicts arose between the old and new docents. As Docent Chair, one of the authors worked with the Curator of Education to understand the culture change faced by the old docent group and integrate the old and new docent groups. This paper analyzes the...

  20. Climate change, human health, and epidemiological transition.

    Science.gov (United States)

    Barrett, Bruce; Charles, Joel W; Temte, Jonathan L

    2015-01-01

    The health of populations depends on the availability of clean air, water, food, and sanitation, exposure to pathogens, toxins and environmental hazards, and numerous genetic, behavioral and social factors. For many thousands of years, human life expectancy was low, and population growth was slow. The development of technology-based civilizations facilitated what Abdel Omran called "epidemiological transition," with increasing life expectancy and rapid population growth. To a large extent, the spectacular growth of human populations during the past two centuries was made possible by the energy extracted from fossil fuels. We have now learned, however, that greenhouse gases from fossil fuel combustion are warming the planet's surface, causing changes in oceanic and atmospheric systems, and disrupting weather and hydrological patterns. Climate change poses unprecedented threats to human health by impacts on food and water security, heat waves and droughts, violent storms, infectious disease, and rising sea levels. Whether or not humanity can reduce greenhouse gas emissions quickly enough to slow climate change to a rate that will allow societies to successfully adapt is not yet known. This essay reviews the current state of relevant knowledge, and points in a few directions that those interested in human health may wish to consider. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. The changing psychology of culture from 1800 through 2000.

    Science.gov (United States)

    Greenfield, Patricia M

    2013-09-01

    The Google Books Ngram Viewer allows researchers to quantify culture across centuries by searching millions of books. This tool was used to test theory-based predictions about implications of an urbanizing population for the psychology of culture. Adaptation to rural environments prioritizes social obligation and duty, giving to other people, social belonging, religion in everyday life, authority relations, and physical activity. Adaptation to urban environments requires more individualistic and materialistic values; such adaptation prioritizes choice, personal possessions, and child-centered socialization in order to foster the development of psychological mindedness and the unique self. The Google Ngram Viewer generated relative frequencies of words indexing these values from the years 1800 to 2000 in American English books. As urban populations increased and rural populations declined, word frequencies moved in the predicted directions. Books published in the United Kingdom replicated this pattern. The analysis established long-term relationships between ecological change and cultural change, as predicted by the theory of social change and human development (Greenfield, 2009).

  2. "The people not the policy": quality improvement, junior doctors, and cultural change.

    Science.gov (United States)

    Grant, Paul

    2011-01-01

    Health care is a highly regulated environment. This has driven what could be characterized as a paper-safe approach, whereby organizations are required to demonstrate to a multiplicity of regulators, inspectorates, and accrediting bodies that they are paper safe. However, for many organizations, this has not produced a system that is actually patient safe; rather, it has in practice operated as a parallel system that does not reflect the true state of safety. This project looks at a quality improvement and patient safety program and critically asks the question of whether it is flawed because of failure to address issues surrounding doctors and cultural change. Johnson & Schole's cultural web framework was used to explore the attitudes of junior doctors toward a patient safety and quality improvement program. Data collection was through the use of focus groups backed up with quantitative data from a web based questionnaire survey. It has been demonstrated that doctors represent a dominant subculture within the National Health Service and their beliefs, attitudes, and value are often at odds or unrecognized by senior health care managers. Unless the cultural differences are adequately addressed, transformational change projects such as "Best & Safest Care" are unlikely to succeed. A better understanding of the organizational context allows for more appropriate change interventions to be developed.

  3. Readying health services for climate change: a policy framework for regional development.

    Science.gov (United States)

    Bell, Erica

    2011-05-01

    Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change.

  4. Forest health in a changing world.

    Science.gov (United States)

    Pautasso, Marco; Schlegel, Markus; Holdenrieder, Ottmar

    2015-05-01

    Forest pathology, the science of forest health and tree diseases, is operating in a rapidly developing environment. Most importantly, global trade and climate change are increasing the threat to forest ecosystems posed by new diseases. Various studies relevant to forest pathology in a changing world are accumulating, thus making it necessary to provide an update of recent literature. In this contribution, we summarize research at the interface between forest pathology and landscape ecology, biogeography, global change science and research on tree endophytes. Regional outbreaks of tree diseases are requiring interdisciplinary collaboration, e.g. between forest pathologists and landscape ecologists. When tree pathogens are widely distributed, the factors determining their broad-scale distribution can be studied using a biogeographic approach. Global change, the combination of climate and land use change, increased pollution, trade and urbanization, as well as invasive species, will influence the effects of forest disturbances such as wildfires, droughts, storms, diseases and insect outbreaks, thus affecting the health and resilience of forest ecosystems worldwide. Tree endophytes can contribute to biological control of infectious diseases, enhance tolerance to environmental stress or behave as opportunistic weak pathogens potentially competing with more harmful ones. New molecular techniques are available for studying the complete tree endobiome under the influence of global change stressors from the landscape to the intercontinental level. Given that exotic tree diseases have both ecologic and economic consequences, we call for increased interdisciplinary collaboration in the coming decades between forest pathologists and researchers studying endophytes with tree geneticists, evolutionary and landscape ecologists, biogeographers, conservation biologists and global change scientists and outline interdisciplinary research gaps.

  5. Effectiveness of a developmental curricular design to graduate culturally competent health practitioners.

    Science.gov (United States)

    Boggis, Debra

    2012-01-01

    With the goal to facilitate cultural competency development of students enrolled in graduate-level health professional education, this study examined the effectiveness of a curricular program guided by the Intercultural Developmental Continuum (IDC) as measured by the Intercultural Developmental Inventory (IDI). The IDI was administered to 17 occupational therapy (OT) students and a control group of 25 non-OT health professional students upon matriculation into their respective programs of graduate study and again upon completion of 3 years of study. OT students participated in a cultural curricular design guided by the IDC, while the control group participated in cultural study not guided by the IDC. Though OT students did not show a significant change in overall developmental orientation mean scores from pre-test to post-test (t = 0.847, p = 0.41), the results indicate that the designed intercultural curriculum increased intercultural competence among those OT students who began their program with the monocultural mindset of polarization (an "us vs. them" evaluative viewpoint) and moved to the interculturally transitional mindset of minimization (recognizing cultural commonalities and elimination of the "us vs. them" mindset). The control group showed a significant decrease in developmental orientation mean scores at post-test (t = 6.1, p competency of OT students, appears to have mitigated a decrease in competence. Results suggest that the cultural challenges that students face appear to be considerable and, without targeted, integrated intercultural preparation, can overwhelm new health professionals' intercultural capability.

  6. Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication: An Agenda for Science and Practice.

    Science.gov (United States)

    Betsch, Cornelia; Böhm, Robert; Airhihenbuwa, Collins O; Butler, Robb; Chapman, Gretchen B; Haase, Niels; Herrmann, Benedikt; Igarashi, Tasuku; Kitayama, Shinobu; Korn, Lars; Nurm, Ülla-Karin; Rohrmann, Bernd; Rothman, Alexander J; Shavitt, Sharon; Updegraff, John A; Uskul, Ayse K

    2016-10-01

    This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient's cultural characteristics and the respective message will increase the communication's effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research. © The Author(s) 2015.

  7. A clash of cultures: A&E and mental health.

    Science.gov (United States)

    Crowley, J J

    2000-01-01

    Accident and emergency (A&E) departments have attracted little attention from psychiatric services, with the exception of emergencies and the management of self harm. Emergency staff gravitate towards those attenders with concrete physical needs, typifying mental health attenders as low status. The aim of this project, which took place over a 12 month period, was to improve the quality of care provided to persons attending an A&E department with mental health needs, through a staff development programme. It was initiated for the generic A&E nurse with no formal training in mental health care. The programme was based on knowledge generated through a collaborative approach using an action research process. This article particularly focuses on the mindsets, values and strategies which evolved through the study. The project indicated that facets of the A&E culture such as staff values, technology, communication patterns and the environment give mental health a low status. Conflict is generated between the individual and the macro culture, dominated by the excitement of trauma care and the short-term, immediate nature of the work.

  8. Medical education for a changing world: moving beyond cultural competence into transnational competence.

    Science.gov (United States)

    Koehn, Peter H; Swick, Herbert M

    2006-06-01

    Given rapidly changing global demographic dynamics and the unimpressive evidence regarding health outcomes attributable to cultural competence (CC) education, it is time to consider a fresh and unencumbered approach to preparing physicians to reduce health disparities and care for ethnoculturally and socially diverse patients, including migrants. Transnational competence (TC) education offers a comprehensive set of core skills derived from international relations, cross-cultural psychology, and intercultural communication that are also applicable for medical education. The authors discuss five limitations (conceptual, vision, action, alliance, and pedagogical) of current CC approaches and explain how an educational model based on TC would address each problem area.The authors then identify and discuss the skill domains, core principles, and reinforcing pedagogy of TC education. The five skill domains of TC are analytic, emotional, creative, communicative, and functional; core principles include a comprehensive and consistent framework, patient-centered learning, and competency assessment. A central component of TC pedagogy is having students prepare a "miniethnography" for each patient that addresses not only issues related to physical and mental health, but also experiences related to dislocation and adaptation to unfamiliar settings. The TC approach promotes advances in preparing medical students to reduce health disparities among patients with multiple and diverse backgrounds, health conditions, and health care beliefs and practices. Perhaps most important, TC consistently directs attention to the policy and social factors, as well as the individual considerations, that can alleviate suffering and enhance health and well-being in a globalizing world.

  9. Improving health care quality through culturally competent physicians: leadership and organizational diversity training

    Directory of Open Access Journals (Sweden)

    Irwin B Horwitz

    2011-02-01

    Full Text Available Irwin B Horwitz1, Marilyn Sonilal2, Sujin K Horwitz31Cameron School of Business, University of St. Thomas, Houston, TX, USA; 2School of Public Health, University of Texas, Houston, TX, USAAbstract: The growing diversity of the population has resulted in substantial challenges for the US health care system. A substantial body of evidence has identified significant disparities in health care among culturally and ethnically diverse patients, irrespective of income, that negatively affects such factors as diagnostic precision, quality of care, adherence to healing protocols, and overall treatment outcomes. Diversity has also been shown to compromise the functionality of health care teams that are increasingly comprised of members with culturally different backgrounds, in which diversity produces misunderstanding and conflict. Many of the problems stem from a lack of cultural competence among both physicians and teams under their supervision. To reduce the numerous problems resulting from inadequate cultural competence among health care professionals, this article examines ways in which the issues of diversity can be effectively addressed in health care institutions. It is advocated that physicians adopt a proactive transformational leadership style to manage diversity because of its emphasis on understanding and aligning follower values which lie at the heart of diversity-related misunderstandings. It is also held that for leadership training among physicians to be fully effective, it should be integrated with organizational-wide diversity programs. By doing so, the complimentary effect could result in comprehensive change, resulting in substantial improvements in the quality of health care for all patients.Keywords: leadership, diversity, health care, disparities, medical education

  10. Impact on human health of climate changes.

    Science.gov (United States)

    Franchini, Massimo; Mannucci, Pier Mannuccio

    2015-01-01

    There is increasing evidence that climate is rapidly changing. These changes, which are mainly driven by the dramatic increase of greenhouse gas emissions from anthropogenic activities, have the potential to affect human health in several ways. These include a global rise in average temperature, an increased frequency of heat waves, of weather events such as hurricanes, cyclones and drought periods, plus an altered distribution of allergens and vector-borne infectious diseases. The cardiopulmonary system and the gastrointestinal tract are particularly vulnerable to the adverse effects of global warming. Moreover, some infectious diseases and their animal vectors are influenced by climate changes, resulting in higher risk of typhus, cholera, malaria, dengue and West Nile virus infection. On the other hand, at mid latitudes warming may reduce the rate of diseases related to cold temperatures (such as pneumonia, bronchitis and arthritis), but these benefits are unlikely to rebalance the risks associated to warming.

  11. CHANGING PRESCRIBING CULTURE - A FOCUS ON CODEINE POSTPARTUM.

    Science.gov (United States)

    Al-Adhami, Noor; Whitfield, Karen; North, Angela

    2016-09-01

    charts for postpartum women (less than 5%). Those that are prescribed are ceased once highlighted to medical staff. The obstetric pharmacist now presents a session on postpartum analgesia at every new resident medical officer orientation outlining suitable medications to prescribe. In addition all new pharmacists to the women's and new born's team receive training about postpartum analgesia. This study highlights the impact that can be achieved when health care professionals work together to change the culture and prescribing habits in a hospital setting, to enhance patient safety. Evaluating the evidence and presenting to stakeholders as well as providing ongoing training and education to medical, nursing and pharmacy staff are all essential to a successful outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Cultural Competence in Pediatrics: Health Care Provider Knowledge, Awareness, and Skills

    Directory of Open Access Journals (Sweden)

    Kirk Dabney

    2015-12-01

    Full Text Available The purpose of this study was to assess the effects of a cultural competence training (CCT program on pediatric health care providers’ self-reported ability to provide culturally competent care to a diverse pediatric patient population. This quantitative, nested ecologic level study design used a repeated measure in the form of pre-test and post-test data to assess percent change in providers’ cultural awareness, experience working or learning about different cultures, and preparedness and skills in working with different cultures before and after CCT. The study was conducted between 2011 and 2012 in a pediatric hospital and associated outpatient offices. The sample consisted of pediatric health care providers from various departments, mainly physicians and nurses (n = 69. Participants completed a pre-intervention cultural competence assessment and then were subjected to a cultural competence-training program, after which they completed the assessment a second time. The baseline and post-intervention data were collected in the form of Likert scales and transformed into a quintile or quartile scale as appropriate. Data were assessed using paired t-tests or Wilcoxon’s signed-rank tests. Providers indicated a 13% increase in knowledge (53.9% vs. 66.7%, t = 3.4, p = 0.001, 8.7% increase in awareness (46.7% vs. 55.4%, t = 3.0, p = 0.002, and 8% statistically marginal increase in skills (66.4% vs. 74.5%, z = 1.8, p = 0.06. Culturally competent training in a pediatric environment significantly enhances knowledge, awareness and to some extent skills in providing care to culturally diverse patient population.

  13. Teaching Health Sciences Students about Culturally Sensitive Communication between Health Professionals and Patients from Diverse Cultures

    Science.gov (United States)

    Olivares, Mónica; Pena, Carmen

    2015-01-01

    As members of a nationally accredited research project (I?+?D+i) InterMED (ref.: FF2011-25500) being carried out in the field of Intercultural Mediation, we are aware of the mediator's delicate role in communicative interactions between health professionals and foreign population. Sales has pointed out the dangers of stereotyping minorities and…

  14. Global health and climate change: moving from denial and catastrophic fatalism to positive action.

    Science.gov (United States)

    Costello, Anthony; Maslin, Mark; Montgomery, Hugh; Johnson, Anne M; Ekins, Paul

    2011-05-13

    The health effects of climate change have had relatively little attention from climate scientists and governments. Climate change will be a major threat to population health in the current century through its potential effects on communicable disease, heat stress, food and water security, extreme weather events, vulnerable shelter and population migration. This paper addresses three health-sector strategies to manage the health effects of climate change-promotion of mitigation, tackling the pathways that lead to ill-health and strengthening health systems. Mitigation of greenhouse gas (GHG) emissions is affordable, and low-carbon technologies are available now or will be in the near future. Pathways to ill-health can be managed through better information, poverty reduction, technological innovation, social and cultural change and greater coordination of national and international institutions. Strengthening health systems requires increased investment in order to provide effective public health responses to climate-induced threats to health, equitable treatment of illness, promotion of low-carbon lifestyles and renewable energy solutions within health facilities. Mitigation and adaptation strategies will produce substantial benefits for health, such as reductions in obesity and heart disease, diabetes, stress and depression, pneumonia and asthma, as well as potential cost savings within the health sector. The case for mitigating climate change by reducing GHGs is overwhelming. The need to build population resilience to the global health threat from already unavoidable climate change is real and urgent. Action must not be delayed by contrarians, nor by catastrophic fatalists who say it is all too late.

  15. Climate change, air quality, and human health.

    Science.gov (United States)

    Kinney, Patrick L

    2008-11-01

    Weather and climate play important roles in determining patterns of air quality over multiple scales in time and space, owing to the fact that emissions, transport, dilution, chemical transformation, and eventual deposition of air pollutants all can be influenced by meteorologic variables such as temperature, humidity, wind speed and direction, and mixing height. There is growing recognition that development of optimal control strategies for key pollutants like ozone and fine particles now requires assessment of potential future climate conditions and their influence on the attainment of air quality objectives. In addition, other air contaminants of relevance to human health, including smoke from wildfires and airborne pollens and molds, may be influenced by climate change. In this study, the focus is on the ways in which health-relevant measures of air quality, including ozone, particulate matter, and aeroallergens, may be affected by climate variability and change. The small but growing literature focusing on climate impacts on air quality, how these influences may play out in future decades, and the implications for human health is reviewed. Based on the observed and anticipated impacts, adaptation strategies and research needs are discussed.

  16. Does the introduction of nursing home culture change practices improve quality?

    Science.gov (United States)

    Miller, Susan C; Lepore, Michael; Lima, Julie C; Shield, Renee; Tyler, Denise A

    2014-09-01

    To understand whether nursing home (NH) introduction of culture change practices is associated with improved quality. NH-level panel study using multivariate fixed-effects statistical modeling to estimate the effect of culture change introduction on quality outcomes. Eight hundred twenty-four U.S. NHs with culture change practice involvement beginning between 2005 and 2010. Directors of nursing and nursing home administrators. A culture change practice score (derived from a 2009/10 national NH survey) was used to stratify NHs according to practice implementation (high (scores in the top quartile; n = 217) vs other (n = 607)). NH-level outcomes included prevalence of seven care practices and three resident outcomes, health-related and quality-of-life weighted survey deficiencies, and average number of hospitalizations per resident year. For NHs with high practice implementation, introduction of culture change was associated with a significant decrease in prevalence of restraints, tube feeding, and pressure ulcers; an increase in the proportion of residents on bladder training programs; and a small decrease in the average number of hospitalizations per resident year (coefficient -0.04, standard error (SE) 0.02, P = .06). For NHs with lower practice implementation (practice scores in lower three quartiles), introduction was associated with fewer health-related (coefficient -5.26, SE 3.05; P = .09) and quality-of-life (coefficient -0.10, SE 0.05; P = .04) survey deficiencies, although these NHs also had small statistically significant increases in the prevalence of residents with urinary tract infections and in average hospitalizations per resident year (coefficient 0.03, SE 0.01, P = .02). The introduction of NH culture change appears to result in significant improvements in some care processes and outcomes in NHs with high practice implementation. For other NHs, culture change introduction results in fewer survey deficiencies. © 2014, Copyright the

  17. Cultural Identity Among Afghan and Iraqi Traumatized Refugees: Towards a Conceptual Framework for Mental Health Care Professionals.

    Science.gov (United States)

    Groen, Simon P N; Richters, Annemiek; Laban, Cornelis J; Devillé, Walter L J M

    2017-01-20

    Cultural identity in relation with mental health is of growing interest in the field of transcultural psychiatry. However, there is a need to clarify the concept of cultural identity in order to make it useful in clinical practice. The purpose of this study is to unravel the complexity and many layers of cultural identity, and to assess how stress and acculturation relate to (changes in) cultural identity. As part of a larger study about cultural identity, trauma, and mental health, 85 patients from Afghanistan and Iraq in treatment for trauma-related disorders were interviewed with a Brief Cultural Interview. The interviews were analysed through qualitative data analysis using the procedures of grounded theory. The analysis resulted in three domains of cultural identity: personal identity, ethnic identity and social identity. Within each domain relationships with stress and acculturation were identified. The results offer insight into the intensity of changes in cultural identity, caused by pre-and post-migration stressors and the process of acculturation. Based on the research findings recommendations are formulated to enhance the cultural competency of mental health workers.

  18. Why do Chinese Canadians not consult mental health services: health status, language or culture?

    Science.gov (United States)

    Chen, Alice W; Kazanjian, Arminée; Wong, Hubert

    2009-12-01

    Data from the Canadian Community Health Survey Cycle 1.1 showed that Chinese immigrants to Canada and Chinese individuals born in Canada were less likely than other Canadians to have contacted a health professional for mental health reasons in the previous year in the province of British Columbia. The difference persisted among individuals at moderate to high risk for depressive episode. Both immigrant and Canadian-born Chinese showed similar characteristics of mental health service use. The demographic and health factors that significantly affected their likelihood to consult mental health services included Chinese language ability, restriction in daily activities, frequency of medical consultations, and depression score. Notwithstanding lower levels of mental illness in ethnic Chinese communities, culture emerged as a major factor explaining differences in mental health consultation between Chinese and non-Chinese Canadians.

  19. The effectiveness of strategies to change organisational culture to improve healthcare performance.

    Science.gov (United States)

    Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

    2011-01-19

    abstracts and then to screen the full reports of selected citations. At each stage results were compared and discrepancies solved through discussion. The search strategy yielded 4239 records. After the full text assessment, no studies met the quality criteria used by the EPOC Group and evaluated the effectiveness of strategies to change organisational culture to improve healthcare performance. It is not possible to draw any conclusions about the effectiveness of strategies to change organisational culture because we found no studies that fulfilled the methodological criteria for this review. Research efforts should focus on strengthening the evidence about the effectiveness of methods to change organisational culture to improve health care performance.

  20. Women’s Art and Women Artists in Cultural Change

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    ON March 3rd, 1998, an exhibition titled "Century · Women" drew up its curtain at the China Arts Gallery in Beijing, and attracted a vast number of visitors with its large scale, historical overview, and representation of a great number of painters with various styles. While people strolled in the gallery, a lively forum on the topic of "Visual Angle of Gender: Women’s Arts and Women Artists in Cultural Change" was also taking place in Beijing. The purpose of the forum was to corroborate the academic value of the exhibition, as well as to analyze the cultural significance of women’s art through the exploration of the history and present situation of Chinese women’s art, Over 30 scholars and artists presented speeches on the topic; the audience numbered in the hundreds.

  1. Phenotypic Changes Exhibited by E. coli Cultured in Space

    DEFF Research Database (Denmark)

    Zea, Luis; Larsen, Michael; Estante, Frederico

    2017-01-01

    Bacteria will accompany humans in our exploration of space, making it of importance to study their adaptation to the microgravity environment. To investigate potential phenotypic changes for bacteria grown in space, Escherichia coli was cultured onboard the International Space Station with matched...... controls on Earth. Samples were challenged with different concentrations of gentamicin sulfate to study the role of drug concentration on the dependent variables in the space environment. Analyses included assessments of final cell count, cell size, cell envelope thickness, cell ultrastructure, and culture...... morphology. A 13-fold increase in final cell count was observed in space with respect to the ground controls and the space flight cells were able to grow in the presence of normally inhibitory levels of gentamicin sulfate. Contrast light microscopy and focused ion beam/scanning electron microscopy showed...

  2. Culture and health reporting: a comparative content analysis of newspapers in the United States and China.

    Science.gov (United States)

    Tang, Lu; Peng, Wei

    2015-01-01

    Health reporting has the potential to educate the public and promote health behaviors. Culture influences the style of such communication. Following the theorization of national cultures by Hofstede and Hofstede (2005) and Wilber (2000), this study compares health reporting in the United States and China through a content analysis of leading newspapers. The authors discover significant differences in health reporting in terms of controllability attribution, temporal orientation, citation of authority sources, and use of statistics. As one of the first comparative content analysis studies of health reporting in Eastern and Western cultures, this study provides a unique cultural lens for health communication scholars to better understand health information in the news media.

  3. Are staffing shortages changing the culture of midwifery?

    Science.gov (United States)

    Edwards, Nadine; Gilbert, Arianna; Mander, Rosemary; McHugh, Nessa; Murphy-Lawless, Jo; Patterson, Jenny

    2016-03-01

    The effects of budgetary changes on midwives' practice environment have raised concerns in many settings. A survey of midwives and student midwives in the UK and Republic of Ireland in 2014 produced 280 responses. Staffing shortages were regarded as underpinning many changes, one of which was that of previously optional 'extra' activities, such as unpaid overtime, becoming mandatory. Shortages were aggravated in less acute areas by the transfer of midwives to more acute settings. One of the fears expressed by midwives was that a permanent change in the culture of midwifery would result. These phenomena are the everyday experiences of practising midwives, but they have failed to be addressed in the documents published by regulatory and review bodies.

  4. Translating Latin American/US Latina frameworks and methods in gender and health equity: linking women's health education and participatory social change.

    Science.gov (United States)

    Shapiro, Ester R

    This article applies transdisciplinary approaches to critical health education for gender equity by analyzing textual and political strategies translating/culturally adapting the U.S. feminist health text, Our Bodies Ourselves (OBOS), for Latin American/Caribbean and U.S. Latina women. The resulting text, Nuestros Cuerpos, Nuestras Vidas (NCNV), was revised at multiple levels to reflect different cultural\\sociopolitical assumptions connecting individual knowledge, community-based and transnational activist organizations, and strategic social change. Translation/cultural adaptation decisions were designed to ensure that gender-equitable health promotion education crossed cultural borders, conveying personal knowledge and motivating individual actions while also inspiring participation in partnerships for change. Transdisciplinary approaches integrating critical ecosystemic frameworks and participatory methods can help design health promotion education mobilizing engaged, gender-equitable health citizenship supporting both personal and societal change.

  5. [Science, technique, and culture: relations between risk and health practices].

    Science.gov (United States)

    Czeresnia, Dina

    2004-01-01

    This article discusses the cultural consequences of discourses and practices aimed at training subjects for a rational, informed choice in relation to risks, calculated on the basis of scientific knowledge. The epidemiological risk concept is a central element in this process, especially in the context of health practices. The article begins by briefly characterizing the epidemiological risk concept, emphasizing that as an abstract model, it reduces the complexity of the phenomena it studies. Grasping reality through this abstraction generates values and meanings. Canguilhem's reflection on the relations between science, technique, and life is further discussed from the perspective of deepening an understanding of the cultural consequences of this process, contributing to the transformation of classical concepts of individuality, autonomy, and sociability. Such vital themes as individuality, alterity, and the relationship with death are present (albeit disguised) in issues that involve the central nature of risk in the contemporary world.

  6. Between Flexibility and Reliability. Changing Planning Culture in China

    Directory of Open Access Journals (Sweden)

    Chiu-Yuan Wang

    2014-10-01

    Full Text Available The aim of this research is to provide an outline to address questions with regard to the transformation of planning in China that has occurred after the 1980s. The research is using “planning evolution” as the main research skeleton. The starting point is to investigate to what extent Chinese urban planning has developed after the opening up and other reforms under the state-led and market-driven modes of Chinese reformation, and to investigate how the different modes and various actors have influenced urban planning, based on the investigation of the respective political and economic changes within the initial reformation in general, and planning in particular.In recent years, China has undeniably undergone a dramatic process of urban growth and transformation. Apart from its speed and scope, it is less recognized that these processes are confronting the Chinese planning institutions with new and unexpected demands almost on a daily basis. In reference to the increasing importance of private investments and developments within the Chinese urbanization process, a new balance between public planning and private developments, and between top-down and bottom-up approaches is required to be able to generate both a reliable and responsible framework for long-term urban development and a flexible system of implementation that meets the needs of changing conditions and new demands. Flexibility and reliability become the new demands for planning practice.Based on the theory of planning culture, planning traditions, concepts, systems and decision-making processes are always related to the cultural context and cultural background of the people and societies involved. Investigating the contemporary urban transformation and urban development processes in China can allow us to outline the new planning culture of contemporary China in relation to its historical roots and traditional characteristics in a long term framework. I argue that the changing role

  7. From Cultural Knowledge to Intercultural Communicative Competence: Changing Perspectives on the Role of Culture in Foreign Language Teaching

    Science.gov (United States)

    Piatkowska, Katarzyna

    2015-01-01

    Approaches to the concept of culture and teaching cultural competence in a foreign language classroom have been changing over the last decades. The paper summarises, compares, contrasts and evaluates four major approaches to teaching cultural competence in foreign language teaching, that is, knowledge-based approach, contrastive approach,…

  8. From Cultural Knowledge to Intercultural Communicative Competence: Changing Perspectives on the Role of Culture in Foreign Language Teaching

    Science.gov (United States)

    Piatkowska, Katarzyna

    2015-01-01

    Approaches to the concept of culture and teaching cultural competence in a foreign language classroom have been changing over the last decades. The paper summarises, compares, contrasts and evaluates four major approaches to teaching cultural competence in foreign language teaching, that is, knowledge-based approach, contrastive approach,…

  9. An Investigation of Organizational Culture Changes and Effectiveness at Jefferson College: 1963-Present

    Science.gov (United States)

    McCaffrey, Dena M.

    2012-01-01

    A fundamental factor in the internal dynamics of a college is its culture. Central to understanding organizational culture is to minimize the occurrence and consequences of cultural conflict and help foster the development of shared goals. Modifying organizational culture is important. Without culture change, there is little hope of enduring…

  10. Environmental health implications of global climate change.

    Science.gov (United States)

    Watson, Robert T; Patz, Jonathan; Gubler, Duane J; Parson, Edward A; Vincent, James H

    2005-09-01

    This paper reviews the background that has led to the now almost-universally held opinion in the scientific community that global climate change is occurring and is inescapably linked with anthropogenic activity. The potential implications to human health are considerable and very diverse. These include, for example, the increased direct impacts of heat and of rises in sea level, exacerbated air and water-borne harmful agents, and--associated with all the preceding--the emergence of environmental refugees. Vector-borne diseases, in particular those associated with blood-sucking arthropods such as mosquitoes, may be significantly impacted, including redistribution of some of those diseases to areas not previously affected. Responses to possible impending environmental and public health crises must involve political and socio-economic considerations, adding even greater complexity to what is already a difficult challenge. In some areas, adjustments to national and international public health practices and policies may be effective, at least in the short and medium terms. But in others, more drastic measures will be required. Environmental monitoring, in its widest sense, will play a significant role in the future management of the problem.

  11. Environmental health implications of global climate change

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Robert T.; Patz, Jonathan; Gubler, Duane J.; Parson, Edward A.; Vincent, James H.

    2005-07-01

    This paper reviews the background that has led to the now almost-universally held opinion in the scientific community that global climate change is occurring and is inescapably linked with anthropogenic activity. The potential implications to human health are considerable and very diverse. These include, for example, the increased direct impacts of heat and of rises in sea level, exacerbated air and water-borne harmful agents, and - associated with all the preceding - the emergence of environmental refugees. Vector-borne diseases, in particular those associated with blood-sucking arthropods such as mosquitoes, may be significantly impacted, including redistribution of some of those diseases to areas not previously affected. Responses to possible impending environmental and public health crises must involve political and socio-economic considerations, adding even greater complexity to what is already a difficult challenge. In some areas, adjustments to national and international public health practices and policies may be effective, at least in the short and medium terms. But in others, more drastic measures will be required. Environmental monitoring, in its widest sense, will play a significant role in the future management of the problem. (Author)

  12. Sex Workers and HIV/AIDS: Analyzing Participatory Culture-Centered Health Communication Strategies

    Science.gov (United States)

    Basu, Ambar; Dutta, Mohan J.

    2009-01-01

    An emerging trend in health communication research advocates the need to foreground articulations of health by participants who are at the core of any health campaign. Scholarly work suggests that the culture-centered approach to health communication can provide a theoretical and practical framework to achieve this objective. The culture-centered…

  13. Sex Workers and HIV/AIDS: Analyzing Participatory Culture-Centered Health Communication Strategies

    Science.gov (United States)

    Basu, Ambar; Dutta, Mohan J.

    2009-01-01

    An emerging trend in health communication research advocates the need to foreground articulations of health by participants who are at the core of any health campaign. Scholarly work suggests that the culture-centered approach to health communication can provide a theoretical and practical framework to achieve this objective. The culture-centered…

  14. Phenotypic Changes Exhibited by E. coli Cultured in Space.

    Science.gov (United States)

    Zea, Luis; Larsen, Michael; Estante, Frederico; Qvortrup, Klaus; Moeller, Ralf; Dias de Oliveira, Sílvia; Stodieck, Louis; Klaus, David

    2017-01-01

    Bacteria will accompany humans in our exploration of space, making it of importance to study their adaptation to the microgravity environment. To investigate potential phenotypic changes for bacteria grown in space, Escherichia coli was cultured onboard the International Space Station with matched controls on Earth. Samples were challenged with different concentrations of gentamicin sulfate to study the role of drug concentration on the dependent variables in the space environment. Analyses included assessments of final cell count, cell size, cell envelope thickness, cell ultrastructure, and culture morphology. A 13-fold increase in final cell count was observed in space with respect to the ground controls and the space flight cells were able to grow in the presence of normally inhibitory levels of gentamicin sulfate. Contrast light microscopy and focused ion beam/scanning electron microscopy showed that, on average, cells in space were 37% of the volume of their matched controls, which may alter the rate of molecule-cell interactions in a diffusion-limited mass transport regime as is expected to occur in microgravity. TEM imagery showed an increase in cell envelope thickness of between 25 and 43% in space with respect to the Earth control group. Outer membrane vesicles were observed on the spaceflight samples, but not on the Earth cultures. While E. coli suspension cultures on Earth were homogenously distributed throughout the liquid medium, in space they tended to form a cluster, leaving the surrounding medium visibly clear of cells. This cell aggregation behavior may be associated with enhanced biofilm formation observed in other spaceflight experiments.

  15. Ferula gummosa Boiss. Embryogenic culture and karyological changes.

    Science.gov (United States)

    Bernard, Françoise; Bazarnov, Hossein Shaker; Khatab, Leila Javadi; Darabi, Ahmad Shafiei; Sheidai, Massoud

    2007-06-15

    Ferula gummosa Boiss. a highly valuable medicinal plant which naturally propagates in very limited areas of the Middle East with specific environmental conditions. The production of Ferula gummosa somatic embryos and the karyological analysis of somatic seedlings were the purpose of this study. High frequency indirect embryogenesis was induced in callus derived from zygotic embryonic axes. Embryogenesis was obtained when callus tissues were placed onto an agar induction Murashige and Skoog medium with 1-naphthalene acetic acid and after the transfer of the cultures in a thermoperiod regime of 16 h, 19 degrees C/8 h, 7 degrees C under photoperiod of 16 h light/8h dark. Embryogenic callus tissues were maintained by subculture on induction medium. Globular proliferation was achieved with suspension culture in the Murashige and Skoog medium added with 1-naphthalene acetic acid or 2,4-dichlorophenoxyacetic acid for two weeks. Maturation of embryos and development of plantlets arose on the induction agar medium, but was better after transfer into the hormone free Murashige and Skoog medium. However, the level of abnormal embryos was high. Direct embryogenesis was obtained from somatic seedlings. The best results were obtained from hypocotyl explants. Embryo induction was achieved by two week culture of the explants in 2,4-dichlorophenoxyacetic acid liquid medium; somatic embryo growth and maturation was recovered on the hormone free medium. High level of abnormalities was recorded in the culture. Karyological analysis showed a high incidence level of cytochimerism in somatic seedlings with chromosome stickiness, polypoidy and aneuploidy in metaphase cells of the same root tip. The frequency of these karyological changes varied with the type of somatic embryos with regard to morphological abnormalities. Normal and abnormal rooted somatic seedlings were able to grow until production of the first leaf and then entered dormancy in the same manner as zygotic plantlets.

  16. Phenotypic Changes Exhibited by E. coli Cultured in Space

    Directory of Open Access Journals (Sweden)

    Luis Zea

    2017-08-01

    Full Text Available Bacteria will accompany humans in our exploration of space, making it of importance to study their adaptation to the microgravity environment. To investigate potential phenotypic changes for bacteria grown in space, Escherichia coli was cultured onboard the International Space Station with matched controls on Earth. Samples were challenged with different concentrations of gentamicin sulfate to study the role of drug concentration on the dependent variables in the space environment. Analyses included assessments of final cell count, cell size, cell envelope thickness, cell ultrastructure, and culture morphology. A 13-fold increase in final cell count was observed in space with respect to the ground controls and the space flight cells were able to grow in the presence of normally inhibitory levels of gentamicin sulfate. Contrast light microscopy and focused ion beam/scanning electron microscopy showed that, on average, cells in space were 37% of the volume of their matched controls, which may alter the rate of molecule–cell interactions in a diffusion-limited mass transport regime as is expected to occur in microgravity. TEM imagery showed an increase in cell envelope thickness of between 25 and 43% in space with respect to the Earth control group. Outer membrane vesicles were observed on the spaceflight samples, but not on the Earth cultures. While E. coli suspension cultures on Earth were homogenously distributed throughout the liquid medium, in space they tended to form a cluster, leaving the surrounding medium visibly clear of cells. This cell aggregation behavior may be associated with enhanced biofilm formation observed in other spaceflight experiments.

  17. Cultured stem cells are sensitive to gravity changes

    Science.gov (United States)

    Buravkova, L. B.; Romanov, Yu. A.; Konstantinova, N. A.; Buravkov, S. V.; Gershovich, Yu. G.; Grivennikov, I. A.

    2008-09-01

    Stem and precursor cells play an important role in development and regeneration. The state of these cells is regulated by biochemical substances, mechanical stimuli and cellular interactions. To estimate gravity effects we used two types of cultured stem cells: human mesenchymal stromal cells (hMSCs) from bone marrow and mice embryonic stem (mESC) line R1. Gravity changes were simulated by long-term (4-7 days) slow clinorotation and leaded to decreased hMSC proliferation, changes of cell morphology and modified F-actin cytoskeleton. We did not find the shifts in cell phenotype except for decreased expression of HLA 1 and CD105 but excretion of IL-6 into medium increased significantly. Remodeling of cytoskeleton started after first 4 h and was similar to preapoptotic changes. This data suggested the modification in cell adhesion and possible commitment of hMSC. It was observed that expression of alkaline phosphatase by MSC in osteogenic medium was more intensive in control. On the contrary, clinorotation did not change formation of mESC colonies and increased proliferation activity in LIF+-medium. However, the number of embryonic bodies after clinorotation was less than in static control. It is suggested that ESCs kept the viability and proliferative potential but decreased the differentiation ability after changes in gravity stimulation.

  18. In Brief: Report details climate change effects on cultural sites

    Science.gov (United States)

    Zielinski, Sarah

    2007-04-01

    A new report from UNESCO (United Nations Educational, Scientific, and Cultural Organization) details how 26 World Heritage sites could be affected by coming climate changes. The 26 examples, which are meant to be representative of the range of threats to the 830 sites inscribed in the World Heritage List, are divided into five types: archaeological sites, glaciers, historic cities and settlements, marine biodiversity, and terrestrial biodiversity. Some of the examples include the Great Barrier Reef, which is expected to experience more frequent episodes of coral bleaching; Timbuktu in Mali, threatened by desertification; and the Chavín Archaeological Site in the Peruvian Central Andes, one of the earliest and best-known pre-Columbian sites, which could be affected by glacier melting and flooding. The report, ``Case Studies on Climate Change and World Heritage,'' is available at http://whc.unesco.org/documents/publi_climatechange.pdf

  19. Organizational capacity for change in health care: Development and validation of a scale.

    Science.gov (United States)

    Spaulding, Aaron; Kash, Bita A; Johnson, Christopher E; Gamm, Larry

    We do not have a strong understanding of a health care organization's capacity for attempting and completing multiple and sometimes competing change initiatives. Capacity for change implementation is a critical success factor as the health care industry is faced with ongoing demands for change and transformation because of technological advances, market forces, and regulatory environment. The aim of this study was to develop and validate a tool to measure health care organizations' capacity to change by building upon previous conceptualizations of absorptive capacity and organizational readiness for change. A multistep process was used to develop the organizational capacity for change survey. The survey was sent to two populations requesting answers to questions about the organization's leadership, culture, and technologies in use throughout the organization. Exploratory and confirmatory factor analyses were conducted to validate the survey as a measurement tool for organizational capacity for change in the health care setting. The resulting organizational capacity for change measurement tool proves to be a valid and reliable method of evaluating a hospital's capacity for change through the measurement of the population's perceptions related to leadership, culture, and organizational technologies. The organizational capacity for change measurement tool can help health care managers and leaders evaluate the capacity of employees, departments, and teams for change before large-scale implementation.

  20. Information and Communication Technology and Cultural Change How ICT Changes Self-Construal and Values

    NARCIS (Netherlands)

    Hansen, Nina; Postmes, Tom; van der Vinne, Nikita; van Thiel, Wendy

    2012-01-01

    This paper studies whether and how information and communication technology (ICT) changes self-construal and cultural values in a developing country. Ethiopian children were given laptops in the context of an ICT for development scheme. We compared children who used laptops (n = 69) with a control g

  1. Culture matters: a case of school health promotion in Canada.

    Science.gov (United States)

    McIsaac, Jessie-Lee D; Read, Kendra; Veugelers, Paul J; Kirk, Sara F L

    2013-08-14

    Rising concerns of poor health behaviours of children and youth have stimulated international support for a comprehensive approach to promoting the development of healthy behaviours in the early years. Health promoting schools (HPS) is increasingly adopted as an approach to guide supportive practices, but there is limited research that has reported how to effectively implement HPS at a population level. The purpose of this research was to qualitatively explore the factors preventing and facilitating implementation of HPS practices in the Canadian province of Nova Scotia. Interviews (n = 23) were conducted with school stakeholders (principals, teachers and parents) from a diverse sample of schools (n = 9) and data were analysed to develop an understanding of how school circumstances and experiences influenced HPS implementation. At a broad level, the reported barriers were structural and systemic, whereas the facilitating factors were related to organizational capacity and political leadership. It was evident that implementing and sustaining HPS required a shift in values and integration of supportive school health practices into school priorities. The results suggest that, without addressing the competing culture, which is persistently reinforced by strict academic mandates and unhealthy community norms, HPS will be vulnerable to circumstances that prevent implementation. Considering the emerging importance of mental wellbeing, it will also be important to provide schools with adequate and appropriate staff capacity and support to address this issue. Sustaining the positive effects of HPS will require continuous engagement and collaboration with multiple stakeholders to embed health promotion into school community norms.

  2. Social Change and Cultural Values in a Small Community

    Directory of Open Access Journals (Sweden)

    Sanmartín Arce, Ricardo

    2008-12-01

    Full Text Available This article describes how social change has affected the cultural values in a small community of fishermen in the Albufera Lake of Valencia. Industrial development, tourism, new employment and jobs changed the ecology of the lake, the mutual dependency among neighbours and the efficiency of old cultural values to orient social interaction. Both the new role played by of women and the Spanish Constitution of 1978 lie at the basis of new conflicts which are at once a challenge and an opportunity for the emergence of new horizons.

    El artículo describe cómo ha afectado el cambio social a los valores culturales en una pequeña comunidad de pescadores en el lago de la Albufera de Valencia. El desarrollo industrial, el turismo y el nuevo empleo y trabajos cambiaron la ecología del lago, la mutua dependencia entre los vecinos y la eficiencia de los viejos valores culturales para orientar la interacción social. El nuevo rol de la mujer y la Constitución están en la base de nuevos conflictos como reto y como apertura de nuevos horizontes a la vez.

  3. Cultural change, hybridity and male homosexuality in Mexico.

    Science.gov (United States)

    Carrillo, H

    1999-01-01

    This paper analyzes how contemporary perceptions of male homosexuality are being shaped in Mexico. Ethnographic analysis included four short case studies from 64 mostly middle class individuals for two years in Guadalajara City. Mexican sexual culture is often portrayed traditionally as grounded in values inherent in machismo and influenced by Catholicism. There is a contrast between these traditional interpretations of roles and sexual identities in Mexico and the identities that are being adopted by many contemporary Mexican homosexual men. The homosexual men were categorizable in terms of 1) those who dominated in the sexual relationship and who were capable of maintaining a nonstigmatized identity as regular men, 2) those who assumed a feminine role and were penetrated and who were stigmatized for their effeminate demeanor, and 3) a minority of men who assumed both roles and who were termed "anally active and passive". The study revealed that middle-class homosexuals established networks in which individuals, supported by their friends, acquired the strength to effect personal changes along with other larger cultural changes. Thus, individual actions are beginning to have a collective effect on the society at large.

  4. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Science.gov (United States)

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-01-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation.

  5. [Patient safety culture in directors and managers of a health service].

    Science.gov (United States)

    Giménez-Júlvez, Teresa; Hernández-García, Ignacio; Aibar-Remón, Carlos; Gutiérrez-Cía, Isabel; Febrel-Bordejé, Mercedes

    To assess patient safety culture in directors/managers. Cross-sectional descriptive study carried out from February to June 2011 among the executive/managing staff of the Aragón Health Service through semi-structured interviews. A total of 12 interviews were carried out. All the respondents admitted that there were many patient safety problems and agreed that patient safety was a priority from a theoretical rather than practical perspective. The excessive changes in executive positions was considered to be an important barrier which made it difficult to establish long-term strategies and achieve medium-term continuity. This study recorded perceptions on patient safety culture in directors, an essential factor to improve patient safety culture in this group and in the organisations they run. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Religious culture and health promotion: care, practice, object

    Directory of Open Access Journals (Sweden)

    Viola Timm

    2015-06-01

    Full Text Available At the margins of modern medical practice, pushing the very limits of science, and indefatigably rendering the precincts of public discourse, still functional remnants of Christian civilization continue to provide care for the hopeless, perform healing sacraments for the incurable, and curate objects of votive devotion for the suffering and needy. These public services go largely unaccounted for, though they secure an ordered world, structure perception, and serve as ontological anchors. Lost in the vague, scientifically unrarified notions of spirituality that brace a general, undifferentiated worldwide metaphysical experience and disregard immense cultural, functional, geographic and performative distinctness, Catholic sacramental practices aimed at alleviating suffering and promoting healthy lifestyles are receiving only marginal mention in scientific literature(1, despite the fact that they make up daily reality in large parts of contemporary Europe and Latin America. Writing this editorial from the Northeast of Brazil, where traditional religious practice has sustained generations through the calamities of severe droughts, slavery, extreme poverty, high child mortality, failed political orders, and a harsh global economic reality, it is difficult to underestimate the power of sacramental experience to sustain a cultural identity. It was defined the concept of care of the sick in the context of the religious experience of the Northeast of Brazil which is historically relevant to health promotion. Until the emergence of national health care in the late nineteenth century, it was largely the order of the Franciscan friars that was charged with promoting healthy lives in the region. The Catholic concept of care that guided their efforts structures three procedural reality principles: the psychological reality of the transference to the person in one’s charge (care/caritas, the performative practice of religious sacrament such as the anointment

  7. The promotion of mental health through cultural values, institutions, and practices: a reflection on some aspects of botswana culture.

    Science.gov (United States)

    Sabone, Motshedisi B

    2009-12-01

    Botswana has seen rapid socioeconomic development since the 1970s that has contributed to the erosion of the values, institutions, and practices that are believed to be supportive of mental health. In this paper, the author argues that the aspects of culture that are supportive of mental health have been diluted by the process of urbanization and the interactions of Batswana (the indigenous people of Botswana) with other cultural groups, particularly those from the western hemisphere. The paper further highlights some of the values, institutions, and practices native to Botswana and describes how they promote mental health. Lastly, recommendations for reviving the cultural values, institutions, and practices of Botswana are discussed.

  8. The role of culture in health literacy and chronic disease screening and management.

    Science.gov (United States)

    Shaw, Susan J; Huebner, Cristina; Armin, Julie; Orzech, Kathryn; Orzech, Katherine; Vivian, James

    2009-12-01

    Cultural and language differences and socioeconomic status interact with and contribute to low health literacy, defined as the inability to understand or act on medical/therapeutic instructions. Health literacy is increasingly recognized as an important factor in patient compliance, cancer screening utilization, and chronic disease outcomes. Commendable efforts have been initiated by the American Medical Association and other organizations to address low health literacy among patients. Less work has been done, however, to place health literacy in the broader context of socioeconomic and cultural differences among patients and providers that hinder communication and compliance. This review examines cultural influences on health literacy, cancer screening and chronic disease outcomes. We argue that cultural beliefs around health and illness contribute to an individual's ability to understand and act on a health care provider's instructions. This paper proposes key aspects of the intersection between health literacy and culturally varying beliefs about health which merit further exploration.

  9. Health Behavior Change after Blood Pressure Feedback.

    Directory of Open Access Journals (Sweden)

    Jia Pu

    Full Text Available Better understanding is needed for antihypertensive medication initiation and lifestyle modification among younger populations with elevated blood pressure. This study aimed to assess health behavior change after receiving a report of elevated blood pressure among African Americans and Caucasians younger than 50 years old. We used the Coronary Artery Risk Development in Young Adults (CARDIA repository dataset. By examination year twenty, 424 out of 2,478 Caucasian and 2,637 African American participants had received feedback from the CARDIA study due to elevated blood pressure readings. Blood pressure was measured by trained CARDIA researchers at the participant's home and was repeatedly recorded at seven examinations over twenty years. A feedback/referral letter was sent to participants with an elevated blood pressure reading. On average, participants first had an elevated blood pressure reading at the age of 34. After receiving the feedback letter, 44% of the previously undiagnosed participants received a formal diagnosis. In addition, 23% initiated the use of antihypertensive medication if they had not received medication treatment before. Among the participants with at-risk lifestyle behaviors, 40% reduced alcohol consumption, 14% increased exercise level, 11% stopped smoking, and 8% reached normal weight. While none of the studied patient factors were associated with lifestyle modification, age had a positive impact on antihypertensive medication initiation (p<0.05. We found no evidence of differences in health behavior change between African American and Caucasian participants after receiving the feedback letter. This research is one of the first to study what followed after receiving a feedback letter about elevated blood pressure outside of healthcare settings. Although additional referral care and behavior interventions are needed to facilitate medication initiation and lifestyle modification, our observations suggest that providing

  10. Quantitative analysis of organizational culture in occupational health research: a theory-based validation in 30 workplaces of the organizational culture profile instrument

    National Research Council Canada - National Science Library

    Marchand, Alain; Haines, 3rd, Victor Y; Dextras-Gauthier, Julie

    2013-01-01

    This study advances a measurement approach for the study of organizational culture in population-based occupational health research, and tests how different organizational culture types are associated...

  11. Acute-care surgical service: a change in culture.

    Science.gov (United States)

    Parasyn, Andrew D; Truskett, Philip G; Bennett, Michael; Lum, Sharon; Barry, Jennie; Haghighi, Koroush; Crowe, Philip J

    2009-01-01

    The provision of acute surgical care in the public sector is becoming increasingly difficult because of limitation of resources and the unpredictability of access to theatres during the working day. An acute-care surgical service was developed at the Prince of Wales Hospital to provide acute surgery in a more timely and efficient manner. A roster of eight general surgeons provided on-site service from 08.00 to 18.00 hours Monday to Friday and on-call service in after-hours for a 79-week period. An acute-care ward of four beds and an operating theatre were placed under the control of the rostered acute-care surgeon (ACS). At the end of each ACS roster period all patients whose treatment was undefined or incomplete were handed over to the next rostered ACS. Patient data and theatre utilization data were prospectively collected and compared to the preceding 52-week period. Emergency theatre utilization during the day increased from 57 to 69%. There was a 11% reduction in acute-care operating after hours and 26% fewer emergency cases were handled between midnight and 08.00 hours. There was more efficient use of the entire theatre block, suggesting a significant cultural change. Staff satisfaction was high. On-site consultant-driven surgical leadership has provided significant positive change to the provision of acute surgical care in our institution. The paradigm shift in acute surgical care has improved patient and theatre management and stimulated a cultural change of efficiency.

  12. Nursing home organizational change: the "Culture Change" movement as viewed by long-term care specialists.

    Science.gov (United States)

    Miller, Susan C; Miller, Edward Alan; Jung, Hye-Young; Sterns, Samantha; Clark, Melissa; Mor, Vincent

    2010-08-01

    A decade-long grassroots movement aims to deinstitutionalize nursing home (NH) environments and individualize care. Coined "NH Culture Change" the movement is often described by its resident-centered/directed care focus. While empirical data of "culture change's" costs and benefits are limited, it is broadly viewed as beneficial and widely promoted. Still, debate abounds regarding barriers to its adoption. We used data from a Web-based survey of 1,147 long-term care specialists (including NH and other providers, consumers/advocates, state and federal government officials, university/academic, researchers/consultants, and others) to better understand factors associated with perceived barriers. Long-term care specialists view the number-one barrier to adoption differently depending on their employment, familiarity with culture change, and their underlying policy views. To promote adoption, research and broad-based educational efforts are needed to influence views and perceptions. Fundamental changes in the regulatory process together with targeted regulatory changes and payment incentives may also be needed.

  13. Laying the foundations of a culture of health as a pedagogical problem

    Directory of Open Access Journals (Sweden)

    Khalajtsan A.P.

    2014-05-01

    Full Text Available Purpose : to show the dominant influence of educational - educational process lay the groundwork for a culture of health students. Material : processed more than 40 references, conducted a survey, questionnaires and observation of the living conditions of students. Results : named main reasons for creating a culture of health of students should be considered as primary pedagogical problem. The preconditions and conditions of the foundations of the culture of youth health, namely: social, educational, health, environmental, economic, geographic, individual. Traced the sequence and phasing of the pedagogical process of building a culture of health of students in the course of many years of teaching in higher education. Conclusions : proven pedagogical influence priority basis forming a culture of health of students in the individual development and identity formation for learning in higher education. The sequence and structure of the solution of pedagogical problems of forming the foundations of a culture of health students.

  14. Predictors of behavior change intention using health risk appraisal data.

    Science.gov (United States)

    Marzec, Mary L; Lee, Seung Pil; Cornwell, T Bettina; Burton, Wayne N; McMullen, Judith; Edington, Dee W

    2013-07-01

    To investigate predictors of behavior change intention and discuss potential implications for practitioners. Health risk appraisal (HRA) data from 2 organizations were used to develop and confirm a path analysis model for predictors of intention to change behavior. Lower self-rated health perception and higher ratings of stress corresponded to higher behavior-change intention scores. Stress was associated with poorer health perception. Higher stress and lower perception of health status were directly associated with intention to change behavior. Incorporating stress management and awareness of health perception into health promotion strategies could enhance wellness programs by aligning programs with motivating factors.

  15. The impact on attitudes towards cultural difference of participation in a health focused study abroad program.

    Science.gov (United States)

    Inglis, A; Rolls, C; Kristy, S

    2000-01-01

    The changes in attitudes towards cultural difference of seventeen participants in a three-week community health study abroad program to Nepal were compared with the changes in attitudes of a similar group who did not participate in the tour. Participants in the tour group were surveyed eight weeks prior to departure and in the last week of the tour using a twenty-six item questionnaire employing a six-point forced-choice response scale. The responses of participants in the tour group showed significant shifts in relation to eight items compared while the responses for the control group showed no significant shifts. Observed student advantages of participation in this study tour included the development of independent behaviour and positive cultural adjustment and adaptation.

  16. Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations

    Science.gov (United States)

    Andrulis, Dennis P.; Brach, Cindy

    2016-01-01

    Objective To understand the interrelationship of literacy, culture, and language and the importance of addressing their intersection. Methods Health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed. Results Strategies to improve health literacy for low-literate individuals are distinct from strategies for culturally diverse and individuals with limited English proficiency (LEP). The lack of integration results in health care that is unresponsive to some vulnerable groups’ needs. A vision for integrated care is presented. Conclusion Clinicians, the health care team, and health care organizations have important roles to play in addressing challenges related to literacy, culture, and language. PMID:17931131

  17. Climate change and human health : Indian context

    Directory of Open Access Journals (Sweden)

    Poonam K. Singh & Ramesh C. Dhiman

    2012-06-01

    Full Text Available The article reviews the issue of climate change and health in the Indian context. The importance of climatechange leading to estimated loss of above 2.5 million DALYs in southeast Asia, mortality due to heat waves, andthe importance of air quality related respiratory diseases, disasters due to excessive floods, malnutrition due toreduction in rice, maize and sorghum crops etc. Latest work undertaken in India, vis-a-vis current scenario andneed for further work has been discussed. There is felt need of further studies on assessing the impact on dengueand chikungunya as the transmission dynamics of these diseases involve water availability, storage and lifestyle, etc. Uncertainties and knowledge gaps identified in the studies undertaken so far have also been highlighted.As regards to vector borne diseases, there is a need to concentrate in the areas which are presently free frommalaria and with use of best available tools of interventions in already disease endemic areas like northeasternstates, the risk of climate change impacts can be minimized.

  18. Culture change in care homes: a literature review.

    Science.gov (United States)

    Wild, Deirdre; Kydd, Angela

    2016-08-01

    This article is the first of a two-part series that explores a programme of culture change in care homes. A UK care home company sought the authors' expertise to design and facilitate an independent programme of learning to encourage and support staff in two of its homes to become the architects of their own quality improvement. The article reviews the literature that was an essential information base for the authors in their dual roles as designers of the learning programme and facilitators of its delivery to participant staff. The literature is necessarily broad in reflecting the nature and context of care homes, residents' needs and wants from care, and the particular challenges that might be faced by care home staff and managers when making quality improvements. In the second article, the reality of running the programme in the two homes is described.

  19. Diet, social differentiation and cultural change in Roman Britain

    DEFF Research Database (Denmark)

    Cheung, Christina; Schroeder, Hannes; Hedges, R. E. M.

    2012-01-01

    This study uses stable isotope analyses (d 13 C and d 15 N) of human bone collagen to reconstruct the diet of three Romano-British (first to early fifth century AD) populations from Gloucestershire in South West England. Gloucestershire was an important part of Roman Britain with two major admini...... sensitive, if settlement-specific, indicator of social differentiation and culture change.......This study uses stable isotope analyses (d 13 C and d 15 N) of human bone collagen to reconstruct the diet of three Romano-British (first to early fifth century AD) populations from Gloucestershire in South West England. Gloucestershire was an important part of Roman Britain with two major...

  20. Dental Education Required for the Changing Health Care Environment.

    Science.gov (United States)

    Fontana, Margherita; González-Cabezas, Carlos; de Peralta, Tracy; Johnsen, David C

    2017-08-01

    To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21(st) Century."

  1. The Changing World Today: Cultural Change in Japan, Kenya, and India. Student Text and Student Study Guide.

    Science.gov (United States)

    Clawson, Elmer U.; Rice, Marion J.

    This student text and accompanying pupil study guide for intermediate grades examine cultural change in Japan, Kenya, and India. The unit objective is to help students examine processes of change occurring in the world today by systematically presenting cultural change concepts and illustrations in case study settings. The books provide students…

  2. The cultural adjustment and mental health of Japanese immigrant youth.

    Science.gov (United States)

    Yeh, Christine J; Arora, Agnes K; Inose, Mayuko; Okubo, Yuki; Li, Robin H; Greene, Pamela

    2003-01-01

    Interviews were conducted with eight Japanese immigrant youth about their experiences with respect to adjusting to life in the United States, dealing with discrimination, and coping with cultural challenges. They were also questioned about their mental health and family and peer relations. Results indicate that participants managed to maintain bicultural identities and to cope with the problems that they encountered. Nevertheless, they experienced the following difficulties: racism and prejudice, language barriers, and conflict regarding identity and values. In terms of coping, participants mostly relied on friends for support; only one had sought the help of a professional counselor. The implications of the findings are discussed in terms of working with immigrant youth from Japan.

  3. Microradiometers Reveal Ocean Health, Climate Change

    Science.gov (United States)

    2013-01-01

    When NASA researcher Stanford Hooker is in the field, he pays close attention to color. For Hooker, being in the field means being at sea. On one such research trip to the frigid waters of the Arctic, with a Coast Guard icebreaker looming nearby and the snow-crusted ice shelf a few feet away, Hooker leaned over the edge of his small boat and lowered a tethered device into the bright turquoise water, a new product devised by a NASA partner and enabled by a promising technology for oceanographers and atmospheric scientists alike. Color is a function of light. Pure water is clear, but the variation in color observed during a visit to the beach or a flight along a coastline depends on the water s depth and the constituents in it, how far down the light penetrates and how it is absorbed and scattered by dissolved and suspended material. Hooker cares about ocean color because of what it can reveal about the health of the ocean, and in turn, the health of our planet. "The main thing we are interested in is the productivity of the water," Hooker says. The seawater contains phytoplankton, microscopic plants, which are the food base for the ocean s ecosystems. Changes in the water s properties, whether due to natural seasonal effects or human influence, can lead to problems for delicate ecosystems such as coral reefs. Ocean color can inform researchers about the quantities and distribution of phytoplankton and other materials, providing clues as to how the world ocean is changing. NASA s Coastal Zone Color Scanner, launched in 1978, was the first ocean color instrument flown on a spacecraft. Since then, the Agency s ocean color research capabilities have become increasingly sophisticated with the launch of the SeaWiFS instrument in 1997 and the twin MODIS instruments carried into orbit on NASA s Terra (1999) and Aqua (2002) satellites. The technology provides sweeping, global information on ocean color on a scale unattainable by any other means. One issue that arises from

  4. Using health psychology to help patients: theories of behaviour change

    OpenAIRE

    Barley, Elizabeth; Lawson, Victoria

    2016-01-01

    Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that ...

  5. Pathway to Change? An Appraisal of the Australian Defence Force’s Strategy for Cultural Change

    Science.gov (United States)

    2013-12-13

    ILLUSTRATIONS Page Figure 1. A Multisystem Ethical Framework ..................................................................26 Figure 2. The...respectively, Linda Trevino and Katherine Nelson’s 6 “Multisystem Ethical Culture Framework ,” and Peter Checkland’s “Soft System Methodology.” Chapter...academics in the field of organizational change, including Geert Hofstede and Edgar Schein: “A set of shared mental assumptions that guide interpretation

  6. The challenge of effective workplace change in the health sector.

    Science.gov (United States)

    Kerr, Michael S; Mustard, Cam

    2007-01-01

    There is significant personal injury risk associated with the provision of high-quality healthcare. The magnitude of this risk, combined with the possibility that it can often go underappreciated by caregivers and the organizations they work for, might help explain why the health sector has largely missed out on the benefits of an overall declining trend in injury rates. Despite covering two very different topics in their lead papers, Shamian and El-Jardali and Clements, Dault and Priest present a surprising degree of overlap in relation to what might help enable effective workplace change. Leadership, role clarity, trust, respect, values and workplace culture are all viewed as key enablers of effective teamwork by Clements, Dault and Priest. They could also be considered required ingredients of successful workplace health initiatives, as discussed by Shamian and El-Jardali. A lot of background and positional work regarding teamwork and healthy workplaces exists, but this has not necessarily translated into front-line change. These authors have done an excellent job of pointing out the potential benefits of workplace changes. What is needed now is for someone to take the lead in developing, implementing and evaluating these changes. The adult human form is an awkward burden to lift or carry. Weighing up to 200 pounds or more, it has no handles, it is not rigid, and it is susceptible to severe damage if mishandled or dropped. When lying in bed, a patient is placed inconveniently for lifting and the weight and placement of such a load would be tolerated by few industrial workers.

  7. Why change habits? Early modern medical innovation between medicalisation and medical culture.

    Science.gov (United States)

    Loetz, Francisca

    2010-01-01

    Based on a discussion of the concept of medicalisation and medical culture in Anglo-American, French-, and German-speaking historiography the paper argues that medical innovation in Europe from the sixteenth to the mid-nineteenth century should be approached in a different way. Instead of asking from the perspective of a too narrow concept of medicalisation why medical innovations were rejected by the population, (medical) historians should analyse medical culture and ask why people should have changed their health and illness behaviour. This conceptual argument is deduced from four empirical examples: the introduction of smallpox vaccination, "medical police," the problem of medical professionalization, and the questions arising around the relations between the healthy/sick and their practitioners.

  8. Perception of risk for Domoic Acid related health problems: A Cross-cultural study.

    Science.gov (United States)

    Roberts, Sparkle M; Grattan, Lynn M; Toben, Alexandra C; Ausherman, Christina; Trainer, Vera; Tracy, Kate; Morris, J Glenn

    2016-07-01

    Risk perception is a complex process that refers to the way people approach, think about and interpret risks in their environment. An important element of risk perception is that it is culturally situated. Since HAB's can present a health risk in many places around the world, looking at cultural parameters for understanding and interpreting risks are important. This study examined how two different groups of people perceive the potential health risks of low level exposure to domoic acid (DA) through razor clam consumption. The risk perceptions of Washington State, USA coastal dwelling Native American nations (NA) were compared to that of a community sample of recreational razor clam harvesters (CRH). Overall, the findings support the hypothesis that cultural and community specific contexts impact the perception of risk of a DA related illness. Specifically, the NA sample was distinguished by worrying more about ocean pollution, attributing DA risks to climate change, expressing concerns about the potential impact of DA on future generations, and feeling better informed than the CRH group. The CRH group were more likely to attribute the DA problem to anthropogenic or industrial causes; and view the risk of health problems as lower than that associated with smoking, high cholesterol, anxiety or depression, alcoholism, high blood pressure or obesity. The CRH group was also more likely to turn to the media for DA related information. Both groups trust the decisions of state and tribe health and natural resources officials and demonstrated a complex pattern of findings that involved gender. It was recommended that risk communication and outreach activities are designed to take into consideration factors that specifically apply to each cultural community.

  9. Does health care role and experience influence perception of safety culture related to preventing infections?

    Science.gov (United States)

    Braun, Barbara I; Harris, Anthony D; Richards, Cheryl L; Belton, Beverly M; Dembry, Louise-Marie; Morton, David J; Xiao, Yan

    2013-07-01

    Growing evidence reveals the importance of improving safety culture in efforts to eliminate health care-associated infections. This multisite, cross-sectional survey examined the association between professional role and health care experience on infection prevention safety culture at 5 hospitals. The findings suggest that frontline health care technicians are less directly engaged in improvement efforts and safety education than other staff and that infection prevention safety culture varies more by hospital than by staff position and experience.

  10. Cultural health capital and the interactional dynamics of patient-centered care.

    Science.gov (United States)

    Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

    2013-09-01

    As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. The Changing Educational Needs of Mental Health and Disability Nurses.

    Science.gov (United States)

    Norman, Ian J.; Redfern, Sally J.; Bodley, Denise; Holroyd, Sue; Smith, Clive; White, Edward

    A study identified and explored the changing educational needs of mental health and learning disability nurses in Britain following the 1990 National Health Service and Community Care Act. A literature review focused on service developments in mental health and learning disability nursing and changes in education. Interviews were conducted with…

  12. Cultural competence: a literature review and conceptual model for mental health services.

    Science.gov (United States)

    Hernandez, Mario; Nesman, Teresa; Mowery, Debra; Acevedo-Polakovich, Ignacio D; Callejas, Linda M

    2009-08-01

    This article presents a conceptual model of organizational cultural competence for use in mental health services that resulted from a comprehensive review of the research literature. The model identifies four factors associated with cultural competence in mental health services (community context, cultural characteristics of local populations, organizational infrastructure, and direct service support) and redefines cultural competence as the degree of compatibility among these factors. A strength of this model of organizational cultural competence is that it facilitates future research and practice in psychiatric services settings and links culturally competent practices to service parity.

  13. LANGUAGE AND SOCIO-CULTURAL CHANGE IN EJAGHAM ...

    African Journals Online (AJOL)

    organisation, the complex of cultural traits which governs the relation of individu- als and ..... habits that this need takes precedence and consequently modifies the speech habits ... Culture, Language and Personality (Los Angels: University of.

  14. Work-Life Balance and Cultural Change: A Narrative of Eligibility

    Science.gov (United States)

    Lester, Jaime

    2013-01-01

    Using Schein's (1992) framework of cultural change, this study examined two institutions of higher education that have achieved or attempted a cultural change to understand if and how to develop a culture of work-life balance for faculty and staff. The results identified a narrative of eligibility that arose from the discourse of faculty…

  15. Work-Life Balance and Cultural Change: A Narrative of Eligibility

    Science.gov (United States)

    Lester, Jaime

    2013-01-01

    Using Schein's (1992) framework of cultural change, this study examined two institutions of higher education that have achieved or attempted a cultural change to understand if and how to develop a culture of work-life balance for faculty and staff. The results identified a narrative of eligibility that arose from the discourse of faculty…

  16. The relationship between drivers and policy in the implementation of cultural competency training in health care.

    Science.gov (United States)

    Dogra, Nisha; Betancourt, Joseph R; Park, Elyse R; Sprague-Martinez, Linda

    2009-02-01

    In recent years, cultural competence has appeared on the agendas of the medical profession as well as other health care providers. Through semistructured interviews with staff at different types of health care institutions, we explored the motivation for and barriers against the implementation of cultural competence training. The findings show that while some progress has been made, there is still work to be done in making cultural competency an integral part of the organizational fabric of health care. National organizations need to consider their leadership role in helping health care organizations translate broad statements of cultural competence into meaningful action.

  17. Persistence of contrasting traditions in cultural evolution: unpredictable payoffs generate slower rates of cultural change.

    Science.gov (United States)

    Caldwell, Christine A; Eve, Roland M

    2014-01-01

    We report an experimental test of the hypothesis that contrasting traditions will persist for longer, maintaining cultural differences between otherwise similar groups, under conditions of uncertainty about payoffs from individual learning. We studied the persistence of two alternative, experimentally-introduced, task solutions in chains of human participants. In some chains, participants were led to believe that final payoffs would be difficult to predict for an innovative solution, and in others, participants were aware that their final payoff would be directly linked to their immediate solution. Although the difference between the conditions was illusory (only participants' impressions were manipulated, not actual payoffs) clear differences were found between the conditions. Consistent with predictions, in the chains that were less certain about final payoffs, the distinctive variants endured over several replacement "generations" of participants. In contrast, in the other chains, the influence of the experimentally-introduced solutions was rapidly diluted by participants' exploration of alternative approaches. The finding provides support for the notion that rates of cultural change are likely to be slower for behaviors for which the relationship between performance and payoff may be hard to predict.

  18. Persistence of contrasting traditions in cultural evolution: unpredictable payoffs generate slower rates of cultural change.

    Directory of Open Access Journals (Sweden)

    Christine A Caldwell

    Full Text Available We report an experimental test of the hypothesis that contrasting traditions will persist for longer, maintaining cultural differences between otherwise similar groups, under conditions of uncertainty about payoffs from individual learning. We studied the persistence of two alternative, experimentally-introduced, task solutions in chains of human participants. In some chains, participants were led to believe that final payoffs would be difficult to predict for an innovative solution, and in others, participants were aware that their final payoff would be directly linked to their immediate solution. Although the difference between the conditions was illusory (only participants' impressions were manipulated, not actual payoffs clear differences were found between the conditions. Consistent with predictions, in the chains that were less certain about final payoffs, the distinctive variants endured over several replacement "generations" of participants. In contrast, in the other chains, the influence of the experimentally-introduced solutions was rapidly diluted by participants' exploration of alternative approaches. The finding provides support for the notion that rates of cultural change are likely to be slower for behaviors for which the relationship between performance and payoff may be hard to predict.

  19. Human Performance Optimization: Culture Change and Paradigm Shift.

    Science.gov (United States)

    Deuster, Patricia A; OʼConnor, Francis G

    2015-11-01

    The term "Human Performance Optimization" (HPO) emerged across the Department of Defense (DoD) around 2006 when the importance of human performance for military success on the battlefield was acknowledged. Likewise, the term Total Force Fitness (TFF) arose as a conceptual framework within DoD in response to the need for a more holistic approach to the unparalleled operational demands with multiple deployments and strains on the United States Armed Forces. Both HPO and TFF are frameworks for enhancing and sustaining the health, well-being, and performance among our warriors and their families; they are fundamental to accomplishing our nation's mission. A demands-resources model for HPO is presented within the context of TFF to assist in operationalizing actions to enhance performance. In addition, the role leaders can serve is discussed; leaders are uniquely postured in the military chain of command to directly influence a culture of fitness for a ready force, and promote the concept that service members are ultimately responsible for their fitness and performance.

  20. Help Preferences among Employees Who Wish to Change Health Behaviors

    Science.gov (United States)

    Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L.

    2014-01-01

    Objective: To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e.,…

  1. General systems theory, cultural change, and a human science foundation for planning and design

    Energy Technology Data Exchange (ETDEWEB)

    Motloch, J.L.; Woodfin, T.

    1993-12-31

    This paper integrates the knowledge-base concerning systems, their behavior and structure, and the management of complex systems - to provide insight to physical planning and design in equilibrium and rapidly-changing conditions. It contributes to the redefinition of the professions of physical planning and design; and the establishment of their human science foundations. This paper begins with a description of general systems theory, and the types of organizational structures that emerge in systems that are either in a state of equilibrium, controlled change, or chaos. It addresses the changes in system dynamics that occur as a culture moves from a condition of equilibrium or slow evolutionary change, to one of profound, rapid change. Conceptual approaches to decision-making to address these changing conditions are explored, with a focus on strategies to manage change and retard its rate, or conversely to maximize rate of change with reduced ability to manage that change. The paper presents the recent history of South Africa, Value Systems Theory and the differential manner in which people image the world - in an effort to establish intergroup harmony. It introduces problems that are emerging due to different value systems and need satisfaction; and on-going efforts to facilitate rapid paradigmatic change through equilibrium processes. The paper addresses recent efforts at the national level, roadblocks to change, and {open_quotes}change triggers{close_quotes} that can facilitate that change. It addresses case-study research to identify urbanization {open_quotes}delivery models{close_quotes} that can facilitate change at the local community-planning level. This paper develops the scientific basis within which to address urban planning and design as community facilitation, and as the management of ecological and human health. It establishes the need for a human science foundation for physical planning and design. 116 refs.

  2. Health care delivery in Malaysia: changes, challenges and champions.

    Science.gov (United States)

    Thomas, Susan; Beh, LooSee; Nordin, Rusli Bin

    2011-09-05

    Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care.

  3. Health care delivery in Malaysia: changes, challenges and champions

    Directory of Open Access Journals (Sweden)

    Susan Thomas

    2011-09-01

    Full Text Available Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH, being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care.

  4. Worldwide genetic and cultural change in human evolution.

    Science.gov (United States)

    Creanza, Nicole; Feldman, Marcus W

    2016-12-01

    Both genetic variation and certain culturally transmitted phenotypes show geographic signatures of human demographic history. As a result of the human cultural predisposition to migrate to new areas, humans have adapted to a large number of different environments. Migration to new environments alters genetic selection pressures, and comparative genetic studies have pinpointed numerous likely targets of this selection. However, humans also exhibit many cultural adaptations to new environments, such as practices related to clothing, shelter, and food. Human culture interacts with genes and the environment in complex ways, and studying genes and culture together can deepen our understanding of human evolution.

  5. Changing the Culture of Academic Medicine: Critical Mass or Critical Actors?

    Science.gov (United States)

    Helitzer, Deborah L; Newbill, Sharon L; Cardinali, Gina; Morahan, Page S; Chang, Shine; Magrane, Diane

    2017-05-01

    By 2006, women constituted 34% of academic medical faculty, reaching a critical mass. Theoretically, with critical mass, culture and policy supportive of gender equity should be evident. We explore whether having a critical mass of women transforms institutional culture and organizational change. Career development program participants were interviewed to elucidate their experiences in academic health centers (AHCs). Focus group discussions were held with institutional leaders to explore their perceptions about contemporary challenges related to gender and leadership. Content analysis of both data sources revealed points of convergence. Findings were interpreted using the theory of critical mass. Two nested domains emerged: the individual domain included the rewards and personal satisfaction of meaningful work, personal agency, tensions between cultural expectations of family and academic roles, and women's efforts to work for gender equity. The institutional domain depicted the sociocultural environment of AHCs that shaped women's experience, both personally and professionally, lack of institutional strategies to engage women in organizational initiatives, and the influence of one leader on women's ascent to leadership. The predominant evidence from this research demonstrates that the institutional barriers and sociocultural environment continue to be formidable obstacles confronting women, stalling the transformational effects expected from achieving a critical mass of women faculty. We conclude that the promise of critical mass as a turning point for women should be abandoned in favor of "critical actor" leaders, both women and men, who individually and collectively have the commitment and power to create gender-equitable cultures in AHCs.

  6. Changes in cultural representations on Indonesian children's television from the 1980s to the 2000s

    NARCIS (Netherlands)

    Hendriyani, H.; Hollander, E.H.; d'Haenens, L.S.J.; Beentjes, J.W.J.

    2016-01-01

    This study describes the changes over time in the portrayal of socio-cultural characteristics; namely gender, age, ethnicity, religious outlook, family unit, violence experienced, living conditions, and cultural values in Indonesian children's television programs. Using systematic-quantitative conte

  7. Changes in cultural representations on Indonesian children's television from the 1980s to the 2000s

    NARCIS (Netherlands)

    Hendriyani, H.; Hollander, E.H.; d'Haenens, L.S.J.; Beentjes, J.W.J.

    2016-01-01

    This study describes the changes over time in the portrayal of socio-cultural characteristics; namely gender, age, ethnicity, religious outlook, family unit, violence experienced, living conditions, and cultural values in Indonesian children's television programs. Using systematic-quantitative conte

  8. Drive for leanness and health-related behavior within a social/cultural perspective.

    Science.gov (United States)

    Tod, David; Edwards, Christian; Hall, Gareth

    2013-09-01

    We examined relationships between drive for leanness and perceived media pressure to change appearance, internalization of an ideal physique, exercise frequency, and dieting. Men and women (N=353) completed the Drive for Leanness Scale, the Sociocultural Attitudes Toward Appearance Questionnaire-3, the Eating Attitudes Test-26, and a demographic inventory. Drive for leanness was significantly correlated with athletic internalization (.52), pressure to attain an ideal physique (.25), exercise frequency (.36), and dieting (.25). Structural equation modeling revealed a good fitting model (χ(2)=2.85, psocial/cultural theory helps enhance the understanding of the drive for leanness and its relationship with health-related behavior.

  9. Preparing the U.S. health community for climate change.

    Science.gov (United States)

    Jackson, Richard; Shields, Kyra Naumoff

    2008-01-01

    In society's effort to address and prepare for climate change, the health community itself must ensure that it is prepared. Health personnel will require flexible and iterative action plans to address climate change at the individual, hospital, local health department, state, and national levels. This requires that health workers analyze the impact of climate change with a view to human health, and then formulate robust policy and demonstrate authentic leadership. In this review, we summarize the status of the health community's preparation for climate change and provide specific recommendations for action at each level. Although preparation status and recommendations vary, our observation is that it is not enough for public health and medical care agencies and departments to develop policies and advocate change. They have a direct responsibility to demonstrate substantive leadership.

  10. Educating About Global Climate Change With A Cultural Perspective

    Science.gov (United States)

    Valdez, C.; Fessenden, J.; Kanjorski, N.; Hall, M. K.

    2004-12-01

    Predominantly minority populated schools in Northern New Mexico are plagued by low standardized test scores and high drop-out rates. The school system is currently failing students, and success in science is reliant on self-motivation among students. In order for students to gain momentum in a system where exposure to science is not prevalent, it is important for them to get outside support that catalyzes their interest. Collaboration between Los Alamos National Laboratory (LANL), Science Education Solutions (SES), and local schools has been established to identify student needs and provide them with the opportunity to engage in science through hands-on experience with world-class scientists. Students are being introduced to the prospects of a scientific career while getting the unique chance to explore different aspects of several LANL scientists' research. This initiative also incorporates cultural awareness efforts to promote parent and community involvement. In the past year, two pilot projects were carried out to test the concepts, goals, and methods of the collaboration. One pilot project used plant growth studies in predominantly Hispanic fifth-grade classrooms to stimulate student interest. Students explored tree ring cores and tested water-use efficiency with sponges. The other pilot project included a two-day workshop for Native American students from Jemez Pueblo focusing on global climate change. This project combined a class component and hands-on field research. Samples were taken from LANL research sites with in-field lessons from scientists who monitor the sites. In addition, Jemez Pueblo officials were able to tie the sites to the student's lives with a historical and cultural overview. The most successful elements from these pilot projects are being used to develop a long-term project that will pique student interest in the science disciplines. Field activities garnered the most enthusiastic response from students, while in-class lessons were less

  11. Sustainable Change: A Model for Transforming Departmental Culture to Support STEM Education Innovation

    CERN Document Server

    Corbo, Joel C; Dancy, Melissa H; Deetz, Stanley; Finkelstein, Noah

    2014-01-01

    This paper describes a strategic effort to improve teaching and learning in STEM departments at the University of Colorado Boulder. In contrast to many other higher education STEM change efforts that focus primarily on disseminating practices, our two synergistic change strategies focus on explicit cultural change that integrates interventions across the entire university system, impacting faculty members, administrators, and, most importantly, whole departments. Our outside-in strategy works with both faculty and administrators to create changes that will combine to influence departmental culture, and our middle-out strategy works directly with departments to enact a large-scale cultural change process. Both of these strategies aim to align departmental cultures with six core cultural commitments that are emblematic of highly productive departments. We argue that this holistic approach to shifting culture is required to foster and sustain meaningful change. Additionally, our strategies are grounded in change...

  12. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.

    OpenAIRE

    Betancourt, Joseph R.; Green, Alexander R.; Carrillo, J. Emilio; Ananeh-Firempong, Owusu

    2003-01-01

    OBJECTIVES: Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care. METHODS: The authors conducted a literature...

  13. National culture and business model change: a framework for successful expansions

    DEFF Research Database (Denmark)

    Dalby, J.; Nielsen, L.S.; Lueg, Rainer;

    2014-01-01

    Dalby, J., Nielsen, Lueg, R., L. S., Pedersen, L., Tomoni, A. C. 2014. National culture and business model change: a framework for successful expansions. Journal of Enterprising Culture, 22(4): 379-498.......Dalby, J., Nielsen, Lueg, R., L. S., Pedersen, L., Tomoni, A. C. 2014. National culture and business model change: a framework for successful expansions. Journal of Enterprising Culture, 22(4): 379-498....

  14. Translation of interviews from a source language to a target language: examining issues in cross-cultural health care research.

    Science.gov (United States)

    Al-Amer, Rasmieh; Ramjan, Lucie; Glew, Paul; Darwish, Maram; Salamonson, Yenna

    2015-05-01

    To illuminate translation practice in cross-language interview in health care research and its impact on the construction of the data. Globalisation and changing patterns of migration have created changes to the world's demography; this has presented challenges for overarching social domains, specifically, in the health sector. Providing ethno-cultural health services is a timely and central facet in an ever-increasingly diverse world. Nursing and other health sectors employ cross-language research to provide knowledge and understanding of the needs of minority groups, which underpins cultural-sensitive care services. However, when cultural and linguistic differences exist, they pose unique complexities for cross-cultural health care research; particularly in qualitative research where narrative data are central for communication as most participants prefer to tell their story in their native language. Consequently, translation is often unavoidable in order to make a respondent's narrative vivid and comprehensible, yet, there is no consensus about how researchers should address this vital issue. An integrative literature review. PubMed and CINAHL databases were searched for relevant studies published before January 2014, and hand searched reference lists of studies were selected. This review of cross-language health care studies highlighted three major themes, which identify factors often reported to affect the translation and production of data in cross-language research: (1) translation style; (2) translators; and (3) trustworthiness of the data. A plan detailing the translation process and analysis of health care data must be determined from the study outset to ensure credibility is maintained. A transparent and systematic approach in reporting the translation process not only enhances the integrity of the findings but also provides overall rigour and auditability. It is important that minority groups have a voice in health care research which, if accurately

  15. Intervention in Multi-cultural Organizations -Prevention of Accidents as political change processes

    DEFF Research Database (Denmark)

    Dyhrberg, Mette Bang; Kamp, Annette; Koch, Christian

    1999-01-01

    A selective study of literature within safety culture, corporate culture and organisational theory have shown that the safety culture approach can benefit from the corporate culture approaches and organisational theory dealing with political processes. The implicit models of organisation within m...... of an organisation as a Multi-cultural Organisation. Second on change processes as political processes where the needed change have to be negotiated and reshaped....... culture approaches.The Concept of a multicultural organisation thus aims at encompassing the multitude of actor positions within an organisation with possible influence on the prevention work. A case study within industry is used to demonstrate the benefits of mobilizing these additional approaches...

  16. Understanding the organisational culture of district health services: Mahalapye and Ngamiland health districts of Botswana

    Directory of Open Access Journals (Sweden)

    Oathokwa Nkomazana

    2015-02-01

    Full Text Available Background: Botswana has a shortage of health care workers, especially in primary healthcare. Retention and high performance of employees are closely linked to job satisfaction and motivation, which are both highest where employees’ personal values and goals are realised.Aim: The aim of the study was to evaluate employees’ personal values, and the current and desired organisational culture of the district health services as experienced by the primary health care workers.Setting: The study was conducted in the Ngamiland and Mahalapye health districts.Method: This was a cross sectional survey. The participants were asked to select 10 values that best described their personal, current organisational and desired organisational values from a predetermined list.Results: Sixty and 67 health care workers completed the survey in Mahalapye and Ngamiland districts, respectively. The top 10 prevalent organisational values experienced in both districts were: teamwork, patient satisfaction, blame, confusion, job insecurity, not sharing information and manipulation. When all the current values were assessed, 32% (Mahalapye and 36% (Ngamiland selected by health care workers were potentially limiting organisational effectiveness. The organisational values desired by health care workers in both districts were: transparency, professional growth, staff recognition, shared decision-making, accountability, productivity, leadership development and teamwork.Conclusions: The experience of the primary health care workers in the two health districts were overwhelmingly negative, which is likely to contribute to low levels of motivation, job satisfaction, productivity and high attrition rates. There is therefore urgent need for organisational transformation with a focus on staff experience and leadership development.

  17. Community health center provider and staff's Spanish language ability and cultural awareness.

    Science.gov (United States)

    Baig, Arshiya A; Benitez, Amanda; Locklin, Cara A; Campbell, Amanda; Schaefer, Cynthia T; Heuer, Loretta J; Lee, Sang Mee; Solomon, Marla C; Quinn, Michael T; Burnet, Deborah L; Chin, Marshall H

    2014-05-01

    Many community health center providers and staff care for Latinos with diabetes, but their Spanish language ability and awareness of Latino culture are unknown. We surveyed 512 Midwestern health center providers and staff who managed Latino patients with diabetes. Few respondents had high Spanish language (13%) or cultural awareness scores (22%). Of respondents who self-reported 76-100% of their patients were Latino, 48% had moderate/low Spanish language and 49% had moderate/low cultural competency scores. Among these respondents, 3% lacked access to interpreters and 27% had neither received cultural competency training nor had access to training. Among all respondents, Spanish skills and Latino cultural awareness were low. Respondents who saw a significant number of Latinos had good access to interpretation services but not cultural competency training. Improved Spanish-language skills and increased access to cultural competency training and Latino cultural knowledge are needed to provide linguistically and culturally tailored care to Latino patients.

  18. Climate change and the right to health for Māori in Aotearoa/New Zealand.

    Science.gov (United States)

    Jones, Rhys; Bennett, Hayley; Keating, Gay; Blaiklock, Alison

    2014-06-14

    Climate change is widely regarded as one of the most serious global health threats of the 21st century. Its impacts will be disproportionately borne by the most disadvantaged populations, including indigenous peoples. For Māori in Aotearoa/New Zealand, as with other indigenous peoples worldwide, colonization has led to dispossession of land, destabilization of cultural foundations, and social, economic, and political marginalization. Climate change threatens to exacerbate these processes, adding future insult to historical and contemporary injury. Yet the challenges posed by climate change are accompanied by considerable opportunities to advance indigenous rights and reduce health disparities. In this paper, we examine issues related to climate change and Māori health using a right to health analytical framework, which identifies obligations for the New Zealand government.

  19. Health care change: challenge for nurse administrators.

    Science.gov (United States)

    Bonalumi, N; Fisher, K

    1999-01-01

    Nursing administrators facing reorganization understand the difficulties and resistance that accompany organizational change. This article discusses resilience, a critical character trait for successfully managing change. Understanding the change process can assist those charged with the challenge of leading organizational change to manage the journey more effectively.

  20. Preparing health services for climate change in Australia.

    Science.gov (United States)

    Blashki, Grant; Armstrong, Greg; Berry, Helen Louise; Weaver, Haylee J; Hanna, Elizabeth G; Bi, Peng; Harley, David; Spickett, Jeffery Thomas

    2011-03-01

    Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather-related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change-prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.

  1. One Health - a strategy for resilience in a changing arctic.

    Science.gov (United States)

    Ruscio, Bruce A; Brubaker, Michael; Glasser, Joshua; Hueston, Will; Hennessy, Thomas W

    2015-01-01

    The circumpolar north is uniquely vulnerable to the health impacts of climate change. While international Arctic collaboration on health has enhanced partnerships and advanced the health of inhabitants, significant challenges lie ahead. One Health is an approach that considers the connections between the environment, plant, animal and human health. Understanding this is increasingly critical in assessing the impact of global climate change on the health of Arctic inhabitants. The effects of climate change are complex and difficult to predict with certainty. Health risks include changes in the distribution of infectious disease, expansion of zoonotic diseases and vectors, changing migration patterns, impacts on food security and changes in water availability and quality, among others. A regional network of diverse stakeholder and transdisciplinary specialists from circumpolar nations and Indigenous groups can advance the understanding of complex climate-driven health risks and provide community-based strategies for early identification, prevention and adaption of health risks in human, animals and environment. We propose a regional One Health approach for assessing interactions at the Arctic human-animal-environment interface to enhance the understanding of, and response to, the complexities of climate change on the health of the Arctic inhabitants.

  2. Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2006-08-01

    Full Text Available Abstract Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM. Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.

  3. Changing gender relations in Thailand: a historical and cultural analysis.

    Science.gov (United States)

    Tantiwiramanond, D

    1997-01-01

    In response to the stereotyping of Thai women in the media as either modern businesswomen or victims of male oppression, this article studies the changing gender roles and status of women in Thailand to identify the various roles played by Thai women and the ways these roles are linked to key cultural, economic, and political mechanisms in Thai society. After an introduction, the first section of the paper analyzes pre-modern Thai history from the mid-13th century with a look at the traditional social, political, and economic structure of feudal society to determine how women's status was affected by Thai Buddhism, absolute monarchy (the affect of the legal system on upper-class women), and matrifocal kinship (the effect of subsistence agriculture on lower-class women). This section also compares the historic status of upper- and lower-class Thai women. The second section of the article considers the effects of 1) the encroachment of Western colonialism in Southeast Asia during the period 1850-1925 and attendant criticisms of polygamy, 2) the post-1932 revolution that resulted in a constitutional monarchy, and 3) the post 1950s period of economic nationalism that has resulted in globalization. The article concludes that lower-class women have certain rights under the feudal system (before 1932) but were forced into certain roles by economic necessity and motherhood. Upper-class women enjoyed high status, but all women were victims of the Buddhist patriarchy and hierarchical systems. Western modernization caused a decline in polygamy and new opportunities for educated women but the status of Thai women has not changed substantially, and class-specific forms of female oppression continues unabated making lower-class women vulnerable to sexual exploitation.

  4. Deploying a culture change programme management approach in support of information and communication technology developments in Greater Glasgow NHS Board.

    Science.gov (United States)

    Frame, Joanne; Watson, Janice; Thomson, Katie

    2008-06-01

    This article reports on the project management and Culture Change Programme adopted by the NHS Greater Glasgow Health Board to deliver an electronic patient record (EPR) to support cardiology and stroke clinical services. To achieve its vision for the EPR (;to "really make a difference" to patient care by providing to the right person, the right information, under the right safeguards') the Board recognized that attending to social and organizational issues is at least of equal importance to addressing strictly technical concerns. Consequently, an ICT Culture Change Programme (ICT CCP) was devised and implemented to assist in the management of change, and in particular to facilitate a visionary clinical and cultural environment operating in conjunction with the evolving technical environment. In this article we describe the key components of this approach, outline the benefits we believe have accrued, and describe the steps being taken to build upon lessons learned.

  5. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2017-08-17

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  6. Climate Change, Economic Growth, and Health

    NARCIS (Netherlands)

    Ikefuji, M.; Magnus, J.R.; Sakamoto, H.

    2010-01-01

    This paper studies the interplay between climate, health, and the economy in a stylized world with four heterogeneous regions, labeled ‘West’ (cold and rich), ‘China’ (cold and poor), ‘India’ (warm and poor), and ‘Africa’ (warm and very poor). We introduce health impacts into a simple integrated ass

  7. Worry about health in smoking behaviour change

    NARCIS (Netherlands)

    Dijkstra, A; Brosschot, J

    2003-01-01

    Many smokers and ex-smokers worry about their health. Given that worry keeps attention focused on the threat, it was expected that worrying about health in smokers would motivate them to quit and in ex-smokers may prevent relapse. Furthermore, worry was expected to influence the process of smoking c

  8. Climate Change, Economic Growth, and Health

    NARCIS (Netherlands)

    Ikefuji, M.; Magnus, J.R.; Sakamoto, H.

    2010-01-01

    This paper studies the interplay between climate, health, and the economy in a stylized world with four heterogeneous regions, labeled ‘West’ (cold and rich), ‘China’ (cold and poor), ‘India’ (warm and poor), and ‘Africa’ (warm and very poor). We introduce health impacts into a simple integrated

  9. Prison health advocacy and its changing boundaries.

    Science.gov (United States)

    Awofeso, Niyi

    2008-01-01

    Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well-being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners' wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner-initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community's self-interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re-entering the community.

  10. Ottawa to Bangkok: changing health promotion discourse.

    Science.gov (United States)

    Porter, Christine

    2007-03-01

    The discourse of the 2005 Bangkok Charter for Health Promotion in a Globalized World represents a radical departure from that of the Ottawa Charter that, in 1986, staked a place for the health promotion field in mainstream public health. Via a critical analysis of the discourse in these two Charters, this paper illustrates a shift from a 'new social movements' discourse of ecosocial justice in Ottawa to a 'new capitalist' discourse of law and economics in Bangkok. The Bangkok Charter's content may identify 'actions, commitments and pledges required to address the determinants of health in a globalized world through health promotion', but this paper shows how its discourse works to naturalize and perpetuate many of detrimental determinants associated with 'globalization'.

  11. [Climate changes, floods, and health consequences].

    Science.gov (United States)

    Michelozzi, Paola; de' Donato, Francesca

    2014-02-01

    In the European Region, floods are the most common natural disaster, causing extensive damage and disruption. In Italy, it has been estimated that over 68% of municipalities are at high hydrogeological risk and with the recent intense rainfall events local populations have been facing severe disruptions. The health consequences of floods are wide ranging and are dependent upon the vulnerability of the environment and the local population. Health effects can be a direct or indirect consequence of flooding. The immediate health impacts of floods include drowning, heart attacks, injuries and hypothermia. The indirect effects include, injuries and infections, water-borne infectious disease, mental health problems, respiratory disease and allergies in both the medium and long term after a flood. Future efforts should be addressed to integrate health preparedness and prevention measures into emergency flood plans and hydrological warning systems.

  12. Community health workers as cultural producers in addressing gender-based violence in rural South Africa.

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2016-01-01

    South Africa has been experiencing an epidemic of gender-based violence (GBV) for a long time and in some rural communities health workers, who are trained to care for those infected with HIV, are positioned at the forefront of addressing this problem, often without the necessary support. In this article, we pose the question: How might cultural production through media making with community health workers (CHWs) contribute to taking action to address GBV and contribute to social change in a rural community? This qualitative participatory arts-based study with five female CHWs working from a clinic in a rural district of South Africa is positioned as critical research, using photographs in the production of media posters. We offer a close reading of the data and its production and discuss three data moments: CHWs drawing on insider cultural knowledge; CHWs constructing messages; and CHWs taking action. In our discussion, we take up the issue of cultural production and then offer concluding thoughts on 'beyond engagement' when the researchers leave the community.

  13. Changing Operating Room Culture: Implementation of a Post-Operative Debrief and Improved Safety Culture.

    Science.gov (United States)

    Magill, Stephen T; Wang, Doris D; Rutledge, W Caleb; Lau, Darryl; Berger, Mitchel S; Sankaran, Sujatha; Lau, Catherine Y; Imershein, Sarah G

    2017-08-23

    Patient safety is foundational to neurosurgical care. Post-procedural "debrief" checklists have been proposed to improve patient safety, but there is limited data about their use in neurosurgery. Here, we implemented an initiative to routinely perform post-operative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical operating room staff at a major academic medical center before and 18-months after implementation of a post-operative debriefing initiative. Rates of debrief compliance and changes in attitudes before and after the survey were evaluated. The survey utilized a Likert scale and analyzed with standard statistical methods. After the debrief initiative, the rate of debriefing increased from 51% to 86% of cases for the neurosurgery service. Baseline SAQ responses found that neurosurgeons had a more favorable perception of OR safety than anesthesiologists and nurses. Following implementation of the post-operative debriefing process, perceptions of OR safety significantly improved for neurosurgeons, anesthesiologists and nurses. Furthermore, the disparity between nurses and surgeons was no longer significant. After debrief implementation, neurosurgical OR staff had improved perceptions of patient safety compared to surgical services that did not commonly perform debriefing. Debriefing identified OR efficiency concerns in 26.9% of cases and prevention of potential adverse events/near misses were reported in 8% of cases. Post-operative debriefing can be effectively introduced into the operating room and improves the safety culture after implementation. Debriefing is an effective tool to identify OR inefficiencies and potential adverse events. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

    Science.gov (United States)

    Dietrich, A J; Olson, A L

    1981-01-01

    A primary care system was established at Zuni-Ramah Indian Health Service Hospital and clinic in New Mexico. Continuity and coordination of care were added to a health care system that was already accountable, accessible, and comprehensive. The new system offered each patient a personal health care provider who worked as a member of a multidisciplinary team. In changing the health care system, special attention was given to its cultural and political setting, the village of Zuni. After thorough discussion with community and staff, community members' concerns about patients' privacy and free choice were better understood, and special efforts were made to safeguard them. Ongoing evaluation is essential to maintain continuity. Eight months after the primary care system was begun, 64 percent of patients who came for care had established a personal relationship with a health care provider. For 59 percent of the visits during the 1-month evaluation period, patients saw their regular provider and, for 82 percent, patients saw their provider or one of his or her team colleagues. These percentages include night and walk-in visits. The system required no extra funding or staff. The political process of planning and consultation helped anticipate and alleviate the community's concerns, but resistance from physician's assistants and some physicians was unexpected. A flexible approach has led to a gradual acceptance of this voluntary system. This experience with the people of Zuni village shows that a primary care system can be started in a rural Indian Health Service facility with minimal outside help. Apparent improvements in quality of care make the continuity of primary care worthy of further consideration in the IHS and similar health services systems.

  15. Developing evidence for structural approaches to build a culture of health: a perspective from the Robert Wood Johnson Foundation.

    Science.gov (United States)

    Mockenhaupt, Robin; Woodrum, Amy

    2015-04-01

    We believe that reframing the conversation to creating a culture around health rather than focusing on discrete actions or activities will capture national consciousness and enable us to make new progress as a nation. Thus, in 2014, the Robert Wood Johnson Foundation (RWJF) announced a new vision to help build a "Culture of Health" to enable everyone in our diverse society to lead healthier lives now and for generations to come. In supporting the development of this supplement of Health Education & Behavior, RWJF sought to contribute to a better understanding of the ways in which policy, environmental, and financial approaches can contribute to such a Culture of Health. However, while this supplement issue of Health Education & Behavior stands as a testament to the fact that a broad evidence base, rather than a single approach to health improvement, is necessary to have an impact on social change, more empirical evidence is needed on structural approaches if we are to be successful in understanding and improving health outcomes for individuals, families, communities, states, and nations. © 2015 Society for Public Health Education.

  16. Changing Safety Culture, One Step at a Time: The Value of the DOE-VPP Program at PNNL

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Patrick A.; Isern, Nancy G.

    2005-02-01

    The primary value of the Pacific Northwest National Laboratory (PNNL) Voluntary Protection Program (VPP) is the ongoing partnership between management and staff committed to change Laboratory safety culture one step at a time. VPP enables PNNL's safety and health program to transcend a top-down, by-the-book approach to safety, and it also raises grassroots safety consciousness by promoting a commitment to safety and health 24 hours a day, 7 days a week. PNNL VPP is a dynamic, evolving program that fosters innovative approaches to continuous improvement in safety and health performance at the Laboratory.

  17. The challenges of change management in Aboriginal community-controlled health organisations. Are there learnings for Cape York health reform?

    Science.gov (United States)

    Coombe, Leanne L

    2008-11-01

    The health status of Aboriginal and Torres Strait Islander peoples continues to be significantly poorer than Australia's general population. Clearly there is a need for change, hence the renewed interest in transitioning to a community control model for health services as a health intervention. Yet this requires a significant change management process, which is a process developed using Western business philosophies, and may not be applicable for community-controlled services that need to operate within the Aboriginal cultural domain. This paper examines the literature on organisational change management processes, and features of Aboriginal community-controlled health organisations and Aboriginal management styles. It identifies challenges and synergies that can be used to inform more effective transition processes to a community-control model for health services. The findings also highlight the need for a fundamental systems change approach to achieve such major reform agendas through the creation of a "collective responsibility" to achieve the vision for change, utilising participatory change management processes both internally and externally.

  18. Telemedicine and competitive change in health care.

    Science.gov (United States)

    LaMay, C L

    1997-01-01

    Telemedicine--the delivery of health care services to the underserved through communications technologies--has the potential to bring medical care to remote areas where health care is either inadequate or nonexistent. Telemedicine can be something as simple as a phone call, a network transmission of a radiograph or other diagnostic image, or, much more advanced, realtime video surgical consultations from anywhere on the globe. Telemedicine programs operate throughout Europe, Japan, and Australia. International programs, for profit and nonprofit, serve Asia, Africa, and the Middle East. The United States is also a major telemedicine developer, principally through government agencies such as the Department of Defense and the Office of Rural Health Policy, and, to a lesser extent, the private sector. But telemedicine in the United States has yet to prove itself economically viable, and it faces a number of political and regulatory barriers. Even more significantly, telemedicine's potential to increase overall health care spending by increasing access to health care has deterred private industry from investing heavily in it. In the short term, telemedicine's most important contribution to health care may be raising fundamental questions about United States health care policy.

  19. The human health chapter of climate change and ozone depletion ...

    African Journals Online (AJOL)

    Climate change is one of the greatest emerging threats of the 21st century. ... frequent weather extremes, increase in epidemics, food and water scarcity. Indirect risks to health are related to changes in temperature and precipitation, leading to ...

  20. Effect of climate change on human health and some adaptive ...

    African Journals Online (AJOL)

    Effect of climate change on human health and some adaptive strategies – a review. ... The impact of human-induced climate change and ozone depletion are now ... and death that is more premature and disease related to air pollution.

  1. Does Perception of Corporate Culture Change in Time? An Empirical Research

    Directory of Open Access Journals (Sweden)

    Nahit Erdem KÖKER

    2013-03-01

    Full Text Available Fundamental values and belief systems in a corporation show themselves as; norms, behaviours, symbols and compose the corporate culture. When corporate culture is undertaken in terms of business management, it is seen that corporations in different fields have studies directed to culture. In studies of education science and studies that cover educational orporations, corporate culture is named as school culture. Due to the reason that schools are educational corporations, they are a subject to studies of corporate culture. Studies directed to school culture cover the subjects such as; components of school culture, its’ dimensions, structural characteristics, importance of leadership, ect. This study is directed to displaying the changes in the perceptions about school culture of Ege University Faculty of Communication students along their studentship, which is a cultural component and a sub-culture of school culture. With this purpose, data have been collected from students for four years with the same question form. These students were in 1st grade during 2009-2010 academical year. While students are in their 1st, 2nd, 3rd and 4th years, it was foreseen that there were going to be meaningful changes in their perceptions about the dimensions of corporate culture. And the direction of change in their perceptions of faculty culture has been detected in their last year.

  2. Climate Change, Indoor Environment and Health

    Science.gov (United States)

    Climate change is becoming a driving force for improving energy efficiency because saving energy can help reduce the greenhouse gas emissions that contribute to climate change. However, it is important to balance energy saving measures with ventilation...

  3. Overcoming Resistance to Culture Change: Nursing Home Administrators’ Use of Education, Training and Communication

    OpenAIRE

    Tyler, Denise A.; Lepore, Michael; Shield, Renee R.; LOOZE, JESSICA; Miller, Susan C.

    2013-01-01

    Nursing home culture change is becoming more prevalent and research has demonstrated its benefits for nursing home residents and staff, but little is known about the role of nursing home administrators in culture change implementation. The purpose of this study was to determine what barriers nursing home administrators faced in implementing culture change practices and to identify the strategies used to overcome these. We conducted in-depth individual interviews with 64 administrators identif...

  4. Changing the system by changing the workforce: employing consumers to increase access, cultural diversity, and engagement.

    Science.gov (United States)

    Wenz-Gross, Melodie; Irsfeld, Toni DuBrino; Twomey, Tammy; Perez, Ana; Thompson, Judith; Wally, Martha; Colleton, Barbara; Kroell, Christine; McKeown, Steven K; Metz, Peter

    2012-06-01

    Services to families have traditionally been delivered in a medical model. This presents challenges including workforce shortages, lack of cultural diversity, lack of training in strength-based work, and difficulty in successfully engaging and retaining families in the therapy process. The system of care (SOC) effort has worked to establish formal roles for caregivers in SOC to improve services. This paper provides an example of one community's efforts to change the SOC by expanding the roles available to caregivers in creating systems change. It describes the model developed by Communities of Care (CoC), a SOC in Central Massachusetts, and its evolution over a 10 year period. First person accounts by system partners, caregivers hired into professional roles as well as a family receiving services, demonstrate how hiring caregivers at all levels can change systems and change lives, not only for those being served but for the caregiver/professionals doing the work. It also demonstrates, however, that change at the system level is incremental, takes time, and can be fleeting unless an ongoing effort is made to support and sustain those changes.

  5. The Impact of Service-Learning on Health Education Students' Cultural Competence

    Science.gov (United States)

    Housman, Jeff; Meaney, Karen S.; Wilcox, Michelle; Cavazos, Arnoldo

    2012-01-01

    Background: Development of cultural competence in future health educators is often mentioned as a goal of health education preparation programs; however research demonstrating evidence-based methods for development of cultural competence is limited. Purpose: To determine the impact of a service-learning project on development of cultural…

  6. Challenges of creating synergy between global mental health and cultural psychiatry

    NARCIS (Netherlands)

    de Jong, J.T.V.M.

    2014-01-01

    This article addresses four major challenges for efforts to create synergy between the global mental health movement and cultural psychiatry. First, although they appear to share domains of mutual interest, the worlds of global mental health and cultural psychiatry have distinct lineages. Expanding

  7. Culturally tailored postsecondary nutrition and health education curricula for indigenous populations

    Directory of Open Access Journals (Sweden)

    Sarah McConnell

    2013-08-01

    Full Text Available Background . In preparation for the initial offering of the University of Alaska Fairbanks (UAF, Interior–Aleutians Campus Rural Nutrition Services (RNS program, a literature review was conducted to establish the need for the proposed program and to substantiate the methodology for delivering integrated, culturally tailored postsecondary education and extension to Alaska Natives and rural Alaskans. There was a striking absence of peer-reviewed journal articles describing culturally tailored postsecondary health curricula for indigenous populations. Objective . To complete and discuss a current (November 2012 literature review for culturally tailored postsecondary health curricula designed and delivered for indigenous populations. Methods/Design . The author conducted an expanded online search that employed multiple configurations of key terms using Google and Google Scholar, as well as pertinent sources. The author located archived reports in person and contacted authors by email. Results . The expanded search produced a modest amount of additional literature for review. A disappointing number of publications describing or evaluating culturally tailored postsecondary health curricula in mainstream institutions are available. Related resources on culturally tailored extension and resources for the development and delivery of culturally tailored nutrition and health curricula were identified. Conclusions . The present results demonstrate a significant absence of literature on the topic, which may or may not indicate the absence of sufficient culturally tailored postsecondary health curricula for indigenous populations. There are indications that culturally tailored postsecondary health curricula for indigenous populations have the potential to effectively address certain issues of health literacy and health disparities.

  8. The Changing Health of Canadian Grandparents

    Directory of Open Access Journals (Sweden)

    Rachel Margolis

    2015-10-01

    Full Text Available Fertility postponement and mortality decline are shifting the demography of the grandparent population in Canada. The ways in which the aging of the grandparent population affects families depends in large part on the health of grandparents. In this article, we document the aging of Canadian grandparents between 1985 and 2011. However, despite being older, grandparents are healthier, signaling that the compression of morbidity is outpacing the postponement of grandparenthood. This shift is partly due to the higher educational attainment of this population and partly due to secular improvements in health over time. The improved health of grandparents in Canada has important implications for intergenerational transfers and relationships.

  9. In praise of cultural-competence training for mental health professionals.

    Science.gov (United States)

    Mirsky, Julia

    2012-01-01

    Mental health practitioners in Israel encounter clients from a variety of ethnic groups and cultural backgrounds. Yet, culturally-informed practice standards have neither been defined nor promoted by the professional establishment. A model for cultural-competence training for mental health professionals is presented and evaluated based on self-reports of 51 trainees. An increase in the trainees' understanding of their clients' cultural experiences is elicited, as well as the expansion of their cultural self-awareness, empathy and respect for cultural diversity. this is a qualitative evaluation with a limited number of respondents and provides data only on short term effects of the training. the evaluation demonstrates positive training effects on the practice. Hopefully, this experience will encourage addressing cultural issues in the practice and training of mental health professionals in Israel.

  10. Across-Time Change and Variation in Cultural Tightness-Looseness.

    Science.gov (United States)

    Mandel, Anne; Realo, Anu

    2015-01-01

    Cultural tightness-looseness, a dimension which describes the strength, multitude, and clarity of social norms in a culture, has proved significant in explaining differences between cultures. Although several studies have compared different cultures on this domain, this study is the first that targets both within-country differences and across-time variation in tightness-looseness. Using data from two nationally representative samples of Estonians, we found that the general tightness level had changed over a period of 10 years but the effect size of the change was small. A significant within country variance in 2002 had disappeared by 2012. Our results suggest that tightness-looseness, similarly to cultural value orientations, is a relatively stable and robust characteristic of culture-that is, change indeed takes place, but slowly. Future studies about across-time change and within-country variance in tightness-looseness should target more culturally diverse and socially divided societies.

  11. Across-Time Change and Variation in Cultural Tightness-Looseness.

    Directory of Open Access Journals (Sweden)

    Anne Mandel

    Full Text Available Cultural tightness-looseness, a dimension which describes the strength, multitude, and clarity of social norms in a culture, has proved significant in explaining differences between cultures. Although several studies have compared different cultures on this domain, this study is the first that targets both within-country differences and across-time variation in tightness-looseness. Using data from two nationally representative samples of Estonians, we found that the general tightness level had changed over a period of 10 years but the effect size of the change was small. A significant within country variance in 2002 had disappeared by 2012. Our results suggest that tightness-looseness, similarly to cultural value orientations, is a relatively stable and robust characteristic of culture-that is, change indeed takes place, but slowly. Future studies about across-time change and within-country variance in tightness-looseness should target more culturally diverse and socially divided societies.

  12. Climate Change and Health: Transcending Silos to Find Solutions.

    Science.gov (United States)

    Machalaba, Catherine; Romanelli, Cristina; Stoett, Peter; Baum, Sarah E; Bouley, Timothy A; Daszak, Peter; Karesh, William B

    2015-01-01

    Climate change has myriad implications for the health of humans, our ecosystems, and the ecological processes that sustain them. Projections of rising greenhouse gas emissions suggest increasing direct and indirect burden of infectious and noninfectious disease, effects on food and water security, and other societal disruptions. As the effects of climate change cannot be isolated from social and ecological determinants of disease that will mitigate or exacerbate forecasted health outcomes, multidisciplinary collaboration is critically needed. The aim of this article was to review the links between climate change and its upstream drivers (ie, processes leading to greenhouse gas emissions) and health outcomes, and identify existing opportunities to leverage more integrated global health and climate actions to prevent, prepare for, and respond to anthropogenic pressures. We conducted a literature review of current and projected health outcomes associated with climate change, drawing on findings and our collective expertise to review opportunities for adaptation and mitigation across disciplines. Health outcomes related to climate change affect a wide range of stakeholders, providing ready collaborative opportunities for interventions, which can be differentiated by addressing the upstream drivers leading to climate change or the downstream effects of climate change itself. Although health professionals are challenged with risks from climate change and its drivers, the adverse health outcomes cannot be resolved by the public health community alone. A phase change in global health is needed to move from a passive responder in partnership with other societal sectors to drive innovative alternatives. It is essential for global health to step outside of its traditional boundaries to engage with other stakeholders to develop policy and practical solutions to mitigate disease burden of climate change and its drivers; this will also yield compound benefits that help address

  13. Impacts of Climate Change on Inequities in Child Health.

    Science.gov (United States)

    Bennett, Charmian M; Friel, Sharon

    2014-12-03

    This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world's poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

  14. Impacts of Climate Change on Inequities in Child Health

    Directory of Open Access Journals (Sweden)

    Charmian M. Bennett

    2014-12-01

    Full Text Available This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world’s poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

  15. Adolescent Reproductive Health:Challenges and Change

    Institute of Scientific and Technical Information of China (English)

    Laurie Schwab Zabin

    2004-01-01

    @@ The field of reproductive health has had long experience negotiating challenging environments in ways that other health fields have not -- perhaps because other health fields usually deal with illness which everyone agrees is not a good thing. Or maybe because we have all been born, we all think we know something about reproduction. Whatever the reason,we have over the years seen bitter political and ideological debates over population and family planning, abortion, the treatment of HIV/AIDS, in vitro fertilization, new contraceptive technologies--and now adolescent reproductive health. We shouldn't be surprised.But just as we have had to prevail in those debates in the past, they are crucial today: the numbers of young people entering their reproductive years throughout the world, especially the developing world, make it essential that youth be reached not only with messages and services crafted in the last 40 years but also with new messages, new ideas and new services.

  16. Changing Your Habits: Steps to Better Health

    Science.gov (United States)

    ... safe to do so. Set aside one grocery shopping day a week, and make healthy meals that ... Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Events Health Information Diabetes Digestive ...

  17. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

    Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.

  18. Community Changes Address Common Health Threat

    Centers for Disease Control (CDC) Podcasts

    2013-09-30

    This podcast helps residents living in multiunit housing, like apartments and condos, understand the threat of secondhand smoke. It also helps residents understand what steps they can take to breathe a little easier if involuntarily exposed to secondhand smoke.  Created: 9/30/2013 by Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 9/30/2013.

  19. Linking Cultural Competence to Functional Life Outcomes in Mental Health Care Settings.

    Science.gov (United States)

    Michalopoulou, Georgia; Falzarano, Pamela; Butkus, Michael; Zeman, Lori; Vershave, Judy; Arfken, Cynthia

    2014-01-01

    Minorities in the United States have well-documented health disparities. Cultural barriers and biases by health care providers may contribute to lower quality of services which may contribute to these disparities. However, evidence linking cultural competency and health outcomes is lacking. This study, part of an ongoing quality improvement effort, tested the mediation hypothesis that patients' perception of provider cultural competency indirectly influences patients' health outcomes through process of care. Data were from patient satisfaction surveys collected in seven mental health clinics (n=94 minority patients). Consistent with our hypothesis, patients' perception of clinicians' cultural competency was indirectly associated with patients' self-reported improvements in social interactions, improvements in performance at work or school, and improvements in managing life problems through the patients' experience of respect, trust, and communication with the clinician. These findings indicate that process of care characteristics during the clinical encounter influence patients' perceptions of clinicians' cultural competency and affect functional outcomes.

  20. Salud de Corazon: Cultural Resources for Cardiovascular Health among Older Hispanic Women.

    Science.gov (United States)

    Perez, Adriana; Fleury, Julie; Shearer, Nelma

    2012-06-01

    The prevalence of cardiovascular disease risk factors in Hispanic women has been substantiated across studies. While many studies have focused on the impact of these risk factors, few qualitative studies have addressed cultural and contextual meanings of cardiovascular health promotion in this population. This research explored cultural resources for cardiovascular health promotion among older Hispanic women. A qualitative descriptive methodological design using focus groups with 7 Hispanic women was used. Culture provided an overarching perspective, guiding identification and choice of resources and supports in order to promote cardiovascular health. Themes included Living Tradition, Caring for Family, Connecting with Friends, Having Faith, and Moving as Life. Data provide an initial step toward generating a more complete understanding of perceived cultural resources for cardiovascular health in older Hispanic women. Researchers and clinicians are increasingly recognizing that individuals, families and communities uniquely define cultural and contextual meaning of cardiovascular health promotion.

  1. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  2. Limits to health adaptation in a changing climate

    Science.gov (United States)

    Ebi, K. L.

    2015-12-01

    Introduction: Because the health risks of climate variability and change are not new, it has been assumed that health systems have the capacity, experience, and tools to effectively adapt to changing burdens of climate-sensitive health outcomes with additional climate change. However, as illustrated in the Ebola crisis, health systems in many low-income countries have insufficient capacity to manage current health burdens. These countries also are those most vulnerable to climate change, including changes in food and water safety and security, increases in extreme weather and climate events, and increases in the geographic range, incidence, and seasonality of a variety of infectious diseases. The extent to which they might be able to keep pace with projected risks depends on assumptions of the sustainability of development pathways. At the same time, the magnitude and pattern of climate change will depend on greenhouse gas emission pathways. Methods: Review of the success of health adaptation projects and expert judgment assessment of the degree to which adaptation efforts will be able to keep pace with projected changes in climate variability and change. Results: Health adaptation can reduce the current and projected burdens of climate-sensitive health outcomes over the short term in many countries, but the extent to which it could do so past mid-century will depend on emission and development pathways. Under high emission scenarios, climate change will be rapid and extensive, leading to fundamental shifts in the burden of climate-sensitive health outcomes that will challenging for many countries to manage. Sustainable development pathways could delay but not eliminate associated health burdens. Conclusions: To prepare for and cope with the Anthropocene, health systems need additional adaptation policies and measures to develop more robust health systems, and need to advocate for rapid and significant reductions in greenhouse gas emissions.

  3. Using health psychology to help patients: theories of behaviour change.

    Science.gov (United States)

    Barley, Elizabeth; Lawson, Victoria

    2016-09-08

    Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that may help them. This article outlines five well-established theories of behaviour change: the health belief model, the theory of planned behaviour, the stages of change model, self-determination theory, and temporal self-regulation theory. The evidence for interventions that are informed by these theories is then explored and appraised. The extent and quality of evidence varies depending on the type of behaviour and patients targeted, but evidence from randomised controlled trials indicates that interventions informed by theory can result in behaviour change.

  4. Public health impacts of climate change in Nepal.

    Science.gov (United States)

    Joshi, H D; Dhimal, B; Dhimal, M; Bhusal, C L

    2011-04-01

    Climate change is a global issue in this century which has challenged the survival of living creatures affecting the life supporting systems of the earth: atmosphere, hydrosphere and lithosphere. Scientists have reached in a consensus that climate change is happening. The anthropogenic emission of greenhouse gases is responsible for global warming and therefore climate change. Climate change may directly or indirectly affect human health through a range of pathways related to temperature and precipitation. The aim of this article is to share knowledge on how climate change can affect public health in Nepal based on scientific evidence from global studies and experience gained locally. In this review attempt has been made to critically analyze the scientific studies as well as policy documents of Nepalese Government and shed light on public health impact of climate change in the context of Nepal. Detailed scientific study is recommended to discern impact of climate change on public health problems in Nepal.

  5. Monitoring Educational Organizations' Culture of Sustainable Consumption: Initiating and Evaluating Cultural Change in Schools and Universities

    Directory of Open Access Journals (Sweden)

    Daniel Fischer

    2011-01-01

    Full Text Available Problem Statement: Patterns of consumption are considered as a main driver of unsustainable development. In the debate, education and educational organizations are unisonous considered as a key player to contribute to a more sustainable socialization of young consumers. Both schools and universities are challenged to become places and life-worlds in which sustainable consumption can be learned and experienced. The objective of this paper was to explore how educational organizations can effectively engage their members in bringing about the aspired transformations and monitoring their effects. Approach: The study used a conceptual approach that included three steps. Firstly, the concept of an educational organization’s Culture Of Consumption (COC was adopted as an analytical frame of reference. In a second step, methodological propositions for changing the organizational COC were discussed drawing on the concepts of mode-2 knowledge production and participatory change management. In a third step, existing tools and approaches to sustainability auditing in the educational context were screened and critically discussed against the background of recent innovations in mode-2 approaches to sustainability evaluation. Results: The findings revealed that while existing sets of indicators did adequately account for key consumption-related organizational operations and to some extent for educational goals and aspirations, they failed to tap the realm of underlying and tacit basic assumptions that substantiate the essence of an organizational COC. To remedy this shortcoming, additional indicators and modifications were proposed. As a synthesis, a synoptic framework of a monitoring system for an educational organization’s COC was presented. Conclusion: The study’s results highlighted the need to develop monitoring frameworks that go beyond assessing operative performances and pay greater attention to reflective, interpretative and deliberative

  6. Ethical Theories for Promoting Health through Behavioral Change.

    Science.gov (United States)

    O'Connell, Janelle K.; Price, James H.

    1983-01-01

    Arguments based on the philosophies of natural law, utilitarianism, paternalism, and distributive justice are examined for their pertinence to health behavior change strategies. Health educators should prepare individuals to make health-generating decisions but may need to limit the conditions under which they intervene. (Author/PP)

  7. Ethical Theories for Promoting Health through Behavioral Change.

    Science.gov (United States)

    O'Connell, Janelle K.; Price, James H.

    1983-01-01

    Arguments based on the philosophies of natural law, utilitarianism, paternalism, and distributive justice are examined for their pertinence to health behavior change strategies. Health educators should prepare individuals to make health-generating decisions but may need to limit the conditions under which they intervene. (Author/PP)

  8. Mexican-Origin Youth's Cultural Orientations and Adjustment: Changes from Early to Late Adolescence

    Science.gov (United States)

    Updegraff, Kimberly A.; Umana-Taylor, Adriana J.; McHale, Susan M.; Wheeler, Lorey A.; Perez-Brena, Norma J.

    2012-01-01

    Drawing from developmental and cultural adaptation perspectives and using a longitudinal design, this study examined: (a) mean-level changes in Mexican-origin adolescents' cultural orientations and adjustment from early to late adolescence and (b) bidirectional associations between cultural orientations and adjustment using a cross-lag panel…

  9. Public health adaptation to climate change in OECD countries

    NARCIS (Netherlands)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine ho

  10. Multidisciplinary Health Services as External Agents of Change

    DEFF Research Database (Denmark)

    Westerholm, Peter; Hasle, Peter; Fortuin, Rick

    2000-01-01

    A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....

  11. Public health adaptation to climate change in OECD countries

    NARCIS (Netherlands)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine

  12. Public health adaptation to climate change in OECD countries

    NARCIS (Netherlands)

    Austin, Stephanie E.; Biesbroek, Robbert; Berrang-Ford, Lea; Ford, James D.; Parker, Stephen; Fleury, Manon D.

    2016-01-01

    Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine ho

  13. Climate Change in the US: Potential Consequences for Human Health

    Science.gov (United States)

    Maynard, Nancy G.

    2001-01-01

    The U.S. National Assessment identified five major areas of consequences of climate change in the United States: temperature-related illnesses and deaths, health effects related to extreme weather events, air pollution-related health effects, water- and food-borne diseases, and insect-, tick-, and rodent-borne diseases. The U.S. National Assessment final conclusions about these potential health effects will be described. In addition, a summary of some of the new tools for studying human health aspects of climate change as well as environment-health linkages through remotely sensed data and observations will be provided.

  14. The cultural production of health inequalities: a cross-sectional, multilevel examination of 52 countries.

    Science.gov (United States)

    Mansyur, Carol Leler; Amick, Benjamin C; Harrist, Ronald B; Franzini, Luisa; Roberts, Robert E

    2009-01-01

    In a 2001 report, the U.S. National Institutes of Health called for more integration of the social sciences into health-related research, including research guided by theories and methods that take social and cultural systems into consideration. Based on a theoretical framework that integrates Hofstede's cultural dimensions with sociological theory, the authors used multilevel modeling to explore the association of culture with structural inequality and health disparities. Their results support the idea that cultural dimensions and social structure, along with economic development, may account for much of the cross-national variation in the distribution of health inequalities. Sensitivity tests also suggest that an interaction between culture and social structure may confound the relationship between income inequality and health. It is necessary to identify important cultural and social structural characteristics before we can achieve an understanding of the complex, dynamic systems that affect health, and develop culturally sensitive interventions and policies. This study takes a step toward identifying some of the relevant cultural and structural influences. More research is needed to explore the pathways leading from the sociocultural environment to health inequalities.

  15. Does culture or illness change a smoker's perspective on cessation?

    Science.gov (United States)

    Poureslami, Iraj M; Shum, Jessica; Cheng, Natalie; FitzGerald, J Mark

    2014-09-01

    To explore cultural context for smoking cessation within Chinese communities in Vancouver, and identify opportunities to support development of culturally appropriate resources for cessation. Applied participatory approach involving community members, patients, and key-informants in the design and implementation of the research. Whereas many participants were motivated to quit, their perceptions of desire to do so were not supported by effective interventions and many attempts to quit were unsuccessful. Tobacco control clinics and care providers need to adopt culturally and linguistically relevant interventions to facilitate behavioral modifications and cessation in ethnic minority communities.

  16. Climate change and health: Research challenges for health in the developing countries

    Directory of Open Access Journals (Sweden)

    Pandve Harshal

    2010-01-01

    Full Text Available Climate change has emerged as one of the most important environmental issues ever to confront humanity. Recent events have emphatically demonstrated our growing vulnerability to climate change, and health hazards are a major concern. Research pertaining to the effects of climate change on human health is the need of the hour. This paper discusses the broad challenges in health research in developing countries with specific reference to climate change.

  17. Financing reform and structural change in the health services industry.

    Science.gov (United States)

    Higgins, C W; Phillips, B U

    1986-08-01

    This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms.

  18. "Symptoms of something all around us": Mental health, Inuit culture, and criminal justice in Arctic communities in Nunavut, Canada.

    Science.gov (United States)

    Ferrazzi, Priscilla; Krupa, Terry

    2016-09-01

    Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. This study explores whether the therapeutic aims of these resource-intensive, mainly urban initiatives can be achieved in criminal courts in Nunavut's resource constrained, culturally distinct and geographically remote communities. A qualitative multiple-case study in the communities of Iqaluit, Arviat and Qikiqtarjuaq involved 55 semi-structured interviews and three focus groups with participants representing four sectors essential to these initiatives: justice, health, community organizations and community members. These interviews explored whether the therapeutic jurisprudence (TJ) principles that guide criminal court mental health initiatives and the component objectives of these principles could be used to improve the criminal court response to people with mental illness in Nunavut. Interviews revealed 13 themes reflecting perceptions of Inuit culture's influence on the identification of people with mental illness, treatment, and collaboration between the court and others. These themes include cultural differences in defining mental illness, differences in traditional and contemporary treatment models, and the importance of mutual cultural respect. The findings suggest Inuit culture, including its recent history of cultural disruption and change, affects the vulnerability of Nunavut communities to the potential moral and legal pitfalls associated with TJ and criminal court mental health initiatives. These pitfalls include the dominance of biomedical approaches when identifying a target population, the medicalization of behaviour and culture, the risk of "paternalism" in therapeutic interventions, and shortcomings in interdisciplinary collaboration that limit considerations of Inuit culture. The

  19. Climate change, food, water and population health in China.

    Science.gov (United States)

    Tong, Shilu; Berry, Helen L; Ebi, Kristie; Bambrick, Hilary; Hu, Wenbiao; Green, Donna; Hanna, Elizabeth; Wang, Zhiqiang; Butler, Colin D

    2016-10-01

    Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially - although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources - e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change - e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases - are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change.

  20. Reducing Disparities through Culturally Competent Health Care: An Analysis of the Business Case

    Science.gov (United States)

    Brach, Cindy; Fraser, Irene

    2016-01-01

    Finding ways to deliver high-quality health care to an increasingly diverse population is a major challenge for the American health care system. The persistence of racial and ethnic disparities in health care access, quality, and outcomes has prompted considerable interest in increasing the cultural competence of health care, both as an end in its own right and as a potential means to reduce disparities. This article reviews the potential role of cultural competence in reducing racial and ethnic health disparities, the strength of health care organizations’ current incentives to adopt cultural competence techniques, and the limitations inherent in these incentives that will need to be overcome if cultural competence techniques are to become widely adopted. PMID:12938253

  1. Climate Change, Economic Growth, and Health

    Energy Technology Data Exchange (ETDEWEB)

    Ikefuji, Masako [Institute of Social and Economic Research, Osaka University, Osaka (Japan); Magnus, J.R. [Department of Econometrics and Operations Research, Tilburg University, Tilburg (Netherlands); Sakamoto, Hiroaki [Department of Economics, Kyoto University, Kyoto (Japan)

    2010-08-08

    This paper studies the interplay between climate, health, and the economy in a stylized world with four heterogeneous regions, labeled 'West' (cold and rich), 'China' (cold and poor), 'India' (warm and poor), and 'Africa' (warm and very poor). We introduce health impacts into a simple integrated assessment model where both the local cooling effect of aerosols as well as the global warming effect of CO2 are endogenous, and investigate how those factors affect the equilibrium path. We show how some of the important aspects of the equilibrium, including emission abatement rates, health costs, and economic growth, depend on the economic and geographical characteristics of each region.

  2. Impact of organisational change on mental health: a systematic review.

    Science.gov (United States)

    Bamberger, Simon Grandjean; Vinding, Anker Lund; Larsen, Anelia; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

    2012-08-01

    Although limited evidence is available, organisational change is often cited as the cause of mental health problems. This paper provides an overview of the current literature regarding the impact of organisational change on mental health. A systematic search in PUBMED, PsychInfo and Web of Knowledge combining MeSH search terms for exposure and outcome. The criterion for inclusion was original data on exposure to organisational change with mental health problems as outcome. Both cross-sectional and longitudinal studies were included. We found in 11 out of 17 studies, an association between organisational change and elevated risk of mental health problems was observed, with a less provident association in the longitudinal studies. Based on the current research, this review cannot provide sufficient evidence of an association between organisational change and elevated risk of mental health problems. More studies of long-term effects are required including relevant analyses of confounders.

  3. Goal setting as a strategy for health behavior change.

    Science.gov (United States)

    Strecher, V J; Seijts, G H; Kok, G J; Latham, G P; Glasgow, R; DeVellis, B; Meertens, R M; Bulger, D W

    1995-05-01

    This article discusses the beneficial effects of setting goals in health behavior change and maintenance interventions. Goal setting theory predicts that, under certain conditions, setting specific difficult goals leads to higher performance when compared with no goals or vague, nonquantitative goals, such as "do your best." In contrast to the graduated, easy goals often set in health behavior change programs, goal setting theory asserts a positive linear relationship between degree of goal difficulty and level of performance. Research on goal setting has typically been conducted in organizational and laboratory settings. Although goal setting procedures are used in many health behavior change programs, they rarely have been the focus of systematic research. Therefore, many research questions still need to be answered regarding goal setting in the context of health behavior change. Finally, initial recommendations for the successful integration of goal setting theory in health behavior change programs are offered.

  4. Transtheoretical Model of Health Behavior Change Applied to Voice Therapy

    OpenAIRE

    2007-01-01

    Studies of patient adherence to health behavior programs, such as physical exercise, smoking cessation, and diet, have resulted in the formulation and validation of the Transtheoretical Model (TTM) of behavior change. Although widely accepted as a guide for the development of health behavior interventions, this model has not been applied to vocal rehabilitation. Because resolution of vocal difficulties frequently depends on a patient’s ability to make changes in vocal and health behaviors, th...

  5. Does cultural and linguistic diversity affect health-related outcomes for people with stroke at discharge from hospital?

    Science.gov (United States)

    Davies, Sarah E; Dodd, Karen J; Hill, Keith D

    2017-04-01

    Primary purpose to determine if cultural and linguistic diversity affects health-related outcomes in people with stroke at discharge from hospital and secondary purpose to explore whether interpreter use alters these outcomes. Systematic search of: Cochrane, PEDro, CINAHL, Medline, Pubmed, Embase, PsycINFO and Ageline databases. Publications were classified into whether they examined the impact of diversity in culture, or language or culture and language combined. Quality of evidence available was summarized using Best Evidence Synthesis. Eleven studies met inclusion criteria and were reviewed. Best Evidence Synthesis indicated conflicting evidence about the impact of culture alone and language barriers alone on health-related outcomes. There was strong evidence that hospital length of stay does not differ between groups when the combined impact of culture and language was investigated. Conflicting evidence was found for other outcomes including admission, discharge and change in FIM scores, and post-hospital discharge living arrangements. It is unknown if interpreter use alters health-related outcomes, because this was infrequently reported. The current limited research suggests that cultural and linguistic diversity does not appear to impact on health-related outcomes at discharge from hospital for people who have had a stroke, however further research is needed to address identified gaps. Implications for Rehabilitation The different language, culture and beliefs about health demonstrated by patients with stroke from minority groups in North America do not appear to significantly impact on their health-related outcomes during their admission to hospital. It is not known whether interpreter use influences outcomes in stroke rehabilitation because there is insufficient high quality research in this area. Clinicians in countries with different health systems and different cultural and linguistic groups within their communities need to view the results with caution

  6. Climate change and health: temperature and health impacts

    CSIR Research Space (South Africa)

    Matooane, M

    2009-03-01

    Full Text Available Africa, climate sensitive health concerns include an increase in the occurrence of heat stroke, skin rashes, non-melanoma skin cancer and dehydration (DEAT, 2004), although the magnitude, and temporal and spatial variability of these effects are not yet...

  7. Cultural Change, the Hybrid Administrative System and Public ...

    African Journals Online (AJOL)

    2013-01-17

    Jan 17, 2013 ... crackdown on corruption, this article explores the view that it is the hybrid .... decentralization and public participation in governance creates new demands. ..... The Hybrid Administrative System and Corporate Culture.

  8. The western Aleutians: Cultural isolation and environmental change

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Recent research in the western Aleutians addresses two primary issues: the nature and extent of cultural exchange along the Aleutian chain, and Holocene...

  9. Environmental Education and the Health Professions: Framing Climate Change as a Health Issue

    Science.gov (United States)

    Adlong, William; Dietsch, Elaine

    2015-01-01

    The likelihood of adverse health impacts from climate change is high. Actions to reduce emissions, however, not only mitigate climate change but often have more immediate health co-benefits. One substantial co-benefit is gained through reductions of the high health costs of pollution from fossil fuel power stations, particularly coal. Evidence…

  10. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

    Science.gov (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

    2010-01-01

    Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

  11. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

    Science.gov (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

    2010-01-01

    Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

  12. Using transformational change to improve organizational culture and climate in a school of nursing.

    Science.gov (United States)

    Springer, Pamela J; Clark, Cynthia M; Strohfus, Pamela; Belcheir, Marcia

    2012-02-01

    A positive organizational culture and climate is closely associated with an affirming workplace and job satisfaction. Especially during a time of faculty shortages, academic leaders need to be cognizant of the culture and climate in schools of nursing. The culture of an organization affects employees, systems, and processes, and if the culture becomes problematic, transformational leadership is essential to create change. The purpose of this article is to describe an 8-year journey to change the culture and climate of a school of nursing from one of dissatisfaction and distrust to one of high employee satisfaction and trust. Kotter's model for transformational change was used to frame a longitudinal study using the Cultural and Climate Assessment Scale to transform the organizational culture and climate of a school of nursing.

  13. Italian Family Business Cultures Involved in the Generational Change

    OpenAIRE

    Ruggero Ruggieri; Maura Pozzi; Silvio Ripamonti

    2014-01-01

    In family firms, the business and the family are two arenas in which processes significantly overlap and influence management. The present paper investigates the overlap of the family system and the business through the use of culture. Adopting an idiographic approach and recognising the unique psychodynamic process of family business (FB), this study aims to identify the cultural patterns within the FB, starting from what families define as a) family, b) business and, c) the generational cha...

  14. An ill wind? Climate change, migration, and health.

    Science.gov (United States)

    McMichael, Celia; Barnett, Jon; McMichael, Anthony J

    2012-05-01

    Climate change is projected to cause substantial increases in population movement in coming decades. Previous research has considered the likely causal influences and magnitude of such movements and the risks to national and international security. There has been little research on the consequences of climate-related migration and the health of people who move. In this review, we explore the role that health impacts of climate change may play in population movements and then examine the health implications of three types of movements likely to be induced by climate change: forcible displacement by climate impacts, resettlement schemes, and migration as an adaptive response. This risk assessment draws on research into the health of refugees, migrants, and people in resettlement schemes as analogs of the likely health consequences of climate-related migration. Some account is taken of the possible modulation of those health risks by climate change. Climate-change-related migration is likely to result in adverse health outcomes, both for displaced and for host populations, particularly in situations of forced migration. However, where migration and other mobility are used as adaptive strategies, health risks are likely to be minimized, and in some cases there will be health gains. Purposeful and timely policy interventions can facilitate the mobility of people, enhance well-being, and maximize social and economic development in both places of origin and places of destination. Nevertheless, the anticipated occurrence of substantial relocation of groups and communities will underscore the fundamental seriousness of human-induced climate change.

  15. Historical Changes of Ginkgo Biloba L.Culture

    Institute of Scientific and Technical Information of China (English)

    CHEN Feng-jie; FAN Bao-min

    2012-01-01

    Ginkgo Biloba L.is a rare species endemic to China,strengthening the study of Ginkgo culture is of great significance to eco-economic development.This paper uses the historical research methods to study the Ginkgo and its cultural development process in China.According to the characteristics of the development of Ginkgo culture,the process can be divided into three stages:Shang and Zhou Dynasties to the Northern and Southern Dynasties(which is named theological era),Sui and Tang Dynasties to early Qing Dynasty(which is named the literature era),and the modern China which is named the scientific era.The history of Ginkgo culture is a history of Ginkgo being gradually recognized,and the Ginkgo culture’s connotation and extension are gradually deepened and developed.The construction of Ginkgo today’s culture should be in the inheritance of historical culture,and combined with the needs of the times comprehensive innovation,take the science and human harmonious development road.

  16. Culture, health, and bigotry: How exposure to cultural accounts of fatness shape attitudes about health risk, health policies, and weight-based prejudice.

    Science.gov (United States)

    Frederick, David A; Saguy, Abigail C; Gruys, Kjerstin

    2016-09-01

    We conducted three experiments to examine how cultural frames shape attitudes about health, focusing on obesity, which is considered a public health crisis and is imbued with symbolic meaning. College students (Ns = 99, 114, and 293) read news articles that presented high body weight according to one or more of the following frames: 1) public health crisis; 2) personal responsibility; 3) health at every size (HAES); or 4) fat rights. Compared to people who read the HAES and Fat Rights articles, those who read the Public Health Crisis and Personal Responsibility articles expressed more belief in the health risks of being fat (ds = 1.28 to 1.79), belief that fat people should pay more for insurance (ds = 0.53 to 0.71), anti-fat prejudice (ds = 0.61 to 0.69), willingness to discriminate against fat people (ds = 0.41 to 0.59), and less willingness to celebrate body-size diversity (ds = 0.77 to 1.07). They were less willing to say women at the lower end of the obese range could be healthy. Exposure to these articles increased support for price-raising policies to curb obesity but not support for redistributive or compensatory policies. In Experiment 3, in comparison to a control condition, exposure to HAES or Fat Rights frames significantly reduced beliefs in the risks of obesity and support for charging fat people more for insurance. However, only people exposed to the Fat Rights frame expressed fewer anti-fat attitudes and more willingness to celebrate body-size diversity. Our findings suggest that simply disseminating information that people can be both fat and healthy will not suffice to reduce prejudice. Given that anti-fat stigma is a health risk and barrier to collective solidarity, fat rights viewpoints can buffer against the negative consequences of anti-fat stigma and promote a culture of health by fostering empathy and social justice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Organizational change theory: implications for health promotion practice.

    Science.gov (United States)

    Batras, Dimitri; Duff, Cameron; Smith, Ben J

    2016-03-01

    Sophisticated understandings of organizational dynamics and processes of organizational change are crucial for the development and success of health promotion initiatives. Theory has a valuable contribution to make in understanding organizational change, for identifying influential factors that should be the focus of change efforts and for selecting the strategies that can be applied to promote change. This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners. Theoretically derived considerations for practitioners who seek to foster organizational change include the extent to which the initiative is modifiable to fit with the internal context; the amount of time that is allocated to truly institutionalize change; the ability of the agents of change to build short-term success deliberately into their implementation plan; whether or not the shared group experience of action for change is positive or negative and the degree to which agencies that are the intended recipients of change are resourced to focus on internal factors. In reviewing theories of organizational change, the article also addresses strategies for facilitating the adoption of key theoretical insights into the design and implementation of health promotion initiatives in diverse organizational settings. If nothing else, aligning health promotion with organizational change theory promises insights into what it is that health promoters do and the time that it can take to do it effectively.

  18. Narratives of climate change : outline of a systematic approach to narrative analysis in cultural sociology

    OpenAIRE

    Arnold, Annika

    2015-01-01

    This study addresses in particular research gaps in cultural sociology and in the analysis of climate change communication. Narratives have long played a significant role in cultural sociological analysis of empirical data. However, a systematic approach to social stories has yet to be developed and presents a gap in recent research in the realm of young cultural sociology. Following among others Smith’s model of genre an integrated model of cultural narrative analysis aims at integrating vit...

  19. Health Effects of Climate Change (Environmental Health Student Portal)

    Science.gov (United States)

    ... in new places. In areas hit very hard, global warming can affect the social structure and economy, too. Did you know ? Climate change may increase the risk of diseases spread by mosquitoes and other insects. ...

  20. Management system of organizational and economic changes in health services

    Directory of Open Access Journals (Sweden)

    Natalya Vasilyevna Krivenko

    2013-03-01

    Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market