Methods used in cross-cultural comparisons of vasomotor symptoms and their determinants

Methodological differences among studies of vasomotor symptoms limit rigorous comparison or systematic review. Vasomotor symptoms generally include hot flushes and night sweats although other associated symptoms exist. Prevalence rates vary between and within populations, but different studies collect data on frequency, bothersomeness, and/or severity using different outcome measures and scales, making comparisons difficult. We reviewed only cross-cultural studies of menopausal symptoms that explicitly examined symptoms in general populations of women in different countries or different ethnic groups in the same country. This resulted in the inclusion of nine studies: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). These studies highlight the methodological challenges involved in conducting multi-population studies, particularly when languages differ, but also highlight the importance of performing multivariate and factor analyses. Significant cultural differences in one or more vasomotor symptoms were observed in 8 of 9 studies, and symptoms were influenced by the following determinants: menopausal status, hormones (and variance), age (or actually, the square of age, age2), BMI, depression, anxiety, poor physical health, perceived stress, lifestyle factors (hormone therapy use, smoking and exposure to passive smoke), and acculturation (in immigrant populations). Recommendations are made to improve methodological rigor and facilitate comparisons in future cross-cultural menopause studies.

Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants : Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies

This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms “cross cultural comparison” and “menopause.” Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction.

Creative suburbia : rethinking urban cultural policy – the Australian case

This article considers the question of whether creative workers demonstrate a preference for inner cities or suburbs, drawing upon research findings from the ‘Creative Suburbia’ project undertaken by a team of Australian researchers over 2008–2010 in selected suburban areas of Brisbane and Melbourne. Locating this question in wider debates about the relationship of the suburbs to the city, as well as the development of new suburban forms such as master-planned communities, the article finds that the number of creative industries workers located in the suburbs is significant, and those creative workforce members living and working in suburban areas are generally happy with this experience, locating in the suburbs out of personal choice rather than economic necessity. This runs counter to the received wisdom on creative cities, which emphasize cultural amenity in inner city areas as a primary driver of location decisions for the ‘creative class’. The article draws out some implications of the findings for urban cultural policy, arguing that the focus on developing inner urban cultural amenity has been overplayed, and that more attention should be given to how to better enable distributed knowledge systems through high-speed broadband infrastructure.

From critique to cultural recovery: critical futures studies and casual layered analysis

Critical futures studies is not about the careers of a few scholars, rather it is about projects that transcend the narrow boundaries of the self. This biographical monograph examines the life and work of Richard Slaughter and Sohail Inayatullah.

From cultural to creative industries : theory, industry, and policy implications

Across post-industrial societies worldwide, the creative industries are increasingly seen as a key economic driver. These industries - including fields as diverse as advertising, art, computer games, crafts, design, fashion, film, museums, music, performing arts, publishing, radio, theatre and TV - are built upon individual creativity and innovation and have the potential to create wealth and employment through the mechanism of intellectual property. Creative Industries: Critical Readings brings together the key writings - drawing on both journals and books - to present an authoritative and wide-ranging survey of this emerging field of study. The set is presented with an introduction and the writings are divided into four volumes, organized thematically: Volume 1: Concepts - focuses on the concept of creativity and the development of government and industry interest in creative industries; Volume 2: Economy - maps the role and function of creative industries in the economy at large; Volume 3: Organization - examines the ways in which creative institutions organize themselves; and Volume 4: Work - addresses issues of creative work, labour and careers This major reference work will be invaluable to scholars in economics, cultural studies, sociology, media studies and organization studies.

Literacies programs: Debates and demands in cultural context

An introduction to the "four resources" model of literacy, where coding, semantics, pragmatic and critical text work are viewed as necessary components for literacy in contemporary society.

Free our cultural archives.

Australians are the creators and custodians of a broad range of cultural materials. This material includes literary, photographic, video and audio archives. These archives should be made available to all Australians for access and reuse, as part of a pre-competitive platform which promotes the interests of the Australian public in gaining access to a diverse range of content that contributes to the development of national and cultural identity. This does not mean that all material must be made available for access and reuse for free and in an unrestricted fashion. But for publicly funded content, free and unrestricted access should be the default. The Venturous Australia report on the National Innovation System recommended that “[t]o the maximum extent possible, information, research and content funded by Australian governments – including national collections – should be made freely available over the internet as part of the global public commons.”1 The report further stated that “both for its direct and indirect benefits to Australia and for the greater global good, Australia should energetically and proudly maximise the extent to which it makes government funded content available as part of the global digital commons...

Creative suburbia : cultural research and suburban geographies

Suburbanisation today is not necessarily what it used to be: rather than suburbs being outer urban commuter zones for people who work in the central business district, people living in new suburbs are increasingly likely to work in those suburbs, or to commute to other outer suburbs as their places of work. At one level, such trends affirm the analyses of the ‘Los Angeles School’ of urban geographers about the shift from the classical modernist city, with radial zones spreading out from a city centre where core businesses were located, to a more decentralised, ‘postmodern’ city. But they increasingly move beyond this postmodern perspective, in that the many suburbs are themselves centres of work and industry, and not simply centres of lifestyle and consumption. This article critically reflects upon the contemporary dynamics of the suburbs, and the public discourses that surround their development, in the context of the rise of the creative industries.

The role of cultural beliefs in contributing to risky road use behaviour in Pakistan

Background Pakistan has the highest population rate of road fatalities in South Asia (25.3 fatalities per 100,000 people: Global Status Report on Road Safety, WHO 2009). Along with road environment and vehicle factors, human factors make a substantial contribution to traffic safety in Pakistan. Beliefs about road crash causation and prevention have been demonstrated to contribute to risky road use behaviour and resistance to preventive measures in a handful of other developing countries, but has not been explored in Pakistan. In particular, fatalism (whether based on religion, other cultural beliefs or experience) has been highlighted as a barrier to achieving changes in attitudes and behaviour. Aims The research reported here aimed (i) to explore perceptions of road crash causation among policy makers, police officers, professional drivers and car drivers in Pakistan; (ii) to identify how cultural and religious beliefs influence road use behaviour in Pakistan; and (iii) to understand how fatalistic beliefs may work as obstacles to road safety interventions. Methods In-depth interviews were conducted by the primary author (mostly in Urdu) in Lahore, Rawalpindi and Islamabad with 12 professional drivers (taxi, bus and truck), 4 car drivers, 6 police officers, 4 policy makers and 2 religious orators. All but two were Muslim, two were female, and they were drawn from a wide range of ages (24 to 60) and educational backgrounds. The interviews were taped and transcribed, then translated into English and analysed for themes related to the aims. Results Fatalism emerged as a pervasive belief utilised to justify risky road use behaviour and to resist messages about preventive measures. There was a strong religious underpinning to the statement of fatalistic beliefs (this reflects popular conceptions of Islam rather than scholarly interpretations), but also an overlap with superstitious beliefs which have longer-standing roots in Pakistani culture. These beliefs were not limited to people of poor educational background or position. A particular issue which was explored in more detail was the way in which these beliefs and their interpretation within Pakistani society contributed to poor police reporting of crashes. Discussion and conclusions The pervasive nature of fatalistic beliefs in Pakistan affects road user behaviour by supporting continued risk taking behaviour on the road, and by interfering with public health messages about behaviours which would reduce the risk of traffic crashes. The widespread influence of these beliefs on the ways that people respond to traffic crashes and the death of family members contribute to low crash reporting rates and to a system which is difficult to change. The promotion of an evidence-based approach to road user behaviour is recommended, along with improved professional education for police and policy makers.

A case study examination of the influence of cultural diversity in the multicultural nursing workforce on the quality of care and patient safety in a Saudi Arabian hospital

The purpose of the study: The purpose of this study is to investigate the influence of cultural diversity, in a multicultural nursing workforce, on the quality and safety of patient care and the work environment at King Abdul-Aziz Medical City, Riyadh region. Study background: Due to global migration and workforce mobility, to varying degrees, cultural diversity exists in most health services around the world, particularly occurring where the health care workforce is multicultural or where the domestic population comprises minority groups from different cultures speaking different languages. Further complexities occur when countries have a multicultural workforce which is different from the population for whom they care, in addition to the workers being from culturally diverse countries and with different languages. In Saudi Arabia the health system is mainly staffed by expatriate nurses who comprise 67.7% of the total number of nurses. Study design: This research utilised a case study design which incorporated multiple methods including survey, qualitative interviews and document review. Methods: The participant nurses were selected for the survey via a population sampling strategy; 319 nurses returned their completed Safety Climate Survey questionnaires. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. For the qualitative component of the study, a purposive sampling strategy was used; 24 nurses were interviewed using a semi-structured interview technique. The documentary review included KAMC-R policy documents that met the inclusion criteria using a predetermined data abstraction instrument. Content analysis was used to analyse the policy documents data. Results: The data revealed the nurses‘ perceptions of the clinical climate in this multicultural environment is that it was unsafe, with a mean score of 3.9 out of 5. No significant difference was detected between the age groups or years of experience of the nurses and the perception of safety climate in this context; the study did reveal a statistically significant difference between the cultural background categories and the perception of safety climate. The qualitative phase indicated that the nurses within this environment were struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patients‘ cultural and spiritual needs as well as maintaining a high standard of care. The results also indicated that nurses were disempowered in this context. Importantly, there was inadequate support by the organisation to manage the cultural diversity issue and to protect patients from any associated risks, as demonstrated by the policy documents and supported by the nurses‘ experiences. The study also illustrated the limitations of the conceptual framework of cultural competence when tested in this multicultural workforce context. Therefore, this study generated amendments to the model that is suitable to be used in the context of a multicultural nursing workforce. Conclusion: The multicultural nature of this nursing work environment is inherently risky due to the conflicts that arise from the different cultural norms, beliefs, behaviours and languages. Further, there was uncertainty within the multicultural nursing workforce about the clinical and cultural safety of the patient care environment and about the cultural safety of the nursing workforce. The findings of the study contribute important new knowledge to the area of patient and nurse safety in a multicultural environment and contribute theoretical development to the field of cultural competence. Specifically, the findings will inform policy and practice related to patient care in the context of cultural diversity.

Review: Barbara T. Hoffman (ed) - Art and Cultural Heritage : Law, Policy and Practice

In Art and Cultural Heritage: Law, Policy and Practice Barbara Hoffman as editor brings together an impressive array of practitioners from a variety of fields (from archaeologists to lawyers), to present in single volume aspects of policy, law and practice relevant to cultural heritage, which are not normally addressed in such texts. The book is indeed a comprehensive work to be recommended to policy makers, practitioners, students and other interested readers...

Walking the Coleridge Way : using cultural tourism to change perceptions of Somerset after the foot and mouth epidemic of 2001

This paper explores one of the ways in which the Somerset region in the United Kingdom, devastated by the foot and mouth epidemic in 2001, is trying to free itself from recurring negative representations and create more positive images of the area. After the epidemic projects were sought that would promote a more positive image and draw tourists back to the area. One of these projects drew on literary tourism to reinvigorate the site. A Walking and Bridle trail called the ‘Coleridge Way Walk’ has been implemented to take the images of the area from ones of disease and dirtiness to ones of Romantic longing. The Coleridge Way Walk uses past imaginings to re-energise the area. This energy, in part, comes from ‘re-imagining’ the site through past imaginings. The Coleridge Way Walk uses the past to create future direction for the once tainted area.

Cultural factors affecting tertiary education access for Bundjalung men

Despite documented changes to mainstream educational systems, Indigenous educational achievements are still at critically low levels across all phases of formal education. According to the Australian Bureau of Statistics (2011) Indigenous students are still less likely than non-Indigenous students to complete their final years of schooling (45% compared with 77% in 2009); tertiary level entry and outcomes are also significantly lower than non-Indigenous entry and outcomes. Although significant research has focused on the area of Indigenous education, in particular, identifying and making recommendations on how to close educational gaps between Indigenous and non-Indigenous people, these studies have failed to bring about the change needed and to engage successfully with Indigenous communities and draw on Indigenous communities’ insights for best practice. This thesis focuses on Indigenous perspectives and takes a closer look at the cultural factors that impact on tertiary education access for Indigenous young men who come from a Bundjalung community on the far north coast of northern New South Wales. To date, this community has not been the focus of serious postgraduate study. Their experiences and the values and ideas of their community have not been investigated. To do this, the study uses an Indigenous methodological framework. It draws on Indigenous Standpoint Theory to analyse data through concepts of the cultural interface and tensions (Nakata, 2007, pp. 195-217). The study’s framing also draws on decolonising methods (Porsanger, 2004; Smith, 1999) and Indigenist research methods (Rigney, 1997). Such methodologies are intended to benefit both the research participants (community members) and the researcher. In doing so, the study draws on Creswell’s (2008) methods of restorying and retelling to analyse the participants’ interviews and yarns about their lives and experiences relating to tertiary educational access. The research process occurred in multiple stages: (1) selection of research sites, (2) granting of access which was requested through consultation with local Aboriginal Elders and through the local Aboriginal Lands Council, (3) conducting of interviews with participants/ data collection, (4) analysis of data, (5) documentation of findings, (6) theory development, and (7) reporting back to the nominated Indigenous community on the progress and findings of the research. The benefits of this research are numerous. First, this study addresses an issue that has been identified from within the local Aboriginal community as an issue of high precedence, looking at the cultural factors surrounding the underrepresentation of Indigenous people accessing tertiary education. This is not only of local significance but has been identified in the literature as a local, national and international area of concern amongst Indigenous peoples (Department of Economic and Social Affairs, 2009; Herbert, 2010; King, 2011). Secondly, the study draws on local Indigenous knowledges and learning processes from within a Bundjalung community to gain inside perspectives, namely the cultural factors that are being expressed from a range of Indigenous community members – young men, community Elders and community members – and finding out what they perceive inhibit and/or promote tertiary education participation within their community. Such perspectives are rarely heard. Finally, recommendations made from this study are aimed at revealing investigative styles that may be utilised by Western institutions to improve access for Indigenous young men living in the Narlumdarlum1 region in the tertiary context.