Culture and behaviour in the English National Health Service:overview of lessons from a large multimethod study

Background - Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS). Methods - Mixed-methods study involving collection and triangulation of data from multiple sources, including interviews, surveys, ethnographic case studies, board minutes and publicly available datasets. We narratively synthesised data across the studies to produce a holistic picture and in this paper present a highlevel summary. Results - We found an almost universal desire to provide the best quality of care. We identified many 'bright spots' of excellent caring and practice and high-quality innovation across the NHS, but also considerable inconsistency. Consistent achievement of high-quality care was challenged by unclear goals, overlapping priorities that distracted attention, and compliance-oriented bureaucratised management. The institutional and regulatory environment was populated by multiple external bodies serving different but overlapping functions. Some organisations found it difficult to obtain valid insights into the quality of the care they provided. Poor organisational and information systems sometimes left staff struggling to deliver care effectively and disempowered them from initiating improvement. Good staff support and management were also highly variable, though they were fundamental to culture and were directly related to patient experience, safety and quality of care. Conclusions - Our results highlight the importance of clear, challenging goals for high-quality care. Organisations need to put the patient at the centre of all they do, get smart intelligence, focus on improving organisational systems, and nurture caring cultures by ensuring that staff feel valued, respected, engaged and supported.

Culture and the psychological impacts of natural disasters: Implications for disaster management and disaster mental health

In recent decades, natural disasters have caused extensive losses and damages to human psychological wellbeing, economy, and society. It has been argued that cultural factors such as social values, traditions, and attachment to a location influence communities facing and responding to natural disasters. However, the issue of culture in disaster mental health seems to have received limited attention in policy and practice. This review highlights the importance of cultural background in the assessment of vulnerability to the psychological impacts of disasters, disaster preparedness, and provision of disaster mental health services. In particular, this paper suggests the importance of cultural competence in the planning and delivery of effective disaster mental health services. In order to address the varying circumstances of people with different cultural backgrounds, disaster mental health services must be developed in a culturally sensitive manner. Development of culturally competent disaster mental health services requires significant changes in policy making, administration, and direct service provision

Soccer, South Africa and celebrity status:Mark Fish, popular culture and the post-apartheid state

The rise of celebrity culture is a theme that has attracted a significant amount of attention within both mainstream sociology and cultural studies in more recent times. Ensuing debate has identified contemporary sports figures as an important facet of the celebrity‐media nexus and as possible signifiers of cultural change. In this paper we take one particular sports celebrity, South African soccer star Mark Fish, and evaluate his image in relation to debates surrounding sport, politics and the post‐apartheid state. We argue that because Fish appears to enjoy all the benefits of celebrity status (within his home country at least), an analysis of his career and identity provide a useful means by which to think about the changing political and nationalistic values within South African society.

Low gravity rotational culture and the integration of immunomodulatory stem cells reduce human islet allo-reactivity

Modification of human islets prior to transplantation may improve long-term clinical outcome in terms of diabetes management, by supporting graft function and reducing the potential for allo-rejection. Intragraft incorporation of stem cells secreting beta (β)-cell trophic and immunomodulatory factors represents a credible approach, but requires suitable culture methods to facilitate islet alteration without compromising integrity. This study employed a three-dimensional rotational cell culture system (RCCS) to achieve modification, preserve function, and ultimately influence immune cell responsiveness to human islets. Islets underwent intentional dispersal and rotational culture-assisted aggregation with amniotic epithelial cells (AEC) exhibiting intrinsic immunomodulatory potential. Reassembled islet constructs were assessed for functional integrity, and their ability to induce an allo-response in discrete T-cell subsets determined using mixed islet:lymphocyte reaction assays. RCCS supported the formation of islet:AEC aggregates with improved insulin secretory capacity compared to unmodified islets. Further, the allo-response of peripheral blood mononuclear cell (PBMC) and purified CD4+ and CD8+ T-cell subsets to AEC-bearing grafts was significantly (p < 0.05) attenuated. Rotational culture enables pre-transplant islet modification involving their integration with immunomodulatory stem cells capable of subduing the allo-reactivity of T cells relevant to islet rejection. The approach may play a role in achieving acute and long-term graft survival in islet transplantation.

Agitation conditions for the culture and detachment of hMSCs from microcarriers in multiple bioreactor platforms

In our recent work in different bioreactors up to 2.5L in scale, we have successfully cultured hMSCs using the minimum agitator speed required for complete microcarrier suspension, N JS. In addition, we also reported a scaleable protocol for the detachment from microcarriers in spinner flasks of hMSCs from two donors. The essence of the protocol is the use of a short period of intense agitation in the presence of enzymes such that the cells are detached; but once detachment is achieved, the cells are smaller than the Kolmogorov scale of turbulence and hence not damaged. Here, the same approach has been effective for culture at N JS and detachment in-situ in 15mL ambr™ bioreactors, 100mL spinner flasks and 250mL Dasgip bioreactors. In these experiments, cells from four different donors were used along with two types of microcarrier with and without surface coatings (two types), four different enzymes and three different growth media (with and without serum), a total of 22 different combinations. In all cases after detachment, the cells were shown to retain their desired quality attributes and were able to proliferate. This agitation strategy with respect to culture and harvest therefore offers a sound basis for a wide range of scales of operation.

Aggregate dividends and consumption smoothing

We show that net equity payouts from the corporate sector play a crucial role in helping individuals manage their consumption path across the business cycle. In particular, we show that, as investors' desire to smooth consumption increases, optimal aggregate dividends become both more volatile and more counter-cyclical to help counterbalance pro-cyclical labor income. These findings are robust to whether or not agency conflicts exist in the economy.

Women in Europe between the wars:politics, culture and society

The central aim of this interdisciplinary book is to make visible the intentionality behind the 'forgetting' of European women's contributions during the period between the two world wars in the context of politics, culture and society. It also seeks to record and analyse women's agency in the construction and reconstruction of Europe and its nation states after the First World War, and thus to articulate ways in which the writing of women's history necessarily entails the rewriting of everyone's history. By showing that the erasure of women's texts from literary and cultural history was not accidental but was ideologically motivated, the essays explicitly and implicitly contribute to debates surrounding canon formation. Other important topics are women's political activism during the period, antifascism, the contributions made by female journalists, the politics of literary production, genre, women's relationship with and contributions to the avant-garde, women's professional lives, and women's involvement in voluntary associations. In bringing together the work of scholars whose fields of expertise are diverse but whose interests converge on the inter-war period, the volume invites readers to make connections and comparisons across the whole spectrum of women's political, social, and cultural activities throughout Europe.

The influence of culture and market orientation on services brands:insights from Irish banking and retail firms

Purpose: This paper aims to examine the influence of the culture of the service firm on its interpretation of the role of the brand and on the development and implementation of its brand values. Design/methodology/approach: A grounded theory approach was used. Interviews were conducted with 20 managers within two leading banking firms in Ireland and two leading grocery retailers in Ireland. Findings: The development of the brand, and its role within the firm, is closely related to the firm's culture. The research shows obstacles and opportunities created by the cultural context of firms wishing to disseminate and embed a set of brand values. The paper presents an "involvement model" of brand values implementation and outlines changes required to implement brand values. Research limitations/implications: The study was bound by access to firms, and managers' availability. The authors sought an insight into the relationship between each firm's culture and its brands. They advocate quantitative research to further investigate the findings within these service sectors and to test proposed antecedents (transformational leadership, employee involvement) and outcomes (employee-based brand equity and consumer-based brand equity) of values adoption. Practical implications: The paper identifies aspects of retail and banking cultures which support or detract from brand development. In particular, it presents the learnings from successful brand values implementation in a clan culture, aspects of which are applicable across other cultures. Originality/value: The paper provides valuable insights into the role of the brand within the service firm and the positive and negative influence of context on brand values and their development and implementation. © Emerald Group Publishing Limited.

Kultúra és teljesítmény a közigazgatásban (Culture and performance in the public administration)

A szerző dolgozatában egy közigazgatásban végzett kérdőíves vizsgálat eredményeit összegezi. A kutatás alapkérdése: a közigazgatási szervezetek körében hogyan befolyásolja a szervezeti kultúra a szervezeti teljesítményt? A kutatás e kérdést egy hat magyar minisztériumban folytatott kérdőíves vizsgálat révén kísérli meg megválaszolni. ____ In his study the author presents the results of a questionnaire survey of the Hungarian public administration. The main issue of this survey was how to influence the organizational culture the organizational performance in the public administration? This survey would try to answer this issue.

Vágyott kultúra és reális értékítélet - Tudásmenedzsment-rendszer kiépítésének előfeltétele egy felsőoktatási intézményben (Desired culture and real value judgement – Precondition of development a knowledge management system in a higher education institution)

A tudásmenedzsment-rendszerek kiépítése és működtetése egyre népszerűbb vállalati cél. A legnagyobb igyekezet ellenére is kudarccal végződhet egy ilyen változás megvalósítása, ha a szükséges feltételek nélkül próbálkozunk ezzel a beavatkozással a szervezet életében. Az egyik legfontosabb előfeltétel a bizalomra, közös tanulásra, fejlődésre épülő, nyitott szervezeti kultúra, mely a tanulószervezeti jellemzőkkel írható le. A szerzők kutatásukban arra voltak kíváncsiak, milyen elképzeléseik, vágyaik vannak a felsőoktatásban oktató kollégáknak az ideálisnak nevezett szervezeti kultúráról. Ezeket az elképzeléseket egy külső tanácsadó cég által végzett kérdőíves felmérésen alapuló vizsgálat segítségével tudták meg, melynek kiértékelésére a circumplex-módszer szolgált. Az eredményeket összevetették a tanulószervezeti jellemzőkkel, vizsgálva azt a hipotézist, miszerint az oktató kollégák tudat alatt is olyan ideális szervezetet képzelnek el, mely a tanulószervezeti kultúra jellemzőivel azonos. _________ To create and to operate a knowledge management system is becoming a more and more popular target of the companies. Realizing the changes above can result in a failure – in spite of the biggest will – if organizations lack certain prerequisites which are necessary in companies’ lives. One of the most important prerequisites is organizational culture which can be characterized by confidence, common learning, development and open atmosphere. This is called a learning organizational culture. In their research the authors would have liked to know what kind of dreams the colleagues have about their own organizational culture. They achieve these results from an investigation with questionnaires which were realized by an advisory team. To evaluating the results of this investigation circumplex method was used. These results were compared with the characteristics of learning organization to confirm our hypothesis. According to this idea colleagues have the same images about their successful organization as the characteristics of learning organizations.

The impact of the changing weaving industry on the culture and socioeconomic development of Maya women in Guatemala

Growing demand for handwoven Maya textiles from Guatemala parallels recent international fascination with Maya civilization. This thesis surveys the effects of increases in demands for artisan textiles in Guatemala, and explores the reactions of women involved in Aj Quen, a weavers' association. The hypothesis is that the well-being of Maya women depends on their participation in the association. This is tested by using indicators of the weavers' attitudes defined as their "well-being" regarding (1) health, (2) education levels, (3) child care practices, and (4) economic stability. Interviews were conducted with 127 Maya women. Data were documented, providing a crucial missing link in the current literature of "women in Guatemala." The results of this study yield baseline data demonstrating that health and child care practices are not directly related to women's participation in the association. Their education levels increased as a direct result of working with the association, as did economic stability, although less consistently.

Without women: Masculinities, gay male sexual culture and sexual behaviors in Miami, Florida

Recent studies have reported alarmingly high rates of HIV infection and risky sexual behaviors among gay men in Miami, Florida. Previous research has suggested that the risky sexual behaviors of many gay men reflect the pursuit of intimacy and love, and that barriers to intimate relationships among gay men may stem from traditional masculinity norms. This dissertation examines the meanings which gay men ascribe to their sexual behaviors, as well as the intersections of those meanings with both traditional masculinity constructions and Miami's gay male sexual culture. ^ The study is based upon participant observation, print media content analysis, surveys and ethnographic interviews of a purposive snowball sample of 30 Cuban American, Puerto Rican, African American and Anglo gay men who reside in Miami-Dade County, Florida. Analysis of research questions was accomplished through grounded theory methods and descriptive and non-parametric statistics, including Pearson chi-square, Fisher's Exact and Mann-Whitney U tests. ^ The study shows that culturally-specified masculinity norms vary in the relative importance ascribed to heterosexual prowess, economic providership and competitiveness. These cultural differences appear important not only to the timing of sexual awareness and to the strength of homosexual stereotyping as effeminacy, but also to men's strategies in coming out as gay. The meanings men attributed to their sexual behaviors were, however, constructed in response to both inherited masculinity norms and the hypermasculine structure of Miami's gay male sexual culture. In addition to providing an ethnographic account of this subculture, the study elaborates men's issues relative to casual sex and committed relationships. Unprotected anal intercourse with casual partners during the previous twelve months was associated with growing up without one's father in the home, having been teased for effeminacy during childhood, being defensive about one's masculinity, not trusting men, having been cheated on by boyfriends, and believing that long-term gay male relationships are problematic. ^ It is concluded that the continuing epidemic of HIV infections among local gay men, as well as the hypermasculine form of the gay sexual subculture itself, are nihilistic symptoms embedded in the masculinist gender structure of the larger society. ^

Graduate program culture and intention to persist: Working adults in cohort and non-cohort programs

Cohort programs have been instituted at many universities to accommodate the growing number of mature adult graduate students who pursue degrees while maintaining multiple commitments such as work and family. While it is estimated that as many as 40–60% of students who begin graduate study fail to complete degrees, it is thought that attrition may be even higher for this population of students. Yet, little is known about the impact of cohorts on the learning environment and whether cohort programs affect graduate student retention. Retention theory stresses the importance of the academic department, quality of faculty-student relationships and student involvement in the life of the academic community as critical determinants in students' decisions to persist to degree completion. However, students who are employed full-time typically spend little time on campus engaged in the learning environment. Using academic and social integration theory, this study examined the experiences of working adult graduate students enrolled in cohort (CEP) and non-cohort (non-CEP) programs and the influence of these experiences on intention to persist. The Graduate Program Context Questionnaire was administered to graduate students (N = 310) to examine measures of academic and social integration and intention to persist. Sample t tests and ANOVAs were conducted to determine whether differences in perceptions could be identified between cohort and non-cohort students. Multiple linear regression was used to identify variables that predict students' intention to persist. While there were many similarities, significant differences were found between CEP and non-CEP student groups on two measures. CEP students rated peer-student relationships higher and scored higher on the intention to persist measure than non-CEP students. The psychological integration measure, however, was the strongest predictor of intention to persist for both the CEP and non-CEP groups. This study supports the research literature which suggests that CEP programs encourage the development of peer-student relationships and promote students' commitment to persistence.

Environment, culture, and medicinal plant knowledge in an indigenous Amazonian community

Diminishing cultural and biological diversity is a current global crisis. Tropical forests and indigenous peoples are adversely affected by social and environmental changes caused by global political and economic systems. The purpose of this thesis was to investigate environmental and livelihood challenges as well as medicinal plant knowledge in a Yagua village in the Peruvian Amazon. Indigenous peoples’ relationships with the environment is an important topic in environmental anthropology, and traditional botanical knowledge is an integral component of ethnobotany. Political ecology provides a useful theoretical perspective for understanding the economic and political dimensions of environmental and social conditions. This research utilized a variety of ethnographic, ethnobotanical, and community-involved methods. Findings include data and analyses about the community’s culture, subsistence and natural resource needs, organizations and institutions, and medicinal plant use. The conclusion discusses the case study in terms of the disciplinary framework and offers suggestions for research and application.

Tocqueville in Miami: Political culture and political organizing in Miami's Cuban community

This study examines the effectiveness of civic organizations focusing on leadership and the role of culture in politics. The study is based on a quasi-experimental research design and relies primarily on qualitative data. The study focuses on Miami's Cuban community in order to examine the role of public initiative in grassroots civic and community organizations. ^ The Miami Cuban community is a large, institutionally complex and cohesive ethnic community with dense networks of community organizations. The political and economic success of the community makes it an opportune setting for a study of civic organizing. The sheer number of civic organizations to be found in Miami's Cuban community suggests that the community's civic organizations have something to do with the considerable vibrancy and civic capacity of the community. How have the organizations managed to be so successful over so many years and what can be learned about successful civic organizing from their experience?^ Civic organizations in Miami's Cuban community are overwhelmingly ethnic-based organizations. The organizations recreate collective symbols that come from community members' memories of and attachments to the place of origin they hold dear as ethnic Cubans. They recreate a collective Cuban past that community members remember and that is the very basis of the community to which they belong.^ Cuban Miami's ethnically based civic organizations have generally performed better than the literature on civic organizations says they should. They gained greater access to community ties and social capital, and they exhibited greater organizational longevity. The fit between the political culture of civic organizations and that of the broader political community helps to explain this success. Yet they do not perform in the same way or in support of the same social purposes. Some stress individual agency rather than community agency, and some pursue an externally-oriented social purpose, whereas others focus on building an internal community.^