Understanding the mental health of refugees: Trauma, stress, and the cultural context

Long considered important for professionals working with minority and under-represented populations, cross-cultural competency has become a requisite for all health care providers. As society in the US increasingly diversifies, there is a crucial need to prepare health care professionals to effectively treat this changing population. The Massachusetts General Hospital Textbook on Diversity and Cultural Sensitivity in Mental Health addresses the importance and relevance of cultural sensitivity in US mental health. Prominent researchers and clinicians examine the cultural and cross-cultural mental health issues of Native American, Latino, Asian, African American, Middle Eastern, Refugee and LGBQT communities. The discussion includes understanding the complexities in making mental health diagnoses and the various meanings it has for the socio-cultural group described, as well as biopsychosocial treatment options and challenges. In understanding the specific populations, the analysis delves into overarching concepts that may apply to specific populations and to those at the intersection of multiple cultures. An invaluable resource for mental health professionals, including clinicians, researchers, educators, leaders and advocates in the United States, The Massachusetts General Hospital Textbook on Diversity and Cultural Sensitivity in Mental Health provides the necessary understanding and insights for research and clinical practice in specific cultural and multicultural groups.

The reach and rationale for community health fairs

Latinos living in the USA account for one third of the uninsured population and face numerous cultural, linguistic, and financial barriers to accessing healthcare services. Community health fairs have developed to address the unmet need for no- and low-cost services that target prevention and education among underserved communities. The current research describes an ongoing effort in a community in Southern California and examines the barriers to health care among participants registering to receive free breast health screenings, one of the major services offered at a 2010 health fair. A total of 186 adult Latina women completed a brief questionnaire assessing their healthcare utilization and self-reported barriers to engaging in preventive and screening services. Approximately two thirds of the participants reported never receiving or having more than 2 years passing since receiving a preventive health check-up. Participants identified cost (64.5 %) and knowledge of locations for services (52.3 %) as the primary barriers to engaging in routine healthcare services. Engaging with health professionals represents a leading way in which adults obtain health information; health fairs offering cancer health screenings represent a culturally appropriate venue for increased cancer health equity. Implications of the current research for future health fairs and their role in community cancer education are discussed.

Health and prevention among East African women in the U.S.

African-born individuals in the U.S. face significant health challenges, including low utilization of preventive screening services. Using a community-based participatory research framework, we describe preliminary efforts at establishing a collaborative relationship with the East African communities of San Diego, identifying salient community health needs, and developing a framework for disseminating information and addressing identified health gaps. To this end, 40 East African-born women participated in focus groups with the purpose of eliciting community perspectives on U.S. health care services, beliefs about preventive screening, and to garner recommendations for future outreach. Qualitative analyses identified participants’ desire to engage in primary prevention techniques that incorporated best practices from their home countries and the U.S., and the need for health education programs to provide information on increasingly prevalent chronic diseases. The findings are discussed in connection with continued community-engaged efforts and the implications for health and resettlement policies to reduce inequities disfavoring resettled refugees.

Characterizing fatigue: The effects of ethnicity and acculturation

It is unknown if fatigue measures like the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF; Stein, Jacobsen, Blanchard, & Thors, 2004) appropriately describe fatigue in Hispanics or if acculturation plays a role in fatigue. This study compared fatigue in community samples of Hispanics and Anglos. The MFSI-SF and pertinent questionnaires were administered to adults in San Diego County via telephone survey. Some differences in fatigue were observed in initial comparisons between Hispanics and Anglos, including when acculturation was considered. When age and education were controlled, Hispanics reported less general fatigue than Anglos, regardless of acculturation status, p = < .01. Exploratory factor analyses indicate that the MFSI-SF general-fatigue subscale was problematic for Hispanics. Implications, limitations, and future directions are discussed.

Cultural adaptation and resilience: Controversies, issues and emerging models

What enables people to bounce back from stressful experiences? How do certain individuals maintain a sense of purpose and direction over the long term, even in the face of adversity? This is the first book to move beyond childhood and adolescence to explore resilience across the lifespan. Coverage ranges from genetic and physiological factors through personal, family, organizational, and community processes. Contributors examine how resilience contributes to health and well-being across the adult life cycle; why—and what happens when—resilience processes fail; ethnic and cultural dimensions of resilience; and ways to enhance adult resilience, including reviews of exemplary programs.

Support services for higher degree research students: A survey of three Australian universities

A survey was conducted across three Australian universities to identify the types and format of support services available for higher degree research (HDR, or MA and Ph.D.) students. The services were classified with regards to availability, location and accessibility. A comparative tool was developed to help institutions categorise their services in terms of academic, administrative, social and settlement, language and miscellaneous (other) supports. All three universities showed similarities in the type of academic support services offered, while differing in social and settlement and language support services in terms of the location and the level of accessibility of these services. The study also examined the specific support services available for culturally and linguistically diverse (CALD) students. The three universities differed in their emphases in catering to CALD needs, with their allocation of resources reflecting these differences. The organisation of these services within the universities was further assessed to determine possible factors that may influence the effective delivery of these services, by considering HDR and CALD student specific issues. The findings and tools developed by this study may be useful to HDR supervisors and university administrators in identifying key support services to better improve outcomes for the HDR students and universities.

Social Influence and Blood Donation: Cultural Differences Between Scotland and Australia

People can be motivated to carryout behaviours which contribute to improvement of quality of life for reasons driven by cultural norms. There is a common perception that people within a cultural cluster, particularly one with a common language such as English, will exhibit similar consumer behaviours. However there is an emerging field of research investigating intra-cultural differences in marketing that challenges this perception. In particular, the role of peers and norms as drivers of altruistic behaviours that benefit society may differ between these countries. Altruism is an important motivation for pro-social behaviours such as blood donation, water conservation and peer counselling for health problems. Understanding the social influences for these behaviours assists marketers to develop programs that meet the needs of donors and potential donors. An ongoing foundation of altruistic consumers is essential for delivering services that improve quality of life for people. Without blood donors, there would be no blood products for cancer sufferers or accident victims, without a sufficient water supply the quality of life for residents would be compromised and without breastfeeding peer counselling, new mothers and their babies would have reduced quality of life. This chapter reports the findings of two online surveys with Scottish and Australian blood donors and demonstrates differences in the way social norms influence donation behaviour, and importantly different impacts of cultural factors in the two populations.

Lähiympäristö nepalilaisessa arjessa - oppilaiden ja opettajien käsityksiä omista vaikutusmahdollisuuksistaan

Aims. Sustainable development has become the most important theme in the development co-operation in the 21st century. Sustainable development is pursued by environmental education among other things. This research rose from the discussion about the meaning of environmental education in developing countries and especially the effect it might have in the environment and society. Nepal and one of its rural private schools was selected as a research object. The themes and questions of the research are: 1. Conceptions of the immediate environment of students and teachers: What does immediate environment mean according to the students and teachers? 2. Students most important acts in the environment: What kind of effect do the students think they can have on the environment in their everyday life? 3. Teachers opinions, experiences and methods in environmental education: What do teachers think should be taught to the students in environmental education? What are the teachers actually teaching? What kind of methods are the teachers using while teaching environmental education? Researching the conceptions of immediate environment and acts in the environment gives information about the students and teachers relation with the nature in their everyday life and the baseline from which environmental education will be implemented from. Teachers opinions, experiences and methods in environmental education provide information on the current implementation of the environmental education. Methods. Ethnography was selected as a research method. Before collecting the actual data, a pre-study was conducted. The aim of the pre-study was to specify the research themes and practice the cross-cultural interview as a research method. The actual data was collected in the last week of January 2010 in Dhangadhi, Nepal. The data included twenty-two drawings and captions from the students and one group interview with the teachers. The data was analyzed with brief quantitative analysis and full analysis was done with a qualitative method called content analysis. Results and conclusions. Teachers and student s conceptions of immediate environment differ from each other. Students saw the immediate environment from the scientific approach while the teachers thought it was more social conception. The interface was found in their own personal environment. This interface is a good baseline for environmental education. The most important acts in the environment for the students were protection towards the environment. The students saw their possibilities to have an influence in the environment through the school. A connection between the school and acting in the environment was evident. In the teachers opinions and experiences of environmental education, environmental problems and the importance of teaching attitudes and values were found. No logic thematic entities were discovered but the teachers did use different kinds of methods in their teaching. Achieving the international aims for environmental education was very challenging in the research school because of the teachers lack of information and skills to teach the subject. The context where the school works was also challenging.

A noticeboard in "both worlds" unsurprising interfaces supporting easy bi-cultural content publication

We describe the design of a digital noticeboard to support communication within a remote Aboriginal community whose aspiration is to live in "both worlds", nurturing and extending their Aboriginal culture and actively participating in Western society and economy. Three bi-cultural aspects have emerged and are presented here: the need for a bi-lingual noticeboard to span both oral and written language traditions, the tension between perfunctory information exchange and social, embodied protocols of telling in person and the different ways in which time is represented in both cultures. The design approach, developed iteratively through consultation, demonstration and testing led to an "unsurprising interface", aimed at maximizing use and appropriation across cultures by unifying visual, text and spoken contents in both passive and interactive displays in a modeless manner.

Gender and National Identity Constructions in the Cross-Border Merger Context

In this article we explore ways in which vertical gender inequality is accomplished in discourse in the context of a recent chain of cross-border mergers and acquisitions that resulted in the formation of a multinational Nordic company. We analyse social interactions of ‘doing’ gender in interviews with male senior executives from Denmark, Finland and Sweden. We argue that their explanations for the absence of women in the top echelons of the company serve to distance vertical gender inequality. The main contribution of the article is an analysis of how national identities are discursively (re)constructed in such distancing. New insights are offered to studying gender in multinationals with a cross-cultural team of researchers. Our study sheds light on how gender intersects with nationality in shaping the multinational organization and the identities of male executives in globalizing business.

Finnish-French Fundamental Cultural Antagonisms in Organising

Seeking to challenge the belief that within-West cultural differences should be seen as insignificant in organisations, this paper seeks to demonstrate how two given Western European ‘organising cultures’ (i.e. Finnish culture and French culture, as they are expressed in the process of organising) can contrast, if not conflict, with each other. Further, it aims to help the reader realise what kinds of fundamental ‘cultural antagonisms’ these contrasting organising behaviours may come from, to help her/him understand ‘the other culture’ better, and thus allow for a first step towards an improvement of Finnish-French intercultural interactions in organisational contexts. After shortly introducing what should be understood here as ‘cultural antagonisms’, the paper addresses four fundamental Finnish-French antagonisms, regarding the vision of the organisation (‘functionalist vs. personalist’), the relative importance of ‘consensus vs. dissensus’, the typical trade-off between reliability and flexibility, and the striking differences in communication, respectively. These four fundamental antagonisms are found to be closely interrelated and integrated, serving as explanation, justification and legitimisation for each other. That does not mean, however, that differences, however striking they may be, should merely be a threat to co-operation: some implications introduced at the end of the paper suggest that, provided people are aware of them, cultural antagonisms can also be seen as opportunities for a more fruitful work interaction.

Factors affecting perceptions of corporate social responsibility implementation: an emphasis on values

This dissertation is a broad study of factors affecting perceptions of CSR issues in multiple stakeholder realms, the main purpose being to determine the effects of the values of individuals on their perceptions regarding CSR. It examines perceptions of CSR both at the emic (observing individuals and stakeholders) and etic levels (conducting cross-cultural comparison) through a descriptive-empirical research strategy. The dissertation is based on quantitative interview data among Chinese, Finnish and US stakeholder groups of industry companies (with an emphasis on the forest industries) and consists of four published articles and two submitted manuscripts. Theoretically, this dissertation provides a valuable and unique philosophical and intellectual perspective on the contemporary study of CSR `The Harmony Approach to CSR'. Empirically, this dissertation does values assessment and CSR evaluation of a wide variety of business activities covering CSR reporting, business ethics, and three dimensions of CSR performance. From the multi-stakeholder perspective, this dissertation use survey methods to examine the perceptions and stakeholder salience in the context of CSR by describing, comparing the differences between demographic factors as well as hypothetical drivers behind perceptions. The results of study suggest that the CSR objective of a corporation's top management should be to manage the divergent and conflicting interests of multiple stakeholders, taking others than key stakeholders into account as well. The importance of values as a driver of ethical behaviour and decision-making has been generally recognized. This dissertation provides more empirical proof of this theory by highlighting the effects of values on CSR perceptions. It suggests that since the way to encourage responsible behaviour and develop CSR is to develop individual values and cultivate their virtues, it is time to invoke the critical role of moral (ethics) education. The specific studies of China and comparison between Finland and the US contribute to a common understanding of the emerging CSR issues, problems and opportunities for the future of sustainability. The similarities among these countries can enhance international cooperation, while the differences will open up opportunities and diversified solutions for CSR in local conditions.

Avaliação das habilidades de compreensão e expressão em criança com paralisia cerebral através do uso da comunicação alternativa: contribuições para uma Investigação Transcultural

A linguagem e a comunicação são certamente as aquisições mais notáveis e significativas no processo de evolução humana. A fala é apenas um das formas da linguagem, embora seja a mais empregada pelo ser humano. Cerca de uma em cada duzentas pessoas é incapaz de comunicar-se através da fala devido a problemas neurológicos, físicos, emocionais e cognitivos, como é o caso das pessoas com paralisia cerebral, autismo, deficiência intelectual e alterações cognitivas. Nestes casos, pode ser necessário o uso da comunicação alternativa. A Comunicação Alternativa é definida como qualquer forma de comunicação diferente da fala, como o uso gestos manuais, expressões faciais e corporais, símbolos gráficos, linguagem alfabética, voz digitalizada ou sintetizada dentre outros, e é utilizada em contextos de comunicação face a face. O objetivo do presente trabalho é descrever e analisar os padrões comunicativos de duas crianças de doze anos de idade, Tereza, com paralisia cerebral não oralizada que faz uso de sistema alternativo de comunicação, e Alicia, com desenvolvimento normal e que faz uso da fala (sujeito controle). Este estudo faz parte de um projeto transcultural cujo objetivo é descrever como ocorre a compreensão e a expressão de determinados tipos de enunciados gráficos em crianças e jovens de diferentes idades e em diferentes países que utilizam sistemas alternativos de comunicação, e como estes enunciados são compreendidos por seus parceiros - pais, professores e pares. O sistema de comunicação utilizado pela criança com paralisia cerebral consistia de fotografias e do sistema PCS (Picture Communication System), no formato de um livro de comunicação. Para a coleta de dados foram utilizados os seguintes instrumentos: entrevistas semi-estruturadas com os pais e professora de Tereza, Tereza e Alicia; avaliação do sistema de comunicação e da educação da criança realizada pelos pais e pela professora de Tereza; instrumentos normatizados de avaliação da inteligência, da linguagem receptiva, aplicados em ambas as participantes; instrumento aplicado em Tereza para avaliar suas habilidades motoras; tarefas comunicativas aplicadas às duas meninas (provas de compreensão e produção). Os dados revelaram maior competência e conhecimento da mãe quanto ao uso do sistema de comunicação alternativa, bem como no favorecimento do desenvolvimento da linguagem alternativa da criança especial. O envolvimento da professora quanto ao emprego da comunicação alternativa por Tereza em sala de aula foi limitado. Os dados também ressaltaram dificuldades na linguagem compreensiva e expressiva de Tereza que pareceram estar relacionadas à falta de vivência, ao reduzido uso da linguagem alternativa por parte dos interlocutores da criança, bem como à diferença entre as organizações sintáticas da linguagem gráfica e da linguagem oral. Os resultados revelaram portanto a dificuldade de Tereza nas tarefas comunicativas, mas também apontaram para a necessidade de um treinamento mais sistemático no uso desses sistemas direcionados a esses jovens especiais e seus interlocutores.

Tradução, adaptação cultural e validação do Nonarthritic Hip Score para o Brasil

A avaliação da qualidade de vida tem sido cada vez mais utilizada pelos profissionais da área de saúde para mensurar o impacto de doenças na vida dos pacientes, bem como para avaliar os resultados dos tratamentos realizados. O crescente interesse por protocolos de pesquisa clínica em doenças não degenerativas do quadril tem encontrado muitos obstáculos na avaliação objetiva de seus resultados, principalmente nos estudos de observação de novas intervenções terapêuticas, como a artroscopia. O Nonarthritic Hip Score (NAHS) é um instrumento de avaliação clínica, desenvolvido originalmente em inglês, cujo objetivo é avaliar a função da articulação do quadril em pacientes jovens e fisicamente ativos. O objetivo desse estudo foi traduzir esse instrumento para a língua portuguesa, adaptá-lo para a cultura brasileira e validá-lo para que possa ser utilizado na avaliação de qualidade de vida de pacientes brasileiros com dor no quadril, sem doença degenerativa. A metodologia utilizada é a sugerida por Guillemin et al. (1993) e revisado por Beaton et al. (2000), que propuseram um conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida, incluindo cinco etapas: tradução, tradução de volta, revisão pelo comitê, pré-teste e teste, com reavaliação dos pesos dos escores, se relevante. A versão de consenso foi aplicada em 30 indivíduos. As questões sobre atividades esportivas e tarefas domésticas foram modificadas, para melhor adaptação à cultura brasileira. A versão brasileira do Nonarthritic Hip Score (NAHS-Brasil) foi respondida por 64 pacientes com dor no quadril, a fim de avaliar as propriedades de medida do instrumento: reprodutibilidade, consistência interna e validade. A reprodutibilidade foi 0,9, mostrando uma forte correlação; a consistência interna mostrou correlação entre 0,8 e 0,9, considerada boa e excelente; a validade foi considerada respectivamente boa e excelente; a correlação entre NAHS-Brasil e WOMAC foi 0,9; e a correlação entre o NAHS-Brasil e Questionário Algofuncional de Lequesne foi 0,79. O Nonarthritic Hip Score foi traduzido para a língua portuguesa e adaptado à cultura brasileira, de acordo com o conjunto de instruções padronizadas para adaptação cultural de instrumentos de qualidade de vida. Sua reprodutibilidade, consistência interna e validade foram também demonstradas.