Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

BACKGROUND: As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. METHODS: A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. RESULTS: Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p < 0.005), and significantly higher proportion of "good/very good" responses for 4/9 items. After adjusting for explanatory variables, physicians remained more likely to have higher skillfulness (β = 0.13, p = 0.05). Among all, higher skillfulness was associated with perception/awareness of problems in the following areas: inadequate cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p < 0.005) was negatively correlated with skillfulness. CONCLUSIONS: Overall, there is much room for cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.

Cultural transmission can inhibit the evolution of altruistic helping.

The study of culturally inherited traits has led to the suggestion that the evolution of helping behaviors is more likely with cultural transmission than without. Here we evaluate this idea through a comparative analysis of selection on helping under both genetic and cultural inheritance. We develop two simple models for the evolution of helping through cultural group selection: one in which selection on the trait depends solely on Darwinian fitness effects and one in which selection is driven by nonreproductive factors, specifically imitation of strategies achieving higher payoffs. We show that when cultural variants affect Darwinian fitness, the selection pressure on helping can be markedly increased relative to that under genetic transmission. By contrast, when variants are driven by nonreproductive factors, the selection pressure on helping may be reduced relative to that under genetic inheritance. This occurs because, unlike biological offspring, the spread of cultural variants from one group to another through imitation does not reduce the number of these variants in the source group. As a consequence, there is increased within-group competition associated with traits increasing group productivity, which reduces the benefits of helping. In these cases, selection for harming behavior (decreasing the payoff to neighbors) may occur rather than selection for helping.

Accesibilidad y conservación del patrimonio cultural: Aproximación y encuentro

Conceptualització multidisciplinar de la trobada Accessibilitat-Patrimoni, de manera que s'acordi un llenguatge comú en termes d'accessibilitat i de conservació del Patrimoni entre tots els membres del consorci, així com un coneixement exhaustiu de la situació de l'accessibilitat a Espanya en relació amb els diferents àmbits d'actuació abastats en el projecte, des de la demanda potencial d'usuaris, magnitud, tipus i estat del Patrimoni Cultural, als instruments d'anàlisis i intervenció utilitzables.

La Accesibilidad en los Bienes de Interés cultural: situación y necesidades

Anàlisi normativa d'àmbit europeu, nacional, autonòmic i municipal existent sobre Accessibilitat en l'edificació, Accessibilitat al patrimoni i Protecció de Béns Culturals i Patrimoni Històric. Identificació dels conflictes d'aplicació entre les normatives d'accessibilitat i la conservació del patrimoni històric

Adapting dating violence prevention to francophone Switzerland: a story of intra-western cultural differences.

Dating violence prevention programs, which originated in the United States, are beginning to be implemented elsewhere. This article presents the first adaptation of a violence prevention program for a European culture, Francophone Switzerland. A U.S. dating violence prevention program, Safe Dates (Foshee & Langwick, 1994), was reviewed in 19 youth and 4 professional focus groups. The most fundamental program concepts--"dating" and "violence"--are not the same in Switzerland and the United States. Swiss youth were not very focused on establishing monogamous romantic relationships, and there is no ready translation for "dating." Violence has not become the focus of a social movement in Switzerland to the same extent that it has in the United States, and distinctions among terms such as "dating violence" and "domestic violence" are not well known. Psychoeducational approaches are also less common in the Swiss context. As the movement to prevent violence extends worldwide, these issues need greater consideration.

Cultural leaders and the clash of civilizations

This article builds a micro founded model of the clash of cultures. The clash is defined as the parent's fear of a trait change by their child in an overlapping generations model with intergenerational transmission of cultural traits. The extent of the clash is manipulated by cultural leaders who benefit from the cultural education effort by parents. We identify three channels through which the leaders can affect the clash of cultures: (i) by providing beneficial cultural values, (ii) by claims of cultural superiority and (iii) by cultural alienation, i.e. by inducing cultural dislike towards their own group. We show that all three channels can be in the leader's interest but channels (ii) and (iii) reduce the utility of the leader's goup members. This hints to a strong conflict of interest within groups - between the population at large and the benefactors of radicalization. We further show how the use of alienation relates to the economic opportunities available to a group.

Cirugía del Bien Cultural. Técnicas de Rehabilitación/Refuerzos para edificios históricos del Patrimonio Cultura (E2.26)

La vulnerabilitat dels vells edificis històrics de maçoneria, a causa del dany desproporcionat fora del plànol de càrrega (causat pel vent, explosions, inundacions o moviments sísmics és un dels greus problemes que enfronten avui dia els enginyers estructurals En l'actualitat s'han desenvolupat diverses tècniques innovadores de rehabilitació d'edificis històrics. L'eficàcia de moltes d'elles ha estat provada tant en laboratoris o sota condicions de càrrega real, tals com moviments sísmics. La qualitat i tipus dels materials de maçoneria i el disseny estructural són criteris fonamentals en l'elecció del mètode de reforç. En aques document es presenten les tècniques més utilitzades en la rehabilitació tradicional i les tècniques modernes i innovadores de rehabilitació utilitzant composites avançats

La Accesibilidad en el Patrimonio Cultural: Necesidades funcionales, barreras y análisis de la intervención

Com part de l'Estat de l'Art que aborda aquest primer subprojecte de PATRAC es continua en aquest segon lliurable amb una major concreció sobre els condicionaments funcionals de la població a l'hora d'accedir a edificacions i espais del patrimoni. Atès que PATRAC pretén desenvolupar solucions i alternatives als problemes concrets d'accessibilitat en el patrimoni, hem considerat necessari aprofundir en el coneixement de les limitacions funcionals humanes i les condicions concretes dels entorns que determinen l'existència de barreres. Aquestes anàlisis s'acompanyen de recomanacions per a facilitar l'accés de persones amb diferents perfils funcionals als entorns i serveis públics, tals com els quals es presten en monuments del patrimoni històric-cultural. Finalment el document revisa les formes d'intervenció habituals de les empreses i especialistes en el camp de l'auditoria d'accessibilitat i en la restauració del patrimoni a l'efecte de buscar fórmules de coordinació per a una millora de resultats des del punt de vista d'incrementar l'accessibilitat per a tot tipus de persones.

Dimensionality of drinking consequences - cross-cultural comparability and stability over time

Despite the long tradition for asking about the negative social and health consequences of alcohol consumption in surveys, little is known about the dimensionality of these consequences. Analysing cross-sectional and longitudinal data from the Nordic Taxation Study collected for Sweden, Finland, and Denmark in two waves in 2003 and 2004 by means of an explorative principal component analysis for categorical data (CATPCA), it is tested whether consequences have a single underlying dimension across cultures. It further tests the reliability, replicability, concurrent and predictive validity of the consequence scales. A one-dimensional solution was commonly preferable. Whereas the two-dimensional solution was unable to distinguish clearly between different concepts of consequences, the one-dimensional solution resulted in interpretable, generally very stable scales within countries across different samples and time.

Hezbollah's identities and their relevance for cultural and religious IR

This working paper analyses the role of religious and resistance identities in Hezbollah’s transformation and foreign relations. It argues that this Islamist movement has privileged material concerns over the religious dogma when both factors have not been coincidental. To do so, it uses a theoretical framework that presents the main characteristics of the anthropological and political interpretations of the role of culture and religion in defining the behaviour of international actors. In the chapter dedicated to Hezbollah, close attention is paid to the domestic and regional levels of analysis. When assessing Hezbollah’s religious identity, this paper argues that the salience of the pan-Islamic religious identity in Hezbollah’s origins has been replaced by an increased political pragmatism. It also argues that the fight against Israel represents Hezbollah’s raison d’être and that its resistance identity has not suffered major transformations and has been easily combined with religious rhetoric. Linking Hezbollah’s case study with the theoretical framework, this paper argues that political conceptions of cultural and religious identities provide the best analytical tool to understand the evolution of this Islamist movement.