Managing Cultural Diversity in Healthcare Partnerships: The Case of LIFT

Purpose: The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. Design/methodology/approach: The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Findings: Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. Research limitations/implications: As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care. Originality/value: To the authors' knowledge this is the first study of the role of culture in mediating LIFT partnerships and the findings add to the evidence on public-private partnerships in the NHS

Cognitive Adaptation to the Experience of Social and Cultural Diversity

Diversity is a defining characteristic of modern society, yet there remains considerable debate over the benefits that it brings. The authors argue that positive psychological and behavioral outcomes will be observed only when social and cultural diversity is experienced in a way that challenges stereotypical expectations and that when this precondition is met, the experience has cognitive consequences that resonate across multiple domains. A model, rooted in social categorization theory and research, outlines the preconditions and processes through which people cognitively adapt to the experience of social and cultural diversity and the resulting cross-domain benefits that this brings. Evidence is drawn from a range of literatures to support this model, including work on biculturalism, minority influence, cognitive development, stereotype threat, work group productivity, creativity, and political ideology. The authors bring together a range of differing diversity experiences and explicitly draw parallels between programs of research that have focused on both perceiving others who are multicultural and being multicultural oneself. The findings from this integrative review suggest that experiencing diversity that challenges expectations may not only encourage greater tolerance but also have benefits beyond intergroup relations to varied aspects of psychological functioning.

Explaining the relationship between ingroup identification and intergroup bias following recategorization: A self-regulation theory analysis

We tested the hypothesis that regulation of discrepancies between perceived actual and ideal differentiation between the ingroup and outgroup could help to explain the relationship between ingroup identification and intergroup bias when participants are recategorized into a superordinate group. Replicating previous findings, we found that following recategorization, identification was positively related to intergroup bias. No such differences emerged in a control condition. However, we also, in the recategorization condition only, observed a positive association between ingroup identification and the perceived discrepancy between actual and ideal degree of differentiation from the outgroup: at higher levels of identification, participants increasingly perceived the ingroup to be less differentiated from the outgroup than they would ideally like. This tendency mediated the relationship between identification and bias. We discuss the theoretical, methodological and practical implications of these findings.

The Cultural Heritage of Pilgrim Itineraries: The Camino de Santiago

The Camino de Santiago comprises a lattice of European pilgrimage itineraries which converge at Santiago de Compostela in north-west Spain. This Working Paper introduces the historical and contemporary representation of these routes as a heritage complex that is imagined and codified within varied cultural meanings of a journey undertaken. Particular attention is given to the Camino Frances and the Via de la Platawhich contrast as mature and formative pilgrimage settings. Within this spatial sphere, the analysis deals with the Camino de Santiago as official heritage, as development instrument, as civil society, and as personal experience. The paper concludes by critically reviewing a previous conceptualisation of pilgrim route-based tourism, derived from fieldwork completed in 1994. Some substantive additions to that model are then advanced which arguably fit better with the many context changes that have occurred over the past two decades.

A Case Study in Policy Delivery:Examining Social Inclusion through Interpretation and Practice

The current body of literature regarding social inclusion and the arts tends to focus
on two areas: the lack of clear or common understanding of the terminology involved
(GLLAM, 2000) and the difficulty in measuring impact (Newman 2001). Further, much
of the literature traces the historical evolution of social inclusion policy within the arts
from a political and social perspective (Belfiore & Bennett, 2007), whilst others
examine the situation in the context of the museum as an institution more generally
(Sandell, 2002b). Such studies are essential; however they only touch on the
importance of understanding the context of social inclusion programmes. As each
individual’s experience of exclusion (or inclusion) is argued to be different (Newman
et al., 2005) and any experience is also process-based (SEU 2001), there is a need
for more thorough examination of the processes underpinning project delivery
(Butterfoss, 2006), particularly within a field that has its own issues of exclusion, such
as the arts (Bourdieu & Darbel, 1991). This paper presents case study findings of a
programme of contemporary arts participation for adults with learning difficulties
based at an arts centre in Liverpool. By focusing on practice, the paper applies
Wenger’s (1998) social theory of learning in order to assert that rather than search
for measurable impacts, examining the delivery of programmes within their individual
contexts will provide the basis for a more reflective practice and thus more effective
policy making.

Cultural and Genetic Influences on the “Biological Standard of Living”

This study suggests an improvement of a popular measure of living standards, namely the biological standard of living. One influence on it is a population's consumption pattern. Since there are different dietary patterns all over the world, researchers estimate the influences of national diets on final average male height. These habits are predominantly related to income, but also to genetics, cultural history, and decisions regarding whether to trade or consume high-quality foodstuffs. Systematic differences are found when analyzing protein-consumption habits among 51 countries between the 1960s and the 1980s. The author calculates metric correction values which can facilitate international comparisons of male average height. While the proposed correction values make a little difference on average, they can be valuable in a comparison of countries with markedly different dietary patterns.

The Cultural Heritage of Pilgrim Itineraries: The Camino de Santiago

The Camino de Santiago comprises a lattice of European pilgrimage itineraries that converge at Santiago de Compostela in northwest Spain. This article introduces the historical and contemporary representation of these routes as a heritage complex that is imagined and codified within varied cultural meanings of a journey undertaken. Particular attention is given to the Camino Frances and the Via de la Plata, which contrast as mature and formative pilgrimage settings. Within this spatial sphere, the analysis deals with the Camino de Santiago as official heritage, as development instrument, as civil society, and as personal experience. The article concludes by offering a contemporary conceptualization of the evolving Camino de Santiago cultural heritage complex.

Challenges of a Developmental Idea towards Sustainability

This paper attempts to situate and deconstruct the meanings associated with the term development in the context of the developing world. The arguments made highlights the deeply contested and fragmented terrain of development. The paper provides a historical overview of the changing nature of discourses on development, how the imageries of development have shifted since the postwar period. It deploys diverse meanings associated with development as a concept and as a theory. Thus development without dignity means little for those living in the margins of the society. At the same time the language of development has undergone revolutions and convulsions and the role of buzzwords and catch phrases have only helped to prolong misery in a neoliberal world. Development has become a 'one size fits all' concept shorn of cultural and regional specificities. It has been decontextualised and dehumanised to relate to targets
resulting in greater dissonance than resolution of aim and outcomes. The way forward is a better appreciation of the cultural capacity of the social groups for whom development is critical for survival. The conclusion highlights the endemic contradictions inherent in the meaning and delivery of development as a goal, especially when we seek to achieve resilient and sustainable development.

Keywords: Development, Neoliberalism, growth, participation, empowerment,
efficiency, market, state, societies, entitlements and capabilities, stakeholder, rights, structural adjustments, globalisation, self-help, doing development, freedom and
unfreedom.

Gender, religion, and sociopolitical issues in cross-cultural online education

Cross-cultural education is thought to develop critical consciousness of how unequal distributions of power and privilege affect people’s health. Learners in different sociopolitical settings can join together in developing critical consciousness – awareness of power and privilege dynamics in society – by means of communication technology. The aim of this research was to define strengths and limitations of existing cross-cultural discussions in generating critical consciousness. The setting was the FAIMER international fellowship program for mid-career interdisciplinary health faculty, whose goal is to foster global advancement of health professions education. Fellows take part in participant-led, online, written, task-focused discussions on topics like professionalism, community health, and leadership. We reflexively identified text that brought sociopolitical topics into the online environment during the years 2011 and 2012 and used a discourse analysis toolset to make our content analysis relevant to critical consciousness. While references to participants’ cultures and backgrounds were infrequent, narratives of political-, gender-, religion-, and other culture-related topics did emerge. When participants gave accounts of their experiences and exchanged cross-cultural stories, they were more likely to develop ad hoc networks to support one another in facing those issues than explore issues relating to the development of critical consciousness. We suggest that cross-cultural discussions need to be facilitated actively to transform learners’ frames of reference, create critical consciousness, and develop cultural competence. Further research is needed into how to provide a safe environment for such learning and provide faculty development for the skills needed to facilitate these exchanges.

The working practices of Birmingham's Centre for Contemporary Cultural Studies

This article offers a history of the working practices of the Birmingham Centre for Contemporary Cultural Studies. Based on extensive interviews with former members and on research into a new archive of the Centre, housed in the Cadbury Research Library, University of Birmingham, it argues that cultural studies as practised in the 1970s was always a heterogeneous subject. The CCCS was heavily influenced by the events of 1968 when it tried to develop a new type of radical and collaborative research and teaching agenda. Despite Stuart Hall's efforts to impose a focused link between politics and academic practice, the agenda soon gave way to a series of diverse and fruitful initiatives associated with the ‘sub-groups’ model of research.

Historical Dialogue and Memory in Organisational Transition: the case of the Police in Northern Ireland

During Northern Ireland’s transition towards peace the role of the police as an actor in the conflict has been a key point of contention. As such, the reform of policing has been central to conflict transformation. Within this process, the role of dialogue about what policing had been and could be in the future has been vital. Such institutional post violence change processes have been hugely significant in illustrating both organisational resistance to change and the need for transitions to be powerfully manoeuvred through complex, political, organisational and cultural processes (Buchanan and Badham 1999; Pettigrew 2012). The radical and reforming nature of policing transition (Murphy 2013) has been both organisationally challenging (requiring significant transformational leadership, resourcing and external engagement from wider civic society) and politically unusual. Indeed, in a society emerging from violence the NI police are the only public sector organisation to have engaged structurally and culturally in understanding the point at which their core roles intersected with the ‘management’ of the conflict in NI generally. This paper presents an analysis of the role of historical dialogue in organisational change process, using the RUC / PSNI case. It proposes that historical dialogue is not just an external, societal process but also an internal organisational process and as such, has implications for managing institutional change in societies emerging from conflict. In doing so, it builds theoretical links between literature on conflict transformation and that on organisational memory and empirically explores messaging internal to the RUC before and during the four main periods of organisational change (Murphy 2013), with dialogue aimed at an external audience. It offers an analysis of how historical dialogue itself impacts on and is impacted by the organisational realities of change itself.