988 resultados para Cultural evolution


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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.

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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.

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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

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Adaptació de habitatge al Regne Unit. Ponència presentada al "2º Espacio de Encuentro Rehabilitación y Adaptación Funcional de la Vivienda" (Sant Sebastià, 2 Juny 2010)

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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.

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The aim of this paper is to verify, for the Spanish case, whether between 1977 and 2008 has increased the internal democracy of the major political parties (PSOE, AP / PP, PCE / IU, PNV and CDC). To do this, we will focus on their leadership selection processes, one of the key elements associated with intra-party democracy. The paper is going to introduce data on four different dimensions of leadership selection: the certification process, the voting procedure, the inclusiveness of the selectorate and, finally, the degree of competitiveness. The results will show that have been few changes in the leadership selection processes of the Spanish political parties since 1977. However, the results of the Spanish case will also be used to suggest some preliminary links between the four dimensions.

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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.

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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

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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.

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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.

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Purpose: to describe a case of probable bilateral diffuse uveal melanocytic proliferation (BDUMP) with scleral involvement, free from systemic malignancies and cataract. Methods: fifty months of follow up with recurrent complete ophthalmological examinations, including fundus photography, fluorescein/indocyanine green angiography (FA) and optical coherence tomography (OCT). Investigations also included an electroretinography (ERG) and histological examination of scleral biopsy. Extraocular malignancies were repeatedly searched. Results: the patient was a 61 year-old Italian man with chronic hepatitis type C. At first visit his best corrected visual acuity (BCVA) was 20/32 in OS and 20/25 in OD. Funduscopy showed multiple patch-shaped pigmented alterations involving macular region and mid retinal periphery. FA showed corresponding areas of late-phase hyperfluorescent pinpoints (figure 1a, OS) and intemediate-phase hypocyanescence (figure 1b, OS), with subtle serous neurosensory retinal detachment confirmed by OCT. Photopic and scotopic ERG tested normal. Systemic prednisone was administered for one month without any improvement. After ten months round pigmentary lesions appeared also in superior scleral surface of both eyes. Biopsy allowed to disclose slightly pigmented spindle cells. BCVA worsened for further 10 months, with enlargement of FA alteration areas but lenses still clear. After 30 months spontaneous coalescence and atrophy of retinal lesions started, paralleled by progressive visual recovery. At the end of our follow up BCVA was 20/25 in OU while scleral pigmentary lesions remained unchanged. Conclusions: we report the case of a patient with main features of BDUMP and some unusual findings. Although not all classical diagnostic criteria were fulfilled, the presence of scleral pigmented lesions and spontaneous visual recovery may enlarge clinical spectrum of the disease.