A qualitative study on the role of cultural background in patients perspectives on rehabilitation

Background Low back pain (LBP) is one of the major concerns in health care. In Switzerland, musculoskeletal problems represent the third largest illness group with 9.4 million consultations per year. The return to work rate is increased by an active treatment program and saves societal costs. However, results after rehabilitation are generally poorer in patients with a Southeast European cultural background than in other patients. This qualitative research about the rehabilitation of patients with LBP and a Southeast European cultural background, therefore, explores possible barriers to successful rehabilitation. Methods We used a triangulation of methods combining three qualitative methods of data collection: 13 semi-structured in-depth interviews with patients who have a Southeast European cultural background and live in Switzerland, five semi-structured in-depth interviews and two focus groups with health professionals, and a literature review. Between June and December 2008, we recruited participants at a Rehabilitation Centre in the German-speaking part of Switzerland. Results To cope with pain, patients prefer passive strategies, which are not in line with recommended coping strategies. Moreover, the families of patients tend to support passive behaviour and reduce the autonomy of patients. Health professionals and researchers propagate active strategies including activity in the presence of pain, yet patients do not consider psychological factors contributing to LBP. The views of physicians and health professionals are in line with research evidence demonstrating the importance of psychosocial factors for LBP. Treatment goals focusing on increasing daily activities and return to work are not well understood by patients partly due to communication problems, which is something that patients and health professionals are aware of. Additional barriers to returning to work are caused by poor job satisfaction and other work-related factors. Conclusions LBP rehabilitation can be improved by addressing the following points. Early management of LBP should be activity-centred instead of pain-centred. It is mandatory to implement return to work management early, including return to adapted work, to improve rehabilitation for patients. Rehabilitation has to start when patients have been off work for three months. Using interpreters more frequently would improve communication between health professionals and patients, and reduce misunderstandings about treatment procedures. Special emphasis must be put on the process of goal-formulation by spending more time with patients in order to identify barriers to goal attainment. Information on the return to work process should also include the financial aspects of unemployment and disability.

A case study examination of the influence of cultural diversity in the multicultural nursing workforce on the quality of care and patient safety in a Saudi Arabian hospital

The purpose of the study: The purpose of this study is to investigate the influence of cultural diversity, in a multicultural nursing workforce, on the quality and safety of patient care and the work environment at King Abdul-Aziz Medical City, Riyadh region. Study background: Due to global migration and workforce mobility, to varying degrees, cultural diversity exists in most health services around the world, particularly occurring where the health care workforce is multicultural or where the domestic population comprises minority groups from different cultures speaking different languages. Further complexities occur when countries have a multicultural workforce which is different from the population for whom they care, in addition to the workers being from culturally diverse countries and with different languages. In Saudi Arabia the health system is mainly staffed by expatriate nurses who comprise 67.7% of the total number of nurses. Study design: This research utilised a case study design which incorporated multiple methods including survey, qualitative interviews and document review. Methods: The participant nurses were selected for the survey via a population sampling strategy; 319 nurses returned their completed Safety Climate Survey questionnaires. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. For the qualitative component of the study, a purposive sampling strategy was used; 24 nurses were interviewed using a semi-structured interview technique. The documentary review included KAMC-R policy documents that met the inclusion criteria using a predetermined data abstraction instrument. Content analysis was used to analyse the policy documents data. Results: The data revealed the nurses‘ perceptions of the clinical climate in this multicultural environment is that it was unsafe, with a mean score of 3.9 out of 5. No significant difference was detected between the age groups or years of experience of the nurses and the perception of safety climate in this context; the study did reveal a statistically significant difference between the cultural background categories and the perception of safety climate. The qualitative phase indicated that the nurses within this environment were struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patients‘ cultural and spiritual needs as well as maintaining a high standard of care. The results also indicated that nurses were disempowered in this context. Importantly, there was inadequate support by the organisation to manage the cultural diversity issue and to protect patients from any associated risks, as demonstrated by the policy documents and supported by the nurses‘ experiences. The study also illustrated the limitations of the conceptual framework of cultural competence when tested in this multicultural workforce context. Therefore, this study generated amendments to the model that is suitable to be used in the context of a multicultural nursing workforce. Conclusion: The multicultural nature of this nursing work environment is inherently risky due to the conflicts that arise from the different cultural norms, beliefs, behaviours and languages. Further, there was uncertainty within the multicultural nursing workforce about the clinical and cultural safety of the patient care environment and about the cultural safety of the nursing workforce. The findings of the study contribute important new knowledge to the area of patient and nurse safety in a multicultural environment and contribute theoretical development to the field of cultural competence. Specifically, the findings will inform policy and practice related to patient care in the context of cultural diversity.

Approaches to learning accounting : a cross-cultural study

Purpose – The purpose of this study is to examine the relationship between the cultural background of students and their learning approaches in a first year undergraduate accounting program.

Design/methodology/approach – While prior research in this area has more generally focused on the investigation of the approaches to learning by accounting students, there appears to have been little investigation into the learning approaches of students from different cultures who are studying accounting together at the same institution. The paper presents the results of a study of 550 students enrolled in an undergraduate accounting program at a multi-campus university in Victoria, Australia, which used Biggs' study process questionnaire (SPQ) to assess the approaches to learning utilised by local and Chinese students.

Findings – The results showed that, while there were no significant differences in the use of surface and deep learning strategies by the Chinese and Australian students, there were significant differences in the learning motives of the two groups. Furthermore, the results contradict prior claims that Asian students rely principally on the memorisation and reproduction of factual information as a means of achieving academic success.

Originality/value – The study provides support for the notion that Chinese students may in fact have a culturally induced bias towards seeking understanding through deeper approaches to study.

Student characteristics and approaches to learning: a cross-cultural study

The principal aim of this study is to examine the relationship between the cultural background of students and their learning approaches in a tertiary accounting program. While prior research in this area has more generally focused on the investigation of the learning approaches of accounting students, there appears to have been little investigation into the learning approaches of students from different cultures who are studying together at the same institution. The paper presents the results of a study of 550 students enrolled in an undergraduate accounting program at a multi-campus Victorian university where learning approaches and cultural background variables were investigated together with other background variables such as gender and age.

The findings extend prior research on the impact cultural factors may have on the learning approaches of accounting students and also assists in clarifying the relationship between memorisation in the process of learning given the diverse ways that students from different cultures study accounting.

Understanding cross-cultural negotiation : A model integrating affective events theory and communication accommodation theory

Business interactions are increasingly crossing boundaries. Boundary crossing is a process of joining or parting people. Negotiation is the media of this process. This paper is an attempt to bridge the boundaries of strategic business negotiation, communication and emotion in a cross-cultural context. In particular, we argue that miscommunications are ‘boundary crossing mishaps’. Such mishaps are affected by negotiators’ understanding of the respective cultures of the parties, negotiation skill, affective cultural background of the parties, cultural differences, emotional awareness and regulation, negative affect and discrepancy in convergence divergence between the interactants. When too many of these hassles or mishaps occur, negotiation breaks down. In this way, it is the accumulation of many little things, many little misunderstandings, that break negotiation.

Effect of social background on the development of probabilistic concepts

This research explores how the social backgrounds of a group of students contributed to their intuitive knowledge in probabilistic reasoning, and influenced their processing of the associated mathematics. A group of Year 11 students who came from families for whom the phenomenon of track gambling formed an important part of their cultural background was identified. Another group consisting of students in the same mathematics course (Year 11 Maths in Society) but from families for whom the phenomenon of gambling in any form was totally absent from their social backgrounds was identified. Twenty students were selected from each group. The research employed a qualitative methodology in which a phenomenographic approach was used to investigate the qualitatively different ways in which individuals within the two groups thought about concepts involving probabilistic reasoning, and processed the related mathematical skills and concepts. The cognitive processes involved in the applications of probabilistic and related mathematical concepts in a variety of both gambling and non-gambling situations were studied in order to determine whether this culturally based knowledge could be viewed as a type of ‘ethnomathematics.’ Data were obtained through individual structured interviews which enabled patterns of reasoning to be compared and contrasted. Analyses of these data enabled intuitive mathematical understandings possessed by the gamblers not only to be identified, but also to be linked with their social backgrounds. Also differences between how individuals in the two groups processed probabilistic and associated mathematical knowledge were determined. This research complements and extends existing knowledge and theories related to culturally-based mathematical knowledge. Implications for further research, for classroom teaching, and for curriculum development in the study of probability in senior secondary mathematics classes are discussed.

Effect of personal and cultural diversity on outdoor thermal comfort perception

The urban squares are the gathering places where people interact with each other. Therefore, they are seen as important places contributing in the integration and social cohesion within societies. To ensure equality in urban places, designers are to take into considerations the need of the diverse nature of different users. This task is hard especially in global cities where populations are characterized by their cultural plurality. To ensure the creation of successful urban places, the designer is to take the comfort of users into consideration. However, the outdoor thermal comfort is not easily assessed as it examines the climatic and personal variables for users. This paper aims to contribute in assessing the thermal comfort for users of different personal and cultural background in Melbourne city, Australia as one of the global cities characterized by the diversity and plurality of its population due to migration. A case study approach is adopted to examine the users’ thermal comfort within the contextual variables of Federation Square. Multiple sources of evidence such as climate measurements, observations and questionnaires will be used to ensure the validity of results. The findings are to contribute in the quality and equality of design for outdoor urban places in multicultural cities.

Políticas Culturais e Gestão Cultural: a Secretaria Municipal da Cultura e do Turismo SEMUC (2005-2010) de Limoeiro do Norte-CE

The study analyzed regarding cultural policies developed in the city of North-EC Limoeiro by the Municipal Culture and Tourism (Semuc) in the period between the years 2005 and 2010. Period that marks the resumption of the figure of the State Ministry of Culture (MinC) as a major factor in formulating and implementing public policies in the area of culture in the country, especially with the creation of the National Culture System (CNS) and the preparation of National Culture Plan (NCP). The work was through research documents (laws) about what had legislated on culture in the city, the reports of consultation activities undertaken by Semuc and interviews with former managers, a former - employee and the Secretary of that folder. Thus, given the contemporary context where the culture is replaced by increasing visibility, the analysis undertaken on policies developed by cultural Semuc revealed the most diverse forms of action: investment in events (capture and promotion), the institution permanent cultural policies, cultural background, the appreciation of local culture, and specific actions

A SENSIBILIDADE CULTURAL DO ADVENTISMO COMO MODELO MISSIOLÓGICO EM GRANDES CENTROS URBANOS: UMA ANÁLISE DE IGREJAS ADVENTISTAS ÉTNICAS NA CIDADE DE SÃO PAULO

Esta pesquisa objetiva analisar o desenvolvimento da missão adventista na cidade de São Paulo em busca de um modelo missiológico para centros urbanos. São Paulo, uma das maiores metrópoles do mundo tem uma formação cultural plural, não apenas pelas forças atuantes da modernização, secularização, globalização e pós-modernidade. A composição da população da cidade possui uma gênese étnica plural. Além da matriz autóctone indígena, do colonizador branco europeu e dos escravos africanos, desde o início do século XIX chegaram outros imigrantes, europeus e asiáticos. Nas primeiras décadas do século XX, o Brasil foi o país que mais recebeu imigrantes em todo o mundo. Estima-se que nos anos de 1920, apenas um terço da população na cidade de São Paulo fosse de brasileiros, o restante era composto por imigrantes. A inserção do adventismo em São Paulo se deu por missionários imigrantes que trabalharam primeiro com outros imigrantes antes de evangelizar e desenvolver a missão adventista com os brasileiros nacionais. De alguma forma, esse início deixou marcas na missão adventista paulistana. São Paulo é hoje a cidade com o maior número total de adventistas no mundo e a única com Igrejas Adventistas étnicas que atendem cinco grupos étnicos distintos: japoneses, coreanos, judeus, árabes e bolivianos/peruanos. Esta pesquisa busca investigar a formação de uma sensibilidade cultural no adventismo paulistano que lhe permitiu dialogar com a pluralidade cultural da metrópole paulistana.

Expatriate managers adjustment and its impact on subordinates reactions: a cross cultural leadership study of Kenya and Ethiopia

Research on culture, leadership and adjustment shows that societal culture influences leadership in such a way that it can impact on expatriate managers' effectiveness and adjustment in a new culture. In previous research, cultural background, personality, motives or behaviour of expatriate managers and their followers' reactions to them have been investigated in Europe, America and Asia. However, little attention has been paid on research on expatriate managers in African cultures especially in Eastern Africa. The present study represents an attempt to address the gap by examining how societal culture, leadership and adjustment success are interrelated for expatriate managers in Kenya and Ethiopia. Questionnaire data were obtained from a) local middle managers (N=160) for studying societal culture and leadership in Kenya and Ethiopia, b) expatriate managers in non-governmental organizations - NGOs (N=28) for studying expatriate managers' personality, motives and adjustment success and c) their immediate subordinates (N=125) for studying the expatriate managers' behaviours and their subordinates' reactions to them. Additionally, expatriate managers were interviewed and responses were coded for implicit motives, experiences and adjustment. SPSS was used to analyse data from questionnaires to obtain cultural and leadership dimensions, leader behaviour and subordinate reactions. The NVIVO computer based disclosure analysis package was used to analyse interview data. Findings indicate that societal culture influences leadership behaviours and leadership perceptions while the expatriate managers' motives, behaviours, personality and the cross cultural training they received prior to their assignment impact on the expatriates' adjustment success and on subordinates' reactions to them. The cultural fit between expatriate managers' home country (19 countries) and the target country (Kenya or Ethiopia) had no significant association with adjustment success but was positively related to expatriate behaviour and negatively associated with subordinates reactions. However, some particular societal practices - obviously adopted by expatriates and transferred to their target country - did predict subordinates' commitment, motivation and job satisfaction. Furthermore, expatriates' responsibility motivation was positively related to their adjustment success. Regarding leadership behaviours and effectiveness, expatriate' supportive behaviours predicted subordinates' job satisfaction most strongly. Expatriate managers expressing their management philosophies and experience shed light on the various aspects of adjustment and management of NGOs. In addition, review of Kenyan and Ethiopian cultures and the NGO context in these countries offers valuable information for expatriate managers. This study's general imphcation for Cross Cultural Management and lnternational Human Resources Management is that the combination of culture general and culture specific knowledge and reflections on Eastern Africa countries can inform senior management and international HR staff about the critical issue of what to include in training, coaching, and actual experience in a particular host country in order to ensure effective leadership. Furthennore, this knowledge is expected to influence expatriate managers' behaviour modification to enhance positive subordinate reactions. Questions about how to prepare expatriate managers and subordinates to work more competently and sensitively across cultures are addressed. Further theoretical implications, limitations of the study and directions for future research are also addressed.

Nothing succeeds like moderation:a social self-regulation perspective on cultural dissimilarity and individual performance.

Addressing inconsistencies in relational demography research, we examine the relationship between cultural dissimilarity and individual performance through the lens of social self-regulation theory, which extends the social identity perspective in relational demography with the analysis of social self-regulation. We propose that social self-regulation in culturally diverse teams manifests itself as performance monitoring (i.e., individuals' actions to meet team performance standards and peer expectations). Contingent on the status associated with individuals' cultural background, performance monitoring is proposed to have a curvilinear relationship with individual performance and to mediate between cultural dissimilarity and performance. Multilevel moderated mediation analyses of time-lagged data from 316 members of 69 teams confirmed these hypotheses. Cultural dissimilarity had a negative relationship with performance monitoring for high cultural-status members, and a positive relationship for low cultural-status members. Performance monitoring had a curvilinear relationship with individual performance that became decreasingly positive. Cultural dissimilarity thus was increasingly negatively associated with performance for high culturalstatus members, and decreasingly positively for low cultural-status members. These findings suggest that cultural dissimilarity to the team is not unconditionally negative for the individual but, in moderation, may in fact have positive motivational effects.

A SENSIBILIDADE CULTURAL DO ADVENTISMO COMO MODELO MISSIOLÓGICO EM GRANDES CENTROS URBANOS: UMA ANÁLISE DE IGREJAS ADVENTISTAS ÉTNICAS NA CIDADE DE SÃO PAULO

Esta pesquisa objetiva analisar o desenvolvimento da missão adventista na cidade de São Paulo em busca de um modelo missiológico para centros urbanos. São Paulo, uma das maiores metrópoles do mundo tem uma formação cultural plural, não apenas pelas forças atuantes da modernização, secularização, globalização e pós-modernidade. A composição da população da cidade possui uma gênese étnica plural. Além da matriz autóctone indígena, do colonizador branco europeu e dos escravos africanos, desde o início do século XIX chegaram outros imigrantes, europeus e asiáticos. Nas primeiras décadas do século XX, o Brasil foi o país que mais recebeu imigrantes em todo o mundo. Estima-se que nos anos de 1920, apenas um terço da população na cidade de São Paulo fosse de brasileiros, o restante era composto por imigrantes. A inserção do adventismo em São Paulo se deu por missionários imigrantes que trabalharam primeiro com outros imigrantes antes de evangelizar e desenvolver a missão adventista com os brasileiros nacionais. De alguma forma, esse início deixou marcas na missão adventista paulistana. São Paulo é hoje a cidade com o maior número total de adventistas no mundo e a única com Igrejas Adventistas étnicas que atendem cinco grupos étnicos distintos: japoneses, coreanos, judeus, árabes e bolivianos/peruanos. Esta pesquisa busca investigar a formação de uma sensibilidade cultural no adventismo paulistano que lhe permitiu dialogar com a pluralidade cultural da metrópole paulistana

Audiovisual Storytelling and Ideological Horizons : Audiences, Cultural Contexts and Extra-textual Meaning Making

Abstract: Audiovisual Storytelling and Ideological Horizons: Audiences, Cultural Contexts and Extra-textual Meaning Making In a society characterized by mediatization people are to an increasing degree dependent on mediated narratives as a primary means by which we make sense of our experience through time and our place in society (Hoover 2006, Lynch 2007, Hjarvard 2008, Hjarvard & Lövheim 2012). American media scholar Stewart Hoover points to symbols and scripts available in the media environment, what he call the “symbolic inventory” out of which individuals make religious or spiritual meaning (Hoover 2006: 55). Vernacular meaning-making embedded in everyday life among viewers’ dealing with fiction narratives in films and tv-series highlight a need for a more nuanced understanding of complex audiovisual storytelling. Moving images provide individuals with stories by which reality is maintained and by which humans construct ordered micro-universes for themselves using film as a resource for moral assessment and ideological judgments about life (Plantinga 2009, Johnston 2010, Axelson 2015). Important in this theoretical context are perspectives on viewers’ moral frameworks (Zillman 2005, Andersson & Andersson 2005, Frampton 2006, Avila 2007).This paper presentation will focus on ideological contested meaning making where audiences of different cultural background engage emotionally with filmic narratives, possibly eliciting ideological and spiritual meaning-making related to viewers’ personal world views. Through the example of the Homeland tv-series I want to discuss how spectators’ cultural, religious, political and ideological identities could be understood playing a role in the interpretative process of decoding content. Is it possible to trace patterns of different receptions of the multilayered and ambiguous story depicted in Homeland by religiously engaged Christians and Moslems as well as non-believers, in America, Europe and Middle East? How is the fiction narrative dealt with by spectators in the audience in different cultural contexts and how is it interpreted through the process of extra-text evaluation and real world2understanding in a global era preoccupied with war on terror? The presentation will also discuss methodological considerations about how to reach out to audiences anchored in different cultural context.

Cultural and linguistic context and lexical inferencing in English language learning: A case study

In an increasingly multilingual world, English language has kept a marked predominance as a global language. In many countries, English is the primary choice for foreign language learning. There is a long history of research in English language learning. The same applies for research in reading. A main interest since the 1970s has been the reading strategy defined as inferencing or guessing the meaning of unknown words from context. Inferencing has ben widely researched, however, the results and conclusions seem to be mixed. While some agree that inferencing is a useful strategy, others doubt its usefulness. Nevertheless, most of the research seem to agree that the cultural background affects comprehension and inferencing. While most of these studies have been done with texts and contexts created by the researches, little has been done using natural prose. The present study will attempt to further clarify the process of inferencing and the effects of the text’s cultural context and the linguistic background of the reader using a text that has not been created by the researcher. The participants of the study are 40 international students from Turku, Finland. Their linguistic background was obtained through a questionnaire and proved to be diverse. Think aloud protocols were performed to investigate their inferencing process and find connections between their inferences, comments, the text, and their linguistic background. The results show that: some inferences were made based on the participants’ world knowledge, experience, other languages, and English language knowledge; other inferences and comments were made based on the text, its use of language and vocabulary, and few cues provided by the author. The results from the present study and previous research seem to show that: 1) linguistic background is a source of information for inferencing but is not a major source; 2) the cultural context of the text affected the inferences made by the participants according to their closeness or distance from it.