Respect For Cultural Differences Research Articles

A Study of Engagement in Neighborhood-Based Child Welfare Services

This article reports the results of a mixed-method study that examined processes and outcomes of parent-worker engagement in child welfare. Knowledge gained from a qualitative exploration of engagement at one neighborhood-based child welfare agency informed the gathering of quantitative data from 74 different parent-worker dyads in this sequential exploratory design. Seven themes instrumental to engagement emerged: (a) clear, collaborative goal setting; (b) hope-fulness; (c) parent acknowledgment of their situations; (d) motivation; (e) respect for cultural differences; (f) honest and straightforward communication; and (g) persistent and timely efforts by all. Quantitative analyses yielded little relationship between engagement and either visitation rate or case disposition by 9 months post placement. Although these data provide support for the clinical benefits of working to improve parent-worker engagement in child welfare services, they fail to provide evidence of a relationship between engagement and improved case outcomes.

Social Work in Natural Disasters: The Case of Spirituality and Post-traumatic Growth

This study explored the role of social work in natural disasters by examining the relationship between spirituality and the post traumatic growth of people in a collectivist culture. In this case, a retrospective study was conducted among people in Taiwan who had survived a major earthquake five years earlier . The hypothesis tested was that those who reported higher levels of spirituality would also report higher levels of post traumatic growth. A concurrent triangulation mixed-methods design was employed for this study. Six hundred and forty participants completed the Post traumatic Growth Inventory (PTGI). Twenty-eight others participated in semi- structured in-depth interviews. Results indicate that, in Taiwan—described here as a collectivist culture—traditional cultural narratives around suffering and adversity, many of which are voiced as spiritual beliefs, have a significant effect on post traumatic growth. In this situation, social workers need to work with or support spiritual leaders, folk healers, and indigenous religious organizations, as they provide helping services. Respect for cultural differences may require that social workers primarily act as community organizers or developers, not clinicians focusing on coordination and development of material resources.

Countering ‘Theoretical Imperialism’: Some Possibilities from Japan

When scholars of any nation become so proud of their mastery of alien concepts that they forget or suppress their own cultural identity, they willingly succumb to ‘theoretical imperialism’. The flip side is the arrogant and wholesale imposition by Western scholars of theories created in the crucible of one culture on other cultures, subcultures or historical eras with divergent philosophical foundations. This article introduces several key Japanese critical theories that modify or fuse Japanese and Western psychoanalytic and aesthetic concepts, arguing that they can be fruitfully applied by theatre and performance scholars to works originating either in Japan or elsewhere. The article proposes a ‘both/and’ perspective that respects cultural differences without exoticizing the Other.

The Early Development Index and children from culturally and linguistically diverse backgrounds

The Early Development Index (EDI) is a teacher‐completed checklist, intended to be a population‐level tool to measure children's readiness for school and to alert communities to potential developmental problems in children. In response to the increasing popularity of the EDI, this paper provides a critical and timely evaluation and identifies the areas for improvement and modifications. The paper aims: (1) to identify the limitations of the EDI as a universal screening tool, particularly with regard to children from culturally and linguistically diverse backgrounds (CALD); (2) to alert readers to the potential negative implications of the current EDI for communities and society, and (3) to recommend ways for improvement so that the EDI will become a valid and culturally appropriate screening tool for monitoring early development in CALD children. The ultimate aim is to help build an education system and a society that can respect cultural and individual differences.

Nonpharmaceutical Interventions for Pandemic Influenza, National and Community Measures

The World Health Organization's recommended pandemic influenza interventions, based on limited data, vary by transmission pattern, pandemic phase, and illness severity and extent. In the pandemic alert period, recommendations include isolation of patients and quarantine of contacts, accompanied by antiviral therapy. During the pandemic period, the focus shifts to delaying spread and reducing effects through population-based measures. Ill persons should remain home when they first become symptomatic, but forced isolation and quarantine are ineffective and impractical. If the pandemic is severe, social distancing measures such as school closures should be considered. Nonessential domestic travel to affected areas should be deferred. Hand and respiratory hygiene should be routine; mask use should be based on setting and risk, and contaminated household surfaces should be disinfected. Additional research and field assessments during pandemics are essential to update recommendations. Legal authority and procedures for implementing interventions should be understood in advance and should respect cultural differences and human rights.

Accessibility Assessment of the Health Care Improvement Program in Rural Taiwan

An experimental Health Care Improvement Program (HCIP) was initiated by the Bureau of National Health Insurance in 1997 to improve the accessibility of health care in several rural, mountainous districts. This longitudinal study evaluated service availability, utilization patterns, and effectiveness of services under the HCIP in the A-Li Mountain District. Outpatient claims made by residents in the A-Li Mountain District were extracted from the database of the National Health Insurance program. Changes in utilization pattern and volume were analyzed. Satisfaction levels were assessed by 2-stage face-to-face interviews with local residents. After the HCIP, the average population served by each doctor decreased 75%, and total outpatient visits increased 15.4%. The total number of in-district outpatient visits increased 83.6%. The proportion of in-district outpatient visits to all visits increased from 22.1% to 35.1%. The total in-district outpatient visit fee claimed increased 100.2%, and the total out-of-district outpatient visit fee claimed increased only 7.2%. About 60.4% of the residents were not satisfied with overall health care services before the HCIP. The proportion decreased to 32.4% after the HCIP. The HCIP improved accessibility, enriched local medical care resources, changed the utilization pattern of some residents, and increased residents' satisfaction level. A well-managed program with stabilized financial resources is more likely to succeed if it also respects cultural differences and responds to community needs.

Biculturalism and Personnel Administration

The author explains the historical reasons for the distribution of Canadians in industry along cultural-linguistic lines, describes the present evolution toward a better equilibrium, the problems thus posed and the prerequisites — both individual and institutional — for their proper solution on the basis of increased efficiency through respect for cultural differences and rational use of people of both languages.

The History of Brazil

The intended audience for this series is students and interested laypeople seeking “up-to-date, concise and analytical histories.” Levine’s many productive years of scholarship, teaching, and writing on Brazilian history made him an excellent choice to author such a work. In fact, with the almost concurrent appearance of The History of Brazil (first publ l ished by Greenwood Press in 1999), his important Brazilian Legacies, The Brazil Reader (with John J. Crocitti), and Father of the Poor? Levine had marked out his place as one of the principal interpreters of modern Brazilian history writing in English. Levine’s skill at synthesizing the field’s growing literature makes The History of Brazil informative, inclusive, and up-to-date, yet accessible in its concision and brisk narrative cohesion. I should point out, however, that the St. Martin’s edition does not cover the period beyond 1998, since Levine’s death precluded further revision. It is also sadly ironic, as Levine’s commitment to democracy and social justice in Brazil surely meant he would have had much to contribute to a new edition on the limits and possibilities of the presidency of Luis Inácio da Silva.After an introductory overview, the book devotes a chapter each to the colonial period, the Empire, the First Republic, the Vargas era, and the post-Vargas period. By design, the post-WWII period receives greater emphasis, bolstered by two final chapters on the political culture and socioeconomic realities of contemporary Brazil. As the series editors sought texts that helped make sense of Brazil’s place in the world at the end of the twentieth century, an implicit larger question guiding much of The History of Brazil is quite presentist: namely, what economic structures, political institutions, and cultural traditions brought Brazil to its present circumstances? Levine answers with his customary critical analysis, balanced by his respect for cultural difference. He has a practiced eye for teasing out the larger significance of political events or economic arrangements without belaboring his point, although on rare occasion his prose can be too succinct and its exact meaning thereby unclear. Levine uses comparisons between nations to good effect, emphasizing both the singularities and commonalities of Brazil’s historical experience, first vis-à-vis Spanish America’s colonial enterprises and later in comparison to the United States.Present throughout the text are themes and topics that have characterized Levine’s writing over the last decade. For example, The History of Brazil routinely emphasizes the poor quality of life suffered by Brazil’s rural poor and urban working classes, as well as the country’s regional and cultural diversity. (Brazilianists will recognize in the last two chapters an emphasis not unlike that of Brazilian Legacies, especially.) Quite inventively, Levine also uses a selective biographic appendix as a vehicle to broaden the representativeness of historical writing on Brazil, including such individuals as favela-dwelling diarist Carolina Maria de Jesus, protofeminist/first lady Nair de Teffe, and nineteenth-century Afro-Brazilian poets Antonio Gonçalves Crespo and João Cruz e Silva. Subjects such as environmental history, the Movimento Sem Terra (Landless Workers’ Movement), and human rights issues also receive scattered attention. The bibliographic essay is a shortened version of the “Suggestions for Further Reading” from The Brazil Reader; while not “comprehensive” as the series editors suggest, it is appropriate for a general readership. There is a lot to recommend this text for undergraduate classroom use, especially for courses outside history departments that demand or expect knowledge of, rather than intend to critically interrogate, Brazil’s historical background. History professors may find the greater detail of Skidmore’s Five Centuries of Change, the Cambridge History volumes edited by Leslie Bethell, or even Boris Fausto’s A Concise History of Brazil more suitable to accompany t l heir lectures. And Levine and Crocitti’s above-mentioned Brazil Reader is more conducive to promoting and engaging critical thinking and classroom discussion relating to Brazil’s past. Yet, if perhaps not the best textbook for classroom use, Brazilianists should be pleased to have the option of recommending this very worthwhile text to friends and acquaintances intending to travel to Brazil or having recently returned and wanting to learn more about the country’s political and economic heritage.

Culturally Competent Nursing Care

Culturally Competent Nursing Care

Feminist Politics of Recognition

To elaborate these points I examine the cultural dimensions of two different feminist struggles: debate over the Equal Rights Amendment in the United States between 1970 and 1982 and current efforts to end practice of in Africa and elsewhere. (As I explain later I use the term female circumcision in quotation marks and with some trepidation.) In using these cases I am extending the idiom of the politics of recognition beyond the terrain to which it has generally been directed by theorists in North America and in Europe--to the struggles of minority or marginalized cultures in Western nation-states. I contend that a feminist critical theory of recognition is relevant to virtually every contemporary society. Feminists must negotiate tensions between the pursuit of sex equality and respect for cultural differences not only with regard to women in other cultures; this task is central to all feminist struggles to give new meanings to prevailing gendered norms and practices. Moreover a basic corollary to my call for a hermeneutical feminist critical theory of recognition is that such a theory must be elaborated contextually. (excerpt)

STUDENTJAMA. Cultural competence training in US medical schools.

CULTURAL PERCEPTIONS OF ILLNESS HAVE BEEN REPORTED TO influence health-seeking behaviors, patient-physician communication, and health outcomes. Recent changes in US demographics have underscored the demand for cultural awareness in clinical settings, as the current minority population in the United States is projected to exceed 50% by 2056. The percentage of minority physicians and medical students, however, has not been increasing proportionately. Medical schools have responded in part with 2 broad strategies: cultural immersion programs and cultural competence curricula. The former typically include either a clinical rotation in another country or a more local experience with native communities. In 2002, 38% of US medical students participated in international electives, compared with 6% in 1982. By contrast, cultural competence curricula use case-based, small-group formats to explore the core cultural issues and health beliefs of various ethnic groups, complementary and alternative medicine, language barriers, substance abuse, racism, and cross-cultural interviewing skills. Such curricula also include role play, panel discussions with patient advocates and interpreters, and simulated encounters. As of 2000, 87% of US medical schools addressed cultural competence in 3 or fewer lectures during the preclinical years, and 8% of schools offered separate courses on the topic. This compares with only 13% that included any such material in 1991. Students who participated in cross-cultural exchanges, particularly international rotations, reported that they had gained improved cultural sensitivity, communication skills, appreciation for public health, and respect for cultural differences. Preclinical medical students in a 2001 program that fused domestic and international immersion experiences, including domestic community service, didactic seminars on cultural issues, a 6-week foreign language program abroad, and interaction with local minority families reported increased knowledge of local cultures and greater ease with patients of other cultures. Because these findings are based on self-reported data, however, it is not clear whether they accurately reflect students’ actual knowledge and abilities. No studies have reported lack of impact or negative effects of immersion programs, although negative findings may be subject to publication bias. Reports documenting the outcomes of intramural cultural competence training are scarce and inconsistent. We searched MEDLINE and PubMed databases for articles reporting outcome data for cultural competence training using key words such as cross-cultural education, cultural competence, medical education, multicultural curriculum development, and outcomes. This yielded 2 articles, neither of which used objective measures of learning or behavior. Crandall et al described the outcomes of a year-long, 20session course for second-year medical students to promote knowledge of culture and diversity. Postcourse surveys showed increases in students’ estimates of their proficiency in cross-cultural skills. For instance, participants reported a greater awareness of patients’ cultural sensibilities, alternative therapies, and cultural cues during interviews and physical examinations as well as increased skill in interacting with interpreters. The study’s limitations, such as the small number of students participating in the course, possible selection bias in the volunteer group, and potential biases inherent in self-reported data, again require cautious interpretation of the results. Beagan reported a lack of impact on firstand secondyear medical students following a 2-year course that focused on cultural and social issues such as medical ethics, health policy, and population health. In this case, student questionnaire responses indicated a failure to recognize the impact of these issues and the effects of race, class, sex, culture, and sexual orientation on health care. Similar to the previous study, the limitations of this study include a crosssectional design that did not guarantee comparable cohorts of students before the course began, self-reported data that may have been skewed or inaccurate, and course content that did not foster specific cross-cultural skills but that was rather an amalgam of preexisting courses displaced by curricular change.

The ethics of cultural competence.

Cultural competence curricula have proliferated throughout medical education. Awareness of the moral underpinnings of this movement can clarify the purpose of such curricula for educators and trainees and serve as a way to evaluate the relationship between the ethics of cultural competence and normative Western medical ethics. Though rarely stated explicitly, the essential principles of cultural competence are (1) acknowledgement of the importance of culture in people's lives, (2) respect for cultural differences, and (3) minimization of any negative consequences of cultural differences. Culturally competent clinicians promote these principles by learning about culture, embracing pluralism, and proactive accommodation. Generally, culturally competent care will advance patient autonomy and justice. In this sense, cultural competence and Western medical ethics are mutually supportive movements. However, Western bioethics and the personal ethical commitments of many medical trainees will place limits on the extent to which they will endorse pluralism and accommodation. Specifically, if the values of cultural competence are thought to embrace ethical relativity, inexorable conflicts will be created. The author presents his view of the ethics of cultural competence and places the concepts of cultural competence in the context of Western moral theory. Clarity about the ethics of cultural competence can help educators promote and evaluate trainees' integration of their own moral intuitions, Western medical ethics, and the ethics of cultural competence.

Cultural considerations for Canadians in the diagnosis of brain death.

This articles explores cultural perceptions and values related to brain death and organ donation from both a Western and non-Western perspective. Anthropological literature review of the historical concept of brain death in Canada using Eastern culture as a comparison. Although the concept of brain death and concomitant organ donation have become widely practiced in Western nations such as Canada, from a cross-cultural point of view these concepts and practices can be deeply troubling and may hold profoundly different meaning to people new to Canada. Canada has a deep commitment and obligation to respect diversity as reflected in the Canadian Charter of Rights and Freedoms. Therefore, healthcare workers have an obligation to respect cultural differences. To truly respect cultural differences we must first explore our own culturally formulated belief systems and then consider how our views may interface with other cultures. Our findings call for a greater analysis of the cultural influences on the concept of brain death and organ donation as a means of building a better understanding and respect for cultural diversity.

Achieving Top Level Performance from a Multicultural Workforce

ABSTRACT Today the business environment calls for top level performance. This means employees and managers must be highly motivated. This paper suggests there is one overriding force that forms the foundation upon which other motivational techniques must be built or applied. The foundation is: respect for cultural differences. Other managerial techniques are presented herein, that when built upon this foundation provide for potential employee and managerial success.

Spain in the Southwest: A Narrative History of Colonial New Mexico, Arizona, Texas, and California

Spain in the Southwest: A Narrative History of Colonial New Mexico, Arizona, Texas, and California. By John L. Kessell. (Norman: University of Oklahoma Press, 2002. Pp. VII, 462. Illustrations, preface, abbreviations, notes, glossary, works cited, index. $45.00.) Can historians understand the motivations of people with languages, spiritual beliefs, and historical circumstances altogether different from our own? In our postmodern era, human nature is no easy concept to defend or even define, and respect for cultural differences has led historians to some of their best recent work. Yet without some belief that we can understand people vastly different from ourselves, historians could not interpret the actions of even the literate colonizers of the Americas, to say nothing of their neighbors-native, African, and European-who left no written or oral records. John L. Kessell's Spain in the Southwest challenges the recent emphasis on difference and wonder in early cross-cultural contact. An emeritus professor of history at the University of New Mexico, Kessell argues not only that historians can understand colonial peoples but that they understood one another quickly and well, at least when they needed to. Starting with sixteenth-century contact between Spaniards and Indians, Kessell guides his readers through early, faltering Spanish attempts at exploration, conversion, and settlement; the founding of Santa Fe in 1610; the Pueblo Revolt of 1680 and subsequent war and reconquest; Comanche expansion in the mid-eighteenth century; gradual Spanish moves into Texas and California as other Europeans challenged Spanish dominance; and, finally, clashes between the Mexican and United States republics. Building on his own work, including the influential Kiva, Cross, and Crown (1979), and other secondary sources, Kessell reveals the imperial, religious, and individual motivations that drew Europeans and their descendants to what New Mexico governor Diego de Vargas called kingdom, at the ends of the earth (p. 160). While Spaniards occupy the center of Spain in the Southwest, Kessell integrates recent thinking regarding colonialism and Indian diversity and agency and reminds the reader of the vast Indian world beyond, including places like the upper Arkansas River valley, where Europeans had no power and little presence. Kessell's fluid and gripping narrative, interspersed with a rich variety of illustrations and maps, makes this complicated world comprehensible. …

Cultural mistrust: An important psychological construct for diagnosis and treatment of African Americans.

Although clinicians are encouraged to be more sensitive to cultural factors in the diagnosis and treatment of mental disorders, as evidenced by the significant changes in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994), little information is provided to help them determine which aspects of culture are important to the mental health of African Americans. This article discusses the importance of cultural mistrust as a psychological construct in the lives of African Americans. The origins of the construct, the research it has generated over the past 2 decades, and implications for improving interventions with Black clients seeking mental health care are discussed. The need for greater cultural sensitivity in psychological interventions with African Americans often places mental health clinicians in a double bind. On the one hand, they are told to acknowledge and respect cultural differences. On the other hand, they are warned about relying on stereotypes and generalizations in working with people of African descent who are in need of psychological services. One way to avoid this apparent contradiction is to review the literature and identify cultural themes or issues that have been shown to have direct relevance to the mental health treatment of African Americans. Psychologists interested in cultural variables often fail to identify the specific aspects of culture that are thought to influence behavior (Betancourt & Lopez, 1993). Prevalence studies indicate that paranoid schizophrenia is the most frequent diagnosis given to African Americans (Collins, Rickman, & Mathura, 1980; Mukherjee, Shukla, Woodle, Rosen, & Olarte, 1983; Toch, Adams, & Greene, 1987). This finding has been explained by some in terms of clinicians' insensitivity to different cultural norms for paranoid ideations in the Black population (Adebimpe, 1981; Grier & Cobbs, 1968; Jones & Gray, 1986; Ridley, 1984). However, this explanation remains an unARTHUR L. WHALEY received his PhD in clinical psychology from Rutgers

The Robert Tiffany Lectureship. Vital signs at the millennium: becoming more than we are.

Presenting this lecture named for my colleague, the late Robert Tiffany, is an honor. He was part of the first International Conference on Cancer Nursing 20 years ago, which was my first international meeting. It was part of what expanded our Texas--only cancer prevention and detection program for nurses into an international effort. Lessons acquired through this work in the past include learning to respect and honor cultural differences, adapting control programs to the resources at hand, accepting a role as a leader and being an agent for change, and passing on what has been learned to others. The challenges of today include the worldwide death and disability toll of lung cancer, the threat of breast cancer and the promise of regular screening to lower its morbidity and mortality, and the hope that a willingness to adapt screening for cervical cancer in developing countries will lower its mortality rate. Twenty years in the future we can expect nurses to remain educators, exemplars, and agents of change; cancer prevention and early detection to rise in the hierarchy of care; continued collaborative care between physicians and nurses; enhanced patient care through information access; and a larger role for cancer genetics in nursing practice.

Neurobiology, treatment innovations, and a cyclone in the Cook Islands: Implications for understanding and treating PTSD.

This article is an overview of the three article published in the ejournal, TRAUMATOLOGYe's Volume IV, Issue 1 in 1998. Regarding the issue's first article (Bergmann, 1998), it is noted that recent discoveries make it possible to not only understand brain functions associated with experiencing and recovering from a traumatic experience, but may explain why EMDR works. This article then reviews Gentry (1998), noting the innovative treatment approach and the need for research. The latter part of the article includes a review of Taylor (1998). The author is impressed with the effort to respect cultural differences in providing post-disaster assistance. The final section discusses important research implications in each of the areas represented by these articles. Language: en

Immigrants in the Political Process

Immigrants, who comprise a growing group in many European countries, are usually under‐represented in the political process. Sweden's immigrant policy, with its far‐reaching social and political rights, liberal citizenship laws and respect for cultural differences, is often regarded as an exemplary model of how to integrate immigrants in society. The 1975 electoral reform in Sweden gave immigrants the opportunity to become active in the democratic process by allowing foreign citizens to vote in local political elections. This article examines the political and organizational participation of immigrants. The findings indicate widespread and significant exclusion and under‐representation of immigrants in political and organizational life. We argue that immigrant political participation is best understood in terms of a tension between individual characteristics and institutional and organizational factors. In particular, the long‐term exclusion of large numbers of immigrants from labor related organizations is shown to be an important obstacle to their further social and political participation.

Family Friendliness of Community-Based Services for Children and Adolescents with Emotional and Behavioral Disorders and Their Families

In systems of care, the term family friendly is used to describe services that are aligned with the needs of the families and delivered in a manner that shows professionals value and respect family involvement, empowerment, and cultural differences. The authors devised a 42-item structured observation instrument to rate the family friendliness of one component of the systems of care in Virginia for children with emotional and behavioral disorders (EBD) and their families. The instrument covers typical aspects of the meeting process, such as meeting management, case presentation, and formulation of service plans. It also allows for the collection of data on relevant characteristics of the meeting participants as well as demographic information on the children and their families. This instrument was used to rate the family friendliness of Family Assessment and Planning Team (FAPT) meetings, the purpose of which is to develop community-based service plans for children with EBD who are referred to the team. These teams meet in local communities and typically consist of representatives from the local juvenile court, education, health, mental health, and social service agencies. The authors observed 79 case presentations at 31 FAPT meetings in 7 localities. Although there were variations within, between, and among localities, the overall rating of family friendliness across all case presentations was good (63%). Improvements in the FAPT process are needed to assure increased family friendliness in the planning of services for children with EBD and their families.