Conflict management styles of Asian and Asian American nurses: implications for the nurse manager

Foreign nurses and American nurses who are culturally diverse make up an increasing number of the US nursing workforce. Of foreign nurses, Asians constitute the largest number. Conflict is an inevitable aspect of human relations in health care settings. Nurses and other health team members with diverse cultural background bring to the workplace different conflict behaviors that directly impact the outcomes of conflicts. It is essential for health care team members and managers to be cognizant of different conflict behaviors as well as different conflict management styles so that strategies can be designed to build a culturally diverse health care team that is able to effectively achieve group and organizational objectives.     

Commitment to diversity. A system's diversity program prepares it for the future

Three years ago the president/chief executive officer of Franciscan Health System of Cincinnati, Inc., developed a vision in which diversity would be the key to a major cultural shift of the organization. In April 1993 the system formed a Diversity Steering Committee to establish an infrastructure for a healthy, multicultural environment. The committee outlined two key objectives: to develop consensus around a vision of diversity for the organization, and to conduct research to determine the organizational culture with regard to diversity issues. By 1994 diversity had become one of the system's 10 strategic initiatives, and a Diversity Department had been added to the corporate structure. The Diversity Steering Committee developed a three-year management action plan that includes seven major goals: Demonstrate the corporate commitment to diversity Educate, train, build, and support a diverse organization Communicate the importance of diversity Create a diverse work force Track diversity progress Establish accountability for diversity implementation Build loyalty with diverse external customers.     

Silencing trust: confidence and familiarity in re-engineering knowledge infrastructures

Medicine, Health Care and Philosophy - In this paper, we tell the story of efforts currently underway, on diverse fronts, to build digital knowledge repositories (‘knowledge-bases’) to...     

Breast cancer screening: cultural beliefs and diverse populations

This article addresses the role of culture in breast cancer screening behavior among African American, American Indian/Alaskan Native, Asian American/Pacific Islander, and Hispanic/ Latina women. It reviews cultural beliefs, attitudes, and knowledge and their relative influence on women's decisions regarding health tests. The article explores how to build on these cultural values, simultaneously mediating their barrier effects. Building on cultural explanatory models of health behavior, suggestions for incorporating culture into early detection strategies for ethnically and racially diverse, underserved women are provided. In addition, the article offers four practice principles that can be used with all of the groups: inclusion and use of indigenous support; cross-application of approaches for diverse populations; honor and incorporation of culture; and attention to language, literacy, and cultural information.     

Modification of the Epworth Sleepiness Scale in Central China

Purpose  

The well-known excessive daytime sleepiness (EDS) assessment, Epworth Sleepiness Scale (ESS), is not consistently qualified for patients with diverse living habits. This study is aimed to build a modified ESS (mESS) and then to verify its feasibility in the assessment of EDS for patients with suspected sleep-disordered breathing (SDB) in central China.     

Survey of accredited master of public health (MPH) programs with health education concentrations: a resource for strengthening the public health workforce

The authors designed survey research to assess accredited master of public health (MPH) programs with health education concentrations. A Web-based survey was distributed to program directors and was used to collect characteristics of program faculty, students, graduates, internships, employment, and competency development. Results indicate that students and graduates are diverse; 72% of students complete internships and 61% of graduates work in government or community public health-related agencies; 98% of faculty hold a doctoral degree and 67% have at least one degree from an accredited public health school or program; and 85% of programs build competencies in most of the Institute of Medicine-suggested areas. The authors conclude that accredited MPH programs with a concentration in health education train diverse public health practitioners highly likely to work in a government or community public health agency with competencies to enhance public health.     

Using community-based system dynamics modeling to understand the complex systems that influence health in cities: The SALURBAL study

We discuss the design, implementation, and results of a collaborative process designed to elucidate the complex systems that drive food behaviors, transport, and health in Latin American cities and to build capacity for systems thinking and community-based system dynamics (CBSD) methods among diverse research team members and stakeholders. During three CBSD workshops, 62 stakeholders from 10 Latin American countries identified 98 variables and a series of feedback loops that shape food behaviors, transportation and health, along with 52 policy levers. Our findings suggest that CBSD can engage local stakeholders, help them view problems through the lens of complex systems and use their insights to prioritize research efforts and identify novel solutions that consider mechanisms of complexity.     

刍议军队研究型疗养院建设

建设研究型疗养院,是军队疗养院落实科学发展观、军队和国防建设主题主线重大战略思想的重要举措,是新时期军队疗养院提升保障服务能力,完成多样化疗养保障任务需求的具体要求。深化对研究型疗养院的认识和理解,把握疗养院内涵式发展的特点规律,对实现军队疗养院跨越式发展具有重要意义。     

Findings from a Community-based Participatory Prevention Research Intervention Designed to Increase Social Capital in Latino and African American Communities

A community-based participatory research intervention, Poder es Salud/Power for Health, employed Community Health Workers who used popular education to identify and address health disparities in Latino and African American communities in a metropolitan area in the United States. We assessed participants’ social capital, self-rated health, and depressive symptoms at baseline and the end of the intervention. Social support and self-rated health improved while depressive symptoms decreased. Public health interventions involving diverse communities that are designed to build upon assets, such as existing levels of social capital, may improve health in those communities.     

破解社会办医难题的政府责任研究*

鼓励和发展社会办医是新医改的重要内容,目的是满足人们多层次、多样化的医疗服务需求,本文通过分析制约社会办医发展的社会认可、规划准入、审批、人才、税收和补贴等方面的问题,进一步指出政府在破解社会办医难题中要承担起宏观规划和指导、营造公平政策环境和严格监管的责任,以更好的促进社会办医的发展。     

Acknowledging Diversity in Home Literacy Practices: Moving Towards Partnership with Parents

Parent involvement in their children's literacy learning has long been recognized as an important factor in school success. As a result, schools have frequently attempted to build programs that assist parents to support their children's literacy. Unfortunately, many of these initiatives are based on deficit views of learning and fail to acknowledge the diverse background and needs of all children. In this paper the author provides an overview of major initiatives in family literacy, and argues for a fundamental change in the way schools relate to the parents and the community. It is suggested that schools and communities need to develop more effective partnerships that provide the opportunity for parents and teachers to develop a greater sense of shared understanding. The author argues that such initiatives will encourage parents and teachers to enter into dialogue based on a shared commitment to improving children's learning, and that this will lead to positive outcomes for all students.     

Learning to value differences. A Catholic healthcare system implements a cultural diversity education program

Each year the U.S. labor force is becoming increasingly diverse. Many healthcare organizations are adopting plans to meet the needs of leaders who manage culturally diverse groups of employees and to ensure that the organization can continue to attract and retain employees of all cultures. In December 1988 Mercy Health Services, Farmington Hills, MI, began a cultural diversity program to increase the number of minority and women employees, especially in management and leadership positions. Its education program was designed to enhance manager and employee awareness of their own biases and those of others and to build skills in dealing with persons from a variety of cultures. Mercy Health Services first held 90-minute educational sessions for managers. The sessions covered expected demographic changes and the importance of working together. Employees then attended sessions where they practiced interactive exercises to help each person recognize his or her own biases. In the subsequent weeks the corporate human resources staff experienced an increase in the number of employee relations problems managers and nonmanagers attributed to diversity conflict. In response, Mercy developed a pilot series of awareness- and skill-building workshops for those who managed Mercy's most culturally diverse staffs. They heard lectures on racial and gender issues and watched and discussed conflict resolution videos. Most workshop participants increased their awareness of cultural bias and their commitment to learning and practicing skills to deal with conflict.     

Lack of access due to costs remains a problem for some in Massachusetts despite the state's health reforms

Did the Massachusetts health reforms, which provided near-universal insurance coverage, also address problems of unmet need resulting from the cost of care and of inadequate preventive care for diverse patient groups? We found that nearly a quarter of adults who were in fair or poor health reported being unable to see a doctor because of cost during the implementation of the reforms. We also found that state residents earning less than $25,000 per year were much less likely than higher earners to receive screening for cardiovascular disease and cancer. The state needs to implement new strategies to build on the promise of universal coverage and address specific needs of vulnerable populations, such as limiting out-of-pocket spending for this group. Also, more data are needed on the social determinants of health to identify specific barriers related to cost and access for vulnerable groups that general insurance reforms may not address.     

Experiences and perceptions of social constraints and social change among lesbian,gay, bisexual and transgender persons in Lesotho

Lesbian, gay, bisexual, transgender and other sexually and gender diverse persons negotiate for their identities, create communities and advocate for their rights throughout the world. However, there are limited data about the perceptions of social change among sexually and gender diverse persons in contexts where same-sex sexual practices have been recently decriminalised, such as in 2010 in Lesotho. We conducted semi-structured in-depth interviews with sexually and gender diverse persons (n?=?46) and six key informants. Findings were analysed using Social Worlds Theory. Participants discussed social constraints and marginalisation across structural (legal systems, employment, education), community (beliefs that sexual and gender diversity are incongruent with Basotho culture; stigma), and familial (tensions with religion and cultural gendered economic traditions) dimensions. The narratives also revealed perceived change across structural (changing norms in legal, employment and education spheres), community (larger community and LGBT community change), familial (negotiating acceptance), and internal (active resistance) domains. The findings reported here can inform multi-faceted programmes to challenge stigma, violence and gender inequity; build social capital; and address the health and human rights priorities of sexually and gender diverse persons in Lesotho.     

More than just a cut: A qualitative study of penile practices and their relationship to masculinity, sexuality and contagion and their implications for HIV prevention in Papua New Guinea

ABSTRACT: Background Male circumcision (MC) has been shown to reduce vaginal transmission of HIV to men. While community acceptability is important in a countries preparedness to introduce MC, it is equally important to map contemporary MC and other penile cutting practices, and the socio-cultural dimensions underpinning these practices. Methods A total of 482 men and women (n=276 and n=210, respectively) participated in 82 semi-structured and 45 focus group discussions from four different provinces of Papua New Guinea (PNG), each representing one of the four socially and geographically diverse regions of the country. Results Of the men interviewed 131 self-reported that they had undergone a penile alteration with some reporting multiple types. Practices were diverse and could be grouped into five broad categories: traditional (customary) penile cutting; contemporary penile cutting; medical circumcision; penile inserts; and penile bloodletting practices in which sharp objects are used to incise the glans and or inserted and withdrawn from the male urethra or in order to induce bleeding. Socio-cultural traditions, enhanced sexual pleasure and improved genital hygiene were key motivators for all forms of penile practices. Conclusions The findings from this study highlight the complex and diverse nature of penile practices in PNG and their association with notions of masculinity, sexuality and contagion. Contemporary penile practices are critical to a community's acceptance of MC and of a country's ability to successfully implement MC in the context of a rich and dynamic culture of penile practices. If a MC program were to be successfully rolled out in PNG to prevent HIV it would need to work within and build upon these diverse cultural meanings and motivators for penile practices already commonly performed in PNG by men.     

Vaccine Trust Gauge: Mixed methods research to measure and understand vaccine trust

IntroductionWhile trust in vaccination is one factor in the ecosystem that surrounds vaccine decision-making and acceptance, understanding its role may provide insights into effective and tailored approaches to help build individual-level vaccine confidence. The authors developed the Vaccine Trust Gauge (VTG), a scale used to measure trust in vaccines, and conducted mixed methods research to provide an in-depth understanding of the various factors shaping vaccine trust in the United States.Materials and methodsThe VTG instrument was developed from previous and scoping research of questionnaires (Larson et al., 2018; Palmedo et al., 2021) and fielded in the US to n = 3026 adults ages ≥18. Based on survey responses, participants were segmented by vaccine trust level (low, medium, or high) through an aggregated scoring system constructed from the VTG. 65 respondents were recruited to participate in in-depth interviews or focus groups conducted by phone or video conference. A conceptual definition of vaccine trust was developed using components of the VTG scale.ResultsMultivariate regressions found that higher levels of vaccine trust measured by the VTG are closely associated with trust in healthcare providers and trust in government. College or higher degree, Democrats, and those aged 55+ were more likely to have higher trust in vaccines compared to Black/African Americans, and those experiencing discrimination in the healthcare system.The qualitative analysis allowed the authors to add diverse, contextual elements to the vaccine trust levels summarized here.DiscussionThese mixed methods findings suggest future implications for research and practice. Ideas for potential communication, policy, and public health strategies are offered to build vaccine confidence and advance uptake for COVID-19 and other vaccines.ConclusionsThere are diverse underlying factors that influence an individual’s trust in vaccines, which means trust categories and demographic characteristics cannot be used as monolithic identifiers. Assessing vaccine trust provides insights into a foundation for engagement to promote individual-level vaccine acceptance. The authors present recommendations for the use of the VTG, future implications for research and practice, and potential strategies to build vaccine confidence.     

3D QSAR for GSK-3beta inhibition by indirubin analogues

Glycogen synthase kinase 3 (GSK-3) plays an important role in a diverse number of regulatory pathways by phosphorylation of several different cellular targets and its inhibitors have been evaluated as promising drug candidates. Indirubin analogues show favorable inhibitory activity targeting GSK-3beta, which is closely related to the property and position of substituents. Two methods were used to build 3D-QSAR models for indirubin derivatives. The conventional 3D-QSAR (ligand-based) studies were performed based on the lower energy conformations employing atom fit alignment rule. The receptor-based 3D-QSAR models were also derived using bioactive conformations obtained by docking the compounds to the active site of GSK-3. Conclusions of models based on two methods are similar and reliable. The results indicate that both ligand-based and receptor-based are feasible tools to build 3D-QSAR models. Contour maps of the receptor-based CoMSIA model (q(2) = 0.766, r(2) = 0.908, N (number of components) = 5) including the steric, electronic and hydrophobic fields were taken as representative to explain factors affecting activities of inhibitors.     

Prediction of soil sorption coefficient of organic pesticides from the atom-type electrotopological state indices

A group contribution approach based on atom-type electrotopological state indices for predicting the soil sorption coefficient (log KOC) of a diverse set of 201 organic pesticides is presented. Using a training set of 143 compounds, for which the log KOC values were in the range from 0.42 to 5.31, multiple linear regression (MLR) and artificial neural networks were used to build the models. The models were validated using two test sets of 20 and 38 chemicals not included in the training set. The statistics for a linear model with 12 structural parameters were, in test set 1, r2 = 0.79, s = 0.45 and, in test set 2, r2 = 0.74, s = 0.65. These results clearly show that soil sorption coefficients can be accurately and rapidly estimated from easily calculated structural parameters.     

青少年网络欺凌研究进展

青少年网络欺凌是在电子社交网络环境下,通过电子手段对青少年实施的攻击性暴力行为,且由于网络的匿名性和传播的快速性,对青少年身心产生严重而深远的影响。随着信息技术的发展,网络欺凌方式层出不穷,网络欺凌的影响因素和形成机制多样复杂。本文从流行特征、影响因素、相关理论模型等角度系统阐述了青少年网络欺凌的研究进展,以期能为家庭、学校、社会构建预防青少年网络欺凌的公共卫生体系提供借鉴。     

Principles for educational game development for young children

The use of media devices such as tablets is increasing with 41% of children engaged in more than two hours of screen time per day. The number of educational games has also significantly increased but little has been to done to assess the effectiveness and validity. Given the increase in access and use of devices, and increased popularity of educational games, a set of principles is needed. We present guiding principles that are useful for the design and development of educational games for children, under 5 years. We provide evidence from child development research findings that games should: (1) be developmentally appropriate content; (2) integrate the theoretical frameworks from the learning science field; (3) embed learning in socially rich contexts; (4) develop diverse content; and (5) create a balance between play and real-world learning opportunities. We build the principles around a hypothetical educational game designed to facilitate language development.