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Cultural adaptation, compounding vulnerabilities and conjunctures in Norse Greenland.

ABSTRACT: Norse Greenland has been seen as a classic case of maladaptation by an inflexible temperate zone society extending into the arctic and collapse driven by climate change. This paper, however, recognizes the successful arctic adaptation achieved in Norse Greenland and argues that, although climate change had impacts, the end of Norse settlement can only be truly understood as a complex socioenvironmental system that includes local and interregional interactions operating at different geographic and temporal scales and recognizes the cultural limits to adaptation of traditional ecological knowledge. This paper is not focused on a single discovery and its implications, an approach that can encourage monocausal and environmentally deterministic emphasis to explanation, but it is the product of sustained international interdisciplinary investigations in Greenland and the rest of the North Atlantic. It is based on data acquisitions, reinterpretation of established knowledge, and a somewhat different philosophical approach to the question of collapse. We argue that the Norse Greenlanders created a flexible and successful subsistence system that responded effectively to major environmental challenges but probably fell victim to a combination of conjunctures of large-scale historic processes and vulnerabilities created by their successful prior response to climate change. Their failure was an inability to anticipate an unknowable future, an inability to broaden their traditional ecological knowledge base, and a case of being too specialized, too small, and too isolated to be able to capitalize on and compete in the new protoworld system extending into the North Atlantic in the early 15th century.

SUBMITTER: Dugmore AJ

PROVIDER: S-EPMC3309771 | biostudies-other | 2012 Mar

REPOSITORIES: biostudies-other

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Project description:IntroductionMeasuring nurses' cultural competence is an important aspect in monitoring the acceptable quality in multicultural populations, and is a means for efficient modification of the educational process of nurses based on this assessment.PurposeThe goal of this article is to offer a preliminary assessment of the cultural competence of nurses based on a Polish-language and -culture version of the Nurse Cultural Competence Scale (NCCS).Research methodAn adaptive and diagnostic cross-disciplinary concept was used in the research. Two hundred thirty-eight professionally active nurses in the southeast region of Poland took part in this study. The NCCS-Polish version (NCCS-P) questionnaire was used after linguistic adaptation and analysis of psychometric properties.ResultsModerate levels of competence in the Cultural Knowledge Subscale (M = 3.42) were found in the group of nurses studied. The results indicate lowest competency levels in the Cultural Skill Subscale (M = 3.14). The highest values were obtained for the Cultural Awareness Subscale (M = 3.98) and the Cultural Sensitivity Subscale (M = 3.72). The Cronbach's alpha reliability coefficient for the NCCS-P scale was 0.94, with the subscale values ranging from 0.72 to 0.95. Factor validity analysis of the Polish adaptation of the NCCS-P scale pointed to its four-factor structure. The Kaiser-Mayer-Olkin sampling adequacy test was 0.905, and the Bartlett test of sphericity result was χ2 = 5755.107; df = 820; p<0.001. The four-factor structure is affirmed by the Kaiser criterion and the scree test result.ConclusionsThe NCCS-P psychometric properties were highly reliable and significant because of the opportunity for using them for research in Poland.Practical implicationsThe scale can be used in intercultural research for comparing cultural competence of nurses, including Polish ones. This scale facilitates the precise monitoring of cultural competence among nurses and nurse managers, which may help in developing nursing policies geared toward a commitment to expanding cultural competence.

Project description:Purpose: Health care disparities exist for people from culturally and linguistically diverse (CALD) communities. Addressing the cultural competence of health care providers could limit these disparities. The aim of this study was to improve cultural knowledge of and humility regarding pain in a CALD community. Method: This interpretive description qualitative study used focus group discussions (FGDs) to generate ideas about how South Asian culture could influence how health care providers manage pain. A total of 14 people with pain and of South Asian background (6 women and 8 men, aged 28-70 y) participated. Two investigators independently analyzed the data. This process involved repeatedly reading the transcripts, then manually sorting the key messages into categories. The investigators compared their categorizations and resolved differences through discussion. Next, similar categories and concepts were grouped into ideas (potential themes). These ideas, along with supporting categories and verbatim quotes, were presented to the full research team for feedback. After compiling the feedback, the ideas formed the thematic representation of the data. Results: The data from the FGDs revealed how pain management could be culturally adapted. The FGDs generated four themes about South Asian cultural perspectives that could influence the pain management experience for people living with pain: (1) cultural and linguistic impediments to communication, (2) understanding of pain in terms of the extent to which it interferes with function and work, (3) nurturing or personal attention as a marker of good care, and (4) value attributed to traditional ideas of illness and treatment. Conclusion: This study demonstrates how engaging with CALD people living with pain can lead to improved cultural knowledge and humility that can form the basis for adapting pain management. Through this process, it is more likely that a meaningful and client-centred pain management plan can be developed.

Project description:INTRODUCTION:Patient decision-aids (PDAs) support patients in selecting evidence-based treatment options. PDA is useful only if the user understands the content to make personalised decisions. Cultural adaptation is a process of adjusting health messages so that the information is accurate, relevant and understandable to users from a different population. A PDA has been developed to assist Malaysian patients with secondary drug failure to initiate insulin therapy to control their type 2 diabetes mellitus (T2DM). Likewise, patients with T2DM in neighbouring Singapore face similar barriers in commencing insulin treatment, which a PDA may facilitate decision-making in selecting personalised therapy. OBJECTIVE:The study aimed to explore the views and perceptions of Singaporean primary care providers on the Malaysia PDA to initiate insulin therapy and described the cultural adaptation process used in the design and development of a new PDA, which would be trialled in a Singapore primary healthcare institution. METHOD:Qualitative research method was deployed to conduct one-to-one in-depth interviews of the healthcare providers at the trial site (SingHealth Polyclinics-SHP), including six primary care physicians and four nurses to gather their views and feedbacks on the Malaysian PDA. The interviews were transcribed, audited and analysed (standard content analysis) to identify themes relating to the content, layout, concerns of the original PDA and suggestions to the design of the new SHP PDA. RESULTS:Cultural adaptation of the new PDA includes change to the overall design, graphics (including pictograms), presentation styles, additional contextualised content (personalisation, subheadings, cost and treatment option), modified phrasing of the subtitles and concerns (choice of words) relevant to the new users. CONCLUSION:A PDA on insulin therapy underwent cultural adaptation before its implementation in another population in a neighbouring country. Its relevance and effectiveness will be evaluated in future research.

Project description:Objectives: The implementation of obstetric hybrid simulation and interprofessional collaboration between midwives and anesthetists in labor emergencies fostered the need to evaluate the impact of such a program. The original Interprofessional Attitude Scale (IPAS) assesses interprofessional attitudes among health professional students and includes the 2011 and 2016 Interprofessional Collaborative Practice report competency domains. The purpose of this study was to create a German version of the IPAS (G-IPAS) to use for the education of healthcare students. Methods: We performed the translation and validation of the IPAS in five steps: translation to German according to the International Society of Pharmaeconomics and Outcome Research guidelines; nine cognitive interviews with healthcare professionals and students;calculation of the Content Validity Index (CVI) by expert opinion; exploratory factor analysis (EFA); and internal consistency by Cronbach's alpha. All study participants gave written informed consent and the cantonal ethics committee waived further ethical approval. Results: The cognitive interviews led to replacement of single-item wording. We retained 27 items for CVI analysis. The averaged overall CVI was 0.79, with 15 items ?0.89. 185 students (70 medicine, 51 nursing, 48 physiotherapy, and 16 midwifery) contributed with data for the EFA and it produced three subscales. "Teamwork, roles, and responsibilities" with factor loadings ?0.49, "Patient-centeredness" with factor loadings ?0.31, and "Community-centeredness" with factor loadings ?0.57. Two items of the total scale were deleted, and four items were redistributed to another subscale. Cronbach's alpha for the overall G-IPAS scale was 0.87. After deleting and redistributing items in subscales, a new Scale-CVI/Average was calculated and was 0.82. Conclusions: Based on a rigorous validation process, the G-IPAS provides a reliable tool to assess attitudes towards interprofessional education among different healthcare professions in German-speaking countries.

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Cultural adaptation, compounding vulnerabilities and conjunctures in Norse Greenland.

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