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PubMedDate not supplied

Transforming ethnocentricity in nursing: a culturally relevant experience of reciprocal visits between Malta and the Midwest.

Despite efforts by the nursing profession to enhance culture competence among nurses, some limitations in understanding the potential lack of culture competence in the patient remain. Nurses are often not aware of their own cultural bias from the patient's perspective (ethnocentricity) and fail to understand that many patients are trying to function in unfamiliar social and medical cultures simultaneously. This article reviews the experiences of student nurses from Malta and the Midwestern United States who were given the opportunity to explore their cultural biases by visiting the healthcare institutions of their respective countries.

Attitude of Health Personnel↗
PubMed1972

Number of deoxyribonucleic acid uptake sites in competent cells of Bacillus subtilis.

Two direct methods are presented for estimating the average number of deoxyribonucleic acid (DNA) uptake sites in competent cells of Bacillus subtilis from measurement of (14)C- or (3)H-thymine-labeled DNA uptake by competent culture. Advantage is taken of two facts: (i) effective contact between competent cells and transforming DNA molecules is established within a short time after mixing them together, and (ii) DNA molecules enter the competent B. subtilis cells in a linear fashion at a finite speed. From the number of DNA molecules initially attached to competent cells by brief exposure to transforming DNA in the first method or from the rate of DNA uptake by competent culture in the second method, the average number of DNA uptake sites is calculated to be 20 to 53 per competent cell.

Bacillus subtilis↗
PubMed2002

Breastfeeding in African-American women.

Currently, a disparity in breastfeeding exists between White, Hispanic, and African-American women. When education and income level are similar in women of these populations, the disparity is minimized. Until similar education and incomes are more fully realized, the disparity in breastfeeding may be reduced by provision of culturally competent care. The purpose of this manuscript is to provide data supporting the disparity in breastfeeding, define culture, and relate how one provides culturally competent care in relation to breastfeeding. Cultural points such as kinship, religion, matriarchy, characteristics of males and adolescents in this group, as well as early introduction of cereal feedings are reviewed. Interventions based on cultural points and characteristics that have been found to or may promote breastfeeding in African-American women are presented.

Adolescent↗
PubMed2005

Dosage effects of diabetes self-management education for Mexican Americans: the Starr County Border Health Initiative.

OBJECTIVE: The objective of this study was to compare two diabetes self-management interventions designed for Mexican Americans: "extended" (24 h of education, 28 h of support groups) and "compressed" (16 h of education, 6 h of support groups). Both interventions were culturally competent regarding language, diet, social emphasis, family participation, and incorporating cultural beliefs. RESEARCH DESIGN AND METHODS: We recruited 216 persons between 35 and 70 years of age diagnosed with type 2 diabetes >/=1 year. Intervention groups of eight participants and eight support persons were randomly assigned to the compressed or extended conditions. The interventions differed in total number of contact hours over the year-long intervention period, with the major difference being the number of support group sessions held. The same information provided in the educational sessions of the extended intervention was compressed into fewer sessions, thus providing more information during each group meeting. RESULTS: The interventions were not statistically different in reducing HbA(1c); however, both were effective. A "dosage effect" of attendance was detected with the largest HbA(1c) reductions achieved by those who attended more of the extended intervention. For individuals who attended >/=50% of the intervention, baseline to 12-month HbA(1c) change was -0.6 percentage points for the compressed group and -1.7 percentage points for the extended group. CONCLUSIONS: Both culturally competent diabetes self-management education interventions were effective in promoting improved metabolic control and diabetes knowledge. A dosage effect was evident; attending more sessions resulted in greater improvements in metabolic control.

Adult↗
PubMed2000

The intersection of socioeconomic variables, oral health, and systemic disease: all health care is cultural.

In the last decade, there has been an increase in the proportion of the American population that lacks health insurance. Additionally, long-term disparities in health access and status for populations of color have continued to exist without major change. A review of the literature in periodontia shows a statistical relationship between the risk of periodontal disease and a range of sociodemographic characteristics (race, income, social class). However, the factors giving rise to this increased risk or how to reduce it are unclear. Cultural competence, an elaboration of biopsychosocial theory, hypothesizes a relationship between the culture of a group and its risk of disease and the kind and quality of services obtained. Four areas of a culturally competent approach are cited as a minimum base of standards for providing services to people of color.

Chronic Disease↗
PubMed1988

Highly efficient genetic transformation of Bacillus subtilis attached to sand grains.

Genetic transformation at the solid/liquid interface was studied using Bacillus subtilis 1G20 (trpC2) with a flow-through system of columns filled with chemically pure sea sand. Studies were done at 23 degrees C. In one type of experiment, competent cultures were incubated with sand-adsorbed DNA, and in another, competent cultures were exposed to sand and then incubated with dissolved DNA for transformation. Of the applied cells, around 10% were retained in columns filled with DNA-loaded sand and around 1% in columns with pure sand. Reversible attachment of some of the cells to surfaces of sand grains could be demonstrated. The overall transformation frequencies obtained were 25- to 50-fold higher than in a standard liquid culture procedure. In this standard procedure, transformation was sensitive to DNAase I concentrations above 50 ng ml-1, whereas in sand columns it was resistant to DNAase I concentrations up to 1 microgram ml-1. Quantification of transformants eluting from columns indicated that sand-attached cells detach at some point after DNA binding or uptake.

Adsorption↗
PubMed2002

Ethnicity and clinical psychology: a content analysis of the literature.

As the demographics of the U.S. population continues to change and become increasingly diverse, clinical psychologists will need to demonstrate their competence in providing culturally appropriate treatments to a wide variety of populations. This article summarizes a comprehensive content analysis of five of the leading scholarly journals in clinical psychology over a 17-year period (1980-1997). Results indicate that only 29.3% of the published articles in the clinical psychology literature included ethnic minority participants. Furthermore, only 5.4% of the articles actually focused specifically on ethnic minority populations. Thus, the clinical psychology literature does not contain adequate coverage of ethnically diverse populations in the U.S., despite their growing numbers. This content analysis provides the field with a baseline for future comparison to determine whether the field in general is responding to the needs of an increasingly diverse society, and to help gauge whether clinical psychologists have the scholarly resources available to assist them with becoming more culturally competent. Implications for the paucity of research and recommendations to ameliorate the problem are discussed.

Cultural Diversity↗
PubMed2003

Confronting "culture" in medicine's "culture of no culture".

The author presents reflections from medical anthropology on the institutional culture of medicine and medical education, which sees itself as a "culture of no culture" and which systematically tends to foster static and essentialist conceptions of "culture" as applied to patients. Even though requirements designed to address cultural competence are increasingly incorporated into medical school curricula, medical students as a group may be forgiven for failing to take these very seriously as long as they perceive that they are quite distinct from the real competence that they need to acquire. To change this situation will require challenging the tendency to assume that "real" and "cultural" must be mutually exclusive terms. Physicians' medical knowledge is no less cultural for being real, just as patients' lived experiences and perspectives are no less real for being cultural. Whether this lesson can be effectively conveyed within existing curricular frameworks remains an open question. Cultural competence curricula will, perhaps, achieve their greatest success if and when they put themselves out of business-if and when, that is, medical competence itself is transformed to such a degree that it is no longer possible to imagine it as not also being "cultural."

Attitude of Health Personnel↗
PubMedDate not supplied

Creating an inclusive environment for black and minority ethnic nurses.

Black and minority ethnic nurses are an important part of today's NHS and acknowledging the part that they play and creating an environment where they feel valued is essential for multiprofessional working. Celebration of the diversity that nurses from different ethnic backgrounds bring to nursing care and to team working is often absent from the cultural environment in which nurses work. In fact, nurses can feel discriminated against and feel that their ethnic background is adversely affecting their career progression (Beishon et al, 1995). Creating a culturally competent environment should be central to the ethos of the NHS and cultural awareness and cultural empowerment are key components of an enhanced level of cultural competence. Education and career development opportunities are essential in enhancing confidence and self-esteem and in creating career progression equality for nurses from different ethnic backgrounds.

Attitude of Health Personnel↗
PubMed1983

Mutually antagonistic effects of hydrocortisone and retinyl acetate on envelope competence in cultured malignant human keratinocytes.

Serially propagated SCC-13 keratinocytes, derived from a human squamous cell carcinoma, are greatly influenced by culture conditions in their ability to form ionophore-inducible cross-linked envelopes. Supplementation of the growth medium with fetal bovine serum at concentrations ranging from 0.5 to 20 percent had little effect on competence to form envelopes in confluent cultures. At each serum concentration, however, addition of hydrocortisone to the medium led to an increase in competence of almost fourfold, from approximately 20 to nearly 80 percent. With the serum supplementation held at 5 percent, addition of retinyl acetate to the medium suppressed competence in a concentration-dependent manner over the range of 1 to 100 ng/ml. At the highest concentration employed, competence was reduced over fourfold in the presence of hydrocortisone and virtually eliminated in its absence. When the cells were grown using serum depleted of endogenous vitamin A, a majority were competent in the absence of hydrocortisone. Under this condition, retinyl acetate suppressed competence over fivefold in the absence of hydrocortisone, but not at all in its presence. We conclude that hydrocortisone stimulates envelope competence primarily by antagonizing the suppressive effect of vitamin A. The SCC-13 cell line may prove valuable in studying mechanisms of retinoid and corticosteroid therapeutic action on diseased human keratinocytes.

Carcinoma, Squamous Cell↗
PubMed2004

Individual and cultural-diversity competency: focus on the therapist.

The Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology was held in Arizona in November 2002. One of the workshops, Individual and Cultural Differences (ICD), focused on racism, homophobia, and ageism. The consensus was that self-awareness and knowledge about the three "isms" are critical components in the education and training of psychologists. This article, authored by four of the workshop attendees, is a review of the current research and theoretical literature. Implications that address both content and context in graduate programs and training sites are presented. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.

Clinical Competence↗
PubMed1999

Cultural views of cancer around the world.

Social attitudes toward cancer, participation in early detection and screening services, and compliance with treatment are all known to be profoundly affected by cultural beliefs and norms. It is thus imperative that oncology nurses develop cultural competence and deliver culturally sensitive care. Cross-cultural nursing studies also require cultural sensitivity because they rely on the accurate choice of culturally relevant research methods. However, the specific steps that should be taken to enhance the cultural relevance of both nursing health care delivery and nursing research have yet to be elaborated. This article aims to clarify these issues on the basis of a critical survey of the literature on cultural views of cancer in multiethnic societies and in various countries around the world. The analysis of studies focusing on this subject illuminates misconceptions that may interfere with the application of cancer nursing to other cultures, and possible misinterpretations of cultural and cross-cultural research findings. The conclusions drawn from this analysis concern practical means for facilitating nurses' ability to properly address cultural diversity through the incorporation of culture-related variables into nursing interventions. They also relate to the education of nurses about cross-cultural aspects of cancer, culturally sensitive assessment tools, comparative studies, and theories in the field of international cancer nursing, all of which await further development.

Attitude to Health↗
PubMed1996

Professional development in nursing research--a culturally diverse postdoctoral experience.

Given the current shift from culturally-sensitive to culturally-competent healthcare, preparing culturally diverse nurse-scientists beyond the doctorate is crucial to the ability to better understand the healthcare of diverse client populations. The probability of ethnic-minority postdoctoral fellows having mentors of the same race is low. This article describes key issues to consider for culturally integrated professional development experiences between ethnic-minority postdoctoral nursing research fellows and White, non-Hispanic nurse-scientists. The discussion delineates three characteristics that describe a scientific community: communality, colleagueship, and constructive competition. Conclusions are that four factors are critical to ensuring the survival and success of ethnic-minority researchers: instruction, affiliation and mentoring, sustaining ethnic-minority researchers' contributions, and expanding the number of ethnic-minority researchers.

Culture↗
PubMed2003

Approaching death in multicultural Australia.

Culture is a system of shared ideas, concepts, rules and meanings that underlies the way we live--and approach death. Cultural diversity refers to more than ethnic diversity: age, gender, sexual preference, capabilities, education, place of residence, and occupation (including the health professions) contribute to diversity of culture. Clinical decision making involves values and ethical principles, which are influenced by culture--not only of the patient but also of the carers and health professionals. Care of patients approaching death involves the whole healthcare system--but may need, from time to time, palliative care specialist input, including specialised cultural competence. Education and training of palliative medicine specialists in Australia needs to include a focus on cultural competence.

Attitude to Death↗
PubMedDate not supplied

An educational model for child welfare practice with English-speaking Caribbean families.

Implemented in New York City, the Child Welfare Fellowship Project is an international collaboration between social work educators in the United States and Jamaica, the West Indies, the public child welfare agency, and selected community-based agencies. This model educational program prepared selected Masters of Social Work (MSW) Fellowship students for exemplary child welfare practice with English-speaking Caribbean families by providing enhanced programs designed to support culturally competent skill development and a preventive approach to child welfare practice. These educational enhancements, combined with academic course work, increased professionalism, self-efficacy, and culturally competent skill development among participants and averted foster care placement for families seen over the duration of the project.

Caribbean Region↗
PubMed1992

Analysis of competence in cultured sea urchin micromeres.

Sea urchin embryo micromeres form the primary mesenchyme, the skeleton-producing cells of the embryo. Almost nothing is known about nature and timing of the embryonic cues which induce or initiate spicule formation by these cells. A related question concerns the competence of the micromeres to respond to the cues. To examine competence in this system we have exposed cultured sea urchin micromeres to an inducing medium containing horse serum for various periods of time and have identified a period when micromeres are competent to respond to serum and form spicules. This window, between 30 and 50 h after fertilization, corresponds to the time when mesenchyme cells in vivo are aggregating and beginning to form the syncytium in which the spicule will be deposited. The loss of competence after 50 h is not due to impaired cell health since protein synthesis at this time is not significantly different from controls. Likewise the accumulation of a spicule matrix mRNA (SM 50) and a cell surface glycoprotein (msp 130), both indices of micromere/mesenchyme differentiation, still occurs in cells that have lost competence to respond to serum by forming spicules. These experiments demonstrate that the acquisition and loss of competence in these cells are regulated developmental events and establish an in vitro system for the identification of the molecular basis for inductive signal recognition and signal transduction.

Animals↗
PubMed2001

Quality nursing care celebrates diversity.

At the beginning of the 21st century, the familiar biomedical health care "culture" must accommodate not only persons from diverse cultures, but also diverse systems of care. For perhaps the first time in over a century, biomedicine must accommodate others rather than require them to assimilate into its "culture." This fundamental shift requires nurses to move quickly to develop cultural competency as individuals and to provide leadership for this system-wide change. Such competence is important when using complementary and alternative modalities. This article addresses America s experience with diversity and its legacy in today s health indicators; it explores cultural competency and its achievement at the individual and system levels; and it discusses the use of complementary and alternative treatments that are a part of this health care "revolution." Nurses are challenged to shape this reform as did the founder of modern nursing 150 years ago.

Clinical Competence↗