Recent publications have urged researchers to address neuropsychological assessment issues among culturally and linguistically diverse individuals for whom current assessment measures are not typically appropriate. This dissertation examined cultural considerations in clinical neuropsychological practice with Cree-speaking Canadians residing in Saskatchewan. Four inter-related studies focused on understanding cultural perceptions of normal aging and dementia within a Canadian Aboriginal population, modifying existing screening and neuropsychological assessment instruments for use in both normal aging research and clinical practice, and investigating the role of culture in cognitive aging with Cree-speaking. Study 1 involved the qualitative analyses of a series of key informant interviews with an Aboriginal Grandmothers Group. Three related themes were identified that highlighted Aboriginal experiences of aging, caregiving, and dementia within the healthcare system. The third theme, the importance of culturally grounded healthcare, directly informed test development for Studies 2 and 3. In Study 2, two screening measures that were adapted for use with seniors from diverse cultural groups were further modified and examined for use with Canadian Aboriginal seniors. Overall, performance was consistent across the two screening measures, and the measures informed clinical diagnosis and were well-received by both the Aboriginal patients and their family members. Study 3 describes the development of the Grasshoppers and Geese Test battery (G&G), created by modifying and integrating existing instruments and paradigms for language and memory assessment for use with culturally diverse seniors. All G&G subtests demonstrated adequate preliminary psychometric properties and generated excellent sensitivity and good specificity in differentiating healthy older adults from adults with Alzheimers disease. Finally, Study 4 examined performance on the G&G and on other neuropsychological measures in groups of young-middle aged and older adults from majority culture and Cree background. Cree participants mean scores were lower on measures of confrontational naming, semantic memory, verbal fluency, prospective memory, and processing speed, and were presumed to be in keeping with the significantly fewer years of education, lower estimated reading ability, and possible health disparities in the participants of Cree background. Findings of the four studies are discussed in the context of implications for current clinical practice and with regard to future research.

Recent publications have urged researchers to address neuropsychological assessment issues among culturally and linguistically diverse individuals for whom current assessment measures are not typically appropriate. This dissertation examined cultural considerations in clinical neuropsychological practice with Cree-speaking Canadians residing in Saskatchewan. Four inter-related studies focused on understanding cultural perceptions of normal aging and dementia within a Canadian Aboriginal population, modifying existing screening and neuropsychological assessment instruments for use in both normal aging research and clinical practice, and investigating the role of culture in cognitive aging with Cree-speaking. Study 1 involved the qualitative analyses of a series of key informant interviews with an Aboriginal Grandmothers Group. Three related themes were identified that highlighted Aboriginal experiences of aging, caregiving, and dementia within the healthcare system. The third theme, the importance of culturally grounded healthcare, directly informed test development for Studies 2 and 3. In Study 2, two screening measures that were adapted for use with seniors from diverse cultural groups were further modified and examined for use with Canadian Aboriginal seniors. Overall, performance was consistent across the two screening measures, and the measures informed clinical diagnosis and were well-received by both the Aboriginal patients and their family members. Study 3 describes the development of the Grasshoppers and Geese Test battery (G&G), created by modifying and integrating existing instruments and paradigms for language and memory assessment for use with culturally diverse seniors. All G&G subtests demonstrated adequate preliminary psychometric properties and generated excellent sensitivity and good specificity in differentiating healthy older adults from adults with Alzheimers disease. Finally, Study 4 examined performance on the G&G and on other neuropsychological measures in groups of young-middle aged and older adults from majority culture and Cree background. Cree participants mean scores were lower on measures of confrontational naming, semantic memory, verbal fluency, prospective memory, and processing speed, and were presumed to be in keeping with the significantly fewer years of education, lower estimated reading ability, and possible health disparities in the participants of Cree background. Findings of the four studies are discussed in the context of implications for current clinical practice and with regard to future research.

There are 5.7 million people in India who are living with HIV/AIDS and many more are indirectly affected by the epidemic (families, children). Since HIV/AIDS is a growing problem, further research for prevention and treatment is needed. Family therapists possess an important role in the AIDS crisis given that some family therapy models have been shown to work well with HIV issues. Although there is a need for family therapy in India, the profession of family therapy is in its infancy. This study attempts to understand what marriage and family therapy interventions work best with Indian clients especially those who are HIV positive. Psychoeducation, directive therapy, addressing the presenting problem and systems therapy (particularly focusing on the couple husband-wife system) are interventions found in this study to be most utilized by Indian therapists with their clients. / Ph. D.

Abstract HIV/AIDS is a global epidemic with the greatest burden in terms of prevalence, morbidity and mortality in sub-Saharan Africa, parts of Asia and, more recently, the Caribbean. Immigrants from these regions of birth now make up a significant proportion of people living with HIV in many high-income countries, including Australia. The higher priority accorded to people from culturally and linguistically diverse (CALD) backgrounds in Australian national and local HIV/AIDS strategies generates a broad question on ‘how’ to implement HIV prevention interventions with immigrants to address what are often atypical modes of HIV transmission and observed disparities in areas such as later presentation with HIV. HIV prevention in Australia has included whole-of-population approaches alongside targeted approaches, which address HIV prevention with specific groups – usually those disproportionately affected by HIV/AIDS such as gay men or injecting drug users. Targeted health promotion interventions for immigrants have also formed part of the HIV response in Australia. Immigrants in Australia may have acquired HIV prior to their first arrival in Australia, on subsequent travel abroad, or within Australia. A key gap in our evidence base in Australia includes what we can learn from interventions implemented in other high-income countries to guide new, or strengthen existing, approaches to culturally appropriate primary and secondary HIV prevention with immigrants locally. Typically it is taken as a given that prevention interventions will be more effective if they are culturally appropriate to the population they serve, and a range of strategies and activities are used to achieve this. However, there is rarely an examination of what mechanisms – the ‘change elements’ or program theories of the intervention – contribute to culturally appropriate interventions. This research, in the form of a realist review of evidence, sought to ‘unpack’ the mechanisms for achieving cultural appropriateness in HIV prevention interventions with immigrants that have been implemented in contexts similar to Australia. Thus the broad question the research sought to answer was ‘How and why do interventions work (or not), for which groups of immigrants, and in what contexts?’ The review of evidence in HIV prevention included a span of interventions from community-level approaches using mass media through to interventions delivered at a group level to immigrants. Systematic searches were carried out on major public health databases (PubMed, CINAHL, Sociological Abstracts, PsychInfo) and Google Scholar to find peer-reviewed and grey literature relevant to HIV prevention among immigrants. Two types of studies contributed to the review of evidence – studies of interventions and qualitative studies of immigrants’ views on HIV/AIDS prevention – in order to bring together ‘expert’ and ‘lay’ understandings of HIV prevention among immigrants. Simultaneously, a scan of the literature mapped preliminary mechanisms contributing to cultural appropriateness in HIV prevention interventions with immigrants. This preliminary set of seven mechanisms – ‘authenticity’, ‘understanding’, ‘consonance’, ‘specificity’, ‘embeddedness’, ’endorsement’ and ‘framing’ – were theorised as the key, rather than the only, interrelated mechanisms contributing to cultural appropriateness in interventions with immigrants. These preliminary mechanisms were then tested, revised and refined against evidence – 74 ‘grey’ and peer-reviewed studies and reports relevant to HIV prevention with immigrants – found in systematic searches. The evidence indicates that the pivotal mechanisms contributing to cultural appropriateness in HIV prevention interventions with immigrants are ‘understanding’ and ‘consonance’ – ensuring that language (usually the ‘mother tongue’) and cultural values are included as key elements in the development and implementation of the intervention. ‘Authenticity’, ‘specificity’ and ‘embeddedness’were moderately important in contributing to cultural appropriateness – mechanisms that dealt with staffing, targeting through ethnicity and using settings for interventions – from the evidence included in the review. Finally, there was mixed evidence for the roles of ‘endorsement’ and ‘framing’, which suggests that gaining community endorsement or partnering initiatives with immigrants or immigrant community institutions were the least critical mechanisms in contributing to cultural appropriateness in terms of HIV prevention interventions. Further research is needed to examine the relationships between these seven mechanisms and any impacts they contribute to the effectiveness of interventions and HIV-related health outcomes among immigrants.

No description available.

Users can assess the visual appeal of a web page within 50 milliseconds and color is the first thing noticed onscreen. That directly influences user perception of the website, and choosing appealing color combinations is therefore crucial for successful web design. Recent scientific research has identified which individual colors are culturally preferred in web design in different countries but there is no similar research on hue combinations. Currently no effective, scientifically based guidelines on combining hues for web designers exist either, since recent research by Ou et al and Szabo et al, among others, proves the classic color harmonies invalid. Therefore this study aims to identify guidelines for culturally appropriate hue combination in context of web design. The study is limited to culturally appropriate combining of hues in Thai and Swedish web design.

<p>Urban Aboriginal health and health-related issues are steeped within the sociohistorical, sociocultural, and sociopolitical experiences of Aboriginal peoples since European contact. Thus, urban Aboriginal health issues are very complex in that they consist of aspects associated with collective as well as individual cultural and political life experiences. Therefore, in order to adequately address Aboriginal health issues a comprehensive and multidisciplinary approach is required.</p> <p>This study examines how Anishnawbe Health Toronto, an urban Aboriginal community health centre, addresses the specific healthcare needs of the urban population through a multidisciplinary culturally appropriate healthcare model. As my research evolved, a few themes emerged from the data. First, the health issues experienced by the clientele were inherently complex and simultaneously infused with a culturally collective and individualistic quality. Second, practitioners acknowledged and addressed the complex nature of the clients’ health problems through a unique model of health care created at the centre. Third, the philosophy, infrastructure, and model of health care at Anishnawbe Health Toronto goes beyond the notion of merely offering access to both systems of health care, and instead constitutes an innovative and culturally appropriate system of care which is under Aboriginal control, development and implementation. Therefore, through my analysis of these themes, I conclude that the model of health care developed at the centre is an example of complex solutions designed to address complex Aboriginal health issues and as a result, facilitate the embodiment of self-determination in the area of health care.</p> / Doctor of Philosophy (PhD)

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when delivering culturally appropriate diabetes care, so a focus on cultural knowledge, intercultural patient-provider communication skills, and cultural assessment were key to this case study. One pilot study was conducted to test the focus group questions with 3 diabetes providers (i.e., certified nurse diabetes educator [CDE], registered nutritionist, and dietitian) who help patients to self-manage their diabetes. The second pilot study was conducted with 5 African immigrant patients who had been diagnosed with Type 2 diabetes. The primary focus groups were conducted with 5 CDEs and 10 patients. The transcribed responses were analyzed and categorized to identify the 17 themes that emerged (9 from the CDEs and 8 from the patients). One implication for social change is that a patient-centered approach to patient-provider communication will mean better health outcomes. To ensure culturally appropriate patient-provider communication, a change in health care delivery is required to incorporate cultural constructs as part of diabetes care and education to accommodate various ethnic and racial groups.

The growing number of minority populations living in the United States makes it mandatory that all health care organizations seek to be culturally sensitive. There is no consensus on the definition of the term cultural sensitivity. The goal of this thesis is to define what cultural sensitivity means in a rural health center, from the perspective of the staff as well as the Hispanic patient. Anthropological methods, such as participant observation, semi-structured interviews, and archival data analysis, show that the qualities that Hispanic patients value in a clinic are 1) attention, 2) availability of Spanish language, 3) financial assistance, 4) solution to their health problems, 5) presence of Hispanics around the clinic, and 6) clinic services. Furthermore, 90% of staff responses indicate acceptance and respect of patients health beliefs and practices. Results demonstrate that while the clinic is culturally sensitive, there are a few recommendations that would improve the quality of care that Hispanics receive. Based on the results of the data collection, a practical model for other rural health centers to build upon a culturally sensitive health care system is developed.

The purpose of this study, which is grounded in applied linguistics, was to investigate two ways of presenting vocabulary in a German language class in order to determine whether Frame Semantics is a feasible tool with regards to students’ vocabulary acquisition and culturally appropriate usage of vocabulary. In addition, this study examined learners’ attitudes toward the new method of vocabulary teaching and learning. A total of 34 university students enrolled in four second-semester German classes participated in this study. In the Control Group rote memorization techniques were used, while the in the Treatment Group frame semantics was utilized for the teaching and learning of vocabulary. The data was analyzed through quantitative methods. The quantitative data was derived from an online demographic survey, a vocabulary pre-test, two vocabulary post-tests (an immediate post-test and delayed post-test), a cultural appropriateness pre-test, two cultural appropriateness post-tests (an immediate post-test and delayed post-test), as well as an pre-test and post-test attitude scale provided as an online questionnaire. Analysis of the data indicates that there was no statistically significant difference between the two groups with regards to their cultural appropriate usage of the vocabulary items, and no statistically significant differences were observed with regards to vocabulary recall and retention. In addition, only the factor of enjoyment yielded significant differences with regards to learners’ attitude, while the factors of motivation, interest and confidence did not show statistically significant differences between the groups. Thus, the results indicate that both methods – Frame Semantics and the more traditional methods – are suitable for vocabulary learning and teaching as both methods resulted in an increase of learners’ vocabulary knowledge, including long-term retention. / text