Thesis (M.A.)--University of Hawaii at Manoa, 1997 / Pacific Islands Studies

Multidimensional aesthetics in photomedia practice shift the emphasis away from the culturally dominating singularity of the camera's eye-piece towards a supple interplay of semi-transparent image planes and shifting positions. Using various image-capture devices that can produce digital, film, still or moving pictures, I create bodies of work that invite the viewer to see many perspectives simultaneously. The challenge is to implement the effectiveness of the technologies and simultaneously dislodge those principles and values fundamental to their imperialist cultural backgrounds. My practice investigates a diplomatic negotiability of aesthetic language to accommodate conceptual and cultural difference/s. Located on the print surface or in animated sequences are symbolic representations that disclose histories, cultures, times and places in subtle and ambiguous ways. The interplay of allure and resistance, repetition and change, are strategies that reveal the delicate and paradoxical nature of the multidimensional psyche.

Bakgrund: Den växande kulturella mångfalden i Sverige har lett till nya utmaningar för samhället och inte minst för sjukvården. Kultur är universellt för alla människor och speglas bland annat av faktorer som religion, värderingar, språk, miljö och kön. Den kulturella bakgrunden influerar våra uppfattningar av hälsa och sjukdom och hur vi ger uttryck för smärta och obehag. Det finns likheter och olikheter som leder till att vårdande kan förstås på olika sätt och kräver därför kulturellt kompetenta vårdgivare. Syfte: Syftet är att belysa hur vårdtagare med olika kulturella bakgrunder och vårdpersonal upplever transkulturella möten inom den svenska sjukvården. Metod: Litteraturöversikt där tolv kvalitativa studiers resultat har syntetiserats och sammanställts. Sex artiklar utgår från ett vårdtagarperspektiv och sex från ett vårdpersonalperspektiv. Gemensamt för studierna är att de belyser upplevelser av transkulturella möten i svensk sjukvård. Resultat: Tre teman framkom med två subteman vardera. Det första temat är ”Utmaningar relaterat till kommunikation”, med två subteman, ”Språket som hinder” och ”Användning av tolk”. Det andra temat är ”Utmaningar relaterat till kulturella olikheter”, med två subteman, ”Olikheter i synen på vård och vårdande” och ”Uppfattningar om könsskillnader”. Det tredje temat är ”Fördomar och kränkande bemötande”, med två subteman, ”Fördomar och misstro” och ”Upplevelser och tankar om kränkande bemötande”. Diskussion: Resultatet i denna studie ger en bild av att transkulturella möten i vården inte är helt okomplicerade. Det saknas verktyg att närma sig varandra i transkulturella möten och det handlar om att hitta nya vägar att kommunicera, både verbalt men också icke-verbalt. Vårdpersonal upplever känslor av frustration och osäkerhet när de vårdar människor med andra kulturella bakgrunder än den egna. Dessa känslor kan ses som exempel på ett etnocentriskt förhållningssätt. För att vårdpersonal ska kunna utveckla kulturell kompetens krävs utbildning och reflektion om transkulturell omvårdnad. / Background: The increasing cultural diversity in Sweden has led to new challenges for the society and the health care services. Culture is universal for all humans and is reflected by factors such as religion, values, language, environment and gender. The cultural background influence our perceptions about health and sickness and how we express pain and discomfort. There are similarities and differences which leads to different understandings about caring hence the importance of cultural competence among health care staff. Aim: To illuminate clients and health care staff´s experiences of transcultural meetings in the context of Swedish health care. Methods: A litterature overview. The results of twelve qualitative studys have been synthesized and summarized. Six articles are from a clients perspective and the other six from a health care staff perspective. All of the studys have in common that they illuminate experiences of transcultural meetings in Swedish health care. Results: Three themes emerged with two subthemes each. The first theme is ”Challenges related to communication” with two subthemes, ”Language as a barrier” and ”The use of interpreter”. The second theme is ”Challenges related to cultural differences” with two subthemes, ”Different views of care and caring” and ”Perceptions about gender-differences”. The third theme is ”Prejudices and offensive treatment” with two subthemes, ”Prejudices and disbeliefs” and ”Perceptions and thoughts about offensive treatments”. Discussion: The result in this study provides a picture that transcultural meetings are not entirely uncomplicated. There are lack of tools to approach one another in transcultural meetings and it is a matter of finding new ways to communicate, both verbally and non-verbally. Health care staff experience feelings of frustration and insecurity when they care for people with different cultural backgrounds than their own. These feelings can be understood as examples of an ethnocentric approach. In order to develope cultural competence the health care staff needs education and reflection of transcultural care.

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-08-29T18:19:24Z No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) / Approved for entry into archive by Ronildo Prado (producaointelectual.bco@ufscar.br) on 2017-11-09T17:47:10Z (GMT) No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) / Approved for entry into archive by Ronildo Prado (producaointelectual.bco@ufscar.br) on 2017-11-09T17:47:20Z (GMT) No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) / Made available in DSpace on 2017-11-09T17:55:04Z (GMT). No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) Previous issue date: 2017-02-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introduction: The Wheelchair Skills Test Questionnaire is a tool that measures the functional mobility in different environments and that can contribute to improving the skills of people in wheelchairs reflecting on trust, safety and independence. In Brazil, there is a gap of assessment, encompassing the use of assistive technology and functional mobility at the level of the necessary skills in the daily lives of people who use wheelchairs and caregivers. Objective: Cross-cultural adaptation of Wheelchair Skills Test Questionnaire (WST-Q), version 4.3 for manual wheelchair users and caregivers, to Portuguese language (Brazil). Methodology: The methodological procedure involved the steps of: 1) translation; 2) back translation; 3) analysis by a committee of experts; 4) pretest according to international guidelines. Results: The version was assessment by 15 wheelchair users and 15 caregivers. In total 8 out of 30 participants presented suggestions to facilitate an understanding of the target audience. The instrument is displayed for easy understanding. Conclusion: The participants approved the WST-Q 4.3 as useful in the Brazilian reality. It is recommended to evaluate the measurement properties for a version in a representative sample. / Introdução: O Wheelchair Skills Test Questionnaire é uma ferramenta que avalia a mobilidade funcional em diferentes ambientes e que pode contribuir para melhorar as habilidades de pessoas em cadeira de rodas repercutindo na confiança, segurança e independência. No Brasil, existe uma lacuna de ferramentas de avaliação, que articulem o uso da tecnologia assistiva e a mobilidade funcional no nível das capacidades necessárias no cotidiano de pessoas que usam cadeira de rodas e de cuidadores. Objetivo: realizar a adaptação transcultural do instrumento Wheelchair Skills Test Questionnaire (WST-Q), versão 4.3 para usuários de cadeiras de rodas manuais e cuidadores, na língua portuguesa (Brasil). Metodologia: O procedimento metodológico envolveu as etapas de: 1) tradução; 2) retrotradução; 3) Análise por um comitê de especialistas; 4) pré-teste conforme diretrizes internacionais. Resultados: A versão resultante deste processo passou por um pré-teste com a população alvo, 15 usuários de cadeira de rodas e 15 cuidadores. No total 8 de 30 participantes apresentaram sugestões para facilitar a compreensão do público alvo. O instrumento se mostrou de fácil compreensão. Conclusão: Os participantes avaliaram o WST-Q 4.3 como útil à realidade brasileira. Recomenda-se avaliação das propriedades de medidas dessa versão numa amostra representativa.

Mångkulturell hälso- och sjukvård har ökat i Sverige på senare år på grund av krig i Syrien, och oro i andra länder i bland annat Mellanöstern och Afghanistan. Det har medfört mänskliga tragedier och stora flyktingströmmar. Sverige har tagit emot en stor andel av flyktingströmmen. Detta ställer nya krav på distriktssköterskan som i ett tidigt skede möter flyktingarna. Syftet med studien var att beskriva distriktssköterskans erfarenheter av hälsofrämjande och förebyggande arbete med nyanlända flyktingar ur ett vårdcentralsperspektiv. Metod: En kvalitativ intervjustudie med sju distriktssköterskor från olika vårdcentraler inom en västsvensk region. Materialet analyserades med en kvalitativ innehållsanalys. Resultat: Det framkom åtta subteman och fyra teman i analysen. Huvudteman var: Egenvårdens betydelse för att främja hälsan, Förebyggande arbete ur ett vårdcentralsperspektiv, Att kommunicera via tredje part samt Samordning mellan parter. Slutsats: Distriktssköterskornas hälsofrämjande och förebyggande arbete var betydelsefullt för de nyanlända flyktingarna eftersom distriktssköterskan var en av de yrkesprofessioner som de träffade i ett tidigt skede. Egenvårdsråd utmärkte det hälsofrämjande arbetet med nyanlända flyktingar men kunde vara svårt då många nyanlända flyktingar var vana från sina hemländer att alltid möta en läkare. Det utmärkande för det förebyggande arbetet var framförallt arbetet med vaccinationsuppföljning, som innebar en stor och krävande arbetsinsats för distriktssköterskorna. / Multicultural health and medical care has increased in Sweden during the last few years due to war in Syria and unrest in other countries among others in the Middle East and in Afghanistan. This has led to human tragedies and big streams of refugees. Sweden has received a large number of these refugees. This poses new demands on district nurses who at an early stage meet the refugees. The purpose of the study was to describe district nurses experience of health promoting and preventive care of newly arrived refugees from a perspective of the care centre. Method: A qualitative interview study with seven district nurses from different care centres within a region in West Sweden. The material was analysed with a qualitative analysis of content. Result: The analysis resulted in eight subthemes and four themes. Main themes were: The importance of self-care in order to promote health, Preventive work from a perspective of the care centre, To communicate through a third party and Co-ordination between parties. Conclusion: District nurses health promoting and preventive care was important for newly arrived refugees as the district nurse was one of the professionals they met at an early stage. Advice on self-care characterized the health promoting work with newly arrived refugees but could be difficult, as many refugees were used always to meet a doctor in their home countries. Characteristic for the preventive work was above all the follow-up of vaccinations, which required big and demanding efforts for district nurses.

The need for nurses to become culturally competent is well documented in transcultural nursing literature. The subjective multidimensional nature of pain makes it imperative for nurses to use assessment methods that are culturally congruent. This study set out to explore the differences and similarities in conceptualization, experience, expression and management of pain between nurses and clients in the United Arab Emirates. The purpose of the study was to develop guidelines in the cultural pain assessment in the UAE context. The findings confirmed that nurses rely on biomedical approaches in assessment and relief of pain; clients were found to rely on the family for emotional support and on nurses for pharmacological interventions. Clients used sensory descriptors, and analogy when describing pain, nurses relied on the technical background and experience. Religious factors had a significant impact on clients' pain behavior. This study offers nurses new insights into cultural assessment of pain. / Health Studies / M. A. (Health Studies)

Yoko Tawada, écrivaine contemporaine d’expression japonaise et allemande, mène depuis trente ans une carrière qui connaît un succès critique considérable dans ses deux langues et pays d’écriture. Œuvre hybride à la croisée des genres, des langues, des cultures et des littératures, définie par une démarche autoréflexive et métalinguistique, c’est un sujet de choix pour la littérature comparée, avec laquelle elle partage des affinités fondamentales. Pourtant, elle n’est encore que peu étudiée par les comparatistes ; cette thèse se donne donc pour objet de combler en partie cette lacune. Au long d’un parcours à travers les champs de recherche et plusieurs problématiques de la littérature comparée, nous éclairons réciproquement le fonctionnement de l’écriture tawadienne et les enjeux comparatistes contemporains dans le but de démontrer l’intérêt d’un véritable dialogue entre la démarche critique et son objet. La première étape consiste à établir la pertinence et la nécessité d’une approche comparatiste. Ensuite, mimant le geste autoréflexif de l’écrivaine, nous analysons les rapports de la critique à l’œuvre littéraire afin de déterminer leurs apports mutuels. Puis nous étudions le traitement littéraire et épistémologique de la notion d’espace, et plus précisément celle de passage, centrales dans la poétique tawadienne comme dans la pratique comparatiste, avant de nous pencher sur l’Europe, espace géographique et culturel au cœur de la création chez Tawada et de la définition de la littérature comparée. Enfin, nous achevons ce parcours sur une réflexion dans les termes de Tawada sur la traduction littéraire et la littérature en traduction, nœud gordien du comparatisme. / Contemporary bilingual writer Yoko Tawada has received much critical acclaim for both her German and her Japanese literary work since 30 years now. Her hybrid writing between genres, languages, cultures and literatures, defined by a characteristic self reflexive and metalinguistic stance, is an ideal research topic for Comparative Literature. However, it has yet to be thoroughly studied by comparatists. In our thesis, we endeavour to fill part of this gap by connecting Tawada’s writing to comparative research fields and issues, in order for them to shed light on each other. Thus we aim to demonstrate what we can gain from a real dialogue between the researcher and its object of study. The first step will be to assess the meaningfulness and use of a comparative approach in the case of Tawada’s literature. Then, we will mimic the writer’s own self reflexive gesture in order to analyse the relationship between literary work and criticism and determine how they might benefit each other. Afterwards, we will study closely the epistemological and literary uses of space and passage, two crucial notions both for Comparatism and Tawada’s writing, before focusing on a more specific geographical and cultural space: that of Europe, which is also central to the writer’s literary journey as well as the very definition of Comparative Literature. Lastly, we will close with a study of Tawada’s thought-provoking take on the Gordian knot of Comparative Literature: literary translation and literature in translation.

The aim of this study is to explore the patterns of emotion recognition in Mexican bilinguals using the JACFEE (Matsumoto & Ekman, 1988). Previous cross cultural research has documented high agreement in judgments of facial expressions of emotion, however, none of the previous studies has included data from Mexican culture. Participants were 229 Mexican college students (mean age 21.79). Results indicate that each of the seven universal emotions: anger, contempt, disgust, fear, happiness, sadness and surprise was recognized by the participants above chance levels (p < .001), regardless of the gender or ethnicity of the posers. These findings replicate reported data on the high cross cultural agreement in emo- tion recognition (Ekman, 1994) and contribute to the increasing body of evidence regardingthe universality of emotions. / Este estudio presenta un meta-análisis sobre la relación entre los valores de Schwartz y el bienestar subjetivo en distintos contextos culturales, con estudiantes, sus familiares e inmigrantes en España. Los resultados confirman una asociación significativa entre los valores y el bienestar. Auto trascendencia y apertura al cambio, y con menor intensidad, conservación, se asocian positivamente con mayor bienestar. Auto trascendencia se asocia con felicidad y satisfacción de forma positiva no homogénea, siendo los inmigrantes quienes presentan medias más bajas. Apertura al cambio se asocia con felicidad, siendo más fuerte la asociación en inmigrantes que en estudiantes. Los valores conservacionistas se asocian homogéneamente. Un segundo estudio sobre criterios de salud psicosocial y bienestar subjetivo -analizando un país sudamericano colectivista y jerárquico como Brasil, y otro europeo más individualista e igualitario como España- confirma que los valores conservacionistas, así como los de apertura al cambio y auto trascendencia, son deseables y favorecen el bienestar.

Culinary narratives are frequently employed to portray migrant identities and societies in Asian diaspora literature This thesis examines cuisine and consumption in Alison Wong’s As The Earth Turns Silver by highlighting the socio-political linkages between material culture and ethnic identity formation of Chinese migrants in New Zealand. Using Brown’s thing theory, food is reframed as site of meaningful discourse to interrogate the role of cuisine and consumption in mediating the migrant experience. It demonstrates the material and cultural importance of food in facilitating ethnic and political identification, transcultural exchange, and independence for frequently oppressed migrant individuals in diaspora literature.  Conversely, food functions as vectors of aggression in racialising the ethnic other by communicating artificial notions of morality, national identity, and purity to reinforce the hegemony. Additionally, culinary objects facilitate how characters articulate their dislocation and fragmentation as hybrid individuals. Finally, I undertake a craft analysis of Wong’s novel by drawing connections between Wong’s hybridity and her narrative design. I use thing theory to demonstrate how characters use culinary objects to negotiate hybridity while the application of transference technique reveals the way material objects are embedded with abstract emotions to communicate writer and character ethnic subjectivity. Findings from the critical analysis are applied to my short story collection Raw. Thing theory provides the theoretical framework for the practical application of transference in my creative thesis, demonstrating its efficacy in improving craft. The creative thesis demonstrates the applicability of theory in creative practice. Finally, it offers an analytical framework for contextualising food as a site of discourse for hybridized identity politics in diaspora literary criticism.

A integridade da pele é fundamental para a adaptação do recém-nascido (RN) à vida extrauterina. A padronização da avaliação de enfermagem sobre a condição de pele dos neonatos é essencial para a uniformidade no manejo das alterações encontradas. A Neonatal Skin Condition Score (NSCS) consiste em ferramenta amplamente utilizada na avaliação da condição de pele do RN em países cujo idioma é o inglês. Este estudo objetivou realizar a adaptação transcultural e validação clínica da NSCS para uso no Brasil. O método utilizado na adaptação transcultural foi proposto por Beaton e colaboradores. A adaptação transcultural se estendeu de junho a dezembro de 2011. Nesta fase a escala foi traduzida e adaptada para uso no Brasil e foi avaliada a clareza da versão pré-final. Para tal, foram incluídos no estudo 38 profissionais de saúde. A avaliação da clareza da escala foi verificada por meio de escala Likert , tendo como resultado um nível de clareza superior a 80% nas três variáveis da escala. Após a validação transcultural procedeu-se a validação clínica, que teve como delineamento um estudo transversal observacional. Os dados foram coletados entre maio e julho de 2012. Foram incluídos nesta etapa da pesquisa RNs de qualquer idade gestacional internados na Unidade de Internação Neonatal (UIN) e no Alojamento Conjunto mãe-bebê (AC) do Hospital de Clínicas de Porto Alegre (HCPA). A seleção da amostra deu-se por conveniência, totalizando 47 RNs na UIN e 40 no AC. Realizou se um total de 188 avaliações na UIN e 160 avaliações no AC, considerando duas presenciais e duas por imagens digitais para cada paciente. A análise estatística da validação clínica buscou verificar a confiabilidade intra e interobservador por meio dos testes: Kappa ajustado (PABAK), coeficiente de correlação intraclasse (ICC) e método de Bland Altman. A análise da concordância item a item demonstrou boa concordância com uso do PABAK em ambas as unidades. A análise dos escores totais expressos pelo ICC demonstrou resultados satisfatórios apenas na UIN com confiabilidade intraobservador de 0,88 (muito forte) e intraobservador de 0,61 (forte). No AC a confiabilidade intraobservador foi de 0,49 (moderada) e a interobservador foi de 0,24 (fraca). O método de Bland Altman demonstrou qual foi a variação entre os escores intra e interobservadores em ambas as unidades, sendo que na UIN observou-se uma média de variação interobservador de 0,24 com 1,38 para mais e 1,87 pontos para menos enquanto a média de variação intraobservador foi de 0,1 com 0,83 pontos para mais e 1,03 pontos para menos. No AC a média de variação interobservador foi de 0,01 com 1,93 para mais e 1,91 para menos, enquanto na confiabilidade intraobservador a média de variação foi de 0,04, com variação de 1,51 pontos para mais e 1,44 para menos. Conclui-se que a adaptação 6 transcultural e validação clínica da NSCS está evidenciada para uso em UIN, sendo denominada Escala de Condição da Pele do Recém-nascido (ECPRN) na versão adaptada para o português falado no Brasil. Sugere-se a realização de novos estudos em AC, para validação da escala nesta área, bem como estudos de intervenções de cuidados com a pele com utilização da ECPRN. / Skin integrity is fundamental for the adaptation of a newborn (NB) to extrauterine life. The standardized assessment of neonatal skin conditions by nurses is essential to ensure that possible abnormalities are handled uniformly. The Neonatal Skin Condition Score (NSCS) is a widely used tool in countries where the language is English. The purpose of this study was to adapt the NSCS cross-culturally and validate it clinically for use in Brazil. The method used for cross-cultural adaptation was originally described by Beaton et al. Cross-cultural adaptation was conducted from June to December 2011. In this phase, the score was translated and adapted for use in Brazil, and the clarity of the prefinal version was evaluated. For that purpose, 38 healthcare workers were included in the study. The evaluation of the clarity of the scale was verified by Likert scale, resulting in a level of clarity above 80% in the three variables. After cross-cultural adaptation was proceeded a clinical validation, which was outlined by a cross-sectional observational study. Data for clinical validation were collected from May to July 2012. Were included in this phase newborns of any gestational age hospitalized in the Neonatal Intensive Care Unit (NICU) and in the Rooming-in Care (RIC) of Hospital de Clínicas de Porto Alegre (HCPA). The sample selection was made by convenience, comprising 47 NB in the NICU and 40 in the RIC. Obtained a total of 188 evaluations in the NICU and 160 in the RC; for each participant, two face-to-face and two evaluations using digital digital images were made. Statistical analyses of clinical validation evaluated intra and interobserver reliability using the following tests: Prevalence-Adjusted Bias-Adjusted Kappa (PABAK), intraclass correlation coefficient (ICC) and Bland-Altman plots. The item-by-item analysis of agreement revealed good concordance using PABAK in both units. The analysis of total scores according to ICC revealed satisfactory results only for the NICU, with interrater reliability of 0.88 (excellent) and intrarater reliability of 0.61 (good). In the OCU, intrarater reliability was 0.49 (moderate), and interrater reliability, 0.24 (fair). Bland-Altman plots revealed the variation between the scores intrarater and interrater in both units. In the NICU, was an average variation interrater of 0.24, with deviation of 1.38 up and 1.87 down while an average variation intrarater reliability observed was 0.1, with deviation of 0.83 up and 1.03 down. In the RIC, average variation of interrater reliability was 0.01, with deviation of 1.93 up and 1.91 down while the average variation of intrarater reliability was 0.04, with deviation of 1.51 up and 1.44 down. We concluded that the cross-cultural adaptation and clinical validation of NSCS is evidenced to use in NICU, is called Escala de Condição da Pele do Recém-Nascido (ECPRN) in the adapted version for Brazilian 8 portuguese. Further studies should be conducted in the RIC to validate the scale for use in this type of unit as well studies of interventions skin care using ECPRN.