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A segmented approach is more effective in cultural tourism destination marketing. This article segments cultural tourists based on attitude and analyses their differences. The study sample consists of 200 tourists visiting Goa. Factor analysis for dimension reduction and further cluster analysis using factor scores were performed to create the segments, and a T-test was used to analyse segmental differences. A two-cluster solution was formed using the factor scores. The attitude towards cultural tourism was shown to vary significantly amongst clusters. Both segments were culturally conscious, but only one was found to be culturally sensitive. The culturally sensitive segment must be promoted at culturally and environmentally sensitive destinations to help protect heritage sites and contribute to restoring cultural tourism attractions. [ABSTRACT FROM AUTHOR]

Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. Given the range of social, spiritual, and cultural issues, the interprofessional team needs increased knowledge specific to the I.A. population to ensure holistic, culturally sensitive care. Utilizing a case study, this article reviews of the needs of I.A. individuals with serious illness and essential skills. The aim is empower palliative care clinicians the knowledge to provide culturally sensitive and congruent care to I.A. individuals with serious illness and their community. [ABSTRACT FROM AUTHOR]

Introduction: This qualitative study explores the experiences and perspectives of international intensive care unit charge nurses providing end-of-life care to Muslim patients in Saudi Arabia. It examines how these nurses navigate the complexities of delivering culturally sensitive care, particularly regarding Islamic beliefs and practices. The study also investigates the challenges encountered by international nurses due to differing healthcare expectations between themselves and patients' families, highlighting the interplay between cultural sensitivity and effective end-of-life care in this unique context. Method: A qualitative descriptive design was employed, using semi-structured interviews to gather data from eight international ICU charge nurses working in a tertiary hospital in Saudi Arabia. Thematic analysis was used to analyze the interview transcripts. Results: This qualitative study explored the experiences of international ICU charge nurses in Saudi Arabia regarding culturally sensitive end-of-life care within Islamic traditions. Analysis revealed nine key themes and 31 subthemes reflecting the multifaceted nature of this sensitive domain. These themes encompassed intercultural anxieties, emotional burdens on families and nurses, the importance of bridging cultural divides, advocating for change in end-of-life care practices, and honoring diverse spiritual needs. Key findings emphasized the significance of family presence, honoring faith in the absence of family, and ensuring peaceful and compassionate passings, highlighting nurses' commitment to holistic, patient-centered care that respects both cultural and individual beliefs.. Conclusion: This study provides valuable insights into the cultural nuances of end-of-life care in Saudi Arabia. The findings underscore the importance of culturally sensitive practices that respect Islamic beliefs, prioritize family involvement, and address the holistic needs of patients and their families. Implications: This study underscores the need for culturally sensitive communication training for healthcare providers working with diverse patient populations. Hospitals and healthcare institutions should prioritize educational initiatives that equip staff with the skills to engage in open dialogues about death and dying, navigate cultural differences in end-of-life preferences, and address the use of traditional healing practices. By fostering greater cultural understanding and communication competency, healthcare systems can better support both patients and families in navigating the complexities of end-of-life care. [ABSTRACT FROM AUTHOR]

Background: In recent years, limited studies have evaluated the development of cultural awareness, sensitivity, skills, communication and competence among nursing students using different models and curricula. Objectives: This study aimed to evaluate the effectiveness of a new internationally developed curriculum for transcultural nursing education. Methods: This mixed methods study was conducted on nursing students (n = 83) who attended a transcultural nursing course from 2021 to 2022 during the fall semester. A paired samples test was used to compare total scores, and the related-samples Wilcoxon signed-rank test was used to compare subscale scores. Results: The vast majority (94.0%) of the participants mentioned Islam as their religion. Turkish was the mother tongue of 91.6% of them, while 10.8% were able to speak English and 6.0% were able to speak Kurdish fluently. The mean score for the achievement of cultural competence subdimension posttest was significantly greater (p < 0.001). Posttest mean scores for challenges and barriers in providing culturally competent care subdimensions were significantly lower (p = 0.003). The mean score on the culturally sensitive communication subdimension pretest was 21.00 ± 4.76, and the mean score on the posttest increased to 23.02 ± 6.05, which was a statistically significantly greater difference (p = 0.024). According to the qualitative results of our study, five main themes were analyzed: transcultural nursing as an opportunity, transcultural nursing as a didactic process, transcultural nursing as a professional field, transcultural care as a safe environment, and transcultural care as an obligation. Conclusions: In this study, after a semester of continuing education, nursing students developed respect for cultural diversity, cultural competence, and culturally sensitive communication. [ABSTRACT FROM AUTHOR]

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Globalization exerts its influence on every nation and impacts all members of society, whether through direct or indirect means. Now more than ever, U.S. social workers must implement cultural competence, cultural humility, cultural awareness, and other similar constructs while working with culturally diverse individuals, families, and communities to ensure effective and culturally responsive practice. The Council on Social Work Education directs social work programs to teach students these invaluable constructs. However, it remains unclear which construct is most effective and how it is regularly measured, how these constructs are taught, and once they are taught, if knowledge is gained and applied directly in the field. This scoping review analyzed literature from 2012–2022 to determine how U.S.-based social work students are equipped to work with culturally diverse individuals. Findings indicate that diverse constructs exist but often lack a clear definition and similar constructs are measured inconsistently, with many studies utilizing unvalidated measures. The literature also points to a myriad of interventions aimed at helping social work students glean the necessary knowledge and skills to work within cultural diversity, including mostly U.S.-based learning opportunities, international opportunities, and a combination of the two. [ABSTRACT FROM AUTHOR]

Over the past two decades, the expanding environmental and ecological crises highlight the need to broaden the concept of sustainability to encompass support for cultural sensitivity and social well-being. This study explores the role of architectural education in fostering cultural sensitivity and social well-being in embassy architecture within a framework of environment–behavior studies. It starts from the premise that the architectural values of a culture are deeply rooted in the relationship between the users, architecture, and surrounding environment. State-sponsored architectural works (e.g., embassies, consulates, cultural centers) built outside the country are viewed as symbolic representations of a nation's diplomatic and cultural influence. These architectural typologies hold a unique potential to act as bridges for cross-cultural dialogue and foster a collective sense of global citizenship. In order to develop and assess the teaching curriculum, a specific assignment was given to master's students of the Faculty of Architecture, University of Belgrade, with the aim to explore how engineering education can be adopted to motivate students toward sustainable attitudes and design solutions. While traditional diplomatic architecture emphasizes inward-facing, fortress-like design strategies, establishing physical and symbolic barriers between the embassy's territory and the surrounding context, this research advocates for a more holistic approach oriented toward cultural sustainability, openness, and integration within an urban context. Key findings highlight creative solutions for balancing cultural representation with functional requirements while prioritizing community engagement, environmental responsibility, and user well-being. By demonstrating the two distinctive architectural strategies, this study contributes to the culturally responsive embassy design within the broader context of sustainable architectural education. [ABSTRACT FROM AUTHOR]

This longitudinal ethnographic study examines the development of the occupational self-concept of low socioeconomic status ultra-Orthodox women participating in a government-sponsored program to promote integration into the workforce. We followed participants for 18 months to learn about their experience and its effects, using group observations, in-depth interviews, and document analysis. The findings revealed central elements of the intercultural encounter of ultra-Orthodox women with a neoliberal organization. A year after the program’s conclusion, the participants unexpectedly underwent occupational regression, intensifying their commitment to their roles in the home arena rather than achieving the declared goal of occupational integration. The process led the women to embrace a self-concept resonating with the neoliberal characteristics presented in the program but applying it in the home and not the occupational space. This article suggests that neoliberal discourse, with its Western, secular, and class origins, left participants with a self-concept incompatible with the collective self characterizing their culture. We emphasize the importance of incorporating culturally sensitive practices for occupational rehabilitation which consider the potential conflict between the hegemonic discourse (represented by the organizations) and the program participants (minority groups from diverse cultural backgrounds). [ABSTRACT FROM AUTHOR]

The intersection of community involvement and empowerment in sexual and reproductive health (SRH) initiatives represents a critical area in public health. This scoping review aimed to explore the pathways from community involvement to empowerment within SRH initiatives, providing a comprehensive understanding of how public health strategies engage and build the capacity of communities. The literature from databases such as PubMed, Scopus and Web of Science were reviewed systematically, focusing on studies published between 2000 and 2023. The review identified various public health interventions that initially engage communities through participation, consultation and collaboration. These interventions often serve as the foundation for subsequent empowerment, characterised by capacity building, autonomy and advocacy. Key findings highlight that effective SRH initiatives involve community members in programme activities and foster environments where they can gain the skills, knowledge and confidence needed to take control of their health outcomes. Our analysis revealed that successful pathways from involvement to empowerment are multifaceted, requiring sustained commitment, resources and culturally sensitive approaches. The review underscores the importance of integrating community involvement and empowerment in designing and implementing SRH programmes to ensure sustainable and impactful health outcomes. This scoping review contributes to the existing literature by mapping the relationship between community involvement and empowerment, offering insights for public health practitioners and policymakers aiming to enhance SRH initiatives. Future research should focus on longitudinal studies to better understand the long-term impacts of these pathways on community health and well-being. [ABSTRACT FROM AUTHOR]

Previous studies have emphasized culturally sensitive curricula in the context of enhancing minoritized students' education. We examined the relationship between second-year higher education students' perceptions of the cultural sensitivity of their curriculum and both majoritized and minoritized students' interest in their course. A total of 286 (228 F) students rated the cultural sensitivity of their curriculum on six scales using a revised version of the Culturally Sensitive Curricula Scales (CSCS-R), the perceived quality of their relationships with teachers, and their interest. The CSCS-R widened the construct with two new scales and showed better reliability. Ethnic minority students (n = 99) perceived their curriculum as less culturally sensitive than White students (n = 182), corroborating previous findings. Black students perceived their curriculum as less culturally sensitive than Asian students. There were no significant differences between ethnic minority and White students on interest or perceived quality of relationships with teachers. Five dimensions of cultural sensitivity (Diversity Represented, Positive Depictions, Challenge Power, Inclusive Classroom Interactions, Culturally Sensitive Assessments) and perceived quality of relationships with teachers predicted interest. Ethnicity did not. Ensuring curricula and assessments represent diversity positively, challenge power and are inclusive may support students' interest while reflecting an increasingly diverse society. [ABSTRACT FROM AUTHOR]

Background/Objectives: People of African Descent (PoAD) in the United Kingdom (UK) are at an increased risk of hypertension and cardiovascular disease (CVD), partly due to dietary habits such as high salt intake. This study sought to understand the dietary salt-related knowledge, attitudes, and practises (KAP) of PoAD in the UK, to inform the development of culturally tailored interventions to reduce dietary salt intake in this population. Methods: We collected data on KAP from 21 PoAD across various regions in the UK through online semi-structured interviews and analysed them using reflexive thematic analysis (TA). Results: The age of the participants ranged from 20 to 70 years (43 ± 11). Six overarching themes were identified: (i) the multifaceted roles of salt in culinary practises, (ii) the increased awareness of health risks associated with high salt intake, (iii) the existence of knowledge gaps regarding recommended daily salt intake, (iv) the cultural influences on salt consumption levels, (v) the lack of engagement with food labels, and (vi) a limited awareness of salt reduction initiatives. Conclusions: Our findings highlight the significance of salt in the culture and culinary practises of PoAD. Despite general awareness of the health risks of excessive salt consumption, there was a notable deficiency in knowledge about the recommended salt intake levels as well as minimal engagement with nutritional labelling. These findings underline a need for culturally sensitive health interventions that integrate culinary practises, beliefs, and preferences of PoAD, aiming to effectively reduce salt intake and mitigate associated health risks. [ABSTRACT FROM AUTHOR]

The Navajo Nation is one of the many reservations that lack access to health care services, leading to increasing chronic health conditions. Navajo rug weaving is a common creative occupation on the reservation. Navajo rug weaving involves multiple steps in creating a beautiful rug. The multiple steps include repetitive gripping, pinching, reaching, pulling, and prolonged sitting. Therefore, weavers are at risk for developing musculoskeletal disorders (MSDs), preventing individuals from participating in meaningful occupations. Occupational therapists have the skills to provide appropriate education through active listening, visual handouts, and family members. However, occupational therapists must demonstrate and understand cultural sensitivity to address cultural occupations. This article will provide strategies for modeling understanding of the Navajo people, Diné, and rug weaving. [ABSTRACT FROM AUTHOR]

Abstract Introduction This qualitative study explores the experiences and perspectives of international intensive care unit charge nurses providing end-of-life care to Muslim patients in Saudi Arabia. It examines how these nurses navigate the complexities of delivering culturally sensitive care, particularly regarding Islamic beliefs and practices. The study also investigates the challenges encountered by international nurses due to differing healthcare expectations between themselves and patients’ families, highlighting the interplay between cultural sensitivity and effective end-of-life care in this unique context. Method A qualitative descriptive design was employed, using semi-structured interviews to gather data from eight international ICU charge nurses working in a tertiary hospital in Saudi Arabia. Thematic analysis was used to analyze the interview transcripts. Results This qualitative study explored the experiences of international ICU charge nurses in Saudi Arabia regarding culturally sensitive end-of-life care within Islamic traditions. Analysis revealed nine key themes and 31 subthemes reflecting the multifaceted nature of this sensitive domain. These themes encompassed intercultural anxieties, emotional burdens on families and nurses, the importance of bridging cultural divides, advocating for change in end-of-life care practices, and honoring diverse spiritual needs. Key findings emphasized the significance of family presence, honoring faith in the absence of family, and ensuring peaceful and compassionate passings, highlighting nurses’ commitment to holistic, patient-centered care that respects both cultural and individual beliefs.. Conclusion This study provides valuable insights into the cultural nuances of end-of-life care in Saudi Arabia. The findings underscore the importance of culturally sensitive practices that respect Islamic beliefs, prioritize family involvement, and address the holistic needs of patients and their families. Implications This study underscores the need for culturally sensitive communication training for healthcare providers working with diverse patient populations. Hospitals and healthcare institutions should prioritize educational initiatives that equip staff with the skills to engage in open dialogues about death and dying, navigate cultural differences in end-of-life preferences, and address the use of traditional healing practices. By fostering greater cultural understanding and communication competency, healthcare systems can better support both patients and families in navigating the complexities of end-of-life care.

Abstract Background In recent years, limited studies have evaluated the development of cultural awareness, sensitivity, skills, communication and competence among nursing students using different models and curricula. Objectives This study aimed to evaluate the effectiveness of a new internationally developed curriculum for transcultural nursing education. Methods This mixed methods study was conducted on nursing students (n = 83) who attended a transcultural nursing course from 2021 to 2022 during the fall semester. A paired samples test was used to compare total scores, and the related-samples Wilcoxon signed-rank test was used to compare subscale scores. Results The vast majority (94.0%) of the participants mentioned Islam as their religion. Turkish was the mother tongue of 91.6% of them, while 10.8% were able to speak English and 6.0% were able to speak Kurdish fluently. The mean score for the achievement of cultural competence subdimension posttest was significantly greater (p

The intersection of community involvement and empowerment in sexual and reproductive health (SRH) initiatives represents a critical area in public health. This scoping review aimed to explore the pathways from community involvement to empowerment within SRH initiatives, providing a comprehensive understanding of how public health strategies engage and build the capacity of communities. The literature from databases such as PubMed, Scopus and Web of Science were reviewed systematically, focusing on studies published between 2000 and 2023. The review identified various public health interventions that initially engage communities through participation, consultation and collaboration. These interventions often serve as the foundation for subsequent empowerment, characterised by capacity building, autonomy and advocacy. Key findings highlight that effective SRH initiatives involve community members in programme activities and foster environments where they can gain the skills, knowledge and confidence needed to take control of their health outcomes. Our analysis revealed that successful pathways from involvement to empowerment are multifaceted, requiring sustained commitment, resources and culturally sensitive approaches. The review underscores the importance of integrating community involvement and empowerment in designing and implementing SRH programmes to ensure sustainable and impactful health outcomes. This scoping review contributes to the existing literature by mapping the relationship between community involvement and empowerment, offering insights for public health practitioners and policymakers aiming to enhance SRH initiatives. Future research should focus on longitudinal studies to better understand the long-term impacts of these pathways on community health and well-being.

This study explores the effects of food quality, service quality, pricing strategy, and ambiance on customer retention in Indonesian restaurants in Taiwan, with customer satisfaction as a mediating variable. This study also investigates the moderating role of cultural similarity in this relationship. A structured survey was conducted in a quantitative study design, collecting data from 400 international customers of Indonesian restaurants in Taiwan. Structural Equation Modeling (SEM) with Partial Least Squares (PLS) was used to analyze the data. The results showed that food quality and pricing strategy significantly increased customer satisfaction. In addition, service quality and ambiance had no significant contribution to customer satisfaction. Furthermore, cultural similarity strengthened the relationship between food quality and customer satisfaction. Finally, customer satisfaction had a significant effect on customer retention. This study provides important insights for Indonesian restaurant owners in Taiwan, emphasizing the important role of service quality and restaurant ambiance in addition to food quality and price to support customer satisfaction and thus increase customer retention.

Ethical clinical practice requires cultural competency. In the United States, Hispanics report stronger attitudinal barriers to drug abuse treatment than any other racial/ethnic group. Hispanics report feeling that drug abuse treatment providers do not understand their unique cultural needs and are unfamiliar with their experiences of discrimination and immigration. Using this case study to explore broader ethical and policy issues, this study investigates the extent to which US universities train counselors to address the culturally specific needs of Hispanic patients and how this is reflected in practice in Los Angeles County. Based on a content analysis of the required courses, syllabi, and course descriptions at 30 universities related to culture/race/racism/ethnicity/diversity at the undergraduate and graduate levels on the addiction therapist track, and thematic analysis of eight in-depth interviews with counselors working in outpatient rehabilitation centers in Los Angeles, I argue that cultural competency education for drug abuse counselors is too surface level and infrequent to adequately prepare students for a career in addiction counseling for Hispanic clients. Significant changes must be made to how cultural diversity is valued and prioritized in the field of psychology to provide better care for Hispanic people with a substance use disorder and fulfill the moral obligation to eliminate this health disparity. Although this study focuses on counselors in Los Angeles, these findings are relevant for professionals and healthcare systems across the United States and beyond who seek to provide equitable and effective care for Hispanic patients. [ABSTRACT FROM AUTHOR]

Existing knee related patient reported outcome measurements (PROMs) have overwhelmingly been developed and validated in western chair-based societies, suggesting a potential for a western bias in PROMs evaluation of patients with knee conditions. We, therefore, endeavor to evaluate the responsiveness of the previously developed culturally relevant Japanese version of the knee injury and osteoarthritis outcome score (JKOOS+). We enrolled 114 patients scheduled for total knee arthroplasty (TKA) across 8 knee clinics in Japan. Patients completed the Oxford Knee Score (OKS) and JKOOS + both at the time of enrollment and again 1-year post-TKA. Responsiveness was evaluated using effect size and standardized response mean (SRM). An effect size or SRM >0.8 is considered adequately responsive. We further tested the difference in responsiveness between the original Japanese language KOOS activities of daily living (ADL) domain and the novel Japanese ADL (JADL) domain using the modified Jacknife test. All domains were adequately responsive with the exception of the KOOS sports and recreation domain, which has previously been ignored by TKA researchers due to its lack of applicability to elderly patients undergoing TKA. The JADL domain outperformed the ADL domain in both effect size (1.51 v. 1.45) and SRM (1.67 v. 1.57) (p < 0.001). The novel Knee Flexion (KF) domain was adequately responsive, though less responsive than other domains except sports and recreation (p < 0.01 v. all other PROMs domains). The JKOOS+ JADL domain is significantly more responsive than the Europe-developed ADL domain to TKA in Japanese knee patients suffering from knee osteoarthritis (OA). The KF domain, unique to the JKOOS+ and intended to assess difficulty with knee flexion, is adequately responsive to TKA in Japanese patients suffering from OA. [ABSTRACT FROM AUTHOR]

Background: Current research has identified how ethnic minority women experience poorer health outcomes during the perinatal period. In the United Kingdom, specialist perinatal mental health services provide mental health treatment for women throughout the perinatal period. Service users have previously highlighted that perinatal services are hard to access and lack cultural sensitivity, whereas healthcare professionals have described limited opportunities and resources for developing cultural competency. Objectives: We explored the experiences of ethnic minority women with National Health Service (NHS) specialist perinatal teams and identified what culturally sensitive perinatal mental health care means to this group. Design: Individual semi‐structured interviews were conducted, and an interpretative phenomenological analysis framework was used to analyse the interview transcripts. Setting and Participants: Participants were recruited from NHS specialist perinatal teams and online via social media. Results: Six women were interviewed. Four group experiential themes central to the experiences of participants emerged: (1) strengthening community networks and peer support; (2) valuing cultural curiosity; (3) making sense of how culture, ethnicity, race and racism impact mental health; and (4) tailoring interventions to ethnic minority women and their families. Discussion and Conclusions: The findings capture how ethnic minority women experience specialist perinatal teams and offer insights into practising culturally sensitive care. Perinatal mental health professionals can support ethnic minority women by strengthening their access to community resources and peer support; being curious about their culture; helping them to make sense of how culture, ethnicity, race and mental health interact; and applying cultural and practical adaptations to interventions. Patient or Public Contribution: A Lived Experience Advisory Group (LEAG) of women from ethnic minority groups contributed to the design and conduct of this study. The LEAG had lived experience of perinatal mental health conditions and accessing specialist perinatal teams. The LEAG chose to co‐produce specific aspects of the research they felt fit with their skills and available time throughout five group sessions. These aspects included developing the interview topic guide, a structure for debriefing participants and advising on the social media recruitment strategy. [ABSTRACT FROM AUTHOR]

Despite the well-documented link between child maltreatment (CM) and mental health, evidence suggests substantial variability in the post-traumatic sequelae of CM across cultures. The perceived acceptability of CM in one's community might moderate the association between CM and mental health, but little research has been conducted on it so far. This study examined how the perceived acceptability of CM may influence the relationship between CM experiences and post-traumatic symptoms in individuals from four different continents and if the pattern of associations is the same across countries. We recruited a sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122). We administered online questionnaires and performed multiple group moderation analyses for total CM, neglect, physical abuse, emotional maltreatment, sexual abuse, and exposure to domestic violence (DV). A significant positive main effect of CM on post-traumatic symptoms was found in the overall sample and in Cameroon; in Germany, only neglect and emotional maltreatment were positively associated to post-traumatic symptoms. Moderation effects were identified; the perceived acceptability of neglect in Cameroon and Germany and of exposure to DV in Cameroon had a dampening effect on the relationship between CM experiences and post-traumatic symptoms. Our findings confirm that CM experiences entail long-term post-traumatic sequelae that can vary across cultures and CM subtypes and further our understanding of this issue by showing that the perceived acceptability of CM may be an understudied moderator. [ABSTRACT FROM AUTHOR]

This study investigates the effectiveness of interventions aimed at enhancing awareness of Autism Spectrum Disorder (ASD) in Minchinabad through a participatory action research approach. A total of 100 participants were included in this research. They were Community Leaders, Healthcare Professionals, Religious Leaders, and Educators picked through Convenience Sampling. Initial data collection reveals prevalent misconceptions and barriers surrounding ASD awareness. Among them, 89% of respondents expressed a lack of sufficient awareness and 85% attributed ASD to divine factors. Subsequently, community-led workshops, social media campaigns, and Religious institutions-based awareness activities were implemented to address these challenges. Evaluation indicates a significant improvement in awareness levels. Improvement with 53% acknowledging adequate awareness. However, more than 40% still perceive a stigma associated with seeking an ASD diagnosis. While cultural beliefs persist, such as 60% to 68% believing in the divine causation of ASD. The interventions have contributed to a positive shift in community perceptions. The findings underscore the importance of sustained efforts to promote understanding and acceptance of ASD within the community, emphasizing the need for continued engagement and advocacy for ASD Awareness. [ABSTRACT FROM AUTHOR]

Objectives. To examine the association between caregiver-perceived cultural sensitivity of health care providers and child health status in the United States. Methods. We analyzed National Survey of Children's Health data (n = 145,226) from 2016–2020. Using logistic regression, we determined odds of reporting a better health status by level of caregiver-perceived provider cultural sensitivity while controlling for potential confounders. Results. Children with providers perceived as more culturally sensitive by their caregivers had 2.38 times the odds (95% confidence interval: 1.73, 3.28) of enjoying a better caregiver-assessed health status compared with children whose providers were perceived as less culturally sensitive. Caregivers of BIPOC children in our sample were 1.99 times more likely (95% CI: 1.89, 2.10) to report their provider as only sometimes or never culturally sensitive. Conclusions. Cultural sensitivity of health care providers, as perceived by caregivers, was associated with caregiver-assessed child health status in our study. This association remained significant when controlling for various sociodemographic variables. Our findings highlight the need for more research around the potential positive impact that improving provider cultural sensitivity could have on the health of children who are Black, Indigenous, or other People of Color (BIPOC). [ABSTRACT FROM AUTHOR]

This study investigates cognitive assessment disparities between literate and illiterate individuals through a comprehensive analysis of the Modified MMSE (MACE) and the HMSE. Using a sample of older adults, the research examines correlations in scores across various cognitive domains, revealing significant associations among literate subjects but nonsignificant correlations among illiterate individuals. Item differences between MACE and HMSE introduce biases in illiterate subjects' scoring profiles, rendering them more vulnerable to higher positivity on MACE than HMSE. The ranking and weighted percentage data highlight variations in subtest difficulty. Despite the small sample size, qualitative comparisons underscore the need for culturally and linguistically sensitive cognitive assessments tailored to diverse educational backgrounds. The study's implications for clinical practice and recommendations for future research are discussed, emphasizing the importance of nuanced interpretations in cognitive assessment. [ABSTRACT FROM AUTHOR]

Despite these children's significant psychological challenges and complex socio-cultural currents, Balasore District orphans present a highly vulnerable group. Consequently, it is vital to understand the mechanisms that enable them to develop resilience in the face of adversity, allowing for more targeted and effective intervention. While numerous studies have explored the phenomenon of orphaned children in general, offering various explanations as to the motivational and risk factors' interaction in determining their psychological resilience, little is known about the nuanced wildlife of these associations in culturally-specific regions such as Balasore. How do these factors work in conjunction to determine the overall impact on psychological resilience, and what is the role of gender in this review? The research aimed to investigate the determinants of psychological resilience among Balasore orphans, specifically exploring the interaction between motivational factors, including social networks, education, and community involvement, and risk factors. An additional interest was to explore whether the influence pattern differed significantly among gender groups, offering opportunities for more proportionate and effective intervention. The cross-section survey was conducted, with data collected from over 300 orphans from different orphanages in Balasore. Structured questionnaires were developed and distributed, with confirmatory factor analysis and other multivariate statistical techniques employed in analysis. The studies revealed the significant enhancing impact of motivational factors the psychological and social resources that support the development and life of orphans available through the motivational factors. Use of education, social support, and community involvement was reported as crucial to resilience, with no significant differences in response pattern across gender groups reported. Such results demonstrate that gender-specific approaches may be rather irrelevant in the case of the category of motivational factor under review. Globally, the implications of this study are immense in terms of informing culturallyeffective psychosocial interventions. This study's contribution lies in uncovering the universally applicable motivational factors that enhance resilience and noting a not-so significant impact of gender on their dynamics. The findings from this study inform the broader discourse on the matter and contribute valuable information to the efforts to develop a unifiedintegrated care system for orphans. The study serves as a valuable contribution to the understanding of how motivational skills and risks interact to determine resilience, especially in less-studied populations. [ABSTRACT FROM AUTHOR]

This paper aims at exploring the dynamics of inclusive education for refugee children in Pakistan and the issues and prospects of inclusive education. Based on the literature review and fieldwork, this paper outlines the complex challenges that hinder refugee children's access to education in Pakistan. This paper focuses on the importance of inclusive education in the creation of social integration, economic growth, and protection of human rights. We look at the practices and ideas that have worked within and outside the country to tackle these problems. The considerations include policy recommendations, ways of engaging the communities, and pedagogical adjustments for the development of the inclusive classroom. Therefore, the purpose of this paper is to enhance the understanding of refugee education and to offer specific recommendations for policymakers, educators, and other stakeholders involved in the process of refugee education in Pakistan and other comparable countries. [ABSTRACT FROM AUTHOR]

Introduction Rural American communities are heavily affected by tobacco-related health disparities. This study aims to evaluate the prevalence of quit attempts (QAs) and factors that promote or impede QA among rural adults who smoke daily. Methods Data from Wave 5 of the Population Assessment of Tobacco and Health study were analyzed. Multivariable logistic regression was used to identify factors associated with QA. Backward selection was used to identify variables included in the final model with statistical significance set at p  < .05. Results Among 1610 rural adults who smoked daily, the prevalence of a QA in the past 12 months was 25.6% (95% confidence interval [CI]: 23.2, 28.2). Factors associated with greater QA odds: having greater education (adjusted odds ratio [aOR] = 1.35, 95% CI: 1.03, 1.77), e-cigarette use (aOR = 1.35 95% CI: 1.03, 1.80), disapproval of smoking from friends/family (aOR = 1.46, 95% CI: 1.09–1.94), greater frequency of thinking about the harm of tobacco (aOR = 1.48, 95% CI: 1.28, 1.71), fair/poor physical health (aOR = 1.31, 95% CI: 1.00, 1.70), and being advised to quit by a doctor (aOR = 1.63, 95% CI:1.25, 2.13). Smokeless tobacco use (aOR = 0.67, 95% CI: 0.47, 0.96) and greater cigarettes per day (aOR = 0.67, 95% CI: 0.47, 0.96) were associated with QA lower odds. Conclusions Only one in four rural adults who smoke made a past-year QA. Interventions that promote provider advice to quit smoking, tobacco health harms, and normative beliefs may increase QAs in rural communities. Implications Along with higher smoking rates and lower QAs, rural communities face limited access to programs, medication, and health care professionals as tools to help them quit smoking. Public Health initiatives should focus on developing cultural sensitivity training targeting health care professionals to advise patients to quit smoking and the role of multiple tobacco product use. Furthermore, given the low rates of smoking QAs, future mixed-methods research is needed to inform policies and interventions targeted at eliminating tobacco-related health disparities. [ABSTRACT FROM AUTHOR]

This study delves into the intricate art of screenwriting by critically examining the reception of the 2023 award-winning film, Everything Everywhere All at Once, among Chinese audiences. Notwithstanding its international laurels, Everything has sparked a divided sentiment in Mainland China. While its audacious blend of genres and the poignant depiction of Chinese–American experiences have been recognized, Everything was absent from Chinese theatres, owing to its explicit content. However, its digital footprint on Chinese streaming platforms has painted a picture of ambivalence. Many Chinese viewers expressed reservations about the screenwriters' frequent use of pop culture references, perceived narrative clichés and the incorporation of elements that seem discordant with conventional Chinese storytelling. Yet, interspersed among these critiques is admiration for its visual brilliance and inclusivity. Grounded in resonance theory, this study scrutinizes Everything, particularly the screenplay's reliance on the oft-touted 'universal' blueprint of the Hero's Journey. Aligning with critiques suggesting such frameworks might be culturally myopic, this study connects these screenwriting choices to the lukewarm reception among Chinese audiences. Through this lens, the study offers invaluable insights for screenwriters keen on crafting narratives that resonate deeply with Chinese viewers. Moreover, it adds to the larger conversation about the need for diversifying screenwriting templates on the global stage, challenging the dominance of western-centric paradigms such as the Hero's Journey. At its core, this study deciphers the intricate tapestry of screenwriting elements that strike a chord within the Chinese sociocultural milieu. [ABSTRACT FROM AUTHOR]

This article examines the intersection of societal realities, religious convictions, and pastoral care within the Evangelical Lutheran Church in Tanzania (ELCT), focusing on unwed mothers. The article, rooted in John 8:1-11 which depicts Jesus’ encounter with the adulterous woman, aims to address the unique challenges faced by unwed mothers within the ELCT. It employs a multidisciplinary approach, including biblical exegesis, pastoral theology, and sociocultural analysis, to explore these complexities and highlight the compassionate aspects of Jesus’ response. The objectives are to examine societal and cultural influences impacting unwed mothers, analyse current pastoral practices within the ELCT, and propose a pastoral care framework that integrates biblical principles with cultural sensitivity. Ultimately, the article seeks to promote an inclusive and compassionate pastoral framework within the ELCT, enhancing the well-being of unwed mothers in the church community.

BackgroundRefugees and migrants may represent the most vulnerable communities in many societies. Health systems should be sensitive to needs of refugees and migrants. The document “The Refugee and Migrant Health: Global Competency Standards for Health Workers (the Standards)” identifies the competencies and areas of practice of health workers working with refugees and migrants. The aim of this study is to provide an analysis of these competences and training needs, identifying the educational priorities for the implementation of the Standards in Sicily, Italy.MethodsA cross-sectional analytical pilot study was conducted by administering a questionnaire, in electronic format “Google Form ®,” to doctors attending the Medical Training Course for General Practitioners in Sicily (Italy). Data obtained were collected in a Microsoft Excel database and analyzed with IBM SPSS Software 24 version. Absolute and relative frequencies were calculated for relevant categorical variables. Univariate analysis of the selected variables was subsequently carried out. The significance level chosen was a p value

Background: To explore the association between ethnicity, as a proxy for language, and participation in clinical trials (CT) conducted by Principal Investigators (PI) who speak one or more language in addition to English. Methods: This retrospective, descriptive study utilized CT participant demographic data extracted from the largest Midwestern non-profit healthcare system between January 1, 2019 and 12/31/2021. The CT participant sample (N = 4308) was divided for comparison: CT Participants of Hispanic or Latino Origin (N = 254; 5.90 %) and CT Participants of Non-Hispanic or Latino Origin (N = 4054; 94.10 %). Logistic regressions were performed to generate the crude and adjusted odds of patients of Hispanic or Latino origin participating in CTs conducted by PIs who speak another language in addition to English. Results: Crude analysis revealed that patients of Hispanic or Latino ethnicity had 2.04 (1.58, 2.64) times greater odds of participating in CTs conducted by PIs who speak another language than English (

In the field of health care, cultural competency refers to the ability of healthcare professionals to acknowledge, respect, and accordingly respond to the varied needs, beliefs, values, and practices followed by persons and the communities they serve. The purpose of the current review is to explore the role of cultural factors and trauma experience, and identify the strategies that can be employed to train and assess medical students in cultural competency pertaining to trauma patients. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and a total of 21 articles were selected based on their suitability with the current review objectives. Cultural factors play a defining role in determining the experiences of trauma patients, and how these patients and family members perceive, cope, and recover from such traumatic events. To meet the diverse needs of the community, the medical curriculum has to be flexible and must include the component of cultural competency. Like any other domain, medical educators must plan for the assessment of cultural competencies while delivering trauma education, as it will provide insights into the readiness of the students to deliver culturally sensitive and effective care to trauma patients. In conclusion, the inclusion of cultural competency training within trauma care in the medical curriculum carries immense utility as it can help healthcare professionals to effectively communicate and respond to the varied needs of trauma patients, regardless of their cultural backgrounds. This calls for the adoption of a combination of teaching–learning methods and assessment methods by medical educators so that medical students can be empowered to deliver culturally sensitive medical care to trauma patients.

Orphans and vulnerable children (OVC) in mainstream rural schools encounter unique challenges stemming from loss, economic instability, and disrupted familial structures. Addressing their needs demands a comprehensive and culturally sensitive approach. This paper thus explored the use of an ethnopsychology framework to understand and address the diverse needs of rural children, emphasizing the importance of culturally sensitive interventions in mainstream schools. It also evaluated the effectiveness of ethnopsychological interventions and the role of community collaboration. This article used secondary data sources to understand how the ethnopsychology approach can be utilized as a potential sustainable intervention strategy for the needs of OVC in mainstream rural schools. The results show that OVC are well-served by the cultural resources that rural schools have in abundance from a cultural perspective. The study also emphasized the significance of cultural practices and beliefs in influencing community responses and developing resilience in assisting OVC. The study supported the care, protection, and psychosocial support to OVC as significantly influenced by family and relationship networks, community-based organizations, and traditional support systems. The paper made recommendations for improving rural schools’ response to OVC needs in light of cultural sensitivity. These include boosting collaboration between formal and informal support systems, creating community networks, fostering cultural adaptation and preservation, and giving community members more agency through programs that increase their knowledge and skills. This study underscored the significance of ethnopsychology principles of community and social connection in leveraging cultural resources, context-based and responsive interventions, and appreciating and sustaining existing indigenous knowledge systems in understanding and addressing the needs of OVC in mainstream rural schools. Understanding and supporting OVC contributes towards cultivating meaningful collaborations and transformative care of OVC in the Global South.

Abstract Health equity and accessing Spanish kidney transplant information continues being a substantial challenge facing the Hispanic community. This study evaluated ChatGPT’s capabilities in translating 54 English kidney transplant frequently asked questions (FAQs) into Spanish using two versions of the AI model, GPT-3.5 and GPT-4.0. The FAQs included 19 from Organ Procurement and Transplantation Network (OPTN), 15 from National Health Service (NHS), and 20 from National Kidney Foundation (NKF). Two native Spanish-speaking nephrologists, both of whom are of Mexican heritage, scored the translations for linguistic accuracy and cultural sensitivity tailored to Hispanics using a 1–5 rubric. The inter-rater reliability of the evaluators, measured by Cohen’s Kappa, was 0.85. Overall linguistic accuracy was 4.89 ± 0.31 for GPT-3.5 versus 4.94 ± 0.23 for GPT-4.0 (non-significant p = 0.23). Both versions scored 4.96 ± 0.19 in cultural sensitivity (p = 1.00). By source, GPT-3.5 linguistic accuracy was 4.84 ± 0.37 (OPTN), 4.93 ± 0.26 (NHS), 4.90 ± 0.31 (NKF). GPT-4.0 scored 4.95 ± 0.23 (OPTN), 4.93 ± 0.26 (NHS), 4.95 ± 0.22 (NKF). For cultural sensitivity, GPT-3.5 scored 4.95 ± 0.23 (OPTN), 4.93 ± 0.26 (NHS), 5.00 ± 0.00 (NKF), while GPT-4.0 scored 5.00 ± 0.00 (OPTN), 5.00 ± 0.00 (NHS), 4.90 ± 0.31 (NKF). These high linguistic and cultural sensitivity scores demonstrate Chat GPT effectively translated the English FAQs into Spanish across systems. The findings suggest Chat GPT’s potential to promote health equity by improving Spanish access to essential kidney transplant information. Additional research should evaluate its medical translation capabilities across diverse contexts/languages. These English-to-Spanish translations may increase access to vital transplant information for underserved Spanish-speaking Hispanic patients.

AbstractAims: We aimed to identify the unique challenges and opportunities faced by international student nurses in Türkiye when practicing patient care. This understanding is essential for educators, healthcare institutions, and policy makers to create more inclusive and supportive environments that enhance learning and professional development. Addressing these challenges can lead to better integration of foreign student nurses into the healthcare system, ultimately improving patient care quality. This research is important for all stakeholders in healthcare - educators, administrators, policymakers, and patients - because a diverse and well-supported nursing workforce is essential for the delivery of culturally competent and high-quality care. Methods: This study employed interpretative phenomenology. Data were collected from 12 foreign nursing students from Iraq, Egypt, Syria, Saudi Arabia, Iran, and the Netherlands. Data were collected between 01 and 20 May 2023 in the Nursing Department of the Faculty of Health Sciences of a state university in the province of Şanlıurfa, located in the southeastern region of Türkiye. Data were analyzed using Colaizzi’s method. Results: We identified four themes: “Metaphors describing patient care practices,” “Factors affecting care practices,” “Needs for education and support,” and “Opportunities during patient care practices.” Positively influencing factors included better education and living standards and economic benefits, while negatively influencing factors were traumatic events before studying abroad, racial discrimination, language and cultural differences, negative emotions, peer victimization, and lack of use of standards. Interviewees reported a need for training and support and that patient care practices provided opportunities for greater awareness, responsibility, and professional integration. Discussion: Positive and negative experiences of foreign student nurses were evident in the delivery of patient care practice. Interventions are needed to alleviate negatively influencing factors, provide training and support for students, and improve opportunities for foreign nationals. Identification of these factors can help medical educators to develop culturally sensitive and inclusive approaches, as well as individual/organisational facilitators that enhance existing opportunities and remove barriers. [ABSTRACT FROM AUTHOR]

Migrant-origin families may have a pronounced need for psychosocial support and healthcare services, but they face barriers in using services. To ensure the timely use of services, it is important that families understand how service systems work and trust care providers. Thirty-two migrant-origin mothers living in Finland participated in five focus-group interviews and shared their wishes for social and healthcare professionals on how trust and understanding can be increased. The data were analyzed with Qualitative Content Analysis. We identified six main themes related to the use of services and professionals' behavior. These were the need for professionals to justify and explain questions, to meet each family as individuals, the importance of non-verbal communication, the need to talk about racism and discrimination, the importance of cultural sensitivity in services, and a discussion of positive aspects of life after migration and children's strengths. To foster trust and mutual understanding in social and healthcare services, professionals should be aware of potential cultural differences in family life, while avoiding pre-conceived ideas. Misunderstandings can rise from language barriers and unclear or intimidating questions. It is important that professionals explain what they do and justify why they might inquire about a family's personal matters. Working with interpreters is necessary when professionals and parents do not share a common fluent language. Professionals should also pay attention to their non-verbal communication and to being friendly. Finally, it is important to show interest in families' experienced hardships such as racism as well as their strengths. [ABSTRACT FROM AUTHOR]

Immersive global learning experiences like Collaborative Online International Learning (COIL) offer students cross-cultural knowledge, awareness, and language fluency, fostering critical analysis, and problem-solving. This paper focuses on U.S. and Dutch students' perceptions of personal growth as future health education specialists regarding cultural sensitivity and competence within a COIL course. The study explores valuable skills for professionals engaging with diverse populations, contributing to the literature on faculty-led internationalization initiatives. Both the COIL research model and the cultural intelligence (CQ) framework guided the design and implementation of the COIL course. A thematic analysis of self-reflection narratives from N = 49 undergraduate students from the U.S. and the Netherlands revealed categories and themes related to cultural perspectives in health promotion, cultural sensitivity and competence, and essential skills for health education specialists. The findings demonstrate the impact of COIL on students' cultural perspectives and knowledge, their awareness of cultural norms, and the importance of diverse strategies and approaches in health promotion. The study highlights the value of COIL courses in developing cultural understanding within educational settings and provides insights for educators and students interested in engaging with diverse populations. [ABSTRACT FROM AUTHOR]

Background: Effective self‐management of type 2 diabetes requires adequate health literacy (HL) and a supportive network. Diabetes self‐management education and support programmes play a crucial role in improving these factors. However, limited research exists on how such programmes can support health literacy among migrants and facilitate the dissemination of knowledge within their social networks. Aim: This study aimed to investigate the perspectives of Arabic‐speaking informants with a migrant background in relation to how their type 2 diabetes‐related health literacy was acquired, applied and distributed within social networks through participation in a culturally sensitive diabetes self‐management education and support (DSMES) programme. Methods: Semi‐structured interviews were conducted with 12 informants during the programme and three to 7 months later, from September 2019 to May 2020. Abductive analysis was applied using HL and distributed health literacy (DHL) theory as frameworks. Results: The analysis generated three themes: (1) sources of health information and the development of health literacy; (2) changes towards active self‐management; and (3) distributed health literacy. Prior to programme participation, informants faced challenges in navigating conflicting information from family, friends and social media. After participating in the programme, they reported improvements in HL, particularly in knowledge acquisition. Many became more actively engaged in decision‐making and exhibited improved health behaviours, such as dietary choices. Nonetheless, some informants continued to struggle with choosing appropriate prevention and treatment strategies. Notably, certain informants acted as HL mediators, sharing their newly acquired knowledge within their social networks in Denmark and abroad. Conclusion: Culturally sensitive diabetes self‐management education programmes have the potential to enhance HL among migrants, leading to the distribution of relevant diabetes knowledge within their social networks. Future studies should explore how members of migrants' social networks perceive their supportive role in type 2 diabetes management. Programmes can benefit from emphasising critical HL and exploring how participant‐informants effectively communicate diabetes‐related knowledge within their networks to address misinformation and conflicting information. [ABSTRACT FROM AUTHOR]