Evaluation Of The Antecedents Of Cultural Competence

Purpose: The threefold purpose of this research is to identify the essential antecedents of cultural competence as identified by international nurse researchers, to compare the content of the extant cultural competence instruments to these antecedents and to potentially identify gaps in their conceptualization. A secondary aim of this research is to initiate validation of Harper\u27s model of ethical multiculturalism. Conceptual Basis: The model of ethical multiculturalism depicts the attributes of ethical multiculturalism as the fulcrum of a balance between two ethical philosophies of fundamentalism and relativism. The attributes of moral reasoning, beneficence/nonmaleficence, respect for persons and communities, and cultural competence form the pyramidal fulcrum. The antecedents form the base of the pyramid and include cultural awareness, culture knowledge, cultural sensitivity, cultural encounters, cultural skill and understanding of ethical principles. Methodology: An on-line Delphi method was conducted with 35 international nurse researchers identified through published research, university directories, and professional organizations. Consensus was reached after two rounds. Following the Delphi rounds, sixteen members of the expert panel participated in an on-line focus group to validate results of the Delphi and discuss cultural competence in the international arena. Findings: Eighty antecedents of cultural competence were identified. Focus group discussion validated findings of the Delphi. Consensual thematic analysis of the focus group transcripts resulted in six themes: chimerical, contact, contextual, collaboration, connections, and considering impact. The Transcultural Self-Efficacy Tool (TSET) contained the most antecedents identified by the expert panel. Conclusions: Cultural competence is a process, not an outcome, and must be considered from the perspective of the recipient of care or research participant. Nurses must strive to deliver culturally acceptable care. The model of ethical multiculturalism is revised to include cultural desire as an antecedent. Nurses must understand the impact of globalization on individual health and care delivery. Implications for Nursing: Further testing of cultural competence instruments is needed to determine the correlation of self-efficacy with behavior, self-assessment with client assessment, and cultural competence with client outcomes. In education, research is needed to determine the most effective methods of teaching cultural competence. Increased recruitment of minorities into nursing programs is warranted. In practice, nurses must be prepared to provide language assistance as needed, recruitment and hiring of minorities must be increased, and minority thresholds must be used to determine cultural knowledge content for organizations

Broughton Archipelago Clam Terrace Survey : final report

During a 1995 aerial video survey of the coastline of Johnstone Strait, an unusual shoreline feature was noted and termed “clam terraces” (inset) because of the terrace-type morphology and the apparent association with high clam productivity on the sandflats. Typical alongshore lengths of the terrace ridges are 20-50m, and across-shore widths are typically 20-40m. An area with an especially high density of clam terraces was noted in the Broughton Archipelago, between Broughton and Gilford Islands of southeastern Queen Charlotte Strait. Clam terraces in this area were inventoried from the aerial video imagery to quantify their distribution. The terraces accounted for over 14 km of shoreline and 365 clam terraces were documented. A three-day field survey by a coastal geomorphologist, archeologist and marine biologist was conducted to document the features and determine their origin. Nine clam terraces were surveyed. The field observations confirmed that: the ridges are comprised of boulder/cobblesized material, ridge crests are typically in the range of 1-1.5m above chart datum, sandflats are comprised almost entirely of shell fragments (barnacles and clams) and sandflats have very high shellfish production. There are an abundance of shell middens in the area (over 175) suggesting that the shellfish associated with the terraces were an important food source of aboriginal peoples. The origin of the ridges is unknown; they appear to be a relict feature in that they are not actively being modified by present-day processes. The ridges may be a relict sea-ice feature, although the mechanics of ridge formation is uncertain. Sand accumulates behind the ridge because the supply rate of the shell fragments exceeds the dispersal rate in these low energy environments. The high density areas of clam terraces correspond to high density areas of shell middens, and it is probable that the clam terraces were subjected to some degree of modification by aboriginal shellfish gatherers over the thousands of years of occupation in the region. (Document contains 39 pages

Death as a problem of meaning: A study of problems encountered by mothers and nurses when a child dies

Thesis (M.S.)--Boston Universit

Relationship between obstructive sleep apnea severity and sleep, depression and anxiety symptoms in newly-diagnosed patients.

Obstructive sleep apnea (OSA) occurs in at least 10% of the population, and leads to higher morbidity and mortality; however, relationships between OSA severity and sleep or psychological symptoms are unclear. Existing studies include samples with wide-ranging comorbidities, so we assessed relationships between severity of OSA and common sleep and psychological disturbances in recently diagnosed OSA patients with minimal co-morbidities. We studied 49 newly diagnosed, untreated OSA patients without major co-morbidities such as mental illness, cardiovascular disease, or stroke; subjects were not using psychoactive medications or tobacco (mean +/- std age: 46.8+/-9.1 years; apnea/hyponea index [AHI]: 32.1+/-20.5 events/hour; female/male: 12/37; weight <125 kg). We evaluated relationships between the AHI and daytime sleepiness (Epworth Sleepiness Scale; ESS), sleep quality (Pittsburg Sleep Quality Index; PSQI), depressive symptoms (Beck Depression Inventory-II; BDI), and anxiety symptoms (Beck Anxiety Inventory; BAI), as well as sex and body mass index (BMI). AHI was similar in females and males. Mean levels of all symptoms were above normal thresholds, but AHI was not correlated with age, ESS, PSQI, BDI, or BAI; only BMI was correlated with OSA severity. No differences in mean AHI appeared when subjects were grouped by normal versus elevated values of ESS, PSQI, BDI, or BAI. Consistent with other studies, a strong link between OSA severity and psychological symptoms did not appear in these newly diagnosed patients, suggesting that mechanisms additional to the number and frequency of hypoxic events and arousals occurring with apneas contribute to adverse health effects in OSA. OSA patients presenting with mild or moderate severity, and no major co-morbidities will not necessarily have low levels of sleep or psychological disturbances

PARSEC: A Constraint-Based Parser for Spoken Language Processing

PARSEC (1), a text-based and spoken language processing framework based on the Constraint Dependency Grammar (CDG) developed by Maruyama [26,27], is discussed. The scope of CDG is expanded to allow for the analysis of sentences containing lexically ambiguous words, to allow feature analysis in constraints, and to efficiently process multiple sentence candidates that are likely to arise in spoken language processing. The benefits of the CDG parsing approach are summarized. Additionally, the development CDG grammars using PARSEC grammar writing tools and the implementation of the PARSEC parser for word graphs is discussed. (1) Parallel ARchitecture Sentence Constraine

The Effect of Burning On Seed Germination and Seedling Growth Rates of Sullivant’s Milkweed (\u3ci\u3eAsclepias Sullivantii\u3c/i\u3e) and Common Milkweed (\u3ci\u3eAsclepias Syriaca\u3c/i\u3e)

Sullivant’s milkweed (Asclepias sullivantii) (SM) and Common milkweed (Asclepias syriaca)(CM) are native Illinois plants that are often used in prairie restoration efforts. Before the seeds can be planted using traditional mechanical planters, the filamentous coma (i.e., silk-like ballooning material) must first be physically removed from each seed, which requires hours of tedious manual labor. A more expedient way to remove the comas is to burn them. However, the impacts of burning on seed germination and seedling growth rates are unknown, which was the purpose of my study. Germination rates from unburned CM seeds (0%) were significantly lower than that from burned CM seeds (20.8%; Χ21 = 5.58, p= 0.02). There was no significant difference in germination rates of unburned (45.8%) and burned SM seeds (45.8%; Χ21= 0, p=1.0). A two-way ANOVA indicated no significant main effects of treatment (burned or unburned) (F1,24 = 2.2, p=0.15) or species (F1,24 = 0.28, p=0.60) on milkweed growth rates. Therefore, burning the coma of milkweed seeds of both species is a more efficient way of processing before planting