26 research outputs found

    Asian Approaches to Human Communication: A Dialogue

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    The Development and Validation of the Intercultural Sensitivity Scale

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    The present study developed and assessed reliability and validity of a new instrument, the Intercultural Sensitivity Scale (ISS). Based on a review of the literature, 44 items thought to be important for intercultural sensitivity were generated. A sample of 414 college students rated these items and generated a 24-item final version of the instrument which contains five factors. An assessment of concurrent validity from 162 participants indicated that the ISS was significantly correlated with other related scales, including interaction attentiveness, impression rewarding, self-esteem, self-monitoring, and perspective taking. In addition, the predicted validity test from 174 participants showed that individuals with high ISS scores also scored high in intercultural effectiveness and intercultural communication attitude scales. Potential limitations of the study were discussed as well

    A review of the concept of intercultural awareness

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    The development of a “global village” strongly demands the ability of intercultural sensitivity between people for all of us to survive in the 21st century. Due to the lack of study on the subject, this paper aims (1) to provide a conceptualization of intercultural sensitivity, (2) to specify the role intercultural sensitivity plays in intercultural training programs, (3) to delineate the components of intercultural sensitivity, and (4) to critique and suggest directions for future study in this line of research. As a result, a working definition of intercultural sensitivity is generated. The components of intercultural sensitivity examined include: (1) self-esteem, (2) self-monitoring, (3) open-mindedness, (4) empathy, (5) interaction involvement, and (6) non-judgement. In addition, the confusion among intercultural awareness, intercultural sensitivity, and intercultural competence is discussed and future directions for research in intercultural sensitivity is suggested

    Feeling Homesick at Home: A Dialogue

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    As we suggested in 2005, “centrisms” exist in historical space, rhetorical space, physical space, national space, postcolonial space, and in mental space. They are inscribed authentically, by those groups who have lived a cultural experience, or inauthentically, by those outside of the community. They reflect a more or less actual history, or they may represent idealized conceptions of how a community should or might be. Centrisms are always at some site of contestation. The avowal of an identity is met with charges of essentialism, and is regarded by some as a binary oversimplification. When viewed as a willing reinscription of identity that replaces what colonial and slave history may have undercut, though, Cote D’Ivoire President Félix Houphouët-Boigny’s words seem apt: “Better to be dominated by a friend than by an enemy.” Our present dialogue questions the utility of centrisms in a globalizing world.” [China Media Research. 2009; 5(1): 87-94

    A Review of the Concept of Intercultural Sensitivity

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    The development of a global village strongly demands the ability of intercultural sensitivity between people for survival in the 21st century. Due to current lack of study on the subject, this paper aims to: (1) provide a conceptualization of intercultural sensitivity; (2) specify the role intercultural sensitivity plays in intercultural training programs; (3) delineate the components of intercultural sensitivity; and (4) critique and suggest directions for future study in this line of research. As a result, a working definition of intercultural sensitivity is generated. The components of intercultural sensitivity examined include: self-esteem, self-monitoring, open-mindedness, empathy, interaction involvement, and non-judgment. In addition, the paper discusses confusion among intercultural awareness, intercultural sensitivity, and intercultural competence and suggests future directions for research in intercultural sensitivity

    Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

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    Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

    Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

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    Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

    Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

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    Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes
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