Flexible Citizenship: The Cultural Logics of Transnationality. Aihwa Ong. Durham, NIC: Duke University Press, 1999. ix. 322 pp., notes, bibliography, index.

Flexible Citizenship: The Cultural Logics of Transnationality

Eliminating indigenous and ethnic health inequities requires addressing the determinants of health inequities which includes institutionalised racism, and ensuring a health care system that delivers appropriate and equitable care. There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care. Some jurisdictions have included cultural competency in health professional licensing legislation, health professional accreditation standards, and pre-service and in-service training programmes. However, there are mixed definitions and understandings of cultural competency and cultural safety, and how best to achieve them. A literature review of 59 international articles on the definitions of cultural competency and cultural safety was undertaken. Findings were contextualised to the cultural competency legislation, statements and initiatives present within Aotearoa New Zealand, a national Symposium on Cultural Competence and Māori Health, convened by the Medical Council of New Zealand and Te Ohu Rata o Aotearoa – Māori Medical Practitioners Association (Te ORA) and consultation with Māori medical practitioners via Te ORA. Health practitioners, healthcare organisations and health systems need to be engaged in working towards cultural safety and critical consciousness. To do this, they must be prepared to critique the ‘taken for granted’ power structures and be prepared to challenge their own culture and cultural systems rather than prioritise becoming ‘competent’ in the cultures of others. The objective of cultural safety activities also needs to be clearly linked to achieving health equity. Healthcare organisations and authorities need to be held accountable for providing culturally safe care, as defined by patients and their communities, and as measured through progress towards achieving health equity. A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development. The unintended consequences of a narrow or limited understanding of cultural competency are discussed, along with recommendations for how a broader conceptualisation of these terms is important.

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Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition

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Dislocating cultures: identities, traditions, and Third World Feminism

Knowledge management (KM) is an emerging, interdisciplinary business model dealing with all aspects of knowledge within the context of the firm, including knowledge creation, codification, and sharing, and using these activities to promote learning and innovation. It encompasses both technological tools and organizational routines of which there are a number of components. These include generating new knowledge; acquiring valuable knowledge from outside sources; using this knowledge in decision making; embedding knowledge in processes, products, and/or services; coding information into documents, databases, and software; facilitating knowledge growth; transferring knowledge to other parts of the organization; and measuring the value of knowledge assets and/or the impact of knowledge management. Knowledge Management: Concepts, Methodologies, Tools, and Applications is the defining reference source for all theories, concepts, and methodologies within the KM discipline. This comprehensive, six-volume collection of research from an international body of KM experts includes chapters on Implementing Knowledge Management (KM) in Organizations; KM Systems Acceptance; KM Communication; Knowledge Representation; Knowledge Sharing; KM Success Models; Knowledge Ontology; and Operational KM. Encompassing over 300 chapters from more than 500 contributors drawn from the world s leading KM experts, this collection will provide libraries with the defining reference to the field and set the standard for all fundamental and emerging models within the discipline.

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Knowledge Management: Concepts, Methodologies, Tools and Applications

Encyclopedia of Knowledge Management

Responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prev...

Wellness for all: the possibilities of cultural safety and cultural competence in New Zealand

Background: Patient-Generated Health Data (PGHD) in remote monitoring programs is a promising source of precise, personalized data, encouraged by expanding growth in the health technologies market. However, PGHD utilization in clinical settings is low. One of the critical challenges that impedes confident clinical use of PGHD is that these data are not managed according to any recognized approach for data quality assurance. Objective: This article aims to identify the PGHD management and quality challenges that such an approach must address, as these are expressed by key PGHD stakeholder groups. Materials and Methods: In-depth interviews were conducted with 20 experts who have experience in the use of PGHD in remote patient monitoring, including: healthcare providers, health information professionals within clinical settings, and commercial providers of remote monitoring solutions. Participants were asked to describe PGHD management processes in the remote monitoring programs in which they are involved, and to express their perspectives on PGHD quality challenges during the data management stages. Results: The remote monitoring programs in the study did not follow clear PGHD management or quality assurance approach. Participants were not fully aware of all the considerations of PGHD quality. Digital health literacy, wearable accuracy, difficulty in data interpretation, and lack of PGHD integration with electronic medical record systems were among the key challenges identified that impact PGHD quality. Conclusion: Co-development of PGHD quality guidelines with relevant stakeholders, including patients, is needed to ensure that quality remote monitoring data from wearables is available for use in more precise and personalized patient care.

https://minerva-access.unimelb.edu.au/bitstream/handle/11343/240481/Patient-generated health data management and quality challenges in remote patient monitoring.pdf

Patient-generated health data management and quality challenges in remote patient monitoring.

Research demonstrates that gambling support services often do not meet the needs of people seeking help for their gambling problems. In particular, the needs of cultural groups, and gender-specific needs of men and women are neglected. Understanding differences in help seeking behaviour can assist in developing early interventions to address gambling related problems and in developing effective strategies. This paper reviews the literature on help seeking by problem gamblers and their families, including barriers to and relevance of services through a gender and cultural lens. Research findings from international and New Zealand studies are examined, highlighting ways in which gender and culturally appropriate strategies can be implemented. Ways of changing barriers and social policies are proposed which may improve the responsiveness of services. Ultimately it may encourage health care access and utilisation for people and their families seeking help for problem gambling.

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An Overview of Help Seeking by Problem Gamblers and their Families Including Barriers to and Relevance of Services

Problem Gambling - Barriers to Help-seeking Behaviours (Final Report)

Little is known about the maternity experiences of migrant mothers in Aotearoa/New Zealand – and in particular the ways in which women adapt and survive when separated from traditional postnatal practices and family support. This paper reports on a study of the maternity care experiences of women from Goa (India) in Auckland, New Zealand. Multiple research strategies were incorporated into the process to prevent reproduction of deficiency discourses. Interviews were carried out with Goan women who had experiences of migration and motherhood. The findings revealed that as a consequence of motherhood and migration, migrant mothers were able to reclaim and re-invent innovative solutions. Nurses and other health professionals can have a significant role in supporting women and their families undergoing the transition to parenthood in a new country and develop their knowledge and understanding of this dual transition.

Ruth DeSouza

Papers

Wellness for all: the possibilities of cultural safety and cultural competence in New Zealand

Patient-generated health data management and quality challenges in remote patient monitoring.

An Overview of Help Seeking by Problem Gamblers and their Families Including Barriers to and Relevance of Services

Problem Gambling - Barriers to Help-seeking Behaviours (Final Report)

Transforming possibilities of care: Goan migrant motherhood in New Zealand.