Shared cross-cultural principles underlie human prosocial behavior at the smallest scale

Prosociality and cooperation are key to what makes us human. But different cultural norms can shape our evolved capacities for interaction, leading to differences in social relations. How people share resources has been found to vary across cultures, particularly when stakes are high and when interactions are anonymous. Here we examine prosocial behavior among familiars (both kin and non-kin) in eight cultures on five continents, using video recordings of spontaneous requests for immediate, low-cost assistance (e.g., to pass a utensil). We find that, at the smallest scale of human interaction, prosocial behavior follows cross-culturally shared principles: requests for assistance are very frequent and mostly successful; and when people decline to give help, they normally give a reason. Although there are differences in the rates at which such requests are ignored, or require verbal acceptance, cultural variation is limited, pointing to a common foundation for everyday cooperation around the world.

Universals and cultural diversity in the expression of gratitude

Gratitude is argued to have evolved to motivate and maintain social reciprocity among people, and to be linked to a wide range of positive effects-social, psychological and even physical. But is socially reciprocal behaviour dependent on the expression of gratitude, for example by saying 'thank you' as in English? Current research has not included cross-cultural elements, and has tended to conflate gratitude as an emotion with gratitude as a linguistic practice, as might appear to be the case in English. Here, we ask to what extent people express gratitude in different societies by focusing on episodes of everyday life where someone seeks and obtains a good, service or support from another, comparing these episodes across eight languages from five continents. We find that expressions of gratitude in these episodes are remarkably rare, suggesting that social reciprocity in everyday life relies on tacit understandings of rights and duties surrounding mutual assistance and collaboration. At the same time, we also find minor cross-cultural variation, with slightly higher rates in Western European languages English and Italian, showing that universal tendencies of social reciprocity should not be equated with more culturally variable practices of expressing gratitude. Our study complements previous experimental and culture-specific research on gratitude with a systematic comparison of audiovisual corpora of naturally occurring social interaction from different cultures from around the world.

Evaluation of a system for providing information resources to nurses

The authors describe a study to plan and implement an information system for nurses. The objectives were to (1) determine the clinical information needs of nurses; (2) adapt an existing clinical information system (CLINT) to address their expressed needs; and (3) evaluate nurses’ use of and satisfaction with the enhanced system.

Thirty-nine nurses on a medical teaching unit in a tertiary hospital in Canada participated in the project. A needs assessment influenced the design of the nursing interface to CLINT and the development of educational and participatory strategies to promote its use. Data were collected before, after, and throughout the implementation period. Qualitative and quantitative methods, including focus groups, online questionnaires, and automated usage data collection, were used to describe nurses’ use of and satisfaction with the system.

The results suggested that peer mentorship, organizational support, and collaboration were the most effective strategies for promoting system use. The hospital information system (IHIS), Netscape, drug information and basic texts were the most frequently used databases. Nurses were satisfied with the system and reported progress in changing clinical practice. CLINT helped them to keep up with educational and professional development.

In conclusions, nurses are willing to use information systems that are relevant to their needs and user friendly. There is, however, a paucity of resources available for evidence-based clinical decision making.

Universal Principles in the Repair of Communication Problems

There would be little adaptive value in a complex communication system like human language if there were no ways to detect and correct problems. A systematic comparison of conversation in a broad sample of the world’s languages reveals a universal system for the real-time resolution of frequent breakdowns in communication. In a sample of 12 languages of 8 language families of varied typological profiles we find a system of ‘other-initiated repair’, where the recipient of an unclear message can signal trouble and the sender can repair the original message. We find that this system is frequently used (on average about once per 1.4 minutes in any language), and that it has detailed common properties, contrary to assumptions of radical cultural variation. Unrelated languages share the same three functionally distinct types of repair initiator for signalling problems and use them in the same kinds of contexts. People prefer to choose the type that is the most specific possible, a principle that minimizes cost both for the sender being asked to fix the problem and for the dyad as a social unit. Disruption to the conversation is kept to a minimum, with the two-utterance repair sequence being on average no longer that the single utterance which is being fixed. The findings, controlled for historical relationships, situation types and other dependencies, reveal the fundamentally cooperative nature of human communication and offer support for the pragmatic universals hypothesis: while languages may vary in the organization of grammar and meaning, key systems of language use may be largely similar across cultural groups. They also provide a fresh perspective on controversies about the core properties of language, by revealing a common infrastructure for social interaction which may be the universal bedrock upon which linguistic diversity rests.

RN and RPN decision making across settings

Nursing decision making was a focus of the Province-Wide Nursing Project (PWNP), a 3-year project to promote best nursing practice. In much of the growing literature on nursing decision making, it is assumed that there are differences in the way RNs and RPNs make decisions. However, there is little scientific evidence to support this assumption. The RN and RPN decision making across settings questionnaire was completed by nurses employed in the 23 agencies of the 4 Participating Complexes taking part in the project. The survey questions were subjected to factor analysis and reduced to five factors. Results revealed measurable differences between the way that RNs and RPNs made decisions. Both RNs and RPNs reported making decisions frequently and experiencing little difficulty in making them. However, there were statistically significant differences in the frequency with which RNs and RPNs perceived they made decisions and the difficulty they found in making them. To plan effective health care, it is important to take account of the strengths of different health care workers. There is a need for further research to investigate the reasons behind the differences revealed in these findings.

Perceived support needs of family caregivers and implications for a telephone support service

The purposes of this study were: to identify the perceived support needs of family caregivers of persons living with chronic illness (physical or cognitive) and receiving home-care services, and to describe the types of telephone services that would meet the expressed needs of caregivers. The qualitative design used semi-structured interviews. A total of 34 caregivers (mean age 62 years) participated in the study. The care recipients (mean age 78 years) were primarily the husband/wife or parent of the caregiver. The most commonly expressed caregiver needs were: a social life, instrumental support (e.g., respite, assistance with physical care, financial compensation), informational support, and emotional support. Most caregivers said they would use a telephone support service provided by a professional (71%) or a fellow caregiver (59%) if available. The results of this study support a pilot study and evaluation of a telephone support service for family caregivers.

Nurses' experiences of restructuring in three Ontario hospitals

PURPOSE

To describe the effects of restructuring, particularly redeployment, on nurses' personal and work lives, and to compare the utility of "survivor syndrome" and empowerment as alternative concepts for understanding these effects and planning change.

METHODS

Twenty-six focus groups or interviews were held with 59 nurses working in three hospitals in Ontario, Canada.

FINDINGS

Participants described how restructuring strategies had affected them as individuals, as members of nursing teams, and as employees. In each of these aspects of their work lives, relationships became less integrated, their work activities became less controllable, and the changes compromised their ability to deliver effective care.

CONCLUSIONS

Restructuring intensifies structural weaknesses in professions, such as nursing, whose members are primarily employed by bureaucracies. Nurses may not find survivor syndrome a useful model to explain their low morale following restructuring because it identifies nurses as "patients" in need of therapy. An empowerment model that takes into account nurses' concerns about uncertainty and integration may be more fruitful for devising strategies to enhance their ability to practice effectively in hospital settings.

Healthcare Restructuring: The Impact of Job Change

Restructuring, particularly redeployment and job change, had a dramatic impact on the working conditions and practices of nursing personnel. This study was conducted to determine whether nurses (RNs and RPNs) who experienced job change perceived their work-lives differently than those who did not undergo job change and, whether nurses who experienced different types of job change (new role, new unit, or new hospital) varied in their perceptions. A questionnaire exploring themes relevant to redeployment was administered to all nurses (N = 3,408) in two large teaching hospitals that had undergone restructuring. The response rate was 50.7% (n = 1,728). Of the responses, 1,662 were used in the analysis. T-tests and ANOVAs were used to compare groups of nurses. Nurses who changed their jobs perceived their commitment to the organization, their work environment and quality of care differently than those who did not change jobs. Nurses with different types of job change differed in their organizational commitment, perceptions of work-related injuries, attitudes towards job change, need for orientation and new knowledge, and feelings about the health care team. Results will assist managers to address the specific needs of nurses with different experiences of job change in the restructured workplace.

The organizational environment and evidence-based nursing

The Province-Wide Nursing Project (PWNP) was designed to remove some of the structural barriers that can impede the ability of nurses in selected health care settings to assess, implement and evaluate best nursing practice. Literature on capacity building and research utilization suggests that the organization is the most important factor in promoting best nursing practice. Therefore, managers and nursing leaders need to encourage the creation of optimum work environments. A survey undertaken by the PWNP Research Centre team assessed the extent to which the 23 agencies in the 4 Participating Complexes provided supportive environments for evidence-based practice. The Characteristics of Agencies in Participating Complexes: Demographics and Resources questionnaire investigated the resources available to help nurses improve their standards of practice in agencies participating in the project. Larger agencies, especially those associated with academic centres, had considerably more resources than agencies in smaller towns. Participation in the Province-Wide Nursing Project enabled agencies to develop strategies to improve the use of evidence in nursing practice.

Do nurses have the information resources and skills for research utilization?

While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.

The research utilization process: the use of guided imagery to reduce anxiety

In the rapidly changing health care environment, nurses need to keep current with developments, assess their applicability to practice, and make changes where appropriate. There is evidence that nursing research is underutilized and that a considerable gap exists between nursing research and practice (Bostrum & Suter, 1993; Brett, 1987; Sokop & Coyle, 1990). The objectives of a study carried out on a bone marrow transplant unit in a teaching hospital were to: (1) by introducing a framework for research-based care, enhance research utilization in a selected setting, and (2) evaluate the outcomes of research utilization on a specific clinical nursing problem chosen by nurses and researchers. This paper describes the research utilization process and its outcomes, presents an evaluation of the participatory approach from the perspective of the participating nurses, and discusses facilitators and barriers to research utilization. Guided imagery was the intervention used to decrease patient anxiety.

Linking the professional literature to nursing practice: challenges and opportunities

Occupational health nurses face the challenge of rapidly changing, increasingly complex work environments. To respond, they must have access to information and know how to manage it effectively to improve their clinical performance and achieve better client outcomes. Information technology has already had an impact on nursing. Many nurses routinely use computers to access laboratory reports, client records, and administrative programs. However few nurses make use of opportunities provided by information technology to access professional literature as a tool for applying new research to their practice.

Literature search and retrieval in the workplace

Nurses do not adequately access and use information to enhance knowledge-based practice. A computerized literature search and retrieval system was installed on a selected hospital unit to evaluate its utility in a work setting. Thirty-three nurses were taught how to use six CD-ROM bibliographic and full-text databases, electronically request articles from the librarian, and to critique the literature. The training program was evaluated by questionnaire and subsequent use of the system. Qualitative data regarding the perceived impact were collected using focus groups. The Michigan Organizational Assessment Questionnaire was administered before and after the intervention. Following training, nurses used the system to successfully answer questions related to patient care, general health issues, and education courses.

Ovarian remnant syndrome: study in laboratory rats

OBJECTIVES

This study was designed to answer two questions: (1) will devascularized ovarian rat tissue reimplant on intact or denuded peritoneal surfaces, and (2) will any revascularized tissue become functional, as evidenced by follicle formation and vaginal cornification?

STUDY DESIGN

A total of 110 young female Sprague-Dawley rats were divided into four study groups and a control group. Bilateral oophorectomy was performed on the rats in the first three study groups. In these groups the ovaries were sutured to the left peritoneal surfaces, where the devascularized tissue might become revascularized. The vascularized ovary was sutured to the right denuded peritoneal surface in the rats in group 4, and an oophorectomy was performed on the rats in the control group. The study animals were killed and evaluated at 3, 6, or 9 weeks postoperatively.

RESULTS

Seventy-five percent of the devascularized ovarian tissue revascularized. Forty-three percent of the viable ovarian tissue demonstrated follicular growth that increased with time to death. Thirty-seven percent of the rats showed the effects of estrogen on the vaginal epithelium.

CONCLUSIONS

This study indicates that devascularized ovarian tissue may reimplant on intact or abraded peritoneal surfaces, where in time it may resume functioning. These findings suggest that great care must be taken when using the laparoscope to collect ovarian specimens.

Prolonged continuous acyclovir treatment of normal adults with frequently recurring genital herpes simplex virus infection. The Acyclovir Study Group

In this 3-year study of suppressive acyclovir for recurrent genital herpes, patients with more than six recurrences per year were randomized initially to 400 mg of acyclovir or placebo orally two times per day, with recurrences treated with 200 mg of acyclovir five times per day for 5 days. In the second year of the study, all patients received acyclovir as a daily suppressive or intermittent acute therapy; in the third year, all received daily acyclovir. Among 525 patients completing 3 study years, 289 received 3 years of suppressive therapy and 236 received 1 year of acute therapy followed by 2 years of suppressive therapy. Of those who completed the third year, 61% were recurrence free that year; 25% of the suppressive therapy-only group were recurrence free for all 3 years. The annual recurrence rate dropped from more than 12 recurrences per year at baseline to 1.0 (suppressive therapy) and 1.4 (acute and suppressive therapy) recurrences during the third year. No significant toxic effects were detected. Daily suppressive acyclovir therapy was effective and well tolerated.