Knowledge Base for Transcultural Health
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This document outlines a proposal for creating a knowledge base called "Medals" to improve transcultural health and medicine. It discusses four competences needed - anthropological, clinical, communicative, and psychological. Poor communication can lead to misdiagnosis or erroneous prescriptions. The knowledge base would include models of health and disease across cultures, linguistic and cultural differences that impact communication, and examples from different languages and cultures. It would integrate data from scientific literature, healthcare professionals, and other sources to reduce cultural gaps and disparities in healthcare.
Knowledge Base for Transcultural Health
- 1. Medals: A Knowledge Base for Transcultural Health and MedicineDr. Riccardo ColasantiRielo Institute for Integral Developmentcolasanti@rieloinstitute.org
- 2. What is Integral health?
- 3. Communicative competenceAnthropological competenceClinical competencePsychological competenceFour competences are defined:
- 4. According Van Wieregen et al. (2002) in medical consultation in general practice mutual understanding was poor in 33% of consultations with ethnic-minority patient versus 13% with native-born patientEur J Public Health. 2002 Mar;12(1):63-8.Intercultural communication in general practice.Van Wieringen JC, Harmsen JA, Bruijnzeels MA.Communication in Transcultural Medicine
- 5. The lack of comprehension may imply, medical misdiagnosis (false positive or false negative), erroneous prescriptions, a possible death toll Outcomes of poor comprehension in medicine
- 6. We need to know:Cultural medical models of the patientHis cultural expectativeHow he/she communicates with linguistical and not-linguistical skills his/her problems How the doctor can communicate to her/himTo improve medical comprehension
- 7. Models of Health and Disease in different cultures According to Tirodkar et al. (2011) …physician’s explanatory models of illness are still largely biomedical in that they emphasize the biological and physical aspects of disease etiology . However, patients or individuals who are experiencing illness may have different explanatory models. Explanatory models of health and disease among South Asian immigrants in ChicagoTirodkar,M.A.; Baker,D.W. ; Makoul,G.T.; Khurana,N.; Paracha,M.W.; Kandula,N.R. J.ImmigrMinor.Health., 2011, 13, 2, 385-394, United States
- 8. Pre-linguisticLinguistic Cultural (Different Customs in Food, Habits etc)Philosophical and Religious (Explanatory Model of Health and Disease, Existential meaning of Life and Disease )The medical incomprehension is a multilayer issue:
- 9. PatientDoctorSicknessIntercultural communication is very complexJudgmentfearsobjectifyingsubjectifyingobjectifying
- 10. Gesture Ambiguity (ex.: nodding and shaking head)Lack of grammatical precisionHyperbolic use of deictical terms (ex. that, this) that hides the meaning in case of lack of contextLexical Differences (Ethnoanatomy)False Friends in the Vocabulary The Rethorical use of Medical LanguageDifferences in Conceptual Schemas (Frames di Minsky)Difference in the medical encyclopediaDifference in Health CustomsDifference in Symbolic Values Difference in philosophical and religious valuesSome tipical issue in Crosscultural Communication in Medicine in
- 11. Some examples
- 12. Tamil terms related to health :The lungs, liver, spleen, and other visceraஈரல் : irelOffensive smell of blood.இரத்தக்கவிச்சு, (irattacavicciù)
- 14. No!
- 15. Foot/Leg Diversity in language(De Blasio, Colasanti 2009)
- 16. Foot-Leg(De Blasio, Colasanti 2009)
- 17. The reduction of the cultural gap in Healthis a two-way pathPatient-PhysicianRelationship and RacialDisparities in the Quality of Health Care Saha et al. American Journal of Public HealthOctober 2003 Vol 93 n. 10
- 18. It is really necessary to constitute a knowledge base of alle the medical observations related to cultural and linguistically topics in all the culture ion the world
- 19. Pub Med (NLM Bethesda) for “cultural diversity” return 10.000 articlesNon medical scientific literature: indetermined numberGoogle Video looking for “traditionalmedicine” return 19.700 clips.Slideshare (presentations) for “traditionalmedicine ”return 28000 Powerpointpresentation. + i social forum, le news etcTerabytedi dataBasic Problem: Huge Dimension of the Data Base
- 20. I we the number of cultural groups is proportional to the number of linguistic differences:How many cultures in the world?How many cultures in the world?
- 21. How many people clusters in the world?Modificato da http://www.joshuaproject.net/how-many-people-groups.php
- 24. BroadUp-to-dateScientificBut open to Social Network of Healthcare Professionals The Knowledge Base has to be
- 25. 3 Structural Blocks of the Knowledge Base123
- 27. Define the taxonomical tree in Medical Anthropology and in Transcultural Medicine1. Taxonomy Ontology Based
- 29. From the scientific literature peer reviewedMedical (Medline)Non MedicalFrom the social Network of Health Care Professional2. Cultural Data Collection
- 30. A data base to be consulted via web Interface user friendlyA IT Social Network platform3. IT database
- 31. 3. IT database: Zentity 2.0
- 32. This vision for an integrated approach is intended to serve as a catalyst for transforming the health care system to meet the needs of limited-literacy, culturally diverse, and limited English proficiency patients. Clinicians and health care staff have an important role to play, but the responsibility for achieving real progress for patients facing challenges related to literacy, culture, and language must extend to organizations that support them.Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse PopulationsDennis P Andrulis, Cindy Brach. American Journal of Health Behavior. : Sep/Oct 2007.