Cross- Cultural Training for
Astronauts and Space Travelers
Tripthi M. Mathew, MD, MPH, MBA, PhD
President & CEO,
Alpha & ...
Presentation Overview
My Background & Experiences
Learning Objectives
Definition- What is Culture?
Background- Some Cultur...
AboutthePresenter
Dr. Tripthi Mary Mathew received her MD degree (7 yr program) from the former Soviet Union
(Georgia & Be...
/
First Preventive Medicine/Public Health Job (Vaccine Preventable & Invasive
Bacterial Diseases Epidemiologist & State In...
AboutthePresenterCont’d,BelaruswithLove
Experience organizing the Injury Prevention Program and
participating at Delaware ...
From Belarussia withLove
Vitebsk State Medical University, Vitebsk, Belarus
Source: http://medicoabroadvsmu.weebly.com/ind...
Learning Objectives
 The participants of this lecture/presentation will be able to define what is
culture?
 The particip...
Definition of Culture
What is Culture (Kultura in Russian)?
Culture of a group, organization, society country consists of ...
Quotes on Culture
“Culture is the widening of the mind and of the spirit”.
- Jawaharlal Nehru
“Culture of the mind must be...
Background
International Space Station (ISS)
International Partnership. Established 14 yrs ago in 1998, first module built...
View from the International Space Station (ISS)
Texas MetropolitanAreas at Night
Astronaut Photography taken on July 1, 20...
Cultural Theories
Schein’s Iceberg Model of Culture
1) Artefacts
2) Espoused Beliefs and Values
3) Basic Underlying Assump...
Hofstede’s Cultural Dimensions
 Power Distance- Power distance is defined as the extent to which the less powerful
member...
Methods
Question: Is there any cross-cultural training done for Astronauts?
What is the effectiveness of cross-cultural tr...
Analysis:Hofstede’sCulturalDimensionScores
forISSPartners
Countries/Agen
cies at ISS
Power
Distance
Index (PDI)
Uncertaint...
Different Business Cultures
Countries Greetings Dress Punctuality Language Other
USA Firm
Handshake
Casual
Business/Inform...
Different Business Cultures
Countries/Agen
cies at ISS
Greetings Dress Punctuality Language Other
Russia (C.I.S
Countries/...
Can you name three classical Hollywood movies that teaches
one or more elements of culture that we defined earlier e.g.
La...
 Similarities between the Aboriginal Tribe in Australia (Dr. Roden’s lecture) and
People of the former Soviet Union with ...
Results
Cultural Dimensions
 Among the five space agency countries (head quarter locations only), there was no equal
(50/...
Cross-Cultural Training Research Findings
• One full day training on Cross- Cultural training for Astronauts (primary data...
Cultural Patches
Ώα
Alpha & Omega Healthcare Management Consultingα Ώ
Recommendations
Continue Team Work
Promote & Continue Collaborative Projects
Continue Promoting Awareness about different ...
Summary
What is Culture?
Organizational Culture Theories (common ones/widely
accepted)
Cultural similarities and differenc...
Contact
Dr. Valsalva (Val)- My Call Sign
Dr.Val_Aerospace@yahoo.com
Dr. Antonio Maria Valsalva
January 17,1666 – February ...
References/Resources1) Say Hello to your very own books of Quotes. Quotes about Culture. Internet
http://www.brainyquote.c...
Acknowledgements
I like to thank the following persons for their direct or indirect
response/feedback/support or informati...
Questions/Comments
Take Home Preventive Medicine Message:
Think of doing “Valsalva”, and other remedies (ear poppers) when...
Cross-Cultural Training For Astronauts and Space Travelers
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Cross-Cultural Training For Astronauts and Space Travelers

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This was a Presentation/Lecture done at the Principles of Aviation and Space Medicine Course at University of Texas Medical Branch, Galveston, Texas, July 26, 2013.

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Cross-Cultural Training For Astronauts and Space Travelers

  1. 1. Cross- Cultural Training for Astronauts and Space Travelers Tripthi M. Mathew, MD, MPH, MBA, PhD President & CEO, Alpha & Omega Healthcare Management Consulting www.alphanomega.info Presented at University of Texas Medical Branch (UTMB), Principles of Aviation and Space Medicine Course July 26, 2013, Galveston, Texas α Ώ Alpha & Omega Healthcare Management Consulting
  2. 2. Presentation Overview My Background & Experiences Learning Objectives Definition- What is Culture? Background- Some Cultural Theories/tools: Hofstede’s Cultural Dimensions & ISS Methods- Primary and Secondary Sources. Analysis- Hofstede’ Cultural Dimension was applied Results- Cultural Dimension Scores of ISS Countries/Agencies Recommendations/Conclusion- Need for Continued Cross-Cultural Training Contact References Acknowledgements Question & Comments
  3. 3. AboutthePresenter Dr. Tripthi Mary Mathew received her MD degree (7 yr program) from the former Soviet Union (Georgia & Belarus), MPH (2 yr full-time) degree from Drexel University, MBA from University of Warwick, and PhD in Business Management with Distinction from Ashwood University, Texas. Has an Offer for Master of Laws (L.L.M) in Public Procurement and Policy at the University of Nottingham, UK. Dr. Mathew has over 10 years of experience in the healthcare industry in various sectors: Private, Public (Federal, State and Local), Academia and Non-profit Dr. Mathew is a member of the World Medical Association, European Medical Association, Russian American Medical Association, Aerospace Medical Association, Women in Aerospace, Aircraft Owners & Pilots Association and member of 50 groups and associations on Linkedin.com Dr. Mathew was nominated as a member to the Global Advisory Board of the American Academy of Project Management; the Editorial Advisory Committee of the Nation's Health- American Public Health Association's Newspaper and is a member of the Harvard Business Review Advisory Council. Dr. Mathew is the Founder, President and CEO of Alpha & Omega Healthcare Management Consulting www.alphanomega.info Multicultural/lingual. Have lived and studied in 4 different continents (Asia-India, Africa- Nigeria, Europe- Former, U.S.S.R, UK, Sweden, Germany, BrusselsLearning to Fly. Discovery Flight on August 30, 2012. In process of preparing for FAA exam for Private Pilot license α Ώ Alpha & Omega Healthcare Management Consulting
  4. 4. / First Preventive Medicine/Public Health Job (Vaccine Preventable & Invasive Bacterial Diseases Epidemiologist & State Influenza Surveillance Coordinator, Infectious Disease Epidemiology Program, WVDHHR, 2000-2001) Became U.S. Citizen in Charleston, West Virginia, 2001 and first media interview Altitude Experiences (Snowshoe Mountain-, West Virginia) Working on investigating a respiratory illness outbreak in a Middle School at Pochantos County, West Virginia. Collection of specimens from children at the Pochantos Memorial Hospital, and riding over the Snow Shoe Mountain (4,711 Ft ) to get there Riding with the regional epidemiologist (visiting the counties) on the Shenandoah Mountain (Mountain Ridge between Virginia & West Virginia, highest peak Shenandoah/Blue Ridge Mountain, West Virginia Source: www.innvirginia.com Source: http://www.snowshoemtn.com West Virginia State Capitol on Kanwaha River, Source: www.countryinns.com Source: www. myhuntprofile.com Map of West Virginia Source: http://www..geology.com Flag of WV Source: commonswikimedia.org Source: en.wikpedia.org Dr. Tripthi Mary Mathew Press Interview in the Charleston Daily, October 2, 2001
  5. 5. AboutthePresenterCont’d,BelaruswithLove Experience organizing the Injury Prevention Program and participating at Delaware State Health Fairs, Public Health Preparedness etc. Experiences related to living in Extreme Conditions (as it pertains to Aerospace Medicine/Wilderness Medicine/Antarctica):  Young age (I had just turned 17yrs), graduated from high school, entered College  First time living home with no camping experiences  No knowledge of Russian language (not one word)  No Relatives or Friends in Former U.S.S.R (CCCP)  Far, Far from home (India) with no phones, cell phones, internet, TV. Only communication with home is by snail mail which takes 2 months (one month if the letter reaches India and another one month to get reply back from India, if it does not get lost)  Extremely Cold weather ( can reach minus 25 to 30 degree Celsius during winter)  Harsh living conditions: In Georgia (1 year Medical Prep School), “Subotnik”  Lived cramped usually 3 girls/women in a hostel room (if lucky to get one)  Used to tie food in grocery bags and hang them out of the window (as there was no refrigerators or microwaves in the hostel rooms)  Can come home (India) only once a year during summer months (for 1-2 months) as per visa stamped and course requirements, short 1-2 weeks break in Winter.  Planning and Rationing of food supply (dried foods, coffee, tea, pickles etc) and other goods (sanitary products etc, all that you need for 1 yr) brought from home to last 1 year,  Purchasing all supplies for the year usually took 1 month back home (food, medicine, sanitary products, warm clothes, English Medical Books etc)  Medium of Medical Studies- only in Russian Language Alpha & Omega Healthcare Management Consulting
  6. 6. From Belarussia withLove Vitebsk State Medical University, Vitebsk, Belarus Source: http://medicoabroadvsmu.weebly.com/index.html α Ώ Alpha & Omega Healthcare Management Consulting
  7. 7. Learning Objectives  The participants of this lecture/presentation will be able to define what is culture?  The participants will become aware about the most common organizational cultural theories in management literature  The participants will be able to understand some cultural similarities and differences among different cultures.  The participants will be able to apply Hofstede’s Cultural dimensions to the international partner countries of the ISS, and understand cultural similarities and differences among them.  The participants will be able to learn the effectiveness of some cross- cultural training conducted in healthcare setting and in the business environment. α Ώ Alpha & Omega Healthcare Management Consulting
  8. 8. Definition of Culture What is Culture (Kultura in Russian)? Culture of a group, organization, society country consists of language (s), religion (s), norms, values, social habits, dress, cuisine, music and arts. As per Geert Hofstede, a Dutch anthropologist, views culture as “collective mental programming” of people. What is Enculturation? It is the process by which people learn the requirements of their surrounding culture and acquire values and behaviors appropriate or necessary in that culture.[ What is Acculturation? The process of adjusting and adapting to a culture other than one’s own. α Ώ Alpha & Omega Healthcare Management Consulting
  9. 9. Quotes on Culture “Culture is the widening of the mind and of the spirit”. - Jawaharlal Nehru “Culture of the mind must be subservient to the heart”. - Mahatma Gandhi “No culture can live if it attempts to be exclusive”. - Mahatma Gandhi “Preservation of one’s own culture does not require contempt or disrespect for other cultures”. -Cesar Chavez “ The tendency to aggression is an innate, independent, instinctual disposition in man…it constitutes the powerful obstacle to culture” . -Sigmund Freud “If everybody is looking for it, then nobody is finding it. If we were cultured, we would not be conscious of lacking culture. We would regard it as something natural and would not make so much fuss about it. And if we knew the real value of this word we would be cultured enough not to give it so much importance.” - Pablo Picasso “No occupation is so delightful to me as the culture of the earth, and no culture comparable to that of the garden” - Thomas Jefferson “If art is to nourish the roots of our culture, society must set the artist free to follow his vision wherever it takes him” - John F. Kennedy α Ώ Alpha & Omega Healthcare Management Consulting
  10. 10. Background International Space Station (ISS) International Partnership. Established 14 yrs ago in 1998, first module built and sent was unmanned Russian Module Zarya. The ISS was manned 12 yrs ago in 2000 (as per Astronaut Sunita Williams, Commander of 33rd Expedition). Consists of 5 Space Agencies (NASA, ESA, Roscosmos, JAXA, CSA) 24 Countries (US, Canada Japan, Russia and ESA Member States: Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, The Netherlands, Norway, Poland, Portugal, Romania, Spain, Sweden, Switzerland and the United Kingdom). Official Language on ISS: English Current Crew on Expedition 36 consists of 3 Russians, 2 Americans and 1 Italian Current Mission (36th) Period: May, 2013 to September, 2013 Pictured on the front row are Expedition 36 Commander Pavel Vinogradov (left) and Flight Engineer Fyodor Yurchikhin. Pictured from the left (back row) are Flight Engineers Alexander Misurkin, Chris Cassidy, Luca Parmitano and Karen Nyberg. Photo credit: NASA α Ώ Alpha & Omega Healthcare Management Consulting
  11. 11. View from the International Space Station (ISS) Texas MetropolitanAreas at Night Astronaut Photography taken on July 1, 2013 α Ώ Alpha & Omega Healthcare Management Consulting
  12. 12. Cultural Theories Schein’s Iceberg Model of Culture 1) Artefacts 2) Espoused Beliefs and Values 3) Basic Underlying Assumptions Handy’s Organizational Culture 1) Power Culture (Spider in the center of a web) 2) Role Culture (Bureaucratic structure) 3) Task Culture (Team) 4) Person Culture Hofstede’s Cultural Dimensions 1) Power Distance (PDI) 2) Uncertainty Avoidance (UAI) 3) Individualism (ID) 4) Masculinity (MAS) 5) Long-Term Orientation (LTO) Trompenaars and Hampden-Turner Dimensions (Seven Dimensions) 1) Universalism vs Particularism 2) Individualism vs Communitarianism 3) Specific vs Diffuse 4) Neutral vs emotional 5) Achievement vs ascription 6) Sequential time vs synchronous time 7) Internal direction vs outer direction α Ώ Alpha & Omega Healthcare Management Consulting
  13. 13. Hofstede’s Cultural Dimensions  Power Distance- Power distance is defined as the extent to which the less powerful members of institutions and organisations within a country expect and accept that power is distributed unequally. It describes how the society deals with the inequalities in power that exist among people.  Uncertainty Avoidance-The extent to which the members of a culture feel threatened by ambiguous or unknown situations and have created beliefs and institutions that try to avoid these situations. It implies the extent to which people can tolerate risk and uncertainty in their lives.  Individualism-It is the degree of interdependence a society maintains among its members. It describes whether a person functions primarily as an individual or within a group.  Masculinity- The fundamental issue here is what motivates people, wanting to be the best (masculine) or liking what you do (feminine). Masculine cultures tend to value competitiveness, assertiveness, ambition, and the accumulation of wealth. Feminine cultures emphasize nurturing roles, interdependence among people, and taking care of less fortunate people.  Long Term vs Short-term Orientation-dealing with society’s search for virtue, the extent to which a society shows a pragmatic future-oriented perspective rather than a conventional historical short-term point of view. Denotes the degree to which people and organizations defer gratification to achieve long- term success. Source: The Hofstede Center, 2013. Internet. http://geert-hofstede.com/dimensions.html α Ώ Alpha & Omega Healthcare Management Consulting
  14. 14. Methods Question: Is there any cross-cultural training done for Astronauts? What is the effectiveness of cross-cultural training? Primary Data Sources: E-mails and Discussions with Dr. Ogata, Dr. Lindgren, Dr. Castleberry, Dr. Beven, Dr. Schmid and Presentation/lecture of Dr. Moore, Dr. Scott & Dr. Vanderploeg . Secondary Sources: Literature review using Google Scholar, Pubmed. Keywords: Cross-Cultural Training in Astronauts, Cross-Cultural Competence
  15. 15. Analysis:Hofstede’sCulturalDimensionScores forISSPartners Countries/Agen cies at ISS Power Distance Index (PDI) Uncertainty Avoidance (UA) Individualism (IDV) Masculinity (MAS) Long Term Orientation USA (NASA) 40 46 91 62 29 Canada (CSA- Canadian Space Agency) 39 48 80 52 23 Russia (Roscosmos- The Russian Federal Space Agency ) 93 95 39 36 - Japan Aerospace Exploration Agency (JAXA) 54 92 46 95 80 France ESA (European Space Agency) 68 86 71 43 - Source: Mathew, TM. Global Management of Healthcare Systems: One-World-One-Care? 4th International Conference of Education, Research and Innovation (ICERI, 2011), November 14-16, 2011; Madrid, Spainα Ώ
  16. 16. Different Business Cultures Countries Greetings Dress Punctuality Language Other USA Firm Handshake Casual Business/Inform al (Moderate Importance) of Highest Importance (Don’t be late-Zero Tolerance) English-High Importance placed on Accent (although Americans all have different accents and come from different countries) Talkative /like to engage in small talk/Frie ndly α Ώ Alpha & Omega Healthcare Management Consulting
  17. 17. Different Business Cultures Countries/Agen cies at ISS Greetings Dress Punctuality Language Other Russia (C.I.S Countries/Former Soviet Union) Unknown Person/First Time meeting- Drasthivithe Well Known- Drasthivithie, Kak Dela (How are you?), and a Hug Of High Importance Well Dressed/F ormal (of Highest Importanc ) Moderate Low- Don’t care about how you speak or pronounce Russian/Gra mmar very complex (Easy to please Russians) Russian Language- 2nd most difficult language, 1st Chinese If you are a Man and happen to be in Russia in the winter, and you are in a meeting (there are women present, expect to help them take their coats off and help themα Ώ Alpha & Omega Healthcare Management Consulting
  18. 18. Can you name three classical Hollywood movies that teaches one or more elements of culture that we defined earlier e.g. Language, music, dress? Cultural Misunderstandings. The Italian Man who went to Malta. 2008 http://www.youtube.com/watch?v=F_N1Cmt_QB0 (1:13) 16 Rude & Interesting Gestures Around the World: explained by Skyscanner http://www.youtube.com/watch?v=a1b6MGoxekY Mind Your Language (Britcom Comedy/ TV series) https://www.youtube.com/watch?v=u1QxzpWbbdI α Ώ Alpha & Omega Healthcare Management Consulting
  19. 19.  Similarities between the Aboriginal Tribe in Australia (Dr. Roden’s lecture) and People of the former Soviet Union with regards to Alcohol Consumption. There is intolerance to drinking (considered a public disgrace).  The tribal markings on the skin made by the Aboriginal tribe in Australia is similar to those of different tribes in Africa.  Can only marry someone from the same Aboriginal tribe (if not punished by having a spear thrown on leg), which is similar to caste system in India (where marriage is allowed only between people from the same caste, if not frowned upon by parents, cut off from relatives, looked down by Indian Society).  “The Cast System is connected to the four varnas, which order and rank humanity by innate spiritual purity. The highest varna is the Brahmins, or Priests (Swami/Sanyasi). Next come the Kshatriyas, the warriors, and then the Vaishyas, the merchants. The lowest varna is the Shudras, consisting of labourers, artisans and servants who do work that is ritually unclean”.  Contact between varnas, particularly the sharing of food and water, must be limited to avoid pollution of higher, purer individuals by lower, more unclean ones. α Ώ Alpha & Omega Healthcare Management Consulting
  20. 20. Results Cultural Dimensions  Among the five space agency countries (head quarter locations only), there was no equal (50/50) distribution on any of Hofstede’s Cultural dimension (IDV, UA, PDI, MAS, LTO) scores .  Among the 5 space agencies, the distribution of feminine countries is 40% and 60 % are masculine countries. In general, the women & men in feminine countries are more modest, and caring than their masculine counterpart countries who are assertive, and competitive.  The women in these masculine countries are not as assertive, competitive as the men, which mean there is a gap between men’s and women’s values.  Canada and US (low scores), 40% of the countries have short term orientation. This kind of orientation is characterized by values of respect for tradition, fulfilling social obligations, and protecting “one’s” face in contrast to countries with long term orientation values of thrift and perseverance (Geert Hofstede.com, 2010).  Three of the partner space agency countries had high Power Distance Index (PDI) scores whereas 2 countries had low scores. This indicates how citizens of these countries view equality of power and wealth within their societies and accepted by the population as a cultural norm. A higher PDI score indicating a high level of inequality of power and wealth within the society, accepted by the population of that country (Geert Hofstede.com, 2010).  Three out of the five space agency countries (60%) had high scores on Individualism (with US being the highest) index. α Ώ Alpha & Omega Healthcare Management Consulting
  21. 21. Cross-Cultural Training Research Findings • One full day training on Cross- Cultural training for Astronauts (primary data sources, Lindgren etc) • Cross- Cultural Training Rotation of Astronauts in 5 different Space Agencies • Hardly any recent studies done on effectiveness of Cross-Cultural training on Astronauts in literature. Most recent one published in 2007. There is a NASA report published in 2011. • From the literature review on the effectiveness of Cross-Cultural Training/Cultural Competence, it is interesting to note the following:  “Cultural competence training improved the knowledge, attitudes & skills of health professionals” (Beach et al, 2005)  “Cross-cultural training as a mechanism to address racial and ethnic disparities in healthcare….”, “The need for significant improvement in cross-cultural care to help eliminate racial and ethnic disparities” (Weissmann et al, 2005)  “Teaching of cultural diversity has been developed in the UK, but seems fragmented” (Dogra et al, 2005)  “Cross-Cultural training in general is effective” (Black, SJ & Mendenhall, M, 1990)  “Documentary and interpersonal training methods had additive benefits in preparing managers for intercultural work assignments” (Earley, 1987) α Ώ Alpha & Omega Healthcare Management Consulting
  22. 22. Cultural Patches Ώα Alpha & Omega Healthcare Management Consultingα Ώ
  23. 23. Recommendations Continue Team Work Promote & Continue Collaborative Projects Continue Promoting Awareness about different Cultures through Cross-Cultural Training. Consider Hofstede’s cultural dimension for a deeper understanding in cross- national interactions with business partners/space agencies, astronauts and value-chain members (commerical space travel organizations, space travelers). Conduct studies on the effectiveness of cross-cultural training on Astronauts. For NASA Astronauts (Continue the move from task-based culture to a skill based culture) Use Language translators/interpreters with medical/scientific background to improve communication. Use devices (OCR) /technology (simulations using HERA & HI-SEAS) that could study facial expressions, social interactions and curtail astronaut conflict. Develop integrated space suits with lingual/cultural resources/capacity to remove cultural barriers for future space travelers (commercial) Astronauts exploring Mars will need to reduce conflict and encourage teamwork. Image Credit: HI- SEAS/Sian HI-SEAS: Hawaii Space Exploration Analog and Simulation Source: http://hi- seas.org/?p=1278 α Ώ Alpha & Omega Healthcare Management Consulting
  24. 24. Summary What is Culture? Organizational Culture Theories (common ones/widely accepted) Cultural similarities and differences among different cultures. Hofestede’s Cultural Dimension Scores of ISS Countries/Agencies and understand cultural similarities and differences among them. Research findings from the literature on the effectiveness of cross-cultural training conducted in healthcare setting and in the business environment. Untethered Astronaut Bruce McCandless Source: wikipedia
  25. 25. Contact Dr. Valsalva (Val)- My Call Sign Dr.Val_Aerospace@yahoo.com Dr. Antonio Maria Valsalva January 17,1666 – February 2,1723 Source: Photo courtesey Wikipedia http://en.wikipedia.org/wiki/Antonio_Maria_Valsalva Astronaut Jeffrey A. HoffmanEVA-1 Valsalva Device Source: Collect Space .com http://www.collectspace.com/collection/artifacts_sts_sts51dvals.html Website: www.alphanomega.info Linkedin.com: http://www.linkedin.com/in/mathewtm You Tube: http://www.youtube.com/user/DrMathewTM Skype: DrTripthiM Alpha & Omega Healthcare Management Consultingα Ώ
  26. 26. References/Resources1) Say Hello to your very own books of Quotes. Quotes about Culture. Internet http://www.brainyquote.com/quotes/keywords/culture.html#u6vcBG8DzWoBKl4I.99 3) REFLECTIVE LEADERSHIP PRACTICE Can Culture Be Changed?2012 http://archive.constantcontact.com/fs082/1106536376264/archive/1109900773525.html 4) Embedding Culture into BCM. 2013. Internet. http://www.continuityinsights.com/articles/2013/03/embedding-culture-bcm 5) Conflicts between Astronauts Could Jeopardize Trip to Mars. 2013. Internet. http://lsiblog.blogspot.com/2013/07/conflicts-between-astronauts-could.html 6) Technology could curtail Astronaut Conflict. 2013. Internet. http://www.astrobio.net/exclusive/5550/technology-could-curtail-astronaut-conflict 7) The Hi-SEAS Habitat. 2013. Internet. http://hi-seas.org/?p=1278 8) Antonio Maria Salva 2013.Internet.http://en.wikipedia.org/wiki/Antonio_Maria_Valsalva 9) EVA-1 Valsalva Device.Internet.2012. http://www.collectspace.com/collection/artifacts_sts_sts51dvals.html 10) Management. Perspective and Practice. Handy’s four tyoes of Organizational Culture.Internet. http://www.open.edu/openlearn/money-management/management/leadership-and-managem... 11) The Seven Dimensions of Culture. Understanding and Managing Cultural Differences. http://www.mindtools.com/pages/article/seven-dimensions.htm 12) Edgar H. Schein (1985). Organizational Culture and Leadership. John Wiley & Sons 13) NASA. Team Training for Long-Duration Missions in Isolated and Confirmed Environments, A Literature Review, an Operational Assessment, and Recommendations for Practice and Research. 2011. α Ώ Alpha & Omega Healthcare Management Consulting
  27. 27. Acknowledgements I like to thank the following persons for their direct or indirect response/feedback/support or information through their lectures on this project/presentation: Dr. Tarah Castleberry Dr. Chuck Mathers, Dr. Richard Jennings, Dr. Charles Berry, Dr. James Vanderploeg, Dr. Sandra Moore, Dr. Josef Schmid, Dr. Gary Bevens, Astronaut Lindgren, Dr. Anil Menon Dr. Katsu Ogata, Dr. Sean Roden Dr. Graham Scott, Dr. Serena Aunon Mrs. Yvette Schulz, Ms. Diane Ellison α Ώ Alpha & Omega Healthcare Management Consulting
  28. 28. Questions/Comments Take Home Preventive Medicine Message: Think of doing “Valsalva”, and other remedies (ear poppers) when you fly, while descending…………… Principles of Aviation and Space Medicine Course, Class of 2013 Group Photo at NBL, Houston, Texas Source: Courtesy Dr. Dalbir Makh α Ώ Alpha & Omega Healthcare Management Consulting

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