title: A survey of the images used on the Arthritis Research UK (ARUK) Osteomalacia Mind-Map in relation to cultural background.
abstract: OBJECTIVE
  To explore the appropriateness of the images in the Arthritis Research UK Mind-Map for Osteomalacia with people for whom it was intended (Bengali; Gujarati; Hindi; Punjabi and Urdu).
  
  
  METHODS
  Participants were identified in a convenient sample from contacts within their communities. They were asked to comment on the images for meaning, suitability and offence to people from their culture. A total of 56 people were surveyed.
  
  
  RESULTS
  Appropriateness responses were either generic: Images of bone metabolism were confusing [31/56]; muscle weakness "looked like knee pain" [16/56]; a bending and cracking bone "looked like a dog's bone" [22/56] and that the bone pain man "looked like he had toothache" [21/56]; or culture-specific the depiction of food and the Burqa as below. Only 3 images caused any offence, phrased as "may offend someone". The Burqa was described as stereotyping.
  
  
  CONCLUSIONS
  The images on the current Osteomalacia Mind-Map are largely appropriate and have little capacity to offend. Some may be improved upon in terms of conveying meaning. One set of images can suit all of the cultures.
  
  
  CONCLUSIONS
  Images can cross cultural barriers. The revised Mind-Map should be more useful in conveying meaning to a wider selection of patients.
authors.affiliation: Freeman Hospital, Newcastle on Tyne UK.
authors.forename: David
authors.initials: D
authors.lastname: Walker
authors.forename: Sandra
authors.initials: S
authors.lastname: Robinson
authors.forename: Yogen
authors.initials: Y
authors.lastname: Jagatsinh
authors.forename: Ade
authors.initials: A
authors.lastname: Adebajo
authors.forename: Philip
authors.initials: P
authors.lastname: Helliwell
authors.forename: Anisur
authors.initials: A
authors.lastname: Rahman
mesh_terms: D001364:Awareness; D003142:Communication; D003469:Culture; D003625:Data Collection; D005006:Ethnicity / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D010018:Osteomalacia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology; D010146:Pain; D010353:Patient Education as Topic / Q000379:methods*; D011859:Radiography; D011795:Surveys and Questionnaires; D006113:United Kingdom