Selecting renal replacement therapies: what do African American and non-African American patients and their families think others should know? A mixed methods study.

BACKGROUND: Little is known regarding the types of information African American and non-African American patients with chronic kidney disease (CKD) and their families need to inform renal replacement therapy (RRT) decisions. METHODS: In 20 structured group interviews, we elicited views of African American and non-African American patients with CKD and their families about factors that should be addressed in educational materials informing patients' RRT selection decisions. We asked participants to select factors from a list and obtained their open-ended feedback. RESULTS: Ten groups of patients (5 African American, 5 non-African American; total 68 individuals) and ten groups of family members (5 African American, 5 non-African American; total 62 individuals) participated. Patients and families had a range (none to extensive) of experiences with various RRTs. Patients identified morbidity or mortality, autonomy, treatment delivery, and symptoms as important factors to address. Family members identified similar factors but also cited the effects of RRT decisions on patients' psychological well-being and finances. Views of African American and non-African American participants were largely similar. CONCLUSIONS: Educational resources addressing the influence of RRT selection on patients' morbidity and mortality, autonomy, treatment delivery, and symptoms could help patients and their families select RRT options closely aligned with their values. Including information about the influence of RRT selection on patients' personal relationships and finances could enhance resources' cultural relevance for African Americans.

Sociocultural and socioeconomic influences on type 2 diabetes risk in overweight/obese African-American and Latino-American children and adolescents.

PURPOSE: It is unclear whether sociocultural and socioeconomic factors are directly linked to type 2 diabetes risk in overweight/obese ethnic minority children and adolescents. This study examines the relationships between sociocultural orientation, household social position, and type 2 diabetes risk in overweight/obese African-American (n = 43) and Latino-American (n = 113) children and adolescents. METHODS: Sociocultural orientation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) questionnaire. Household social position was calculated using the Hollingshead Two-Factor Index of Social Position. Insulin sensitivity (SI), acute insulin response (AIRG) and disposition index (DI) were derived from a frequently sampled intravenous glucose tolerance test (FSIGT). The relationships between AHIMSA subscales (i.e., integration, assimilation, separation, and marginalization), household social position and FSIGT parameters were assessed using multiple linear regression. RESULTS: For African-Americans, integration (integrating their family's culture with those of mainstream white-American culture) was positively associated with AIRG (β = 0.27 ± 0.09, r = 0.48, P < 0.01) and DI (β = 0.28 ± 0.09, r = 0.55, P < 0.01). For Latino-Americans, household social position was inversely associated with AIRG (β = -0.010 ± 0.004, r = -0.19, P = 0.02) and DI (β = -20.44 ± 7.50, r = -0.27, P < 0.01). CONCLUSIONS: Sociocultural orientation and household social position play distinct and opposing roles in shaping type 2 diabetes risk in African-American and Latino-American children and adolescents.

Inventing "French Feminism:" A Critical History

French Feminism has little to do with feminism in France. While in the U.S. this now canonical body of work designates almost exclusively the work of three theorists—Hélène Cixous, Luce Irigaray, and Julia Kristeva—in France, these same thinkers are actually associated with the rejection of feminism. If some scholars have on this basis passionately denounced French Feminism as an American invention, there exists to date no comprehensive analysis of that invention or of its effects. Why did theorists who were at best marginal to feminist thought and political practice in France galvanize feminist scholars working in the United States? Why does French Feminism provoke such an intense affective response in France to this date? Drawing on the fields of feminist and queer studies, literary studies, and history, “Inventing ‘French Feminism:’ A Critical History” offers a transnational account of the emergence and impact of one of U.S. academic feminism’s most influential bodies of work. The first half of the dissertation argues that, although French Feminism has now been dismissed for being biologically essentialist and falsely universal, feminists working in the U.S. academy of the 1980s, particularly feminist literary critics and postcolonial feminist critics, deployed the work of Cixous, Irigaray, and Kristeva to displace what they perceived as U.S. feminist literary criticism’s essentialist reliance on the biological sex of the author and to challenge U.S. academic feminism’s inattention to racial differences between women. French Feminism thus found traction among feminist scholars to the extent that it was perceived as addressing some of U.S. feminism’s most pressing political issues. The second half of the dissertation traces French feminist scholars’ vehement rejection of French Feminism to an affectively charged split in the French women’s liberation movement of the 1970s and shows that this split has resulted in an entrenched opposition between sexual difference and materialist feminism, an opposition that continues to structure French feminist debates to this day. “Inventing ‘French Feminism:’ A Critical History” ends by arguing that in so far as the U.S. invention of French Feminism has contributed to the emergence of U.S. queer theory, it has also impeded its uptake in France. Taken as a whole, this dissertation thus implicitly argues that the transnational circulation of ideas is simultaneously generative and disabling.

The Images of Democracy: Tocqueville and American Exceptionalism

This thesis addresses how Alexis de Tocqueville’s political thought is related to American Exceptionalism. First, I illustrate the multiple meanings of the concept of American Exceptionalism and in what sense it is indebted to Tocqueville. Second, I articulate how the historical background and personal qualities of Tocqueville contribute to the success of his masterpiece Democracy in America. In the main part, by analyzing Tocqueville’s Democracy in America and other writings on America, I argue that he indeed reveals America as exceptional and increasingly recognizes this idea through a process of intellectual development. An elaboration on Tocqueville’s theoretical contribution to the discussion of American Exceptionalism can reveal the different images of modern democracy as he suggests and how they would influence the prospect of human freedom.