Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members.

INTRODUCTION: We aimed to inform the design of behavioral interventions by identifying patients' and their family members' perceived facilitators and barriers to hypertension self-management. MATERIALS AND METHODS: We conducted focus groups of African American patients with hypertension and their family members to elicit their views about factors influencing patients' hypertension self-management. We recruited African American patients with hypertension (n = 18) and their family members (n = 12) from an urban, community-based clinical practice in Baltimore, Maryland. We conducted four separate 90-minute focus groups among patients with controlled (one group) and uncontrolled (one group) hypertension, as well as their family members (two groups). Trained moderators used open-ended questions to assess participants' perceptions regarding patient, family, clinic, and community-level factors influencing patients' effective hypertension self-management. RESULTS: Patient participants identified several facilitators (including family members' support and positive relationships with doctors) and barriers (including competing health priorities, lack of knowledge about hypertension, and poor access to community resources) that influence their hypertension self-management. Family members also identified several facilitators (including their participation in patients' doctor's visits and discussions with patients' doctors outside of visits) and barriers (including their own limited health knowledge and patients' lack of motivation to sustain hypertension self-management behaviors) that affect their efforts to support patients' hypertension self-management. CONCLUSION: African American patients with hypertension and their family members reported numerous patient, family, clinic, and community-level facilitators and barriers to patients' hypertension self-management. Patients' and their family members' views may help guide efforts to tailor behavioral interventions designed to improve hypertension self-management behaviors and hypertension control in minority populations.

Substance use disorders and co-morbidities among Asian Americans and Native Hawaiians/Pacific Islanders

© Cambridge University Press 2014.Background Asian Americans (AAs) and Native Hawaiians/Pacific Islanders (NHs/PIs) are the fastest growing segments of the US population. However, their population sizes are small, and thus AAs and NHs/PIs are often aggregated into a single racial/ethnic group or omitted from research and health statistics. The groups' substance use disorders (SUDs) and treatment needs have been under-recognized. Method We examined recent epidemiological data on the extent of alcohol and drug use disorders and the use of treatment services by AAs and NHs/PIs. Results NHs/PIs on average were less educated and had lower levels of household income than AAs. Considered as a single group, AAs and NHs/PIs showed a low prevalence of substance use and disorders. Analyses of survey data that compared AAs and NHs/PIs revealed higher prevalences of substance use (alcohol, drugs), depression and delinquency among NHs than among AAs. Among treatment-seeking patients in mental healthcare settings, NHs/PIs had higher prevalences of DSM-IV diagnoses than AAs (alcohol/drug, mood, adjustment, childhood-onset disruptive or impulse-control disorders), although co-morbidity was common in both groups. AAs and NHs/PIs with an SUD were unlikely to use treatment, especially treatment for alcohol problems, and treatment use tended to be related to involvement with the criminal justice system. Conclusions Although available data are limited by small sample sizes of AAs and NHs/PIs, they demonstrate the need to separate AAs and NHs/PIs in health statistics and increase research into substance use and treatment needs for these fast-growing but understudied population groups.

Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. METHODS AND RESULTS: We analyzed data from 5146 African Americans in the Jackson Heart Study stratified by QRS duration on baseline 12-lead ECG. We defined QRS prolongation as QRS≥100 ms. We assessed the association between QRS duration and all-cause mortality using Cox proportional hazards models and reported the cumulative incidence of heart failure hospitalization. We identified factors associated with the development of QRS prolongation in patients with normal baseline QRS. At baseline, 30% (n=1528) of participants had QRS prolongation. The cumulative incidences of mortality and heart failure hospitalization were greater with versus without baseline QRS prolongation: 12.6% (95% confidence interval [CI], 11.0-14.4) versus 7.1% (95% CI, 6.3-8.0) and 8.2% (95% CI, 6.9-9.7) versus 4.4% (95% CI, 3.7-5.1), respectively. After risk adjustment, QRS prolongation was associated with increased mortality (hazard ratio, 1.27; 95% CI, 1.03-1.56; P=0.02). There was a linear relationship between QRS duration and mortality (hazard ratio per 10 ms increase, 1.06; 95% CI, 1.01-1.12). Older age, male sex, prior myocardial infarction, lower ejection fraction, left ventricular hypertrophy, and left ventricular dilatation were associated with the development of QRS prolongation. CONCLUSIONS: QRS prolongation in African Americans was associated with increased mortality and heart failure hospitalization. Factors associated with developing QRS prolongation included age, male sex, prior myocardial infarction, and left ventricular structural abnormalities.

When terror hits home: Identity Fused Americans who saw Boston bombing victims as “family” provided aid

When tragedy strikes a group, only some group members characteristically rush to the aid of the victims. What motivates the altruism of these exceptional individuals? Here, we provide one set of answers based on data collected before and shortly after the 15 April 2013, Boston Marathon bombings. The results of three studies indicated that Americans who were strongly “fused” with their country were especially inclined to provide various forms of support to the bombing victims. Moreover, the degree to which participants reported perceiving fellow Americans as psychological kin statistically mediated links between fusion and pro-group outcomes. Together, these findings shed new light on relationships between personal and group identity, cognitive representations of group members, and personally costly, pro-group actions.

Constraints, nostalgia and North Americans' visits to rural Europe

As Américas constituem a mais relevante fonte inter-regional de turistas vindos para a Europa, sendo os EUA de longe o maior mercado de long haul para a Europa. Mas, apesar da relevância deste mercado nas estatísticas, há uma carência de estudos sobre o mesmo. A maioria dos Norte-Americanos que visitam a Europa mantéem-se em áreas urbanas, limitando o potencial efeito do turismo para equilibrar o crescimento económico na Europa, principalmente em áreas rurais que têm vindo cada vez mais a atrair turistas nas últimas décadas, contando sobretudo da EU. Para o turismo ser realmente uma força positiva de desenvolvimento equilibrado na Europa, os pesquisadores do comportamento do consumidor devem tentar entender por que os viajantes Norte-Americanos não arriscam ir para zonas rurais que supostamente têm o capital tradicional e cultural autêntico que sobretudo os turistas nostálgicos procuram. Esta dissertação pretende contribuir para o conhecimento do mercado Norte-Americano que viaja para a Europa. O objectivo deste estudo centra-se na examinação do papel dos constrangimentos, da nostalgia, e da experiência de viagem para as intenções dos turistas Norte-Americanos de revisitar em destinos rurais Europeus. Apesar de existirem referências à nostalgia em pesquisas de turismo, estas centram-se essencialmente em estudos de carácter qualitativo e tem sido dada pouca relevância à construção de ferramentas quantitativas para o estudo da nostalgia a nível do turismo. Neste estudo, é desenvolvida uma escala de nostalgia para o turismo (NOSTOUR). Os resultados mostram que a nostalgia, relacionada com as viagens pode ser concebida e operacionalizada em quatro dimensões: individual, interpessoal, cultural e virtual. A nostalgia, por si só, não tem um efeito mediador nos constrangimentos para viajar a nível da intenção de regressar e visitar destinos rurais na Europa mas com a adição, do determinante experiência de viagem esse efeito existe.

Arshile Gorky: An Armenian in New York

Born in Armenia, the oldest Christian country in the world but nevertheless one of the youngest reinstated republics (1991) after the collapse of the Soviet Union, Arshile Gorky flew to the United States in 1920, where he chose to reinvent himself in the struggle to become an artist. This reinvention meant the creation of a persona with, or behind, which Gorky kept alive the artistic flame inside himself. Gorky became one of the most learned voices lecturing on contemporary European modernist artists and movements of the late nineteenth and early twentieth centuries in the United States (New York) without ever visiting Europe. Moreover, he was able to survive the traumatic events he underwent during the Armenian Genocide (1915-1919) to adapt to his new country and identity, to live through the years of the Depression and, eventually, to become the protagonistof a major artistic breakthrough. This paper proposes an insight into the experience of life and frame of work of this Armenian-American artist, whose simultaneously rich, traumatic, dislocated and reenacted life and work established one of the most fertile links between his middle‑eastern origins, his dreamed of Europe and the particular transit of his American artistic creation.

Asian/Pacific Americans in Iowa: 2013

Demographic profile of the Iowa population Asian and Pacific Islander descent.

Groung : Armenian folksong ; In sireli zavagounks : Armenian folksong / Zabella Panosian, S ; violin & piano accomp.

[Traditions. Asie. Arménie]

The rule of the turk a revised and enlarged edition of the Armenian crisis

UANL

Historical Justice, Nationhood and African Americans

The intelligibility of historical justice is linked to matters of agency and causation. This article presents an account of historical justice limited to transgenerational collective agents which is immune to the agency and causation problems affecting traditional theories of diachronic justice. The novel theory is applied to the case of African Americans, to whom no reparations for past wrongs have been made up to now. When conceived as a transgenerational collective agent – i.e. as a nation–, the African Americans are shown to be owed reparations by the American polity. These reparations are deemed necessary to the goal of reconciliation and to the establishment of relations of mutual respect, which are construed as preconditions to effective distributive justice, here and now.

Famous Americans curricula

This paper presents a history curricula designed for hearing-impaired children between 9 and 11 years of age who are behind their normal-hearing peers in vocabulary, language and reading skills.

Survey of hearing-impaired adults and parents of hearing-impaired children and their knowledge of the Americans with Disabilities Act

This paper discusses the results of a survey about awareness of the American with Disabilities Act.

Genomic evidence for the Pleistocene and recent population history of Native Americans

How and when the Americas were populated remains contentious. Using ancient and modern genome-wide data, we found that the ancestors of all present-day Native Americans, including Athabascans and Amerindians, entered the Americas as a single migration wave from Siberia no earlier than 23 thousand years ago (ka) and after no more than an 8000-year isolation period in Beringia. After their arrival to the Americas, ancestral Native Americans diversified into two basal genetic branches around 13 ka, one that is now dispersed across North and South America and the other restricted to North America. Subsequent gene flow resulted in some Native Americans sharing ancestry with present-day East Asians (including Siberians) and, more distantly, Australo-Melanesians. Putative “Paleoamerican” relict populations, including the historical Mexican Pericúes and South American Fuego-Patagonians, are not directly related to modern Australo-Melanesians as suggested by the Paleoamerican Model.