A Su Salud Injury Prevention expansion: Analysis of injury prevention perceptions in a Hispanic community

Unintentional injury is the leading cause of death for American ages one to 44 and is ranked in the top ten causes of death for all age groups (CDC, 2006a). A Su Salud Injury Prevention was developed to address injury prevention awareness and education. The program is a mass media education campaign that uses role models, mass media, and community outreach to prevent injury. In 2009, University Health System (UHS) expanded the program. Baseline data were collected from 426 residents in targeted neighborhoods northwest of downtown San Antonio to support the expansion. The purpose of this study was to explore injury perceptions, knowledge, and behaviors of adults living in the expansion area, and define the predominant factors associated with these perceptions. A secondary aim was to assess community awareness and willingness to participate in the program.^ Survey results showed motor vehicle crashes (MVC), falls, drinking and driving, and guns and assaults were considered the most serious injures for adults. The most serious child injuries were MVC, abuse and neglect, falls, and head injuries. Residents were knowledgeable of state seatbelt policy, and over 90% responded as compliant for seatbelt and child car seat use. Most were knowledgeable about drinking and driving state policy and negative outcomes. However, 70% of those reporting driving under the influence of alcohol within the last year engaged in repeat high risk behavior. Men and residents under the age of 55 were more likely to engage in repeat drinking and driving (OR= 3.6, 7.0 respectively). Residents consider injury prevention an important issue, and have interest in a local injury prevention program. Younger women are the most likely to participate in a local program as potential role models and volunteers.^ Results from the study are summarized into an injury prevention and demographic profile of the community that will be used to develop tailored injury prevention messages to create a more effective program, and support program coordinators in effective community engagement. Results will also be used as a comparative basis for future evaluation of a behavioral injury prevention program focused on a predominantly Mexican-American community.^

Texas Health & Safety Code, Section 165.002 - Right to Breastfeed in Texas

The language used in Section 165.002 of the Texas Health and Safety Code renders breastfeeding women vulnerable and susceptible to harassment, discrimination, and persecution via the Texas Penal Code, Sec. 30.05 (Criminal Trespassing), Sec. 21.08 (Indecent Exposure), and Sec. 21.22 (Indecency with a Child). ^ The overall goal of this paper is to develop a solution to this problem via a proposed law or legislative action that offers protection and support for breastfeeding women who choose to nurse in public. Data to inform these recommendations were collected through a literature review and structured interviews with several breastfeeding stakeholders. A literature review of state and federal breastfeeding legislation was conducted to compare and contrast differences between existing legislation in the United States. Interviews were conducted with breastfeeding legislation stakeholders, which included state legislators who have been active in breastfeeding legislation, breastfeeding mothers, and representatives from the Central Texas Healthy Mothers Healthy Babies Coalition (Centex HMHB Coalition), Texas Breastfeeding Coalition (TXBF coalition), La Leche League International, and the Texas Business Association. Data from the literature and legislation reviews and interviews were transcribed and examined for common themes using qualitative data techniques. ^ Overall, most of the stakeholders came to a general consensus on three points, (1) breastfeeding women are supported by stakeholders within the community, (2) other legislation or penal codes should not override the right to breastfeed, and (3) the current breastfeeding legislation needs to be improved to adequately support breastfeeding women. The interviews with breastfeeding legislation stakeholders yielded two major recommendations for the improvement of Section 165.002 of the Texas Health and Safety Code: advocacy efforts to change the wording of the legislation and education to inform people about the legislation. ^ The right to breastfeed is an important public health issue in that it provides a host of health benefits for mothers and children, and is more economical and environmentally superior to alternative feeding methods. While breastfeeding in public is not illegal nor ever has been, adequate legislation is important to affirm this right for women so that they can confidently feed their children without embarrassment or harassment.^

Bioterrorism preparedness at a hospital level in the Southwest Region of the United States -- A systematic review

Since the tragic events of September, 11 2001 the United States bioterrorism and disaster preparedness has made significant progress; yet, numerous research studies of nationwide hospital emergency response have found alarming shortcomings in surge capacity and training level of health care personnel in responding to bioterrorism incidents. The primary goals of this research were to assess hospital preparedness towards the threat of bioterrorist agents in the Southwest Region of the United States and provide recommendations for its improvement. Since little formal research has been published on the hospital preparedness of Oklahoma, Arizona, Texas and New Mexico, this research study specifically focused on the measurable factors affecting the respective states' resources and level of preparedness, such as funding, surge capacity and preparedness certification status.^ Over 300 citations of peer-reviewed articles and 17 Web sites were reviewed, of which 57 reports met inclusion criteria. The results of the systematic review highlighted key gaps in the existing literature and the key targets for future research, as well as identified strengths and weaknesses of the hospital preparedness in the Southwest states compared to the national average. ^ Based on the conducted research, currently, the Southwest states hospital systems are unable fully meet presidential preparedness mandates for emergency and disaster care: the staffed beds to 1,000 population value fluctuated around 1,5 across the states; funding for the hospital preparedness lags behind hospital costs by millions of dollars; and public health-hospital partnership in bioterrorism preparedness is quite weak as evident in lack of joint exercises and training. However, significant steps towards it are being made, including on-going hospital preparedness certification by the Joint Commission of Health Organization. Variations in preparedness levels among states signify that geographic location might determine a hospital level of bioterrorism preparedness as well, tending to favor bigger states such as Texas.^ Suggested recommendations on improvement of the hospital bioterrorism preparedness are consistent with the existing literature and include establishment and maintenance of solid partnerships between hospitals and public health agencies, conduction of joint exercises and drills for the health care personnel and key partners, improved state and federal funding specific to bioterrorism preparedness objectives, as well as on-going training of the clinical personnel on recognition of the bioterrorism agents.^

Use of contraception and contraceptive services among U.S. Hispanic women: 2006--2008

This study investigates the association between race/ethnicity and acculturation variables (language preference and nativity) with use of contraception and contraceptive services among Mexican/Mexican American and “other” Hispanic women aged 15-44 when compared to non- Hispanic white women.^ Data was analyzed from the 2006-2008 National Survey of Family Growth. The sample contained 3357 women aged 15-44. Multivariate logistic regression analysis was used to examine the association between race/ethnicity and acculturation variables and contraceptive-related behaviors adjusted for other known covariates. ^ After multivariate analysis, neither nativity nor language preference were significantly associated with contraception use or contraceptive services. Mexican/Mexican American women did not differ in their contraception-related behaviors when compared to non-Hispanic whites. Other Hispanic women, however, were less likely to obtain contraceptive services than non-Hispanic whites (OR=0.67, 95% CI=0.45-1.00). Women aged 30-39 and 40-44 were less likely to obtain contraception and contraceptive services than those aged 15-19. Single women were less likely to use contraception (OR=0.72, 95% CI=0.56-0.92) and contraceptive services (OR=0.69, 95% CI=0.53-0.89) than married/co-habiting women. Women with healthcare coverage were more likely to use contraception and contraceptive services than uninsured women.^ Among Hispanic women of different origin groups, age, marital status, and healthcare coverage were stronger indicators of contraception-related behavior than race/ethnicity, language preference, and nativity. Reproductive health programs that target increased use of contraception and contraceptive services among Hispanic origin groups should specifically target women who are over 30, single, and uninsured.^

Prevalence of HIV risk-related behaviors among undocumented Central American immigrant women in Houston, Texas, 2010

The primary aim of this dissertation research is to provide epidemiological data on HIV risk-related behaviors among undocumented Central American immigrant women living in Houston, Texas. Between February and May 2010, we used respondent driven sampling (RDS) to recruit 230 Guatemalan, Honduran, and El Salvadoran women, ages 18 to 50 years, living in Houston without a valid United States visa or residency papers. RDS is a probability-based sampling method that utilizes social networks to access members of hidden populations that lack a sampling frame. Participants completed an interview regarding their demographics, access to and utilization of healthcare services, HIV testing, and sexual behaviors. Data from this study were used 1) to describe the prevalence of sexual HIV risk-related behaviors among undocumented Central American immigrant women, comparing those who recently immigrated to the U.S. (within the past five years) to those with more established residency (of over five years); 2) to describe the prevalence of lifetime HIV testing and evaluate its associated factors in this target population; and 3) to describe the effectiveness of RDS to access members of this target population. ^ As described in Paper 1, there was a generally low prevalence of individual HIV risk-related behaviors (i.e., multiple, concurrent, convenience, and casual sexual partnerships) among the undocumented Central American immigrant women in this study. However, there was evidence of HIV risk due to unprotected sex with male partners who have concurrent sexual partnerships. We identified recent immigrants as the subpopulation at greatest risk, as they were significantly more likely than established immigrants to have multiple and/or concurrent sexual partners. As described in Paper 2, the lifetime prevalence of HIV testing was almost 70%. After adjusting for age, number of years living in the U.S., income security, and resource barriers, lifetime HIV testing was significantly associated with being from Honduras, having more than a sixth grade education, having a regular healthcare provider, and having knowledge of available healthcare resources. Finally, as described in Paper 3, RDS was an effective method for obtaining a diverse sample of Central American immigrant women in Houston. ^ This project is the first to use RDS to conduct an HIV behavioral survey among undocumented Central American immigrant women. Our results will inform the design of future research studies and the implementation of HIV prevention activities among undocumented Central American immigrants in the U.S.^

Risk factors for metabolic syndrome among overweight and obese Hispanic children attending a pediatric clinic in New Braunfels, Texas

Childhood obesity is a persistent problem in the U.S., especially among Hispanics. Health complications like hypertension, type II diabetes, and metabolic syndrome (Met-S) are being seen at younger ages, and current screening procedures may be inadequate. This study sought to describe the risk factors for Met-S present in a sample of 106 overweight and obese Hispanic children, aged 5-14 years, participating in Nutrition and Exercise Start Today (NEST), a randomized weight management intervention trial at a rural health clinic in New Braunfels, Texas; and to determine associations between these factors and other clinical and socio-demographic characteristics linked to obesity. Baseline data was analyzed for the prevalence of large waist circumference (WC), elevated blood pressure (BP), high fasting serum glucose and serum triglycerides (TG), and low serum HDL cholesterol, in relationship with selected sample characteristics. Main findings included high baseline prevalence rates of large WC (77%), reduced HDL (57%), and elevated BP (30%). WC was significantly associated with BMI percentile and the serum liver function test alanine aminotransferase (ALT) by Fisher's exact test (p<0.001 and p=0.032, respectively), while there were significant relationships between HDL and both female gender and ALT. BMI percentile and ALT were associated with all sets of Met-S diagnostic criteria examined. BMI percentile also had a strong association (p=0.005) with total number of Met-S risk factors, while ALT had a weaker association (p=0.093). WC is a low-cost, simple measure whose use may improve clinic surveillance for childhood obesity and complications like Met-S. WC, BP, HDL and ALT may be used as part of targeted screening for obesity complications like Met-S, particularly in situations where resources are limited.^

Between violent and non-violent action strategies: a study on extreme-right organizations in Italy and Spain. IHS Political Science Series No. 130, July 2012

This paper focuses on the different forms of action adopted by extreme right organizations (both political parties and non-party groups) in Italy and Spain during their recent mobilization and links them to the environmental conditions and internal organizational factors which might affect them. With particular attention paid to the actors’ perceptions of reality, the macro-level factors (such as the favourable or unfavourable political opportunities of the context, the availability of allies in power, the degree of repression by authorities, etc.) as well as the meso-level factors (such as the internal characteristics of extreme right groups and their dynamics) will be explored in order to understand the action strategies of extreme right organizations and their recourse to violence. This paper, drawing on a combination of qualitative and quantitative research techniques, will be based on 20 semi-structured interviews with extreme right representatives of the main right wing organizations in Italy and Spain as well as a protest event analysis of newspapers dating from 2005 to 2009.

Bridging qualified majority and unanimity decision-making in the EU. IHS Political Science Series No. 132, February 2013

The EU has tried to bridge decision making by qualified majority and unanimity over the years by expanding qualified majorities (consensus) or by making unanimities easier to achieve. I call this decision-making procedure q-“unanimity” and trace its history from the Luxembourg compromise to the Lisbon Treaty, and to more recent agreements. I analyze the most recent and explicit mechanism of this bridging (article 31 (2) of the Lisbon Treaty) and identify one specific means by which the transformation of qualified majorities to unanimities is achieved: the reduction of precision or scope of the decision, so that different behaviors can be covered by it. I provide empirical evidence of such a mechanism by analyzing legislative decisions. Finally, I argue that this bridging is a ubiquitous feature of EU institutions, used in Treaties as well as in legislative decision-making.

Déjà-vu (again): The Lisbon Treaty Referendum in Ireland. IHS Political Science Series No. 133, February 2013

There has been an increasing use of direct democracy in the form of referendums on aspects of European integration. Two such referendums have been held in Ireland in 2008 and 2009 with the outcome changing from a No to a Yes vote. This paper addresses the question of what explains the change in outcome in two referendums on essentially the same document. It will do so by looking at the role of the campaign in providing information and hence reducing uncertainty, the importance of issue frames and the impact of domestic considerations on vote choice. It is suggested that there has not been a change in underlying attitudes but a change in how the Irish electorate weighed the same factors differently at both referendums. In addition, a change in economic conditions at the time of the second referendum also had an effect on how voters decided the second time around.

The European Citizens‘ Initiative – Chances, Constraints and Limits. IHS Political Science Series No. 134, April 2013

In order to celebrate the 20th anniversary of the establishment of European Union citizenship under the Maastricht Treaty in 1993, the year 2013 has been designated by the European Commission as the ‘European Year of Citizens’. The European Citizen’s Initiative (ECI) – labelled by the Commission as a ‘direct gateway through which citizens can make their voices heard in Brussels’ - may emerge in the European awareness as a new appealing platform for policy-shaping and communication. The ECI, through its transnational vox civilis character, figures among the most important novelties in the Lisbon Treaty and in the long run may facilitate and accelerate the bottom-up building of a European demos. The question is, however, whether the mechanism of pan-European signature collection is strong enough to face the democratic challenges present in the EU, especially during the ongoing financial crisis.

Transforming Power Relationships: Leadership, Risk, and Hope. IHS Political Science Series No. 135, May 2013

Chronic communal conflicts resemble the prisoner’s dilemma. Both communities prefer peace to war. But neither trusts the other, viewing the other’s gain as its own loss, so potentially shared interests often go unrealized. Achieving positive-sum outcomes from apparently zero-sum struggles requires a kind of riskembracing leadership. To succeed leaders must: a) see power relations as potentially positive-sum; b) strengthen negotiating adversaries instead of weakening them; and c) demonstrate hope for a positive future and take great personal risks to achieve it. Such leadership is exemplified by Nelson Mandela and F.W. de Klerk in the South African democratic transition. To illuminate the strategic dilemmas Mandela and de Klerk faced, we examine the work of Robert Axelrod, Thomas Schelling, and Josep Colomer, who highlight important dimensions of the problem but underplay the role of risk-embracing leadership. Finally we discuss leadership successes and failures in the Northern Ireland settlement and the Israeli-Palestinian conflict.

Strategic Voting in Proportional Systems: The Case of Finland. IHS Political Science Series No. 138, September 2014

Voters try to avoid wasting their votes even in PR systems. In this paper we make a case that this type of strategic voting can be observed and predicted even in PR systems. Contrary to the literature we do not see weak institutional incentive structures as indicative of a hopeless endeavor for studying strategic voting. The crucial question for strategic voting is how institutional incentives constrain an individual’s decision-making process. Based on expected utility maximization we put forward a micro-logic of an individual’s expectation formation process driven by institutional and dispositional incentives. All well-known institutional incentives to vote strategically that get channelled through the district magnitude are moderated by dispositional factors in order to become relevant for voting decisions. Employing data from Finland – because of its electoral system a particularly hard testing ground - we find considerable evidence for observable implications of our theory.

Las Casas as a bishop : a new interpretation based on his holograph petition in the Hans P. Kraus Collection of Hispanic American manuscripts = Las Casas, obispo : una nueva interpretación basada en su petición autógrafa conservada en la Colección Hans P. Kraus de manuscritos hispanoamericanos /

Includes indexes.

The Hispanic American historical review.

Includes "Bibliographical section".