The illness narratives of Hispanic American women with coronary heart disease (CHD): An ethnographic approach

Purpose. To provide a descriptive representation of the illness narratives described by Hispanic American women with CHD. ^ Design. Focused ethnographic design. ^ Setting. One outpatient general medicine clinic, one nurse-managed health promotion clinic, and informants' homes in a large metropolitan city located in southeast Texas. ^ Sample. Purposeful sampling from two different sites resulted in 17 interviews being conducted with 14 informants. ^ Method. Focused ethnographic techniques were employed in the designation of participants for the study, data collection, analysis and re-presentation. Audiotaped interviews and fieldwork were transcribed verbatim and analyzed through an iterative process of data reduction, data display, drawing conclusions and verification. ^ Findings. The developing conceptual framework that emerged from the data is labeled after the overarching experience described by informants, the experience of Embodied Exhaustion. Embodied Exhaustion, as described in this study, refers to an ongoing, dynamic, indeterminate experience of mind-body exhaustion resulting from a complex constellation of biologic, psychological and social distresses occurring over the life course. The experience consists of three categories: Taking Care of Others, Wearing Down and Hurting Hearts. Two stabilizing forces were identified: Collective Self and Believing in God. ^ Conclusions. The findings of this study emphasize the importance of framing all research, theory and practice targeting Hispanic women with CHD within a sociocentric paradigm. Nursing is challenged to provide care that extends beyond the physical body of the patient to include the social context of illness, especially the family. ^

Lifetime prevalence and risk factors for cancer in a Mexican American population with severe health disparities: The Cameron County Hispanic Cohort

Retrospective data from the Cameron Country Hispanic Cohort (1) were analyzed to assess the burden of cancer in the Mexican American population living in Brownsville TX. Data provided by the study participants for themselves and their parents and other extended relatives on cancer and related risk factors were used to determine both the prevalence of cancer and these risk factors as well as any associations between them. Lifetime incidence of cancer among the study participants was of 2.8%. Lifetime incidence of cancer among the parents of the study population was calculated for cancer in general and for specific cancer sites to determine the ranking of occurrence of each type of cancer. Some cancer types in this population were ranked higher than what would be expected when compared with national data from Hispanics in the U.S, these were: Liver cancer (3rd vs. 7th nationally in males and 6th vs. 13th nationally in females), stomach cancer (4th vs. 8th nationally in males and 5th vs. 11th nationally in females) and ovarian cancer (3rd vs. 8th nationally in females). A significant association with cancer was found for being born in the United States compared to being born elsewhere (O.R. 1.62, 95% C.I. 1.01–2.60) among study participants and the same association was also found between birth of parents in the United States regardless of gender for cancers in general (O.R. 1.38 95% C.I. 1.12–1.70), stomach cancer (O.R. 1.92 95% C.I. 1.01–3.67) and colorectal cancer (O.R. 2.93 95% C.I. 1.28–6.72). Having been born in the United States and having a family history of cancer was also found to be significantly associated with other risk factors for cancer such as obesity, diabetes and insulin resistance, both among the parents and the participant population, suggesting these interactions are complex. These high rates of cancer and particular prominence of less usual cancer such as liver and ovary in health disparities warrant evaluation of early detection strategies.^

The experiences of Cuban American women attending a Hispanic serving institution and the influences on identity development

The purpose of this study was to gain an understanding and gather insight into the experiences of Cuban American women attending a 4-year, public, Hispanic Serving Institution and how those experiences influenced their identity development. This was accomplished by conducting in-depth interviews and focus groups with 12 self-identified Cuban American women who were classified as sophomores, juniors, seniors, or graduate students. All of the participants had attended Florida International University for at least 1 year. The women had varying degrees of on and off campus academic and campus involvement activities. Participants were asked about six topics: (a) family, (b) cultural influences, (c) gender, (d) ethical and moral development, (e) education, and (f) ethnic identity. Based on the coding of the data provided by the participants, several interconnected themes emerged including the importance of family, familial support, cultural pride, expected gender roles, core values, decision making, biculturalism, and the value of attending a Hispanic Serving Institution. These themes were found to be all related to the identity development of the participants. It was found that looking at identity through a multidimensional lens is essential. Looking at personal growth and development through anthropological, sociological, and psychosocial lenses gave greater insight to a population of students who have been largely underrepresented in the literature. The findings of this case study are that culture is contextual and identity development is complex for first and second generation Cuban American women attending a Hispanic Serving Institution in a majority minority city. It was found that several factors, including the importance of family and gender roles, were not found to be more important than one another; rather they supported each other in regards to the participants' identity development. The notion of biculturalism as it has been presented in the literature was challenged in this study as it was found that the participants' experiences living and attending a school in a majority minority city presented a new way of understanding what it might mean to be bicultural. For professionals in the field, the findings of this study may lead to a broader understanding of nuances within the Hispanic community and a better understanding of the distinctiveness of what it means to be a Cuban American woman.

An investigation of the relationship between maltreatment and alcohol and other drug (AOD) problems in African -American and Hispanic adolescent girls

Maltreatment experienced in childhood or adolescence is a known risk factor for later problem alcohol and/or other drug (AOD) use (Bailey & McCloskey, 2005; Shin, Edwards, Heeren, 2009). A growing body of empirical work has found significant associations between adolescent girls’ AOD use and maltreatment experiences. However, questions remain as to how this relation unfolds with African-American and Hispanic adolescent girls. Guided by four relational models that have been proposed in the literature, this study examined the links between maltreatment, trauma symptoms, and alcohol and/or other drug (AOD) problems in a sample of 170 African-American and Hispanic adolescent girls who were participants in a school-based AOD use intervention. Results of this study revealed that maltreatment experiences (physical and emotional abuse) were positively related to trauma symptoms, which were positively related to AOD problem severity, alcohol abuse, alcohol dependency, drug abuse, and drug dependency. Perceived discrimination moderated this relation between sexual abuse and trauma symptoms, such that more perceived discrimination resulted in a stronger effect of sexual abuse on trauma symptoms. Ethnic identity moderated the relation between sexual abuse and AOD problem severity, such that ethnic identity demonstrated protective properties in the relation between sexual abuse and AOD problem severity. My research adds to extant knowledge on the relation between maltreatment and AOD use in adolescent girls and suggests the importance of developing interventions targeting maltreatment and AOD use concurrently.

It's academic : American studies in a time of crisis

My archive- the collection of resources I have drawn upon for my comments- includes, among other sources, a panel on international American studies held at the American Studies Association conference in Montreal in November 1999, the Wednesday Higher Education supplement of the Australian newspaper, and another supplement- this is one in the Derridean sense of the word- the Howard government. I hope to draw these threads together to focus on the present crisis facing American studies and, not coincidentally, this Association. To arrive at this point I take a tour through theoretical and disciplinary responses to the prevailing situation.

Constraints to park visitation: a meta-analysis of North American studies

The constraints that curb visitation to parks have received considerable research attention and remain an important issue. Constraints to outdoor leisure in parks include structural barriers, such as cost of entry, interpersonal barriers, for example, lack of a partner to visit with, or intrapersonal barriers, including lack of interest. Using a meta-analysis approach, this article integrates the findings of 22 North American studies with 541 estimates, conducted over a 30-year period, to determine the key constraints to park visitation based on various socio-demographic factors. The findings highlight the varying roles that constraints play in limiting the visitation of people according to race, age, gender, education and income. Gaps in the literature are identified, with implications for encouraging visitation for more constrained groups discussed. An agenda for future research is presented.