On-time mammography screening with a focus on Latinas with low income: a proposed cultural model.

BACKGROUND: Initial U.S.A. breast cancer screening rates have risen, but not repeat screening, especially among low-income minority populations. Latinas are particularly at-risk of underscreening. Consequently, late-detection is common, with increased risk of dying after diagnosis. Why women with low-income, particularly Latinas, who had initial mammography, were not regularly screened was examined. PATIENTS AND METHODS: An expanded model was tested, incorporating the Theory of Planned Behavior (TPB), cultural factors, potential facilitators and barriers. Participants were 112 women, 72 of whom were Latinas, who had contacted an Early-Detection Program and received a mammogram 3-4 years earlier. RESULTS: The TPB did not explain mammography rescreening behavior among Latinas. The cultural factors: high familism and low fatalism showed significant multivariate associations with recent mammogram among Latinas. A major barrier for Latinas was "distorted familism": neglecting own health because family was first priority. CONCLUSION: A cultural model is proposed, which can guide interventions for improving on-time mammography among Latinas.

The protective influence of spirituality and "Health-as-a-Value" against monthly substance use among adolescents varying in risk.

PURPOSE: To investigate the influence of two potentially protective factors, Health-as-a-Value and spirituality, on monthly alcohol, cigarette, and marijuana use in two multiethnic groups of adolescents varying in risk. METHODS: Three-hundred-eighty-two students from continuation/alternative high school, a population considered at risk for drug use, participated in the study. The other sample of 260 students was drawn from a medical magnet high school, and is considered to be at lower risk. Similar surveys containing measures of spirituality, "Health-as-a-Value," and monthly substance use, were distributed. Logistic regression analyses were performed. RESULTS: The analyses revealed that spirituality was protective against monthly alcohol use and marijuana use in the lower risk sample. In the higher risk sample, spirituality was protective against all monthly use. "Health-as-a-Value" (HAV) was protective against monthly alcohol use in the low risk sample, and protective against all monthly use in the higher risk sample. Importantly, when both constructs were entered into the same model, spirituality and HAV were independently protective of all monthly use for the higher risk sample and of monthly alcohol use in the lower risk sample. CONCLUSIONS: These findings extend earlier work on protective factors. "Health-as-a-Value" and spirituality may be protective against substance use in environments with different levels of use. Future studies should explore these findings in longitudinal analyses.

Cardiomiopatia periparto: estudo clínico evolutivo / Peripartum cardiomyopathy: clinical and follow-up study

No contexto de um estudo prospectivo sobre cardiopatías primariamente envolvendo o miocárdio, 16 pacientes mantiveram o diagnóstico de cardiomiopatia periparto firmado em bases clínicas e laboratoriais, de 1978 a 1984, no Hospital das Clínicas da Faculdade de Medicina de Ribeiräo Preto. Säo apresentadas as características clínicas, eletrocardiográficas, radiológicas, ecocardiográficas e hemodinâmicas apresentadas por essas pacientes, como obtidas no período puerperal imediato. Säo analisados os aspectos evolutivos, nesse período de seis anos, relativamente ao tratamento clínico, ao impacto de gravidez subseqüente e às complicaçöes fatais verificadas. Os resultados do presente trabalho säo discutidos à luz dos conhecimentos disponíveis na literatura sobre a cardiomiopatia periparto, e analisadas as implicaçöes prognósticas envolvidas nesta patologia