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1.
Nurs Res ; 68(6): 494-500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693556

RESUMO

BACKGROUND: Recognizing the effects of acculturation on quality of life and emotional health, especially during pregnancy, we developed an intervention that would target these factors in order to improve maternal well-being during the prenatal period and potentially improve infant outcomes, particularly preterm birth for Mexican-American women (Latinas). OBJECTIVE: The purpose of these pilot studies was to test the acceptability, feasibility, and preliminary efficacy of the mastery lifestyle intervention (MLI) to decrease depressive and anxiety symptoms and improve coping as implemented in prenatal clinics with culturally homogenous groups of Latinas. METHODS: The MLI was tested in three small pilot studies (n = 15), one in El Paso, Texas (an urban area), and two in Bastrop, Texas (a rural area outside Austin), for acceptability and feasibility. A pretest/posttest, quasi-experimental design was used with pregnant self-identified Mexican-American Latinas at 14-20 weeks' gestation. Measures of anxiety, depressive symptoms, and positive and negative coping were used. RESULTS: Feasibility was a success in terms of implementation of the MLI in an active prenatal clinic setting and the use of electronic tablets for data collection and entry of data into REDcap. Satisfaction was high, with the location of the MLI being at their primary OB/GYN clinic. Participants reported that six intervention sessions appear to be ideal as was the class length of 1.5 to 2 hours. On Cohen's d, there were medium to large effect size decreases in depressive and anxiety symptoms and small to medium effect size decreases in the use of negative coping strategies and small effect sizes for increases in positive coping strategies. DISCUSSION: Pilot testing of the MLI indicated that it was well accepted from the participants and feasible as a culturally tailored behavioral therapy administered in a group setting by nurse practitioners. Our initial pilot results also suggest preliminary efficacy as indicated by moderate to large Cohen's d effect sizes for depression and anxiety.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Estilo de Vida/etnologia , Americanos Mexicanos/psicologia , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal , Aculturação , Adaptação Psicológica , Adulto , Ansiedade/etnologia , Depressão/etnologia , Estudos de Viabilidade , Feminino , Humanos , Projetos Piloto , Gravidez , Complicações na Gravidez/etnologia , Qualidade de Vida , Texas
2.
Occup Ther Int ; 2019: 4175184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558888

RESUMO

The Activity Card Sort (ACS) measures the level of participation, as perceived by each person which, unlike other scales, makes it both personal and significant. However, there is a limitation to applying the ACS to Spanish older adults as it is restricted to culturally relevant activities solely in the United States. Therefore, the aim of this study was to select activity items that reflected Spanish older adults' lifestyles in order to develop the Activity Card Sort-Spain Version (ACS-SP). Frequently, activities performed in Spain (n = 103) were listed in an initial draft. The Likert scale was administrated to a large group of Spanish nationals over the age of 60 years (n = 98) to establish which type of activities will be eventually included in the Spanish version. The final version was drawn up comprising 79 activities distributed between four performance areas. In addition, other activities that were not previously included by other assessment tools were considered and have been listed in this review, such as taking a nap, going out for a drink or "tapas," or searching for a job. The gradual adaptation to ACS for Spaniards will make it possible to measure the level of an individual's participation within a community. However, further work on psychometric properties is needed.


Assuntos
Atividades Cotidianas/psicologia , Características Culturais , Estilo de Vida/etnologia , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Ocupacional/instrumentação , Psicometria , Espanha
3.
Fortschr Neurol Psychiatr ; 87(9): 504-510, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31519026

RESUMO

BACKGROUND: Neuropsychological dementia diagnosis of migrants are limited regarding the testing of cognitive abilities as well as the recording of everyday activities (Activities of Daily Living, ADL) such as linguistic, educational, lifestyle and cultural-religious factors have not been taken into account in psychometric instruments. AIM OF THE STUDY: We aimed to develop a culturally sensitive ADL scale, which is suitable for both German people and Turkish migrants that takes into consideration gender, cultural-religious and lifestyle aspects. A further aim was to determine the quality criteria for the newly proposed ADL scale. METHODS: After the initial phase, including qualitative interviews (N = 15) with cognitively unimpaired German participants and Turkish migrants, a first version of the ADL instrument was developed. This version was then completed by cognitively unimpaired Germans (n = 197) and Turkish participants (n = 53) and the shortened ADL scale was generated based on an item analysis. It consisted of the three subscales 'cognition', 'Basic Activities of Daily Living (BADL)' and 'Instrumental Activities of Daily Living (IADL)'. For Turkish participants, questions about Islamic prayers were added. Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS) were applied to rule out cognitive impairment and depression. The 'Bayer-ADL' was used to measure the validity of the scale. RESULTS: The everyday life of Germans and Turkish migrants differs in aspects of religious practice and in terms of sociocultural activities, which are taken into account in the CC-ADL. The reliability of the new ADL scale in terms of internal consistency (Cronbach's alpha) were regarding 'cognition' α = .43 for Germans and α = .80 for Turkish migrants; 'BADL' α = .55 for Germans and α = -.04 for Turkish migrants; 'IADL' α = .91 for Germans and α = .83 for Turkish migrants and α = .73 for Turkish migrants under the 'prayer items'. The correlation of the ADL total score with the Bayer ADL for Germans was ρ = .347 (p < .00) and for the Turkish sample ρ = .520 (p < .01). CONCLUSION: The development of a final version of the CC-ADL scale requires further data from healthy participants and patients (Mild Cognitive Impairment and dementia).


Assuntos
Atividades Cotidianas , Competência Cultural , Demência/diagnóstico , Demência/psicologia , Emigrantes e Imigrantes/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Feminino , Alemanha , Humanos , Estilo de Vida/etnologia , Masculino , Testes Neuropsicológicos , Religião e Psicologia , Reprodutibilidade dos Testes , Turquia/etnologia
4.
J Dermatol ; 46(10): 825-834, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31436343

RESUMO

Atopic dermatitis is a chronic, inflammatory skin disease characterized by intense pruritus and eczematous lesions. It is considered one of the most common chronic conditions, with an estimated global prevalence of nearly 230 million. As in the rest of the world, prevalence of atopic dermatitis has been increasing in Asian countries over the last few decades. This increased prevalence in Asian countries has been attributed to factors such as rapid urbanization, increasingly Westernized lifestyles, and improved standards of living and education. As a result, it is important to understand the increasing burden of disease in Asian countries and the differences between the countries in terms of epidemiology, diagnostic criteria, management, quality of life and economic burden.


Assuntos
Efeitos Psicossociais da Doença , Dermatite Atópica/epidemiologia , Qualidade de Vida , Ásia/epidemiologia , Dermatite Atópica/complicações , Dermatite Atópica/economia , Humanos , Estilo de Vida/etnologia , Prevalência , Fatores de Risco
5.
Aust N Z J Public Health ; 43(5): 429-435, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31339603

RESUMO

OBJECTIVE: To examine country of birth differences in the odds of reporting chronic diseases among those of Lebanese ethnicity in comparison to those of Australian ethnicity. METHODS: Participants were 41,940 Australians aged 45 years and older, sampled from the 45 and Up Study baseline dataset. Participants included those of Lebanese ethnicity born in Lebanon (n=401), Australia (n=331) and other countries (n=73); and those of Australian ethnicity (n=41,135). Logistic regression models were conducted to examine differences in the odds of reporting chronic disease between those of Lebanese ethnicity and those of Australian ethnicity. RESULTS: Those of Lebanese ethnicity had higher odds of reporting diabetes (OR 1.62; 95%CI 1.32-2.00) and lower odds of reporting hypertension (OR 0.82; 95%CI 0.70-0.96) when compared with those of Australian ethnicity. After country of birth stratification, only those born in Lebanon had higher odds of reporting diabetes (OR 2.21; 95%CI 1.71-2.85) and also had lower odds of reporting cancer (OR 0.66; 95%CI 0.46-0.97), when compared with those of Australian ethnicity. CONCLUSIONS: Country of birth differences in health exist among those of Lebanese ethnicity. Implications for public health: Country of birth is an important factor that could assist in explaining differences in health among ethnic groups of the same origin.


Assuntos
Doença Crônica/etnologia , Emigrantes e Imigrantes/psicologia , Comportamento Alimentar/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Estilo de Vida/etnologia , Obesidade/etnologia , Comportamento Sedentário/etnologia , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Doença Crônica/epidemiologia , Grupos de Populações Continentais , Comparação Transcultural , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Líbano/etnologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Vigilância da População , Qualidade de Vida/psicologia , Características de Residência , Fatores de Risco , Autorrelato , Fatores Socioeconômicos , Inquéritos e Questionários
6.
J Stroke Cerebrovasc Dis ; 28(8): 2232-2241, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31178360

RESUMO

BACKGROUND: TIAregistry.org is an international cohort of patients with transient ischemic attack (TIA) or minor stroke within 7 days before enrollment in the registry. Main analyses of 1-year follow-up data have been reported.5 We conducted subanalysis on the baseline and 1-year follow-up data of Japanese patients. METHODS: The patients were classified into 2 groups based on Japanese ethnicity, Japanese (345) and non-Japanese (3238), and their baseline data and 1-year event rates were compared. We also determined risk factors and predictors of 1-year stroke. RESULTS: Current smoking, regular alcohol drinking, intracranial arterial stenosis, and small vessel occlusion; and hypertension, dyslipidemia, coronary artery disease, and extracranial arterial stenosis were more and less common among Japanese patients, respectively. Stroke risk was higher and TIA risk was lower at 1-year follow-up among Japanese patients. The baseline risk factors for recurrent stroke were diabetes, alcohol drinking, and large artery atherosclerosis. Independent predictors of 1-year stroke risk were prior congestive heart failure and alcohol consumption. CONCLUSIONS: The two populations of patients featured differences in risk factors, stroke subtypes, and outcome events. Predictors of recurrent stroke among Japanese patients included congestive heart failure and regular alcohol drinking. Strategies to attenuate residual risk of stroke aside from adherence to current guidelines should take our Japanese-patient specific findings into account.


Assuntos
Grupo com Ancestrais do Continente Asiático , Disparidades nos Níveis de Saúde , Ataque Isquêmico Transitório/etnologia , Estilo de Vida/etnologia , Acidente Vascular Cerebral/etnologia , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/etnologia , Comorbidade , Feminino , Humanos , Ataque Isquêmico Transitório/diagnóstico , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fumar/efeitos adversos , Fumar/etnologia , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo
7.
Int J Circumpolar Health ; 78(1): 1630233, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31199204

RESUMO

Historically, heart health was approached holistically by First Nations (FN) peoples, which was integrated into daily living. Caring for the physical, emotional and spiritual needs of individuals, community, family, and the living environment was integral. The Truth and Reconciliation Commission of Canada demonstrates the decimation of health practices through governmental policy to destroy the cultural foundations of FN peoples. Relational systems and ways of living were outlawed, and the health of FN people suffered. A digital storytelling study collaborated with Manitoba FN women with lived experience of caring for a biomedical-diagnosed heart condition. The objective was to identify concepts, language, and experiences of heart health among FN women. Six women created five digital stories; four are available publically online. Themes addressed by the storytellers include: changes to diet and lifestyle, related health conditions, experiences with healthcare system, residential schools, and relationships with children and grandchildren. The intersection of Western and FN knowledges heard in the women's stories suggests heart health knowledge and care is embedded within historical and social contexts. Insights into the non-dichotomous relationship between FN and biomedical knowledge of heart health, along with their conceptualisations of heart, suggests historical and social roots underlying heart health issues First Nations women face.


Assuntos
Assistência à Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Cardiopatias/etnologia , Índios Norte-Americanos/psicologia , Regiões Árticas , Dieta/etnologia , Relações Familiares/etnologia , Feminino , Humanos , Estilo de Vida/etnologia , Manitoba , Narração
8.
Aust N Z J Public Health ; 43(5): 443-450, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31091346

RESUMO

OBJECTIVES: Recreational physical activities of New Zealand women were examined to develop ethnic-specific suggestions encouraging physical activity (PA) participation as a targeted approach to reduce obesity rates among different groups. METHODS: Healthy Maori, Pacific and European women (n=331; 16-45 years of age) completed an online Recent Physical Activity Questionnaire to assess recreational PA and adherence to PA guidelines. Existing PA preferences were tailored to make ethnic-specific suggestions aimed at increasing PA participation. RESULTS: Achievement of PA guidelines was: Maori 74%; Pacific 60%; European 70%. Highest participation across all women was for walking (Maori 72%, Pacific 60%, European 83%), followed by floor exercise (Maori 54%, Pacific 37%, European 56%). Gym-type activities (e.g. weights, aerobics) and jogging were also common across ethnic groups. Group/team activities (dance, netball, touch football) were among the top 10 activities for Maori and Pacific, but not European women. CONCLUSION: Obesity rates among specific ethnic groups of New Zealand women might be reduced by promoting activities that are: family/whanau-oriented (netball, touch), community-linked (hula, dance) and outdoor-based. Implications for public health: Tailoring existing PA preferences to develop ethnic-specific sets of activity suggestions could be important avenues to increase PA participation, improving the PA habits and subsequent health of New Zealand women and their communities.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Exercício , Estilo de Vida/etnologia , Adolescente , Adulto , Comparação Transcultural , Estudos Transversais , Características Culturais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Nova Zelândia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Adulto Jovem
10.
Public Health ; 170: 122-128, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31029834

RESUMO

OBJECTIVES: Mediation analyses were conducted to explore the contribution of lifestyle behaviours in the ethnic pattern of poor health outcomes in Leicester, England. STUDY DESIGN: Cross-sectional study. METHODS: The study used data on 1959 participants from the Leicester Health and Well-being Survey (2015). Lifestyle behaviours were physical activity, diet, smoking and alcohol drinking. Poor health outcomes were the presence of long-term illness and poor self-reported health. RESULTS: Poor health outcomes were less common in Black and Minority Ethnic groups (BMEs) than Whites. Smoking was less common in BMEs than Whites. Poor health outcomes were more common in ex-smokers and current smokers than never smokers. Health outcomes were associated with smoking even after adjusting for ethnicity. The association of ethnicity and health outcomes reduced after adjusting for smoking, suggesting that the effect was mediated by smoking. CONCLUSIONS: In Leicester, Whites had poorer health outcomes than BMEs, which were not mediated by physical activity, diet and alcohol drinking but were mediated by smoking.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Disparidades nos Níveis de Saúde , Estilo de Vida/etnologia , Grupos Minoritários/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/etnologia , Estudos Transversais , Dieta/etnologia , Inglaterra/epidemiologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Exercício/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Fumar/etnologia
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(4): 394-399, 2019 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-31006197

RESUMO

Objective: To investigate the relationship between duration of sleep and all-cause mortality in patients with type 2 diabetes. Methods: A total of 17 452 type 2 diabetic patients who were under the National Basic Public Health Service Project, in Changshu county, Qinghe district and Huai'an district in Huai'an city of Jiangsu province, were recruited as participants. Cox proportional hazards regression models were used to estimate the associations between different levels on the duration of sleep and all-cause mortality. Stratified analysis was performed according to factors as gender, age, and lifestyle. Results: Among the 67 912 person-years of observation, from the fo1low- up program, the median time of follow-up was 4 years, with 1 057 deaths occurred during the follow-up period. Taking patients with duration of sleep as 7 h/d for reference, the multivariate adjusted hazard ratios (95%CI) of all-cause mortality appeared as ≤6, 8, 9 and ≥10 h/d were 1.14 (0.94-1.37), 1.10 (0.91-1.32), 1.33 (1.05-1.70), and 1.52 (1.24-1.87), respectively which were associated with the duration of sleep. Data from the subgroup analysis showed that this was consistent with the whole population. Longer duration of sleep was associated with the all-cause mortality but no significant association was found between shorter duration of sleep and the all-cause mortality. Conclusion: Longer duration of sleep seemed to have increased the risk of all-cause mortality in type 2 diabetic patients.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Diabetes Mellitus Tipo 2/mortalidade , Sono/fisiologia , Causas de Morte , China/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Humanos , Estilo de Vida/etnologia , Mortalidade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Análise de Sobrevida
12.
Artigo em Inglês | MEDLINE | ID: mdl-30934779

RESUMO

Rates of diabetes are high in many communities of Pacific Island peoples, including people from Fiji. This qualitative study explores knowledge and attitudes towards diabetes among i-Taukei Fijians to facilitate the cultural tailoring of diabetes prevention and management programs for this community. Fijians aged 26 to 71 years (n = 15), residing in Australia, participated in semi-structured interviews; 53% (n = 8) were male. Interviews were audio-recorded, transcribed verbatim, then thematically analyzed. Diabetes is recognized as an important and increasing health problem requiring action in the i-Taukei Fijian community. Widespread support for culturally appropriate lifestyle interventions utilizing existing societal structures, like family networks and church groups, was apparent. These structures were also seen as a crucial motivator for health action. Intervention content suggestions included diabetes risk awareness and education, as well as skills development to improve lifestyle behaviors. Leveraging existing social structures and both faith and family experiences of diabetes within the Fijian community may help convert increased awareness and understanding into lifestyle change. Ongoing in-community support to prevent and manage diabetes was also regarded as important. We recommend building upon experience from prior community-based interventions in other high-risk populations, alongside our findings, to assist in developing tailored diabetes programs for Fijians.


Assuntos
Diabetes Mellitus/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Estilo de Vida/etnologia , Adulto , Idoso , Austrália/epidemiologia , Conscientização , Relações Familiares/etnologia , Feminino , Fiji/etnologia , Educação em Saúde/organização & administração , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa , Fatores Socioeconômicos
13.
J Drugs Dermatol ; 18(3s): s121-123, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30909358

RESUMO

Photoaging is a complex and chronic process that induces structural and functional changes in sun-exposed skin, including coarse wrinkles, laxity, dyschromia, telangiectasias, and potential precancerous lesions. Pigmented skin presents different structure and physiology that contribute to distinctive photoaging process. The skin of color population is reported to "age better" than their Caucasian counterparts in general, with fewer wrinkles and better skin texture. However, pigmentary disorders and sun-exposure related dyschromia are highly prevalent in skin of color. Hispanics are the fastest growing population in the U.S. and represents a heterogenous group of people with different skin tones and Fitzpatrick phototypes. They demonstrate large diversity and heterogeneity in skin physiology, pigmentary disorders, and photoaging-related skin color shifting. Specific concerns around hyperpigmentation, skin tone evenness, and texture or roughness are very common among Hispanics, demanding targeted medical and cosmeceutical solutions. Customized daily routines including sufficient photo-protection are essential to address such needs. This mini review identifies some of the specific skin concerns of Hispanics in America and emphasizes the needs for long-term sunscreen use and education. J Drugs Dermatol. 2019;18(3 Suppl):s121-123.


Assuntos
Hispano-Americanos , Transtornos da Pigmentação/prevenção & controle , Lesões Pré-Cancerosas/prevenção & controle , Envelhecimento da Pele/efeitos da radiação , Adulto , Idoso , Cosmecêuticos/administração & dosagem , Feminino , Humanos , Estilo de Vida/etnologia , Educação de Pacientes como Assunto , Transtornos da Pigmentação/diagnóstico , Transtornos da Pigmentação/etiologia , Transtornos da Pigmentação/patologia , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/etiologia , Lesões Pré-Cancerosas/patologia , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Envelhecimento da Pele/efeitos dos fármacos , Envelhecimento da Pele/fisiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/prevenção & controle , Pigmentação da Pele/efeitos dos fármacos , Pigmentação da Pele/fisiologia , Pigmentação da Pele/efeitos da radiação , Luz Solar , Protetores Solares/administração & dosagem , Estados Unidos
14.
BMC Public Health ; 19(1): 186, 2019 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-30760246

RESUMO

BACKGROUND: Physical inactivity and unhealthy diet are modifiable behaviors that lead to several cancers. Biologically, these behaviors are linked to cancer through obesity-related insulin resistance, inflammation, and oxidative stress. Individual strategies to change physical activity and diet are often short lived with limited effects. Interventions are expected to be more successful when guided by multi-level frameworks that include environmental components for supporting lifestyle changes. Understanding the role of environment in the pathways between behavior and cancer can help identify what environmental conditions are needed for individual behavioral change approaches to be successful, and better recognize how environments may be fueling underlying racial and ethnic cancer disparities. METHODS: This cross-sectional study was designed to select participants (n = 602 adults, 40% Hispanic, in San Diego County) from a range of neighborhoods ensuring environmental variability in walkability and food access. Biomarkers measuring cancer risk were measured with fasting blood draw including insulin resistance (fasting plasma insulin and glucose levels), systemic inflammation (levels of CRP), and oxidative stress measured from urine samples. Objective physical activity, sedentary behavior, and sleep were measured by participants wearing a GT3X+ ActiGraph on the hip and wrist. Objective measures of locations were obtained through participants wearing a Qstarz Global Positioning System (GPS) device on the waist. Dietary measures were based on a 24-h food recall collected on two days (weekday and weekend). Environmental exposure will be calculated using static measures around the home and work, and dynamic measures of mobility derived from GPS traces. Associations of environment with physical activity, obesity, diet, and biomarkers will be measured using generalized estimating equation models. DISCUSSION: Our study is the largest study of objectively measured physical activity, dietary behaviors, environmental context/exposure, and cancer-related biomarkers in a Hispanic population. It is the first to perform high quality measures of physical activity, sedentary behavior, sleep, diet and locations in which these behaviors occur in relation to cancer-associated biomarkers including insulin resistance, inflammation, impaired lipid metabolism, and oxidative stress. Results will add to the evidence-base of how behaviors and the built environment interact to influence biomarkers that increase cancer risk. TRIAL REGISTRATION: ClinicalTrials.gov NCT02094170 , 03/21/2014.


Assuntos
Ambiente Construído , Exposição Ambiental/efeitos adversos , Estilo de Vida/etnologia , Neoplasias/etiologia , Obesidade/etnologia , Comportamento Sedentário/etnologia , Adulto , California , Exercício , Comportamentos de Risco à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Obesidade/complicações
15.
Eur J Oncol Nurs ; 38: 57-64, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30717937

RESUMO

PURPOSE: Behavioral interventions targeting cancer survivors often fail to address the clustering of unhealthy behaviors among family members and friends, and the impact of close relationships on behavior change. The study's aim was to identify factors associated with receptivity and preferences for lifestyle behavior change among family members of African-American survivors of lung cancer. METHODS: Principles of social cognitive theory guided the design. A descriptive, qualitative study recruited 26 African-American family members of lung cancer survivors from two teaching hospitals in the southeastern United States. A 20-item Information Form collected demographic, health status, and health behavior information. Family members participated in one of three semi-structured focus group discussions. RESULTS: Four major themes emerged: family members and survivors both resisted the caregiver role; dramatic changes evoked by the diagnosis of lung cancer were facilitators and barriers to lifestyle choices; leaning on faith was the primary source of support; and these families live with a constant threat of multiple cancers. Findings emphasize the importance of meaningful conversations among health-care providers, survivors, and family members during the time of diagnosis, treatment, and recovery, so that family members are better prepared to cope with anticipated changes. CONCLUSIONS: This study highlights the stressors that affect family members and sheds light on their unique needs. The stressors limit their ability to change health behaviors. Family members need basic education, skills training, and support related to the lung cancer diagnosis and other cancers. Current methods to provide these services are limited in their accessibility, availability, and effectiveness.


Assuntos
Afro-Americanos/psicologia , Sobreviventes de Câncer/psicologia , Família/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Neoplasias Pulmonares/etnologia , Neoplasias Pulmonares/psicologia , Adaptação Psicológica , Adulto , Idoso , Cuidadores/psicologia , Família/etnologia , Feminino , Amigos/psicologia , Humanos , Estilo de Vida/etnologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Apoio Social
16.
Dig Dis Sci ; 64(1): 249-261, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30259278

RESUMO

Ethnic health disparity is a well-acknowledged issue in many disease settings, but not diseases of the exocrine pancreas. A systematic review and meta-analysis was conducted to explore the race- and ethnicity-specific burden of diseases of the exocrine pancreas. Studies that compared health-related endpoints between two or more ethnicities were eligible for inclusion. Proportion meta-analyses were conducted to compare burden between groups. A total of 42 studies (24 on pancreatic cancer, 17 on pancreatitis, and one on pancreatic cyst) were included in the systematic review, of which 19 studies were suitable for meta-analyses. The incidence of pancreatic cancer was 1.4-fold higher among African-Americans, while the incidence of acute pancreatitis was 4.8-fold higher among an indigenous population (New Zealand Maori) compared with Caucasians. The prevalence of post-pancreatitis diabetes mellitus was up to 3.0-fold higher among certain ethnicities, including Asians, Pacific Islanders, and indigenous populations compared with Caucasians. The burden of diseases of the exocrine pancreas differs between ethnicities, with African-Americans and certain indigenous populations being at the greatest risk of developing these diseases. Development of race- and ethnicity-specific screening as well as protocols for lifestyle modifications may need to be considered with a view to reducing the disparities in burden of diseases of the exocrine pancreas.


Assuntos
Afro-Americanos , Disparidades nos Níveis de Saúde , Saúde das Minorias/etnologia , Pâncreas Exócrino , Pancreatopatias/etnologia , Grupos Populacionais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/etnologia , Humanos , Incidência , Estilo de Vida/etnologia , Pâncreas Exócrino/patologia , Cisto Pancreático/diagnóstico , Cisto Pancreático/etnologia , Pancreatopatias/diagnóstico , Pancreatopatias/mortalidade , Pancreatopatias/terapia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/etnologia , Pancreatite/diagnóstico , Pancreatite/etnologia , Fatores de Risco
17.
Cultur Divers Ethnic Minor Psychol ; 25(3): 371-378, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30335406

RESUMO

OBJECTIVES: This study explored whether cultural identity predicts health lifestyle behaviors. METHOD: Participants included 302 recently immigrated (<5 years in the U.S.) Latinx adolescents (53% boys; mean age 14.51 years at baseline) from Miami and Los Angeles. Participants completed cultural identity measures at baseline and 1-year post baseline. A path analysis was used to estimate associations between cultural identities (ethnic, national, and bicultural) and health lifestyle behaviors (physical activity, diet, and sleep hygiene). RESULTS: Ethnic identity positively predicted diet. Results also indicated a significant interaction between ethnic and national identity on sleep hygiene. Specifically, when national identity was high (+1 SD), ethnic identity positively predicted sleep hygiene. CONCLUSION: This study focuses on health lifestyle behaviors such as physical activity, diet, and sleep hygiene in this population. Results highlight the need to explore the protective nature of cultural identity retention in relation to health lifestyle behaviors in Latinx adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Comportamento do Adolescente/etnologia , Emigrantes e Imigrantes/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Hispano-Americanos/psicologia , Estilo de Vida/etnologia , Identificação Social , Aculturação , Adolescente , Comportamento do Adolescente/psicologia , Cultura , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Florida , Hispano-Americanos/estatística & dados numéricos , Humanos , Los Angeles
18.
Dermatol Ther ; 32(1): e12784, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30458063

RESUMO

Female alopecia patients in China often present with a frontal pattern hair loss. This feature is seen less frequently in western women. Women in China frequently style their hair in a ponytail. Thus, we hypothesized that the high prevalence of frontal pattern hair loss in Chinese women is due to traction alopecia. To better understand this, we studied 43 women presenting frontal alopecia at a hair clinic. Among the women presenting frontal alopecia, 79% reported styling their hair in a ponytail four or more days per week for an average period of 10 years. To our knowledge, this is the first study to elucidate the cause of frequent frontal alopecia in Chinese women. Although cultural style changes are difficult to change, we believe that awareness of the medical implications of frequent ponytail styling will reduce the rate of frontal alopecia among Chinese women.


Assuntos
Alopecia/etnologia , Grupo com Ancestrais do Continente Asiático , Estética , Estilo de Vida/etnologia , Adolescente , Adulto , Idoso , Alopecia/diagnóstico , China/epidemiologia , Características Culturais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
19.
J Health Commun ; 24(1): 1-8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30540224

RESUMO

Minority group members tend to have more negative health outcomes compared to majority group members. As reducing health inequalities is a global imperative, research testing strategies to improve minority patient health outcomes are important. Evidence exists that ethnic concordance in patient-physician communication is statistically associated with positive outcomes for minority patients. Previous research has exclusively relied on non-experimental observational methods. The present study adds to this literature by presenting supplementary experimental evidence, thus increasing confidence in the causal interpretation of the relationships observed in previous studies. Individuals with Turkish migration backgrounds living in Germany (N = 256) were randomly assigned to a hypothetical medical consultation in which a physician, Dr. Thomas Kirsch ("German majority physician"; ethnic-discordance condition) or Dr. Çagdas Kiliç ("Turkish minority physician"; ethnic-concordance condition) talked about lifestyle factors associated with chronic non-communicable diseases (tobacco smoking, an unhealthy diet, and physical inactivity). The analysis indicates that ethnic concordance improved belief in the physician, reduced reactance-related outcomes, and improved prevention-related knowledge transfer. Notably, the effect of ethnic concordance on knowledge was especially pronounced in low health-literacy participants. We discuss the implications related to the ongoing calls for a more diverse physician workforce.


Assuntos
Comunicação , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Grupos Minoritários/psicologia , Relações Médico-Paciente , Médicos/psicologia , Médicos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Atitude Frente a Saúde/etnologia , Feminino , Alemanha , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Alfabetização em Saúde/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Estilo de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Doenças não Transmissíveis/etnologia , Doenças não Transmissíveis/prevenção & controle , Fatores de Risco , Turquia/etnologia , Adulto Jovem
20.
Heart ; 105(6): 439-448, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30538094

RESUMO

OBJECTIVE: Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers. METHODS: Cross-sectional data from 7404 employed individuals, aged 18-74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models. RESULTS: Hispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures. CONCLUSIONS: Our results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.


Assuntos
Cardiotoxinas , Doenças Cardiovasculares , Metais/toxicidade , Exposição Ocupacional , Praguicidas/toxicidade , Aculturação , Adulto , Idoso , Cardiotoxinas/análise , Cardiotoxinas/toxicidade , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/classificação , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Estilo de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
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