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1.
Cultur Divers Ethnic Minor Psychol ; 26(1): 42-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31021142

RESUMO

OBJECTIVE: Acculturation-acculturative stress profiles and their association with depression symptoms were examined in a sample of mainland Puerto Ricans (N = 367) using latent profile analysis. METHODS: Bidimensional behavioral acculturation, bidimensional ethnic identity, and acculturative stress were used as indicators to derive profiles. Differences in depressive symptoms across latent profile members were determined using an automatic mixture modeling with continuous outcomes approach. RESULTS: Three profiles were identified, each demonstrating a distinctive configuration of adherence to bidimensional behavioral acculturation, bidimensional ethnic identity, and level of acculturative stress. The largest profile resembled individuals following a partial marginalization strategy. Participants in this profile were also reported more depression symptoms than all other participants. CONCLUSIONS: The identification of a large partial marginalization profile offers important information about sociocultural indicators of depression among Puerto Ricans living in the United States. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Aculturação , Depressão/etnologia , Hispano-Americanos/psicologia , Autorrevelação , Estresse Psicológico/etnologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Porto Rico/etnologia , Estados Unidos
2.
BMC Public Health ; 19(1): 1710, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856774

RESUMO

BACKGROUND: While PWID of Puerto Rican origin have been migrating to the US for decades, the range of factors influencing their migration to the US and the resources they draw on to do so are not well understood. This is particularly true for rural Puerto Rican PWID, and the present study is the first empirical research to document migration patterns among this population. The specificities of their migration raise important challenges that need to be documented in order to implement more effective harm reduction policies at home (Puerto Rico) and abroad (US). METHODS: This paper draws from data obtained employing a modified NHBS survey which was administered to (N =296) PWID in four rural municipalities of Puerto Rico with participants 18 years or older. The primary dependent variables for this paper are the number of times a person has lived in the continental US, and if they are planning on moving to the continental US in the future. RESULTS: Findings suggest that 65% of the sample reported ever lived in the US and that 49% are planning on moving in the future. The number of times living in the US is associated with higher education and older age, but not with self-reported positive HIV or HCV statuses. Planning to move to the US is associated with knowing PWID who have moved or plan to move, negatively associated with age, and is not associated with HIV or HCV status. Around one third of those that lived in the US reported having some sort of support, with the majority receiving support from family sources. No participant received help to enter HIV/HCV treatment. CONCLUSIONS: A multi-region approach to prevention is required to make a dent in curbing HIV/HCV transmission in this population. Understanding PWID migration patterns, risk behaviors, and health care needs in the US is now more important than ever as natural disasters prompted by human-made climate change will only increase in the future, raising demands not only for service providers but also harm reduction policies to cope with an increasing influx of "climate refugees" as PWID move across national borders.


Assuntos
Emigração e Imigração/estatística & dados numéricos , Hispano-Americanos/psicologia , População Rural/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/etnologia , Adolescente , Adulto , Idoso , Feminino , Redução do Dano , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico/etnologia , Fatores de Risco , Apoio Social , Estados Unidos/epidemiologia , Adulto Jovem
3.
BMC Health Serv Res ; 19(1): 818, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703682

RESUMO

BACKGROUND: While Medicare is a federal health insurance program, managed Medicare limits access to healthcare services to networks within states or territories. However, if a natural disaster requires evacuation, displaced patients are at risk of losing coverage for their benefits. Previous literature has discussed the quality of managed Medicare plans within Puerto Rico but has not addressed the adequacy of this coverage if residents are displaced to the continental United States. We explore Hurricane Maria's impact on a resident of Puerto Rico with chronic health problems, and the challenges he faces seeking healthcare in New York. CASE PRESENTATION: A 59-year-old male with a history of diabetes mellitus type II, coronary artery disease, peripheral vascular disease status post right foot amputation, and end-stage kidney disease on hemodialysis was admitted in October of 2017 for chest pain and swelling of legs for 5 days. The patient had missed his last three dialysis sessions after Hurricane Maria forced him to leave Puerto Rico. In examining this patient's treatment, we observe the effect of Hurricane Maria on the medical management of Puerto Rican residents and identify challenges managed Medicare may pose to patients who cross state or territory lines. CONCLUSIONS: We employ this patient's narrative to frame a larger discussion of Puerto Rican managed Medicare and provide additional recommendations for healthcare providers. Moreover, we consider this case in the context of disaster-related continuity of care for patients with complex medical conditions or treatment regimens. To address the gaps in the care of these patients, this article proposes (1) developing system-based approaches for screening displaced patients, (2) increasing the awareness of Special Enrollment Periods related to Medicare among healthcare providers, and (3) creating policy solutions to assure access to care for patients with complex medical conditions.


Assuntos
Tempestades Ciclônicas , Assistência à Saúde/normas , Desastres , Medicare/normas , Múltiplas Afecções Crônicas/terapia , Hispano-Americanos , Humanos , Seguro Saúde , Masculino , Turismo Médico , Pessoa de Meia-Idade , Múltiplas Afecções Crônicas/etnologia , Cidade de Nova Iorque , Aceitação pelo Paciente de Cuidados de Saúde , Porto Rico/etnologia , Refugiados , Diálise Renal , Estados Unidos
4.
Nurs Res ; 68(5): 348-357, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31464828

RESUMO

BACKGROUND: Through its influence on social interactions, simpatía may have a wide-ranging influence on Latinx health. Simpatía-which does not have a direct English translation-refers to being perceived as likeable, pleasant, and easygoing. Research to investigate the influence simpatía on Latinx health is limited, likely due to a lack of options for measuring simpatía among diverse Latinx populations. OBJECTIVES: The goal of this research was to develop a bilingual, survey-based simpatía scale for use among ethnically diverse Latinx adults in health-related settings. METHODS: Data were obtained through a telephone survey data of 1,296 Mexican American, Puerto Rican, and Cuban American adults living in the United States. Interviews were conducted in English and Spanish. Exploratory factor analysis, item response theory analysis, confirmatory factor analysis, and computation of estimates of internal consistency reliability were conducted to inform the development of the final simpatía scale. RESULTS: Results indicate that the final, nine-item, simpatía scale has high internal consistency (α = .83) and measurement invariance among Mexican American, Puerto Rican, and Cuban American adults. Two dimensions were identified, as indicated by a perceptions subscale and a behavior subscale. Cuban Americans were found to have the highest simpatía scores, followed by Puerto Ricans and Mexican Americans. DISCUSSION: Culture is often identified as a powerful potential influence on health-related behaviors, but measures are often not available to assess specific cultural traits. By developing a new tool for measuring simpatía, this research advances opportunities for understanding and promoting Latinx health.


Assuntos
Comportamentos Relacionados com a Saúde/etnologia , Hispano-Americanos/psicologia , Americanos Mexicanos/psicologia , Multilinguismo , Inquéritos e Questionários , Adulto , Idoso , Cuba/etnologia , Características Culturais , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Porto Rico/etnologia , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Estados Unidos
6.
J Health Care Poor Underserved ; 30(2): 866-887, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31130555

RESUMO

A range of social and structural barriers continue to impede timely diagnosis and consistent access to care for Latinos living with HIV in the U.S. Navigation programs have helped other populations overcome comparable barriers to care. This qualitative paper examined nine navigation programs that were culturally tailored for Mexicans or Puerto Ricans, using a transnational framework that situated clients in the context of lives that bridge the U.S. and their countries of origin. We completed in-depth semi-structured interviews with 48 clients and 27 intervention providers. A framework approach guided analysis. We identified two overarching themes: developing trusting and supportive relationships between navigators and clients and empowering clients to connect and stay in primary care, which summarized the impact of the interventions on participants' lives and the approaches used to increase their care engagement. Our findings highlight the importance of tailoring intervention strategies to the unique experiences of specific Latino populations.


Assuntos
Infecções por HIV/etnologia , Hispano-Americanos , Navegação de Pacientes/métodos , Adulto , Emigrantes e Imigrantes , Feminino , Infecções por HIV/terapia , Humanos , Entrevistas como Assunto , Masculino , México/etnologia , Navegação de Pacientes/organização & administração , Participação do Paciente/métodos , Porto Rico/etnologia , Estados Unidos
7.
Soc Psychiatry Psychiatr Epidemiol ; 54(3): 369-378, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30649577

RESUMO

PURPOSE: The manuscript compares the rates of psychiatric disorder among island Puerto Ricans, the US population and US Puerto Ricans in order to examine whether social support explains differences in psychiatric disorder among these three groups. METHODS: Unadjusted and adjusted rates for sociodemographic factors and social support of main psychiatric disorders are compared among three population-based psychiatric epidemiology studies carried in Puerto Rico (PR) and the United States (US) as part of the NCS-R and NLAAS studies. RESULTS: Comparison of adjusted rates showed island Puerto Ricans had similar overall rates of psychiatric disorder as those of the US, lower rates of anxiety disorders, but higher rates of substance use disorders. US Puerto Ricans had higher rates of adjusted anxiety and depression but not of overall psychiatric disorder, as compared to the island. When the rates of disorder were adjusted also for social support, the differences between these two groups disappeared. CONCLUSIONS: The findings suggest that social support is a variable worthy of further exploration for explaining differences in disorder prevalence particularly among Puerto Ricans depending on where they live.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Transtornos Mentais/epidemiologia , Apoio Social , Adolescente , Adulto , Ansiedade/etnologia , Depressão/etnologia , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/etnologia , Pessoa de Meia-Idade , Prevalência , Porto Rico/epidemiologia , Porto Rico/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
8.
Disaster Med Public Health Prep ; 13(1): 24-27, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30696508

RESUMO

OBJECTIVES: The aim of this study was to compare the effect of Hurricane Maria on internalizing and posttraumatic stress disorders (PTSD) among Puerto Ricans who moved to Florida after the storm versus those who stayed on the island. METHODS: In March through April 2018 (6 months after Hurricane Maria), an online survey was used to assess the effects of the storm on mental health. A sample of 213 displaced Puerto Ricans living in urban and rural/suburban areas in Florida, as well as urban and rural areas of Puerto Rico, participated in the study. RESULTS: Rates of PTSD were high in both sites (Florida, 65.7%; Puerto Rico, 43.6%); however, participants in Florida were far more likely than those in Puerto Rico to meet diagnostic criteria for PTSD (OR, 2.94; 95% CI, 1.67-5.26). Among participants in both Florida and Puerto Rico, those living in urban areas were more likely than those in rural/suburban areas to meet criteria for PTSD and generalized anxiety disorder. CONCLUSIONS: Results suggest that post-Hurricane Maria adjustment and adaptation may have been more psychologically taxing for Puerto Ricans who moved to Florida than it was for those who remained on the island, and more difficult for those in urban areas than it was for those in suburban or rural areas. (Disaster Med Public Health Preparedness. 2019;13:24-27).


Assuntos
Tempestades Ciclônicas/estatística & dados numéricos , Hispano-Americanos/psicologia , Saúde Mental/estatística & dados numéricos , Adulto , Feminino , Florida/epidemiologia , Florida/etnologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Saúde Mental/etnologia , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Psicometria/estatística & dados numéricos , Porto Rico/epidemiologia , Porto Rico/etnologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etnologia , Inquéritos e Questionários
9.
Phys Sportsmed ; 47(2): 227-231, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30412458

RESUMO

OBJECTIVE: To evaluate the association of habitual physical activity engagement on changes in cognitive function among Puerto Rican adults. METHODS: Longitudinal data (2-year follow-up) from the Boston Puerto Rican Health Study were analyzed (n = 862; mean age = 56.5 year). A daily energy expenditure score was calculated using the number of hours over a 24-h period engaged in various activities, including sleeping, light activity, and moderate-to-vigorous exercise. Energy expenditure estimates were weighted based on the rate of oxygen consumption associated with each activity. Seven cognitive function outcomes were evaluated, including an assessment of general cognitive function, episodic memory, attention and working memory, cognitive flexibility, response inhibition, processing speed, and visuo-spatial organization. From these, overall executive function and memory capacity were derived using principal components analysis. RESULTS: Physical activity was not associated with changes in overall executive function. However, compared to those with low baseline physical activity, those with moderate physical activity had 48% reduced odds of having ≥1 standard deviation decline in memory function (OR = 0.52; 95% CI: 0.32, 0.84; p = 0.008) in 2 years. CONCLUSION: Among Puerto Rican adults, physical activity may help attenuate memory decline.


Assuntos
Cognição/fisiologia , Exercício Físico/psicologia , Hispano-Americanos/psicologia , Idoso , Atenção/fisiologia , Boston , Metabolismo Energético , Função Executiva/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Consumo de Oxigênio , Porto Rico/etnologia
10.
Med Anthropol ; 38(3): 210-223, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30247078

RESUMO

Puerto Rico's politically liminal status as a US territory has dire consequences for Puerto Rico's economy: the island does not receive the same funding as states for health insurance. In addition, Puerto Rico's unraveling health care system, coupled with the island's high poverty rate and the medical brain drain, interact. I weave my research on depression into this article as an example of the ways in which political and economic factors aggravate disease.


Assuntos
Assistência à Saúde/etnologia , Acesso aos Serviços de Saúde , Seguro Saúde , Antropologia Médica , Humanos , Pobreza/etnologia , Porto Rico/etnologia
11.
Cultur Divers Ethnic Minor Psychol ; 25(2): 152-169, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30272471

RESUMO

OBJECTIVES: Two studies and data sources were used to empirically compare and cross-validate three bidimensional acculturation measurement models. METHOD: Following a cross-sectional design and confirmatory factor analysis (CFA), Study 1 examined the models in a sample of Central Florida Puerto Ricans (n = 484). In Study 2, the measurement model was retested on a separate sample of island Puerto Ricans (n = 399). To ensure adequate comparisons across the two samples, measurement invariance tests were performed. RESULTS: A bidimensional six-factor model (B6F) resulted in the best model fit for both samples. Results indicated full configural, metric, uniqueness, factor variance, covariance, and partial scalar invariance between the 2 groups. An examination of mean differences between the samples revealed that Central Florida Puerto Ricans had a significantly stronger endorsement of Puerto Rican and European American values than those living in the island. CONCLUSIONS: This examination revealed that both groups share the same acculturation structure. That is, acculturation among Central Florida and island Puerto Ricans can be conceptualized as a bidimensional construct of simultaneous adherence to Puerto Rican and European American cultural aspects across behavioral, values, and ethnic identity domains. The B6F model of island Puerto Rican acculturation suggests that even in the absence of a migration experience, island Puerto Ricans may experience bidimensional and multifaceted acculturation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Aculturação , Emigrantes e Imigrantes/psicologia , Hispano-Americanos/psicologia , Identificação Social , Adaptação Psicológica , Estudos Transversais , Feminino , Florida , Humanos , Masculino , Porto Rico/etnologia
12.
PLoS Genet ; 14(12): e1007791, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30517106

RESUMO

The ApoE ε4 allele is the most significant genetic risk factor for late-onset Alzheimer disease. The risk conferred by ε4, however, differs across populations, with populations of African ancestry showing lower ε4 risk compared to those of European or Asian ancestry. The cause of this heterogeneity in risk effect is currently unknown; it may be due to environmental or cultural factors correlated with ancestry, or it may be due to genetic variation local to the ApoE region that differs among populations. Exploring these hypotheses may lead to novel, population-specific therapeutics and risk predictions. To test these hypotheses, we analyzed ApoE genotypes and genome-wide array data in individuals from African American and Puerto Rican populations. A total of 1,766 African American and 220 Puerto Rican individuals with late-onset Alzheimer disease, and 3,730 African American and 169 Puerto Rican cognitively healthy individuals (> 65 years) participated in the study. We first assessed average ancestry across the genome ("global" ancestry) and then tested it for interaction with ApoE genotypes. Next, we assessed the ancestral background of ApoE alleles ("local" ancestry) and tested if ancestry local to ApoE influenced Alzheimer disease risk while controlling for global ancestry. Measures of global ancestry showed no interaction with ApoE risk (Puerto Rican: p-value = 0.49; African American: p-value = 0.65). Conversely, ancestry local to the ApoE region showed an interaction with the ApoE ε4 allele in both populations (Puerto Rican: p-value = 0.019; African American: p-value = 0.005). ApoE ε4 alleles on an African background conferred a lower risk than those with a European ancestral background, regardless of population (Puerto Rican: OR = 1.26 on African background, OR = 4.49 on European; African American: OR = 2.34 on African background, OR = 3.05 on European background). Factors contributing to the lower risk effect in the ApoE gene ε4 allele are likely due to ancestry-specific genetic factors near ApoE rather than non-genetic ethnic, cultural, and environmental factors.


Assuntos
Afro-Americanos/genética , Doença de Alzheimer/genética , Apolipoproteína E4/genética , Hispano-Americanos/genética , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Frequência do Gene , Variação Genética , Genética Populacional , Estudo de Associação Genômica Ampla , Humanos , Masculino , Porto Rico/etnologia , Fatores de Risco
13.
J Nutr ; 148(11): 1804-1813, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30383277

RESUMO

Background: The role of acculturation in dietary behaviors among Hispanics/Latinos in the United States remains unclear. Discrepancies may be explained by variations in acculturation constructs or ethnicity-specific dynamics. Objective: We aimed to compare relations between 3 different acculturation constructs with dietary quality and patterns among Puerto Ricans in the mainland United States. Methods: We analyzed cross-sectional data with 1194-1380 Puerto Ricans, aged 45-75 y. Acculturation was measured with the use of a language-based scale (0-100; higher score denotes more English use), a psychological-based scale (0-50; higher score denotes stronger US orientation), and years living in the mainland United States. Diet quality scores (higher scores denote healthier diet) were defined with the use of the Alternate Healthy Eating Index-2010 (AHEI) and the Mediterranean Diet Score (MeDS). Three dietary patterns were previously derived with the use of principal components analysis. Adjusted multivariable regression models tested the association of each acculturation construct with diet quality score or pattern. Interaction terms were included for income or education status. Results: Psychological-based acculturation, but not the other constructs, was positively associated with AHEI (ß ± SE: 0.013 ± 0.004; P = 0.002) and MeDS (0.009 ± 0.005; P = 0.041). Income, but not education, moderated this association (P = 0.03), with higher diet quality observed with higher income (>$25,000) and stronger US orientation. All constructs were inversely associated with a traditional dietary pattern, with the language-based scale being stronger (z score ß ± SE: -0.160 ± 0.032; P < 0.0001) than the psychological-based scale (-0.097 ± 0.028; P = 0.001) or years living in the mainland United States (-0.058 ± 0.028; P = 0.041). No associations were observed for the Western or sweets/desserts patterns. Conclusions: In Puerto Rican adults, stronger psychological US orientation was associated with higher diet quality, particularly with higher income. More Spanish use, stronger psychological Puerto Rican orientation, and shorter length of mainland-US residency were associated with traditional dietary patterns. Appropriate diet-related acculturation constructs should be carefully considered among Hispanics/Latinos. This trial was registered at clinicaltrials.gov as NCT01231958.


Assuntos
Aculturação , Dieta/psicologia , Idoso , Estudos Transversais , Feminino , Hispano-Americanos , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico/etnologia
14.
J Nutr Educ Behav ; 50(8): 829-835, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30196884

RESUMO

OBJECTIVE: To examine the associations among acculturation, food environment, and food insecurity among Puerto Ricans in Boston. METHODS: The researchers used data from the second wave of the Boston Puerto Rican Health Study. The sample included 719 Puerto Rican adults in Boston. The researchers used logistic regression to examine the associations between psychological and language acculturation and food insecurity. RESULTS: Individuals with medium psychological acculturation were more likely to be food insecure than were those with low or high psychological acculturation (P = .01). The association between language acculturation and food insecurity differed by distance of residence from primary shopping location (P = .02). CONCLUSIONS AND IMPLICATIONS: This study extends the understanding of acculturation and food insecurity by investigating the impact of psychological and language acculturation. The findings highlight biculturalism, indicated by medium psychological acculturation, as a risk factor for food insecurity. People with low language acculturation who live far from food shopping locations had the highest prevalence of food insecurity.


Assuntos
Aculturação , Abastecimento de Alimentos/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Adulto , Boston , Dieta/etnologia , Humanos , Idioma , Porto Rico/etnologia , Fatores de Risco
15.
Nutrients ; 10(9)2018 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-30200655

RESUMO

Polyunsaturated fatty acid (PUFA) consumption is recommended as part of a healthy diet, but evidence of the impact of individual species and biological concentrations on cognitive function is limited. We examined prospective associations of PUFA erythrocyte composition and dietary intake with measures of cognitive function among participants of the Boston Puerto Rican Health Study (aged 57 years). Erythrocyte and dietary PUFA composition were ascertained at baseline and associated with 2-year scores on the Mini-Mental State Exam (MMSE) (n = 1032) and cognitive domain patterns derived from a battery of tests (n = 865), as well as with incidence of cognitive impairment. Erythrocyte and dietary n-3 PUFA were not significantly associated with MMSE score. However, total erythrocyte and dietary n-3 very-long-chain fatty acids (VLCFA), and intake of individual species, were associated with better executive function (P-trend < 0.05, for all). There was evidence that greater erythrocyte n-6 eicosadienoic acid concentration was associated with lower MMSE and executive function scores (P-trend = 0.02). Only erythrocyte arachidonic acid (ARA) concentration predicted cognitive impairment (Odds Ratio = 1.26; P = 0.01). Among Puerto Rican adults, we found that n-3 VLCFA consumption may beneficially impact executive function. Further, these findings provide some evidence that n-6 metabolism favoring greater ARA tissue incorporation, but not necessarily dietary intake, could increase the risk of cognitive impairment.


Assuntos
Transtornos Cognitivos/psicologia , Cognição , Eritrócitos/metabolismo , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-6/administração & dosagem , Biomarcadores/sangue , Boston/epidemiologia , Transtornos Cognitivos/sangue , Transtornos Cognitivos/etnologia , Transtornos Cognitivos/prevenção & controle , Função Executiva , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/efeitos adversos , Ácidos Graxos Ômega-6/sangue , Feminino , Hispano-Americanos/psicologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Proteção , Porto Rico/etnologia , Fatores de Risco
16.
Gerodontology ; 35(4): 339-349, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30109895

RESUMO

OBJECTIVE: To examine the mouth and body knowledge, beliefs and behaviours of Dominican, Puerto Rican and African American older adults, and their relationships to oral and general health and health care. BACKGROUND: In his seminal framework, Handwerker posited that the norms, attitudes and behaviours related to the experience of disease and treatment reflect where patients live and have lived and are seeking and have sought care, along with their webs of social and health relations. This framework guides the analysis for the present study, wherein qualitative data are used to understand mouth and body knowledge, beliefs and behaviours among racial/ethnic minority older adults, ie, why individuals do what they do and what it means to them. MATERIALS AND METHODS: Focus groups were conducted in Spanish or English with 194 racial/ethnic minority older adults living in northern Manhattan who participated in one of 24 focus group sessions about improving oral health. All groups were digitally audio-recorded, transcribed and translated into English from Spanish, where apt. Analysis involved the classification of evidence from all datasets, organised to identify patterns and relationships. RESULTS: Four themes were manifest in the data regarding cultural understandings of the mouth, the body and health: (a) the ageing mouth and its components; (b) the mouth in relation to the body, health and disease; (c) social meanings of the mouth; and (d) care of the ageing mouth. CONCLUSION: Underserved older adults from diverse cultural backgrounds understand the importance of their mouths to both their overall health and social lives.


Assuntos
Afro-Americanos , Cultura , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos , Saúde Bucal/etnologia , Higiene Bucal , Idoso , Idoso de 80 Anos ou mais , Dentaduras , República Dominicana/etnologia , Feminino , Grupos Focais , Humanos , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Doenças da Boca/etnologia , Doenças da Boca/prevenção & controle , Cidade de Nova Iorque , Porto Rico/etnologia , Pesquisa Qualitativa , Comportamento Social
17.
Psychosom Med ; 80(8): 733-741, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30045347

RESUMO

OBJECTIVE: Limited evidence demonstrates pathways linking food insecurity (FI) to chronic disease. Allostatic load (AL) may elucidate potential pathways, capturing both primary (neuroendocrine, inflammation) and secondary (metabolic, cardiovascular) physiological disturbances. We examined the longitudinal association of FI with 5-year AL and primary and secondary subsystem dysregulation and tested moderation by Supplemental Nutrition Assistance Program (SNAP) participation. METHODS: We analyzed data from the longitudinal Boston Puerto Rican Health Study among 733 adults aged 45 to 75 years. Participants categorized as food insecure (assessed by US survey module) experienced FI at baseline and/or year 5. AL score comprised 11 biological components (5 primary, 6 secondary). We classified participants as having high scores for AL (≥6 dysregulated components), primary system (≥3), and secondary system (≥4). Multivariate models estimated odds ratios (OR), adjusting for baseline AL, sociodemographic, cultural, and behavioral characteristics. RESULTS: By study end, 33.8% had experienced FI, 65.5% had participated in SNAP, and 37.5% had high AL. In adjusted models, FI was not associated with AL (OR [95% confidence intervals] = 1.07 [0.70-1.64]) or secondary system (0.82 [0.48-1.40]) scores, but was associated with high primary system scores (1.71 [1.25-2.36]). SNAP participation seemed to moderate the FI-primary system relationship (p = .06); food-insecure participants never receiving SNAP (mean (SE) = 2.06 (0.14)) had higher scores than food-secure participants receiving (1.72 (0.06], p = .02) or never receiving SNAP (1.64 (0.10), p = .01) and food-insecure participants receiving SNAP (1.80 (0.07), p = .08). CONCLUSIONS: FI is associated with dysregulated components of the primary AL system, and this relationship may be stronger for those not receiving SNAP. Research is needed in additional populations to test AL as a plausible pathway connecting FI to chronic disease and SNAP as a moderator.


Assuntos
Alostase/fisiologia , Assistência Alimentar/estatística & dados numéricos , Pobreza/etnologia , Idoso , Boston/etnologia , Feminino , Seguimentos , Abastecimento de Alimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Porto Rico/etnologia
18.
Environ Res ; 166: 595-601, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29982147

RESUMO

Air pollution has been linked to adverse cardiovascular outcomes; however, susceptibility may vary by population. Puerto Rican adults living in the US may be a susceptible group due to a high rate of adverse cardiovascular events. We evaluated the effect of changes in ambient particle number concentration (PNC, a measure of ultrafine particles) and effects on biomarkers of cardiovascular risk in the Boston Puerto Rican Health Study (BPRHS), a longitudinal cohort (n = 1499). Ambient PNC was measured at a fixed site between 2004 and 2013 and daily mean concentrations were used to construct PNC metrics, including lags of 0, 1 and 2 days and moving averages (MAs) of 3, 7 and 28 days. We examined the association of each metric with C-reactive protein (CRP) and blood pressure. Each model included subject-specific random intercepts to account for multiple measurements. An interquartile range (IQR) increase in PNC was associated with CRP for all metrics, notably a 3-day increase in PNC was associated with a 7.1% (95% CI: 2.0%, 12.2%) increase in CRP. Significant associations with CRP were seen in women, but not men; with current and former (but not non-) smokers; participants younger (but not older) than 65 y; those without diabetes (but not with), and those with (but not without), hypertension. Our study extends knowledge about the health effects of air pollution to a vulnerable population that has been understudied.


Assuntos
Poluição do Ar/análise , Biomarcadores/sangue , Sistema Cardiovascular , Adulto , Pressão Sanguínea , Boston/epidemiologia , Proteína C-Reativa/análise , Feminino , Hispano-Americanos , Humanos , Estudos Longitudinais , Masculino , Material Particulado , Porto Rico/etnologia
19.
Psychol Addict Behav ; 32(4): 466-474, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29781627

RESUMO

Heavy cannabis use is associated with a wide array of physical, mental, and functional problems. Therefore, cannabis use disorders (CUDs) may be a major public health concern. Given the adverse health consequences of CUDs, the present study seeks to find possible precursors of CUDs. The current study consisted of 5 waves of data collection from the Harlem Longitudinal Development Study. Among 816 participants, about half are African Americans (52%), and the other half are Puerto Ricans (48%). We used Mplus to obtain the triple trajectories of alcohol use, tobacco use, and depressive symptoms. Logistic regression analyses were then conducted to examine the associations between the trajectory groups and CUDs. The 5 trajectory groups were (1) moderate alcohol use, high tobacco use, and high depressive symptoms (MHH; 12%); (2) moderate alcohol use, high tobacco use, and low depressive symptoms (MHL; 26%); (3) moderate alcohol use, low tobacco use, and low depressive symptoms (MLL; 18%); (4) low alcohol use, no tobacco use, and high depressive symptoms (LNH; 11%); and (5) low alcohol use, no tobacco use, and low depressive symptoms (LNL; 33%). The MHH, MHL, MLL, and LNH trajectory groups were associated with an increased likelihood of having CUDs compared to the LNL trajectory group after controlling for a number of confounding factors (e.g., CUDs in the late 20s). The findings of the current longitudinal study suggest that treatments designed to reduce or quit drinking as well as smoking and to relieve depressive symptoms may reduce the prevalence of CUDs. (PsycINFO Database Record


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Depressão/etnologia , Abuso de Maconha/etnologia , Uso de Tabaco/etnologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/psicologia , Depressão/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Abuso de Maconha/epidemiologia , Abuso de Maconha/psicologia , Cidade de Nova Iorque/epidemiologia , Prevalência , Porto Rico/etnologia , Uso de Tabaco/psicologia , Adulto Jovem
20.
Cultur Divers Ethnic Minor Psychol ; 24(4): 588-595, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29771548

RESUMO

OBJECTIVES: The available literature on ethnic identity among Puerto Ricans has focused on those living in the United States, with little to no attention placed on examining ethnic identity and psychological constructs among youth living in Puerto Rico. Using a colonial mentality framework, the current study examined the associations between ethnic identity, cultural stress, and self-concept among adolescent boys and girls living in Puerto Rico. METHOD: The current cross-sectional study surveyed participants (N = 187) recruited from several junior high schools in the metropolitan area in Puerto Rico. RESULTS: Relations between ethnic identity, cultural stress, and self-concept differed by gender. First, cultural stress was associated with self-concept for boys, such that higher cultural stress predicted lower self-concept. Second, among girls, cultural stress moderated the relation between ethnic identity and self-concept. Specifically, for girls experiencing high cultural stress, exploration and resolution of their ethnic identity was associated with higher ratings of self-concept. CONCLUSIONS: Although cultural stress has been widely understood as a phenomena associated with immigrants, our study indicated that cultural stress is important in understanding self-concept of youth living in Puerto Rico. For boys, cultural stress, but not ethnic identity, is particularly important to their self-concept. Among girls experiencing high cultural stress, exploration and resolution of ethnic identity was associated with higher self-concept. Results suggested that the cultural stress associated with the colonial context of Puerto Rico is salient in ethnic identity and self-concept development, even though Puerto Rican youth are the ethnic majority in the island. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Aculturação , Comportamento do Adolescente/psicologia , Hispano-Americanos/psicologia , Autoimagem , Identificação Social , Adaptação Psicológica , Adolescente , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Masculino , Porto Rico/etnologia , Fatores Socioeconômicos , Estados Unidos
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