(25/1128) Anthropological and psychological merge: design of a stress measure for Mexican farmworkers.

This study implements qualitative and quantitative methodologies in the development of a culturally appropriate instrument of stress for Mexican immigrant farmworkers. Focus groups were used to uncover culturally based perspectives on life stressors, definitions of stress, and stress mediators. Qualitative data were analyzed using QSR NVivo and then used to develop a 23-item stress scale. The scale was tested for reliability and validity in an independent sample and demonstrates excellent reliability (alpha = 0.9123). Test-retest coefficients of the stress scale are also strong (r = 0.8344, p = 0.0000). Qualitative analyses indicated three major sources of stress: work, family, and community. Emotional aspects of stress also emerged, demonstrating a cultural perspective of stress closely related to feelings of despair and not being able to find a way out of despairing situations. This paper reveals themes gathered from the qualitative data and identifies reliability and validity constructs associated with the scale. The stress scale developed as part of this investigation is a reliable and culturally appropriate instrument for assessing stress among Mexican immigrant farmworkers.  (+info)

(26/1128) Maternal employment and overweight among Hispanic children of immigrants and children of natives.

This research examines the relationship between maternal employment and child overweight among fifth grade Hispanic and non-Hispanic white children. Data from the Early Childhood Longitudinal Study Kindergarten (ECLS-K) cohort fifth grade sample (N = 4,360) were analyzed. OLS regression models were estimated predicting percentile BMI as a function of maternal employment, ethnicity, parental nativity status, income, and the interactions of employment, ethnicity/nativity, and income. Among Hispanic children of immigrants, maternal employment is associated with lower percentile BMI and this association strengthens at higher levels of income. Among Hispanic children of natives and non-Hispanic whites, maternal employment is beneficial (i.e. associated with lower percentile BMI) among low-income children but detrimental among high-income children, but this pattern is significantly greater in strength for Hispanics than non-Hispanic whites. Thus, maternal employment is associated with worse health outcomes only in the case of Hispanic children of natives, and maternal employment is associated with the best outcomes for Hispanic children of mothers from high-income families. We speculate that among children of immigrants, maternal employment may signify and/or accelerate assimilation towards middle- or upper-class American values of healthy weight and body size. Diet, meal regularity and supervision, and childcare did not mediate the relationship between maternal employment and overweight.  (+info)

(27/1128) Legal status, emotional well-being and subjective health status of Latino immigrants.

Among the many stresses that undocumented Latino immigrants experience, worries about their legal status and preoccupation with disclosure and deportation can heighten the risk for emotional distress and impaired quality of health. To better document these effects, this study examined the relationship between deportation concern and emotional and physical well-being among a group of Latino immigrants in a midwestern city. One-hundred-forty-three persons were recruited through community sources. Fifty-six participants (39%) expressed concern with seeking services for fear of deportation, while 87 did not endorse this concern. Measures of emotional distress, Hispanic immigrant stress and subjective health status were administered. Results indicate that Latino immigrants with concerns about deportation are at heightened risk of experiencing negative emotional and health states (particularly anger), Hispanic immigrant stress associated with extrafamilial factors and substandard health status. Findings inform policymakers of culturally relevant stressors of undocumented Latino immigrants that help to create and perpetuate the health and mental health disparities of this group.  (+info)

(28/1128) De novo depression and anxiety disorders and influence on adherence during peginterferon-alpha-2a and ribavirin treatment in patients with hepatitis C.

BACKGROUND: Depression and anxiety have been associated with interferon treatment and low treatment adherence. AIM: To study the incidence and associated risk factors of depressive and anxiety disorders during pegylated interferon plus ribavirin and treatment adherence in a prospective cohort of 176 patients with chronic hepatitis C patients. METHODS: Patients were interviewed at baseline using the Structured Clinical Interview for DSM-IV Mental Disorders and the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were completed. Both questionnaires were completed also after 4, 12 and 24 weeks of treatment. RESULTS: De novo depressive and/or anxiety disorders were diagnosed in 53 (36%) patients, in whom antidepressants and/or anxiolytics were administered. Higher baseline depression-subscale score (OR = 27.8, 95% CI = 2.82-333), primary education level (OR = 3.1, 95% CI = 1.40-7.03) and being an immigrant (OR = 3.2, 95% CI = 1.12-9.47) were predictors of psychiatric disorders during anti-viral therapy. The percentage of patients with good adherence was lower in those with depression and/or anxiety (79% vs. 90%, P < 0.04). Only one patient (1%) discontinued treatment because of a major depressive episode. Depression and/or anxiety disorders had no effect on attainment of sustained virological response. CONCLUSION: Early detection and treatment of depressive and anxiety disorders favours good adherence to anti-viral treatment in hepatitis C.  (+info)

(29/1128) Active screening for pulmonary tuberculosis among immigrants by chest x-ray at the Swiss border.

AIM: To assess the number of immigrants with pulmonary tuberculosis detected by chest x-ray screening at the Swiss border. METHOD: All adult immigrants entering Switzerland in 2004 were screened by chest x-ray (CXR). The number of radiological abnormalities suggestive of pulmonary tuberculosis, and the proportion requiring treatment for tuberculosis, were assessed retrospectively. The frequency of symptoms among immigrants with documented TB was compared with a sample of immigrants with a normal CXR. RESULTS: Among 8995 immigrants, 8240 had a normal CXR, 630 had some abnormality not suggestive of active TB and 125 (1.4%) had a CXR suggestive of pulmonary TB. A final diagnosis of tuberculosis requiring treatment was made in 50 (11 with positive smear and culture, 16 with positive culture and 23 with negative culture), 57 had fibrotic lesions and 18 had another disease or a normal x-ray on control. The prevalence of symptoms did not differ between 27 immigrants with documented TB (smear+/culture+: 82%, smear-/culture+: 75%), and 23 with smear-/culture-tuberculosis (91%), but lower in 57 immigrants with fibrotic lesions (60%). Cough was more frequent among the 27 immigrants with documented TB (70%) than among 198 smokers without TB (37%) and among 229 non-smokers without TB (15%) CONCLUSIONS: Only 22% (27/125) of immigrants with CXR abnormalities suggestive of pulmonary tuberculosis were documented by smear and/or culture and 40% (50/125) needed antituberculous treatment. 2/11 smear-positive immigrants would not have been detected by a questionnaire on symptoms.  (+info)

(30/1128) Cancer and communication in the health care setting: experiences of older Vietnamese immigrants, a qualitative study.

BACKGROUND: As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants. OBJECTIVE: To learn about the cancer-related communication experiences of older Vietnamese immigrants from the insider perspective. DESIGN: Qualitative study (grounded theory, constant comparative method) using individual interviews with older Vietnamese immigrants with the purpose of discussing how they learn about cancer. Interviews were conducted in Vietnamese. PARTICIPANTS: Vietnamese immigrants aged 50-70 years, recruited through community-based organizations. Most had low education and limited English proficiency. The sample size of 20 was sufficient to achieve theoretical saturation. RESULTS: We identified 3 categories of themes concerning informants' experiences with cancer communication in the health care setting: (1) attitudes about addressing screening with providers, (2) issues/problems communicating with physicians about cancer, and (3) language/translation difficulties. There was substantial overlap between informants who mentioned each theme category, and 40% of the participants mentioned all 3 categories. CONCLUSION: Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening.  (+info)

(31/1128) Health-related quality of life and migration: a cross-sectional study on elderly Iranians in Sweden.

BACKGROUND: Although elderly Iranian immigrants in Sweden are the largest elderly group born outside Europe, little is known about their health-related quality of life (HRQL). The aim of this study was to examine the association between migration status and HRQL in a comparison of elderly Iranians in Iran, elderly Iranian immigrants in Sweden, and elderly Swedes in Sweden. METHODS: The Short Form Health Survey (SF-36) was administered to a total of 625 men and women aged 60-84 years to collect HRQL information on elderly Iranians in Sweden (n = 176) and elderly Iranians in Iran (n = 298). A Swedish control group (n = 151) was also randomly selected from the general population. Multiple linear regression procedures were applied to analyze data while adjusting for age, which was categorized into 60-69, and 70-84 years, and education. RESULTS: Iranian women in Sweden with shorter times of residence scored lower on vitality (beta-coefficient = -7.9, 95% CI = -14.3 to -1.5) compared with other women in this study. The lower vitality dimension score remained nearly unchanged in the main model (beta-coefficient = -7.3, 95% CI = -13.7 to -0.9). A longer period of residence in Sweden had a positive association with social functioning (beta-coefficient = 14.1, 95% CI = 3.1-25.1) and role limitation due to emotional problems (beta-coefficient = 18.3, 95% CI = 1.4-35.2) among elderly Iranian women. In general, the Swedish subsample scores higher on all dimensions of the SF-36 among women and in six out of eight among men in relation to the rest of the subsamples. CONCLUSION: The HRQL of elderly Iranians in Sweden was more like that of their countrymen in Iran than that of Swedes, who reported a better HRQL than Iranians in this study. However, length of time since migration to Sweden is not associated with poorer HRQL among elderly Iranians. The association varied, however, with sex. Elderly Iranian women showed an increase in two of eight dimensions of the SF-36 with additional years in Sweden, whereas, among elderly Iranian men, additional years in Sweden were not associated with HRQL.  (+info)

(32/1128) The healthy migrant effect: new findings from the Mexican Family Life Survey.

OBJECTIVES: We used nationally representative longitudinal data from the Mexican Family Life Survey to determine whether recent migrants from Mexico to the United States are healthier than other Mexicans. Previous research has provided little scientific evidence that tests the "healthy migrant" hypothesis. METHODS: Estimates were derived from logistic regressions of whether respondents moved to the United States between surveys in 2002 and 2005, by gender and urban versus rural residence. Covariates included physical health measurements, self-reported health, and education measured in 2002. Our primary sample comprised 6446 respondents aged 15 to 29 years. RESULTS: Health significantly predicted subsequent migration among females and rural males. However, the associations were weak, few health indicators were statistically significant, and there was substantial variation in the estimates between males and females and between urban and rural dwellers. CONCLUSIONS: On the basis of recent data for Mexico, the largest source of migrants to the United States, we found generally weak support for the healthy migrant hypothesis.  (+info)