Agricultural Injury in California Hispanic Farm Workers: MICASA Follow-up Survey

ABSTRACT

The authors report here results from the first follow-up survey of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) cohort of community-dwelling immigrant Hispanic farm workers in California's Central Valley. Among 560 participants the authors observed cumulative 1-year injury incidence of 6.6% (all injuries) and 4.3% (agricultural injuries). Increased prospective injury risk was associated with males, US birth, years lived in the United States, family income, and poor self-rated health. Agricultural injuries were associated most frequently with being struck by an object, falls, and cutting instruments, whereas over two thirds of nonagricultural injuries involved motor vehicles. Prevention should focus on safe handling of tools and materials, falls, and motor vehicle safety.     

Bimodal Distribution of Risk for Childhood Obesity in Urban Baja California, Mexico

In Mexico, higher socioeconomic status (SES) has been found to be associated with increased risk for obesity in children. Within developed urban areas, however, there may be increased risk among lower SES children. Students in grades 4–6 from five public schools in Tijuana and Tecate, Mexico, were interviewed and weight, height and waist circumference (WC) measurements were taken. Interviews consisted of questions on food frequency, food insecurity, acculturation, physical activity and lifestyle practices. Multivariate logistic models were used to assess risk factors for obesity (having a body mass index [BMI] ≥95th percentile) and abdominal obesity (a WC >90th percentile) using Stata 11.0. Five hundred and ninety students were enrolled; 43.7% were overweight or obese, and 24.3% were obese and 20.2% had abdominal obesity. Independent risk factors for obesity included watching TV in English (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.06–2.41) and perceived child food insecurity (OR 1.57, 95% CI 1.05–2.36). Decreased risk for obesity was associated with female sex (OR 0.64, 95% CI 0.43–0.96), as was regular multivitamin use (OR 0.63, 95% CI 0.42–0.94). Risk obesity was also decreased with increased taco consumption (≥1×/week; OR 0.64, 95% CI 0.43–0.96). Independent risk factors for abdominal obesity included playing video games ≥1×/week (OR 1.18, 95% CI 1.11–2.96) and older age group (10–11 years, OR 2.47, 95% CI 1.29–4.73 and ≥12 years, OR 2.21, 95% CI 1.09–4.49). Increased consumption of tacos was also associated with decreased risk for abdominal obesity (≥1×/week; OR 0.56, 95% CI 0.40–1.00). We found a bimodal distribution for risk of obesity and abdominal obesity in school aged children on the Mexican border with the United States. Increased risk for obesity and abdominal obesity were associated with factors indicative of lower and higher SES including watching TV in English, increased video game playing and perceived food insecurity. Increased consumption of tacos (≥1×/week) was associated with decreased risk, possibly suggesting an association with children from middle income families. Regular multivitamin use was protective and future studies may focus on micronutrient supplementation as a means to prevent obesity in children or further investigate factors associated with vitamin use. Additionally, future studies need to examine the processes of acculturation on both sides of the US–Mexican border that contribute to increased risk for obesity in children in relation to SES.     

Lived experiences of internationally educated nurses in hospitals in the United States of America

JOSE M. M. (2011) Lived experiences of internationally educated nurses in hospitals in the United States of America. International Nursing Review 58 , 123–129 Aim: The overall goal of this study was to elicit and describe the lived experiences of internationally educated nurses (IENs) who work in a multi‐hospital medical centre in the urban USA. Background: Since World War Two, US health care agencies have addressed the nursing shortage by hiring IENs. While other countries have produced substantial research findings about their IENs, much less research has been done about IENs in the USA. Findings from the limited US studies suggest that more research is needed and first‐hand reports of lived experiences must be added. Methods: Using a phenomenology of practice study design and Giorgi's principles of data analysis, narratives from the guided interviews with 20 new immigrant IENs who had migrated from the countries of the Philippines, Nigeria and India to the USA, were collected and studied for themes. Findings and discussion: Six themes that emerged from the stories of IENs together describe a trajectory of lived experiences that the IENs encountered during their adjustments to living and working in the USA. The emergent themes weredreams of a better life, a difficult journey, a shocking reality, rising above the challenges, feeling and doing better and ready to help others. Study findings are similar to studies done in other countries and highlight the needs of IENs. Conclusion: The study findings provide important first‐hand insights from the subjective perspectives of the IENs in US hospitals and will guide recruitment and retention of a diverse nursing workforce. Findings will enrich orientation and transition programs for IENs as well as strengthen the cohesiveness of a diverse nursing workforce in the USA.     

Acculturation, depression, and function in individuals seeking pain management in a predominantly Hispanic southwestern border community

Acculturation does not inform practice in the acute or primary care setting; nor does it explain ethnic disparities in the recognition and treatment of chronic diseases, particularly chronic pain. As clinicians, it is imperative that we recognize contributing factors, comorbid conditions, and the impact of chronic pain on individuals and families. The purposes of this article are to present evidence that exemplifies the nonsignificant role acculturation plays in expression of pain and function of a predominantly Hispanic population on the United States border; and to identify more meaningful perspectives of culture that may lessen health disparities and improve pain management.     

Concept analysis of acculturation in Filipino immigrants within health context

Although acculturation has been widely used as a health research variable among other immigrant populations, it is nonexistent to the Filipino immigrant population. Accurate assessment, measurement, and exploration of acculturation of Filipinos in the United States can help improve the overall health care of this population. The work of Walker and Avant is used as a guide to analyze and clarify the operational definition of acculturation of this group within the context of health.     

Sexual and reproductive health issues of Turkish immigrants in the Netherlands

Objective To identify factors that influence aspects of sexual and reproductive health behaviour, such as contraceptive use and teenage pregnancies, among Turkish immigrants in the Netherlands.

Method This socio-cultural review compares data from demographic surveys and opinion studies. The explanation for the trends found in these data was sought in the differences between the cultural backgrounds of immigrant and host populations, and in the socio-cultural changes that people undergo after immigration.

Data In the Netherlands, 2.3% of the population are first- and second-generation Turkish immigrants. These people often originate from more traditional or underdeveloped rural areas in Eastern and Southern Turkey. Reproductive behaviour in the Netherlands differs greatly from that in Eastern and Southern Turkey, especially with regard to the use of contraception, abortion and the age at which women have children. These differences are largely the result of community-bound sets of opinions and role patterns.

Conclusion After immigration, the acculturation process will lead to a change in behaviour. During this process conflicts in relationships will arise within and between first- and second generation Turkish immigrants. These conflicts are particularly evident within the second generation that grew up in the Netherlands. These persons have adopted a number of opinions prevailing in the host country but, at the same time, cling to various traditional values. Second-generation Turkish women seem to adapt faster to the new culture than their male counterparts.     

Cultural and social network predictors of drinking among Korean American women

This study estimated the association of cultural and social mechanisms with Korean American women’s drinking behaviors. Data were drawn from telephone interviews with 591 Korean women selected from a random sample of households in California with Korean surnames during 2007. About 62% of eligible respondents completed the interview. Respondents reported any lifetime drinking (yes/no), drinking volume (typical number of drinks consumed on drinking days), level of acculturation, and described their social network by assessing who encouraged or discouraged drinking (drinking support) or drank (drinking models). Multivariable regressions were used for analyses. About 70% (95% confidence interval [95%CI]:, 67, 74) of Korean American women reported any lifetime drinking and current drinkers drank 1.18 (95%CI: 1.07, 1.28) drinks on drinking days. Acculturation was not significantly associated with any lifetime drinking or drinking volume, whereas models and support for drinking were statistically significantly associated with a higher probability of any lifetime drinking and drinking more on drinking days. Each additional encourager, or one or fewer discourager, for drinking in women’s social networks was associated with a 2% (95%CI: 1, 3) higher probability of any lifetime drinking and drinking 0.25 (95%CI: −0.53, 1.18) more drinks on drinking days. Each additional drinker in women’s networks was associated with a 4% (95%CI: 1, 8) higher probability of any lifetime drinking and drinking 0.26 (95%CI: −0.05, 0.60) more drinks on drinking days. Korean American women’s drinking appears to be strongly related to their social networks, although how women take on traits of their new environment was not.     

A Latino advantage in oral health-related quality of life is modified by nativity status

Explanations for the social gradient in health status are informed by the rare exceptions. This cross-sectional observational study examined one such exception, the “Latino paradox” by investigating the presence of a Latino advantage in oral health-related quality of life and the effect of nativity status on this relationship. A nationally representative sample of adults (n = 4208) completed the National Health and Nutrition Examination Survey (NHANES) 2003–2004. The impact of oral disorders on oral health-related quality of life was evaluated using the NHANES Oral Health Impact Profile. Exposures of interest were race, ethnicity and nativity status. Covariates included sociodemographic characteristics, smoking status, self-rated health, access to dental care and number of teeth. Unconditional logistic regression models estimated odds of impaired oral health-related quality of life for racial/ethnic and nativity groups compared to the Non-Latino white population. Overall, prevalence of impaired oral health-related quality of life was 15.1%. A protective effect of Latino ethnicity was modified by nativity status, such that Latino immigrants experienced substantially better outcomes than non-Latino whites. However, the effect was limited to first-generation Latinos. U.S. born Latinos did not share the oral health-related quality of life advantage of their foreign-born counterparts. This advantage was not attributable to the healthy migrant phenomenon since immigrants of non-Latino origin did not differ from Non-Latino whites. The excess risk among Non-Hispanic Blacks was rendered non-significant after adjustment for socioeconomic position. A protective effect conferred by Latino nativity is unexpected given relatively disadvantaged socioeconomic position of this group, their language barrier and restrictions to needed dental care. As the Latino advantage in oral health-related quality of life is not explained by healthy immigrant selection, cultural explanations seem more likely than explanations based on characteristics of individuals.     

Compliance with Smoke-Free Policies in Korean Bars and Restaurants in California: a Descriptive Analysis

Background: Compliance with California’s smoke-free restaurant and bar policies may be more a functionof social contingencies and less a function of legal contingencies. The aims of this study were: 1) to reportindications of compliance with smoke-free legislation in Korean bars and restaurants in California; 2) to examinethe demographic, smoking status, and acculturation factors of who smoked indoors; and 3) to report social cuesin opposition to smoking among a sample of Koreans in California. Materials and Methods: Data were collectedby telephone surveys administered by bilingual interviewers between 2007-2009, and included California adultsof Korean descent who visited a Korean bar or restaurant in a typical month (N=2,173, 55% female). Results:1% of restaurant-going participants smoked inside while 7% observed someone else smoke inside a Koreanrestaurant. Some 23% of bar-going participants smoked inside and 65% observed someone else smoke insidea Korean bar. Presence of ashtrays was related to indoor smoking in bars and restaurants. Among participantswho observed smoking, a higher percentage observed someone ask a smoker to stop (17.6%) or gesture to asmoker (27.0%) inside Korean restaurants (N=169) than inside Korean bars (n=141, 17.0% observed verbal cueand 22.7% observed gesture). Participants who smoked inside were significantly younger and more acculturatedthan participants who did not. Less acculturated participants were significantly more to likely to be told to stopsmoking. Conclusions: Ten years after implementation of ordinances, smoking appears to be common in Koreanbars in California.