The construction of ethnic differences in work incapacity risks: Analysing ordering practices of physicians in the Netherlands.

PubMed

Meershoek, Agnes; Krumeich, Anja; Vos, Rein

2011-01-01

Drawing from Science and Technology Studies we investigate the consequences for social differentiation of physicians' practices in Dutch illness certification. Using participant observation methods, we followed six 'Arbodienst' physicians for two weeks each. Our analysis explores whether and how the work of Dutch physicians contributes to the appearance of a category of 'problematic migrant patients'. We present how physicians, in using instruments to distinguish plausible from implausible claims for sick leave, impose order upon reality. In particular situations this ordering involves a distinction between Dutch and migrant clients. Here ethnicity appears in physicians' practice as a separate instrument to constitute order, which in the case of migrants overrules the productive instruments that are used for 'Dutch' clients. By interpreting clients' behaviour in cultural terms and making them into strangers, physicians lose their ability to fine-tune their coaching activities to the needs of these clients. As a result migrants remain work incapacitated for a longer period, which leads to a higher risk of their ending up in the disability pension program. As a consequence migrants become visible as a problematic group in the data on work incapacity and disability. The practice to categorise migrant clients with separate instruments thus results in a 'hard' category of problematic migrant clients and leads to social differentiation. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Intercultural health care policy from the perspective of health care providers and Mapuche clients].

PubMed

Alarcón, Ana María; Astudillo, Paula; Barrios, Sara; Rivas, Edith

2004-09-01

Intercultural health is becoming an emergent topic in the design of health care programs for Mapuche people of Chile. This process faces important challenges such as the scarce theoretical support about the meaning of intercultural health and their practical consequences for providers and clients. To explore the perception in providers and Mapuche clients about intercultural health. A survey performed in 11 counties with the highest concentration of Mapuche people, of the IX region of Chile. The perception about the development of a new health policy specially designed for Mapuche patients was surveyed in 399 Mapuche patients and 64 providers of primary health care centers. Mapuche clients considered, as the main regional challenges, the indifference and discrimination of health care teams towards Mapuche patients, aggravated by the indifference of authorities. Providers considered that the main problem was a lack of knowledge about Mapuche culture and skills to deal with this ethnic group. Patients and providers agreed on the need to use Mapuche dialect in health care attentions, to coordinate actions with traditional healers and to accept ethnical therapeutic practices. There is scarce agreement between providers and Mapuche clients about the need for an special intercultural health policy, its contents, and the regional conditions for its implementation and development.

Interpersonal complementarity in the mental health intake: a mixed-methods study.

PubMed

Rosen, Daniel C; Miller, Alisa B; Nakash, Ora; Halpern, Lucila; Halperin, Lucila; Alegría, Margarita

2012-04-01

The study examined which socio-demographic differences between clients and providers influenced interpersonal complementarity during an initial intake session; that is, behaviors that facilitate harmonious interactions between client and provider. Complementarity was assessed using blinded ratings of 114 videotaped intake sessions by trained observers. Hierarchical linear models were used to examine how match between client and provider in race/ethnicity, sex, and age were associated with levels of complementarity. A qualitative analysis investigated potential mechanisms that accounted for overall complementarity beyond match by examining client-provider dyads in the top and bottom quartiles of the complementarity measure. Results indicated significant interactions between client's race/ethnicity (Black) and provider's race/ethnicity (Latino) (p = .036) and client's age and provider's age (p = .044) on the Affiliation axis. The qualitative investigation revealed that client-provider interactions in the upper quartile of complementarity were characterized by consistent descriptions between the client and provider of concerns and expectations as well as depictions of what was important during the meeting. Results suggest that differences in social identities, although important, may be overcome by interpersonal variables early in the therapeutic relationship. Implications for both clinical practice and future research are discussed, as are factors relevant to working across cultures.

CULTURAL COMPETENCE IN OUTPATIENT SUBSTANCE ABUSE TREATMENT: MEASUREMENT AND RELATIONSHIP TO WAIT TIME AND RETENTION

PubMed Central

Guerrero, Erick; Andrews, Christina M.

2011-01-01

BACKGROUND Culturally competent practice is broadly acknowledged to be an important strategy to increase the quality of services for racial/ethnic minorities in substance abuse treatment. However, few empirically derived measures of organizational cultural competence exist, and relatively little is known about how these measures affect treatment outcomes. METHOD Using a nationally representative sample of outpatient substance abuse treatment (OSAT) programs, this study used item response theory to create two measures of cultural competence-organizational practices and managers' culturally sensitive beliefs—and examined their relationship to client wait time and retention using Poisson regression modeling RESULTS The most common and precisely measured organizational practices reported by OSAT managers included matching providers and clients based on language/dialect; offering cross-cultural training; and fostering connections with community and faith-based organizations connected to racial and ethnic minority groups. The most culturally sensitive belief among OSAT managers was support for language/dialect matching for racial and ethnic minority clients. Results of regression modeling indicate that organizational practices were not related to either outcome. However, managers' culturally sensitive beliefs were negatively associated with average wait time (p < 0.05), and positively associated with average retention (p < 0.01). CONCLUSIONS Managers' culturally sensitive beliefs—considered to be influential for effective implementation of culturally competent practices—may be particularly relevant in influencing wait time and retention in OSAT organizations that treat Latinos and African American clients. PMID:21680111

An Analogue Study of Counselor Ethnicity and Client Preference.

ERIC Educational Resources Information Center

Franco, Juan N.; LeVine, Elaine

1980-01-01

Providing student clients with background information about their prospective Chicano or Anglo counselors may increase the counselor's attractiveness, regardless of his ethnicity. Male counselors appear significantly more attractive as more information is provided about them, although subjects appear to have no preference for counselors of the…

Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited English proficiency.

PubMed

Gilmer, Todd P; Ojeda, Victoria D; Barrio, Concepcion; Fuentes, Dahlia; Garcia, Piedad; Lanouette, Nicole M; Lee, Kelly C

2009-02-01

The authors examined data for 7,784 Latino, Asian, and non-Latino white Medi-Cal beneficiaries with schizophrenia to determine the relationship between patients' preferred language for mental health services--English, Spanish, or an Asian language--and their adherence to treatment with antipsychotic medications. Data reflected 31,560 person-years from 1999 to 2004. Pharmacy records were analyzed to assess medication adherence by use of the medication possession ratio (MPR). Clients were defined as nonadherent (MPR<.5), partially adherent (MPR=.5-<.8), or adherent (MPR=.8-1.1) or as an excess filler of prescriptions (MPR<1.1). Regression models were used to examine adherence, hospitalization, and costs by race-ethnicity and language status. Latinos with limited English proficiency were more likely than English-proficient Latinos to be medication adherent (41% versus 36%; p<.001) and less likely to be excess fillers (15% versus 20%; p<.001). Asians with limited English proficiency were less likely than English-proficient Asians to be adherent (40% versus 45%; p=.034), more likely to be nonadherent (29% versus 22%; p<.001), and less likely to be excess fillers (13% versus 17%; p=.004). When analyses controlled for adherence and comorbidities, clients with limited English proficiency had lower rates of hospitalization and lower health care costs than English-proficient and white clients. Adherence to antipsychotic medications varied by English proficiency among and within ethnic groups. Policies supporting the training of bilingual and multicultural providers from ethnic minority groups and interventions that capitalize on patients' existing social support networks may improve adherence to treatment in linguistically diverse populations.

Urogenital Chlamydia trachomatis infections among ethnic groups in Paramaribo, Suriname; determinants and ethnic sexual mixing patterns.

PubMed

van der Helm, Jannie J; Bom, Reinier J M; Grünberg, Antoon W; Bruisten, Sylvia M; Schim van der Loeff, Maarten F; Sabajo, Leslie O A; de Vries, Henry J C

2013-01-01

Little is known about the epidemiology of urogenital Chlamydia trachomatis infection (chlamydia) in Suriname. Suriname is a society composed of many ethnic groups, such as Creoles, Maroons, Hindustani, Javanese, Chinese, Caucasians, and indigenous Amerindians. We estimated determinants for chlamydia, including the role of ethnicity, and identified transmission patterns and ethnic sexual networks among clients of two clinics in Paramaribo, Suriname. Participants were recruited at two sites a sexually transmitted infections (STI) clinic and a family planning (FP) clinic in Paramaribo. Urine samples from men and nurse-collected vaginal swabs were obtained for nucleic acid amplification testing. Logistic regression analysis was used to identify determinants of chlamydia. Multilocus sequence typing (MLST) was performed to genotype C. trachomatis. To identify transmission patterns and sexual networks, a minimum spanning tree was created, using full MLST profiles. Clusters in the minimum spanning tree were compared for ethnic composition. Between March 2008 and July 2010, 415 men and 274 women were included at the STI clinic and 819 women at the FP clinic. Overall chlamydia prevalence was 15% (224/1508). Age, ethnicity, and recruitment site were significantly associated with chlamydia in multivariable analysis. Participants of Creole and Javanese ethnicity were more frequently infected with urogenital chlamydia. Although sexual mixing with other ethnic groups did differ significantly per ethnicity, this mixing was not independently significantly associated with chlamydia. We typed 170 C. trachomatis-positive samples (76%) and identified three large C. trachomatis clusters. Although the proportion from various ethnic groups differed significantly between the clusters (P = 0.003), all five major ethnic groups were represented in all three clusters. Chlamydia prevalence in Suriname is high and targeted prevention measures are required. Although ethnic sexual mixing differed between ethnic groups, differences in prevalence between ethnic groups could not be explained by sexual mixing.

Urogenital Chlamydia trachomatis Infections among Ethnic Groups in Paramaribo, Suriname; Determinants and Ethnic Sexual Mixing Patterns

PubMed Central

van der Helm, Jannie J.; Bom, Reinier J. M.; Grünberg, Antoon W.; Bruisten, Sylvia M.; Schim van der Loeff, Maarten F.; Sabajo, Leslie O. A.; de Vries, Henry J. C.

2013-01-01

Background Little is known about the epidemiology of urogenital Chlamydia trachomatis infection (chlamydia) in Suriname. Suriname is a society composed of many ethnic groups, such as Creoles, Maroons, Hindustani, Javanese, Chinese, Caucasians, and indigenous Amerindians. We estimated determinants for chlamydia, including the role of ethnicity, and identified transmission patterns and ethnic sexual networks among clients of two clinics in Paramaribo, Suriname. Methods Participants were recruited at two sites a sexually transmitted infections (STI) clinic and a family planning (FP) clinic in Paramaribo. Urine samples from men and nurse-collected vaginal swabs were obtained for nucleic acid amplification testing. Logistic regression analysis was used to identify determinants of chlamydia. Multilocus sequence typing (MLST) was performed to genotype C. trachomatis. To identify transmission patterns and sexual networks, a minimum spanning tree was created, using full MLST profiles. Clusters in the minimum spanning tree were compared for ethnic composition. Results Between March 2008 and July 2010, 415 men and 274 women were included at the STI clinic and 819 women at the FP clinic. Overall chlamydia prevalence was 15% (224/1508). Age, ethnicity, and recruitment site were significantly associated with chlamydia in multivariable analysis. Participants of Creole and Javanese ethnicity were more frequently infected with urogenital chlamydia. Although sexual mixing with other ethnic groups did differ significantly per ethnicity, this mixing was not independently significantly associated with chlamydia. We typed 170 C. trachomatis-positive samples (76%) and identified three large C. trachomatis clusters. Although the proportion from various ethnic groups differed significantly between the clusters (P = 0.003), all five major ethnic groups were represented in all three clusters. Conclusion Chlamydia prevalence in Suriname is high and targeted prevention measures are required. Although ethnic sexual mixing differed between ethnic groups, differences in prevalence between ethnic groups could not be explained by sexual mixing. PMID:23874730

Fundamental Contradictions in Cultural Competence

ERIC Educational Resources Information Center

Johnson, Yvonne M.; Munch, Shari

2009-01-01

Cultural competence (CC) is considered highly relevant to social work practice with clients belonging to ethnic and racial minority groups, as the burgeoning literature and creation of practice standards on CC attest. However, examination of the conceptual underpinnings of CC reveals several major anomalies. The authors argue that several aspects…

Self-Compassion among College Counseling Center Clients: An Examination of Clinical Norms and Group Differences

ERIC Educational Resources Information Center

Lockard, Allison J.; Hayes, Jeffrey A.; Neff, Kristin; Locke, Benjamin D.

2014-01-01

There has been growing interest in the mental health benefits of self-compassion. This study was designed to establish norms on the Self-Compassion Scale-Short Form, a popular measure of self-compassion for individuals seeking counseling, and to examine group differences in self-compassion based on gender, race/ethnicity, sexual orientation,…

Counseling Preferences of African American Women

ERIC Educational Resources Information Center

Smith, Jacqueline R.; Wermeling, Linda

2007-01-01

African American women hold the greatest need for mental health services among ethnic groups but receive effective counseling least often. This study investigated their preferences of counseling services. Results revealed that the type of service delivery might not be as salient to African American women as counselor-client racial similarity.

Design of multi-language trading system of ethnic characteristic agricultural products based on android

NASA Astrophysics Data System (ADS)

Huanqin, Wu; Yasheng, Jin; Yugang, Dai

2017-06-01

Under the current situation where Internet technology develops rapidly, mobile E-commerce technology has brought great convenience to our life. Now, the graphical user interface (GUI) of most E-commerce platforms only supports Chinese. Thus, the development of Android client of E-commerce that supports ethnic languages owns a great prospect. The principle that combines front end design and database technology is adopted in this paper to construct the Android client system of E-commerce platforms that supports ethnic languages, which realizes the displaying, browsing, querying, searching, trading and other functions of ethnic characteristic agricultural products on android platforms.

Racial Microaggressions: A Primer with Implications for Counseling Practice

ERIC Educational Resources Information Center

Houshmand, Sara; Spanierman, Lisa B.; De Stefano, Jack

2017-01-01

Given their societal toll and ubiquitous nature, counselors and other mental health professionals inevitably will encounter clients who have experienced racial microaggressions in their practice. In this primer, we examine key issues relative to racial microaggressions and their impact on the lives of members of racial and ethnic minority groups.…

Comorbid depression and substance abuse among safety-net clients in Los Angeles: a community participatory study.

PubMed

Chang, Evelyn T; Wells, Kenneth B; Gilmore, James; Tang, Lingqi; Morgan, Anna U; Sanders, Starr; Chung, Bowen

2015-03-01

Depression and substance abuse are common among low-income adults from racial-ethnic minority groups who receive services in safety-net settings, although little is known about how clients differ by service setting. This study examined characteristics and service use among depressed, low-income persons from minority groups in underresourced communities who did and did not have a substance abuse history. The study used cross-sectional baseline client data (N=957) from Community Partners in Care, an initiative to improve depression services in Los Angeles County. Clients with probable depression (eight-item Patient Health Questionnaire) from substance abuse programs were compared with depressed clients with and without a history of substance abuse from primary care, mental health, and social and community programs. Sociodemographic, health status, and services utilization variables were examined. Of the 957 depressed clients, 217 (23%) were from substance abuse programs; 269 (28%) clients from other sectors had a substance abuse history, and 471 (49%) did not. Most clients from substance abuse programs or with a substance abuse history were unemployed and impoverished, lacked health insurance, and had high rates of arrests and homelessness. They were also more likely than clients without a substance abuse history to have depression or anxiety disorders, psychosis, and mania and to use emergency rooms. Clients with depression and a substance abuse history had significant psychosocial stressors and high rates of service use, which suggests that communitywide approaches may be needed to address both depression and substance abuse in this safety-net population.

Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands.

PubMed

Fassaert, Thijs; Nielen, Mark; Verheij, Robert; Verhoeff, Arnoud; Dekker, Jack; Beekman, Aartjan; de Wit, Matty

2010-01-01

There is widespread concern about access to good quality health care for ethnic minority groups. This study investigates differences between ethnic groups regarding prevalence of anxiety and depression, and adherence to treatment guidelines by family practitioners in urban areas in the Netherlands. Data from electronic medical records, collected for the Netherlands Information Network of General Practice. Diagnoses were based on the International Classification of Primary Care. Adherence to guidelines included at least five consultations, prescription of psychotropics for 6 weeks at most (indicative of cessation in case of nonresponse) or 5 months at least (suggesting continuation in case of response), and/or a referral to a mental health care specialist. Data were analyzed using multilevel logistic regression analyses. A total of 6413 patients (4.4% of practice population) were diagnosed with anxiety and/or depression. Prevalence was highest in Turkish patients (5.2%). Of diagnosed patients, 42.9% received guideline-concordant treatment. Only Surinamese/Antillean patients were less likely than ethnic Dutch to receive treatments according to guidelines. Prevalence of and quality of care for anxiety and depression were comparable between ethnic minority clients, but some differences suggest that efforts to educate primary care providers in management of anxiety/depression should be continued and tailored to specific ethnic groups. Copyright 2010 Elsevier Inc. All rights reserved.

The Impact of Client Race on Clinician Detection of Eating Disorders

ERIC Educational Resources Information Center

Gordon, Kathryn H.; Brattole, Marissa M.; Wingate, LaRicka R.; Joiner, Thomas E., Jr.

2006-01-01

Eating disorders are thought to occur less among African-American women than among women of other ethnic groups. Ninety-one clinicians read 1 of 3 passages (differing only with regards to the girl's race: African-American, Caucasian, or Hispanic) describing disturbed eating patterns of a fictional character named Mary. Participants were then asked…

Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico

PubMed Central

Pitpitan, Eileen V.; Strathdee, Steffanie A.; Semple, Shirley J.; Wagner, Karla D.; Chavarin, Claudia V.; Earnshaw, Valerie A.; Patterson, Thomas L.

2013-01-01

HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino vs. non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed. PMID:23979714

Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico.

PubMed

Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Earnshaw, Valerie A; Patterson, Thomas L

2015-02-01

HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino versus non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed.

Challenging Stereotypes of Eating and Body Image Concerns among College Students: Implications for Diagnosis and Treatment of Diverse Populations

ERIC Educational Resources Information Center

Nelson, Dana L.; Castonguay, Louis G.; Locke, Benjamin D.

2011-01-01

The authors describe a study that was conducted to provide better understanding of eating and body image concerns among clients in university counseling centers. First, they explored the prevalence of such concerns among stereotype-congruent (White, heterosexual, female) and stereotype-incongruent groups (e.g., ethnic/sexual minorities, men).…

Ethnic health care advisors: a good strategy to improve the access to health care and social welfare services for ethnic minorities?

PubMed

Hesselink, Arlette E; Verhoeff, Arnoud P; Stronks, Karien

2009-10-01

Empirical studies indicate that ethnic minorities have limited access to health care and welfare services compared with the host population. To improve this access, ethnic health care (HC) advisors were introduced in four districts in Amsterdam, the Netherlands. HC advisors work for all health care and welfare services and their main task is to provide information on health care and welfare to individuals and groups and refer individuals to services. Action research was carried out over a period of 2 years to find out whether and how this function can contribute to improve access to services for ethnic minorities. Information was gathered by semi-structured interviews, analysing registration forms and reports, and attending meetings. The function's implementation and characteristics differed per district. The ethnicity of the health care advisors corresponded to the main ethnic groups in the district: Moroccan and Turkish (three districts) and sub-Sahara African and Surinamese (one district). HC advisors reached many ethnic inhabitants (n = 2,224) through individual contacts. Half of them were referred to health care and welfare services. In total, 576 group classes were given. These were mostly attended by Moroccan and Turkish females. Outreach activities and office hours at popular locations appeared to be important characteristics for actually reaching ethnic minorities. Furthermore, direct contact with a well-organized back office seems to be important. HC advisors were able to reach many ethnic minorities, provide information about the health care and welfare system, and refer them to services. Besides adapting the function to the local situation, some general aspects for success can be indicated: the ethnic background of the HC advisor should correspond to the main ethnic minority groups in the district, HC advisors need to conduct outreach work, there must be a well-organized back office to refer clients to, and there needs to be enough commitment among professionals of local health and welfare services.

Experiences of Kurdish war-wounded refugees in communication with Swedish authorities through interpreter.

PubMed

Fatahi, Nabi; Nordholm, Lena; Mattsson, Bengt; Hellström, Mikael

2010-02-01

To study experiences of war-wounded Kurdish refugees with respect to cross-cultural communication through interpreters. Semi-structured interviews were conducted with ten men, aged 31-42. Content analysis was used for analysis and interpretation of data. War-wounded Kurdish refugees experienced a number of difficulties regarding communication through interpreters, mainly related to the insufficient language link to the Swedish authorities, particularly health care personnel. In many instances, interpreters were selected based on the immigrant's citizenship rather than mother tongue, leading to a more complex, tri-lingual interpretation situation. Differences in cultural background, fear, suspicion and lack of confidence in interpreters were addressed as other problems by the participants. Interpreter competence and patient confidence in the interpreter are essential for an adequate cross-cultural health communication. Assignment of interpreters should be based on knowledge of the patient's/client's mother tongue, rather than citizenship, and the outcome is improved by a common ethnic and cultural background of interpreter and patient/client. Our study should be considered as a pilot study, and the results should be validated in larger cohorts as well as in other ethnic and language groups. In order to minimize communication misunderstandings, complicated tri-lingual interpretation situations should be avoided. Interpreters should ideally be assigned according to patient's/client's mother tongue rather than citizenship. Interpreters' competence and patient's/client's confidence in interpreter may have significant impact on communication outcome. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Culturally sensitive social work practice with Arab clients in mental health settings.

PubMed

al-Krenawi, A; Graham, J R

2000-02-01

Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.

African-American women: considering diverse identities and societal barriers in psychotherapy.

PubMed

Greene, B

1996-06-18

Effective psychotherapy with African-American women explicitly requires cultural literacy and competence of its practitioners. Cultural literacy includes understanding the collective social plight of African-American women and the individual client in the context of the prevailing reality of race, gender, and sexual orientation bias and the interpersonal and institutional barriers that result from that bias. Cultural literacy presumes a willingness on the part of the therapist to educate himself or herself about the clients cultural background and milieu and validate the client's accurate perceptions of discrimination and bias and their impact on the client's life. Cultural competence may be seen as the appropriate level of technical skill in applying those concepts to the understanding of the client and the conduct of the psychotherapeutic inquiry. The culturally literate practitioner will acknowledge and appreciate the wide range of diversity within African-American women as a group. The individual client's intrapsychic and familial endowments and personal relationship history as they are embedded in the aforementioned context should be carefully explored and understood as well as are all relevant social factors. Finally, therapists must be willing to scrutinize their own feelings and motivations for working with African-American women. What should follow is a careful analysis of the developmental interactions of these variables, how they promote an individual's view of the world, her perceptions of her options, her strategies for negotiating institutional barriers, her relationships with other persons, as well as any contributions she makes, consciously or unconsciously, to her own dilemma. A culturally literate and antiracist therapist must begin with an understanding of the role of multiple identities and oppressions in client's lives and must have or be willing to acquire a familiarity with the clients' cultural and ethnic heritage and the role of institutional barriers in a client's life. This includes clients' varying experiences of their ethnic and cultural history. The therapist must also be willing to acknowledge each client's personal barriers and resources by exploring significant figures, relationships, and their patterns, and events in their personal lives. Having done all of this, the therapist must avoid the temptation to reduce a client's dilemma to a series of dichotomized "either-ors." Rarely is institutional oppression the sole source of all of a client's difficulties. The struggle of negotiating discriminatory barriers may at times be less painful to explore than troubled or conflicted personal histories with loved and trusted figures. It is essential to strike an appropriate balance between prematurely dismissing a client's realistic complaints about discrimination and focusing on such complaints exclusively. Similarly, exploring or exposing personal difficulties in a client's life should not be used to minimize problems that are a function of the client's oppressed status. While there are realistic racist and sexist barriers in the world that African-American women share as a group, each individual has her own unique experience and understanding of that reality, and that is what the therapist seeks ultimately to understand. The therapist must avoid romanticizing the strengths forged from African-American women's struggles with institutional barriers by neglecting to appreciate the often debilitating effects of those struggles. Furthermore, the temptation to use these struggles as an explanation for all of a client's problems must be avoided as well. Exposing or exploring the parameters of characterological difficulty or psychopathology in a client does not mean that she is to "blame" for everything that happens to her or that racism and sexism are just excuses for internal deficiencies.

Uptake and Repeat Use of Postexposure Prophylaxis in a Community-Based Clinic in Los Angeles, California

PubMed Central

Bolan, Robert K.; Flynn, Risa P.; Kerrone, Dustin R.; Pieribone, David L.; Kulkarni, Sonali P.; Stitt, Jackelyn C.; Mejia, Everardo; Landovitz, Raphael J.

2014-01-01

Abstract Postexposure prophylaxis (PEP) has become an important tool for HIV prevention in the men who have sex with men (MSM) communities within Los Angeles County. However, it is unclear as to whether the most sexually at-risk MSM populations are accessing PEP services. Furthermore, it is unclear what behavioral risk factors differentiate individuals who utilize PEP once (single PEP) versus those who utilize it multiple times (re-PEP). Data were collected between May 2011 and December 2012 on all clients enrolled in the Los Angeles LGBT Center's (the Center) PEP-LA program as well as on all sexually transmitted infection (STI) screening clients visiting the Center. Multivariate logistic regression models were used to analyze results. PEP clients had greater odds of having a history of gonorrhea in the past year when compared to high-risk, non-PEP clients (OR: 1.71; CI: 1.25–2.35). Furthermore, they had greater odds of using methamphetamines (OR: 1.71; CI: 1.30–2.24) and inhaled nitrates (OR: 1.62; CI: 1.30–2.01) in the past 12 months when compared to high-risk, non-PEP clients. Re-PEP clients had greater odds of methamphetamine use than single PEP clients (OR: 2.80; CI: 1.65–4.75). There were no significant differences by race/ethnicity between high-risk, non-PEP clients and PEP clients in either the entire cohort or MSM only sample. However, African Americans made up 8.5% of persons accessing PEP services but 16.7% of persons who tested HIV positive. Similar proportions of PEP use by race/ethnicity are problematic considering the disproportionate burden of HIV infections in the African American community. Although uptake among the highest risk populations has been brisk (n=649), inequities based upon race/ethnicity suggest the need for increased outreach. PMID:24970113

Making Cross-Racial Therapy Work: A Phenomenological Study of Clients' Experiences of Cross-Racial Therapy

ERIC Educational Resources Information Center

Chang, Doris F.; Berk, Alexandra

2009-01-01

A phenomenological and consensual qualitative study of clients' lived experiences of cross-racial therapy was conducted to enhance the understanding of whether, how, and under what conditions race matters in the therapy relationship. The sample consisted of 16 racial and/or ethnic minority clients who received treatment from 16 White, European…

Gender Disparities in Utilization and Outcome of Comprehensive Substance Abuse Treatment Among Racial/Ethnic Groups

PubMed Central

Guerrero, Erick G.; Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon; Andrews, Christina

2014-01-01

This study examined gender differences within Black, Latino, and White subgroups in the utilization of comprehensive services and their relation to posttreatment substance use. Survey data were collected during the National Treatment Improvement Evaluation Study (NTIES), a prospective, longitudinal, multisite study of substance abuse treatment programs and their clients in the United States. The analytic sample consisted of 1,812 Blacks (734 women and 1,078 men), 486 Latinos (147 women and 339 men), and 844 Whites (147 women and 339 men) from 59 service delivery organizations. Results related to service utilization indicated that compared to men, women in all racial and ethnic groups needed and received more services targeted to their needs and reported more positive relations with service providers. Gender was a significant moderator of the relationship between service receipt and treatment outcomes for all racial and ethnic groups, but especially for the Latino subsample. Findings point to the need to consider race-specific gender differences in the development of culturally competent, comprehensive substance abuse treatment. PMID:24560127

Adherence to antipsychotics among Latinos and Asians with schizophrenia and limited English proficiency

PubMed Central

Gilmer, Todd P.; Ojeda, Victoria D.; Barrio, Concepcion; Fuentes, Dahlia; Garcia, Piedad; Lanouette, Nicole M.; Lee, Kelly C.

2011-01-01

OBJECTIVES We examined the relationship between preferred English, Spanish, or an Asian language for mental health services and adherence to treatment with antipsychotic medication and Medi-Cal beneficiaries with schizophrenia in San Diego, California. METHODS Data included 31,560 person-years from 1999–2004. Pharmacy records were analyzed to assess adherence to antipsychotic medication, based on the medication possession ratio (MPR). Clients were defined as nonadherent (MPR<0.5), partially adherent (0.5<=MPR<0.8), adherent (0.8<=MPR<=1.1), or as an excess filler (MPR>1.1). Regression models were used to examine adherence, hospitalization, and costs by race/ethnicity and language status. RESULTS Limited English proficient Latinos were more likely to be adherent to antipsychotic medications than English proficient Latinos (40.8% vs. 35.9%, P<0.001). Limited English proficient Latinos were less likely to be excess fillers than English proficient Latinos (15.1% vs. 20.4%, P<0.001). Limited English proficient Asians were less likely to be adherent than English proficient Asians (40.1% vs. 45.1%, P=0.034). Compared to English proficient Asians, limited English proficient Asians were more likely to be nonadherent (28.7% vs. 22.0%, P<0.001) and less likely to be excess fillers (12.5% vs. 17.4%, P=0.004). Controlling for adherence and comorbidities, limited English proficient clients had lower rates of hospitalization and health care costs than English proficient and white clients. CONCLUSIONS Adherence to antipsychotic medications varies among and within ethnic groups by English proficiency. Policies supporting the training of bilingual and multicultural ethnic minority providers, and interventions that capitalize on existing social support networks, may improve adherence to treatment among linguistically diverse populations. PMID:19176410

‘A morass of considerations’: exploring attitudes towards ethnicity-based haemoglobinopathy-carrier screening in primary care

PubMed Central

Henneman, L; de Jonge, A; van El, C G; van Tuyl, L H; Cornel, M C; Lagro-Janssen, A L M

2013-01-01

Background. The Netherlands does not have a national haemoglobinopathy (HbP)-carrier screening programme aimed at facilitating informed reproductive choice. HbP-carrier testing for those at risk is at best offered on the basis of anaemia. Registration of ethnicity has proved controversial and may complicate the introduction of a screening programme if based on ethnicity. However, other factors may also play a role. Objective. To explore perceived barriers and attitudes among GPs and midwives regarding the registration of ethnicity and ethnicity-based HbP-carrier screening. Methods. Six focus groups in Dutch primary care, with a total of 37 GPs (n = 9) and midwives (n = 28) were conducted, transcribed and content analysed using Atlas-ti. Results. Both GPs and midwives struggled with correctly identifying ethnicities at risk for HbP. Ethical concerns regarding privacy seemed to originate from World War II experiences, when ethnic and religious registration facilitated deportation of Jewish citizens, coupled with the political climate at the time focus groups were held. Some respondents thought the ethnicity question might undermine the relationship with their clients. Software programmes prevented GPs from registering ethnicity of patients at risk. Financial implications for patients were also a concern. Despite this, respondents seemed positive about screening and were familiar with identifying ethnicity and used this for individual patient care. Conclusions. Although health professionals are generally positive about screening, ethical, financial and practical issues surrounding ethnicity-based HbP-carrier screening need to be clarified before introducing such a programme. Primary care professionals can be targeted through professional organizations but they need national policy support. PMID:23629736

Rural Status, Suicide Ideation, and Telemental Health: Risk Assessment in a Clinical Sample.

PubMed

Tarlow, Kevin R; Johnson, Tina A; McCord, Carly E

2018-06-25

Individuals living in rural areas die by suicide at higher rates than those living in metropolitan areas. Telemental health interventions provide rural residing individuals with access to needed care. Identifying telemental health clients at risk for suicide is an important task for clinicians and policymakers. This study evaluated to what degree rural status and other demographic variables predicted suicide ideation in clients seeking services at a telemental health clinic. Study participants included 457 low-income clients residing in the medically underserved, geographically diverse Brazos Valley region of Texas. Clients completed the patient health questionnaire during their initial counseling appointment, which assessed depression severity and suicide ideation in the 2 weeks prior to assessment. Suicide ideation was common among telemental health clients, with approximately 40% of clients in all demographic groups reporting some recent thoughts of suicide. Rates of suicide ideation did not significantly differ by geographic designation (ie, rural/metropolitan status), gender, or race/ethnicity. However, depression was a strong predictor of recent suicide ideation. Telemental health programs can effectively connect clinicians with rural residing clients who are otherwise isolated from health care services. However, clinicians working in high-need, historically underserved areas should be prepared to encounter a high prevalence of suicide ideation and depression. In these regions, clinical and diagnostic features may be better indicators of suicide ideation than demographic variables. © 2018 National Rural Health Association.

Directions in Rehabilitation Counseling. Volume 9.

ERIC Educational Resources Information Center

Directions in Rehabilitation Counseling, 1998

1998-01-01

Rehabilitation counselors must stay apprised of numerous issues in their field. To help them remain current, this volume features 12 lessons which can count as continuing education credits. Lesson 1 explores issues surrounding Latino clients, focusing on cultural considerations, ethnic identity, and the counselor-client relationship. Sexuality…

Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults with Type 2 Diabetes?

ERIC Educational Resources Information Center

Murayama, Hiroshi; Spencer, Michael S.; Sinco, Brandy R.; Palmisano, Gloria; Kieffer, Edith C.

2017-01-01

Background: Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective…

African Urbanism: Preparation for Multi-Ethnic Schools' Counselors.

ERIC Educational Resources Information Center

Makinde, Olu

1987-01-01

Focuses on cross-cultural perspectives of urbanization and urbanism by comparing the Yoruba cities of western Nigeria with cities of Europe and North America. Concludes that cross-cultural counselors working with Yoruba clients must understand Yoruba city clients and their home life, physical environment, family structure, parent attitudes, and…

Judging Mental Disorder in Youths: Effects of Client, Clinician, and Contextual Differences

ERIC Educational Resources Information Center

Pottick, Kathleen J.; Kirk, Stuart A.; Hsieh, Derek K.; Tian, Xin

2007-01-01

Using a vignette-based, mailed survey of 1,401 experienced psychologists, psychiatrists, and social workers, the authors examined how clients' race/ethnicity and clinicians' professional and social characteristics affect their judgment of mental disorder among antisocially behaving youths. Vignettes described problematic behaviors meeting the …

Treatment Strategies for Hispanic Developmentally Disabled Clients.

ERIC Educational Resources Information Center

Omdahl, Doris

Professionals who work with developmentally disabled Hispanic clients must enhance their own ability to work with ethnic minorities and become thoroughly familiar with the culture of the people they serve. To encourage disabled Hispanic individuals to apply for services, agencies can employ strategies such as bilingual capability, use of…

Ethical Issues in Counseling Religious Clients.

ERIC Educational Resources Information Center

Gardner, Jim N.

While the mental health profession's acceptance of cultural diversity has been commendable with regard to race, gender, and ethnicity, it has not extended this acceptance adequately to the religious client: counselors have failed to adhere to the American Counseling Association's Code of Ethics when working with this particular population. There…

A Systematic Review of Promising Strategies of Faith-Based Cancer Education and Lifestyle Interventions Among Racial/Ethnic Minority Groups.

PubMed

Hou, Su-I; Cao, Xian

2017-09-13

Church-based interventions have been used to reach racial/ethnic minorities. In order to develop effective programs, we conducted a comprehensive systematic review of faith-based cancer prevention studies (2005~2016) to examine characteristics and promising strategies. Combination terms "church or faith-based or religion," "intervention or program," and "cancer education or lifestyle" were used in searching the five major databases: CINAHL; ERIC; Health Technology Assessments; MEDLINE; and PsycInfo. A total of 20 studies met study criteria. CDC's Community Guide was used to analyze and review group interventions. Analyses were organized by two racial groups: African American (AA) and Latino/Hispanic American groups. Results showed most studies reviewed focused on breast cancer alone or in combination with other cancers. Studies of Latino/Hispanic groups targeted more on uninsured, Medicare, or Medicaid individuals, whereas AA studies generally did not include specific insurance criteria. The sample sizes of the AA studies were generally larger. The majority of these studies reviewed used pre-post, posttest only with control group, or quasi-experience designs. The Health Belief Model was the most commonly used theory in both groups. Community-based participatory research and empowerment/ecological frameworks were also used frequently in the Latino/Hispanic studies. Small media and group education were the top two most popular intervention strategies in both groups. Although one-on-one strategy was used in some Latino studies, neither group used reducing client out-of-pocket costs strategy. Client reminders could also be used more in both groups as well. Current review showed church-based cancer education programs were effective in changing knowledge, but not always screening utilization. Results show faith-based cancer educational interventions are promising. To maximize intervention impact, future studies might consider using stronger study designs, incorporating a variety of proven effective strategies, including those frequently used evidence-based strategies, as well as exploring promising strategies among specific target groups.

Breaking traditions: sexual health and ethnicity in nursing research: a literature review.

PubMed

Serrant-Green, Laura

2005-09-01

The aim of this paper is to explore some reasons for the lack of focus on ethnicity and sexual health in nursing research, and suggest ways to advance the nursing evidence-base required for practice development. The United Kingdom National Strategy for Sexual Health and human immunodeficiency virus published in July 2001 highlighted the continued rise in sexual ill health amongst minority ethnic groups. In order to improve sexual health, research evidence is needed explain why particular ethnic groups appear to be at greater risk of sexual ill health. The Strategy identified nurses as key to bringing about improvements in sexual health. Nursing research includes many studies exploring links between ethnicity and health. However, with the exception of extensive work on human immunodeficiency virus/acquired immunodeficiency syndrome as a specific disease, nursing research into ethnicity has not systematically included sexual health. Literature searches were conducted using the BIDS database, World Wide Web and United Kingdom Department of health website between June 2000 and August 2003. Papers written in English incorporating the keywords 'sexual health', 'sexually transmitted infection' and 'health and ethnicity' in the title or abstract were selected for review. Nursing research into the association between sexual health and ethnicity is rare. It has been hampered by a variety of political and social constraints concerning the nature of sexual health practice in nursing, researching sexual health, and researching ethnicity and health. The result is a dearth of research evidence to support the development of sexual health practice and the education of healthcare professionals to underpin care of minority ethnic clients. Barriers to researching ethnicity and sexual health by nurses must be addressed through nursing education and practice. Without this, a detailed evidence base will fail to materialize and healthcare practices to implement the priorities to improve sexual health in minority ethnic communities will remain undeveloped.

Congruence between Culturally Competent Treatment and Cultural Needs of Older Latinos

ERIC Educational Resources Information Center

Costantino, Giuseppe; Malgady, Robert G.; Primavera, Louis H.

2009-01-01

This study investigated a new 2-factor construct, termed "cultural congruence", which is related to cultural competence in the delivery of mental health services to ethnic minority clients. Cultural congruence was defined as the distance between the cultural competence characteristics of the health care organization and the clients' perception of…

The Effect of Bilingualism on Self-Perceived Multicultural Counseling Competence

ERIC Educational Resources Information Center

Ivers, Nathaniel N.; Villalba, José A.

2015-01-01

Ethnic and linguistic minorities continue to underutilize and prematurely terminate counseling services at higher rates than their ethnic majority counterparts. To improve the provision of counseling services to culturally diverse clients, new avenues supported by theory and research need to be uncovered. One factor that has received little…

Effective Counseling for Racial/Ethnic Minority Clients: Examining Changes Using a Practice Research Network

ERIC Educational Resources Information Center

Lockard, Allison J.; Hayes, Jeffrey A.; Graceffo, James M.; Locke, Benjamin D.

2013-01-01

Studies have shown that counseling decreases students' academic distress. These findings, however, are based primarily on European American students. This study explored the impact of counseling on academic distress for treatment-seeking racial/ethnic minority college students using the Counseling Center Assessment of Psychological…

Nursing clients of Greek ethnicity at home.

PubMed

Davidhizar, R; King, V; Bechtel, G; Giger, J N

1998-09-01

The home healthcare nurse who cares for persons with Greek ancestry should be aware of their unique cultural heritage. The nurse should also be aware that Greek people throughout the world are proud and independent, valuing their religious faith and practices, good health, education, and success. Care should be designed to include appreciation of traditions and customs that these clients may have. The nurse should make a special effort to develop trust with the Greek client and family members in order to effectively implement culturally competent healthcare.

Pregnancy intentions among female sex workers: recognising their rights and wants as mothers.

PubMed

Duff, Putu; Shoveller, Jeannie; Feng, Cindy; Ogilvie, Gina; Montaner, Julio; Shannon, Kate

2015-04-01

To better understand the prevalence and correlates of pregnancy intentions among female sex workers (FSWs). Cross-sectional analysis using data from an open prospective cohort of street and off-street FSWs in Vancouver, Canada, in partnership with local sex work and community agencies. FSWs were recruited through outreach to street and off-street locations (e.g. massage parlours, micro-brothels) and completed interviewer-administered questionnaires and HIV/sexually transmitted infection testing. Bivariable and multivariable logistic regression was used to evaluate correlates of pregnancy intention, based on a 'yes' or 'no' response to the question "Are you planning on have any (any more) children in the future?". Of the 510 women, 394 (77.3%) reported prior pregnancy, with 140 (27.5%) of the entire sample reporting positive pregnancy intentions. Regarding ethnicity, 35.3% were Caucasian and 26.3% were Asian/visible minority, with no differences in pregnancy intention by ethnicity or HIV status; 38.4% reported Canadian Aboriginal ancestry. In our final multivariable model, servicing clients in formal indoor settings, inconsistent condom use by clients, younger age, and intimate partner violence (IPV) were associated with pregnancy intention. FSWs may have pregnancy intention levels similar to that of women in other occupations. Policy changes are needed to improve FSWs' access to integrated HIV and reproductive health services and harm reduction services, particularly for FSWs experiencing IPV. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cross-Cultural Counseling. A Guide for Nutrition and Health Counselors.

ERIC Educational Resources Information Center

Schilling, Brenda; And Others

The United States is a land of people with diverse cultural and ethnic backgrounds. There will be a time when every counselor is called on to serve clients from a culture different from his or her own. This guide promotes awareness of cross-cultural counseling problems, and provides information for counseling clients with different beliefs,…

Cultural sensitivity and supportive expressive psychotherapy: an integrative approach to treatment.

PubMed

White, Tracela M; Gibbons, Mary Beth Connolly; Schamberger, Megan

2006-01-01

Cultural sensitivity is a concept that has become increasingly important in psychotherapy research and practice. In response to the growing ethnic minority population and the increased demand for psychological services among minority clients, many therapists and researchers have attempted to identify competencies and guidelines for providing culturally sensitive approaches to treatment. However, many cultural sensitivity concepts are theoretical and have rarely been integrated into an established psychotherapeutic framework. The purpose of this manuscript is to operationalize the concepts of cultural sensitivity into specific therapeutic techniques using a manual-guided Supportive Expressive Psychotherapy approach. Developing these strategies may serve to further assist therapists with the delivery of mental health services to ethnic minority clients.

Racial and Ethnic Differences in Substance Abuse Service Needs, Utilization, and Outcomes in California

PubMed Central

Niv, Noosha; Pham, Rhoda; Hser, Yih-Ing

2010-01-01

Objective This study examined differences in service needs and treatment utilization, retention, and outcomes between African-American, Hispanic, and white substance abusers in community-based treatment programs. Methods Data were collected from 2,401 African Americans, 3,222 Hispanics, and 7,980 whites who were admitted to 43 drug treatment programs across California from 2000 to 2001. The Addiction Severity Index (ASI) was administered at intake to assess clients’ problem severity in a number of domains (alcohol use, drug use, employment, family and social relationships, legal, medical, and psychological), and treatment retention and arrest data were obtained from administrative records. A subsample was followed up at three months to assess service utilization (N=2,145) and again at nine months to readminister the ASI (N=2,566). Results All three groups had similar severity levels of drug and legal problems upon treatment entry. Upon entry to treatment, white clients had the highest severity levels of alcohol, family, and psychiatric problems and African Americans had the highest severity levels of employment problems compared with the other two groups. Treatment retention did not differ between the three groups, but whites received a greater number of alcohol treatment services than did African Americans or Hispanics, and African Americans received a greater number of employment services than did Hispanic and white clients. All three groups showed significant improvement in all outcome domains except for medical outcomes. At the nine-month follow-up, whites had worse outcomes in the alcohol domain compared with the other two groups, and whites had worse outcomes in the legal domain compared with Hispanics. Compared with whites, African Americans were significantly less likely to be charged with driving under the influence in the year after treatment admission. Conclusions All three groups improved after treatment, although benefits from treatment can be further enhanced if services underscore different facets of the psychosocial problems of each racial and ethnic group. PMID:19797375

A Self-Assessment of Cultural Competence in Military Mental Health Providers

DTIC Science & Technology

2008-01-31

attitudes about the mental health system, and are more concerned about therapist cultural competence (Banks, 2001). Asian Americans (Herrick & Brown...competence expertise and therapists with extensive clinical experience and training in working with ethnic minorities. There was poor overall agreement...American client reporting seeing spirits. A culturally competent therapist might approach this piece of information by hypothesizing that the client

Three year outcomes in an early intervention service for psychosis in a multicultural and multiethnic population.

PubMed

Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Persaud, Albert; Murphy, Suzanne; Zaman, Rashid

2008-12-01

Concern has been expressed that it may be difficult to provide certain interventions to some ethnic groups in an Early Intervention Service for Psychosis, and that as a consequence, three-year outcomes for the different Ethnic Groups may be different in different groups. To test whether there are differences between the three year outcomes of different ethnic groups represented in the patient population of an Early Intervention service for Psychosis. The three-year outcomes for the first group of 62 Patients to receive three years treatment in the Early Intervention Service in Luton, Bedfordshire were examined. This group well represented the ethnic mix of the population of Luton. It does not appear that there are major differences between the three-year outcomes of any one of the three groups studied. However the South Asian Patients appear to present earlier, with shorter DUPs, seemed more likely to marry, live with their families, and seem more likely to return to higher education after a first psychotic episode of psychosis compared to the Caucasians. Afro-Carribeans and South Asians were more likely to be unemployed, but many South Asians were employed, as were Caucasians. The fewest persons employed were in the Afro-Caribbean group. While slightly more South Asians and Afro-Carribeans were admitted compulsorily under the mental health act over the three years, 60% of each of the two non-white groups were never admitted compulsorily. This is different from the reported national trends of the Mental Health act being used excessively with the Afro-Caribbean population. No previous study has looked at the outcomes of Early Intervention Services for First Psychotic Episodes according to the Ethnic Origin of the Clients. The better outcomes seen with South Asians are probably due to cultural factors among the South Asians born in this country, rather than to issues related to the Psychotic Illness itself. These findings are important in planning services in areas where there is much ethnic diversity. The above conclusions must be understood as relating to patients who are well engaged with services. It would be unwise to extrapolate these outcomes to patients in the general population who have not engaged with services.

Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults With Type 2 Diabetes?

PubMed

Murayama, Hiroshi; Spencer, Michael S; Sinco, Brandy R; Palmisano, Gloria; Kieffer, Edith C

2017-06-01

Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective program design, few studies have explored whether levels of racial/ethnic identity among participants can influence the effectiveness of CHW interventions. We tested the relationship between level of racial/ethnic identity and changes in hemoglobin A1c and diabetes self-efficacy among low-income African American and Latino adults with type 2 diabetes who participated in a CHW intervention. Data came from a randomized controlled trial of the CHW intervention with a 6-month delayed control group design for 164 African American and Latino adults in Detroit, Michigan. Racial/ethnic identity was created from two items and classified into high, moderate, and low. We combined the two arms (immediate and delayed) into one because there was no significant difference in baseline characteristics, other than age and postintervention self-efficacy, and multivariable linear regression models were applied in the analysis. Possession of high racial/ethnic identity was associated with greater improvement both in hemoglobin A1c and diabetes self-efficacy at 6 months. Moreover, among those with high hemoglobin A1c at preintervention, higher racial/ethnic identity had a greater impact on hemoglobin A1c improvement, compared with those with lower identity. This study suggests the importance of considering racial/ethnic identity of the participants in designing and operating the CHW intervention for racial/ethnic minority population.

The future of intercultural mediation in Belgium.

PubMed

Nierkens, Vera; Krumeich, Anja; de Ridder, Ri; van Dongen, Martien

2002-04-01

Intercultural mediation was developed to solve problems between western (Belgian) health professionals and Turkish, Moroccan and Italian clients. The need for intercultural mediation in Belgium Health Care was measured by asking intercultural mediators to complete a questionnaire about situations in which language, culture, social-economic and personal circumstances cause difficulties. Results show that the profession 'intercultural mediator' continues to be important in improving the quality and accessibility of the Belgian health care for ethnic minorities. Even if clients speak Flemish fluently, there are still difficulties between health professional and client caused by culture, social-economic and personal circumstances.

Euro-Education: Employability for all (EEE4all). Design and implementation of an international course for future health-care professionals.

PubMed

Lindh Falk, Annika E; Sandqvist, Jan L; Liedberg, Gunilla M

2012-01-01

Employment is a priority in the European Union, and it is essential to address the needs of individuals disadvantaged at the labour market on grounds such as ethnicity, age, gender or disability, to increase the opportunities for these groups to gain employment. The Council of the European Union recognize the important role of national organisations in increasing gender equality and the need to integrate a gender perspective in all policies. Gender equality perspectives should also, according to the EU Plan of Action and Gender Equality be integrated in education. To equip students in higher education with knowledge, about gender, age, disability and ethnicity in relation to employability, a European group initiated a project; Euro-Education: Employability for all (EEE4all). The project, funded by the European Lifelong Learning Programme, was aimed to develop and implement four course modules, each relating to employability with different focus: gender, age, disability or ethnicity. In this paper design, implementation, and evaluation of the course focused on gender, provided by the Occupational Therapy Programme at Linkoping University, is described. The students highlighted the importance of awareness and knowledge about gender theory and its application in relation to employability and client-centred approach.

The health care system: factoring in the ethnicity, cultural and health care needs of women and children of color.

PubMed

Griffin, F N

1994-01-01

The author reviews the literature on factors which influence the health of African Americans. The concept of poverty as a health problem is discussed as well as the feminization of poverty. The author implores health care workers, to begin to implement the concepts of ethnicity and culture when giving care to clients of color.

Depressive symptoms of elderly Chinese in Guangzhou, Hong Kong, and Taipei.

PubMed

Lai, Daniel W L

2009-09-01

Understanding the socio-cultural context is an important pre-requisite for understanding global aging and mental health. This study aimed to examine the variation in the types of depressive symptoms of aging Chinese in three ethnic Chinese societies. Data were based on a mixed purposive and random sample of aging Chinese in Guangzhou, Hong Kong, and Taipei. The 891 Chinese participants of 65 years or older were included. Depressive symptoms were measured by a Chinese 15-item Geriatric Depression Scale. Factor analysis was used to identify the factor structure of the scale when used with elderly Chinese in the three cities. There are 'within-ethnic group' differences in manifestation of depressive symptoms. Symptoms of the elderly Chinese in Guangzhou and Hong Kong were similarly related to items that indicate uncertainty and disinterest in living. The ones in Taipei expressed symptoms indicating disinterest and a negative mood. These differences were probably due to the variations in the socio-cultural, demographic, and structural characteristics among the three cities. Depressive symptoms can be culturally related and manifested differently by people sharing a similar ethnicity. The same ethnicity does not mean homogeneity. The findings should be useful for mental health practitioners in Western societies working with older Chinese immigrants. Knowing the mental health characteristics of these client groups will facilitate the designing of appropriate assessment and intervention tools to fit the culturally unique mental health needs of different subgroups in these ethno-cultural communities.

Examining the premises supporting the empirically supported intervention approach to social work practice.

PubMed

McBeath, Bowen; Briggs, Harold E; Aisenberg, Eugene

2010-10-01

Federal, state, and local policymakers and funders have increasingly organized human service delivery functions around the selection and implementation of empirically supported interventions (ESIs), under the expectation that service delivery through such intervention frameworks results in improvements in cost-effectiveness and system performance. This article examines the validity of four premises undergirding the ESI approach: ESIs are effective, relevant to common client problems and needs, culturally appropriate, and replicable and sustainable in community-based settings. In reviewing available literature, the authors found insufficient support for the uniform application of an ESI approach to social work practice in the human service sector, particularly as applied within agency contexts serving ethnic minority clients. The authors recommend that greater attention be devoted to the development and dissemination of social work interventions that respond to needs that are broadly understood and shared across diverse cultural groups, have proven clinical efficacy, and can be translated successfully for use across different agency and cultural environments. Such attention to the research and development function of the social work profession is increasingly necessary as policymakers and human service system architects require reduced costs and improved performance for programs serving historically oppressed client populations.

Prevalence of HCV infection among clients in community-based health settings in Hawaii, 2002-2010: assessing risk factors.

PubMed

Porter, Jeremy C; Lusk, Heather M; Katz, Alan R

2014-08-01

We sought to determine the prevalence of HCV infection and identify risk factors associated with HCV infection among at-risk clients presenting to community-based health settings in Hawaii. Clients from 23 community-based sites were administered risk factor questionnaires and screened for HCV antibodies from December 2002 through May 2010. We performed univariate and multivariate logistic regression analyses. Of 3306 participants included in the analysis, 390 (11.8%) tested antibody positive for HCV. Highest HCV antibody prevalence (17.0%) was in persons 45 to 64 years old compared with all other age groups. Significant independent risk factors were current or prior injection drug use (P < .001), blood transfusion prior to July 1992 (P = .002), and having an HCV-infected sex partner (P = .03). Stratification by gender revealed sexual exposure to be significant for males (P = .001). Despite Hawaii's ethnic diversity, high hepatocellular carcinoma incidence, and a statewide syringe exchange program in place since the early 1990s, our HCV prevalence and risk factor findings are remarkably consistent with those reported from the mainland United States. Hence, effective interventions identified from US mainland population studies should be generalizable to Hawaii.

Client Predictors of Short-term Psychotherapy Outcomes among Asian and White American Outpatients

PubMed Central

Kim, Jin E.; Zane, Nolan W.; Blozis, Shelley A.

2015-01-01

Purpose To examine predictors of psychotherapy outcomes, focusing on client characteristics that are especially salient for culturally diverse clients. Method Sixty clients (31 women; 27 White Americans, 33 Asian Americans) participated in this treatment study. Client characteristics were measured at pre-treatment, and outcomes were measured post-fourth session via therapist ratings of functioning and symptomatology. Regression analyses were utilized to test for predictors of outcomes, and bootstrap analyses were utilized to test for mediators. Results Higher levels of somatic symptoms predicted lower psychosocial functioning at post-treatment. Avoidant coping style predicted more negative symptoms and more psychological discomfort. Non-English language preference predicted worse outcomes; this effect was mediated by an avoidant coping style. Conclusions Language preference, avoidant coping style, and somatic symptoms predicted treatment outcome in a culturally diverse sample. Findings suggest that race/ethnicity-related variables may function through mediating proximal variables to affect outcomes. PMID:22836681

Kin KeeperSM: Design and Baseline Characteristics of a Community-Based Randomized Controlled Trial Promoting Cancer Screening in Black, Latina, and Arab Women

PubMed Central

Williams, Karen Patricia; Roman, LeeAnne; Meghea, Cristian Ioan; Penner, Louis; Hammad, Adnan; Gardiner, Joseph

2013-01-01

Background Although breast and cervical cancer deaths have declined due to early screening, detection, and more effective treatment, racial and ethnic disparities persist. This paper describes the study design and baseline characteristics of a randomized controlled trial (RCT) evaluating the effectiveness of the Kin KeeperSM Cancer Prevention Intervention, a family-focused educational intervention for underserved women applied in a community-based setting to promote health literacy and screening adherence to address cancer disparities Methods Female public health community health workers (CHWs) were trained to administer the intervention. They recruited female clients from their public health program caseload and asked each to assemble two to four adult female family members for the breast and cervical cancer home-based education sessions the CHWs would deliver in English, Spanish or Arabic. We randomized the clients into the kin keeper group (treatment) or the participant client group (control) Results Complete data were obtained on 514 Black, Latina, and Arab women. Close to half were unemployed and had yearly family income below $20,000. Thirty-four percent had no medical insurance, and 21% had diabetes. Almost 40% had no mammography in the last year. Treatment and control groups were similar on most sociodemographics but showed differences in breast and cervical screening history. Conclusions This innovative study demonstrates the implementation of an RCT using community-based participatory research, while delivering cancer prevention education across woman’s life span with women not connected to the health care system. PMID:23274402

The staying power of pain. A comparison of torture survivors from Bosnia and Colombia and their rates of anxiety, depression and PTSD.

PubMed

Alexander, Abigail; Blake, Stacie; Bernstein, Michael A

2007-01-01

The article describes symptoms of anxiety, depression and PTSD among Bosnian (n=17) and Colombian (n=17) torture survivors served by the Florida Center for Survivors of Torture, a programme of Gulf Coast Jewish Family Services, Inc. Information from clients enrolled in the programme for six months or more was collated over a 14 month period in order to better prioritize and design services for the two distinct populations. On average, the Bosnians in this sample experienced torture approximately 14 years ago while the Colombians'experience was approximately six years ago. Types of torture experienced by clients are documented using HURIDOCS and the number of family and friends affected by extreme trauma are counted. Employment and education levels attained are also identified. Findings show that 100% of Bosnians are symptomatic for depression and over half possess symptoms of PTSD compared to 35% of Colombians for depression and 18% for PTSD, despite the differences in years since trauma occurred. High incidences of torture experienced by Bosnian clients and high numbers of family and friends affected support the high rates of symptoms. For the Colombian clients, high rates of employment and years of education, as well as earlier intervention, may contribute to their lower rates of symptoms. The two client groups are distinguished by the unique circumstances experienced by each, including punctuated wartime versus a prolonged insurgency, as well as the refugee versus asylum seeker experience. This exploratory project informs the torture treatment model while recognizing the importance of ethnic, political and cultural perspectives affecting the healing process.

Provider Cultural Competency, Client Satisfaction, and Engagement in Home-Based Programs to Treat Child Abuse and Neglect

PubMed Central

Damashek, Amy; Bard, David; Hecht, Debra

2017-01-01

Home-based programs to treat child abuse and neglect suffer from high rates of attrition, limiting their impact. Thus, research is needed to identify factors related to client engagement. Using data (N = 1,305) from a statewide family preservation program, this study investigated the role of program type (i.e., SafeCare® [SC] vs. Services as Usual [SAU]) and client perceived provider cultural competence on client satisfaction and engagement with services. Families in SC completed more treatment goals than those in SAU. In addition, provider cultural competence and client satisfaction were higher in SC than in SAU. Higher provider cultural competence was associated with higher goal attainment and satisfaction, and these effects partially mediated the service program differences. The effects of service type and cultural competence on goal attainment and satisfaction varied somewhat by client ethnicity. Findings suggest that clients receiving manualized programs for child maltreatment may be more likely to meet their goals and may perceive such programs to be culturally appropriate and satisfactory. PMID:22007034

Do therapist cultural characteristics influence the outcome of substance abuse treatment for Spanish-speaking adults?

PubMed Central

Suarez-Morales, Lourdes; McCabe, Brian E.; Feaster, Daniel J.; Martino, Steve; Cuzmar, Ivette Y.; Carroll, Kathleen M.; Bedregal, Luis; Paris, Manuel; Szapocznik, José

2010-01-01

This secondary data analysis of the Clinical Trials Network’s Motivational Enhancement Therapy effectiveness trial with Spanish-speaking substance users examined whether the degree of birthplace and acculturation similarities between clients and therapists, as well as the therapists’ own level of acculturation and birthplace were related to the clients’ participation in treatment and level of substance use during outpatient substance use treatment. Sixteen therapists and their 235 clients from the larger effectiveness trial were included in the analyses for this study. Results of the multilevel regression models for client participation in substance use treatment and client days of substance use taking into account within and between therapist cultural characteristics revealed that birthplace match and acculturation similarity between each therapist and his/her clients did not predict client outcomes. Instead, therapists’ birthplace and level of acculturation independently predicted days of substance use, but not treatment participation for monolingual Spanish-speaking clients. These findings are discussed in the context of the results of the main effectiveness trial and of psychotherapy research with ethnic minority populations, in particular Hispanic minorities. PMID:20438158

Client/patient perceptions of achieving equity in primary health care: a mixed methods study.

PubMed

Akhavan, Sharareh; Tillgren, Per

2015-08-12

To provide health care on equal terms has become a challenge for the health system. As the front line in health services, primary care has a key role to play in developing equitable health care, responsive to the needs of different population groups. Reducing inequalities in care has been a central and recurring theme in Swedish health reforms. The aim of this study is to describe and assess client/patient experiences and perceptions of care in four primary health care units (PHCUs) involved in Sweden's national Care on Equal Terms project. Mixed Method Research (MMR) was chosen to describe and assess client/patient experiences and perceptions of health care with regard to equity. There was a focus group discussion, and individual interviews with 21 clients/patients and three representatives of patient associations. Data from the Swedish National Patient Survey (NPS), conducted in 2011 and followed up in 2013, were also used. The interview data were divided into two main categories and three subcategories. The first category "Perception of equitable health care" had two subcategories, namely "Health care providers' perceptions" and "Fairness and participation". The second category "To achieve more equitable health care" had four subcategories: "Encounter", "Access", "Interpreters and bilingual/diverse health care providers" and "Time pressure and continuity". Results from the NPS showed that two of the PHCUs improved in some aspects of patient perceived quality of care (PPQC) while two were not so successful. Clients/patients perceived health care providers' perceptions of their ethnic origin and mental health status as important for equitable health care. Discriminatory perceptions may lead to those in need of care refraining from seeking it. More equitable care means longer consultations, better accessibility in terms of longer opening hours, and ways of communicating other than just via voice mail. It also involves continuity in care and access to an interpreter if needed. Employing bilingual/diverse kinds of health providers is a way of providing more equitable primary health care.

A meta-analysis of multicultural competencies and psychotherapy process and outcome.

PubMed

Tao, Karen W; Owen, Jesse; Pace, Brian T; Imel, Zac E

2015-07-01

For decades, psychologists have emphasized the provision of multiculturally competent psychotherapy to reduce racial and ethnic disparities in mental health treatment. However, the relationship between multicultural competencies (MC) and other measures of clinical process and treatment outcome has shown heterogeneity in effect sizes. This meta-analysis tested the association of client ratings of therapist MC with measures of therapeutic processes and outcome, including: (a) working alliance, (b) client satisfaction, (c) general counseling competence, (d) session impact, and (e) symptom improvement. Among 18 studies (20 independent samples) included in the analysis, the correlation between therapist MC and outcome (r = .29) was much smaller than the association with process measures (r = .75), but there were no significant differences in correlations across different types of MC or clinical process measures. Providing some evidence of publication bias, effect sizes from published studies (r = .67) were larger than those from unpublished dissertations (r = .28). Moderator analyses indicated that client age, gender, the representation of racial-ethnic minority (R-EM) clients, and clinical setting were not associated with effect size variability. Based on these findings, we discuss implications and recommendations for future research that might lead to a better understanding of the effects of therapist MC on treatment process and outcome. Primary needs in future research include the development and evaluation of observer ratings of therapist MC and the implementation of longitudinal research designs. (c) 2015 APA, all rights reserved).

The Cultural Ecogram: A Tool for Enhancing Culturally Anchored Shared Understanding in the Treatment of Ethnic Minority Families

PubMed Central

YASUI, MIWA

2015-01-01

Ethnic and racial disparities in mental health care continue to exist, highlighting the increasing concern within the realm of clinical practice as to how clinicians are to effectively integrate the central role of culture and context into the treatment delivery process for culturally diverse children and families. The current paper presents the Cultural Ecogram, - a clinical engagement tool designed to facilitate the development of a culturally anchored shared understanding – as one method that may facilitate clinician-client shared understanding on the client’s cultural, ethnic and racial context central to the effective implementation of treatments with ethnic minority children and families. PMID:26273233

Organisational systems' approaches to improving cultural competence in healthcare: a systematic scoping review of the literature.

PubMed

McCalman, Janya; Jongen, Crystal; Bainbridge, Roxanne

2017-05-12

Healthcare organisations serve clients from diverse Indigenous and other ethnic and racial groups on a daily basis, and require appropriate client-centred systems and services for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development and student education. This paper aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically mapping key concepts, types of evidence, and gaps in research. A literature search was completed as part of a larger systematic search of evaluations and measures of cultural competence interventions in health care in Canada, the United States, Australia and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched from 2002 to 2015. Overall, 109 studies were found, with 15 evaluating systems-level interventions or describing measurements. Thematic analysis was used to identify key implementation principles, intervention strategies and outcomes reported. Twelve intervention and three measurement studies met our inclusion criteria. Key principles for implementing systems approaches were: user engagement, organisational readiness, and delivery across multiple sites. Two key types of intervention strategies to embed cultural competence within health systems were: audit and quality improvement approaches and service-level policies or strategies. Outcomes were found for organisational systems, the client/practitioner encounter, health, and at national policy level. We could not determine the overall effectiveness of systems-level interventions to reform health systems because interventions were context-specific, there were too few comparative studies and studies did not use the same outcome measures. However, examined together, the intervention and measurement principles, strategies and outcomes provide a preliminary framework for implementation and evaluation of systems-level interventions to improve cultural competence. Identified gaps in the literature included a need for cost and effectiveness studies of systems approaches and explication of the effects of cultural competence on client experience. Further research is needed to explore the extent to which cultural competence improves health outcomes and reduces ethnic and racially-based healthcare disparities.

Exploring perceptions of "wellness" in black ethnic minority individuals at risk of developing psychosis.

PubMed

Codjoe, Louisa; Byrne, Majella; Lister, Matthew; McGuire, Philip; Valmaggia, Lucia

2013-03-01

The NICE Schizophrenia guidelines (NICE, 2009, Update) recommend that services should address cultural differences in treatment, expectations and adherence, and clients' explanatory models of illness should be better understood. Service users from Black African and Black Caribbean communities are overrepresented in psychosis services in the UK, yet there is no literature on how wellness is understood by this group. This study explored perceptions of wellness in Black African and Black Caribbean individuals with an At Risk Mental State (ARMS) for psychosis. A Q set of potential meanings of wellness was identified from a literature search and interviews with people at risk of developing psychosis. From this, 50 potential definitions were identified; twenty Black African and Black Caribbean ARMS clients ranked these definitions. Following factor analysis of completed Q sorts, six factors emerged that offered insight into perceptions of wellness in this population. These factors included: sense of social purpose explanation, the surviving God's test explanation, the internalization of spirituality explanation, understanding and attribution of symptoms to witchcraft explanation, avoidance and adversity explanation, and seeking help to cope explanation. Although preliminary, differences between the factors suggests that there may be perceptions of wellness specific to these groups that are distinct from the medical view of wellness promoted within early detection services. These differences may potentially impact upon engagement, particularly factors that clients feel may facilitate or aide their recovery. It is suggested that these differences need to be considered as part of the assessment and formulation process.

Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

PubMed

Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

2016-08-01

This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cultural diversity and patient teaching.

PubMed

Price, J L; Cordell, B

1994-01-01

Cultural diversity challenges health care providers to facilitate bridging cross-cultural gaps with clients. It is through providing culturally relevant care that health care practitioners truly serve the needs of all clients in our diverse society. A theory of Cultural Care Diversity and Universality offers a framework for building linkages of clinical knowledge to cultural care. A four-step approach to providing culturally sensitive patient teaching is described: (1) health care providers should assess their own cultural beliefs and be aware of general ethnic, regional, and religious beliefs and practices in their area; (2) develop a teaching plan; (3) implement the plan; (4) evaluate the success of the teaching-learning process and make alterations based on evaluation. When providers assess clients' beliefs and practices and incorporate them into the teaching plan design, teaching becomes more relevant and clients become more successful at learning.

[Multi-ethnic nursing].

PubMed

Gambera, Angelo Antonio; Marucci, Anna Rita; Pezzino, Marcello

2008-01-01

Among the many activities of nurses, the role of intermediary between the client and the health institutions is one of the most important . In this role, nurses may have to deal with cultural conflicts in order to fulfill the requirements of a multi-ethnic client population coming from may different cultures. By adopting an instrument capable of assessing the trans-cultural and inter-cultural knowledge of nurses, it may be possible to fill in any gaps by means of appropriate training or education. The study was performed using an anonymous questionnaire issued to the nurses working in the out-patient structures of the Gynaecological and Maternity Department of the Vittorio Emanuele II Hospital in Catania, which deals with the highest number of non-EEC citizens. The results of the questionnaire indicated that educational intervention to improve knowledge of the principal aspects of transcultural and intercultural nursing , as well as other anthropological and caring aspects was required.

Cultural issues in an Outpatient Program for stimulant abusers.

PubMed

Pérez-Arce, P; Carr, K D; Sorensen, J L

1993-01-01

Cocaine abuse has created widespread problems, especially in poor urban ethnic minority communities. This article discusses the cultural issues in delivering a cocaine treatment program to a predominantly minority patient population. The Stimulant Treatment Outpatient Program (STOP) of San Francisco General Hospital's Substance Abuse Services was established in 1990 as a public service clinic. Many program elements apply equally well to various cultural groups, including individual and group counseling, limited time in treatment, and crisis intervention. Culturally linked clinical issues include provision of a supportive infrastructure, role models in leadership positions, understanding the cultural influences in patients' lives, and establishing communication links with Cultural themes are discussed as they apply to treating African-Americans, Latinos, Asian-Americans, Native Americans, and clients of different genders. Programmatic outcome indicators, including program attrition, suggest that different cultural groups benefit differentially from the treatment.

Engaging women from South Asian communities in cardiac rehabilitation.

PubMed

Vishram, S; Crosland, A; Unsworth, J; Long, S

2007-01-01

This study sought to describe experiences and perceptions of cardiac rehabilitation among a sample of women from South Asian communities. Data were collected via eight semi-structured interviews with staff and a focus group discussion with nine clients from a community-based, culturally sensitive cardiac rehabilitation service. A number of individual, cultural and practical barriers to participation were identified. Facilitators centred on whether the format and content of the sessions could be considered "appropriate". For example, a women's dance group proved to be successful through the selection of a familiar local venue, supportive session leader, and activity that was felt to be both enjoyable and beneficial. This study has shown that it is possible to engage hard-to-reach groups in cardiac rehabilitation and physical activity. Further work is needed to explore whether this research is applicable in other ethnic groups and whether the lessons learned could be successfully incorporated into mainstream health services.

Prevalence of HCV Infection Among Clients in Community-Based Health Settings in Hawaii, 2002–2010: Assessing Risk Factors

PubMed Central

Porter, Jeremy C.; Lusk, Heather M.

2014-01-01

Objectives. We sought to determine the prevalence of HCV infection and identify risk factors associated with HCV infection among at-risk clients presenting to community-based health settings in Hawaii. Methods. Clients from 23 community-based sites were administered risk factor questionnaires and screened for HCV antibodies from December 2002 through May 2010. We performed univariate and multivariate logistic regression analyses. Results. Of 3306 participants included in the analysis, 390 (11.8%) tested antibody positive for HCV. Highest HCV antibody prevalence (17.0%) was in persons 45 to 64 years old compared with all other age groups. Significant independent risk factors were current or prior injection drug use (P < .001), blood transfusion prior to July 1992 (P = .002), and having an HCV-infected sex partner (P = .03). Stratification by gender revealed sexual exposure to be significant for males (P = .001). Conclusions. Despite Hawaii’s ethnic diversity, high hepatocellular carcinoma incidence, and a statewide syringe exchange program in place since the early 1990s, our HCV prevalence and risk factor findings are remarkably consistent with those reported from the mainland United States. Hence, effective interventions identified from US mainland population studies should be generalizable to Hawaii. PMID:24028267

A behaviour sentinel surveillance for female sex workers in the Social Hygiene Service in Hong Kong (1999-2000).

PubMed

Chan, Michael Kam Tim; Ho, King Man; Lo, Kuen Kong

2002-12-01

Behavioural serial sentinel surveillance survey for female sex workers (FSWs) was carried out in the Government Social Hygiene Clinics in Hong Kong during 1999 and 2000. A total of 1366 and 1451 FSWs participated in the questionnaire survey respectively. The results showed that the majority of FSWs attending the clinics were of Chinese ethnicity (83.8%, 87.6%) while Thai (13.0%, 9.49%) and Filipino (2.1%, 2.7%) were the main foreign ethnic groups. The karaoke night club was the most frequent reported workplace (32.0%, 32.6%) followed by a club (8.9%, 11.7%) and free-lancing (8.6%, 9.0%). The proportion of FSWs who always used condoms in vaginal sex with commercial sex partners was 70.9% and 75.0% respectively (P=0.038). Compared with previous results, a rising trend of condom use by FSWs in commercial sex was observed. However, there was a relatively low condom use during commercial oral sexual intercourse (30.7%, 36.6%) and sex with their regular sex partners in all forms of sexual activities. Client dislike is the main attributed factor for not wearing condoms. The point prevalence of both infectious syphilis and HIV infection was 0.1% in both years. These data are useful for planning, resource allocation and evaluation of outreach activities and STI services targeting at FSWs and their clients. They provide a sampling framework for further surveillance.

Examining the relationship between ethnicity and the use of drug-related services: an ethnographic study of Nepali drug users in Hong Kong

PubMed Central

Tang, Wai-Man

2014-01-01

A recent survey has shown that Nepali drug users in Hong Kong tend to have a low rate of usage of day-care and residential rehabilitation services, but a high rate of usage of methadone services. Little is known about the reasons behind such a pattern. Therefore, in this study, a 12-month ethnographic examination has been implemented in three sites, including a day-care center, residential rehabilitation center, and methadone clinic, to explore the experiences of 20 Nepali drug users in their use of drug-related services in Hong Kong and to examine the relationship between ethnicity and the use of drug-related services. The result shows that the reason for this pattern of service use is related to the approach of the services and the cultural perception of the service providers about the service users. The day-care and residential rehabilitation services emphasize an integrated approach, but the staff tend to overlook the heterogeneity of their clients, for example, the differences in caste and sex, and fail to provide suitable services to them, whereas the methadone service follows a biomedical model, which seldom addresses the social characteristics of the service users, which in turn minimizes the opportunity for misunderstandings between the staff and the clients. This research shows that ethnicity is a significant factor in drug treatment and that culture-specific treatment that takes into consideration the treatment approach and the heterogeneity of the clients is strongly needed. PMID:25114609

A statistical investigation into the stability of iris recognition in diverse population sets

NASA Astrophysics Data System (ADS)

Howard, John J.; Etter, Delores M.

2014-05-01

Iris recognition is increasingly being deployed on population wide scales for important applications such as border security, social service administration, criminal identification and general population management. The error rates for this incredibly accurate form of biometric identification are established using well known, laboratory quality datasets. However, it is has long been acknowledged in biometric theory that not all individuals have the same likelihood of being correctly serviced by a biometric system. Typically, techniques for identifying clients that are likely to experience a false non-match or a false match error are carried out on a per-subject basis. This research makes the novel hypothesis that certain ethnical denominations are more or less likely to experience a biometric error. Through established statistical techniques, we demonstrate this hypothesis to be true and document the notable effect that the ethnicity of the client has on iris similarity scores. Understanding the expected impact of ethnical diversity on iris recognition accuracy is crucial to the future success of this technology as it is deployed in areas where the target population consists of clientele from a range of geographic backgrounds, such as border crossings and immigration check points.

Prevalence of HIV, syphilis, and HCV infection and associated risk factors among male clients of low-paying female sex workers in a rural county of Guangxi, China: a cross-sectional study.

PubMed

Zhang, Chen; Li, Xiaoming; Su, Shaobing; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu

2014-05-01

The purpose of this study was to examine prevalence of HIV, syphilis and hepatitis C virus (HCV) infection as well as related risk factors among a group of male clients of low-paying female sex workers (FSW) (eg, women who usually encounter their clients on the street or small establishments in rural or less developed areas, or who charge low fees for each sexual service) in a rural county of China. Cross-sectional study conducted in 2011 in a rural county of Guangxi in China. A total of 102 clients who reported information on demographics and HIV risks (eg, inconsistent condom use) and provided blood sample to test for HIV, HCV and syphilis were included in the data analysis. Both bivariate and multivariate analyses were employed to explore risk factors of HIV, HCV and syphilis infection. Most of participants were of Han ethnicity with a mean age of 61.8 years. The majority of them lived in rural areas and worked as farmers with limited disposable cash incomes. The sample reported a high rate of unprotected sex with FSW in the last sex episode (83.7%) and inconsistent condom use in the last 6 months (95.9%). The overall prevalence of HIV, HCV and syphilis was 1.9%, 1.0% and 18.4%, respectively. Findings suggest that male clients, especially the elderly ones, are at a high risk of HIV infection given prevalent unprotected sex and high prevalence of syphilis. Culturally-appropriate, age-specific interventions are urgently needed to curb the HIV/sexually transmitted infection epidemic among this at-risk population in China.

Interventions to improve cultural competency in healthcare: a systematic review of reviews

PubMed Central

2014-01-01

Background Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area. Methods A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong. Results Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes. Conclusion This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs. PMID:24589335

An Empirical Model and Ethnic Differences in Cultural Meanings Via Motives for Suicide.

PubMed

Chu, Joyce; Khoury, Oula; Ma, Johnson; Bahn, Francesca; Bongar, Bruce; Goldblum, Peter

2017-10-01

The importance of cultural meanings via motives for suicide - what is considered acceptable to motivate suicide - has been advocated as a key step in understanding and preventing development of suicidal behaviors. There have been limited systematic empirical attempts to establish different cultural motives ascribed to suicide across ethnic groups. We used a mixed methods approach and grounded theory methodology to guide the analysis of qualitative data querying for meanings via motives for suicide among 232 Caucasians, Asian Americans, and Latino/a Americans with a history of suicide attempts, ideation, intent, or plan. We used subsequent logistic regression analyses to examine ethnic differences in suicide motive themes. This inductive approach of generating theory from data yielded an empirical model of 6 cultural meanings via motives for suicide themes: intrapersonal perceptions, intrapersonal emotions, intrapersonal behavior, interpersonal, mental health/medical, and external environment. Logistic regressions showed ethnic differences in intrapersonal perceptions (low endorsement by Latino/a Americans) and external environment (high endorsement by Latino/a Americans) categories. Results advance suicide research and practice by establishing 6 empirically based cultural motives for suicide themes that may represent a key intermediary step in the pathway toward suicidal behaviors. Clinicians can use these suicide meanings via motives to guide their assessment and determination of suicide risk. Emphasis on environmental stressors rather than negative perceptions like hopelessness should be considered with Latino/a clients. © 2017 Wiley Periodicals, Inc.

Effectiveness of an Educational Intervention on Reducing Misconceptions Among Ethnic Minorities With Complicated Mild to Severe Traumatic Brain Injury

PubMed Central

Pappadis, Monique R.; Sander, Angelle M.; Łukaszewska, Beata; Struchen, Margaret A.; Leung, Patrick; Smith, Dennis W.

2018-01-01

Objective To evaluate the effectiveness of an educational intervention designed to reduce traumatic brain injury (TBI)–related misconceptions among blacks and Latinos with complicated mild to severe TBI. Design Randomized controlled trial with masked 1-month follow-up. Setting Community. Participants Persons (N = 52) with complicated mild to severe TBI (mean best day 1 Glasgow Coma Scale score, 11.27±3.89) were randomly recruited from 141 eligible participants (mean age, 37.71±13.88y; age range, 19–66y; mean months postinjury, 24.69±11.50); 25 participants (48.1%) of participants were black and 27 (51.9%) were Hispanic/Latino. Of the Hispanic/Latino participants, 18 (66.7%) were non-U.S. born and 12 (44.4%) spoke Spanish as their primary language. Twenty-seven individuals were randomized to the educational intervention group and 25 were randomized to the wait-list control group. Interventions Single-session educational intervention with written materials provided in English or Spanish. Main Outcome Measures Forty-item Common Misconceptions about Traumatic Brain Injury Questionnaire administered at baseline and 1-month follow-up. Results After controlling for ethnic and language differences, a significant between-group main effect (P = .010) and a significant time-group interaction for the Common Misconceptions about Traumatic Brain Injury Questionnaire were noted (Wilks Λ = .89; F1,46 = 6.00; P = .02). The intervention group showed a decrease in TBI misconception percentages, whereas the wait-list control group maintained similar percentages. At 1-month follow-up, the wait-list control group reported more misconceptions than did the intervention group (P = .019). Conclusions An educational intervention developed to address the recovery process, common symptoms, and ways to handle the symptoms provides promise as a tool to decrease TBI misconceptions among persons from ethnically and educationally diverse backgrounds. The effects of therapist characteristics and the client-therapist relation on outcomes should be further explored. PMID:28007444

Are we bridging the gap? A review of cultural diversity within stoma care.

PubMed

Cooper-Gamson, Louise

2017-09-28

The aim of this article is to highlight the aspects of how religion, ethnic grouping, age, gender, and learning disabilities affect how stoma care is approached and supported. It will try to highlight the positive and negative approaches documented so far and how this has affected the quality of stoma care given. By following guidelines set out by the Nursing and Midwifery Council (NMC) (2015) and the Association of Stoma Care Nurses (ASCN) (2015) the aim of the article will be to expand cultural awareness in stoma care nursing. By learning about the multifaceted aspects of culture as it applies to stoma care and then being able to apply that knowledge, usefully and skilfully, expands the SCN's ability to provide services for any cultural diverse client group.

A systematic review on US-based community health navigator (CHN) interventions for cancer screening promotion--comparing community- versus clinic-based navigator models.

PubMed

Hou, Su-I; Roberson, Kiersten

2015-03-01

This study synthesized lessons learned from US-based community and clinic health navigator (CHN) interventions on cancer screening promotion to identify characteristics of models and approaches for addressing cancer disparities. The combination terms "cancer screening" and "community health workers or navigators" or "patient navigators" were used in searching Medline, CINAHL, and PsycInfo. A total of 27 articles published during January 2005∼April 2014 were included. Two CHN models were identified: community-based (15 studies) and clinic/hospital-based (12 studies). While both models used the term "navigators," most community-based programs referred them as community health workers/navigators/advisors, whereas clinic-based programs often called them patient navigators. Most community-based CHN interventions targeted specific racial/ethnic minority or rural groups, while clinic-based programs mostly targeted urban low income or mixed ethnic groups. Most community-based CHN programs outreached members from community networks, while clinic-based programs commonly worked with pre-identified in-service clients. Overall, regardless model type, CHNs had similar roles and responsibilities, and interventions demonstrated effective outcomes. Our review identified characteristics of CHN interventions with attention to different settings. Lessons learned have implication on the dissemination and implementation of CHN interventions for cancer screening promotion across setting and target groups.

Gender and racial/ethnic disparities in the impact of HIV prevention programming in substance abuse treatment.

PubMed

Cao, Dingcai; Marsh, Jeanne C; Shin, Hee-Choon

2008-01-01

The objective of the study was to evaluate the capacity of HIV prevention programs offered in substance abuse treatment to reduce HIV-related risk behavior for women and men and for Black, Latino, and White groups. Prospective data was collected at intake, discharage, and 12 months post-treatment from 1992 to 1997 for the National Treatment Improvement Evaluation Study with a sample consisting of 3,142 clients from 59 service delivery units: 972 females, 1,870 males, 1,812 Blacks, 486 Latinos, and 844 Whites. Study findings show that receipt of HIV prevention programming as part of substance abuse treatment services resulted in reductions in HIV-related risk behavior for the sample overall and for women as well as men. However, although Blacks received more prevention services than Latinos and Whites, the significant positive effect of HIV services on reduced HIVrisk behavior held only for Whites. Racial/ethnic disparities exist in the capacity for HIV prevention programming offered as part of substance abuse treatment to reduce HIV-risk behavior. The findings highlight the need for the development of culturally competent service delivery strategies to enhance the impact of these services for all groups.

Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER)

PubMed Central

2012-01-01

Background In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Methods/Design Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. Discussion In total, 7685 clients completed at least one questionnaire, 136 midwives and assistants completed a diary with work-related activities (response 100%), 99 midwives completed a questionnaire (92%), and 319 practices across the country completed a questionnaire (61%), 30 partners of clients participated in focus groups, 21 other care providers were interviewed and 305 consults at six midwifery practices were videotaped. The multicenter DELIVER study provides an extensive database with national representative data on the quality of primary care midwifery in the Netherlands. This study will support evidence-based practice in primary care midwifery in the Netherlands and contribute to a better understanding of the maternity care system. PMID:22433820

Predicting Employment in the Mental Health Treatment Study: Do Client Factors Matter?

PubMed

Metcalfe, Justin D; Drake, Robert E; Bond, Gary R

2017-05-01

For people with psychiatric disabilities, demographic characteristics and measures of clinical status are often used to allocate scarce employment services. This study examined a battery of potential client predictors of competitive employment, testing the hypothesis that evidence-based supported employment would mitigate the negative effects of poor work history, uncontrolled symptoms, substance abuse, and other client factors. In a secondary analysis of 2055 unemployed Social Security Disability Insurance beneficiaries with schizophrenia or affective disorders, we examined 20 baseline client factors as predictors of competitive employment. The analysis used logistic regression to identify significant client predictors and then examined interactions between significant predictors and receipt of evidence-based supported employment. Work history was a strong predictor of employment, and other client measures (fewer years on disability rolls, Hispanic ethnicity, and fewer physical health problems) were modestly predictive. Evidence-based supported employment mitigated negative client factors, including poor work history. Participants with a poor work history benefitted from supported employment even more than those with a recent work experience. Evidence-based supported employment helps people with serious mental illness, especially those with poor job histories, to obtain competitive employment. Factors commonly considered barriers to employment, such as diagnosis, substance use, hospitalization history, and misconceptions about disability benefits, often have little or no impact on competitive employment outcomes.

Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

PubMed Central

2013-01-01

Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process evaluation will also be undertaken. Discussion LEAP for Life may prove a cost-effective way to improve client engagement and other outcomes in the community setting. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612001064897. PMID:24238067

Metaphors as contextual evidence for engaging Haitian clients in practice: a case study.

PubMed

Rahill, Guitele; Jean-Gilles, Michele; Thomlison, Barbara; Pinto-Lopez, Elsa

2011-01-01

Haitian immigrants remain underserved in the United States (U.S.), despite their large presence and their visibility, which increased after the January 12, 2010 earthquake. Employing cultural-specific practice strategies to engage Haitians in the U.S. who experienced loss in their social networks, requires understanding the context of their ecological culture and consideration of relevant linguistic and cultural elements. Through a case example, we describe the use of metaphors in cultural language as part of a strategy used to engage a Haitian immigrant with symptoms of posttraumatic stress disorder. Outcomes indicate that the use of storytelling and metaphors facilitate disclosure of clients' worldviews, experiences, feelings and hopes in a safe environment while providing them with tools to determine progress. We identify four practice guidelines for intervention strategies with ethnic minority groups who share similar cultural contexts. Metaphors, which are a viable approach to practice, focus on cultural strengths and resiliencies over traditional models of deficit and can enhance access to needed effective services for underserved populations, such as Haitians in the United States.

Multicultural Humanistic Psychology: Empirical Investigations of Humanistic Concepts.

ERIC Educational Resources Information Center

Chaffins, Belinda J.; McConnell, Stephen C.

Multicultural psychology examines existential-humanistic concerns in reference to the unique world of the client. Some of these contextual variables include race, age, religion, gender, sexual orientation, ethnicity, sociocultural and sociopolitical influences, as well as the roles of power, privilege, and disadvantage. Diversity impacts…

An Introduction to Multicultural Counseling.

ERIC Educational Resources Information Center

Lee, Wanda M. L.

When client and counselor are from different cultural backgrounds, they tend to view things from disparate perspectives. Though a background in multiculturalism is required for program accreditation, most existing texts limit coverage to ethnicity, without the emphasis of broad concepts such as discrimination and acculturation, or coverage of…

75 FR 66797 - PricewaterhouseCoopers LLP (“PwC”) Internal Firm Services Client Account Administrators Group...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... LLP (``PwC'') Internal Firm Services Client Account Administrators Group, Charlotte, NC; Amended... Firm Services Client Account Administrators Group. Accordingly, the Department is amending this... Firm Services Client Account Administrators Group. The amended notice applicable to TA-W-73,608 is...

75 FR 66796 - Pricewaterhousecoopers LLP (“PwC”), Internal Firm Services Client Account Administrators Group...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... LLP (``PwC''), Internal Firm Services Client Account Administrators Group Atlanta, GA; Amended...''), Internal Firm Services Client Account Administrators Group. Accordingly, the Department is amending this... Firm Services Client Account Administrators Group. The amended notice applicable to TA-W-73,630 is...

Family and community influences on the social and sexual lives of Latino gay men.

PubMed

Guarnero, Peter A

2007-01-01

The purpose of this study was to explore the effect of family and community on the social and sexual lives of a group of Latino gay men living in a metropolitan area. A secondary analysis of four focus groups with 28 Latino gay men was conducted. Families had a difficult time acknowledging and supporting participants' homosexuality. Participants experienced racism, discrimination, and physical and verbal abuse as a result of their ethnicity and homosexuality. These negative effects contributed to their marginalization and made them vulnerable to depression and suicide. Health care professionals should be aware of the effect of family and culture on the social and sexual lives of Latino gay men so that they can intervene and direct the client to the services needed to manage depression, suicidal ideation, and high-risk sexual behavior.

Fundamental contradictions in cultural competence.

PubMed

Johnson, Yvonne M; Munch, Shari

2009-07-01

Cultural competence (CC) is considered highly relevant to social work practice with clients belonging to ethnic and racial minority groups, as the burgeoning literature and creation of practice standards on CC attest. However, examination of the conceptual underpinnings of CC reveals several major anomalies. The authors argue that several aspects of CC contradict central social work concepts or are at odds with current, standard social work practice. These contradictions extend to the epistemological foundations of CC and the rights and dignity of the individual. To further stress the conceptual tensions at the heart of CC, the authors incorporate recent philosophical work addressing collective identities and group rights. The question of whether culturally competent practice is achievable is also addressed. The authors urge academicians and practitioners to thoroughly examine the theoretical and ethical bases of CC because of their highly important ramifications for social work practice.

The Critical Incident Interview and Ethnoracial Identity.

ERIC Educational Resources Information Center

Montalvo, Frank F.

1999-01-01

Describes the critical-incident interview, a cross-cultural training technique that helps social work students assess clients' ethnic- and racial-identity development. Uses examples from student interviews to present the steps involved in teaching the technique. Includes guidelines for selecting and interviewing informants, and gives three scales…

Use of ISDN video-phones for clients receiving palliative and antenatal home care.

PubMed

Miyazaki, Masako; Stuart, Michelle; Liu, Lili; Tell, Sharon; Stewart, Marianne

2003-01-01

We examined the use of ISDN video-phones by health professionals and two types of home care clients: those receiving palliative care and those receiving antenatal care. In the palliative care group, there were four female clients and 15 health professionals; these clients on average had the video-phones at home for six weeks and made 12.5 calls per week. The antenatal care group consisted of six female clients and eight female registered nurses; these clients on average also had the video-phones at home for six weeks and made 12.5 calls per week. Exit interviews were conducted with three clients and eight staff in the palliative care group, and with six clients and three staff in the antenatal care group. Palliative care clients and their families commented that the visual feature of the phone enhanced the care that they received. In the antenatal group, the video-phone was used mainly for booking appointments and arranging home visits. In general, the technology was well received by clients and care providers.

Conceptualizing community: the experience of mental health consumers.

PubMed

Wong, Yin-Ling Irene; Sands, Roberta G; Solomon, Phyllis L

2010-05-01

In this article we describe a focus group study of the perspectives of diverse groups of mental health consumers on the concept of community. We identify the core domains that constitute the notion of community, and commonalities and differences in the perception of community along the lines of ethnicity and sexual orientation/gender identity. Seven focus groups were conducted with a total of 62 participants. Transcripts were analyzed using the grounded theory approach.Two domains-togetherness and community acceptance-emerged as common to four types of communities that were most frequently mentioned in the focus group discussion. Our findings show that identities other than those associated with mental illness and the role of service user are critical to the understanding of the psychological sense of community among persons with psychiatric disabilities. We suggest that mental health providers empower consumers to expand their "personal communities" beyond that of mental health clients using their diverse identities, and design interventions for addressing the stigma emanating from identities that are discriminated against by the wider society.

VR Employment Outcomes of Individuals with Autism Spectrum Disorders: A Decade in the Making

ERIC Educational Resources Information Center

Alverson, Charlotte Y.; Yamamoto, Scott H.

2018-01-01

This study utilized hierarchical linear modeling analysis of a 10-year extant dataset from Rehabilitation Services Administration to investigate significant predictors of employment outcomes for vocational rehabilitation (VR) clients with autism. Predictor variables were gender, ethnicity, attained education level, IEP status in high school,…

Perceptions of Intercultural Social Challenges: Towards Culturally Competent Counselling Practice

ERIC Educational Resources Information Center

Mak, Anita S.; Shaw, Tamara L.

2015-01-01

Increasing ethnic and cultural diversity worldwide and especially in Australia requires that psychologists and counsellors cultivate the know-how to interact and work effectively with clients and stakeholders in cross-cultural contexts. This study aimed to identify and compare themes regarding challenging intercultural social scenarios experienced…

The Issue of Race in Counseling Psychology

ERIC Educational Resources Information Center

Wade, Jay C.

2005-01-01

The articles in this issue of "The Counseling Psychologist" discuss race and have implications for counseling psychology. Bryant-Davis and Ocampo?s (2005 [this issue]) article is about evaluation and treatment of racial-ethnic minority clients and patients and has implications for practice. Utsey, Gernat, and Hammar's (2005 [this issue]) article…

Empowering Ethnically and Racially Diverse Clients through Prejudice Reduction: Suggestions and Strategies for Counselors.

ERIC Educational Resources Information Center

Sandhu, Daya Singh; Brown, Sherlon Pack

1996-01-01

Focuses on the persistent problems of prejudice in multicultural societies. Various theories of prejudice and other psychological, social, and political factors that contribute to prejudice are discussed. Demonstrates several counseling theories and techniques as applied to case vignettes dealing with prejudice and racism. (Author/KW)

Increasing Minority Student Enrollment in Counselor Education

ERIC Educational Resources Information Center

Robinson, Mona C.; Lewis, Denise; Henderson, DeAnna; Flowers, Carl R.

2009-01-01

Counselor education programs across the country often fail to attract, enroll and graduate students in proportion that reflects the diversity of the nation. As our country's demography changes, the impact of race and ethnicity within the client-counselor relationship is likely to have greater importance and, as such, counselor education programs…

[Genital Chlamydia trachomatis infection and associated risk factors in male clients attending sexually transmitted disease clinics in 9 cities in Guangdong province].

PubMed

Shen, H C; Huang, S J; Qin, X L; Zhao, P Z; Lan, Y Y; Zou, H C; Ou, J L; Chen, L; Luo, X M; Zheng, H P; Li, Y; Yang, B

2017-03-10

Objective: To investigate the prevalence of genital Chlamydia trachomatis (GCT) infection and associated risk factors in male clients attending sexually transmitted disease (STD) clinics in Guangdong and provide integrated intervention strategy for this group. Methods: Convenient sampling was used to recruit participants from April to June in 2015 in Guangdong province. The information about their socio-demographic characteristics and sexual behaviors were collected by using a questionnaire, and blood samples were taken from them to test the antibodies against HIV, syphilis and HCV. First pass urine was taken to test GCT and gonorrhea. Results: A total of 1 749 participants with the average age of 39.53 years were recruited. The majority of them were married (73.87%, 1 292/1 749), residents of Guangdong (92.28%, 1 614/1 749) and in Han ethnic group (99.49%, 1 740/1 749). The positive rates for GCT, HIV, syphilis, HCV, Neisseria gonorrhea , and WBC in urinalysis were 6.06% (106/1 749), 0.46% (8/1 749), 3.43% (60/1 749), 0.45% (7/1 550), 2.74% (48/1 749), 7.89% (138/1 749) respectively. Multivariate analysis showed that risk factors for GCT infection include IDUs ( OR =13.98, 95 %CI : 3.35-58.38), anal sex with men ( OR =3.11, 95 %CI : 1.45-6.71), Neisseria gonorrhea positive ( OR =9.64, 95 % CI : 5.09-18.24), and WBC positive ( OR =1.96, 95 %CI : 1.08-3.55). Conclusions: This study demonstrated the high prevalence of GCT infection in male clients attending STD clinics in Guangdong. Therefore precision intervention should target this population at high-risk.

Ethnocultural variations in mental illness discourse: some implications for building therapeutic alliances.

PubMed

Alverson, Hoyt S; Drake, Robert E; Carpenter-Song, Elizabeth A; Chu, Edward; Ritsema, Mieka; Smith, Beverly

2007-12-01

In the delivery of mental health services over the past decade, the field has attempted to shift from paternalism to client-centered care, in which treatment and recovery are based on client-practitioner collaboration. Such a shift requires that providers elicit and work with clients' discursive accounts of their illness experiences and understand these accounts in the context of clients' ethnocultural backgrounds. The purpose of this ethnography was to elucidate ethnocultural aspects of illness accounts and interactions with the mental health system. Over 18 months, 25 ethnically diverse, unemployed, inner-city residents with severe and long-term mental disorders participated in an ethnographic (participant observation) study of illness accounts and their relationship to sociocultural background. Field ethnographers shared in activities with participants at many of their regular haunts, engaging in observation, conversation, and informal interviewing in many real-world contexts and settings. The study revealed significant differences between the ways that European Americans, African Americans, and Puerto Rican Americans discursively constructed their illness experiences and their interactions with the mental health system. The clients' narratives of their illness experiences provided valuable information, which clinicians could use to open up topics for discussion, insert themselves into an engaging relationship with clients, and link clinical advice or guidance with the clients' own conceptions of how mental illness fits into their larger lived world. To develop a working therapeutic partnership with clients, mental health service providers must become aware through context-sensitive, context-informed dialog of the differences in how individual clients "en-story," communicate, and experience their illnesses.

It takes two: the role of partner ethnicity and age characteristics on condom negotiations of heterosexual Chinese and Filipina American college women.

PubMed

Lam, Amy G; Barnhart, James E

2006-02-01

To date, limited attention is paid to how partners influence the condom negotiation process. This study examined whether partner ethnicity and age were associated with condom negotiations (i.e., verbal-direct, verbal-indirect, nonverbal-direct, nonverbal-indirect) in heterosexual Chinese and Filipina American college women. Results from 181 women across four California universities indicated significant effects of partner ethnicity and age on condom negotiation strategies. Asian women with non-Asian partners were more likely to use nonverbal-direct strategies than those with Asian partners. Asian women with older partners were less likely to use verbal strategies (verbal-direct, verbal-indirect) than those with same-age partners. This study suggests that Asian women's safer sex communication varies by partner characteristics. Obtaining information such as partner ethnicity and age can help health educators provide more culturally appropriate sexual communication skills to clients.

Motivations for Non-Medical Prescription Drug Use: A Mixed Methods Analysis

PubMed Central

Rigg, Khary K.; Ibañez, Gladys E.

2010-01-01

Despite a dramatic increase in the non-medical use of prescription drugs among illicit drug users, their motives for abusing prescription drugs are still largely unknown. The objective of this study was to 1) determine the motivations for engaging in the non-medical use of prescription opioids and sedatives among street-based illicit drug users, methadone maintenance patients, and residential drug treatment clients, 2) examine associations between prescription drug abuse motivations and gender, age, race/ethnicity, and user group, and 3) examine associations between specific motivations and prescription drug abuse patterns. Quantitative surveys (n = 684) and in-depth interviews (n = 45) were conducted with a diverse sample of prescription drug abusers in South Florida between March 2008 and November 2009. The three most common motivations reported were “to get high”, “to sleep”, and “for anxiety/stress”. There were age, race/ethnicity, and gender differences by motives. Prescription drug abuse patterns were also found to be associated with specific motivations. While additional research is needed, these findings serve to inform appropriate prevention and treatment initiatives for prescription drug abusers. PMID:20667680

Evaluation of primary care midwifery in The Netherlands: design and rationale of a dynamic cohort study (DELIVER).

PubMed

Manniën, Judith; Klomp, Trudy; Wiegers, Therese; Pereboom, Monique; Brug, Johannes; de Jonge, Ank; van der Meijde, Margreeth; Hutton, Eileen; Schellevis, Francois; Spelten, Evelien

2012-03-20

In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. In total, 7685 clients completed at least one questionnaire, 136 midwives and assistants completed a diary with work-related activities (response 100%), 99 midwives completed a questionnaire (92%), and 319 practices across the country completed a questionnaire (61%), 30 partners of clients participated in focus groups, 21 other care providers were interviewed and 305 consults at six midwifery practices were videotaped.The multicenter DELIVER study provides an extensive database with national representative data on the quality of primary care midwifery in the Netherlands. This study will support evidence-based practice in primary care midwifery in the Netherlands and contribute to a better understanding of the maternity care system. © 2012 Manniën et al; licensee BioMed Central Ltd.

Informal Discussions in Substance Abuse Treatment Sessions with Spanish-speaking Clients

PubMed Central

Bamatter, Wendy; Carroll, Kathleen M.; Añez, Luis M.; Paris, Manuel; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Suarez-Morales, Lourdes; Szapocznik, Jose; Martino, Steve

2010-01-01

This study investigated the extent to which bilingual counselors initiated informal discussions about topics that were unrelated to the treatment of their monolingual Spanish-speaking Hispanic clients in a National Institute on Drug Abuse Clinical Trial Network protocol examining the effectiveness of motivational enhancement therapy (MET). Session audiotapes were independently rated to assess counselor treatment fidelity and the incidence of informal discussions. Eighty-three percent of the 23 counselors participating in the trial initiated informal discussions at least once in one or more of their sessions. Counselors delivering MET in the trial initiated informal discussion significantly less often than the counselors delivering standard treatment. Counselors delivering standard treatment were likely to talk informally the most when they were ethnically non-Latin. Additionally, informal discussion was found to have significant inverse correlations with client motivation to reduce substance use and client retention in treatment. These results suggest that informal discussion may have adverse consequences on Hispanic clients’ motivation for change and substance abuse treatment outcomes and that maintaining a more formal relationship in early treatment sessions may work best with Hispanic clients. Careful counselor training and supervision in MET may suppress the tendency of counselors to talk informally in sessions. PMID:20817381

Helping cancer patients across the care continuum: the navigation program at the Queen's Medical Center.

PubMed

Allison, Amanda L; Ishihara-Wong, Debra D M; Domingo, Jermy B; Nishioka, Jocelyn; Wilburn, Andrea; Tsark, JoAnn U; Braun, Kathryn L

2013-04-01

Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1-83), and the median number of days a case was open was 14 (range 1-216). High intensity cases (those receiving more assistance over longer periods of time) were more likely than low-intensity cases to need help with education and reassurance, transportation, care coordination, and covering costs. Although there were no demographic differences across intensity groups, Neighbor Island patients from Hawai'i, Maui, Moloka'i, Lana'i and Kaua'i were more likely to need help with arranging travel, care coordination, and costs associated with getting treatment (all at P=.05), and patients on public insurance were more likely to have stage 4 cancer (P=.001) and to need help with costs (P=.006). Findings suggest that this hospital-based navigation program is filling a real need of patients across the cancer care continuum. A triage protocol and an integrated data capture system could help improve the targeting and documentation of cancer patient navigation services.

The changing proliferation threat

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sopko, J.F.

Technological advances and new adversaries with new motives have reduced the relevancy and effectiveness of the American nonproliferation strategy that was developed during the Cold War. The Cold War`s end and the breakup of the Soviet Union have created new proliferation dangers even as they have reduced others. The familiar balance of nuclear terror that linked the superpowers and their client states for nearly 50 years in a choreographed series of confrontations has given way to a much less predictable situation, where weapons of unthinkable power appear within the grasp of those more willing to use them. Rogue nations andmore » {open_quotes}clientless{close_quotes} states, terrorist groups, religious cults, ethnic minorities, disaffected political groups, and even individuals appear to have jointed a new arms race toward mass destruction. The author describes recent events that suggest the new trends and a serious challenge to US national security.« less

Making cross-racial therapy work: A phenomenological study of clients’ experiences of cross-racial therapy

PubMed Central

Chang, Doris F.; Berk, Alexandra

2010-01-01

A phenomenological/consensual qualitative study of clients’ lived experiences of cross-racial therapy was conducted to enhance our understanding of whether, how, and under what conditions race matters in the therapy relationship. The sample consisted of 16 racial/ethnic minority clients who received treatment from 16 White, European American therapists across a range of treatment settings. Participants who reported a satisfying experience of cross-racial therapy (n=8) were examined in relation to gender- and in most cases, race/ethnicity-matched controls (n=8) who reported an overall unsatisfying experience. Therapy satisfaction was assessed during the screening process and confirmed during the research interview. Therapy narratives were analyzed using consensual qualitative research to identify the client, therapist, and relational factors that distinguished satisfied from unsatisfied cases. Findings reveal substantial differences at the level of individual characteristics and relational processes, providing evidence of both universal (etic) as well as culture/context-specific (emic) aspects of healing relationships. Recommendations for facilitating positive alliance formation in cross-racial therapy are provided based on clients’ descriptions of facilitative conditions in the therapy relationship. PMID:20414342

Enhancing access and retention in substance abuse treatment: the role of Medicaid payment acceptance and cultural competence.

PubMed

Guerrero, Erick G

2013-10-01

Health insurance coverage and quality of care are common factors believed to improve access for and retention of racial and ethnic minority groups in health care. However, there is little evidence that acceptance of public insurance and provision of culturally responsive care decrease wait time and retention of minority populations in community-based substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, CA. An analytical sample of 13,328 primarily African American and Latino clients nested within 104 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on count measures of days to initiate and days spent in treatment. Programs that accepted public insurance (p<.001) and in which staff reported personal involvement (p<.01) and linkages and resources with minority communities (p<.001) were negatively associated with client wait time. Similarly, programs with culturally responsive policies and assessment and treatment practices (p<.05) were positively associated with retention in treatment, after controlling for individual and program characteristics. These preliminary findings provide an evidentiary base for the role of community-based financial and cultural practices in improving accessibility and treatment adherence in a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to expand public insurance and enhance culturally competent care, are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Client Personality Variables Associated with Counselor Perceptions.

ERIC Educational Resources Information Center

Livneh, Hanoch

1979-01-01

Studies the relationship between clients' personality variables and rehabilitation counselors' perception of these variables. Four client groups were created along two dimensions of personality variables: emotional security need and sexual problems. A significant relationship was found between the client's group membership and his evaluation with…

Workforce Diversity in Outpatient Substance Abuse Treatment: The Role of Leaders’ Characteristics

PubMed Central

Guerrero, Erick G.

2012-01-01

Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers’ tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. PMID:22658932

Occupation, well-being, and culture: Theory and cultural humility.

PubMed

Hammell, Karen R Whalley

2013-10-01

The Canadian Model of Occupational Performance and Engagement depicts individuals embedded within cultural environments that afford occupational possibilities. Culture pertains not solely to ethnicity or race but to any dimension of diversity, including class, gender, sexual orientation, and ability. This paper highlights specific dimensions of cultural diversity and their relationships to occupational engagement and well-being. Cultural variations constitute the basis for a socially constructed hierarchy of traits that significantly determine occupational opportunities and impact mental health and well-being. Cultural humility is an approach to redressing power imbalances in client-therapist relationships by incorporating critical self-evaluation and recognizing that cultural differences lie not within clients but within client-therapist relationships. It is proposed that theoretical relevance would be enhanced if culturally diverse perspectives were incorporated into theories of occupation. Cultural humility is advocated as an approach to theoretical development and in efforts to counter professional Eurocentrism, ethnocentrism, and intellectual colonialism.

Clients' emotional processing in psychotherapy: a comparison between cognitive-behavioral and process-experiential therapies.

PubMed

Watson, Jeanne C; Bedard, Danielle L

2006-02-01

The authors compared clients' emotional processing in good and bad outcome cases in cognitive behavioral therapy (CBT) and process-experiential therapy (PET) and investigated whether clients' emotional processing increases over the course of therapy. Twenty minutes from each of 3 sessions from 40 clients were rated on the Experiencing Scale. A 2x2x3 analysis of variance showed a significant difference between outcome and therapy groups, with clients in the good outcome and PET groups showing significantly higher levels of emotional processing than those in the poor outcome and CBT groups, respectively. Clients' level of emotional processing significantly increased from the beginning to the midpoint of therapy. The results indicate that CBT clients are more distant and disengaged from their emotional experience than clients in PET. Copyright (c) 2006 APA, all rights reserved.

Multilevel Modeling for Research in Group Work

ERIC Educational Resources Information Center

Selig, James P.; Trott, Arianna; Lemberger, Matthew E.

2017-01-01

Researchers in group counseling often encounter complex data from individual clients who are members of a group. Clients in the same group may be more similar than clients from different groups and this can lead to violations of statistical assumptions. The complexity of the data also means that predictors and outcomes can be measured at both the…

"I Didn't Feel Equipped": Social Work Students' Reflections on a Simulated Client "Coming Out"

ERIC Educational Resources Information Center

Logie, Carmen H.; Bogo, Marion; Katz, Ellen

2015-01-01

Few studies have examined social work students' reflections on and experiences working with lesbian, gay, bisexual, queer, and questioning persons and addressing the intersection of race/ethnicity and sexuality within practice. This study explored current master's of social work student (n = 11) and recent graduate (n = 7) reflections on…

Effects of self reflection on engagement in a 12-step addiction treatment programme: a linguistic analysis of diary entries.

PubMed

Stephenson, Geoffrey M; Zygouris, Nikolaos

2007-02-01

Thirty clients receiving Twelve-Step Facilitation Therapy in a rehabilitation setting formed the intervention group. They were asked to complete in third person a weekly evaluation of progress based on reading personal "Feelings" diaries they had written on a daily basis over a period of one week, starting 3weeks previously. The diaries of the clients and of a further 60 clients in two matched control groups were compared. One control group consisted of clients receiving treatment before the intervention was introduced, and clients in the second control group received treatment after the intervention was terminated. Clients in the control groups were matched to the intervention group according to presenting disorder (alcohol, drugs or food), gender and age. Analysis of the number of words written and diaries produced suggested that the experimental group's productivity was enhanced. Linguistic and cluster analyses indicated that the clients in the Intervention group referred more frequently to key elements of the programme (steps and spirituality) and responded in a more integrated way to the major aspects of their treatment regime. The study supported the expectation that by promoting self-reflection on progress in therapeutic settings, an increase in programme engagement can be expected.

Perspectives and concerns of clients at primary health care facilities involved in evaluation of a national mental health training programme for primary care in Kenya

PubMed Central

2013-01-01

Background A cluster randomised controlled trial (RCT) of a national Kenyan mental health primary care training programme demonstrated a significant impact on the health, disability and quality of life of clients, despite a severe shortage of medicines in the clinics (Jenkins et al. Submitted 2012). As focus group methodology has been found to be a useful method of obtaining a detailed understanding of client and health worker perspectives within health systems (Sharfritz and Roberts. Health Transit Rev 4:81–85, 1994), the experiences of the participating clients were explored through qualitative focus group discussions in order to better understand the potential reasons for the improved outcomes in the intervention group. Methods Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 10 clients from the intervention group clinics where staff had received the training programme, and 10 clients from the control group where staff had not received the training during the earlier randomised controlled trial. Results These focus group discussions suggest that the clients in the intervention group noticed and appreciated enhanced communication, diagnostic and counselling skills in their respective health workers, whereas clients in the control group were aware of the lack of these skills. Confidentiality emerged from the discussions as a significant client concern in relation to the volunteer cadre of community health workers, whose only training comes from their respective primary care health workers. Conclusion Enhanced health worker skills conferred by the mental health training programme may be responsible for the significant improvement in outcomes for clients in the intervention clinics found in the randomised controlled trial, despite the general shortage of medicines and other health system weaknesses. These findings suggest that strengthening mental health training for primary care staff is worthwhile even where health systems are not strong and where the medicine supply cannot be guaranteed. Trial registration ISRCTN 53515024. PMID:23343127

Under What Conditions Does Caseworker-Caregiver Racial/Ethnic Similarity Matter for Housing Service Provision? An Application of Representative Bureaucracy Theory.

PubMed

McBeath, Bowen; Chuang, Emmeline; Bunger, Alicia; Blakeslee, Jennifer

2014-03-01

In this article, we examine child welfare caseworkers' housing-related service strategies when they serve culturally similar versus culturally dissimilar clients. Testing hypotheses drawn from representative bureaucracy theory and using data from the second cohort of the National Survey of Child and Adolescent Well-Being, we find that when non-Caucasian caseworkers share the same racial/ethnic background as caregivers, caseworkers use more active strategies to connect caregivers to needed housing services. The relationship between racial/ethnic matching and frontline workers' repertoire of service strategies is most pronounced when the need for housing has been registered formally via referrals and case plans and thus legitimated institutionally. These results reinforce basic tenets of representative bureaucracy theory and provide evidence of the benefits of racial and ethnic diversity in the human service workforce. Our findings also highlight the need for research identifying institutional and frontline organizational factors that enhance the quality of service provision.

Under What Conditions Does Caseworker-Caregiver Racial/Ethnic Similarity Matter for Housing Service Provision? An Application of Representative Bureaucracy Theory

PubMed Central

McBeath, Bowen; Chuang, Emmeline; Bunger, Alicia; Blakeslee, Jennifer

2014-01-01

In this article, we examine child welfare caseworkers’ housing-related service strategies when they serve culturally similar versus culturally dissimilar clients. Testing hypotheses drawn from representative bureaucracy theory and using data from the second cohort of the National Survey of Child and Adolescent Well-Being, we find that when non-Caucasian caseworkers share the same racial/ethnic background as caregivers, caseworkers use more active strategies to connect caregivers to needed housing services. The relationship between racial/ethnic matching and frontline workers’ repertoire of service strategies is most pronounced when the need for housing has been registered formally via referrals and case plans and thus legitimated institutionally. These results reinforce basic tenets of representative bureaucracy theory and provide evidence of the benefits of racial and ethnic diversity in the human service workforce. Our findings also highlight the need for research identifying institutional and frontline organizational factors that enhance the quality of service provision. PMID:25745270

Supporting Pakistani and Chinese families with young children: perspectives of mothers and health visitors.

PubMed

Hogg, R; de Kok, B; Netto, G; Hanley, J; Haycock-Stuart, E

2015-05-01

In the UK, public health nurses (health visitors) provide support and advice to families with young children, including those from minority ethnic communities. While the need for cultural sensitivity is being increasingly recognized, the factors which contribute to this sensitivity are poorly understood. The Pakistani and Chinese communities constitute the two largest minority ethnic groups in Scotland. This study explored Pakistani and Chinese women's experience of motherhood and of the health visiting service and public health nurses' experiences of working with Chinese and Pakistani mothers. Semi-structured individual interviews were carried out with 16 Pakistani and 15 Chinese mothers. Eight health visitors took part in two focus groups. The study was undertaken in an urban area of Scotland. Data were analysed thematically. Chinese and Pakistani mothers negotiate complex processes in order to ensure that their children maintain their own ethnic identity while fitting in with their peers in their adopted country. Health visitors were seen as supportive, although sometimes advice and information given was culturally inappropriate, and their role was often poorly understood. Health visitors were anxious to be sensitive to families' religious and cultural beliefs. Cultural sensitivity is an important factor in providing appropriate advice and help to Pakistani and Chinese families, and involves health visitors in considering views and practices on parenting which may differ across cultures, including their own. Family characteristics need to be understood on an individual basis, rather than making assumptions about clients' cultural norms and lifestyles. This is best achieved by exploring with mothers if they understand the advice and information they are being offered and also if it is appropriate to their cultural and religious beliefs. © 2014 John Wiley & Sons Ltd.

Group Work with Transgender Clients

ERIC Educational Resources Information Center

Dickey, Lore M.; Loewy, Michael I.

2010-01-01

Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…

Care farms in the Netherlands: attractive empowerment-oriented and strengths-based practices in the community.

PubMed

Hassink, Jan; Elings, Marjolein; Zweekhorst, Marjolein; van den Nieuwenhuizen, Noor; Smit, Annet

2010-05-01

Empowerment-oriented and strengths-based practices focusing on community integration have gained recognition for various client groups in recent decades. This paper discusses whether care farms in the Netherlands are relevant examples of such practices. We identify characteristics associated with care farms that are relevant for three different client groups: clients with severe mental health problems, clients from youth care backgrounds, and frail elderly clients. We interviewed 41 clients, 33 care farmers, and 27 health professionals. The study shows that care farms are experienced as unique services because of a combination of different types of characteristic qualities: the personal and involved attitude of the farmer, a safe community, useful and diverse activities, and a green environment. This leads to an informal context that is close to normal life. We found no essential differences in the assessment of characteristics between different client groups and between clients, farmers, and health professionals. Care farms can be considered as an innovative example of community-based services that can improve the quality of life of clients. Copyright 2009 Elsevier Ltd. All rights reserved.

Visitor diversity on national forests-how should managers respond?

Treesearch

Cassandra Johnson; D.B.K English

2007-01-01

Historically, Anglo Americans have been the primary clientèle at nature-based outdoor recreation areas in the United States (Chavez 2001, Dunn et al. 2002). Goldsmith (1 994) highlighted the lack of racial and ethnic diversity among National Park visitors. Citing a Texas A&M study, Goldsmith (1994) reported that less than 1 % of car visitors to Yosemite National...

Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups

PubMed Central

Bil, Janneke P; Prins, Maria; Stolte, Ineke G; Dijkshoorn, Henriëtte; Heijman, Titia; Snijder, Marieke B; Davidovich, Udi; Zuure, Freke R

2017-01-01

Objectives There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands. Setting Data were collected in four different studies among the general population (S1–2) and sexual risk groups (S3–4). Participants S1–Amsterdam residents participating in representative population-based surveys (2008 and 2012; n=6044) drawn from the municipality register; S2–Participants of a population-based study stratified by ethnicity drawn from the municipality register of Amsterdam (2011–2015; n=17 603); S3–Men having sex with men (MSM) participating in an HIV observational cohort study (2008 and 2013; n=597) and S4–STI clinic clients participating in a cross-sectional survey (2007–2012; n=5655). Primary and secondary outcome measures Prevalence of HIV/STI self-test usage and its determinants. Results The prevalence of HIV/STI self-test usage in the preceding 6–12 months varied between 1% and 2% across studies. Chlamydia self-tests were most commonly used, except among MSM in S3. Chlamydia and syphilis self-test usage increased over time among the representative sample of Amsterdam residents (S1) and chlamydia self-test usage increased over time among STI clinic clients (S4). Self-test usage was associated with African Surinamese or Ghanaian ethnic origin (S2), being woman or MSM (S1 and 4) and having had a higher number of sexual partners (S1–2). Among those in the general population who tested for HIV/STI in the preceding 12 months, 5–9% used a self-test. Conclusions Despite low HIV/STI self-test usage, we observed increases over time in chlamydia and syphilis self-test usage. Furthermore, self-test usage was higher among high-risk individuals in the general population. It is important to continue monitoring self-test usage and informing the public about the unknown quality of available self-tests in the Netherlands and about the pros and cons of self-testing. PMID:28939577

Workforce diversity in outpatient substance abuse treatment: the role of leaders' characteristics.

PubMed

Guerrero, Erick G

2013-02-01

Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers' tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

Multi-Family Psycho-Education Group for Assertive Community Treatment Clients and Families of Culturally Diverse Background: A Pilot Study

PubMed Central

Law, Samuel; Andermann, Lisa; Yang, Jian; Leszcz, Molyn; Wong, Jiahui; Sadavoy, Joel

2010-01-01

This study evaluates the incorporation of Multi-Family Psycho-education Group (MFPG) to an Assertive Community Treatment Team developed to serve culturally diverse clients who suffers from severe mental illness. Participants included Chinese and Tamil clients and their family members. Family members’ well-being, perceived burden, and acceptance of clients were assessed before and after the intervention. Focus group interviews with clinicians were conducted to qualitatively examine MFPG. Family members’ acceptance increased after MFPG. Regular attendance was associated with reduction in perceived family burden. Culturally competent delivery of MFPG enhanced family members’ understanding of mental illness and reduced stress levels and negative feelings towards clients. PMID:20414724

Do dimensions of ethnic identity mediate the association between perceived ethnic group discrimination and depressive symptoms?

PubMed

Brittian, Aerika S; Kim, Su Yeong; Armenta, Brian E; Lee, Richard M; Umaña-Taylor, Adriana J; Schwartz, Seth J; Villalta, Ian K; Zamboanga, Byron L; Weisskirch, Robert S; Juang, Linda P; Castillo, Linda G; Hudson, Monika L

2015-01-01

Ethnic group discrimination represents a notable risk factor that may contribute to mental health problems among ethnic minority college students. However, cultural resources (e.g., ethnic identity) may promote psychological adjustment in the context of group-based discriminatory experiences. In the current study, we examined the associations between perceptions of ethnic group discrimination and depressive symptoms, and explored dimensions of ethnic identity (i.e., exploration, resolution, and affirmation) as mediators of this process among 2,315 ethnic minority college students (age 18 to 30 years; 37% Black, 63% Latino). Results indicated that perceived ethnic group discrimination was associated positively with depressive symptoms among students from both ethnic groups. The relationship between perceived ethnic group discrimination and depressive symptoms was mediated by ethnic identity affirmation for Latino students, but not for Black students. Ethnic identity resolution was negatively and indirectly associated with depressive symptoms through ethnic identity affirmation for both Black and Latino students. Implications for promoting ethnic minority college students' mental health and directions for future research are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Medical faculty members' perspectives on the components of cross-cultural competence in the Islamic Republic of Iran: a qualitative study.

PubMed

Bazaz, M Mousavi; Zazoly, A Zabihi; Karimi Moonaghi, H

2015-02-25

Despite the importance of cultural competence in health care, there has been no research to develop a framework for cultural competence in the Iranian context. This qualitative study at Mashhad University of Medical Sciences aimed to elucidate the views of medical faculty staff on the components of cross-cultural competence and compare these with similar studies published in English. Using a combination of archival studies, semi-structured interviews and focus group discussions among faculty members 3 major domains (knowledge, attitude and behaviour) and 21 components were identified to describe the cross-cultural competence of faculty members in medical schools. Participants expressed the importance of knowledge as a precursor to changing attitudes and the 6 knowledge components related to knowledge and awareness of values, beliefs and norms of different ethnic, racial and cultural groups. Experts mostly emphasized the importance of interaction between faculty members and clients (students and patients).

Medical faculty members' perspectives on the components of cross-cultural competence in the Islamic Republic of Iran: a qualitative study.

PubMed

Bazaz, M Mousavi; Zazoly, A Zabihi; Moonaghi, H Karimi

2015-02-02

Despite the importance of cultural competence in health care, there has been no research to develop a framework for cultural competence in the Iranian context. This qualitative study at Mashhad University of Medical Sciences aimed to elucidate the views of medical faculty staff on the components of cross-cultural competence and compare these with similar studies published in English. Using a combination of archival studies, semi-structured interviews and focus group discussions among faculty members 3 major domains (knowledge, attitude and behaviour) and 21 components were identified to describe the cross-cultural competence of faculty members in medical schools. Participants expressed the importance of knowledge as a precursor to changing attitudes and the 6 knowledge components related to knowledge and awareness of values, beliefs and norms of different ethnic, racial and cultural groups. Experts mostly emphasized the importance of interaction between faculty members and clients (students and patients).

Hypnosis in the treatment of trauma: a promising, but not fully supported, efficacious intervention.

PubMed

Cardeña, E

2000-04-01

Hypnotic techniques for the treatment of posttraumatic conditions were often used by the clinical pioneers of the end of the 19th century and by military therapists treating soldiers during the 20th century's conflagrations. More recently, hypnosis has also been used with survivors of sexual assault, accidents, and other traumas, and with various groups, including children and ethnic minorities. Nonetheless, there have been almost no systematic studies on the efficacy of hypnosis for posttraumatic disorders. This state of affairs is especially disappointing considering that: hypnosis can be easily integrated into therapies that are commonly used with traumatized clients; a number of PTSD individuals have shown high hypnotizability in various studies; hypnosis can be used for symptoms associated with PTSD; and hypnosis may help modulate and integrate memories of trauma. Hypnotic techniques may indeed be efficacious for posttraumatic conditions, but systematic group or single-case studies need to be conducted before reaching that conclusion.

Exploring cultural tensions in cross-cultural social work practice.

PubMed

Yan, Miu Chung

2008-10-01

Discussion of cultural tension in the social work literature is piecemeal. As part of a grounded theory study, this article reports some major findings on cultural tensions experienced by 30 frontline social workers. Cultural tensions caused by cultural similarities and differences among social workers, clients, organizations, and society are multifaceted. Social workers, however, are always at the center of the tensions. Findings indicate that the social work profession may need to consider the neutrality claim of the profession, the different experience of ethnic minority social workers, and the need of critical reflexivity for reflective practitioners. Implications for social work practice, social work education for ethnic minority social workers, and social work research are discussed.

Group-oriented coordination models for distributed client-server computing

NASA Technical Reports Server (NTRS)

Adler, Richard M.; Hughes, Craig S.

1994-01-01

This paper describes group-oriented control models for distributed client-server interactions. These models transparently coordinate requests for services that involve multiple servers, such as queries across distributed databases. Specific capabilities include: decomposing and replicating client requests; dispatching request subtasks or copies to independent, networked servers; and combining server results into a single response for the client. The control models were implemented by combining request broker and process group technologies with an object-oriented communication middleware tool. The models are illustrated in the context of a distributed operations support application for space-based systems.

Factors Affecting the Interest of Israeli Social Work Students in Working with Different Client Groups

ERIC Educational Resources Information Center

Krumer-Nevo, Michal; Weiss, Idit

2006-01-01

Employing a large-scale sample of 521 BSW students from 4 Israeli schools of social work, this research examines the factors affecting social work students' interest in working with a wide range of client groups. The results suggest that student interest in working with specific client groups is affected by factors related to desire for…

A cultural accommodation model for cross-cultural psychotherapy: Illustrated with the case of Asian Americans.

PubMed

Leong, Frederick T; Lee, Szu-Hui

2006-01-01

As an extension of F. T. L. Leong's (1996) integrative model, this article presents the cultural accommodation model (CAM), an enhanced theoretical guide to effective cross-cultural clinical practice and research. Whereas F. T. L. Leong's model identifies the importance of integrating the universal, group, and individual dimensions, the CAM takes the next step by providing a theoretical guide to effective psychotherapy with culturally different clients by means of a cultural accommodation process. This model argues for the importance of selecting and applying culture-specific constructs when working with culturally diverse groups. The first step of the CAM is to identify cultural disparities that are often ignored and then accommodate them by using current culturally specific concepts. In this article, several different cultural "gaps" or culture-specific constructs of relevance to Asian Americans with strong scientific foundations are selected and discussed as they pertain to providing effective psychotherapy to this ethnic minority group. Finally, a case study is incorporated to illustrate application of the CAM. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

The Normalization of Cannabis Use Among Bangladeshi and Pakistani Youth: A New Frontier for the Normalization Thesis?

PubMed

Williams, Lisa; Ralphs, Rob; Gray, Paul

2017-03-21

The Asian population in Britain has grown, representing the second largest ethnic group; Bangladeshi, Pakistani, and Indian nationalities are prevalent (Jivraj, 2012 ; Office for National Statistics, 2013 ). Yet, we know relatively little about the nature and extent of their substance use. Jayakody et al. ( 2006 ) argue ethnic minority groups may be influenced by the norms and values of the dominant culture. Given recreational drug use has undergone a process of normalization in Britain (Aldridge et al., 2011 ; Parker et al., 1998 , 2002 ), we explore the degree to which this is occurring in a Bangladeshi and Pakistani community of Muslim faith in Northern England; a group typically assumed to reject substance use because of robust religious and cultural values. To examine the extent, frequency, and nature of substance use, and associated attitudes. A cross-sectional study collecting qualitative data from a sample (N = 43) of adolescents accessing a drug service and a range of professionals working with them during 2014. We also present analyses of routinely collected quantitative client data. Adolescent interviewees reported extensive personal experience smoking skunk cannabis, and professionals working in the community confirmed many young Asians smoked it. Its consumption appeared to be accommodated into the daily lives of young people and the supply of it also showed signs of acceptance. Skunk cannabis may be undergoing a process of normalization within some Asian communities in Britain. Our study has significant implications for the normalization thesis, finding evidence for normalization within a subpopulation that is typically perceived to resist this trend.

Effects of Systematic Group Counseling on Work Adjustment Clients

ERIC Educational Resources Information Center

Roessler, Richard; And Others

1977-01-01

When compared with a group of clients who had received work adjustment services and a placebo treatment (personal hygiene training), experimental clients given Personal Achievement Skills (PAS) and work adjustment services reported greater gains on self-ratings of life perspective (optimism), work-related attitudes, and goal attainment. (Author)

Working with Clients Who Engage in Self-Harming Behaviour: Experiences of a Group of Counsellors

ERIC Educational Resources Information Center

Fox, Claudine

2011-01-01

This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed…

An exploratory comparison of motivations and crowding norms between ethnic groups in downhill ski areas of New York state and Korea

Treesearch

Chung In Park; Chad Dawson

1998-01-01

This study explores the concept that ethnic groups have different motivations and crowding norms when downhill skiing and that visiting and immigrant ethnic groups would respond more like their original ethnic group than they would be like their host ethnic group. The four ethnic groups or sampling strata that were surveyed in this study were: White Anglo skiers at...

Wheelchair Seating Assessment and Intervention: A Comparison Between Telerehabilitation and Face-to-Face Service

PubMed Central

Barlow, Ingrid G; Liu, Lili; Sekulic, Angela

2009-01-01

This study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10) and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural). Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen face-to-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete. PMID:25945159

'Black like Beckham'? Moving beyond definitions of ethnicity based on skin colour and ancestry.

PubMed

Karlsen, Saffron

2004-05-01

The definitions of ethnic status currently employed in, particularly, epidemiological research, tend to focus on skin colour or on perceived historical or ancestral links with certain geographical locations. Neither of these classificatory systems stem from any widely supported theoretical standpoint and their usefulness in terms of explaining any ethnic variation is therefore questionable. In order to enable more informative exploration of ethnicity and its relationship with health and other indicators, a clearer understanding of the processes involved in ethnic identification is required. This paper sets out to explore underlying dimensions which could constitute an ethnic identity across different ethnic groups in England. Principal components factor analyses on the different ethnic groups included in the Ethnic Minority Psychiatric Illness Rates in the community study: Bangladeshi, Caribbean, Indian, Irish and Pakistani people and a 'white majority' group. In each ethnically specific model, three dimensions of ethnic identity were determined; related to multiculturalism, or the sustenance of ethnic difference, racialisation and community participation. In the ethnic minority group models the 'multiculturalism' dimension formed two factors: one related to the presentation of oneself as a member of a particular ethnic group and one exploring attitudes towards cultural assimilation. The findings suggested that the processes of ethnic identification are similar across the different ethnic (minority and majority) groups explored, but that there may be important differences within any particular group. The recognition of these dimensions of ethnic affiliation provide us with an opportunity to improve our indicators of ethnic status. Each of these dimensions would appear to be important to the lives of people from different ethnic groups in England. These findings also highlight the important role that external attitudes play in the understanding of what it means to be a member of any ethnic group. This aspect of ethnic affiliation has been ignored by current definitions of ethnicity and this imbalance should be redressed.

Institutional policy changes aimed at addressing obesity among mental health clients.

PubMed

Knol, Linda L; Pritchett, Kelly; Dunkin, Jeri

2010-05-01

People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. This intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients' weight at 3 and 6 months after policy implementation. At the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. Institutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients.

Financial Health and Mental Health Among Clients of a Community Mental Health Center: Making the Connections.

PubMed

Harper, Annie; Clayton, Ashley; Bailey, Margaret; Foss-Kelly, Louisa; Sernyak, Michael J; Rowe, Michael

2015-12-01

This study evaluated financial challenges, satisfaction with financial-management supports, and interest in additional or alternative supports among clients of a mental health center. Six focus groups were held with 39 clients of an urban community mental health center who reported having difficulty with their finances. Five focus groups were held with direct-care staff who provided services to the clients. Investigators used an inductive analytical approach to distill themes from notes taken during the focus groups. Clients emphasized the challenges of living in poverty and described using complex strategies to sustain themselves, including negotiating benefits systems, carefully planning purchases, and developing and relying on social relationships. They spoke of having uneven access to tools and services for managing their money, such as advice from direct-care staff, representative payees, and bank accounts, and had varying opinions about their value. Noting concerns similar to those of clients, direct-care staff expressed frustration at the lack of support services for helping clients manage their finances. Both clients and staff expressed the need for more services to help clients with their finances. Findings suggest a need for more services to support people with mental illness to manage their finances, particularly a more flexible and broader range of options than are provided by current representative-payee mechanisms.

The use of the super accelerated hepatitis B vaccination regimen in a north London sexual assault referral centre (SARC).

PubMed

Ahmed, Syma M; Volpellier, Muriel; Forster, Greta

2007-02-01

The super accelerated hepatitis B vaccination regimen was offered to survivors of sexual assault, attending the Haven Paddington, who were at possible risk of contracting the virus [Clinical Effectiveness Group. National Guideline on the Management of Adult Victims of Sexual Assault. Sex Trans Inf 2001;(Suppl. 1):S82-S84]. The uptake and completion rates of the vaccination over two time periods from March 2004 and January 2005 were audited, using 150 clients in each group. More clients accepted the initial vaccination at the time of the forensic medical examination in the second audit when compared with the first [80 clients (73%) and 73 clients (71%), respectively]. Similar numbers of clients completed the course during both study periods [34 clients (47%) and 30 clients (38%), respectively]. Of 65% of clients who had their hepatitis B surface antibody titre checked at three months during the first audit, 77% had protective levels [>10 mIU/ml]. There was little difference following the second audit, where 75% of those who had their antibody checked were found to have protective levels. Our study has shown that this client group accepted the super accelerated hepatitis B vaccination regimen. Early serological response compares well with published data for this vaccination regimen in other settings.

Do client fees help or hurt?

PubMed

Barnett, B

1998-01-01

This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

Diagnosing co-occurring substance-related disorders: agreement between SCID, Hispanic clinicians, and Non-Hispanic clinicians.

PubMed

Torres, Luis R; Zayas, Luis H; Cabassa, Leopoldo J; Pérez, M Carmela

2007-11-01

Given the composition of the mental health and substance abuse workforce in the United States, Hispanic immigrants are often assigned to non-Hispanic, English-speaking clinicians. This produces challenges in communication and in understanding linguistic and cultural nuances and greatly impacts the accuracy of diagnoses and the delivery of appropriate services. With the inclusion of objective criteria in diagnostic categories, clinician-to-clinician agreement ought not to be impacted by the ethnicity of the client or the clinician. Both practice and research, however, suggest that this is not the case, particularly when diagnosing co-occurring mental health and substance abuse disorders. We explored the degree to which Hispanic and non-Hispanic clinicians agreed with each other and with the Structured Clinical Interview for DSM-IV-TR, Research Version (SCID) when diagnosing co-occurring substance-related disorders. Using a naturalistic design, 88 adult clients were videotaped in diagnostic intake interviews (utilizing the DSM-IV-TR) with Hispanic or non-Hispanic clinicians. Videotapes were then viewed and rated by clinicians who were ethnically cross-matched to those on tape. Clients were also administered the SCID. Data were collected from September 15, 2003, through February 7, 2005. Non-Hispanic clinicians diagnosed significantly more substance-related disorders than Hispanic clinicians, and both Hispanic and non-Hispanic clinicians significantly under-diagnosed substance-related diagnoses compared to the SCID. Clinicians had very low diagnostic reliability with each other and with the SCID. Implications for the assessment, diagnosis, and treatment of co-occurring substance-related disorders are discussed. Findings seem to concur with past research suggesting that clinicians may be influenced by factors other than the diagnostic criteria (e.g., cultural and social biases) when diagnosing, and that they may make erroneous attributions of pathology when diagnosing across cultures.

Employment-related information for clients receiving mental health services and clinicians.

PubMed

King, Joanne; Cleary, Catherine; Harris, Meredith G; Lloyd, Chris; Waghorn, Geoff

2011-01-01

Clients receiving public mental health services and clinicians require information to facilitate client access to suitable employment services. However, little is known about the specific employment-related information needs of these groups. This study aimed to identify employment-related information needs among clients, clinicians and employment specialists, with a view to developing a new vocational information resource. Employment-related information needs were identified via a series of focus group consultations with clients, clinicians, and employment specialists (n=23). Focus group discussions were guided by a common semi-structured interview schedule. Several categories of information need were identified: countering incorrect beliefs about work; benefits of work; disclosure and managing personal information; impact of earnings on welfare entitlements; employment service pathways; job preparation, planning and selection; and managing illness once working. Clear preferences were expressed about effective means of communicating the key messages in written material. This investigation confirmed the need for information tailored to clients and clinicians in order to activate clients' employment journey and to help them make informed decisions about vocational assistance.

Effects of EAP follow-up on prevention of relapse among substance abuse clients.

PubMed

Foote, A; Erfurt, J C

1991-05-01

Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.

Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders.

PubMed

Muroff, Jordana; Robinson, Winslow; Chassler, Deborah; López, Luz M; Gaitan, Erika; Lundgren, Lena; Guauque, Claudia; Dargon-Hart, Susan; Stewart, Emily; Dejesus, Diliana; Johnson, Kimberly; Pe-Romashko, Klaren; Gustafson, David H

2017-01-01

Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. The evidence-based smartphone recovery application Addiction-Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to culturally and linguistically competent services.

Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) dissemination project: a science to prenatal care practice partnership.

PubMed

Windsor, Richard; Clark, Jeannie; Cleary, Sean; Davis, Amanda; Thorn, Stephanie; Abroms, Lorien; Wedeles, John

2014-01-01

This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia-Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N = 259) were all clients in 2009-2010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006-2007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N = 259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63 % in 2006 to 74 % in 2010. Significant increases were documented in the E Group cessation rate (+9.3 %) and significant reduction rate (+4.5 %), a ≥50 % reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior.

Does Motivational Interviewing (MI) Work with Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes

ERIC Educational Resources Information Center

Young, Tabitha L.; Gutierrez, Daniel; Hagedorn, W. Bryce

2013-01-01

This study investigated the relationships between motivational interviewing (MI) and client symptoms, attendance, and satisfaction. Seventy-nine clients attending a university-based counseling center were purposefully assigned to treatment or control conditions. Statistical analyses revealed client symptoms in both groups improved. However,…

Ethnic density is not associated with psychological distress in Turkish-Dutch, Moroccan-Dutch and Surinamese-Dutch ethnic minorities in the Netherlands.

PubMed

Schrier, Agnes C; Peen, Jaap; de Wit, Matty A S; van Ameijden, Erik J C; Erdem, Ozcan; Verhoeff, Arnoud P; Dekker, Jack J M; Beekman, Aartjan T F

2014-10-01

Ethnic density, the proportion of people of the same ethnic group in the neighbourhood, has been identified as a protective factor with regard to mental health in ethnic minorities. Research on the putative intermediating factors, exposure to discrimination and improved social support, has not yielded conclusive evidence. We investigated the association between ethnic density and psychological well-being in three ethnic minority groups in the Netherlands. We also assessed whether a protective ethnic density effect is related to the degree to which each group experiences discrimination and social support at group level. Using multi-level linear regression modelling, we studied the influence of ethnic density at neighbourhood level on psychological distress, measured with the Kessler Psychological Distress scale (K10), in 13,864 native Dutch, 1,206 Surinamese-Dutch, 978 Turkish-Dutch and 784 Moroccan-Dutch citizens of the four major cities in the Netherlands. Based on a nationwide survey among ethnic minorities on social integration, ethnic groups were ordered with respect to the intermediating factors. Ethnic density was not associated with psychological distress in any of the three ethnic minority groups. As a consequence, we found no support for either experiences of discrimination or for own-group social interactions at group level as intermediating factors. In all three ethnic minority groups, as well as in the native Dutch group, individual demographic and socio-economic factors emerged as the main explanations for individuals' mental well-being. These results suggest that individual demographic and socio-economic risk characteristics outweigh the influence of neighbourhood attributes on mental health.

Developing Culturally Targeted Diabetes Educational Materials for Older Russian-Speaking Immigrants.

PubMed

Van Son, Catherine R

2014-07-01

Older adults who immigrate late in life face many challenges adapting to a new country. Immigrants bring their cultural beliefs and behaviors with them, which can influence their ability to make dietary changes required when they have type 2 diabetes. Culturally targeted patient education materials are needed to improve immigrants' health literacy and abilities to self-manage diabetes. Currently, there is a scarcity of diabetes patient education materials to meet the educational needs of the Russian-speaking immigrant group. The purpose of this article is to describe a project in which culturally targeted diabetes education materials for older Russian-speaking immigrants were designed and developed. Culturally targeted patient education materials are essential if they are to be accepted and used by clients from different ethnic minority populations. The creation of culturally relevant materials requires a team effort and community stakeholder input. The availability of materials on the internet facilitates access and use by health care providers. Culturally targeted education materials are an important component in addressing health literacy in ethnic minority populations. Next steps require that these materials be evaluated to test their impact on diabetes self-management behaviors and clinical outcomes such as adherence, amount of physical activity, and blood glucose levels. © 2014 The Author(s).

Enduring Poverty: Explanations for the Persistence of Minority Poverty in Vietnam

DTIC Science & Technology

2017-03-01

ethnic groups contribute more to the persistence of minority poverty than geography and agricultural livelihoods. When prosperity levels are compared...between the ethnic majority and minority groups, between ethnic groups in similar geographic regions, and between ethnic groups with agricultural ...poverty than geography and agricultural livelihoods. When prosperity levels are compared between the ethnic majority and minority groups, between

Storytelling by community-dwelling older adults: perspectives of home care workers.

PubMed

Mastel-Smith, Beth; Binder, Brenda; Hersch, Gayle; Davidson, Harriett A; Walsh, Teresa

2011-04-01

The purpose of this exploratory, qualitative study was to investigate storytelling by home care clients to their home care workers (HCWs). Specific research questions were: (a) When does storytelling by a care recipient occur during usual care?; (b) How do HCWs engage older clients in storytelling?; (c) How do HCWs respond to the stories told by clients?; and (d) What is the perceived effect of storytelling by older clients on the relationship between the client and the HCW? Two focus groups consisting of 10 HCWs each were conducted. Verbatim transcripts of both focus groups were analyzed using the constant comparative analysis method. Categories and concepts were identified. Characteristics of the HCW and client set the stage for storytelling. The process of storytelling included context, triggers, and temporal aspects. HCWs also shared the content of stories, the impact on their relationship with the client, and the perceived effect on each individual. A visual model depicting the nature of storytelling in association with the care of older clients is presented. Copyright 2011, SLACK Incorporated.

Frequencies and ethnic distribution of ABO and RhD blood groups in China: a population-based cross-sectional study.

PubMed

Liu, Jue; Zhang, Shikun; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Liu, Min

2017-12-03

ABO and RhD blood groups are key factors affecting blood transfusion safety. The distribution of ABO and RhD blood groups varies globally, but limited data exist for ethnic distributions of these blood groups in Asian populations. We aimed to evaluate the distribution of ABO and RhD blood groups among Chinese ethnic groups. A population-based cross-sectional study. Data on ABO groups and ethnicities were obtained from the National Free Preconception Health Examination Project (NFPHEP) with participants from 220 counties of 31 provinces in China PARTICIPANTS: There were 3 832 034 participants aged 21-49 years who took part in the NFPHEP from January 2010 to December 2012 and were included in this study. The proportion of ABO and RhD blood groups among different ethnic groups was calculated. ABO and RhD blood distribution was significantly different among nine ethnic groups (P<0.001). Compared with other ethnic groups, the Yi group had more A phenotypes (34.0%), and the Manchu (33.7%) and Mongolian (33.3%) ethnic groups had more B phenotypes. The Zhuang group had the greatest proportion of O phenotypes (41.8%), followed by the Miao group (37.7%). AB phenotypes were more frequent in the Uygur ethnic group (10.6%) but lower in the Zhuang group (5.5%). Meanwhile, RhD negativity (RhD-) was greater in the Uygur group (3.3%) than in the Mongolian (0.3%) and Manchu ethnic groups (0.4%). O RhD- blood groups were more frequent in the Uygur group (0.8%) than in the other ethnic groups (0.1%-0.4%, P<0.001). ABO and RhD blood phenotypes vary across different ethnic groups in China. The diversity in the distribution of the ABO and RhD blood groups in different ethnic groups should be considered when developing rational and evidence-based strategies for blood collection and management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Correlates of unprotected sex with female sex workers among male clients in Tijuana, Mexico.

PubMed

Goldenberg, Shira M; Gallardo Cruz, Manuel; Strathdee, Steffanie A; Nguyen, Lucie; Semple, Shirley J; Patterson, Thomas L

2010-05-01

Tijuana, situated adjacent to San Diego, CA on the US-Mexico border, is experiencing an emerging HIV epidemic, with prevalence among female sex workers (FSWs) having risen in recent years from <1% to 6%. Comparable data on FSWs' clients are lacking. We explored correlates of unprotected sex with FSWs among male clients in Tijuana. In 2008, males from San Diego (N = 189) and Tijuana (N = 211) aged 18 or older who had paid or traded for sex with a FSW in Tijuana during the past 4 months were recruited in Tijuana's red light district. Participants underwent psychosocial interviews, and were tested for HIV, syphilis (Treponema pallidum), gonorrhea (Neisseria gonorrhoeae), and Chlamydia (Chlamydia trachomatis). Of 394 men, median age was 36 years, 42.1% were married, and 39.3% were unemployed. Ethnic composition was 13.2% white, 79.4% Hispanic, and 7.4% black or other. Half (50.3%) reported unprotected vaginal or anal sex with FSWs in Tijuana in the past 4 months. High proportions reported using drugs during sex (66%), and 36% reported frequenting the same FSW. Factors independently associated with unprotected sex with FSWs were using drugs during sex, visiting the same FSW, being married, and being unemployed. FSWs' clients represent a sexually transmitted infections/HIV transmission "bridge" through unprotected sex with FSWs, wives, and other partners. Tailored interventions to promote consistent condom use are needed for clients, especially within the context of drug use and ongoing relations with particular FSWs.

A Quantitative Review of Ethnic Group Differences in Experimental Pain Response: Do Biology, Psychology and Culture Matter?

PubMed Central

Riley, Joseph L.; Williams, Ameenah K.K.; Fillingim, Roger B.

2012-01-01

Objective Pain is a subjectively complex and universal experience. We examine research investigating ethnic group differences in experimental pain response, and factors contributing to group differences. Method We conducted a systematic literature review and analysis of studies using experimental pain stimuli to assess pain sensitivity across multiple ethnic groups. Our search covered the period from 1944-2011, and utilized the PUBMED bibliographic database; a reference source containing over 17 million citations. We calculated effect sizes, identified ethnic/racial group categories, pain stimuli and measures, and examined findings regarding biopsychosociocultural factors contributing to ethnic/racial group differences. Results We found 472 studies investigating ethnic group differences and pain. Twenty-six of these met our review inclusion criteria of investigating ethnic group differences in experimental pain. The majority of studies included comparisons between African Americans (AA) and non-Hispanic Whites (NHW). There were consistently moderate to large effect sizes for pain tolerance across multiple stimulus modalities; African Americans demonstrated lower pain tolerance. For pain threshold, findings were generally in the same direction, but effect sizes were small to moderate across ethnic groups. Limited data were available for suprathreshold pain ratings. A subset of studies comparing NHW and other ethnic groups showed a variable range of effect sizes for pain threshold and tolerance. Conclusion There are potentially important ethnic/racial group differences in experimental pain perception. Elucidating ethnic group differences, has translational merit for culturally-competent clinical care and for addressing and reducing pain treatment disparities among ethnically/racially diverse groups. PMID:22390201

A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter?

PubMed

Rahim-Williams, Bridgett; Riley, Joseph L; Williams, Ameenah K K; Fillingim, Roger B

2012-04-01

Pain is a subjectively complex and universal experience. We examine research investigating ethnic group differences in experimental pain response and factors contributing to group differences. We conducted a systematic literature review and analysis of studies using experimental pain stimuli to assess pain sensitivity across multiple ethnic groups. Our search covered the period from 1944 to 2011, and used the PubMed bibliographic database; a reference source containing over 17 million citations. We calculated effect sizes; identified ethnic/racial group categories, pain stimuli, and measures; and examined findings regarding biopsychosociocultural factors contributing to ethnic/racial group differences. We found 472 studies investigating ethnic group differences and pain. Twenty-six of these met our review inclusion criteria of investigating ethnic group differences in experimental pain. The majority of studies included comparisons between African Americans (AA) and non-Hispanic Whites (NHW). There were consistently moderate to large effect sizes for pain tolerance across multiple stimulus modalities; AA demonstrated lower pain tolerance. For pain threshold, findings were generally in the same direction, but effect sizes were small to moderate across ethnic groups. Limited data were available for suprathreshold pain ratings. A subset of studies comparing NHW and other ethnic groups showed a variable range of effect sizes for pain threshold and tolerance. There are potentially important ethnic/racial group differences in experimental pain perception. Elucidating ethnic group differences has translational merit for culturally competent clinical care and for addressing and reducing pain treatment disparities among ethnically/racially diverse groups. Wiley Periodicals, Inc.

Ethnic Variations in Gastric cancer in a tertiary care centre of Sikkim in North-East India.

PubMed

Lamtha, Sangey Chhophel; Tripathi, Manish Kumar; Bhutia, Karma Doma; Karthak, Caroline

2016-01-01

The etiology of gastric cancer is multifactorial. Marked differences in the incidence of gastric cancer among different ethnic groups living in the same geographical area have been observed. This study looked at ethnic and dietary factors in patients with gastric cancer diagnosed at a tertiary referral centre in Sikkim over a period of one year. Patients of 60 years and above were included in the study and divided into four ethnic groups : Bhutias, Lepchas, Rais and other groups. 211 cases underwent upper GI endoscopy and 32 were diagnosed to have gastric cancer. Gastric cancer incidence was highest in Bhutia ethnic group. A trend towards higher intake of smoked meats, fermented vegetables, salt tea, and H.pylori positivity in the Bhutia ethnic group was associated with higher incidence of gastric cancer as compared to other ethnic groups. The study with a referral centre bias showed that Bhutia ethnic group had a higher incidence of gastric cancer as compared to other ethnic groups.

The value of normalization: Group therapy for individuals with brain injury.

PubMed

von Mensenkampff, Barbara; Ward, Marcia; Kelly, Grace; Cadogan, Sam; Fawsit, Feargus; Lowe, Niamh

2015-01-01

This paper reports on a client-driven therapy group designed to help clients actively process changes and equip them with the psychological skills necessary to facilitate rehabilitation. This is an exploratory mixed methods research design based in clinical practice. This study documents results from five therapy groups, each group consisting of 2-hour sessions over an average of 6 weeks with a review session 6 weeks later. Forty-five clients (13 female, 32 male, average age = 40.54, SD = 11.87) with brain injury attended the group with Headway psychological services, Cork. Clients' pre- and post-measures of functioning were gathered to assess the potential therapeutic benefits. Thematic analysis was used to evaluate the qualitative data. Results illustrate a number of benefits to the participants, including normalizing effects, helping with acceptance, finding a new identity and positive mental health changes. Findings are encouraging and help to validate the effectiveness of group therapy as an intervention tool.

The Lifestyle Engagement Activity Program (LEAP): Implementing Social and Recreational Activity into Case-Managed Home Care.

PubMed

Low, Lee-Fay; Baker, Jessica Rose; Harrison, Fleur; Jeon, Yun-Hee; Haertsch, Maggie; Camp, Cameron; Skropeta, Margaret

2015-12-01

The Lifestyle Engagement Activity Program (LEAP) incorporates social support and recreational activities into case-managed home care. This study's aim was to evaluate the effect of LEAP on engagement, mood, and behavior of home care clients, and on case managers and care workers. Quasi-experimental. Five Australian aged home care providers, including 2 specializing in care for ethnic minorities. Clients (n = 189) from 5 home care providers participated. The 12-month program had 3 components: (1) engaging support of management and staff; (2) a champion to drive practice change; (3) staff training. Case managers were trained to set meaningful social and/or recreational goals during care planning. Care workers were trained in good communication, to promote client independence and choice, and in techniques such as Montessori activities, reminiscence, music, physical activity, and humor. Data were collected 6 months before program commencement, at baseline, and 6 and 12 months. The Homecare Measure of Engagement Staff report and Client-Family interview were primary outcomes. Secondary outcomes were the Cohen-Mansfield Agitation Inventory; apathy, dysphoria, and agitation subscales of the Neuropsychiatric Inventory-Clinician Rating; the geriatric depression scale; UCLA loneliness scale; and home care satisfaction scale. Staff provided information on confidence in engaging clients and the Utrecht Work Engagement Scale. Twelve months after program commencement, clients showed a significant increase in self- or family-reported client engagement (b = 5.39, t[113.09] = 3.93, P < .000); and a significant decrease in apathy (b = -0.23, t(117.00) = -2.03, P = .045), dysphoria (b = -0.25, t(124.36) = -2.25, P = .026), and agitation (b = -0.97, t(98.15) = -3.32, P = .001) on the Neuropsychiatric Inventory-Clinician. Case managers and care workers both reported significant increases in their confidence to socially and recreationally engage clients (b = 0.52, t(21.33) = 2.80, P = .011, b = 0.29, t(198.69) = 2.58, P = .011, respectively). There were no significant changes in care worker-rated client engagement or client or family self-complete measures of depression or loneliness (P > .05). Client and family self-rated apathy increased over 12 months (b = 0.04, t(43.36) = 3.06, P = .004; b = 3.63, t(34.70) = 2.20, P = .035) CONCLUSIONS: LEAP demonstrated that home care providers can incorporate social and recreational care into usual practice for older clients, and that this benefits clients' engagement, dysphoria, and agitation. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Utilization of emergency and hospital services among individuals in substance abuse treatment

PubMed Central

2014-01-01

Background To examine risk factors for use of hospital services among racial and ethnic minority clients in publicly funded substance abuse treatment in Los Angeles County, California. We explored cross-sectional annual data (2006 to 2009) from the Los Angeles County Participant Reporting System for adult participants (n = 73,251) who received services from treatment programs (n = 231). Methods This retrospective analysis of county admission data relied on hierarchical linear negative binomial regression models to explore number of hospital visits, accounting for clients nested in programs. Client data were collected during personal interviews at admission. Findings Our findings support previous work that noted increased use of emergency rooms among individuals suffering from mental health- and substance use-related issues and extend the knowledge base by highlighting other important features such as treatment need, i.e., residential compared to outpatient treatment. Conclusions These findings have implications for health care policy in terms of the need to increase prevention services and reduce costly hospitalization for a population at significant risk of co-occurring mental and physical disorders. PMID:24708866

Motivational interviewing skills are positively associated with nutritionist self-efficacy.

PubMed

Marley, Scott C; Carbonneau, Kira; Lockner, Donna; Kibbe, Debra; Trowbridge, Frederick

2011-01-01

To examine the relationships between physical and social self-concepts, motivational interviewing (MI), and nutrition assessment skills with dimensions of counseling self-efficacy. Cross-sectional survey. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics. Sixty-five WIC nutritionists. Counseling self-efficacy on topics related to physical activity and nutritional behaviors and in the presence of language and cultural differences. Multiple linear regression. Nutritionists' perception of their own MI skills was positively associated with their self-efficacy for counseling clients of a culture different than their own, when counseling about physical activity, and when counseling about nutrition behavior. Hispanic ethnicity and social self-concept were positively associated with counseling self-efficacy when culture differences were present. Physical self-concept was positively associated with self-efficacy related to physical activity topics. Nutrition assessment skill was negatively associated with self-efficacy for working with non-English-speaking clients. Development of MI skills and strategies to improve social and physical self-concept may increase WIC nutritionists' counseling self-efficacy, particularly when counseling clients from diverse backgrounds. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Encouraging smoking cessation among disadvantaged groups: a qualitative study of the financial aspects of cessation.

PubMed

Bonevski, Billie; Bryant, Jamie; Paul, Christine

2011-07-01

This study aimed to explore perceptions about financial aspects of smoking cessation among a group of disadvantaged welfare agency clients and their carers. Qualitative focus groups and in-depth interviews were supplemented with participant exit surveys about preferred smoking cessation strategies. Each discussion was audiotaped, transcribed and analysed using a thematic analysis. The setting was six non-government community welfare service organisations operating in New South Wales, Australia. Eleven social services offered by these organisations participated. Thirty two clients participated in six client focus groups, 35 staff participated in six staff focus groups and eight manager telephone interviews were conducted. Clients indicated that the cost of nicotine replacement therapy was a barrier to its use and that financial incentives were acceptable. Of the 16 possible strategies listed in the exit survey, the three selected as the most preferred by clients incorporated financial or non-financial assistance. By contrast, staff and managers selected financial and non-financial incentives as the least preferred and least feasible strategies. The study found high acceptance of incentives as a smoking cessation strategy among a disadvantaged group of non-government welfare service clients. The comparatively low level of desirability and feasibility from the perspective of service staff and managers suggests implementation of such an approach within the community service setting requires careful further testing. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness.

PubMed

Browne, Julia; Mihas, Paul; Penn, David L

2016-05-01

The health benefits of exercise are well established, yet individuals with serious mental illness (SMI) have a shorter life expectancy due in large part to physical health complications associated with poor diet and lack of exercise. There is a paucity of research examining exercise in this population with the majority of studies having examined interventions with limited feasibility and sustainability. Before developing an intervention, a thorough exploration of client and clinician perspectives on exercise and its associated barriers is warranted. Twelve clients and fourteen clinicians participated in focus groups aimed at examining exercise, barriers, incentives, and attitudes about walking groups. Results indicated that clients and clinicians identified walking as the primary form of exercise, yet barriers impeded consistent participation. Distinct themes arose between groups; however, both clients and clinicians reported interest in a combination group/pedometer based walking program for individuals with SMI. Future research should consider examining walking programs for this population.

Ecological association between HIV and concurrency point-prevalence in South Africa's ethnic groups.

PubMed

Kenyon, Chris

2013-11-01

HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the spread of HIV. Few studies have, however, investigated if differential concurrency rates could explain differential HIV spread within ethnic groups in South Africa. This ecological analysis, explores how much of the variation in HIV prevalence by ethnic group is explained by differential concurrency rates. Using a nationally representative survey (the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005) the HIV prevalence in each of eight major ethnic groups was calculated. Linear regression analysis was used to assess the association between an ethnic group's HIV prevalence and the point-prevalence of concurrency. Results showed that HIV prevalence rates varied considerably between South Africa's ethnic groups. This applied to both different racial groups and to different ethnic groups within the black group. The point-prevalence of concurrency by ethnic group was strongly associated with HIV prevalence (R(2) = 0.83; p = 0.001). Tackling the key drivers of high HIV transmission in this population may benefit from more emphasis on partner reduction interventions.

Use of GetCheckedOnline, a Comprehensive Web-based Testing Service for Sexually Transmitted and Blood-Borne Infections

PubMed Central

Salway, Travis; Haag, Devon; Fairley, Christopher K; Wong, Jason; Grennan, Troy; Uddin, Zhaida; Buchner, Christopher S; Wong, Tom; Krajden, Mel; Tyndall, Mark; Shoveller, Jean; Ogilvie, Gina

2017-01-01

Background The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO’s objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). Objective The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. Methods We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Results Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis). Conclusions Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings. PMID:28320690

Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia.

PubMed

Smith, Cynthia; McNaughton, Darlene A; Meyer, Samantha

2016-01-01

Type 2 diabetes mellitus (T2DM) is a progressive chronic disease that requires significant self-surveillance and adherence to the treatment protocols for successful management and future health. There is a growing body of evidence suggesting that diabetes education is beneficial for patient outcomes. However, there is some debate about how best to deliver diabetes education, whether individually or in groups. Although several studies have investigated the role of group education in improving the management of T2DM, few studies have examined this issue from the client's perspective. It is here that this study makes a contribution to understanding diabetes management. Drawing on systematic observation of group education sessions provided by diabetic resource nurses and in-depth interviews with clients, this paper describes the experiences, perspectives and significance of these sessions to clients. Our results suggest that group education sessions were seen as valuable to the clients for: the opportunity they provided to meet others living with diabetes; to improve motivation for managing the disease; and to enhance knowledge of diabetes, its management and long-term implications. In short, this study demonstrates that the clients value group education sessions for the social contact, increasing knowledge about the disease for self-management and support they provide; factors recognised as important to maintaining health. In addition, group education sessions appear to be a cost-effective method for diabetes self-management that funders need to consider.

Counselor Beliefs and Perceived Knowledge Regarding Clients with Learning Disabilities

ERIC Educational Resources Information Center

Bell, Tamekia R.

2012-01-01

Clients with learning disabilities constitute a cultural group that has not been extensively studied. The professional literature has found that counselors have reported the need for additional training in working with clients with disabilities. This study explored counselors' beliefs and perceived knowledge regarding counseling clients with…

Group Process in a Women's Career Intervention.

ERIC Educational Resources Information Center

Mawson, Diana L.; Kahn, Sharon E.

1993-01-01

Explored women's experiences of group process in career planning interventions and relationship of those experiences to vocational maturity. Results from 99 career-undecided women revealed that female clients, similar to other counseling clients, highly valued both cognitive and affective components of group process in career counseling groups.…

"Everything that I thought that they would be, they weren't:" family systems as support and impediment to recovery.

PubMed

EnglandKennedy, Elizabeth Sara; Horton, Sarah

2011-10-01

Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA, these were collected as part of a larger, long-term study. We examine the latter's concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members' actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees' perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery. Copyright © 2011 Elsevier Ltd. All rights reserved.

“Everything that I thought that they would be, they weren’t:” Family systems as support and impediment to recovery

PubMed Central

Kennedy, Elizabeth Sara England; Horton, Sarah

2011-01-01

Family help provision for adults diagnosed with co-occurring severe mental illness and substance dependence is understudied. This article draws on verbally-administered structured and semi-structured interviews with one group of 122 behavioral health care clients and one group of 54 client-nominated family members. In New Mexico, USA these were collected as part of a larger, long-term study. We examine the latter’s concerns and fears, relative desire to be involved with treatment, and difficulties connecting with professionals, as well as forms of assistance they gave to clients and intra-family communication. We found that family members’ actions and communications often support client recovery through resource provision and other, intangible forms of help. However, their misunderstandings of and lack of knowledge about client experiences can also impede recovery. We also compare the two groups of interviewees’ perspectives on assistance given to clients by family members. We give examples of family attempts to deliver help and their consequences. Last, we offer suggestions for providers and policymakers to better help family members achieve their goal of caring for clients in recovery. PMID:21880408

Individualism, collectivism and ethnic identity: cultural assumptions in accounting for caregiving behaviour in Britain.

PubMed

Willis, Rosalind

2012-09-01

Britain is experiencing the ageing of a large number of minority ethnic groups for the first time in its history, due to the post-war migration of people from the Caribbean and the Indian subcontinent. Stereotypes about a high level of provision of informal caregiving among minority ethnic groups are common in Britain, as in the US, despite quantitative studies refuting this assumption. This paper reports on a qualitative analysis of in-depth interviews with older people from five different ethnic groups about their conceptualisation of their ethnic identity, and their attributions of motivations of caregiving within their own ethnic group and in other groups. It is argued that ethnic identity becomes salient after migration and becoming a part of an ethnic minority group in the new country. Therefore, White British people who have never migrated do not have a great sense of ethnic identity. Further, a strong sense of ethnic identity is linked with identifying with the collective rather than the individual, which explains why the White British participants gave an individualist account of their motivations for informal care, whereas the minority ethnic participants gave a collectivist account of their motivations of care. Crucially, members of all ethnic groups were providing or receiving informal care, so it was the attribution and not the behaviour which differed.

Role of ethnicity in human papillomavirus vaccination uptake: a cross-sectional study of girls from ethnic minority groups attending London schools.

PubMed

Rockliffe, Lauren; Waller, Jo; Marlow, Laura A V; Forster, Alice S

2017-02-23

Research suggests that girls from ethnic minority groups are less likely to receive the human papillomavirus (HPV) vaccination than white British girls; however, the specific ethnic minority groups that have lower uptake have not been identified. This study aimed to examine the relationship between school-level uptake and ethnicity as well as uptake and other ethnicity-related factors, to understand which specific groups are less likely to receive the vaccination. Aggregated uptake rates from 195 schools were obtained for each of the three recommended vaccine doses from 2008 to 2010. Census data at the lower super output area (LSOA) level for the postcode of each school were also obtained, describing the ethnic breakdown of the resident population (ethnicity, language spoken, religion, proficiency in English and duration of residency in the UK). These were used as proxy measures of the ethnic make-up of the schools. The most prevalent non-majority group for each ethnicity and ethnicity-related factor was assigned to each school. Analyses explored differences in uptake by ethnicity and ethnicity-related factors. No significant differences in vaccination uptake were found by ethnicity or ethnicity-related factors, although descriptive differences were apparent. Schools in areas where black ethnicities were the most prevalent non-white British ethnicities had consistently low rates of uptake for all doses. Schools in areas where some Asian ethnicities were the most prevalent non-white British ethnicities had consistently high rates of uptake for all doses. There was evidence of variability in mean uptake rates for ethnicities within 'black' and 'Asian' ethnic groups. Future research would benefit from focusing on specific ethnicities rather than broad ethnic categories. Replication of this study with a larger sample and using complete individual-level data, collected on a national level, would provide a clearer indication of where ethnic differences in HPV vaccination uptake exist. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Role of ethnicity in human papillomavirus vaccination uptake: a cross-sectional study of girls from ethnic minority groups attending London schools

PubMed Central

Rockliffe, Lauren; Waller, Jo; Marlow, Laura A V; Forster, Alice S

2017-01-01

Objectives Research suggests that girls from ethnic minority groups are less likely to receive the human papillomavirus (HPV) vaccination than white British girls; however, the specific ethnic minority groups that have lower uptake have not been identified. This study aimed to examine the relationship between school-level uptake and ethnicity as well as uptake and other ethnicity-related factors, to understand which specific groups are less likely to receive the vaccination. Methods Aggregated uptake rates from 195 schools were obtained for each of the three recommended vaccine doses from 2008 to 2010. Census data at the lower super output area (LSOA) level for the postcode of each school were also obtained, describing the ethnic breakdown of the resident population (ethnicity, language spoken, religion, proficiency in English and duration of residency in the UK). These were used as proxy measures of the ethnic make-up of the schools. The most prevalent non-majority group for each ethnicity and ethnicity-related factor was assigned to each school. Analyses explored differences in uptake by ethnicity and ethnicity-related factors. Results No significant differences in vaccination uptake were found by ethnicity or ethnicity-related factors, although descriptive differences were apparent. Schools in areas where black ethnicities were the most prevalent non-white British ethnicities had consistently low rates of uptake for all doses. Schools in areas where some Asian ethnicities were the most prevalent non-white British ethnicities had consistently high rates of uptake for all doses. There was evidence of variability in mean uptake rates for ethnicities within ‘black’ and ‘Asian’ ethnic groups. Conclusions Future research would benefit from focusing on specific ethnicities rather than broad ethnic categories. Replication of this study with a larger sample and using complete individual-level data, collected on a national level, would provide a clearer indication of where ethnic differences in HPV vaccination uptake exist. PMID:28235971

Conduct disorder and antisocial personality disorder in persons with severe psychiatric and substance use disorders.

PubMed

Mueser, Kim T; Crocker, Anne G; Frisman, Linda B; Drake, Robert E; Covell, Nancy H; Essock, Susan M

2006-10-01

Conduct disorder (CD) and antisocial personality disorder (ASPD) are established risk factors for substance use disorders in both the general population and among persons with schizophrenia and other severe mental illnesses. Among clients with substance use disorders in the general population, CD and ASPD are associated with more severe problems and criminal justice involvement, but little research has examined their correlates in clients with dual disorders. To address this question, we compared the demographic, substance abuse, clinical, homelessness, sexual risk, and criminal justice characteristics of 178 dual disorder clients living in 2 urban areas between 4 groups: No CD/ASPD, CD Only, Adult ASPD Only, and Full ASPD. Clients in the Adult ASPD Only group tended to have the most severe drug abuse severity, the most extensive homelessness, and the most lifetime sexual partners, followed by the Full ASPD group, compared with the other 2 groups. However, clients with Full ASPD had the most criminal justice involvement, especially with respect to violent charges and convictions. The results suggest that a late-onset ASPD subtype may develop in clients with severe mental illness secondary to substance abuse, but that much criminal behavior in clients with dual disorders may be due to the early onset of the full ASPD syndrome in this population and not the effects of substance use disorders.

Domestic violence, deportation, and women's resistance: notes on managing inter-sectionality.

PubMed

Sen, P

1999-02-01

This article describes the work of Southall Black Sisters (SBS), a small women's group in London that engages in political lobbying, activism, and case work, largely with Asian women immigrants seeking an escape from domestic violence. The strategies that SBS uses include: maintaining a strong link between its case work and the larger policy and social practices that make it difficult for women to counter domestic violence effectively; challenging multiple forms of oppression (based on gender, race, ethnicity, and the patriarchy) simultaneously; and networking with a range of other organizations to accomplish specific tasks. Thus, SBS's work for social change challenges the following: the prevailing culture that permits violence against women to be endemic; the construction and delivery of services to abused women that fail to meet the needs of Asian immigrants with little command of English; and the overriding legal and policy context. In particular, SBS clients face difficulties because the UK's immigration rules require incoming spouses to remain married for a year in order to stay in the country. During this period, incoming spouses are denied the very welfare benefits that provide funding for abused women in shelters. SBS case work includes counseling, arranging accommodations, finding legal counsel, and supporting clients through legal processes. SBS draws on its case work to inform its lobbying and to give a voice to victims of domestic violence.

Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors

PubMed Central

Greenwood, Nan; Holley, Jess; Ellmers, Theresa; Mein, Gill; Cloud, Geoffrey

2016-01-01

Objectives Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. Design This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. Setting Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. Participants 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. Results Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. Conclusions Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers’ part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face. PMID:26826148

Adding a vocational focus to mental health rehabilitation.

PubMed

Blankertz, L; Robinson, S

1996-11-01

The study examined the effect of adding two employment specialists to the staff of a community mental health center; their sole responsibility was to develop the skills and positive work attitudes that clients with severe mental illness need to enter the state vocational rehabilitation system or to seek employment. A total of 122 clients were randomly assigned to a program with an employment specialist or to a control group with no specialized vocational services. Clients in the program were taught work skills and attitudes in group and individual sessions and through a trial work experience. A schedule of rewards reinforced positive changes. Outcomes measured were skill gains, changes in work attitudes, attainment of employment, and entry into the state vocational rehabilitation system. At nine months, 34 of the 61 clients in the program achieved positive changes in vocational status that included competitive employment, participation in training and evaluation programs operated by the state vocational system, and formal referral to the system. Only one client in the control group was linked to the state system. Skill gains and positive changes in work attitudes were found for all program clients. Logistical regression suggested that program participation, rather than client characteristics, was an important predictor of a positive outcome. Over a relatively short time period, targeted vocational programs can help clients with severe mental illness develop the skills and attitudes necessary to attain employment or entry into the vocational rehabilitation system. Vocational rehabilitation can be an integral part of the rehabilitation process for all mental health clients.

A preliminary case-mix classification system for Medicare home health clients.

PubMed

Branch, L G; Goldberg, H B

1993-04-01

In this study, a hierarchical case-mix model was developed for grouping Medicare home health beneficiaries homogeneously, based on the allowed charges for their home care. Based on information from a two-page form from 2,830 clients from ten states and using the classification and regression trees method, a four-component model was developed that yielded 11 case-mix groups and explained 22% of the variance for the test sample of 1,929 clients. The four components are rehabilitation, special care, skilled-nurse monitoring, and paralysis; each are categorized as present or absent. The range of mean-allowed charges for the 11 groups in the total sample was $473 to $2,562 with a mean of $847. Of the six groups with mean charges above $1,000, none exceeded 5.2% of clients; thus, the high-cost groups are relatively rare.

Relating Therapist Characteristics to Client Engagement and the Therapeutic Alliance in an Adolescent Custodial Group Substance Misuse Treatment Program.

PubMed

Daniels, Rachael Anne; Holdsworth, Emma; Tramontano, Carlo

2017-07-29

Client engagement in substance misuse treatment programs is directly associated with positive treatment outcomes. The nature of these programs means there are often difficulties engaging and retaining clients, but authors have consistently found a strong therapeutic alliance is associated with client engagement. While research has focused on the association between the alliance and engagement, the factors that influence the therapeutic alliance have received less attention. To examine therapists' characteristics, namely therapists' stress and empathy levels, as potential predictors of client engagement and the therapeutic alliance, within an adolescent substance misuse group treatment program. The sample included 84 adolescent clients and 14 therapists from a Secure Training Centre in England. Client engagement in the treatment program was observed, while self-reporting measures assessed the therapeutic alliance (client and therapist-rated), and therapists' stress and empathy levels. Multiple regression analysis revealed that therapists' stress levels negatively influenced the therapeutic alliance and had a curvilinear relationship with client engagement, indicating that stress is not exclusively negatively related to engagement. Although stress was found to negatively impact both cognitive and affective empathy, neither cognitive nor affective empathy were significantly related to client engagement or the therapeutic alliance. This study demonstrates the importance of therapist characteristics on client engagement and the therapeutic alliance. Within practice stress can have a positive impact on clients' engagement. Nevertheless, therapists may need additional support to deal with stress effectively. Therapists' empathy may too be fundamental to client engagement, but only it if is perceived by clients.

Ethnic Identity in Diverse Schools: Preadolescents' Private Regard and Introjection in relation to Classroom Norms and Composition.

PubMed

Gharaei, Nadya; Thijs, Jochem; Verkuyten, Maykel

2018-06-19

Ethnic identity plays a key role in the normative development of children and adolescents, and efforts to provide a positive and safe environment for ethnic identity benefit from an understanding of its context-dependency. Following the social identity perspective, we add to research on ethnic identity by considering the role of the classroom context and by conceptualizing ethnic identity in terms of two key dimensions. Specifically, the present study aims to investigate the role of the classroom context for ethnic private regard (positive ethnic self-feelings) and for the under-researched construct of ethnic introjection (subjective self-group merging). These two dimensions of ethnic identity were examined in 51 Dutch school classes among grade 4-6 students (N = 573; M age  = 10.77, SD = 1.02; 54% girls) of Dutch, Turkish and Moroccan ethnic background. We focused on teachers' multicultural norms and classmates' evaluation of the ethnic in-group (peer group norms) in combination with the ethnic class composition. It was found that ethnic introjection was empirically distinct from ethnic private regard, and that the former dimension depended on the classroom context more than the latter. Multicultural teacher norms affected minority preadolescents' private regard positively, but only when the share of in-group classmates was low. Positive peer group norms of in-group classmates strengthened students' introjection, while those of out-group classmates lowered it. The findings indicate that ethnic identity research will be enhanced by more fully considering the conceptual and contextual implications of the social identity perspective.

Boundaries of American Identity: Relations between Ethnic Group Prototypicality and Policy Attitudes.

PubMed

Huynh, Que-Lam; Devos, Thierry; Altman, Hannah R

2015-08-01

We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to anti-minority policy attitudes and acculturation ideologies among majority group members (European Americans) than among minority group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups, and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to anti-minority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities.

Boundaries of American Identity: Relations between Ethnic Group Prototypicality and Policy Attitudes

PubMed Central

Huynh, Que-Lam; Devos, Thierry; Altman, Hannah R.

2014-01-01

We sought to document that the extent to which different ethnic groups are perceived as embodying the American identity is more strongly linked to anti-minority policy attitudes and acculturation ideologies among majority group members (European Americans) than among minority group members (Asian Americans or Latino/as). Participants rated 13 attributes of the American identity as they pertain to different ethnic groups, and reported their endorsement of policy attitudes and acculturation ideologies. We found a relative consensus across ethnic groups regarding defining components of the American identity. However, European Americans were perceived as more prototypical of this American identity than ethnic minorities, especially by European American raters. Moreover, for European Americans but not for ethnic minorities, relative ingroup prototypicality was related to anti-minority policy attitudes and acculturation ideologies. These findings suggest that for European Americans, perceptions of ethnic group prototypicality fulfill an instrumental function linked to preserving their group interests and limiting the rights afforded to ethnic minorities. PMID:26347578

Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

PubMed

Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

2017-12-14

This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

New way of working: Professionals' expectations and experiences of the Culture and Health Project for clients with psychiatric disabilities: A focus group study.

PubMed

Wästberg, Birgitta A; Sandström, Boel; Gunnarsson, Anna Birgitta

2018-02-01

There is a need for various types of interventions when meeting needs of clients with psychiatric disabilities and complementary interventions may also influence their well-being. The Culture and Health project, based on complementary interventions with 270 clients, was created in a county in Sweden for clients with psychiatric disabilities and for professionals to carry out the interventions. The aim of this study was to investigate the professionals' expectations regarding the project and their clients' possibilities for participating, and to investigate the professionals' experiences of the project after its completion. Focus group data with a total of 30 professionals participating were collected. A qualitative content analysis revealed four categories of the professionals' expectations before entering the project: "Clients' own possibilities and limitations for their development and independence", "Professionals' possibilities for supporting the clients", "Societal prerequisites", and "Expectations of a new way of working". Furthermore, the analysis regarding professionals' experiences after working with the project revealed three categories: "Adopting the challenges", "Having ways of working that function - prerequisites and possibilities", and "Meeting the future - an ambition to continue". Working in the Culture and Health project together with the clients in group-based activities was perceived as beneficial, although challenges arose. When implementing cultural activities, support from stakeholder organisations is needed. © 2017 Australian College of Mental Health Nurses Inc.

Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups.

PubMed

Bil, Janneke P; Prins, Maria; Stolte, Ineke G; Dijkshoorn, Henriëtte; Heijman, Titia; Snijder, Marieke B; Davidovich, Udi; Zuure, Freke R

2017-09-21

There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands. Data were collected in four different studies among the general population (S1 - 2) and sexual risk groups (S3 - 4). S1 - Amsterdam residents participating in representative population-based surveys (2008 and 2012; n=6044) drawn from the municipality register; S2 - Participants of a population-based study stratified by ethnicity drawn from the municipality register of Amsterdam (2011-2015; n=17 603); S3 - Men having sex with men (MSM) participating in an HIV observational cohort study (2008 and 2013; n=597) and S4 - STI clinic clients participating in a cross-sectional survey (2007-2012; n=5655). Prevalence of HIV/STI self-test usage and its determinants. The prevalence of HIV/STI self-test usage in the preceding 6-12 months varied between 1% and 2% across studies. Chlamydia self-tests were most commonly used, except among MSM in S3. Chlamydia and syphilis self-test usage increased over time among the representative sample of Amsterdam residents (S1) and chlamydia self-test usage increased over time among STI clinic clients (S4). Self-test usage was associated with African Surinamese or Ghanaian ethnic origin (S2), being woman or MSM (S1 and 4) and having had a higher number of sexual partners (S1-2). Among those in the general population who tested for HIV/STI in the preceding 12 months, 5-9% used a self-test. Despite low HIV/STI self-test usage, we observed increases over time in chlamydia and syphilis self-test usage. Furthermore, self-test usage was higher among high-risk individuals in the general population. It is important to continue monitoring self-test usage and informing the public about the unknown quality of available self-tests in the Netherlands and about the pros and cons of self-testing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The role of national identity representation in the relation between in-group identification and out-group derogation: ethnic versus civic representation.

PubMed

Meeus, Joke; Duriez, Bart; Vanbeselaere, Norbert; Boen, Filip

2010-06-01

Two studies investigated whether the content of in-group identity affects the relation between in-group identification and ethnic prejudice. The first study among university students, tested whether national identity representations (i.e., ethnic vs. civic) moderate or mediate the relation between Flemish in-group identification and ethnic prejudice. A moderation hypothesis is supported when those higher in identification who subscribe to a more ethnic representation display higher ethnic prejudice levels than those higher in identification who subscribe to a more civic representation. A mediation hypothesis is supported when those higher in identification tend towards one specific representation, which in turn, should predict ethnic prejudice. Results supported a mediation hypothesis and showed that the more respondents identified with the Flemish in-group, the more ethnic their identity representation, and the more they were inclined to display ethnic prejudice. The second study tested this mediation from a longitudinal perspective in a two-wave study among high school students. In-group identification at Time 1 predicted over-time changes in identity representation, which in turn, predicted changes in ethnic prejudice. In addition to this, changes in identity representation were predicted by initial ethnic prejudice levels. The implications of these findings are discussed.

Depressive Symptoms, Substance Abuse, and Intimate Partner Violence among Pregnant Women of Diverse Ethnicities

PubMed Central

Holden, Kisha B.; McKenzie, Robetta; Pruitt, Vikki; Aaron, Katrina; Hall, Stephanie

2012-01-01

This study examines the relationship between self-reported depressive symptoms, substance abuse and intimate partner violence among 602 African American, Hispanic, White, Asian American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander pregnant women who are clients of the Augusta Partnership for Children, Inc., a nonprofit collaborative that works with agencies, organizations, and individuals to improve the lives of children and families in Augusta-Richmond County, Georgia. Descriptive statistics and significant relationships among selected variables using correlation and regression analyses were conducted. Findings are intended to inform strategies for community-based programs better to assist women of diverse ethnicities with addressing depression, substance abuse, and intimate partner violence during their pregnancies, with the ultimate aim of improving health and mental health outcomes for women and children. PMID:22643473

The eating and physical activity habits of inner-city adolescents.

PubMed

Sweeney, Nancy M; Glaser, Dale; Tedeschi, Christine

2007-01-01

The purposes of this study were to (a) analyze the body mass index (BMI) percentile and eating and physical activity habits of adolescents, viewing them by sex, ethnicity, household type, and foreign-born or born in the United States, and (b) evaluate diet and activity analysis software for use by practitioners and adolescent clients. A descriptive-correlational study of 74 adolescents from low-income households completed a 24-hour recall of their foods, drinks, and activities, which were analyzed using MyPyramidTracker software. Data were analyzed using parametric and nonparametric methods to test associations and conduct between-group comparisons. Girls, Hispanics, adolescents living with single-parent mothers, and those who were foreign born had the highest mean BMI percentiles and the least healthy eating and physical activity habits. BMI percentile fell as daily calorie expenditure rose. MyPyramidTracker software is suitable for use by adolescents and their family members. To contribute to the reversal of national trends of increasing overweight status among adolescents, practitioners can focus their teaching, counseling, and advocacy on adolescents in these groups.

Racial/ethnic variations in the main and buffering effects of ethnic and nonethnic supports on depressive symptoms among five ethnic immigrant groups in Toronto.

PubMed

Kim, Il-Ho; Noh, Samuel

2016-01-01

This study examined variations in the main and buffering effects of ethnic and nonethnic social support on depressive symptoms associated with discrimination among five immigrant groups in Toronto. Data were taken from the Toronto Study of Settlement and Health, a cross-sectional survey of adult immigrants from five ethnic communities (Vietnamese, Ethiopian, Iranian, Korean, and Irish) in Toronto. A total of 900 surveys were collected through face-to-face interviews conducted between April and September 2001. Significant ethnic variations were observed in the effects of both ethnic and nonethnic social supports on discrimination-related depressive symptoms. Regarding the main effect, ethnic social support was significantly stronger for Iranian, Ethiopian, and Korean immigrants than for Irish immigrants. The benefits of nonethnic support were stronger for Iranian immigrants compared to the effect found in the Irish sample. With respect to stress-buffering or stress-moderating effects of social support, ethnic support was significant in all ethnic groups, except the Vietnamese group. Nonethnic support aggravated the negative impact of discrimination on depressive symptoms in the Irish group, but exerted a stress-buffering effect in the Iranian group. Overall, social supports received from fellow ethnic group members had significant main effects (suppressing depressive symptoms) and stress-buffering effects and were most pronounced in the minority ethnic immigrant groups of Ethiopians, Koreans, and Iranians. The effects were least evident among the Vietnamese and Irish. Evidence for the stress-suppressing and stress-buffering role of cross-ethnic group supports was unclear, and even inverted among Irish immigrants. Empirical evidence from the current study seems to support the sociocultural similarity hypothesis of social support.

Corporal Punishment and Child Aggression: Ethnic-Level Family Cohesion as a Moderator.

PubMed

Lee, Yoona; Watson, Malcolm W

2017-04-01

Ethnicity has been examined as a putative moderator between parents' use of corporal punishment and children's externalizing behaviors. Yet, the reasons for this potential ethnic-level moderator have not been fully examined. The primary objective of this study was to examine whether the effect of corporal punishment on aggression is ethnic-specific using major racial groups inside and outside the U.S. samples and how the mean levels of cohesion in family relationships as found in different ethnic groups moderate the association between mothers' use of corporal punishment and children's aggression. A total of 729 mothers who had children aged 7 to 13 years were sampled from five ethnic groups (i.e., European American, African American, Hispanic American, Korean, and Chinese). Several hypotheses were tested to examine the moderating effect of ethnic-level, family cohesion on the relation of corporal punishment to children's aggression. As expected, the mean level of family cohesion was significantly different across ethnicities. Consistent results across parallel multilevel and fixed effect models showed that high corporal punishment was associated with more aggression in all ethnicities, but there was a significant variation in the association across ethnicities, and the variation was explained by ethnic-level family cohesion. There were weaker associations between corporal punishment and child aggression among ethnic groups with high family cohesion and stronger associations among ethnic groups with low family cohesion. Ethnic/cultural variation in this study emphasizes the importance of understanding family environment of diverse ethnic groups when evaluating the influence of corporal punishment on child behavior in different ethnic/cultural contexts.

Factors Contributing to 50-ft Walking Speed and Observed Ethnic Differences in Older Community-Dwelling Mexican Americans and European Americans

PubMed Central

Hazuda, Helen P.

2015-01-01

Background Mexican Americans comprise the most rapidly growing segment of the older US population and are reported to have poorer functional health than European Americans, but few studies have examined factors contributing to ethnic differences in walking speed between Mexican Americans and European Americans. Objective The purpose of this study was to examine factors that contribute to walking speed and observed ethnic differences in walking speed in older Mexican Americans and European Americans using the disablement process model (DPM) as a guide. Design This was an observational, cross-sectional study. Methods Participants were 703 Mexican American and European American older adults (aged 65 years and older) who completed the baseline examination of the San Antonio Longitudinal Study of Aging (SALSA). Hierarchical regression models were performed to identify the contribution of contextual, lifestyle/anthropometric, disease, and impairment variables to walking speed and to ethnic differences in walking speed. Results The ethic difference in unadjusted mean walking speed (Mexican Americans=1.17 m/s, European Americans=1.29 m/s) was fully explained by adjustment for contextual (ie, age, sex, education, income) and lifestyle/anthropometric (ie, body mass index, height, physical activity) variables; adjusted mean walking speed in both ethnic groups was 1.23 m/s. Contextual variables explained 20.3% of the variance in walking speed, and lifestyle/anthropometric variables explained an additional 8.4%. Diseases (ie, diabetes, stroke, chronic obstructive pulmonary disease) explained an additional 1.9% of the variance in walking speed; impairments (ie, FEV1, upper leg pain, and lower extremity strength and range of motion) contributed an additional 5.5%. Thus, both nonmodifiable (ie, contextual, height) and modifiable (ie, impairments, body mass index, physical activity) factors contributed to walking speed in older Mexican Americans and European Americans. Limitations The study was conducted in a single geographic area and included only Mexican American Hispanic individuals. Conclusions Walking speed in older Mexican Americans and European Americans is influenced by modifiable and nonmodifiable factors, underscoring the importance of the DPM framework, which incorporates both factors into the physical therapist patient/client management process. PMID:25592187

Perceived ethnic discrimination and depressive symptoms: the buffering effects of ethnic identity, religion and ethnic social network.

PubMed

Ikram, Umar Z; Snijder, Marieke B; de Wit, Matty A S; Schene, Aart H; Stronks, Karien; Kunst, Anton E

2016-05-01

Perceived ethnic discrimination (PED) is positively associated with depressive symptoms in ethnic minority groups in Western countries. Psychosocial factors may buffer against the health impact of PED, but evidence is lacking from Europe. We assessed whether ethnic identity, religion, and ethnic social network act as buffers in different ethnic minority groups in Amsterdam, the Netherlands. Baseline data were used from the HEalthy Living In a Urban Setting study collected from January 2011 to June 2014. The random sample included 2501 South-Asian Surinamese, 2292 African Surinamese, 1877 Ghanaians, 2626 Turks, and 2484 Moroccans aged 18-70 years. Depressive symptoms were assessed using the Patient Health Questionnaire-9. PED was measured with the Everyday Discrimination Scale. Ethnic identity was assessed using the Psychological Acculturation Scale. Practicing religion was determined. Ethnic social network was assessed with the number of same-ethnic friends and amount of leisure time spent with same-ethnic people. PED was positively associated with depressive symptoms in all groups. The association was weaker among (a) those with strong ethnic identity in African Surinamese and Ghanaians, (b) those practicing religion among African Surinamese and Moroccans, (c) those with many same-ethnic friends in South-Asian Surinamese, Ghanaians, and Turks, and (d) those who spend leisure time with same-ethnic people among African Surinamese and Turks. Ethnic identity, religion, and ethnic social network weakened the association between PED and depressive symptoms, but the effects differed by ethnic minority group. These findings suggest that ethnic minority groups employ different resources to cope with PED.

Expanding HIV testing and counselling into communities: Feasibility, acceptability, and effects of an integrated family planning/HTC service delivery model by Village Health Teams in Uganda.

PubMed

Brunie, Aurélie; Wamala-Mucheri, Patricia; Akol, Angela; Mercer, Sarah; Chen, Mario

2016-10-01

Improving HIV testing and counselling (HTC) requires a range of strategies. This article reports on HTC service delivery by Village Health Teams (VHTs) in Uganda in the context of a model integrating this new component into pre-existing family planning services. Eight health centres from matched pairs were randomly allocated to intervention or control. After being trained, 36 VHTs reporting to selected facilities in the intervention group started offering HTC along with family planning, while VHTs in the control group provided family planning only. Proficiency testing was conducted as external quality assurance. A survey of all 36 VHTs and 137 family planning clients in the intervention group and 119 clients in the control group and a review of record data were conducted after 10 months. Survey responses by VHTs and their clients in the intervention group demonstrate knowledge of counselling messages and safe testing. External quality assessment results provide additional evidence of competency. Eighty per cent of the family planning clients surveyed in the intervention group received an HIV test during the intervention; 27% of those were first-time testers. More clients had ever tested for HIV in the intervention group compared with the control; clients also retested more often. Findings indicate that this model is feasible and acceptable for expanding quality HTC into communities. This study was registered with ClinicalTrials.gov, number [NCT02244398]. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The residential segregation of detailed Hispanic and Asian groups in the United States: 1980-2010

PubMed Central

Weinberg, Daniel; Hughes, Lauren

2015-01-01

Background Racial and ethnic diversity continues to grow in communities across the United States, raising questions about the extent to which different ethnic groups will become residentially integrated. Objective While a number of studies have examined the residential patterns of pan-ethnic groups, our goal is to examine the segregation of several Asian and Hispanic ethnic groups – Cubans, Dominicans, Mexicans, Puerto Ricans, Salvadorans, Asian Indians, Chinese, Filipinos, Japanese, Koreans, and Vietnamese. We gauge the segregation of each group from several alternative reference groups using two measures over the 1980 to 2010 period. Results We find that the dissimilarity of Hispanics and Asians from other groups generally held steady or declined, though, because most Hispanic and Asian groups are growing, interaction with Whites also often declined. Our analyses also indicate that pan-ethnic segregation indexes do not always capture the experience of specific groups. Among Hispanics, Mexicans are typically less residentially segregated (as measured using the dissimilarity index) from Whites, Blacks, Asians, and other Hispanics than are other Hispanic-origin groups. Among Asian ethnic groups, Japanese and Filipinos tend to have lower levels of dissimilarity from Whites, Blacks, and Hispanics than other Asian groups. Examining different dimensions of segregation also indicates that dissimilarity scores alone often do not capture to what extent various ethnic groups are actually sharing neighborhoods with each other. Finally, color lines vary across groups in some important ways, even as the dominant trend has been toward reduced racial and ethnic residential segregation over time. Conclusions The overarching trend is that ethnic groups are becoming more residentially integrated, suggestive of assimilation, though there is significant variation across ethnic groups. PMID:26097412

Targeting community-dwelling urinary incontinence sufferers: a multi-disciplinary community based model for conservative continence services.

PubMed

St John, Winsome; Wallis, Marianne; James, Heather; McKenzie, Shona; Guyatt, Sheridan

2004-10-01

This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them. The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education. Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community focussed, multi-disciplinary, generalist in nature.

Qualitative focus group study investigating experiences of accessing and engaging with social care services: perspectives of carers from diverse ethnic groups caring for stroke survivors.

PubMed

Greenwood, Nan; Holley, Jess; Ellmers, Theresa; Mein, Gill; Cloud, Geoffrey

2016-01-29

Informal carers, often family members, play a vital role in supporting stroke survivors with post-stroke disability. As populations age, numbers of carers overall and those from minority ethnic groups in particular, are rising. Carers from all ethnic groups, but especially those from black and minority ethnic groups frequently fail to access support services, making understanding their experiences important. The study therefore explored the experiences of carers of stroke survivors aged 45+ years from 5 ethnic groups in accessing and receiving social care services after hospital discharge. This qualitative study used 7 recorded focus groups with informal carers of stroke survivors. Data were analysed thematically focusing on similarities and differences between ethnic groups. Carers were recruited from voluntary sector organisations supporting carers, stroke survivors and black and minority ethnic groups in the UK. 41 carers from 5 ethnic groups (Asian Indian, Asian Pakistani, black African, black Caribbean, white British) participated in the focus groups. Several interconnected themes were identified including: the service gap between hospital discharge and home; carers as the best person to care and cultural aspects of caring and using services. Many themes were common to all the included ethnic groups but some related to specific groups. Across ethnic groups there were many similarities in the experiences of people caring for stroke survivors with complex, long-term care needs. Accessing services demands effort and persistence on carers' part. If carers believe services are unsatisfactory or that they, rather than formal services, should be providing support for stroke survivors, they are unlikely to persist in their efforts. Cultural and language differences add to the challenges black and minority ethnic group carers face. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

American Indian identity in mental health services utilization data from a rural midwestern sample.

PubMed

Hack, Samantha M; Larrison, Christopher R; Gone, Joseph P

2014-01-01

The governing bodies for psychiatry, psychology, and social work all publicly support culturally competent mental health care and have called for increased awareness of the importance of racial, ethnic, and cultural identity in mental health treatment and outcomes. However, since 1960 the population of people identifying as American Indian in the United States has grown faster than can be explained by birth rates, raising questions about the personal meaning of identity for newly self-designated American Indians. For this research, interviews were conducted with 14 self-identified American Indian clients receiving rural mental health care services in the Midwest. The goal was to assess clients' cultural connection to their racial identity and to understand what impact their American Indian identity had on their mental health care experiences. A modified Consensual Qualitative Research (CQR) method was used to develop the interview protocol and code responses. Interview data revealed that clients primarily based their racial identity on family stories of an American Indian ancestor and the majority did not feel their identification as American Indian was relevant to their mental health care. Regardless of lack of cultural connection, participants often reported feeling personal pride associated with identifying as American Indian. Implications for both researchers collecting self-reported race data and for mental health practitioners who might serve self-identified American Indian clients are discussed.

Characterization of fecal microbiota across seven Chinese ethnic groups by quantitative polymerase chain reaction.

PubMed

Kwok, Lai-yu; Zhang, Jiachao; Guo, Zhuang; Gesudu, Qimu; Zheng, Yi; Qiao, Jianmin; Huo, Dongxue; Zhang, Heping

2014-01-01

The human gut microbiota consists of complex microbial communities, which possibly play crucial roles in physiological functioning and health maintenance. China has evolved into a multicultural society consisting of the major ethnic group, Han, and 55 official ethnic minority groups. Nowadays, these minority groups inhabit in different Chinese provinces and some of them still keep their unique culture and lifestyle. Currently, only limited data are available on the gut microbiota of these Chinese ethnic groups. In this study, 10 major fecal bacterial groups of 314 healthy individuals from 7 Chinese ethnic origins were enumerated by quantitative polymerase chain reaction. Our data confirmed that the selected bacterial groups were common to all 7 surveyed ethnicities, but the amount of the individual bacterial groups varied to different degree. By principal component and canonical variate analyses of the 314 individuals or the 91 Han subjects, no distinct group clustering pattern was observed. Nevertheless, weak differences were noted between the Han and Zhuang from other ethnic minority groups, and between the Heilongjiang Hans from those of the other provinces. Thus, our results suggest that the ethnic origin may contribute to shaping the human gut microbiota.

Characterization of Fecal Microbiota across Seven Chinese Ethnic Groups by Quantitative Polymerase Chain Reaction

PubMed Central

Guo, Zhuang; Gesudu, Qimu; Zheng, Yi; Qiao, Jianmin; Huo, Dongxue; Zhang, Heping

2014-01-01

The human gut microbiota consists of complex microbial communities, which possibly play crucial roles in physiological functioning and health maintenance. China has evolved into a multicultural society consisting of the major ethnic group, Han, and 55 official ethnic minority groups. Nowadays, these minority groups inhabit in different Chinese provinces and some of them still keep their unique culture and lifestyle. Currently, only limited data are available on the gut microbiota of these Chinese ethnic groups. In this study, 10 major fecal bacterial groups of 314 healthy individuals from 7 Chinese ethnic origins were enumerated by quantitative polymerase chain reaction. Our data confirmed that the selected bacterial groups were common to all 7 surveyed ethnicities, but the amount of the individual bacterial groups varied to different degree. By principal component and canonical variate analyses of the 314 individuals or the 91 Han subjects, no distinct group clustering pattern was observed. Nevertheless, weak differences were noted between the Han and Zhuang from other ethnic minority groups, and between the Heilongjiang Hans from those of the other provinces. Thus, our results suggest that the ethnic origin may contribute to shaping the human gut microbiota. PMID:24699404

The Relationship of Gender and Academic Performance to Motivation: Within-Ethnic-Group Variations.

ERIC Educational Resources Information Center

Rouse, Kimberly A. Gordon; Austin, James T.

2002-01-01

Three studies examined within-ethnic-group variations in the relationship of grade point average and gender to motivation among African American, Hispanic American, and Euro-American students. Survey data revealed patterns of significant within-ethnic-group differences that varied across ethnic groups. In general, males demonstrated more…

Population genetic study of 34 X-Chromosome markers in 5 main ethnic groups of China.

PubMed

Zhang, Suhua; Bian, Yingnan; Li, Li; Sun, Kuan; Wang, Zheng; Zhao, Qi; Zha, Lagabaiyila; Cai, Jifeng; Gao, Yuzhen; Ji, Chaoneng; Li, Chengtao

2015-12-04

As a multi-ethnic country, China has some indigenous population groups which vary in culture and social customs, perhaps as a result of geographic isolation and different traditions. However, upon close interactions and intermarriage, admixture of different gene pools among these ethnic groups may occur. In order to gain more insight on the genetic background of X-Chromosome from these ethnic groups, a set of X-markers (18 X-STRs and 16 X-Indels) was genotyped in 5 main ethnic groups of China (HAN, HUI, Uygur, Mongolian, Tibetan). Twenty-three private alleles were detected in HAN, Uygur, Tibetan and Mongolian. Significant differences (p < 0.0001) were all observed for the 3 parameters of heterozygosity (Ho, He and UHe) among the 5 ethnic groups. Highest values of Nei genetic distance were always observed at HUI-Uygur pairwise when analyzed with X-STRs or X-Indels separately and combined. Phylogenetic tree and PCA analyses revealed a clear pattern of population differentiation of HUI and Uygur. However, the HAN, Tibetan and Mongolian ethnic groups were closely clustered. Eighteen X-Indels exhibited in general congruent phylogenetic signal and similar cluster among the 5 ethnic groups compared with 16 X-STRs. Aforementioned results proved the genetic polymorphism and potential of the 34 X-markers in the 5 ethnic groups.

The Multigroup Ethnic Identity Measure-Revised: Measurement invariance across racial and ethnic groups

PubMed Central

Brown, Susan D.; Unger Hu, Kirsten A.; Mevi, Ashley A.; Hedderson, Monique M.; Shan, Jun; Quesenberry, Charles P.; Ferrara, Assiamira

2014-01-01

The Multigroup Ethnic Identity Measure-Revised (MEIM-R), a brief instrument assessing affiliation with one’s ethnic group, is a promising advance in the ethnic identity literature. However, equivalency of its measurement properties across specific racial and ethnic groups should be confirmed before using it in diverse samples. We examined a) the psychometric properties of the MEIM-R including factor structure, measurement invariance, and internal consistency reliability, and b) levels of and differences in ethnic identity across multiple racial and ethnic groups and subgroups. Asian (n = 630), Black/African American (n = 58), Hispanic (n = 240), multiethnic (n = 160), and White (n = 375) women completed the MEIM-R as part of the “Gestational diabetes’ Effect on Moms” diabetes prevention trial in the Kaiser Permanente Northern California health care setting (N = 1,463; M age 32.5 years, SD = 4.9). Multiple-groups confirmatory factor analyses provided provisional evidence of measurement invariance, i.e., an equal, correlated two-factor structure, equal factor loadings, and equal item intercepts across racial and ethnic groups. Latent factor means for the two MEIM-R subscales, exploration and commitment, differed across groups; effect sizes ranging from small to large generally supported the notion of ethnic identity as more salient among people of color. Pending replication, good psychometric properties in this large and diverse sample of women support the future use of the MEIM-R. Preliminary evidence of measurement invariance suggests that the MEIM-R could be used to measure and compare ethnic identity across multiple racial and ethnic groups. PMID:24188656

A comparative study on managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012.

PubMed

Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaz

2014-03-01

Organizational and structural obstacles are a group of major obstacles in achievement of appropriate family planning counseling. Detection of these obstacles from the viewpoint of managers, staffs and clients who are key members in health services providing system is a major step toward appropriate planning to modify or delete this group of obstacles. The present study was conducted with the goal of comparing managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 staffs and 126 clients in medical health-care centers in Isfahan in 2012. Managers and the staffs were selected by census sampling and the clients were recruited through convenient random sampling. The date collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. The obtained results showed no significant difference between mean scores of viewpoints in three groups of managers, staffs and clients concerning organizational and structural obstacles in family planning counseling (P = 0.677). In addition, most of the managers, staffs and clients reported organizational and structural obstacles as the obstacles in the process of family planning in moderate level. The results showed the necessity of health services managers' planning to modify or delete organizational and structural obstacles especially the agreed obstacles from the viewpoint of managers, staffs and clients.

The relation between obesity and depressed mood in a multi-ethnic population. The HELIUS study.

PubMed

Gibson-Smith, Deborah; Bot, Mariska; Snijder, Marieke; Nicolaou, Mary; Derks, Eske M; Stronks, Karien; Brouwer, Ingeborg A; Visser, Marjolein; Penninx, Brenda W J H

2018-06-01

To examine the association between obesity and depressed mood in a large multi-ethnic population and check for consistency in this association across six ethnic groups. Data of 21,030 persons (18-70 years) were sourced from the HELIUS study. Cross-sectional relationships between obesity measures [body mass index (kg/m 2 ) and waist circumference (cm)] and depressed mood (PHQ-9 score ≥ 10) were analysed. Consistency of associations was investigated across ethnic groups by interaction terms (ethnicity*obesity measures) in basic (age, sex, education) and fully (health behaviours and somatic health) adjusted models. Obesity was prevalent in all ethnic groups, but varied substantially. After sociodemographic adjustment, obesity measures were associated with increased odds of depressed mood but this was inconsistent across ethnic groups. Obesity (BMI ≥ 30 or highest waist circumference quartile) was strongly and significantly associated with depressed mood in the Dutch [Odds Ratio (OR) = 1.72; 95% Confidence intervals (CI) 1.24-2.40, and OR = 1.86; 95% CI 1.38-2.50], respectively, and African Surinamese (OR = 1.60; 95% CI 1.29-1.98 and OR = 1.59; 95% CI 1.27-2.00, respectively) but had a weaker, non-significant association in other ethnic groups (South-Asian Surinamese, Ghanaian, Moroccan, Turkish groups). Adjustment for health behaviours and somatic health had limited effect on this pattern. Obesity was associated with a higher risk of depressed mood. However, ethnic differences were found: the obesity-depressed mood association was strong in the Dutch and African Surinamese populations, but not in other ethnic groups. Future studies should explore whether differential normative values or pathophysiology across ethnic groups explain why the obesity-depression association is inconsistent across ethnic groups.

Ethnic Variations in Psychosocial and Health Correlates of Eating Disorders.

PubMed

Assari, Shervin; DeFreitas, Mariana R

2018-04-25

The aim of this study is to explore ethnic variations in psychosocial and health correlates of eating disorders in the United States, Specifically, we compared associations between gender, socioeconomic status (SES), body mass index (BMI), physical and mental self-rated health (SRH), and major depressive disorder (MDD) with eating disorders (EDs) across 10 different ethnic groups in the United States. Data was obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES), a national household probability sample collected in 2001⁻2003. Data for this study included a sample of 17,729 individuals with the following ethnic profile: 520 Vietnamese, 508 Filipino, 600 Chinese, 656 Other Asian, 577 Cuban, 495 Puerto Rican, 1442 Mexican, 1106 Other Hispanic, 4746 African American, and 7587 Non-Latino Whites. Gender, SES (education and income), BMI, SRH, MDD, and presence of EDs were measured across different ethnic groups. Logistic regression analysis was conducted for each ethnic group with lifetime EDs as the main outcome. Ethnic group varied in psychosocial and health correlates of EDs. In most ethnic groups, gender and SES were not associated with EDs. In almost all ethnic groups, EDs were associated with MDD and BMI. EDs were found to be associated with SRH in half of the ethnic groups studied. The associations between gender, SES, BMI, SRH, MDD, and EDs vary across different ethnic groups. These differences must be considered in further studies and in clinical practice in order to improve our approach towards diagnosis and treatment of EDs.

A new conceptualization of ethnicity for social epidemiologic and health equity research.

PubMed

Ford, Chandra L; Harawa, Nina T

2010-07-01

Although social stratification persists in the US, differentially influencing the well-being of ethnically defined groups, ethnicity concepts and their implications for health disparities remain under-examined. Ethnicity is a complex social construct that influences personal identity and group social relations. Ethnic identity, ethnic classification systems, the groupings that compose each system and the implications of assignment to one or another ethnic category are place-, time- and context-specific. In the US, racial stratification uniquely shapes expressions of and understandings about ethnicity. Ethnicity is typically invoked via the term, 'race/ethnicity'; however, it is unclear whether this heralds a shift away from racialization or merely extends flawed racial taxonomies to populations whose cultural and phenotypic diversity challenge traditional racial classification. We propose that ethnicity be conceptualized as a two-dimensional, context-specific, social construct with an attributional dimension that describes group characteristics (e.g., culture, nativity) and a relational dimension that indexes a group's location within a social hierarchy (e.g., minority vs. majority status). This new conceptualization extends prior definitions in ways that facilitate research on ethnicization, social stratification and health inequities. While federal ethnic and racial categories are useful for administrative purposes such as monitoring the inclusion of minorities in research, and traditional ethnicity concepts (e.g., culture) are useful for developing culturally appropriate interventions, our relational dimension of ethnicity is useful for studying the relationships between societal factors and health inequities. We offer this new conceptualization of ethnicity and outline next steps for employing socially meaningful measures of ethnicity in empirical research. As ethnicity is both increasingly complex and increasingly central to social life, improving its conceptualization and measurement is crucial for advancing research on ethnic health inequities. Copyright 2010 Elsevier Ltd. All rights reserved.

Investigating ethnic differences in sexual health: focus groups with young people

PubMed Central

Connell, P; McKevitt, C; Low, N

2004-01-01

Objectives: To compare normative beliefs about sexual health in young men and women from black Caribbean, black African, and white ethnic groups in order to better understand ethnic inequalities in sexual health. Methods: Focus group discussions with young people living in an area with known high prevalence of gonorrhoea and chlamydia. Groups were stratified by sex and self defined ethnicity. Results: 22 male and 20 female 16–25 year olds of black Caribbean, black African, and white ethnicity took part in eight discussions. Participants from black ethnic groups were more aware of gonorrhoea than white participants but all ethnic groups regarded these as being less important than unplanned pregnancy or HIV/AIDS. Most participants believed that they would have obvious symptoms if they had a sexually transmitted infection and could determine the cleanliness of sexual partners by visual or behavioural cues. Black Caribbean women were alone in acknowledging the likelihood of their partners having concurrent sexual relationships. Some black Caribbean women described negative attitudes of staff in genitourinary medicine clinics who were from the same ethnic background. Conclusion: In this focus group study we identified ethnic differences in terminology, awareness of sexually transmitted infections, non-exclusive sexual relationships, and experience of sexual health services but gender had a greater influence on normative beliefs. The similarities in norms for all ethnic groups might reflect common social and cultural exposures. The low priority given to sexually transmitted infections by young people from all ethnic groups needs to be addressed if they are to be tackled successfully. PMID:15295130

Habitat Variability and Ethnic Diversity in Northern Tibetan Plateau

NASA Astrophysics Data System (ADS)

Jia, Xin; Lee, Harry F.; Cui, Mengchun; Liu, Chao; Zeng, Lin; Yue, Ricci P. H.; Zhao, Yang; Lu, Huayu

2017-04-01

There are 56 officially-recognized ethnic groups in China. However, the distinct geographic patterns of various ethnic groups in relation to the physical environment in China have rarely been investigated. Based on the geo-referenced physical environmental parameters of 455 Han, Tu, Hui, Salar, Mongolian, and Tibetan communities in Qinghai, we found that the communities could be statistically demarcated by temperature and aridity threshold according to their ethnic populations, implying that the geographic distribution of each ethnic group is mediated by the physical environment. We also observed that the habitat of each ethnic group is ecologically compatible with current subsistence strategies. Tibetans settle in cold high-altitude regions owing to the cultivation of highland barley and the breeding of yak, dzo, Tibetan sheep and Tibetan goat. Mongolians survive by animal husbandry in cold and humid grassland areas. The Han and Tu ethnic groups settle in the Huangshui River Valley, which offers relatively humid climate and flat land for agriculture. The Hui and Salar ethnic groups occupy the Yellow River Valley with its relatively arid environment and grassland vegetation suitable for animal breeding. Our findings offer a new perspective in explaining the geographic pattern and the variety of ethnic groups in China and elsewhere.

Designing, Implementing, and Evaluating a Group Therapy for Underserved Populations

ERIC Educational Resources Information Center

Waltman, Scott H.; Hetrick, Holly; Tasker, Tamara E.

2012-01-01

This article presents the case of a mindfulness-based group therapy that was implemented in a residential treatment facility. The case presented comprised a group of adolescent males with disruptive behavior disorders. The group was designed to be appropriate for the unique demographics of the clients, with the intent to help the clients enhance…

Meaning making in middle childhood: an exploration of the meaning of ethnic identity.

PubMed

Rogers, Leoandra Onnie; Zosuls, Kristina M; Halim, May Ling; Ruble, Diane; Hughes, Diane; Fuligni, Andrew

2012-04-01

Social identity, including identification with one's ethnic group, is an important aspect of social development. However, little is known about the subjective meaning associated with social group memberships, particularly during middle childhood. Using second- and fourth-graders responses to an open-ended question, we explored the meaning of ethnic identity with a sample of Chinese, Dominican, Russian, White, and Black American children. Analyses revealed that middle childhood is an active period for meaning making as children described the ethnic identity to include ideas such as language, physical appearance, pride, relative social position, and culture. While there were few differences in the ethnic identity meaning responses of second- and fourth-grade children, the meaning of ethnic identity varied considerably across the ethnic groups underscoring how the unique features and experiences of different ethnic groups shapes the subjective meaning of ethnic identity. These findings align with prior research on the meaning of ethnic identity among adults and adolescents and offer insight for future research regarding the conceptualization and measurement of the meaning of social group membership. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Predictors of mammography screening among ethnically diverse low-income women.

PubMed

Cronan, Terry A; Villalta, Ian; Gottfried, Emily; Vaden, Yavette; Ribas, Mabel; Conway, Terry L

2008-05-01

Breast cancer is the second leading cause of cancer deaths among women in the United States. Minority women are less likely to be screened and more likely to die from breast cancer than are Caucasian women. Although some studies have examined ethnic disparities in mammography screening, no study has examined whether there are ethnic disparities among low-income, ethnically diverse women. The present study was designed to determine whether there are ethnic disparities in mammography screening and predictors of screening among low-income African American, Mexican American, and Caucasian women, and to determine whether the disparities and predictors vary across ethnic groups. The participants were 146 low-income women who were Mexican American (32%), African American (31%), or Caucasian (37%). Statistical analyses were performed to assess the relationships between mammography screening during the past 2 years and potential predictors of screening, both within ethnic groups and for the combined sample. The results varied depending on whether analyses combined ethnic groups or were performed within each of the three ethnic groups. It is, therefore, important to examine within-group differences when examining ethnic disparities in predictors of mammography.

Individually Tailored Dietary Counseling among Old Home Care Clients - Effects on Nutritional Status.

PubMed

Pölönen, S; Tiihonen, M; Hartikainen, S; Nykänen, I

2017-01-01

To evaluate the effect of individually tailored dietary counseling on nutritional status among home care clients aged 75 years or older. Non-randomised controlled study. The study sample consisted of 224 home care clients (≥ 75 years) (intervention group, n = 127; control group, n = 100) who were at protein-energy malnutrition (PEM) or risk of PEM (MNA score <24 and plasma albumin <35 g/L). Individually tailored dietary counseling; the persons were instructed to increase their food intake with energy-dense food items, the number of meals they ate and their consumption of energy-, protein- and nutrient-rich snacks for six months. The Mini Nutritional Assessment (MNA), Body Mass Index (BMI) and plasma albumin were used to determine nutritional status at the baseline and after the six-month intervention. The mean age of the home care clients was 84.3 (SD 5.5) in the intervention group and 84.4 (SD 5.3) in the control group, and 70 percent were women in both groups. After the six-month nutritional intervention, the MNA score increased 2.3 points and plasma albumin 1.6 g/L in the intervention group, against MNA score decreased -0.2 points and plasma albumin -0.1 g/L in the control group. Individually tailored dietary counseling may improve nutritional status among older home care clients.

Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

PubMed

MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

2017-11-28

Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

Comparison of communication skills between trained and untrained students using a culturally sensitive nurse-client communication guideline in Indonesia.

PubMed

Claramita, Mora; Tuah, Rodianson; Riskione, Patricia; Prabandari, Yayi Suryo; Effendy, Christantie

2016-01-01

A communication guideline that is sensitive to the local culture is influential in the process of nursing care. The Gadjah Mada nurse-client communication guideline, the "Ready-Greet-Invite-Discuss," was meant (1) to strengthen the relationship between the nurse and the client despite of socio-culturally hierarchical gap between health providers and clients in Indonesian context, (2) to provide attention to the unspoken concerns especially in the context of indirect communication which mostly using non-verbal signs and politeness etiquettes, and (3) to initiate dialog in the society which hold a more community-oriented decision making. Our aim is to compare the communication skills of nursing students who had and had not received a training using a culture-sensitive Gadjah Mada nurse-client communication guideline. This was a quasi experimental randomized control study to the fifth semester students of a nursing school at Yogyakarta, Indonesia. The intervention group was trained by the Gadjah Mada nurse-client communication guideline. Both intervention and the control group had learned general nurse-client communication guidelines. The training was 4h with role-plays, supportive information and feedback sessions. An objective-structured clinical examination (OSCE) was conducted 1week after the training, in seven stations, with seven simulated clients. Observers judged the communication skills of the students using a checklist of 5-point Likert scale, whereas simulated clients judged their satisfaction using 4-point Likert scale represented in colorful ribbons. There were significant mean differences in each domain of communication guideline observed between the trained and the control groups as judged by the teachers (p≤0.05) and simulated clients. Training using a culture-sensitive communication skills guideline could improve the communication skills of the nursing students and may increase satisfaction of the clients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cognitive Behavioural Therapy from the Perspective of Clients with Mild Intellectual Disabilities: A Qualitative Investigation of Process Issues

ERIC Educational Resources Information Center

Pert, C.; Jahoda, A.; Stenfert Kroese, B.; Trower, P.; Dagnan, D.; Selkirk, M.

2013-01-01

Background: Clinicians working with clients who have mild intellectual disabilities (IDs) have shown growing enthusiasm for using a cognitive behavioural approach, amid increasing evidence of good treatment outcomes for this client group. However, very little is known about the views and experiences of clients with IDs who have undergone cognitive…

Forgotten resources of older home care clients: focus group study in Finland.

PubMed

Turjamaa, Riitta; Hartikainen, Sirpa; Pietilä, Anna-Maija

2013-09-01

In this qualitative focus group study, the resources available to older home-dwelling people, particularly incoming and existing home care clients, are described from the viewpoint of home care professionals (n = 32). The data were analyzed using inductive content analysis. There were three categories of older people requiring resources from the viewpoint of interviewers: home-dwelling people, incoming home care clients, and existing home care clients. Based on the analysis, the resources of older home-dwelling people were categorized in terms of support, meaningful life, everyday activities, and environment. Incoming home care client resources were support, out-of-home activities, in-home activities, and environment. Existing client resources were described in terms of support, everyday activities, and environment. Home care professionals described the resources of the older home-dwelling people in diverse ways, but those of the perspective of existing clients were reduced. The biggest difference was in everyday activities. Psychological and social resources, including meaningful life and social relationships, seemed to be forgotten. All available resources must be taken into account, especially in the everyday home care services for existing home care clients. © 2013 Wiley Publishing Asia Pty Ltd.

Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample.

PubMed

Hatch, S L; Gazard, B; Williams, D R; Frissa, S; Goodwin, L; Hotopf, M

2016-05-01

Few studies have examined discrimination and mental health in the UK, particularly by migrant status and in urban contexts with greater demographic diversity. This study aims to (1) describe the prevalence of discrimination experiences across multiple life domains; (2) to describe associations between discrimination experiences and common mental disorder (CMD); (3) to determine whether or not the relationship between discrimination and CMD varies by migrant status and ethnicity. Data on major, anticipated and everyday discrimination and CMD symptoms were collected from an ethnically diverse prospective sample of 1052 participants followed up from 2008 to 2013 in the South East London Community Health study, a population-based household survey. With few exceptions, discrimination was most prevalent among those in the Black Caribbean group. However, those in the White Other ethnic group had similar or greater reporting major and anticipated discrimination to Black or mixed ethnic minority groups. The effects of discrimination on CMD were most pronounced for individuals who had recently migrated to the UK, an ethnically heterogeneous group, and for Black and Mixed ethnic minority groups in partially adjusted models. Prior CMD accounted for differences between the Mixed and White British ethnic groups, but the strength of the association for the most recent migrant group and the Black ethnic groups remained two or more times greater than the reference groups. The strength of the relationship suggests a need for more consideration of migration status along with ethnicity in examining the impact of discrimination on mental disorder in community and clinical samples.

Population genetic study of 34 X-Chromosome markers in 5 main ethnic groups of China

PubMed Central

Zhang, Suhua; Bian, Yingnan; Li, Li; Sun, Kuan; wang, Zheng; Zhao, Qi; Zha, Lagabaiyila; Cai, Jifeng; Gao, Yuzhen; Ji, Chaoneng; Li, Chengtao

2015-01-01

As a multi-ethnic country, China has some indigenous population groups which vary in culture and social customs, perhaps as a result of geographic isolation and different traditions. However, upon close interactions and intermarriage, admixture of different gene pools among these ethnic groups may occur. In order to gain more insight on the genetic background of X-Chromosome from these ethnic groups, a set of X-markers (18 X-STRs and 16 X-Indels) was genotyped in 5 main ethnic groups of China (HAN, HUI, Uygur, Mongolian, Tibetan). Twenty-three private alleles were detected in HAN, Uygur, Tibetan and Mongolian. Significant differences (p < 0.0001) were all observed for the 3 parameters of heterozygosity (Ho, He and UHe) among the 5 ethnic groups. Highest values of Nei genetic distance were always observed at HUI-Uygur pairwise when analyzed with X-STRs or X-Indels separately and combined. Phylogenetic tree and PCA analyses revealed a clear pattern of population differentiation of HUI and Uygur. However, the HAN, Tibetan and Mongolian ethnic groups were closely clustered. Eighteen X-Indels exhibited in general congruent phylogenetic signal and similar cluster among the 5 ethnic groups compared with 16 X-STRs. Aforementioned results proved the genetic polymorphism and potential of the 34 X-markers in the 5 ethnic groups. PMID:26634331

Use of GetCheckedOnline, a Comprehensive Web-based Testing Service for Sexually Transmitted and Blood-Borne Infections.

PubMed

Gilbert, Mark; Salway, Travis; Haag, Devon; Fairley, Christopher K; Wong, Jason; Grennan, Troy; Uddin, Zhaida; Buchner, Christopher S; Wong, Tom; Krajden, Mel; Tyndall, Mark; Shoveller, Jean; Ogilvie, Gina

2017-03-20

The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis). Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings. ©Mark Gilbert, Travis Salway, Devon Haag, Christopher K Fairley, Jason Wong, Troy Grennan, Zhaida Uddin, Christopher S Buchner, Tom Wong, Mel Krajden, Mark Tyndall, Jean Shoveller, Gina Ogilvie. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.03.2017.

Barriers to healthy eating among food pantry clients

USDA-ARS?s Scientific Manuscript database

This study explored perspectives on barriers of eating healthy among food pantry clients. Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach. Themes were then identified. Quantitative data were ana...

The Client Satisfaction Questionnaire: psychometric properties in a Dutch addict population.

PubMed

De Wilde, Eveline F; Hendriks, Vincent M

2005-01-01

The aim of this study is to investigate psychometric properties of the Client Satisfaction Questionnaire (CSQ-8) in a Dutch substance abuse population. The CSQ-8 and the Mental Health Thermometer (the standard Dutch satisfaction instrument) were sent to 927 patients of a Dutch substance abuse treatment centre. (response rate 28.3%; n = 262). Data were compared on several variables (i.e., age, gender, ethnicity, treatment type). For a subgroup of responders (n = 84), data were compared with pre-treatment problem severity and treatment need (the European Addiction Severity Index). Both internal consistency and concurrent validity were found to be high. Only treatment type had significant effects on CSQ-8 satisfaction scores. Scores were negatively skewed. The CSQ-8 is as suitable an instrument to be used in addict populations, as it is in other populations. (c) 2005 S. Karger AG, Basel

Mental Health Providers' Attitudes About Criminal Justice-Involved Clients With Serious Mental Illness.

PubMed

Bandara, Sachini N; Daumit, Gail L; Kennedy-Hendricks, Alene; Linden, Sarah; Choksy, Seema; McGinty, Emma E

2018-04-01

Community mental health providers' attitudes toward criminal justice-involved clients with serious mental illness were examined. A total of 627 Maryland psychiatric rehabilitation program providers responded to a survey (83% response rate). Measures assessed providers' experience with, positive regard for, and perceptions of similarity, with their clients with serious mental illness. Chi-square tests were used to compare providers' attitudes toward clients with and without criminal justice involvement. Providers reported lower regard for criminal justice-involved clients than for clients without such involvement. Providers were less likely to report having a great deal of respect for clients with (79%) versus without (95%) criminal justice involvement. On all items that measured providers' perceived similarity with their clients, less than 50% of providers rated themselves as similar, regardless of clients' criminal justice status. Future research should explore how providers' attitudes toward criminal justice-involved clients influence service delivery for this group.

Sticks and stones can break my bones, but ethnophaulisms can alter the portrayal of immigrants to children.

PubMed

Mullen, Brian

2004-02-01

An archival study examined the portrayal of ethnic immigrants to children as a function of the prevailing cognitive representation of those ethnic immigrant groups in ethnophaulisms. The complexity in ethnophaulisms (and, to a lesser degree, the valence in ethnophaulisms) predicted the portrayal of ethnic immigrant groups. Overall, ethnic immigrant groups characterized in terms of ethnophaulisms of low complexity were less frequently present in children's literature, children from these ethnic groups were described more in terms of physical appearance than in terms of personal traits, fictional child characters from those ethnic groups were portrayed with smaller heads and with lower verbal complexity, and the folksongs attributed to these groups had a more negative affective tone. The implications of these results for approaches to intergroup relations are considered.

Exploring beliefs of the four major ethnic groups in Melbourne regarding healthcare and treatment.

PubMed

Leong, Kai'En; Weiland, Tracey J; Dent, Andrew W

2010-11-01

To explore and compare beliefs about healthcare and treatment of four ethnic groups attending a Melbourne emergency department (ED), and the corresponding perceptions held by emergency clinicians. Prospective survey of ED doctors and patients from Greek, Italian, Vietnamese and Anglo-Saxon backgrounds. Vietnamese patients were least likely to believe their ethnic group received the best available care but less likely to believe in the existence of ethnic healthcare disparities. They were most likely to have an ethnically concordant GP and preferred most strongly to raise sensitive issues with an ethnically concordant doctor. Anglo-Saxon patients placed less importance on family support and older Anglo-Saxons were less likely than other groups to turn to God for comfort. Doctors perceived the existence of ethnic healthcare disparity, which was not perceived by the ethnic groups themselves. They underestimated the extent of patient-perceived disease control, external supports for coping, or use of complementary practitioners. Doctors overestimated patient perceived importance of doctor-patient ethnic concordance for Anglo-Saxons but underestimated the importance this has for Vietnamese patients. They also underestimated importance of clinician-demonstrated cultural understanding. Beliefs about healthcare and treatment differ across the four major ethnic groups attending a Melbourne ED. Doctors' misperceptions of patients' beliefs suggest that cultural competence amongst ED doctors could be improved.

Body Movement Synchrony in Psychotherapeutic Counseling: A Study Using the Video-Based Quantification Method

NASA Astrophysics Data System (ADS)

Nagaoka, Chika; Komori, Masashi

Body movement synchrony (i. e. rhythmic synchronization between the body movements of interacting partners) has been described by subjective impressions of skilled counselors and has been considered to reflect the depth of the client-counselor relationship. This study analyzed temporal changes in body movement synchrony through a video analysis of client-counselor dialogues in counseling sessions. Four 50-minute psychotherapeutic counseling sessions were analyzed, including two negatively evaluated sessions (low evaluation groups) and two positively evaluated sessions (high evaluation groups). In addition, two 50-minute ordinary advice sessions between two high school teachers and the clients in the high rating group were analyzed. All sessions represent role-playing. The intensity of the participants' body movement was measured using a video-based system. Temporal change of body movement synchrony was analyzed using moving correlations of the intensity between the two time series. The results revealed (1) A consistent temporal pattern among the four counseling cases, though the moving correlation coefficients were higher for the high evaluation group than the low evaluation group and (2) Different temporal patterns for the counseling and advice sessions even when the clients were the same. These results were discussed from the perspective of the quality of client-counselor relationship.

Sex role ideology among East Asian immigrants in the United States.

PubMed

Barry, Declan T; Beitel, Mark

2006-10-01

Although sex role ideology (i.e., beliefs about the proper roles for men and women) is linked with self-definition and male-female interactions, researchers have rarely examined such beliefs among U.S. immigrants. This study examined the cultural (ethnic identity, self-construal) and demographic (gender, age, years in United States) correlates of sex role ideology among 170 (88 male, 82 female) East Asian immigrants using psychometrically established measures. Male participants who endorsed ethnic identity and interdependent self-construal were more likely to report traditional sex roles; female participants who lived for a longer period of time in the United States and who endorsed independent self-construal were more likely to report sex role equality. Clinicians should consider assessing sex role ideology to reduce the likelihood of stereotyping their immigrant clients. (c) 2007 APA, all rights reserved

Massage therapy services for healthcare: a telephone focus group study of drivers for clients' continued use of services.

PubMed

Smith, Joanna M; Sullivan, S John; Baxter, G David

2009-01-01

To explore opinions of why clients use, value and continue to seek massage therapy as a healthcare option. Telephone focus group methodology was used. Current and repeat users (n = 19) of either relaxation, remedial or sports massage therapy services participated in three telephone focus groups. Audiotaped semi-structured interviews were conducted. Telephone focus group with massage clients from provincial and urban localities in New Zealand. Summary of reported themes of the massage experience and suggested drivers for return to, or continuing with massage therapy. Data were transcribed, categorised (NVivo7) and thematically analysed using the general inductive approach. Key drivers for return to, or continuing with, massage therapy were: positive outcomes, expectations of goals being met, a regular appointment and the massage therapy culture. Massage therapy is perceived and valued as a personalised, holistic and hands-on approach to health management, which focuses on enhancing relaxation in conjunction with effective touch, within a positive client-therapist relationship and a pleasant non-rushed environment. Massage therapy as a health service is result and client driven but is reinforced by the culture of the experience.

Working with childhood sexual abuse: a survey of mental health professionals.

PubMed

Day, Andrew; Thurlow, Katie; Woolliscroft, Jessica

2003-02-01

This study aimed to establish the views of a group of mental health professionals from various disciplines working in mental health service in a British hospital about the needs of clients who had experienced childhood sexual abuse. Staff members were asked to complete an anonymous survey which asked questions relating to knowledge of sexual abuse and its effects, and the needs of clients and staff in working with this client group. A total of 54 people responded to the survey, 42 were female, 11 male. Most (72%) reported having over 10 years experience working in mental health, working in both in-patient and out-patient settings. While respondents were reasonably knowledgeable about childhood sexual abuse, they were not very comfortable, competent or supported in their work with this client group. There were no differences in responses according to the age or gender of respondents, but less experienced staff were more likely to feel supported. Those that had received training and/or supervision felt significantly more capable in working with this client group. The study offers some support for the development of specialist training, consultancy and supervision programs for mental health staff in the area of child sexual abuse.

English Proficiency, Threshold Language Policy and Mental Health Service Utilization among Asian-American Children.

PubMed

Aratani, Yumiko; Liu, Cindy H

2015-10-01

This paper explores the role of English proficiency, ethnicity, and California's threshold language policy in the rates of discontinuing mental health services among Asian-American children. We used data from the 2001-2006 Client and Services Information (CSI) System, which contains county-level information about service users in public mental health systems. Our data included 59,218 service users under the age of 18. We used logistic regression to determine the likelihood of discontinuing services, while controlling for sociodemographic and clinical characteristics. English-speaking Asians were 11% more likely than English-speaking Whites to discontinue mental health services. Non-English-speaking Asians were 50% significantly more likely to stay in services. The results also revealed some inter-ethnic variations in the discontinuation patterns; however, the patterns of mental health service utilization appear to be driven by the availability of mental health services in Asian-ethnic languages in county of residence. Further research is needed to understand the intake and referral processes that Asian children go through within the mental health service system. Copyright © 2015 Elsevier Inc. All rights reserved.

Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy.

PubMed

Sivec, Harry J; Montesano, Vicki L; Skubby, David; Knepp, Kristen A; Munetz, Mark R

2017-02-01

This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

Inequalities in healthy life expectancy between ethnic groups in England and Wales in 2001

PubMed Central

Wohland, Pia; Rees, Phil; Nazroo, James; Jagger, Carol

2015-01-01

Objectives. We aim to develop robust estimates of disability-free life expectancy (DFLE) and healthy life expectancy (HLE) for ethnic groups in England and Wales in 2001 and to examine observed variations across ethnic groups. Design. DFLE and HLE by age and gender for five-year age groups were computed for 16 ethnic groups by combining the 2001 Census data on ethnicity, self-reported limiting long-term illness and self-rated health using mortality by ethnic group estimated by two methods: the Standardised Illness Ratio (SIR) method and the Geographically Weighted Method (GWM). Results. The SIR and GWM methods differed somewhat in their estimates of life expectancy (LE) at birth but produced very similar estimates of DFLE and HLE by ethnic group. For the more conservative method (GWM), the range in DFLE at birth was 10.5 years for men and 11.9 years for women, double that in LE. DFLE at birth was highest for Chinese men (64.7 years, 95% CI 64.0–65.3) and women (67.0 years, 95% CI 66.4–67.6). Over half of the ethnic minority groups (men: 10; women: 9) had significantly lower DFLE at birth than White British men (61.7 years, 95% CI 61.7–61.7) or women (64.1 years, 95% CI 64.1–64.2), mostly the Black, Asian and mixed ethnic groups. The lowest DFLE observed was for Bangladeshi men (54.3 years, 95% CI 53.7–54.8) and Pakistani women (55.1 years, 95% CI 54.8–55.4). Notable were Indian women whose LE was similar to White British women but who had 4.3 years less disability-free (95% CI 4.0–4.6). Conclusions. Inequalities in DFLE between ethnic groups are large and exceed those in LE. Moreover, certain ethnic groups have a larger burden of disability that does not seem to be associated with shorter LE. With the increasing population of the non-White British community, it is essential to be able to identify the ethnic groups at higher risk of disability, in order to target appropriate interventions. PMID:24897306

Inequalities in healthy life expectancy between ethnic groups in England and Wales in 2001.

PubMed

Wohland, Pia; Rees, Phil; Nazroo, James; Jagger, Carol

2015-01-01

We aim to develop robust estimates of disability-free life expectancy (DFLE) and healthy life expectancy (HLE) for ethnic groups in England and Wales in 2001 and to examine observed variations across ethnic groups. DFLE and HLE by age and gender for five-year age groups were computed for 16 ethnic groups by combining the 2001 Census data on ethnicity, self-reported limiting long-term illness and self-rated health using mortality by ethnic group estimated by two methods: the Standardised Illness Ratio (SIR) method and the Geographically Weighted Method (GWM). The SIR and GWM methods differed somewhat in their estimates of life expectancy (LE) at birth but produced very similar estimates of DFLE and HLE by ethnic group. For the more conservative method (GWM), the range in DFLE at birth was 10.5 years for men and 11.9 years for women, double that in LE. DFLE at birth was highest for Chinese men (64.7 years, 95% CI 64.0-65.3) and women (67.0 years, 95% CI 66.4-67.6). Over half of the ethnic minority groups (men: 10; women: 9) had significantly lower DFLE at birth than White British men (61.7 years, 95% CI 61.7-61.7) or women (64.1 years, 95% CI 64.1-64.2), mostly the Black, Asian and mixed ethnic groups. The lowest DFLE observed was for Bangladeshi men (54.3 years, 95% CI 53.7-54.8) and Pakistani women (55.1 years, 95% CI 54.8-55.4). Notable were Indian women whose LE was similar to White British women but who had 4.3 years less disability-free (95% CI 4.0-4.6). Inequalities in DFLE between ethnic groups are large and exceed those in LE. Moreover, certain ethnic groups have a larger burden of disability that does not seem to be associated with shorter LE. With the increasing population of the non-White British community, it is essential to be able to identify the ethnic groups at higher risk of disability, in order to target appropriate interventions.

Racial/Ethnic Differences in Cardiovascular Symptoms in Four Major Racial/Ethnic Groups of Midlife Women: A Secondary Analysis

PubMed Central

Im, Eun-Ok; Ham, Ok Kyung; Chee, Eunice; Chee, Wonshik

2015-01-01

Ethnic minority midlife women frequently do not recognize cardiovascular symptoms that they experience during the menopausal transition. Racial/ethnic differences in cardiovascular symptoms are postulated as a plausible reason for their lack of knowledge and recognition of the symptoms. The purpose of this study was to explore racial/ethnic differences in midlife women’s cardiovascular symptoms and to determine the factors related to these symptoms in each racial/ethnic group. This was a secondary analysis of the data from a larger study among 466 participants, collected from 2006 to 2011. The instruments included questions on background characteristics, health and menopausal status and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics, including Poisson regression and logistic regression analyses. Significant racial/ethnic differences were observed in the total numbers and total severity scores of cardiovascular symptoms (p<0.01). Non-Hispanic Asians had significantly lower total numbers and total severity scores compared to other racial/ethnic groups (p<0.05). The demographic and health factors associated with cardiovascular symptoms were somewhat different in each racial/ethnic group. Further studies are needed about possible reasons for the racial/ethnic differences and the factors associated with cardiovascular symptoms in each racial/ethnic group. PMID:25826460

MEASURING EVERYDAY RACIAL/ETHNIC DISCRIMINATION IN HEALTH SURVEYS: How Best to Ask the Questions, in One or Two Stages, Across Multiple Racial/Ethnic Groups?

PubMed

Shariff-Marco, Salma; Breen, Nancy; Landrine, Hope; Reeve, Bryce B; Krieger, Nancy; Gee, Gilbert C; Williams, David R; Mays, Vickie M; Ponce, Ninez A; Alegría, Margarita; Liu, Benmei; Willis, Gordon; Johnson, Timothy P

2011-01-01

While it is clear that self-reported racial/ethnic discrimination is related to illness, there are challenges in measuring self-reported discrimination or unfair treatment. In the present study, we evaluate the psychometric properties of a self-reported instrument across racial/ ethnic groups in a population-based sample, and we test and interpret findings from applying two different widely-used approaches to asking about discrimination and unfair treatment. Even though we found that the subset of items we tested tap into a single underlying concept, we also found that different groups are more likely to report on different aspects of discrimination. Whether race is mentioned in the survey question affects both frequency and mean scores of reports of racial/ethnic discrimination. Our findings suggest caution to researchers when comparing studies that have used different approaches to measure racial/ethnic discrimination and allow us to suggest practical empirical guidelines for measuring and analyzing racial/ethnic discrimination. No less important, we have developed a self-reported measure of recent racial/ethnic discrimination that functions well in a range of different racial/ethnic groups and makes it possible to compare how racial/ethnic discrimination is associated with health disparities among multiple racial/ethnic groups.

Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians

PubMed Central

2011-01-01

Background The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD) and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians. Methods Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4%) participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used. Results Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p < 0.001). Prevalence of self-reported diabetes varied from 3.0% to 15.0% for the ethnic minority groups versus 1.8% for ethnic Norwegians (p < 0.001). Among individuals without diabetes, the CVD prevalence was 6.0% versus 2.6% for ethnic minorities and Norwegians, respectively (p < 0.001). Corresponding CVD prevalence rates among individuals with diabetes were 15.3% vs. 12.6% (p = 0.364). For individuals without diabetes, the odds ratio (OR) for CVD in the ethnic minority groups remained significantly higher (range 1.5-2.6) than ethnic Norwegians (p < 0.05), after adjustment for age, gender, education, employment, and body height, except for Turkish individuals. Regardless of diabetes status, obesity and physical inactivity were prevalent in the majority of ethnic minority groups, whereas systolic- and diastolic- blood pressures were higher in Norwegians. In nearly all ethnic groups, individuals with diabetes had higher triglycerides, waist-to-hip ratio (WHR), and body mass index compared to individuals without diabetes. Age, diabetes, hypertension, hypercholesterolemia, and WHR were significant predictors of CVD in both ethnic Norwegians and ethnic minorities, but significant ethnic differences were found for age, diabetes, and hypercholesterolemia. Conclusions Ethnic differences in the prevalence of CVD were prominent for individuals without diabetes. Primary CVD prevention including identification of undiagnosed diabetes should be prioritized for ethnic minorities without known diabetes. PMID:21752237

Assimilation or Ethnicization: An Exploration of Inland Tibet Class Education Policy and Practice

ERIC Educational Resources Information Center

Miaoyan, Yang; Dunzhu, Nima

2015-01-01

Assimilation and ethnicization are mainstream voices in current studies of ethnic relations. The former suspects that current social system arrangements are meant to assimilate minority groups into the cultural system of the mainstream ethnic group, while the latter believes that current systemic arrangements will cause minority groups to tend…

Racial/ethnic harassment and discrimination, its antecedents, and its effect on job-related outcomes.

PubMed

Bergman, Mindy E; Palmieri, Patrick A; Drasgow, Fritz; Ormerod, Alayne J

2012-01-01

A general model of workplace prejudice acts, their antecedents, and their consequences is proposed and examined in the context of racial/ethnic harassment and discrimination (REHD). Antecedents proposed and tested here include context and climate, whereas consequences proposed and tested here include work, supervisor, and opportunity satisfaction and turnover intentions. The theoretical model is first tested and cross-validated in two ethnically diverse subsamples (approximately 2,000 each). Then, hierarchical multigroup modeling was conducted to determine whether the relationships among REHD, its antecedents, and its outcomes are equivalent across five racial/ethnic groups (N = 1,000 per group) in the U.S. military. This addresses the issue of differential exposure (i.e., varying amounts of stressors across groups) versus differential vulnerability (i.e., discrepant impact of a stressor on outcomes across groups) across racial/ethnic groups. Consistent with expectations, results suggest that although racial/ethnic groups differ in their mean exposure to REHD, the relationships among REHD and its outcomes are the same across race/ethnicity, supporting the differential exposure view. In addition, the results show some differences between antecedents and REHD across race/ethnicity.

The Geographic Origins of Ethnic Groups in the Indian Subcontinent: Exploring Ancient Footprints with Y-DNA Haplogroups.

PubMed

Mahal, David G; Matsoukas, Ianis G

2018-01-01

Several studies have evaluated the movements of large populations to the Indian subcontinent; however, the ancient geographic origins of smaller ethnic communities are not clear. Although historians have attempted to identify the origins of some ethnic groups, the evidence is typically anecdotal and based upon what others have written before. In this study, recent developments in DNA science were assessed to provide a contemporary perspective by analyzing the Y chromosome haplogroups of some key ethnic groups and tracing their ancient geographical origins from genetic markers on the Y-DNA haplogroup tree. A total of 2,504 Y-DNA haplotypes, representing 50 different ethnic groups in the Indian subcontinent, were analyzed. The results identified 14 different haplogroups with 14 geographic origins for these people. Moreover, every ethnic group had representation in more than one haplogroup, indicating multiple geographic origins for these communities. The results also showed that despite their varied languages and cultural differences, most ethnic groups shared some common ancestors because of admixture in the past. These findings provide new insights into the ancient geographic origins of ethnic groups in the Indian subcontinent. With about 2,000 other ethnic groups and tribes in the region, it is expected that more scientific discoveries will follow, providing insights into how, from where, and when the ancestors of these people arrived in the subcontinent to create so many different communities.

The Geographic Origins of Ethnic Groups in the Indian Subcontinent: Exploring Ancient Footprints with Y-DNA Haplogroups

PubMed Central

Mahal, David G.; Matsoukas, Ianis G.

2018-01-01

Several studies have evaluated the movements of large populations to the Indian subcontinent; however, the ancient geographic origins of smaller ethnic communities are not clear. Although historians have attempted to identify the origins of some ethnic groups, the evidence is typically anecdotal and based upon what others have written before. In this study, recent developments in DNA science were assessed to provide a contemporary perspective by analyzing the Y chromosome haplogroups of some key ethnic groups and tracing their ancient geographical origins from genetic markers on the Y-DNA haplogroup tree. A total of 2,504 Y-DNA haplotypes, representing 50 different ethnic groups in the Indian subcontinent, were analyzed. The results identified 14 different haplogroups with 14 geographic origins for these people. Moreover, every ethnic group had representation in more than one haplogroup, indicating multiple geographic origins for these communities. The results also showed that despite their varied languages and cultural differences, most ethnic groups shared some common ancestors because of admixture in the past. These findings provide new insights into the ancient geographic origins of ethnic groups in the Indian subcontinent. With about 2,000 other ethnic groups and tribes in the region, it is expected that more scientific discoveries will follow, providing insights into how, from where, and when the ancestors of these people arrived in the subcontinent to create so many different communities. PMID:29410676

Barriers to continuity in the pathway toward occupational engagement among ethnic minorities with mental illness.

PubMed

Pooremamali, Parvin; Morville, Anne-Le; Eklund, Mona

2017-07-01

Ethnic minorities have particular needs and difficulties in terms of support for meaningful occupations, lack of access to and use of occupation-based rehabilitation services. They are not established in the labour market and are seldom in paid employment. This study aimed to investigate how mentally ill ethnic minority clients experience, feel and think about participation in occupation-based rehabilitation, and potential barriers they might encounter. Nine participants experiencing mental illness and receiving occupation-based rehabilitation were interviewed. Grounded theory methods were used in order to collect and analyze data. One core category, "barriers for a continuous path towards enriched and meaningful occupation" described the participants' experiences of a variety of barriers related to personal, occupational and system factors that hindered participation in occupation-based rehabilitation and influenced their need for occupational development and growth. The core category was composed of; personal-related barriers, occupational-related barriers, and system-related barriers as well as six related sub-categories. These barriers interacted continually across time and space in ways that increased the participants' sense of occupational deprivation and alienation. The findings also suggested that the issues of paid employment for ethnic minorities with mental illness should feature on the agenda of local, regional and state politicians and professionals involved in occupational rehabilitation.

Use of focus groups in multi-site, multi-ethnic research projects for women's health: a Study of Women Across the Nation (swan) example.

PubMed

Kagawa-Singer, Marjorie; Adler, Shelley R; Mouton, Charles E; Ory, Marcia; Underwood, Lynne G

2009-01-01

To outline the lessons learned about the use of focus groups for the multisite, multi-ethnic longitudinal Study of Women Across the Nation (SWAN). Focus groups were designed to identify potential cultural differences in the incidence of symptoms and the meaning of transmenopause among women of diverse cultures, and to identify effective recruitment and retention strategies. Inductive and deductive focus groups for a multi-ethnic study. Seven community research sites across the United States conducted focus groups with six ethnic populations: African American, Chinese American, Japanese American, Mexican American, non-Hispanic white, and Puerto Rican. Community women from each ethnic group of color. A set of four/five focus groups in each ethnic group as the formative stage of the deductive, quantitative SWAN survey. Identification of methodological advantages and challenges to the successful implementation of formative focus groups in a multi-ethnic, multi-site population-based epidemiologic study. We provide recommendations from our lessons learned to improve the use of focus groups in future studies with multi-ethnic populations. Mixed methods using inductive and deductive approaches require the scientific integrity of both research paradigms. Adequate resources and time must be budgeted as essential parts of the overall strategy from the outset of study. Inductive cross-cultural researchers should be key team members, beginning with inception through each subsequent design phase to increase the scientific validity, generalizability, and comparability of the results across diverse ethnic groups, to assure the relevance, validity and applicability of the findings to the multicultural population of focus.

Ethnic identity in adolescents and adults: review of research.

PubMed

Phinney, J S

1990-11-01

Ethnic identity is central to the psychological functioning of members of ethnic and racial minority groups, but research on the topic is fragmentary and inconclusive. This article is a review of 70 studies of ethnic identity published in refereed journals since 1972. The author discusses the ways in which ethnic identity has been defined and conceptualized, the components that have been measured, and empirical findings. The task of understanding ethnic identity is complicated because the uniqueness that distinguishes each group makes it difficult to draw general conclusions. A focus on the common elements that apply across groups could lead to a better understanding of ethnic identity.

Drinking outcomes following drink refusal skills training: differential effects for African American and non-Hispanic White clients.

PubMed

Witkiewitz, Katie; Villarroel, Nadia Aracelliz; Hartzler, Bryan; Donovan, Dennis M

2011-03-01

Determining whether a particular treatment works for specific groups of people can help tailor dissemination of evidence-based alcohol treatments. It has been proposed that individuals from different racial groups might have better outcomes in treatments that are sensitive to sociocultural issues that impact alcohol use among these groups. The current study was a secondary analysis of data from the combined behavioral intervention (CBI) condition of the COMBINE study. Those randomly assigned to CBI (n = 776) had the opportunity to receive up to 9 skills training modules, which were chosen by the therapist. The goal of the current study was to determine whether receiving 1 of the CBI modules, drink refusal and social pressure skills training, predicted differential outcomes among African American clients. Results indicated that African American clients who received the drink refusal skills training module (n = 25) had significantly fewer heavy drinking days (d = 0.79) 1 year following treatment than African Americans clients who did not receive the module (n = 35). African American clients who received the module also had significantly fewer heavy drinking days (d = 0.86) than non-Hispanic White clients who received the module (n = 241). Good clinical outcomes at 1 year posttreatment were observed among 80% of African Americans who received the module, compared with 54% of African Americans who did not receive the module and 52% of non-Hispanic White clients who did receive the module. Although small sample size limits interpretation, findings provide preliminary evidence supporting the inclusion of drink refusal skills training as part of alcohol interventions for African American clients.

Exploring Ethnic Inequalities in Admission to Russell Group Universities

PubMed Central

Boliver, Vikki

2015-01-01

This article analyses national university applications and admissions data to explore why ethnic minority applicants to Russell Group universities are less likely to receive offers of admission than comparably qualified white applicants. Contrary to received opinion, the greater tendency of ethnic minorities to choose highly numerically competitive degree subjects only partially accounts for their lower offer rates from Russell Group universities relative to white applicants with the same grades and ‘facilitating subjects’ at A-level. Moreover, ethnic inequalities in the chances of receiving an admissions offer from a Russell Group university are found to be greater in relation to courses where ethnic minorities make up a larger percentage of applicants. This latter finding raises the possibility that some admissions selectors at some Russell Group universities may be unfairly rejecting a proportion of their ethnic minority applicants in an attempt to achieve a more ethnically representative student body. PMID:27904229

[Ethnic origin of patients remains important].

PubMed

Stronks, Karien

2013-01-01

The ethnic diversity in medical practices is increasing rapidly. In the Netherlands, ethnic groups are predominantly defined on the basis of their geographical origin, e.g. inhabitants of Turkish, Moroccan or Surinamese origin. The prevalence of health problems and the utilisation of health care differ between ethnic groups. This ethnic variation arises, firstly, from characteristics that are inherent to these groups such as genetic profile and culture, and, secondly, from characteristics that reflect their position in Dutch society such as socio-economic position and discrimination on the other. If we could fully understand which of these specific characteristics leads to a specific pattern of health problems or health care use, the classification of patient into ethnic groups would then become redundant. As long as we do not completely understand this variation, however, ethnic origin is a good entry-point for targeting health care to groups of patients.

Case report: a work simulation program for a manual worker with a fracture injury.

PubMed

Chan, Chi-Chung; Chow, Jonathan H.W.

2000-01-01

Work rehabilitation programs targeting different client groups are available in nearly all major hospital occupational therapy departments in Hong Kong. Clients receiving work rehabilitation are referred from various out-patient clinics and other occupational therapists. Those clients experience limitation in work after their injuries or diseases and plan to return to work after rehabilitation. Program objectives are 1) to assist clients to reach maximum work capacity as rapidly as possible 2) to ensure clients return to work safely 3) to improve clients' work readiness. This case report describes an individualized work simulation program at a general hospital in Hong Kong provided for a typical client who is preparing to return to his worker role. Specific job analysis, goals and program rationale for the client are discussed.

Intergroup Consensus/Disagreement in Support of Group Based Hierarchy: An Examination of Socio-Structural and Psycho-Cultural Factors

PubMed Central

Lee, I-Ching; Pratto, Felicia; Johnson, Blair T.

2011-01-01

A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did and members of lower-power ethnic/racial groups opposed group-based hierarchy more than members of higher-power ethnic/racial groups. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed and implications are developed for social dominance theory, social role theory and biosocial theory, social identity theory, system justification theory, realistic group conflict theory and relative deprivation theory. PMID:22023142

Composition, concentration and deprivation: exploring their association with social cohesion among different ethnic groups in the UK.

PubMed

Bécares, Laia; Stafford, Mai; Laurence, James; Nazroo, James

2011-01-01

Although studies in the US have shown an association between the ethnic residential composition of an area and reports of decreased social cohesion among its residents, this association is not clear in the UK, and particularly for ethnic minority groups. The current study analyses a merged dataset from the 2005 and 2007 Citizenship Survey to assess the evidence for an association between social cohesion and ethnic residential concentration, composition and area deprivation across different ethnic groups in the UK. Results of the multilevel regression models show that, after adjusting for area deprivation, increased levels of social cohesion are found in areas of greater ethnic residential heterogeneity. Although different patterns emerge across ethnic groups and the measure of social cohesion used, findings consistently show that it is area deprivation, and not ethnic residential heterogeneity, which erodes social cohesion in the UK.

Forecasting client transitions in British Columbia's Long-Term Care Program.

PubMed Central

Lane, D; Uyeno, D; Stark, A; Gutman, G; McCashin, B

1987-01-01

This article presents a model for the annual transitions of clients through various home and facility placements in a long-term care program. The model, an application of Markov chain analysis, is developed, tested, and applied to over 9,000 clients (N = 9,483) in British Columbia's Long Term Care Program (LTC) over the period 1978-1983. Results show that the model gives accurate forecasts of the progress of groups of clients from state to state in the long-term care system from time of admission until eventual death. Statistical methods are used to test the modeling hypothesis that clients' year-over-year transitions occur in constant proportions from state to state within the long-term care system. Tests are carried out by examining actual year-over-year transitions of each year's new admission cohort (1978-1983). Various subsets of the available data are analyzed and, after accounting for clear differences among annual cohorts, the most acceptable model of the actual client transition data occurred when clients were separated into male and female groups, i.e., the transition behavior of each group is describable by a different Markov model. To validate the model, we develop model estimates for the numbers of existing clients in each state of the long-term care system for the period (1981-1983) for which actual data are available. When these estimates are compared with the actual data, total weighted absolute deviations do not exceed 10 percent of actuals. Finally, we use the properties of the Markov chain probability transition matrix and simulation methods to develop three-year forecasts with prediction intervals for the distribution of the existing total clients into each state of the system. The tests, forecasts, and Markov model supplemental information are contained in a mechanized procedure suitable for a microcomputer. The procedure provides a powerful, efficient tool for decision makers planning facilities and services in response to the needs of long-term care clients. PMID:3121537

Dermatoglyphics from All Chinese Ethnic Groups Reveal Geographic Patterning

PubMed Central

Jin, Li; Case, D. Troy; Jiao, Yun-Ping; Wang, Xian-Ping; Bai, Chong-Xian; Jin, Gang; Yang, Jiang-Ming; Wang, Han; Yuan, Jian-Bing; Huang, Wei; Wang, Zhu-Gang; Chen, Ren-Biao

2010-01-01

Completion of a survey of dermatoglyphic variables for all ethnic groups in an ethnically diverse country like China is a huge research project, and an achievement that anthropological and dermatoglyphic scholars in the country could once only dream of. However, through the endeavors of scientists in China over the last 30 years, the dream has become reality. This paper reports the results of a comprehensive analysis of dermatoglyphics from all ethnic groups in China. Using cluster analysis and principal component analysis of dermatoglyphics, it has been found that Chinese populations can be generally divided into a southern group and a northern group. Furthermore, there has been considerable debate about the origins of many Chinese populations and about proper assignment of these peoples to larger ethnic groups. In this paper, we suggest that dermatoglyphic data can inform these debates by helping to classify a Chinese population as a northern or southern group, using selected reference populations and quantitative methods. This study is the first to assemble and investigate dermatoglyphics from all 56 Chinese ethnic groups. It is fortunate that data on population dermatoglyphics, a field of physical anthropology, have now been collected for all 56 Chinese ethnic groups, because intermarriage between individuals from different Chinese ethnic groups occurs more frequently in recent times, making population dermatoglyphic research an ever more challenging field of inquiry. PMID:20098698

Perspectives on barriers to eating healthy among food pantry clients

USDA-ARS?s Scientific Manuscript database

The objective of this study was to explore perspectives on barriers of eating healthy among food pantry clients. Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach. Themes were then identified. Qua...

Family group conferences in public mental health care: an exploration of opportunities.

PubMed

de Jong, Gideon; Schout, Gert

2011-02-01

Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public mental health care. The present study reports on an exploratory study on the applicability of family group conferencing in public mental health care. Findings suggest that there are six reasons to start family group conference pilots in public mental health care. First, care providers who work in public mental health care often need to deal with clients who are not motivated in seeking help. Family group conferences could yield support or provide a plan, even without the presence of the client. Second, conferences might complement the repertoire of treatment options between voluntary help and coercive treatment. Third, clients in public mental health care often have a limited network. Conferences promote involvement, as they expand and restore relationships, and generate support. Fourth, conferences could succeed both in a crisis and in other non-critical situations. Sometimes pressure is needed for clients to accept help from their network (such as in the case of an imminent eviction), while in other situations, it is required that clients are stabilized before a conference can be organized (such as in the case of a psychotic episode). Fifth, clients who have negative experiences with care agencies and their representatives might be inclined to accept a conference because these agencies act in another (modest) role. Finally, the social network could elevate the work of professionals. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Analysis of common deafness gene mutations in deaf people from unique ethnic groups in Gansu Province, China.

PubMed

Xu, Bai-Cheng; Bian, Pan-Pan; Liu, Xiao-Wen; Zhu, Yi-Ming; Yang, Xiao-Long; Ma, Jian-Li; Chen, Xing-Jian; Wang, Yan-Li; Guo, Yu-Fen

2014-09-01

The GJB2 gene mutation characteristic of Dongxiang was the interaction result of ethnic background and geographical environment, and Yugur exhibited the typical founder effect. The SLC26A4 gene mutation characteristic of Dongxiang was related to caucasian backgrounds and selection of purpose exons, i.e. ethnic background and the penetrance of ethnic specificity caused the low mtDNA1555A>G mutation frequency in Dongxiang. To determine the prevalence of GJB2 and SLC26A4 genes and mtDNA1555A>G mutations and analyze the ethnic specificity in the non-syndromic sensorineural hearing loss (NSHL) of unique ethnic groups in Gansu Province. Peripheral blood samples were obtained from Dongxiang, Yugur, Bonan, and ethnic Han groups with moderately severe to profound NSHL in Gansu Province. Bidirectional sequencing (or enzyme digestion) was applied to identify the sequence variations. The pathogenic allele frequency of the three gene mutations was different. The frequency of the GJB2 gene among the Dongxiang, Yugur, Bonan, and ethnic Han groups was 9.03%, 12.5%, 5.88%, and 12.17%, respectively. No difference was found between the ethnic groups. The frequencies of the SLC26A4 genes were 3.23%, 8.33%, 0%, and 9.81%, respectively. The mutation frequency of mtDNA1555A>G was 0%, 0%, 0%, and 6.03%, respectively. No difference was found between the ethnic groups, except for the Dongxiang and ethnic Han groups, both in SLC26A4 gene and mtDNA1555A>G.

Conceptualizing Group Dynamics from Our Clients' Perspective: Development of the Conceptualization of Group Dynamics Inventory

ERIC Educational Resources Information Center

Tate, Kevin A.; Rivera, Edil Torres; Conwill, William L.; Miller, M. David; Puig, Ana

2013-01-01

There is a clear call in group counseling practice and training for evidence-based practice (ACA, 2005; ASGW, 2008; CACREP, 2009). At the same time, group counselors also are asked to keep clients' experience at the center of their work (ASGW, 2012). This article outlines the authors' effort to develop and study an instrument designed to measure…

Security Force Assistance: Strategic, Advisory, and Partner Nation Considerations

DTIC Science & Technology

2010-12-01

ethnic groups and tribes (which are further divided into sub-tribes and clans),97 spread out throughout a country with little (and in many places...and Hazara ethnic groups . Claims of certain ethnic groups receiving preferential treatment are common (and certainly not unique to the GIRoA or...the Pashtuns, despite being Afghanistan’s largest ethnic group (comprising 42% of the population),128 continue to be highly underrepresented in the

Should Family and Friends Be Involved in Group-Based Rehabilitation Programs for Adults with Low Vision?

ERIC Educational Resources Information Center

Rees, G.; Saw, C.; Larizza, M.; Lamoureux, E.; Keeffe, J.

2007-01-01

This qualitative study investigates the views of clients with low vision and vision rehabilitation professionals on the involvement of family and friends in group-based rehabilitation programs. Both groups outlined advantages and disadvantages to involving significant others, and it is essential that clients are given the choice. Future work is…

The Sociological Study of Minority Groups as Reflected by Leading Sociological Journals Who Gets Studies and Who Gets Neglected?

ERIC Educational Resources Information Center

Lavender, Abraham D.; Forsyth, John M.

1976-01-01

In view of the small amount of attention given to non-black ethnic groups in the sociological literature, this paper suggests that it is no wonder that so little is known about ethnic-ethnic, ethnic-black, and ethnic-dominant society relations. (Author)

Relationships between Ethnic Identity, Ethnic Attitudes, and Acculturative Stress in Tunisian Individuals in Early and Middle Adolescence

ERIC Educational Resources Information Center

Musso, Pasquale; Inguglia, Cristiano; Lo Coco, Alida

2017-01-01

Framed from an integrative approach, the current article examined the associations between ethnic identity exploration (EIE), ethnic identity commitment (EIC), and acculturative stress by investigating the mediating role of ethnic attitudes (i.e., in-group favoritism and out-group derogation) in these relationships. Additionally, the moderating…

Ethnic Groups and the American Dream(s).

ERIC Educational Resources Information Center

Cortes, Carlos E.

1982-01-01

Examines what the American dream means to ethnic Americans. Specifically discussed are: (1) how official documents of the dream have dealt with ethnicity; (2) how ethnic groups have interpreted the dream; (3) how the 1960s redefined the dream; and (4) the future of the dream in terms of changing American ethnicity. (RM)

Status and Trends in the Education of Racial and Ethnic Groups 2016. NCES 2016-007

ERIC Educational Resources Information Center

Musu-Gillette, Lauren; Robinson, Jennifer; McFarland, Joel; KewalRamani, Angelina; Zhang, Anlan; Wilkinson-Flicker, Sidney

2016-01-01

"Status and Trends in the Education of Racial and Ethnic Groups" examines the educational progress and challenges students face in the United States by race/ethnicity. This report shows that, over time, students in the racial/ethnic groups of White, Black, Hispanic, Asian, Native Hawaiian or Other Pacific Islander, American Indian/Alaska…

Race/ethnicity and racial group composition moderate the effectiveness of mindfulness-based relapse prevention for substance use disorder.

PubMed

Greenfield, Brenna L; Roos, Corey; Hagler, Kylee J; Stein, Elena; Bowen, Sarah; Witkiewitz, Katie A

2018-06-01

Mindfulness-based relapse prevention has shown promise as a treatment for substance use disorder but its efficacy according to racial/ethnic minority status and group composition is unknown. This is a secondary analysis of existing data (Bowen et al., 2014) testing individual race/ethnicity and racial/ethnic group composition as moderators of mindfulness-based relapse prevention (MBRP). Participants (N = 191; 29% female; 47% racial/ethnic minority; mean age = 39) with substance use disorder were randomized to MBRP or relapse prevention (RP). Outcomes were heavy drinking days (HDD) and drug use days (DUD) 12 months after treatment completion. Negative binominal regression models were conducted. Analyses accounted for drug of choice. Individual race/ethnicity was a significant moderator of substance use outcomes. White participants had lower HDD in MBRP than RP (IRR = 0, 95% CI: 0,0), whereas for minority participants, there was no treatment difference in HDD. Conversely, minorities had lower DUD in MBRP than RP (IRR = 0.03, 95% CI: 0.01, 0.10), whereas for whites there was no treatment difference in DUD. Group racial/ethnic composition was a significant moderator. Participants in groups with more than half whites had lower HDD in MBRP than RP (IRR = 0.01, 95% CI: 0, 0.09), whereas for participants in groups with more than half minorities there was no treatment difference in HDD. Exploratory analyses suggested MBRP resulted in better outcomes than RP when individual race/ethnic status was reflected in the group race/ethnicity (i.e., whites in groups with more than half whites or minorities in groups with more than half minorities). Among whites, MBRP appears to be more effective than RP in preventing heavy drinking relapse. However, among racial/ethnic minorities, MBRP appears to more effective than RP in preventing drug use relapse. This suggests that the interaction between individual race/ethnicity and group composition may influence primary outcomes. Copyright © 2018 Elsevier Ltd. All rights reserved.

Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States

PubMed Central

BRESLAU, JOSHUA; KENDLER, KENNETH S.; SU, MAXWELL; GAXIOLA-AGUILAR, SERGIO; KESSLER, RONALD C.

2009-01-01

Background Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample. Method Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States – Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites – were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder. Results Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups. Conclusions Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups. PMID:15841868

Using spiritually modified cognitive-behavioral therapy in substance dependence treatment: therapists' and clients' perceptions of the presumed benefits and limitations.

PubMed

Hodge, David R; Lietz, Cynthia A

2014-11-01

Cognitive-behavioral therapy (CBT) that has been modified to incorporate clients' spiritual beliefs and practices has been used to treat a variety of problems. This study examines the utility of this modality with the treatment of alcohol dependence and other forms of substance abuse. Toward this end, six focus groups (three therapist groups and three client groups) were conducted to identify the presumed benefits and limitations of using spiritually modified CBT in substance dependence treatment. In terms of benefits, spiritually modified CBT was perceived to enhance outcomes through operationalizing horizontal and vertical sources of social support, divine coping resources, and spiritual motivation. Potential challenges include the risk of therapists inadvertently imposing their own beliefs during the modification process and the possibility of offending clients when conflicts in belief systems emerge, particularly in group setting. The article concludes by providing suggestions for incorporating spiritually modified CBT into treatment and develops a number of illustrative examples of spiritually modified CBT self-statements.

Minority acculturation and peer rejection: Costs of acculturation misfit with peer-group norms.

PubMed

Celeste, Laura; Meeussen, Loes; Verschueren, Karine; Phalet, Karen

2016-09-01

How do minority adolescents' personal acculturation preferences and peer norms of acculturation affect their social inclusion in school? Turkish and Moroccan minority adolescents (N = 681) reported their preferences for heritage culture maintenance, mainstream culture adoption, and their experiences of peer rejection as a key indicator of adjustment problems. Additionally, we aggregated peer acculturation norms of maintenance and adoption within ethnically diverse classrooms (N = 230 in 50 Belgian schools), distinguishing between co-ethnic (Turkish or Moroccan classmates only, N = 681) and cross-ethnic norms (also including N = 1,930 other classmates). Cross-ethnic peer-group norms (of adoption and maintenance) and co-ethnic norms (of maintenance, marginally) predicted minority experiences of peer rejection (controlling for ethnic composition). Moreover, misfit of minorities' own acculturation preferences with both cross-ethnic and co-ethnic peer-group norms was harmful. When cross-ethnic norms stressed adoption, 'integrationist' minority youth - who combined culture adoption with maintenance - experienced most peer rejection. Yet, when co-ethnic peers stressed maintenance, 'assimilationist' minority youth experienced most rejection. In conclusion, acculturation misfit with peer-group norms is a risk factor for minority inclusion in ethnically diverse environments. © 2016 The British Psychological Society.

Incidence of oral cancer among South Asians and those of other ethnic groups by sex in West Yorkshire and England, 2001-2006.

PubMed

Csikar, Julia; Aravani, Ariadni; Godson, Jenny; Day, Matthew; Wilkinson, John

2013-01-01

In 2008 there were 11682 cases of oral cancer in the United Kingdom; this is 16.41/100000 population, and 3.7% of all cancers. Ethnic coding of these data is poor, and so databases were combined to report rates for the incidence of oral cancer in South Asians compared with those among other ethnic groups in West Yorkshire, 2001-2006. A total of 2157 patients with oral cancer were identified in West Yorkshire, 138 of whom were South Asian (6.4%). We analysed them by ethnicity, sex, area in which they lived, and site of cancer. Oral cancer was significantly more common among South Asian women than those from other ethnic groups in England and West Yorkshire, and in England alone it was significantly more common in men of other ethnic groups than those from South Asia. Patients from South Asia were at higher risk of being diagnosed with oral cancer than those of other ethnic groups within West Yorkshire, when data were adjusted for age at diagnosis and sex. In England and in West Yorkshire there was a significantly higher rate of oral cancer among Southern Asian women than among those of other ethnic groups, and men in other ethnic groups had a higher incidence than those from South Asia (England only). The excess of oral cancers gives further weight to the association between smokeless tobacco, smoking, alcohol, and dietary intake by ethnic group. This information is particularly pertinent in areas such as West Yorkshire where there are large groups of Asian people. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Ethnicity or cultural group identity of pregnant women in Sydney, Australia: Is country of birth a reliable proxy measure?

PubMed

Porter, M; Todd, A L; Zhang, L Y

2016-04-01

Australia has one of the most ethnically and culturally diverse maternal populations in the world. Routinely few variables are recorded in clinical data or health research to capture this diversity. This paper explores how pregnant women, Australian-born and overseas-born, respond to survey questions on ethnicity or cultural group identity, and whether country of birth is a reliable proxy measure. As part of a larger study, pregnant women attending public antenatal clinics in Sydney, Australia, completed a survey about their knowledge and expectations of pregnancy duration. The survey included two questions on country of birth, and identification with an ethnicity or cultural group. Country of birth data were analysed using frequency tabulations. Responses to ethnicity or cultural group were analysed using inductive coding to identify thematic categories. Among the 762 with 75 individual cultural groups or ethnicities and 68 countries of birth reported. For Australian-born women (n=293), 23% identified with a cultural group or ethnicity, and 77% did not. For overseas-born women (n=469), 44% identified with a cultural group or ethnicity and 56% did not. Responses were coded under five thematic categories. Ethnicity and cultural group identity are complex concepts; women across and within countries of birth identified differently, indicating country of birth is not a reliable measure. To better understand the identities of the women receiving maternity care, midwives, clinicians and researchers have an ethical responsibility to challenge practices that quantify cultural group or ethnicity, or use country of birth as a convenient proxy measure. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The Challenge of Prejudice: Counsellors' Talk about Challenging Clients' Prejudices

ERIC Educational Resources Information Center

Spong, Sheila J.

2012-01-01

This paper considers the implications for training and practice of counsellors' responses to the notion of challenging clients' prejudices. It explores tensions in counselling discourse between social responsibility, responsibility to the client and responsibility for one's self as counsellor. Three focus groups of counsellors were asked whether a…

Sex, drugs and prisons: HIV prevention strategies for over 190 000 clients in Ukraine.

PubMed

Denisiuk, O; Smyrnov, P; Kumar, A M V; Achanta, S; Boyko, K; Khogali, M; Naik, B; Zachariah, R

2014-06-21

One hundred and forty non-governmental organisations implementing human immunodeficiency virus (HIV) prevention programmes among clients, including people who inject drugs, prisoners, female sex workers, men who have sex with men and street children in Ukraine, 2010-2011. Among enrolled clients, to assess factors associated with HIV testing, HIV retesting within a year of initial testing and HIV seroconversion. Retrospective cohort study involving record reviews. Of 192 487 clients, 42 109 (22%) underwent an initial HIV test (22% were positive). Among HIV-negative clients at baseline, 10 858 (27%) were retested within a year: 317 (3%) of these were HIV-positive. HIV testing and retesting rates were lower among prisoners (0.3%) and others (street children and partners of those in risk groups, 6%), and those who did not receive counselling or services such as condom and needle distribution. Individuals who were not counselled were more likely to seroconvert. In this large cohort of high-risk groups from Eastern Europe, HIV testing was low and HIV sero-conversion was high. This is of public health concern, bringing into question the overall quality of counselling and how well it is tailored to the specific needs of various risk groups. Qualitative studies to understand the reasons for non-testing are urgently required for designing client-specific interventions.

The effectiveness of skills training for improving outcomes in supported employment.

PubMed

Mueser, Kim T; Aalto, Steve; Becker, Deborah R; Ogden, John S; Wolfe, Rosemarie S; Schiavo, Diane; Wallace, Charles J; Xie, Haiyi

2005-10-01

This study evaluated whether a supplementary skills training program improved work outcomes for clients enrolled in supported employment programs. Thirty-five recently employed clients with severe mental illness who were receiving supported employment services at a free-standing agency were randomly assigned to participate in either the workplace fundamentals program, a skills training program designed to make work more "successful and satisfying," or treatment as usual. Knowledge of workplace fundamentals (for example, identifying workplace stressors, problem solving, and improving job performance) was assessed at baseline and at nine months; employment outcomes and use of additional vocational services were tracked for 18 months. Clients in the workplace fundamentals group (N=17) improved more in knowledge of workplace fundamentals than those in the control group (N=18) at the nine-month follow-up, but the two groups did not differ in the number of hours or days worked, salary earned, or receipt of additional vocational services over the 18-month period. In general, clients in this study had higher educational levels and better employment outcomes than clients in most previous studies of supported employment, making it difficult to detect possible effects of the skills training intervention on work. Supplementary skills training did not improve work outcomes for clients who were receiving supported employment.

Does closure of children's medical home impact their immunization coverage?

PubMed

Kolasa, M S; Stevenson, J; Ossa, A; Lutz, J

2014-12-01

Little is known about the impact closing a health care facility has on immunization coverage of children utilizing that facility as a medical home. The authors assessed the impact of closing a Medicaid managed care facility in Philadelphia on immunization coverage of children, primarily low income children from racial/ethnic minority groups, utilizing that facility for routine immunizations. Observational longitudinal cohort case study. Eligible children were born 03/01/05-06/30/07, present in Philadelphia's immunization information system (IIS), and were active clients of the facility before it closed in September 2007. IIS-recorded immunization coverage at ages 5, 7, 13, 16 and 19 months through January 2009 was compared between clinic children age-eligible to receive specific vaccines before clinic closing (preclosure cohorts) and children not age-eligible to receive those vaccines prior to closing (postclosure cohorts). Of 630 eligible children, 99 (16%) had no additional IIS-recorded immunizations. Third dose DTaP vaccine coverage at age seven months among preclosure cohorts was 54.4% vs. 40.3% among postclosure cohorts [risk ratio 1.31 (1.15,1.49)]. Fourth dose DTaP coverage at 19 months was 65.9% vs. 57.7% [risk ratio 1.24 (1.08,1.42)]. MMR coverage at 16 months was 79.5% vs. 69.9% [risk ratio 1.47 (1.22, 1.76)]. Coverage for the 431331 vaccination series at 19 months was 63.8% vs. 53.8% [risk ratio 1.28 (1.12,1.88)]. Immunization coverage declined at key age milestones for active clients of a Medicaid managed care that closed as compared with preclosure cohorts of clients from the same facility. When a primary health care facility closes, efforts should be made to ensure that children who had received vaccinations at that facility quickly establish a new medical home. Published by Elsevier Ltd.

Characterizing the nature of home care work and occupational hazards: a developmental intervention study.

PubMed

Markkanen, Pia; Quinn, Margaret; Galligan, Catherine; Sama, Susan; Brouillette, Natalie; Okyere, Daniel

2014-04-01

Home care (HC) aide is the fastest growing occupation, yet job hazards are under-studied. This study documents the context of HC aide work, characterizes occupational safety and health (OSH) hazards, and identifies preventive interventions using qualitative methods. We conducted 12 focus groups among aides and 26 in-depth interviews comprising 15 HC agency, union, and insurance company representatives as well as 11 HC recipients in Massachusetts. All focus groups and interviews were audio-recorded, transcribed, and coded with NVIVO software. Major OSH concerns were musculoskeletal disorders from client care tasks and verbal abuse. Performing tasks beyond specified job duties may be an OSH risk factor. HC aides' safety and clients' safety are closely linked. Client handling devices, client evaluation, care plan development, and training are key interventions for both aides' and clients' safety. Promoting OSH in HC is essential for maintaining a viable workforce. © 2013 Wiley Periodicals, Inc.

Association between Self-Rated Health and the Ethnic Composition of the Residential Environment of Six Ethnic Groups in Amsterdam

PubMed Central

Veldhuizen, Eleonore M.; Musterd, Sako; Dijkshoorn, Henriëtte; Kunst, Anton E.

2015-01-01

Background: Studies on the association between health and neighborhood ethnic composition yielded inconsistent results, possibly due to methodological limitations. We assessed these associations at different spatial scales and for different measures of ethnic composition. Methods: We obtained health survey data of 4673 respondents of Dutch, Surinamese, Moroccan, Turkish other non-Western and other Western origin. Neighborhood ethnic composition was measured for buffers varying from 50–1000 m. Associations with self-rated health were measured using logistic multilevel regression analysis, with control for socioeconomic position at the individual and area level. Results: Overall ethnic heterogeneity was not related to health for any ethnic group. The presence of other Surinamese was associated with poor self-rated health among Surinamese respondents. The presence of Moroccans or Turks was associated with poor health among some groups. The presence of Dutch was associated with better self-rated health among Surinamese and Turks. In most cases, these associations were stronger at lower spatial scales. We found no other associations. Conclusions: In Amsterdam, self-rated health was not associated with ethnic heterogeneity in general, but may be related to the presence of specific ethnic groups. Policies regarding social and ethnic mixing should pay special attention to the co-residence of groups with problematic interrelations. PMID:26569282

The culture of mentoring: Ethnocultural empathy and ethnic identity in mentoring for minority girls.

PubMed

Peifer, Janelle S; Lawrence, Edith C; Williams, Joanna Lee; Leyton-Armakan, Jen

2016-07-01

Many mentoring programs place minority group mentees with majority group mentors. These programs aim to promote beneficial outcomes for their diverse participants. The present study explores mentors of color and White mentors' ethnocultural empathy and ethnic identities in association with their minority group mentees' ethnic identities. Our study examined 95 mentoring pairs of middle school girls of color and college student women from both majority and minority group cultural backgrounds. A series of linear regressions revealed an association between mentors' ethnocultural empathy and EI exploration/commitment and minority group mentees' ethnic identity exploration, regardless of the mentors' majority group status. The results of this preliminary study suggest that mentors' cultural identity and empathy may be linked with mentees' willingness to explore their own ethnic identities. We discuss the implications for mentoring programs that seek to build participants' ethnic identities and ethnocultural empathy. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Different pain responses to chronic and acute pain in various ethnic/racial groups.

PubMed

Rahavard, Behnoosh B; Candido, Kenneth D; Knezevic, Nebojsa Nick

2017-09-01

Our goal in this study was to review the similarities and differences among ethnic groups and their respective responses to acute and chronic clinically related and experimentally induced pain. In this review, the PUBMED and Google-Scholar databases were searched to analyze articles that have assessed the variations in both acute and chronic pain responses among different ethnic/racial groups. According to the results from 42 reviewed articles, significant differences exist among ethnic-racial groups for pain prevalence as well as responses to acute and chronic pain. Compared with Caucasians, other ethnic groups are more susceptible to acute pain responses to nociceptive stimulation and to the development of long-term chronic pain. These differences need to be addressed and assessed more extensively in the future in order to minimize the pain management disparities among various ethnic-racial groups and also to improve the relationship between pain management providers and their patients.

Objectively measured sedentary time among five ethnic groups in Amsterdam: The HELIUS study

PubMed Central

Nicolaou, Mary; Snijder, Marieke B.; Peters, Ron J. G.; Stronks, Karien; Langøien, Lars J.; van der Ploeg, Hidde P.; Brug, Johannes; Lakerveld, Jeroen

2017-01-01

Introduction Sedentary behaviour is increasingly recognised as a health risk. While differences in this behaviour might help explain ethnic differences in disease profiles, studies on sedentary behaviour in ethnic minorities are scarce. The aim of this study was to compare the levels and the socio-demographic and lifestyle-related correlates of objectively measured sedentary time among five ethnic groups in Amsterdam, the Netherlands. Methods Data were collected as part of the HELIUS study. The sample consisted of adults from a Dutch, Moroccan, African Surinamese, South-Asian Surinamese and Turkish ethnic origin. Data were collected by questionnaire, physical examination, and a combined heart rate and accelerometry monitor (Actiheart). Sedentary time was defined as waking time spent on activities of <1.5 metabolic equivalents. Ethnic differences in the levels of sedentary time were tested using ANOVA and ANCOVA analyses, while ethnic differences in the correlates of sedentary time were tested with interactions between ethnicity and potential correlates using general linear models. Associations between these correlates and sedentary time were explored using linear regression analyses stratified by ethnicity (pre-determined). All analyses were adjusted for gender and age. Results 447 participants were included in the analyses, ranging from 73 to 109 participants per ethnic group. Adjusted levels of sedentary time ranged from 569 minutes/day (9.5 hours/day) for participants with a Moroccan and Turkish origin to 621 minutes/day (10.3 hours/day) in African Surinamese participants. There were no statistically significant differences in the levels or correlates of sedentary time between the ethnic groups. Meeting the physical activity recommendations (150 minutes/week) was consistently inversely associated with sedentary time across all ethnic groups, while age was positively associated with sedentary time in most groups. Conclusions No statistically significant differences in the levels of objectively measured sedentary time or its socio-demographic and lifestyle-related correlates were observed among five ethnic groups in Amsterdam, the Netherlands. PMID:28759597

Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social Well-Being and Health longitudinal study.

PubMed

Astell-Burt, Thomas; Maynard, Maria J; Lenguerrand, Erik; Harding, Seeromanie

2012-01-01

To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being. Multilevel models were used in longitudinal analysis of psychological well-being (total difficulties score (TDS) from Goodman's Strengths and Difficulties Questionnaire, higher scores correspond to greater difficulties) for 4782 adolescents aged 11-16 years in 51 London (U.K.) schools. Individual level variables included ethnicity, racism, gender, age, migrant generation, socio-economic circumstances, family type and indicators of family interactions (shared activities, perceived parenting). Contextual variables were per cent eligible for free school-meals, neighbourhood deprivation, per cent own-group ethnic density, and ethnic diversity. Ethnic minorities were more likely to report racism than whites. Ethnic minority boys (except Indian boys) and Indian girls reported better psychological well-being throughout adolescence compared to their white peers. Notably, lowest mean TDS scores were observed for Nigerian/Ghanaian boys, among whom the reporting of racism increased with age. Adjusted for individual characteristics, psychological well-being improved with age across all ethnic groups. Racism was associated with poorer psychological well-being trajectories for all ethnic groups (p<0.001), reducing with age. For example, mean difference in TDS (95% confidence interval) between boys who experienced racism and those who did not at age 12 years=1.88 (+1.75 to +2.01); at 16 years = +1.19 (+1.07 to +1.31). Less racism was generally reported in schools and neighbourhoods with high than low own-group density. Own ethnic density and diversity were not consistently associated with TDS for any ethnic group. Living in more deprived neighbourhoods was associated with poorer psychological well-being for whites and black Caribbeans (p<0.05). Racism, but not ethnic density and deprivation in schools or neighbourhoods, was an important influence on psychological well-being. However, exposure to racism did not explain the advantage in psychological well-being of ethnic minority groups over whites.

Ethnic identity and mental health in American Indian youth: examining mediation pathways through self-esteem, and future optimism.

PubMed

Smokowski, Paul R; Evans, Caroline B R; Cotter, Katie L; Webber, Kristina C

2014-03-01

Mental health functioning in American Indian youth is an understudied topic. Given the increased rates of depression and anxiety in this population, further research is needed. Using multiple group structural equation modeling, the current study illuminates the effect of ethnic identity on anxiety symptoms, depressive symptoms, and externalizing behavior in a group of Lumbee adolescents and a group of Caucasian, African American, and Latino/Hispanic adolescents. This study examined two possible pathways (i.e., future optimism and self-esteem) through which ethnic identity is associated with adolescent mental health. The sample (N = 4,714) is 28.53% American Indian (Lumbee) and 51.38% female. The study findings indicate that self-esteem significantly mediated the relationships between ethnic identity and anxiety symptoms, depressive symptoms, and externalizing behavior for all racial/ethnic groups (i.e., the total sample). Future optimism significantly mediated the relationship between ethnic identity and externalizing behavior for all racial/ethnic groups and was a significant mediator between ethnic identity and depressive symptoms for American Indian youth only. Fostering ethnic identity in all youth serves to enhance mental health functioning, but is especially important for American Indian youth due to the collective nature of their culture.

Importance-performance analysis of dental satisfaction among three ethnic groups in malaysia.

PubMed

Dewi, Fellani Danasra; Gundavarapu, Kalyan C; Cugati, Navaneetha

2013-01-01

To find the differences in patient satisfaction related to dental services among three ethnic groups - Chinese, Indian and Malay - at AIMST University Dental Centre and analyse them with an importance-performance grid, identifying the weak and strong points, in order to provide better service. This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test. Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians. The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.

Group cell phones are feasible and acceptable for promoting optimal breastfeeding practices in a women's microcredit program in Nigeria.

PubMed

Flax, Valerie L; Ibrahim, Alawiyatu Usman; Negerie, Mekebeb; Yakubu, Danjuma; Leatherman, Sheila; Bentley, Margaret E

2017-01-01

As part of a breastfeeding promotion intervention trial in Nigeria, we provided one cell phone per group of 5-7 microcredit clients and instructed the group's cell phone recipient to share weekly breastfeeding voice and text messages with group members. We measured the feasibility and acceptability of using group cell phones by conducting semi-structured exit interviews with 195 microcredit clients whose babies were born during the intervention (target group), in-depth interviews with eight phone recipients and nine non-phone recipients, and 16 focus group discussions with other microcredit clients. Women in the target group said the group phone worked well or very well (64%). They were motivated to try the recommended practices because they trusted the information (58%) and had support from others (35%). Approximately 44% of target women reported that their groups met and shared messages at least once a week. Women in groups that met at least weekly had higher odds of exclusive breastfeeding up to 6 months (OR 5.6, 95% CI 1.6, 19.7) than women in groups that never met. In-depth interviews and focus group discussions indicated that non-phone recipients had positive feelings towards phone recipients, the group phone met participants' needs, and messages were often shared outside the group. In conclusion, group cell phone messaging to promote breastfeeding among microcredit clients is feasible and acceptable and can be part of an effective behaviour change package. © 2016 John Wiley & Sons Ltd.

Perceived Ethnic Discrimination and Problem Behaviors in Muslim Immigrant Early Adolescents: Moderating Effects of Ethnic, Religious, and National Group Identification

ERIC Educational Resources Information Center

Maes, Marlies; Stevens, Gonneke W. J. M.; Verkuyten, Maykel

2014-01-01

Previous research has identified ethnic group identification as a moderator in the relationship between perceived ethnic discrimination and problem behaviors in ethnic minority children. However, little is known about the influence of religious and host national identification on this relationship. This study investigated the moderating role of…

"A NEW CONCEPTUALIZATION OF ETHNICITY FOR SOCIAL EPIDEMIOLOGIC AND HEALTH EQUITY RESEARCH"

PubMed Central

Harawa, Nina T

2010-01-01

Although social stratification persists in the US, differentially influencing the well-being of ethnically defined groups, ethnicity concepts and their implications for health disparities remain under-examined. Ethnicity is a complex social construct that influences personal identity and group social relations. Ethnic identity, ethnic classification systems, the groupings that compose each system and the implications of assignment to one or another ethnic category are place-, time- and context-specific. In the US, racial stratification uniquely shapes expressions of and understandings about ethnicity. Ethnicity is typically invoked via the term, ‘race/ethnicity’; however, it is unclear whether this heralds a shift away from racialization or merely extends flawed racial taxonomies to populations whose cultural and phenotypic diversity challenge traditional racial classification. We propose that ethnicity be conceptualized as a two-dimensional, context-specific, social construct with an attributional dimension that describes group characteristics (e.g., culture, nativity) and a relational dimension that indexes a group’s location within a social hierarchy (e.g., minority vs. majority status). This new conceptualization extends prior definitions in ways that facilitate research on ethnicization, social stratification and health inequities. While federal ethnic and racial categories are useful for administrative purposes such as monitoring the inclusion of minorities in research, and traditional ethnicity concepts (e.g., culture) are useful for developing culturally appropriate interventions, our relational dimension of ethnicity is useful for studying the relationships between societal factors and health inequities. We offer a new conceptualization of ethnicity and outline next steps for employing socially meaningful measures of ethnicity in empirical research. Ethnicity is both increasingly complex and increasingly central to social life; therefore, improving its conceptualization and measurement is crucial for advancing research on ethnic health inequities. PMID:20488602

Ethnic Identity and Social-Cognitive Maturity in a Multicultural Group Experience

ERIC Educational Resources Information Center

Johnson, Jennifer M.; Lambie, Glenn W.

2013-01-01

This study examined a multicultural group experience on students' ("N"= 94) ethnic identity development and social-cognitive maturity. Although no differences were identified between treatment and comparison group participants, group therapeutic factors scores were predictive of ethnic identity development and social-cognitive…

Treatment of Female Sexual Dysfunction Through Symbolic Modeling

ERIC Educational Resources Information Center

Nemetz, Georgia H.; And Others

1978-01-01

Clients (N=16) were randomly assigned to two groups receiving either individual or group treatment. Treatment consisted of relaxation training followed by viewing 45 videotaped vignettes depicting graduated sexual behaviors. Improvement remained stable through a one-year follow-up. Control clients showed no improvement and trends toward…

Intervening with High Risk Youth: A Program Model.

ERIC Educational Resources Information Center

Davis, Ruth B.; And Others

1994-01-01

Describes a program for older adolescents exhibiting substance use problems. After initial assessment and referral, most patients enter outpatient treatment groups. Groups fulfill three purposes: (1) Staff monitors clients; (2) Help clients recognize the promise of recovery; and (3) Change behavior. Difficulties of working with multiple community…

Combat Stress and Substance Use Intervention

DTIC Science & Technology

2017-06-01

Bureau of the Census classification, personnel were divided into four racial/ethnic groups : white, non-Hispanic; African American, non-Hispanic...Bureau of the Census classification, personnel were divided into four racial/ethnic groups : white, non-Hispanic; African American, non-Hispanic...Race/Ethnicity: Following the current U.S. Bureau of the Census classification, personnel were divided into four racial/ethnic groups : white, non

Children's Implicit and Explicit Ethnic Group Attitudes, Ethnic Group Identification, and Self-Esteem

ERIC Educational Resources Information Center

Davis, Stephanie C.; Leman, Patrick J.; Barrett, Martyn

2007-01-01

An increasing amount of research explores how children distinguish different aspects of ethnic group attitudes. However, little work has focused on how these aspects tie in with other social and psychological processes. In the present study, 112 black and white children aged 5-, 7- and 9-years completed tests of implicit and explicit ethnic group…

Possible Barriers to Enrollment in Substance Abuse Treatment among a Diverse Sample of Asian Americans and Pacific Islanders: Opinions of Treatment Clients

PubMed Central

Masson, Carmen L.; Shopshire, Michael S.; Sen, Soma; Hoffman, Kim; Hengl, Nicholas; Bartolome, John; McCarty, Dennis; Sorensen, James L.; Iguchi, Martin

2012-01-01

This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. PMID:22985677

Cognitive Interviews of Vietnamese Americans on Healthy Eating and Physical Activity Health Educational Materials.

PubMed

Nguyen, Bang H; Nguyen, Chi P; McPhee, Stephen J; Stewart, Susan L; Bui-Tong, Ngoc; Nguyen, Tung T

2015-01-01

The purpose of this study was to better understand if a health educational presentation using culturally adapted materials was understandable and culturally appropriate, and that the content was retained, in an older Vietnamese American population. This study used cognitive interviewing. A convenient sampling was used to recruit eight participants by staff of a community-based organization from its client base. This is the first study to document that family eating style poses a challenge for estimating food intake among Vietnamese Americans. Participants who ate in a family eating style were not able to recall or estimate the number of servings of protein and vegetables. Some older Vietnamese Americans used food for healing and self-adjusted portion sizes from dietary recommendations. Cognitive interviewing is a useful method to improve comprehension, retention, and cultural appropriateness of health educational materials. Further nutrition research concerning intake measurement in ethnic groups that practice a family eating style is warranted.

Possible barriers to enrollment in substance abuse treatment among a diverse sample of Asian Americans and Pacific Islanders: opinions of treatment clients.

PubMed

Masson, Carmen L; Shopshire, Michael S; Sen, Soma; Hoffman, Kim A; Hengl, Nicholas S; Bartolome, John; McCarty, Dennis; Sorensen, James L; Iguchi, Martin Y

2013-03-01

This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. Copyright © 2013 Elsevier Inc. All rights reserved.

The family-study interface and academic outcomes: differences and similarities between ethnic minority and ethnic majority students.

PubMed

Meeuwisse, Marieke; Born, Marise Ph; Severiens, Sabine E

2014-07-01

The present study investigated possible differences in the family-study interface between ethnic minority and ethnic majority students as an explanation for the poorer study results of ethnic minority students compared with those of majority students. We used a model for family-study conflict and facilitation derived from family-work and work-study models. This model held true for the full sample and both non-Western ethnic minority students (N = 342) and ethnic majority students (N = 1314) separately at a major Dutch university. Multivariate analyses of variance revealed that ethnic minority students reported less study effort and earned lower grades compared with ethnic majority students. Regarding the family-study interface, ethnic minority students reported more family-study conflict than did ethnic majority students. No differences were found between the 2 groups in family-study facilitation. Ethnic minority students participated more in family activities and were more involved with their family than ethnic majority students. Levels of experienced family support were equal for both groups of students. Students who received more family social support reported less conflict and more facilitation. This latter finding held more strongly for majority students, resulting in more study effort and higher grades for this group. The results demonstrated the explanatory power of the family-study conflict and facilitation model for both groups.

Ethnic identity salience improves recognition memory in Tibetan students via priming.

PubMed

Li, Hongxia; Wang, Echo Xue; Jin, Shenghua; Wu, Song

2016-04-01

Social identity salience affects group-reference effect in memory. However, limited studies have examined the influence of ethnic identity salience on group-reference effect among minority group people in conditions where the minority group dominates. In the present research, we aim to investigate, in a Tibetan-dominant context, whether the salience of ethnic identity among Tibetan students could display an influence on their group-reference effect via priming method. We recruited 50 Tibetan and 62 Han Chinese students from Tibetan University in Lhasa, the capital of Tibet Autonomous Region, where Tibetans were the majority. A month before the experiment, we tested the baseline of ethnic identity salience of both Tibetan and Han Chinese students using the Twenty Statements Test. In the formal experiment, we assessed the effectiveness of priming method first and then conducted a recognition memory test 2 week later via priming approach. The results showed that the ethnic identity both of Tibetan and Han Chinese participants was not salient in the baseline assessment. However, it was successfully induced via priming among Tibetan students. Tibetan students showed a significant group-reference effect in recognition memory task when their ethnic identity was induced via priming. On the contrary, Han Chinese students did not show increased ethnic awareness and superiority of ethnic in-group reference memory after being primed. Current research provides new evidence for the influence of salience of ethnic identity on group-reference effect, contributing to the application and extension of social identity theory among minority group people. (c) 2016 APA, all rights reserved).

[Frequency of glucose-6-phosphate dehydrogenase deficiency (A-376/202) in three Malian ethnic groups].

PubMed

Dolo, A; Maiga, B; Guindo, A; Diakité, S A S; Diakite, M; Tapily, A; Traoré, M; Sangaré, B; Arama, C; Daou, M; Doumbo, O

2014-08-01

Erythrocyte G6PD deficiency is the most common worldwide enzymopathy. The aim of this study was to determine erythrocyte G6PD deficiency in 3 ethnic groups of Mali and to investigate whether erythrocyte G6PD deficiency was associated to the observed protection against malaria seen in Fulani ethnic group. The study was conducted in two different areas of Mali: in the Sahel region of Mopti where Fulani and Dogon live as sympatric ethnic groups and in the Sudanese savannah area where lives mostly the Malinke ethnic group. The study was conducted in 2007 in Koro and in 2008 in Naguilabougou. It included a total 90 Dogon, 42 Fulani and 80 Malinke ethnic groups. Malaria was diagnosed using microscopic examination after Giemsa-staining of thick and thin blood smear. G6PD deficiency (A-(376/202)) samples were identified using RFLP (Restriction Fragment Length Polymorphism) assay and analysis of PCR-amplified DNA amplicon. G6PD deficiency (A-(376/202)) rate was 11.1%, 2.4%, and 13.3% in Dogon, Fulani, and Malinke ethnic group respectively. Heterozygous state for G6PD (A-(376/202)) was found in 7.8% in Dogon; 2.4% in Fulani and 9.3% in Malinke ethnic groups while hemizygous state was found at the frequency of 2.2% in Dogon and 4% in Malinke. No homozygous state was found in our study population.We conclude that G6PD deficiency is not differing significantly between the three ethnic groups, Fulani, Dogon and Malinke.

Ethnic-group socioeconomic status as an indicator of community-level disadvantage: A study of overweight/obesity in Asian American adolescents.

PubMed

Cook, Won Kim; Tseng, Winston; Tam, Christina; John, Iyanrick; Lui, Camillia

2017-07-01

Asian American children and adolescents are an under-investigated subpopulation in obesity research. Informed by a wide socioeconomic diversity among Asian American ethnic groups, this study explored ethnic-group socioeconomic status (SES) as an indicator of community-level disadvantage that may influence overweight/obesity in Asian American adolescents. We hypothesized that ethnic-group SES was inversely associated with overweight/obesity in Asian American adolescents. Multiple logistic regression models were fitted using a sample of 1525 Asian American adolescents ages 12-17 from pooled 2007-2012 California Health Interview Survey (CHIS) data. Age, gender, nativity, individual-level SES (income and education), and two lifestyle variables (fast food consumption and physical activity) were controlled for. We found that adolescents in high- or middle-level SES ethnic groups were far less likely to be overweight/obese than those in low-SES ethnic groups. Further, these relationships were more pronounced for foreign-born adolescents but not significant for U.S.-born adolescents. Ethnic-group SES may be a meaningful indicator of community-level socioeconomic disparities that influence the health of Asian Americans and, potentially, other populations with high proportions of immigrants of diverse socioeconomic and ethnic backgrounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

Allegation of ethnic minorities from 1993-2008: an Equal Employment Opportunity Commission (EEOC) study.

PubMed

Arango-Lasprilla, Juan Carlos; Ketchum, Jessica M; Hurley, Jessica; Getachew, Almaz M; Gary, Kelli Williams

2014-01-01

Approximately 25% of working-aged Americans with disabilities work full or part time, yet still face discrimination despite the passing of the American's with Disabilities Act (ADA) over 20 years ago. To determine if the proportion of allegations of ADA Title I workplace discrimination with merit closed at any year between 1993 and 2008 differs among Whites, African Americans, Hispanics, and Asians; to determine if there was a change over time from 1993 to 2008 in merit closure rate within each race/ethnicity group; and to determine whether changes over time between 1993 and 2008 in the merit closure rate differ among the race/ethnicity groups. Logistic regression was used for this cross-sectional panel study to model the merit closure rate for each ethnic group from 1993 to 2008 using 318,587 charging parties from the EEOC database. All ethnic groups exhibited significant changes over time in the merit closure rate. There were significant differences in the closure rates among the race/ethnicity groups specifically at closure years 1995-2000, 2002, 2003, and 2006. Finally, there was evidence that the trends in merit closure rates over time differed significantly among the race/ethnicity groups. There was significant evidence that the proportion of claims closed with merit was significantly different among the racial/ethnicity groups.

Group cell phones are feasible and acceptable for promoting optimal breastfeeding practices in a women's microcredit program in Nigeria

PubMed Central

Flax, Valerie L.; Ibrahim, Alawiyatu Usman; Negerie, Mekebeb; Yakubu, Danjuma; Leatherman, Sheila; Bentley, Margaret E.

2016-01-01

As part of a breastfeeding promotion intervention trial in Nigeria, we provided one cell phone per group of 5-7 microcredit clients, and instructed the group's cell phone recipient to share weekly breastfeeding voice and text messages with group members. We measured the feasibility and acceptability of using group cell phones by conducting semi-structured exit interviews with 195 microcredit clients whose babies were born during the intervention (target group), in-depth interviews with 8 phone recipients and 9 non-phone recipients, and 16 focus group discussions (FGDs) with other microcredit clients. Women in the target group said the group phone worked well or very well (64%). They were motivated to try the recommended practices because they trusted the information (58%) and had support from others (35%). Approximately 44% of target women reported that their groups met and shared messages at least once a week. Women in groups that met at least weekly had higher odds of exclusive breastfeeding up to 6 months (OR 5.6, 95% CI 1.6, 19.7) than women in groups that never met. In-depth interviews and FGDs indicated that non-phone recipients had positive feelings toward phone recipients, the group phone met participants’ needs, and messages were often shared outside the group. In conclusion, group cell phone messaging to promote breastfeeding among microcredit clients is feasible and acceptable, and can be part of an effective behavior change package. PMID:26990786

The power of information and contraceptive choice in a family planning setting in Mexico

PubMed Central

Ponce, E; Sloan, N; Winikoff, B; Langer, A; Coggins, C; Heimburger, A; Conde-Glez, C; Salmeron, J

2000-01-01

Objectives: This study measured the effect of information about family planning methods and STD risk factors and prevention, together with personal choice on the selection of intrauterine devices (IUDs) by clients with cervical infection. Methods: We conducted a randomised, controlled trial in which family planning clients were assigned to one of two groups, the standard practice (control) group in which the provider selected the woman's contraceptive and the information and choice (intervention) group. The study enrolled 2107 clients in a family planning clinic in Mexico City. Results: Only 2.1% of the clients had gonorrhoea or chlamydial infections. Significantly fewer women in the intervention group selected the IUD than the proportion for whom the IUD was recommended in the standard care group by clinicians (58.2% v 88.2%, p=0.0000). The difference was even more pronounced among infected women: 47.8% v 93.2% (intervention v control group, p=0.0006). Conclusions: The intervention increased the selection of condoms and reduced the selection of IUDs, especially among women with cervical infections, for whom IUD insertion is contraindicated. Key Words: reproductive health; sexually transmitted diseases; contraception PMID:11026883

Theories of ethnicity and the dynamics of ethnic change in multiethnic societies.

PubMed

Blanton, Richard E

2015-07-28

I modify Fredrik Barth's approach, which sees ethnic group building as a signaling system, to place it within a framework that draws from collective action and costly signaling theories. From these perspectives, ethnic signaling, although representing a costly penalty to group members, is one effective form of communication that facilitates collective management of resources. I then identify three contexts in which the benefits of ethnic group building are likely to outweigh its signaling costs: in politically chaotic refuge and periphery zones; in the context of long-distance specialist trading groups; and within the territorial scope of failed states. I point to selected data from the Mughal and Aztec polities to illustrate how a combination of effective public goods management, in highly collective states, and the growth of highly integrated commercial economies will render ethnic group building superfluous.

Language Policy and Group Identification in Taiwan

ERIC Educational Resources Information Center

Liu, Ruey-Ying

2012-01-01

Taiwan is a multicultural and multilingual society. Generally speaking, Taiwanese residents fall into one of four ethnic groups. Each ethnic group has a different cultural context and a preferred language. Therefore, one's use of language may reveal his/her identification with an ethnic group, and language policy implementation may imply the power…

Intergroup consensus/disagreement in support of group-based hierarchy: an examination of socio-structural and psycho-cultural factors.

PubMed

Lee, I-Ching; Pratto, Felicia; Johnson, Blair T

2011-11-01

A meta-analysis examined the extent to which socio-structural and psycho-cultural characteristics of societies correspond with how much gender and ethnic/racial groups differ on their support of group-based hierarchy. Robustly, women opposed group-based hierarchy more than men did, and members of lower power ethnic/racial groups opposed group-based hierarchy more than members of higher power ethnic/racial groups did. As predicted by social dominance theory, gender differences were larger, more stable, and less variable from sample to sample than differences between ethnic/racial groups. Subordinate gender and ethnic/racial group members disagreed more with dominants in their views of group-based hierarchy in societies that can be considered more liberal and modern (e.g., emphasizing individualism and change from traditions), as well as in societies that enjoyed greater gender equality. The relations between gender and ethnic/racial groups are discussed, and implications are developed for social dominance theory, social role theory, biosocial theory, social identity theory, system justification theory, realistic group conflict theory, and relative deprivation theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC).

PubMed

Das-Munshi, Jayati; Bécares, Laia; Boydell, Jane E; Dewey, Michael E; Morgan, Craig; Stansfeld, Stephen A; Prince, Martin J

2012-10-01

Aetiological mechanisms underlying ethnic density associations with psychosis remain unclear. To assess potential mechanisms underlying the observation that minority ethnic groups experience an increased risk of psychosis when living in neighbourhoods of lower own-group density. Multilevel analysis of nationally representative community-level data (from the Ethnic Minorities Psychiatric Illness Rates in the Community survey), which included the main minority ethnic groups living in England, and a White British group. Structured instruments assessed discrimination, chronic strains and social support. The Psychosis Screening Questionnaire ascertained psychotic experiences. For every ten percentage point reduction in own-group density, the relative odds of reporting psychotic experiences increased 1.07 times (95% CI 1.01-1.14, P = 0.03 (trend)) for the total minority ethnic sample. In general, people living in areas of lower own-group density experienced greater social adversity that was in turn associated with reporting psychotic experiences. People resident in neighbourhoods of higher own-group density experience 'buffering' effects from the social risk factors for psychosis.

Comparison of ethnic group classification using naming analysis and routinely collected data: application to cancer incidence trends in children and young people

PubMed Central

Norman, Paul; Kapetanstrataki, Melpo; Fleming, Sarah; Fraser, Lorna K; Parslow, Roger C; Feltbower, Richard G

2017-01-01

Objective Inpatient Hospital Episode Statistics (HES) ethnicity data are available but not always collected and data quality can be unreliable. This may have implications when assessing outcomes by ethnicity. An alternative method for assigning ethnicity is using naming algorithms. We investigate if the association between ethnicity and cancer incidence varied dependent on how ethnic group was assigned. Design Population-based cancer registry cohort study. Setting Yorkshire, UK. Participants Cancer registrations from 1998 to 2009 in children and young people (0–29 years) from a specialist cancer register in Yorkshire, UK (n=3998) were linked to inpatient HES data to obtain recorded ethnicity. Patients’ names, recorded in the cancer register, were matched to an ethnic group using the naming algorithm software Onomap. Each source of ethnicity was categorised as white, South Asian (SA) or Other, and a further two indicators were defined based on the combined ethnicities of HES and Onomap, one prioritising HES results, the other prioritising Onomap. Outcomes Incidence rate ratios (IRR) between ethnic groups were compared using Poisson regression for all cancers combined, leukaemia, lymphoma and central nervous system (CNS) tumours. Results Depending on the indicator used, 7.1%–8.6% of the study population were classified as SA. For all cancers combined there were no statistically significant differences between white and SA groups using any indicator; however, for lymphomas significant differences were only evident using one of the ‘Combined’ indicators (IRR=1.36 (95% CI 1.08 to 1.71)), and for CNS tumours incidence was lower using three of the four indicators. For the other ethnic group the IRR for all cancers combined ranged from 0.78 (0.65 to 0.94) to 1.41 (1.23 to 1.62). Conclusions Using different methods of assigning ethnicity can result in different estimates of ethnic variation in cancer incidence. Combining ethnicity from multiple sources results in a more complete estimate of ethnicity than the use of one single source. PMID:28947444

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

PubMed Central

2013-01-01

Trial design A pragmatic cluster randomised controlled trial. Methods Participants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment. Results Numbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified. Conclusion The training programme did not result in significantly improved recorded diagnostic rates of mental disorders in the routine clinic consultation register, but did have significant effects on patient outcomes in routine clinical practice. Trial registration International Standard Randomised Controlled Trial Number Register ISRCTN53515024. PMID:24188964

Masculinities and ethnicities: Ethnic differences in drive for muscularity in British men and the negotiation of masculinity hierarchies.

PubMed

Swami, Viren

2016-08-01

Although relatively little is known about ethnic differences in men's drive for muscularity, recent theoretical developments suggest that ethnic minority men may desire greater muscularity to contest their positions of relative subordinate masculinity. This study tested this hypothesis in a sample of 185 White, 180 Black British, and 182 South Asian British men. Participants completed self-report measures of drive for muscularity, need for power, adherence to traditional cultural values, and ethnic group affiliation. Taking into account between-group differences in body mass index, results indicated that White men had significantly lower drive for muscularity than Black and South Asian men, who were not significantly different from each other. In addition, greater need for power was significantly associated with higher drive for muscularity in ethnic minority, but not White, men. Greater adherence to traditional cultural values, but not ethnic group affiliation, was associated with lower drive for muscularity in all ethnic groups. These results suggest that ethnic minority men may desire greater muscularity as a means of negotiating masculinity and attendant ideals of appearance. © 2015 The British Psychological Society.

Individualistic and Collective Group Counseling: Effects with Korean Clients.

ERIC Educational Resources Information Center

Lee, In-Ja; Kelly, Eugene W., Jr.

1996-01-01

In a study of 20 female and 21 male Korean clients with three group counseling approaches (individualistic, collective, and combination of both), no treatment effects were found for social commitment or perceptions of counselor effectiveness. Significant changes were seen in individualism-collectivism congruent with different treatments. (Author)

Recognizing and Enhancing the Communication Skills of Your Group Home Clients.

ERIC Educational Resources Information Center

Vicker, Beverly A.

The manual examines ways in which nonprofessional group home health care workers can enhance the communication and interaction skills of developmentally disabled clients. The communication process is explored in terms of information exchange, both verbal and nonverbal. Examples of vocal, nonvocal, and echolalic speech are offered and suggestions…

Observation and Recording Effects on Group Therapy Client Behaviors.

ERIC Educational Resources Information Center

Berman, Alan L.; Decker, Robert E.

This study assesses the effect of visual versus audio observation/recording on both client and therapist verbal and non-verbal behavior in ongoing therapy. Three co-led, therapy groups were studied over six weekly sessions under counterbalanced observation conditions. Measures of verbal behavior, verbal productivity, and non-verbal behavior were…

Clients' Preferences for Small Groups vs. Individual Testing.

ERIC Educational Resources Information Center

Backman, Margaret E.; And Others

Test takers' preferences for group versus individual administration of the Micro-TOWER System of Vocational Evaluation are reported. The system was administered to 211 clients at a vocational rehabilitation center, and consisted of work samples measuring the following job skills: record checking, filing, lamp assembly, message-taking, zip coding,…

Health Benefits Mandates and Their Potential Impacts on Racial/Ethnic Group Disparities in Insurance Markets.

PubMed

Charles, Shana Alex; Ponce, Ninez; Ritley, Dominique; Guendelman, Sylvia; Kempster, Jennifer; Lewis, John; Melnikow, Joy

2017-08-01

Addressing racial/ethnic group disparities in health insurance benefits through legislative mandates requires attention to the different proportions of racial/ethnic groups among insurance markets. This necessary baseline data, however, has proven difficult to measure. We applied racial/ethnic data from the 2009 California Health Interview Survey to the 2012 California Health Benefits Review Program Cost and Coverage Model to determine the racial/ethnic composition of ten health insurance market segments. We found disproportional representation of racial/ethnic groups by segment, thus affecting the health insurance impacts of benefit mandates. California's Medicaid program is disproportionately Latino (60 % in Medi-Cal, compared to 39 % for the entire population), and the individual insurance market is disproportionately non-Latino white. Gender differences also exist. Mandates could unintentionally increase insurance coverage racial/ethnic disparities. Policymakers should consider the distribution of existing racial/ethnic disparities as criteria for legislative action on benefit mandates across health insurance markets.

Ethnicity and cultural models of recovery from breast cancer.

PubMed

Coreil, Jeannine; Corvin, Jaime A; Nupp, Rebecca; Dyer, Karen; Noble, Charlotte

2012-01-01

Recovery narratives describe the culturally shared understandings about the ideal or desirable way to recover from an illness experience. This paper examines ethnic differences in recovery narratives among women participating in breast cancer support groups in Central Florida, USA. It compares groups serving African-American, Latina, and European American women, with the objective of better understanding the appeal of ethnic-specific illness support groups for culturally diverse populations. A mixed-method study design combined qualitative and quantitative measures, including in-depth interviews, participant observation at support group meetings, collection of printed documents, and a structured survey. Core elements of the recovery narrative drew from the dominant societal cancer discourse of optimism and personal transformation through adversity; however, important ethnic differences were evident in the meaning assigned to these themes. Groups gave distinctive salience to themes of faith and spirituality, empowerment through the migration experience, and becoming a better person through the journey of recovery. The findings suggest that ethnic cancer support groups draw upon dominant societal discourses about cancer, but they espouse distinctive recovery narratives that are consonant with the groups' cultural models of illness. Similarity between ethnic members' individual recovery narratives and that of the group may contribute to the appeal of ethnic illness support groups for culturally diverse populations.

The Tooth and Skin Colour Interrelationship across the Different Ethnic Groups

PubMed Central

Haralur, Satheesh B.; Dibas, Ahmed Mohammed; Almelhi, Nabil Abdullah; Al-Qahtani, Dhafer Ali

2014-01-01

Objectives. The purpose of the study was to investigate the relation between skin and tooth colour parameters in various ethnic groups. Materials and Methods. Saudi Arabian, Indian, African, and East Asian ethnic groups of 75 each were included in the study. The tooth colour was determined by spectrophotometer in CIELAB parameters. The skin colour was measured at earlobe, forehead, and malar locations by clinical skin photography. The data was statistically analysed by one-way ANOVA and correlation tests. Results. The “L” vale for the Saudi Arabian group had a strong correlation at earlobe location (r = 0.275), while correlation was found at forehead (r = 0.271) and malar region (r = 0.261) with Indian ethnic group. A strong negative correlation was observed in African ethnic group at all three locations for “L” parameter. The redness value “a” is found to have strong negative linear correlation between the earlobe and tooth for Saudi Arabian (r = −0.240) and Indian ethnic groups (r = −0.268). The “b” showed no correlation with skin location in all groups except positive correlation in African ethnic groups. Conclusions. The strong correlation was found between the skin and tooth colour parameters; hence the skin colour can be used as a guide for artificial tooth selection in edentulous patients. PMID:25101125

The Tooth and Skin Colour Interrelationship across the Different Ethnic Groups.

PubMed

Haralur, Satheesh B; Dibas, Ahmed Mohammed; Almelhi, Nabil Abdullah; Al-Qahtani, Dhafer Ali

2014-01-01

Objectives. The purpose of the study was to investigate the relation between skin and tooth colour parameters in various ethnic groups. Materials and Methods. Saudi Arabian, Indian, African, and East Asian ethnic groups of 75 each were included in the study. The tooth colour was determined by spectrophotometer in CIELAB parameters. The skin colour was measured at earlobe, forehead, and malar locations by clinical skin photography. The data was statistically analysed by one-way ANOVA and correlation tests. Results. The "L" vale for the Saudi Arabian group had a strong correlation at earlobe location (r = 0.275), while correlation was found at forehead (r = 0.271) and malar region (r = 0.261) with Indian ethnic group. A strong negative correlation was observed in African ethnic group at all three locations for "L" parameter. The redness value "a" is found to have strong negative linear correlation between the earlobe and tooth for Saudi Arabian (r = -0.240) and Indian ethnic groups (r = -0.268). The "b" showed no correlation with skin location in all groups except positive correlation in African ethnic groups. Conclusions. The strong correlation was found between the skin and tooth colour parameters; hence the skin colour can be used as a guide for artificial tooth selection in edentulous patients.

Bridging the Ethnic Divide: Student and School Characteristics in African American, Asian-Descent, Latino, and White Adolescents' Cross-Ethnic Friend Nominations

ERIC Educational Resources Information Center

Hamm, Jill V.; Bradford Brown, B.; Heck, Daniel J.

2005-01-01

Based on the revised social contact theory, correlates of cross-ethnic friend nomination among 580 African American, 948 Asian-descent, 860 Latino, and 3986 White adolescents were examined. Socioeconomic and academic disparities between ethnic groups differentiated cross-ethnic friend nomination between schools for all groups but African…

The Effect of Pretherapy Education on Premature Terminations and Therapy Attendance.

ERIC Educational Resources Information Center

Butts, R. Randolph

A review of the research on pretherapy education for psychotherapy clients has found that pretherapy training has a positive impact on encouraging clients to remain in individual or group therapy. Pretherapy training has also been shown to contribute to improving client motivation and attitudes toward the therapeutic process. The evidence suggests…

Attitudes of Disabled Individuals Enrolled in a Workstation Center and a Community College Program

ERIC Educational Resources Information Center

Wada, Michael A.; Brodwin, Martin

1975-01-01

Measured attitudes of disabled individuals toward the staff who gave them rehabilitation services. Attitudes of two groups at a rehabilitation hospital were evaluated: (a) clients from a vocational rehabilitation workshop and (b) clients from a community college satellite program. Found clients in the community college program perceived staff as…

White Ethnic Groups and American Politics, Student Book. The Lavinia and Charles P. Schwartz Citizenship Project.

ERIC Educational Resources Information Center

Krug, Mark M.

This student book, one in a series of civic education materials, focuses on white ethnic groups and how they influence the operation of the American political system. The ethnic groups which are investigated include Poles, Irish, Italians, and Jews. An ethnic person is defined as anyone who decides to identify with and live among those who share…

Understanding the Psychological Processes of the Racial Match Effect in Asian Americans

PubMed Central

Meyer, Oanh; Zane, Nolan; Cho, Young Il

2014-01-01

Some studies on mental health outcomes research have found that when clients and therapists are ethnically or racially matched, this tends to be related to greater satisfaction and better outcomes. However, the precise underlying mechanism for the match effect has not been extensively examined. In this experimental study, we tested the effect of racial match on critical counseling processes (i.e., therapist credibility and the working alliance) using a sample of 171 Asian American respondents. We also examined Asian ethnic identification as a potential moderator of the racial match effect. Structural equation modeling analyses indicated that racially matched individuals perceived greater experiential similarity with the therapist than nonmatched individuals, and experiential similarity was positively associated with therapist credibility. Although racial match did not predict attitudinal similarity, attitudinal similarity was strongly related to the working alliance and therapist credibility. Counseling implications are discussed. PMID:21574698

Racially and Ethnically Diverse Schools and Adolescent Romantic Relationships*

PubMed Central

Strully, Kate

2015-01-01

Focusing on romantic relationships, which are often seen as a barometer of social distance, this analysis investigates how adolescents from different racial-ethnic and gender groups respond when they attend diverse schools with many opportunities for inter-racial-ethnic dating. Which groups respond by forming inter-racial-ethnic relationships, and which groups appear to “work around” opportunities for inter-racial-ethnic dating by forming more same-race-ethnicity relationships outside of school boundaries? Most prior studies have analyzed only relationships within schools and, therefore, cannot capture a potentially important way that adolescents express preferences for same-race-ethnicity relationships and/or work around constraints from other groups’ preferences. Using the National Longitudinal Study of Adolescent Health, I find that, when adolescents are in schools with many opportunities for inter-racial-ethnic dating, black females and white males are most likely to form same-race-ethnicity relationships outside of the school; whereas Hispanic males and females are most likely to date across racial-ethnic boundaries within the school. PMID:25848670

Crossing Boundaries: Nativity, Ethnicity, and Mate Selection

PubMed Central

Qian, Zhenchao; Glick, Jennifer E.; Baston, Christie

2016-01-01

The influx of immigrants has increased diversity among ethnic minorities and indicates that they may take multiple integration paths in American society. Previous research on ethnic integration often focuses on panethnic differences and few have explored ethnic diversity within a racial or panethnic context. Using 2000 U.S. census data for Puerto Rican, Mexican, Chinese, and Filipino origin individuals, we examine differences in marriage and cohabitation with whites, with other minorities, within a panethnic group, and within an ethnic group by nativity status. Ethnic endogamy is strong and, to a less extent, so is panethnic endogamy. Yet, marital or cohabiting unions with whites remain an important path of integration but differ significantly by ethnicity, nativity, age at arrival, and educational attainment. Meanwhile, ethnic differences in marriage and cohabitation with other racial or ethnic minorities are strong. Our analysis supports that unions with whites remain a major path of integration, but other paths of integration also become viable options for all ethnic groups. PMID:22350840

Parental Smoking and Adult Offspring's Smoking Behaviors in Ethnic Minority Groups: An Intergenerational Analysis in the HELIUS Study.

PubMed

Ikram, Umar Z; Snijder, Marieke B; Derks, Eske M; Peters, Ron J G; Kunst, Anton E; Stronks, Karien

2018-05-03

To understand smoking behaviors among ethnic minority groups, studies have largely focused on societal factors, with little attention to family influences. Yet studies among majority groups have identified parental smoking as an important risk factor. It is unknown whether this applies to ethnic minority groups. We investigated the association between parental smoking and adult offspring's smoking behaviors among ethnic minority groups with an immigrant background. We used data from the Healthy Life in an Urban Setting study from Amsterdam (the Netherlands) from January 2011 to December 2015. The sample consisted of 2184 parent-offspring pairs from South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian origin. We collected self-reported smoking data: current status, duration of exposure to parental smoking, number of daily cigarettes, heavy smoking ( > 10 cigarettes/day), and nicotine dependency (using the Fagerström Test). Analyses were stratified by offspring's age, cohabitation with parent, education (parent/offspring), offspring's cultural orientation, and gender concordance within pairs. Logistic regression was used. Overall, parental smoking was associated with offspring's smoking behaviors (eg, current smoking: odds ratio 2.33; 95% confidence interval 1.79-3.03), with little ethnic variation. We found dose-response associations between exposure to parental smoking and offspring's smoking. The associations were similar across different strata but stronger in gender-concordant pairs (3.16; 2.12-4.51 vs. 1.73; 1.15-2.59 in gender-discordant pairs; p-value for interaction .017). Parental smoking is associated with offspring's smoking behaviors in ethnic minority groups across different strata but particularly in gender-concordant pairs. Similar to majority groups, family influences matter to smoking behaviors in ethnic minority groups. Our findings have deepened our understanding of smoking behaviors among ethnic minority groups. Future studies should simultaneously consider societal factors and parental influences, to comprehensively understand their impact on smoking among ethnic minority groups. Also, smoking patterns among family members should be addressed in individual counselling, irrespective of ethnicity.

An investigation into whether clients and/or their respective clinicians are aware of pending service exit in the first two months of treatment admission.

PubMed

Pulford, Justin; Adams, Peter; Sheridan, Janie

2009-11-01

When a client exits an alcohol and other drug (AOD) treatment service against clinical advice, they and their service may incur significant disadvantage. The extent of awareness by both clients and clinicians that treatment would not continue has not been examined. Accordingly, this paper presents findings from a study that sought to identify whether clients and/or their respective clinicians were aware of pending service exit that occurred within the first 2 months of treatment admission. The study was set in an outpatient AOD treatment service located in Auckland, New Zealand. Data were obtained by structured questionnaire and were reported for a group of clients (n = 49), clinicians (n = 46) and matched client/clinician pairs (n = 36). Overall, clients and clinicians were no more likely to accurately identify pending service exit at a rate greater than would be expected by chance alone. However, clinicians were significantly more likely to identify pending service exit as compared with their respective clients (47% vs. 25%), although a large proportion of both groups expected treatment to continue beyond what proved to be the final treatment appointment (44% and 52%, respectively). These findings suggest that service exit that occurs within the first 2 months of treatment admission may be largely unpredictable and that, as a result of this unpredictability, the opportunities for a targeted response may be limited.

Importance of race-ethnicity: An exploration of Asian, Black, Latino, and Multiracial adolescent identity

PubMed Central

Charmaraman, Linda; Grossman, Jennifer M.

2010-01-01

This mixed-method study used a grounded theory approach to explore the meanings underlying the importance adolescents attach to their racial-ethnic identities. The sample consisted of 923 9th–12th grade students from Black, Latino, Asian, and Multiracial backgrounds. Thematic findings identified a broad range of explanations for adolescents’ racial-ethnic centrality, ranging from pride and cultural connection to ambivalence and colorblind attitudes. While racial-ethnic groups differed in reported levels of racial-ethnic centrality, few group differences were identified in participants’ thematic explanations, with the exception of racial-ethnic and gender differences for Positive Regard and Disengagement. These findings highlight the diversity of meanings adolescents attribute to their racial-ethnic centrality as well as the many commonalities among adolescents across gender and racial-ethnic groups. PMID:20438152

Evaluating the Influence of the Client Behavior in Cloud Computing.

PubMed

Souza Pardo, Mário Henrique; Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José

2016-01-01

This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system.

Evaluating the Influence of the Client Behavior in Cloud Computing

PubMed Central

Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José

2016-01-01

This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system. PMID:27441559

Perspectives of Treatment Providers and Clients with Serious Mental Illness Regarding Effective Therapeutic Relationships.

PubMed

Easter, Alison; Pollock, Michele; Pope, Leah Gogel; Wisdom, Jennifer P; Smith, Thomas E

2016-07-01

This study explores the nature of clinical therapeutic relationships between mental health treatment providers and high-need clients with serious mental illness who had recently discontinued treatment. Semi-structured qualitative interviews of 56 clients with serious mental illness who had recently discontinued care and 25 mental health treatment providers were completed. Both clients with serious mental illness and treatment providers emphasized the importance of client-focused goal setting, time and availability of treatment providers, a caring approach, and trust and honesty in the relationship. However, clients with serious mental illness placed greater emphasis on goals involving tangible services, a notable area of discord between the two groups. Individuals with serious mental illness and treatment providers agreed regarding several key elements to a positive clinical relationship. Further attention to client goals related to tangible services may serve to improve relationships between treatment providers and high-need clients with serious mental illness.

Birth outcomes across ethnic groups of women in Nepal.

PubMed

Acharya, Pratima Poudel; Alpass, Fiona

2004-01-01

This study was conducted at the Western Regional Hospital (WRH), Pokhara, Nepal. We investigated the relationship between selected socioeconomic variables, pregnancy indices, birth weight, and maternal health in women of different ethnic origins. In our cross-sectional data set, 29.8% of infants were born with a low birth weight. Our data analysis showed Indo-Aryan and lower caste ethnic groups had significantly lower weight babies than Tibeto-Burman and Newar groups. Further analysis showed that the Tibeto-Burman group received better care during pregnancy. Similarly, the Newar groups had significantly better nutritional intake than the Indo-Aryan and lower caste groups. The outcome of food restriction and antenatal care during pregnancy in specific ethnic groups has important implications for the health care delivery system. Health policymakers should target those ethnic groups and develop culturally based policies to reduce the incidence of low birth weight in Nepal.

Social capital, ethnic density and mental health among ethnic minority people in England: a mixed-methods study.

PubMed

Becares, Laia; Nazroo, James

2013-01-01

Ethnic minority people have been suggested to be healthier when living in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Explanations behind the ethnic density effect propose that positive health outcomes are partially attributed to the protective and buffering effects of increased social capital on health. In fact, a parallel literature has reported increased levels of social capital in areas of greater ethnic residential diversity, but to date, no study in England has explored whether increased social capital mediates the relationship between protective effects attributed to the residential concentration of ethnic minority groups and health. We employ a mixed-methods approach to examine the association between ethnicity, social capital and mental health. We analyse geocoded data from the 2004 Health Survey for England to examine the association between (1) ethnic residential concentration and health; (2) ethnic residential concentration and social capital; (3) social capital and health; and (4) the mediating effect of social capital on the association between the residential concentration of ethnic groups and health. To further add to our understanding of the processes involved, data from a qualitative study of quality older ethnic minority people were be used to examine accounts of the significance of place of residence to quality of life. The association between ethnic density and social capital varies depending on the level of measurement of social capital and differed across ethnic minority groups. Social capital was not found to mediate the association between ethnic density and health. Structural differences in the characteristics of the neighbourhoods where different ethnic groups reside are reflected in the accounts of their daily experiences, and we observed different narratives of neighbourhood experiences between Indian and Caribbean respondents. The use of mixed methods provides an important contribution to the study of ethnic minority people's experience of their neighbourhood, as this approach has allowed us to gain important insights that cannot be inferred from quantitative or qualitative data alone.

Theories of ethnicity and the dynamics of ethnic change in multiethnic societies

PubMed Central

Blanton, Richard E.

2015-01-01

I modify Fredrik Barth’s approach, which sees ethnic group building as a signaling system, to place it within a framework that draws from collective action and costly signaling theories. From these perspectives, ethnic signaling, although representing a costly penalty to group members, is one effective form of communication that facilitates collective management of resources. I then identify three contexts in which the benefits of ethnic group building are likely to outweigh its signaling costs: in politically chaotic refuge and periphery zones; in the context of long-distance specialist trading groups; and within the territorial scope of failed states. I point to selected data from the Mughal and Aztec polities to illustrate how a combination of effective public goods management, in highly collective states, and the growth of highly integrated commercial economies will render ethnic group building superfluous. PMID:25775584

Meeting the needs of elderly with bathing disability.

PubMed

Zingmark, Magnus; Bernspång, Birgitta

2011-06-01

Difficulties with bathing are frequent among older people and are associated with an increasing need for societal support. As loss of independence has a negative impact on health and wellbeing, it is important to study interventions that can provide the required support for people to be able to remain independent. Occupational therapy interventions can improve clients' abilities enabling them to bathe themselves, thus reducing the need for other, more long-term societal support from, e.g. a home help. In this study, two groups of elderly people with difficulties in bathing were compared; the clients in the intervention group were engaged in occupational therapy. A quasi-experimental non-equivalent control group design was used, in which participants with reported difficulties in bathing were recruited consecutively from two municipalities. The clients in the intervention group routinely received occupational therapy, whereas clients in the control group received assistance from a home help for bathing. Activities of daily living, quality of life and home-help allocation were assessed at the baseline and after 15 weeks. Clients in the intervention group received less than three home visits on average, with majority of interventions consisting of graded activity and the use of an encouraging approach. Seventy per cent of the interventions were adaptive. Activities of daily living and quality of life of both groups improved, but the differences of being allocated a home help were significant. Occupational therapy interventions seem beneficial in terms of supporting older people in becoming independent of home help in bathing but the results must be interpreted with caution as there were differences at baseline between the groups. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Australian Association of Occupational Therapists.

Development of a Semi-Quantitative Food Frequency Questionnaire to Assess the Dietary Intake of a Multi-Ethnic Urban Asian Population.

PubMed

Neelakantan, Nithya; Whitton, Clare; Seah, Sharna; Koh, Hiromi; Rebello, Salome A; Lim, Jia Yi; Chen, Shiqi; Chan, Mei Fen; Chew, Ling; van Dam, Rob M

2016-08-27

Assessing habitual food consumption is challenging in multi-ethnic cosmopolitan settings. We systematically developed a semi-quantitative food frequency questionnaire (FFQ) in a multi-ethnic population in Singapore, using data from two 24-h dietary recalls from a nationally representative sample of 805 Singapore residents of Chinese, Malay and Indian ethnicity aged 18-79 years. Key steps included combining reported items on 24-h recalls into standardized food groups, developing a food list for the FFQ, pilot testing of different question formats, and cognitive interviews. Percentage contribution analysis and stepwise regression analysis were used to identify foods contributing cumulatively ≥90% to intakes and individually ≥1% to intake variance of key nutrients, for the total study population and for each ethnic group separately. Differences between ethnic groups were observed in proportions of consumers of certain foods (e.g., lentil stews, 1%-47%; and pork dishes, 0%-50%). The number of foods needed to explain variability in nutrient intakes differed substantially by ethnic groups and was substantially larger for the total population than for separate ethnic groups. A 163-item FFQ covered >95% of total population intake for all key nutrients. The methodological insights provided in this paper may be useful in developing similar FFQs in other multi-ethnic settings.

Genetic admixture studies on four in situ evolved, two migrant and twenty-one ethnic populations of Tamil Nadu, south India.

PubMed

Suhasini, G; Sonaa, E; Shila, S; Srikumari, C R; Jayaraman, G; Ramesh, A

2011-08-01

We analysed the genetic structure of ≈ 1000 samples representing 27 ethnic groups settled in Tamil Nadu, south India, derived from two linguistic families (Dravidians and Indo-Europeans) representing four religious groups (Hinduism, Islam, Christianity and Jainism) using 11 mtDNA markers. Out of 27 ethnic groups, four are in situ populations (Anglo-Indian, Labbai Muslim, Nadar Christian and south Indian Jain) and two are migrants (Gypsy and north Indian Jain) from north India to Tamil Nadu, and 21 are native ethnic groups. Six of the markers we used were monomorphic (HaeIII663, HpaI3592, AluI5176, AluI7025, AluI13262, 9-bp deletion) and five markers were polymorphic (DdeI10394, AluI10397, HinfI12308, HincII13259 and HaeIII16517). Haplogroup frequencies, genetic affinities and admixture analysis are based on the genotype data of polymorphic markers observed in these populations. Haplogroup frequencies indicate that various ethnic groups entered Tamil Nadu during different time periods. Genetic affinities and admixture estimates revealed that the ethnic groups possessing advanced knowledge of farming cluster in a branch (C), and could be the late arrived settlers as agriculture, was introduced to this region at about 5 to 3 thousand years ago. In situ ethnic groups appear to have arisen at various times as a result of the prevailing dominant socio-cultural forces. Hierarchical Hindu caste system created many ethnic groups in the history of its existence; some of them became isolated for considerable period of time. Over all, among Tamil ethnic groups, in spite of caste systems' rigidity, built in flexibility in the system in the form of hypergamy and hypogamy had allowed maternal gene flow between them.

Similarities and Differences in the Outdoor Recreation Participation of Racial/Ethnic Groups: An Example from Illinois

Treesearch

John F. Dwyer

2000-01-01

Much of the initial research on the outdoor recreation participation of racial/ethnic groups focused on between-group differences in percent participating in an activity. This tended to focus research, policy, and management on between-group differences at the expense of a more comprehensive look at the participation patterns of racial/ethnic groups. This paper...

An Ethnic Studies Guide and Resources Mannual for the Carolinas.

ERIC Educational Resources Information Center

1979

The manual contains ethnic studies units on the Indians of North Carolina and information for developing materials on other ethnic groups in North Carolina. Intended for intermediate grade students and teachers, the guide contains three major sections: background information, student manual, and information on ethnic groups other than American…

Serum γ-Glutamyltransferase, Alanine Aminotransferase and Aspartate Aminotransferase Activity in Healthy Blood Donor of Different Ethnic Groups in Gorgan.

PubMed

Marjani, Abdoljalal; Mehrpouya, Masoumeh; Pourhashem, Zeinab

2016-07-01

Measure of liver enzymes may help to increase safety of blood donation for both blood donor and recipient. Determination of liver enzymes may prepare valuable clinical information. To assess serum γ-Glutamyltransferase (GGT), Alanine Aminotransferase (ALT), and Aspartate Aminotransferase (AST) activities in healthy blood donors in different ethnic groups in Gorgan. This study was performed in 450 healthy male blood donors, in three ethnic groups (Fars, Sistanee and Turkman) who attended Gorgan blood transfusion center. Liver enzymes (GGT, ALT and AST) were determined. Serum AST and ALT in three ethnic groups were significant except for serum GGT levels. There was significant correlation between family histories of liver disease and systolic blood pressure and AST in Fars, and GGT in Sistanee ethnic groups. Several factors, such as age, family history of diabetes mellitus, family history of liver disease and smoking habit had no effect on some liver enzymes in different ethnic groups in this area. Variation of AST, ALT, and GGT enzyme activities in healthy subjects was associated with some subjects in our study groups. According to our study, it suggests that screening of AST and GGT enzymes in subjects with family history of liver disease is necessary in different ethnic groups.

Size and clustering of ethnic groups and rates of psychiatric admission in England.

PubMed

Venkatesan, Gayathri; Weich, Scott; McBride, Orla; Twigg, Liz; Parsons, Helen; Scott, Jan; Bhui, Kamaldeep; Keown, Patrick

2018-05-11

Aims and methodTo compare rates of admission for different types of severe mental illness between ethnic groups, and to test the hypothesis that larger and more clustered ethnic groups will have lower admission rates. This was a descriptive study of routinely collected data from the National Health Service in England. There was an eightfold difference in admission rates between ethnic groups for schizophreniform and mania admissions, and a fivefold variation in depression admissions. On average, Black and minority ethnic (BME) groups had higher rates of admission for schizophreniform and mania admissions but not for depression. This increased rate was greatest in the teenage years and early adulthood. Larger ethnic group size was associated with lower admission rates. However, greater clustering was associated with higher admission rates.Clinical implicationsOur findings support the hypothesis that larger ethnic groups have lower rates of admission. This was a between-group comparison rather than within each group. Our findings do not support the hypothesis that more clustered groups have lower rates of admission. In fact, they suggest the opposite: groups with low clustering had lower admission rates. The BME population in the UK is increasing in size and becoming less clustered. Our results suggest that both of these factors should ameliorate the overrepresentation of BME groups among psychiatric in-patients. However, this overrepresentation continues, and our results suggest a possible explanation, namely, changes in the delivery of mental health services, particularly the marked reduction in admissions for depression.Declaration of interestNone.

Genetic polymorphism of Malassezia furfur isolates from Han and Tibetan ethnic groups in China using DNA fingerprinting.

PubMed

Zhang, Hao; Zhang, Ruifeng; Ran, Yuping; Dai, Yaling; Lu, Yao; Wang, Peng

2010-12-01

Reported isolation rates of Malassezia yeast from human skin show geographic variations. In China, the populations of the Han (1,182.95 million) and Tibetan (5.41 million) ethnic groups are distributed over 9.6 and 3.27 million square kilometers respectively, making biodiversity research feasible and convenient. Malassezia furfur clinical strains (n = 29) isolated from different individuals, with or without associated dermatoses, of these two ethnic groups (15 Han and 12 Tibetan) were identified and analyzed with DNA fingerprinting using single primers specific to minisatellites. Using the Bionumerics software, we found that almost all M. furfur clinical isolates and type strains formed five distinct group clusters according to their associated skin diseases and the ethnic groups of the patients. These findings are the first to focus on the genetic diversity and relatedness of M. furfur in the Tibetan and Han ethnic groups in China and reveal genetic variation associated with related diseases, host ethnicity and geographic origin.

Ethnic background and genetic variation in the evaluation of cancer risk: a systematic review.

PubMed

Jing, Lijun; Su, Li; Ring, Brian Z

2014-01-01

The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in 68 studies across six different cancer types, comparing association results between ethnic groups and examining linkage disequilibrium between risk alleles and nearby genetic loci. We find that the relevance of ethnic background depends on the question. If asked whether the association of variants with disease risk is conserved across ethnic boundaries, we find that the answer is yes, the majority of markers show insignificant variability in association with cancer risk across ethnic groups. However if the question is whether a significant association between a variant and cancer risk is likely to reproduce, the answer is no, most markers do not validate in an ethnic group other than the discovery cohort's ancestry. This lack of reproducibility is not attributable to studies being inadequately populated due to low allele frequency in other ethnic groups. Instead, differences in local genomic structure between ethnic groups are associated with the strength of association with cancer risk and therefore confound interpretation of the implied physiologic association tracked by the disease allele. This suggest that a biological association for cancer risk alleles may be broadly consistent across ethnic boundaries, but reproduction of a clinical study in another ethnic group is uncommon, in part due to confounding genomic architecture. As clinical studies are increasingly performed globally this has important implications for how cancer risk stratifiers should be studied and employed.

Is ethnic prejudice declining in Britain? Change in social distance attitudes among ethnic majority and minority Britons.

PubMed

Storm, Ingrid; Sobolewska, Maria; Ford, Robert

2017-09-01

Most literature on racial prejudice deals with the racial attitudes of the ethnic majority and ethnic minorities separately. This paper breaks this tradition. We examine the social distance attitudes of white and non-white British residents to test if these attitudes follow the same trends over time, whether they are driven by the same social processes and whether they are inter-related. We have three main findings. Firstly, social distance from other ethnic groups has declined over time for both white and ethnic minority Britons. For the white majority there are both period and cohort elements to this decline. Secondly, we see some evidence that social distance between the majority and minority groups is reciprocal. Specifically, minorities who experience rejection by the white British feel a greater sense of distance from them. Thirdly, we find that all groups share the perception of the same ethnic hierarchy. We see evidence of particularly widespread hostility towards Muslim Britons from all ethnic groups suggesting that Muslims are singled out for negative attention from many British residents of all other backgrounds, including a large number who do not express hostility to other groups. © London School of Economics and Political Science 2017.

The self-assessed oral health status of individuals from White, Indian, Chinese and Black Caribbean communities in South-east England.

PubMed

Newton, J T; Corrigan, M; Gibbons, D E; Locker, D

2003-06-01

To determine the level of self-assessed oral symptoms and the impact of such symptoms among individuals from four ethnic groups resident in South-east England and the relationship between self-assessed oral health status, age, gender, employment status, educational level and ethnicity. Cross-sectional survey of a convenience sample of 366 individuals drawn from four ethnic groups. Subjective Oral Health Status Indicators (SOHSI). Individuals were recruited through community groups. All participants self-classified their ethnicity. Only completed questionnaires from participants categorising themselves as White, Black Caribbean, Chinese or Indian were included in the data analysis. Univariate statistical analysis revealed significant differences between ethnic groups in all but one of the SOHSI scales. Age and ethnicity (in particular membership of the Chinese community) emerged as significant predictors of SOHSI scale scores. Within the limitations imposed by convenience sampling, it has been found that differences exist among four ethnic groups in the UK in their reporting of self-assessed oral health status. Ethnicity and age, in particular, predict the reporting of self-assessed oral symptoms and the impact of such symptoms.

Community pharmacists require additional support to develop capacity in delivering alcohol-related health information to older adults.

PubMed

Dare, Julie; Wilkinson, Celia; Garlepp, Michael; Lo, Johnny; Allsop, Steve

2017-08-01

This qualitative study explored the barriers and enablers influencing Western Australian (WA) community pharmacists' knowledge, confidence, willingness and practice in engaging older clients (>60 years) in alcohol-related health discussions. Two focus groups were conducted with a total of 14 community pharmacists who had previously completed a formative quantitative survey (n = 63), and indicated willingness to participate in a follow-up focus group. Focus group questions, informed by the survey results, explored participants' perceptions about barriers and enablers to delivering health information and advice about alcohol to older clients (60+ years). Shaw and colleagues' theoretical framework was used to understand barriers and enablers in relation to role legitimacy, role adequacy and role support. Participants acknowledged that providing health information about alcohol to older clients is a legitimate part of a community pharmacist's role, and most were confident performing this role in situations perceived as core to their professional practice, such as while dispensing medicines. However, many participants identified limited knowledge, skills and confidence in assisting older clients who may have alcohol issues, beyond advising them on medication and alcohol use. Structural barriers such as time and financial barriers were also identified. Routine professional practice including dispensing medicine and home medicine reviews may provide valuable opportunities to engage older clients in alcohol-related discussions. However, limited knowledge concerning appropriate strategies to assist older clients reduce their alcohol consumption, coupled with limited skills and confidence among community pharmacists in raising sensitive alcohol-related issues with clients, suggest the need for specific alcohol-related training and support. © 2016 Royal Pharmaceutical Society.

Client characteristics and the cost of home care in the prospective payment system.

PubMed

Livesay, Jody L; Hanson, Kathleen S; Anderson, Mary Ann; Oelschlaeger, Mary

2003-01-01

There has been much speculation in the literature about the effect of the prospective payment system (PPS) on the home care industry but few reports of systematic investigation. Clearly, comprehension of client characteristics is essential for categorizing home care clients into the correct Home Health Resource Groups, for allocating resources appropriately, and for implementing necessary organizational changes to accommodate clients who require variations in the amount of resources predicted by the PPS. The purposes of this study were to compare the characteristics of home health clients that resulted in a financial gain or a financial loss for one agency under the PPS with those of the interim payment system. A secondary data analysis of 140 cases compiled by one not-for-profit hospital-affiliated home care organization was completed. Results suggested that client characteristics of the projected loss group had more recertifications on admission and at the end of the 60-day episode, a longer stay (3 weeks), and more visits, particularly from skilled nursing. Comprehension of client characteristics and the subsequent ability to adjust for the proper case mix will be crucial if home care agencies are to remain financially viable under the PPS. Replication of this project needs to be done using more variables and multiple sites.

Understanding the effect of ethnic density on mental health: multi-level investigation of survey data from England.

PubMed

Das-Munshi, Jayati; Becares, Laia; Dewey, Michael E; Stansfeld, Stephen A; Prince, Martin J

2010-10-21

To determine if living in areas where higher proportions of people of the same ethnicity reside is protective for common mental disorders, and associated with a reduced exposure to discrimination and improved social support. Finally, to determine if any protective ethnic density effects are mediated by reduced exposure to racism and improved social support. Multi-level logistic regression analysis of national survey data, with area-level, own-group ethnic density modelled as the main exposure. Participants and setting 4281 participants of Irish, black Caribbean, Indian, Pakistani, Bangladeshi, and white British ethnicity, aged 16-74 years, randomly sampled from 892 "middle layer super output areas" in England. Common mental disorders (assessed via structured interviews); discrimination (assessed via structured questionnaire); and social support and social networks (assessed via structured questionnaire). Although the most ethnically dense areas were also the poorest, for each 10 percentage point increase in own-group ethnic density, there was evidence of a decreased risk of common mental disorders, for the full ethnic minority sample (odds ratio 0.94 (95% confidence interval 0.89 to 0.99); P=0.02, trend), for the Irish group (odds ratio 0.21 (0.06 to 0.74); P=0.01, trend), and for the Bangladeshi group (odds ratio 0.75 (0.62 to 0.91); P=0.005, trend), after adjusting for a priori confounders. For some groups, living in areas of higher own-group density was associated with a reduction in the reporting of discrimination and with improved social support and improved social networks. However, none of these factors mediated ethnic density effects. A protective effect of living in areas of higher own-group ethnic density was present for common mental disorders for some minority groups. People living in areas of higher own-group density may report improved social support and less discrimination, but these associations did not fully account for density effects.

Ethnicity and ethnic identity as predictors of drug norms and drug use among preadolescents in the US Southwest.

PubMed

Marsiglia, Flavio Francisco; Kulis, Stephen; Hecht, Michael L; Sills, Stephen

2004-06-01

This article reports the results of research exploring how ethnicity and ethnic identity may "protect" adolescents against drug use and help them form antidrug use norms. This study was conducted in 1998 and is based on a sample of 4364 mostly Mexican American seventh graders residing in a large southwestern city of diverse acculturation statuses. It aims at testing existing findings by conducting the research within the unique geographic and ethnic context of the Southwest region of the United States. This research examines how strength of ethnic identity plays a distinctive role in drug use behavior among the various ethnic groups represented in the sample: Mexican Americans, other Latinos, American Indians, African Americans, non-Hispanic Whites, and those of mixed ethnic backgrounds. Positive ethnic identity (i.e., strong ethnic affiliation, attachment, and pride) was associated with less substance use and stronger antidrug norms in the sample overall. Unexpectedly, the apparently protective effects of positive ethnic identity were generally stronger for non-Hispanic White respondents (a numerical minority group in this sample) than for members of ethnic minority groups. Implications for prevention programs tailored for Mexican/Mexican American students are discussed.

Short-Term Group Treatment for Survivors of Sexual Abuse: A Psychoeducational Approach.

ERIC Educational Resources Information Center

Thompson, Nikki; Renninger, Salina

1995-01-01

Counseling survivors of sexual abuse requires acknowledgment of the legitimacy of the client's ego defenses while helping the client abandon those defenses which have become obstacles to leading a fulfilling life. Such defenses may also impede the therapeutic process, as survivors are less likely to trust other people. Clients can arrive at a…

75 FR 62841 - Award of a Single-Source Grant to Chapin Hall at the University of Chicago, Chicago, IL

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... the child-only Temporary Assistance for Needy Families (TANF) client population. Chapin Hall's... and more detailed picture of the TANF child-only caseload, including the dynamics of client entry and..., to gather policy information about a vulnerable and important ACF client group. OPRE will administer...

Examination of Racial Differences on the MMPI-2 Clinical and Restructured Clinical Scales in an Outpatient Sample

ERIC Educational Resources Information Center

Castro, Yessenia; Gordon, Kathryn H.; Brown, Jessica S.; Anestis, Joye C.; Joiner, Thomas E., Jr.

2008-01-01

The current study examined the possibility of differential predictive accuracy of selected Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) clinical and Restructured Clinical (RC) scales in a group of Black and White mental health center clients. Results indicate that Black clients scored higher than White clients on one…

Which Group Teaching Styles Best Promote Information Gain for Adults with Mental Disorders?

ERIC Educational Resources Information Center

Emer, Denise; McLarney, Amber; Goodwin, Melinda; Keller, Peggy

2002-01-01

Group psychoeducation formats were evaluated to determine which promoted the greatest learning and retention of therapeutically relevant information in adult clients with mental disorders. Study 1 compared lecture and interactive formats; Study 2 compared two types of interactive formats. Both studies also measured client satisfaction with the…

Improving the Work Performance of Mentally Retarded Clients in a Sheltered Workshop.

ERIC Educational Resources Information Center

Starke, Mary C.; Wright, Jaice

1986-01-01

Twenty-three mentally retarded workshop clients were assigned to experimental or control groups in a 10-day intervention. The introduction of music as a reinforcer and elimination of distractions were among easily implemented, cost-effective program changes which resulted in significantly higher productivity rates for the experimental groups.…

Efficacy of nursing interventions in reducing social and occupational disabilities among patients with neurosis.

PubMed

Nagarajaiah; Jothimani, G; Parthasarathi, R; Reddemma, K; Giri, A T S

2012-01-01

Individuals suffering from neurosis suffer from social and occupational disabilities similar to that of psychoses. Though understanding of disabilities in neurosis is essential in management of the clients, the relevant interventional studies are very limited. The present study attempted to evaluate the effect of nursing interventions in reducing social and occupational disabilities in neurotic patients. Sixty neurotic patients diagnosed as per ICD 9 criteria were randomly assigned to experimental and control groups followed by pre-assessment by Groningen social disability schedule. Of the 10 sessions of nursing intervention, 3 were individual sessions with clients, 5 with clients and family members and 2 with small group of clients with similar problems; nursing intervention group and non-nursing intervention group received the routine drug treatment at rural community mental health centre, NIMHANS, Bengaluru. The post-assessment was carried out first, second, and the third month followed by the nursing intervention. The findings revealed statistically significant reduction in social and occupational disabilities. A community-based psychosocial intervention led by community health nurses catering to the needs of neurotic patients is indicated by the results.

Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social well-being and Health longitudinal study

PubMed Central

Astell-Burt, Thomas; Maynard, Maria J.; Lenguerrand, Erik; Harding, Seeromanie

2012-01-01

Objective. To investigate the effect of racism, own-group ethnic density, diversity and deprivation on adolescent trajectories in psychological well-being. Design. Multilevel models were used in longitudinal analysis of psychological well-being (total difficulties score (TDS) from Goodman's Strengths and Difficulties Questionnaire, higher scores correspond to greater difficulties) for 4782 adolescents aged 11–16 years in 51 London (UK) schools. Individual level variables included ethnicity, racism, gender, age, migrant generation, socioeconomic circumstances, family type and indicators of family interactions (shared activities, perceived parenting). Contextual variables were per cent eligible for free school-meals, neighbourhood deprivation, per cent own-group ethnic density, and ethnic diversity. Results. Ethnic minorities were more likely to report racism than Whites. Ethnic minority boys (except Indian boys) and Indian girls reported better psychological well-being throughout adolescence compared to their White peers. Notably, lowest mean TDS scores were observed for Nigerian/Ghanaian boys, among whom the reporting of racism increased with age. Adjusted for individual characteristics, psychological well-being improved with age across all ethnic groups. Racism was associated with poorer psychological well-being trajectories for all ethnic groups (p <0.001), reducing with age. For example, mean difference in TDS (95% confidence interval) between boys who experienced racism and those who did not at age 12 years = 1.88 (+1.75 to + 2.01); at 16 years = +1.19 (+1.07 to +1.31). Less racism was generally reported in schools and neighbourhoods with high than low own-group density. Own ethnic density and diversity were not consistently associated with TDS for any ethnic group. Living in more deprived neighbourhoods was associated with poorer psychological well-being for Whites and Black Caribbeans (p <0.05). Conclusion. Racism, but not ethnic density and deprivation in schools or neighbourhoods, was an important influence on psychological well-being. However, exposure to racism did not explain the advantage in psychological well-being of ethnic minority groups over Whites. PMID:22332834

Recognition and context memory for faces from own and other ethnic groups: a remember-know investigation.

PubMed

Horry, Ruth; Wright, Daniel B; Tredoux, Colin G

2010-03-01

People are more accurate at recognizing faces from their own ethnic group than at recognizing faces from other ethnic groups. This other-ethnicity effect (OEE) in recognition may be produced by a deficit in recollective memory for other-ethnicity faces. In a single study, White and Black participants saw White and Black faces presented within several different visual contexts. The participants were then given an old/new recognition task. Old responses were followed by remember-know-guess judgments and context judgments. Own-ethnicity faces were recognized more accurately, were given more remember responses, and produced more accurate context judgments than did other-ethnicity faces. These results are discussed in a dual-process framework, and implications for eyewitness memory are considered.

A proposed group management scheme for XTP multicast

NASA Technical Reports Server (NTRS)

Dempsey, Bert J.; Weaver, Alfred C.

1990-01-01

The purpose of a group management scheme is to enable its associated transfer layer protocol to be responsive to user determined reliability requirements for multicasting. Group management (GM) must assist the client process in coordinating multicast group membership, allow the user to express the subset of the multicast group that a particular multicast distribution must reach in order to be successful (reliable), and provide the transfer layer protocol with the group membership information necessary to guarantee delivery to this subset. GM provides services and mechanisms that respond to the need of the client process or process level management protocols to coordinate, modify, and determine attributes of the multicast group, especially membership. XTP GM provides a link between process groups and their multicast groups by maintaining a group membership database that identifies members in a name space understood by the underlying transfer layer protocol. Other attributes of the multicast group useful to both the client process and the data transfer protocol may be stored in the database. Examples include the relative dispersion, most recent update, and default delivery parameters of a group.

Wyoming's Early Settlement and Ethnic Groups, Unit IV.

ERIC Educational Resources Information Center

Robinson, Terry

This unit on Wyoming's early settlement and ethnic groups provides concepts, activities, stories, charts, and graphs for elementary school students. Concepts include the attraction Wyoming held for trappers; the major social, economic, and religious event called "The Rendezvous"; the different ethnic and religious groups that presently…

Ethnic density as a buffer for psychotic experiences: findings from a national survey (EMPIRIC)†

PubMed Central

Das-Munshi, Jayati; Bécares, Laia; Boydell, Jane E.; Dewey, Michael E.; Morgan, Craig; Stansfeld, Stephen A.; Prince, Martin J.

2012-01-01

Background Aetiological mechanisms underlying ethnic density associations with psychosis remain unclear. Aims To assess potential mechanisms underlying the observation that minority ethnic groups experience an increased risk of psychosis when living in neighbourhoods of lower own-group density. Method Multilevel analysis of nationally representative community-level data (from the Ethnic Minorities Psychiatric Illness Rates in the Community survey), which included the main minority ethnic groups living in England, and a White British group. Structured instruments assessed discrimination, chronic strains and social support. The Psychosis Screening Questionnaire ascertained psychotic experiences. Results For every ten percentage point reduction in own-group density, the relative odds of reporting psychotic experiences increased 1.07 times (95% CI 1.01–1.14, P = 0.03 (trend)) for the total minority ethnic sample. In general, people living in areas of lower own-group density experienced greater social adversity that was in turn associated with reporting psychotic experiences. Conclusions People resident in neighbourhoods of higher own-group density experience ‘buffering’ effects from the social risk factors for psychosis. PMID:22844021

The prevalence and impact of risk factors for ethnic differences in loneliness

PubMed Central

El Fakiri, Fatima

2016-01-01

Background: Previous studies have demonstrated that loneliness is more frequently present in citizens of ethnic minority groups than in natives. The current study investigates whether ethnic differences in emotional and social loneliness between Moroccan, Turkish, Surinamese and Dutch adults living in the Netherlands are due to ethnic differences in the presence and/or impact of an array of possible risk factors, such as partnership, health and socioeconomic status. Methods: The data were collected in 2012 as a part of a general health questionnaire of the Public Health Services in the four major cities of the Netherlands, containing 20.047 Dutch, 1.043 Moroccan, 1.197 Turkish and 1.900 Surinamese respondents. Results: Structural equation models showed that ethnic differences in emotional and social loneliness can be ascribed to ethnic differences in the prevalence and impact of several risk factors. Main findings were that all three ethnic minority groups reported feeling less healthy and more discriminated against than the Dutch group, which was related to increased loneliness. Perceived financial difficulties and people in the neighbourhood not getting along had more impact on feelings of loneliness for the Turkish group than loneliness for the other ethnic groups. Furthermore, members of the Turkish group were found more at risk to feel anxious or depressed, which was in turn related to increased loneliness. Conclusions: Policy makers are encouraged to develop multifaceted prevention strategies concerning those risk factors that are most changeable, thereby focusing per risk factor on those ethnic groups for which it is an important contribution to loneliness. PMID:27497438

Comparable Dietary Patterns Describe Dietary Behavior across Ethnic Groups in the Netherlands, but Different Elements in the Diet Are Associated with Glycated Hemoglobin and Fasting Glucose Concentrations.

PubMed

Dekker, Louise H; van Dam, Rob M; Snijder, Marieke B; Peters, Ron J G; Dekker, Jacqueline M; de Vries, Jeanne H M; de Boer, Evelien J; Schulze, Matthias B; Stronks, Karien; Nicolaou, Mary

2015-08-01

Ethnic minority populations in Western societies suffer from a disproportionate burden of type 2 diabetes (T2D). Insight into the role of dietary patterns in T2D may assist public health nutrition efforts in addressing these health disparities. We explored the association between dietary patterns and biomarkers of T2D in 5 ethnic groups living in Amsterdam, Netherlands. A total of 3776 men and women aged 18-70 y of Dutch, South Asian Surinamese, African-Surinamese, Turkish, and Moroccan origin from the HELIUS (HEalthy LIfe in an Urban Setting) study were included. Diet was assessed by using a food-frequency questionnaire, and dietary patterns were derived separately per ethnic group. First, food group-based dietary patterns were derived by using principal components analysis and the association with glycated hemoglobin (HbA1c) and plasma fasting glucose was assessed by using multivariable linear regression. Second, biomarker-driven dietary patterns based on HbA1c and fasting glucose concentrations were derived by applying reduced rank regression. Two comparable food group-based dietary patterns were identified in each ethnic group: a "meat and snack" pattern and a "vegetable" pattern. The meat-and-snack pattern derived within the Dutch origin population was significantly associated with HbA1c (β = 0.09; 95% CI: 0.00, 0.19) and fasting glucose (β = 0.18; 95% CI: 0.09, 0.26) concentrations. A biomarker-derived pattern characterized by red and processed meat was observed among Dutch-origin participants; however, among ethnic minority groups, this pattern was characterized by other foods including ethnicity-specific foods (e.g., roti, couscous). Although similar food group dietary patterns were derived within 5 ethnic groups, the association of the meat-and-snack pattern with fasting glucose concentrations differed by ethnicity. Taken together with the finding of ethnic differences in biomarker-driven dietary patterns, our results imply that addressing T2D risk in multiethnic populations requires ethnicity-specific approaches. © 2015 American Society for Nutrition.

Self-esteem, ethnic identity, and behavioral adjustment among Anglo and Chicano adolescents in West Texas.

PubMed

Grossman, B; Wirt, R; Davids, A

1985-03-01

This study provides a comparison of similarities and differences with respect to ethnic identity between Anglo and Chicano adolescents from Texas. A path analysis model was used to test a theoretical assumption concerning proposed antecedents and consequences of self-esteem. Research instruments included the Rosenberg Self Esteem Scale, the Semantic Differential (scales for Myself and My Ethnic Group) and the McGuire White Measure of Social Status. Results were consistent with the interpretation that there is a relationship between being Chicano and having lower self-esteem, lower behavioral adjustment, and higher ethnic esteem. The prediction that ethnic esteem would mediate between ethnic group and self-esteem was upheld. Variables such as ethnic group membership per se and sex appear as or more important to the prediction of behavioral level. Clinical implications include recognizing that Chicanos low in self-esteem or behavioral adjustment should not automatically be considered unusual. The problems faced by this group are considered as having something in common with other groups of people who have more problems, lesser status, fewer resources, and fewer sources of available help.

HIV and AIDS, other sexually transmitted diseases, and tuberculosis in ethnic minorities in United Kingdom: is surveillance serving its purpose?

PubMed Central

De Cock, K. M.; Low, N.

1997-01-01

Experience of disease differs across ethnic groups, and ethnicity is a relevant personal characteristic for descriptive epidemiology. Information about ethnicity and country of birth is omitted from the routine notification of many diseases. HIV infection and AIDS, other sexually transmitted diseases, and tuberculosis have different incidence rates in different ethnic groups in the United Kingdom. Omission of ethnic data from surveillance activities allows such differences in incidence to go undetected and unaddressed. Surveillance data that included ethnic details could guide interventions to reduce inequalities in health between different subpopulations. PMID:9202508

Examining the impact of migrant status on ethnic differences in mental health service use preceding a first diagnosis of schizophrenia.

PubMed

Anderson, Kelly K; McKenzie, Kwame J; Kurdyak, Paul

2017-08-01

Some ethnic groups have more negative contacts with health services for first-episode psychosis, likely arising from a complex interaction between ethnicity, socio-economic factors, and immigration status. Using population-based health administrative data, we sought to examine the effects of ethnic group and migrant status on patterns of health service use preceding a first diagnosis of schizophrenia or schizoaffective disorder among people aged 14-35 over a 10-year period. We compared access to care and intensity of service use for first-generation ethnic minority groups to the general population of Ontario. To control for migrant status, we restricted the sample to first-generation migrants and compared service use indicators for ethnic minority groups to the European migrant group. Our cohort included 18,080 people with a first diagnosis of schizophrenia or schizoaffective disorder, of whom 14.4% (n = 2607) were the first-generation migrants. Our findings suggest that the magnitude of ethnic differences in health service use is reduced and no longer statistically significant when the sample is restricted to first-generation migrants. Of exception, nearly, all migrant groups have lower intensity of primary care use, and Caribbean migrants are consistently less likely to use psychiatric services. We observed fewer ethnic differences in health service use preceding the first diagnosis of psychosis when patterns are compared among first-generation migrants, rather than to the general population, suggesting that the choice of reference group influences ethnic patterning of health service use. We need a comprehensive understanding of the mechanisms behind observed differences for minority groups to adequately address disparities in access to care.

Ethnic Variations in Prognosis of Patients with Dementia: A Prospective Nationwide Registry Linkage Study in The Netherlands.

PubMed

Agyemang, Charles; van de Vorst, Irene E; Koek, Huiberdina L; Bots, Michiel L; Seixas, Azizi; Norredam, Marie; Ikram, Umar; Stronks, Karien; Vaartjes, Ilonca

2017-01-01

Data on dementia prognosis among ethnic minority groups are limited in Europe. We assessed differences in short-term (1-year) and long-term (3-year) mortality and readmission risk after a first hospitalization or first ever referral to a day clinic for dementia between ethnic minority groups and the ethnic Dutch population in the NetherlandsMethods: Nationwide prospective cohorts of first hospitalized dementia patients (N = 55,827) from January 1, 2000 to December 31, 2010 were constructed. Differences in short-term and long-term mortality and readmission risk following hospitalization or referral to the day clinic between ethnic minority groups (Surinamese, Turkish, Antilleans, Indonesians) and the ethnic Dutch population were investigated using Cox proportional hazard regression models with adjustment for age, sex, and comorbidities. Age-sex-adjusted short-term and long-term risks of death following a first hospitalization with dementia were comparable between the ethnic minority groups and the ethnic Dutch. Age- and sex-adjusted risk of admission was higher only in Turkish compared with ethnic Dutch (HR 1.57, 95% CI,1.08-2.29). The difference between Turkish and the Dutch attenuated and was no longer statistically significant after further adjustment for comorbidities. There were no ethnic differences in short-term and long-term risk of death, and risk of readmission among day clinic patients. Compared with Dutch patients with a comparable comorbidity rate, ethnic minority patients with dementia did not have a worse prognosis. Given the poor prognosis of dementia, timely and targeted advance care planning is essential, particularly in ethnic minority groups who are mired by cultural barriers and where uptake of advance care planning is known to be low.

Exclusion and Inclusion of Nonwhite Ethnic Minority Groups in 72 North American and European Cardiovascular Cohort Studies

PubMed Central

Ranganathan, Meghna; Bhopal, Raj

2006-01-01

Background Cohort studies are recommended for understanding ethnic disparities in cardiovascular disease. Our objective was to review the process for identifying, including, and excluding ethnic minority populations in published cardiovascular cohort studies in Europe and North America. Methods and Findings We found the literature using Medline (1966–2005), Embase (1980–2001), Cinahl, Web of Science, and citations from references; consultations with colleagues; Internet searches; and RB's personal files. A total of 72 studies were included, 39 starting after 1975. Decision-making on inclusion and exclusion of racial/ethnic groups, the conceptual basis of race/ethnicity, and methods of classification of racial/ethnic groups were rarely explicit. Few publications provided details on the racial/ethnic composition of the study setting or sample, and 39 gave no description. Several studies were located in small towns or in occupational settings, where ethnic minority populations are underrepresented. Studies on general populations usually had too few participants for analysis by race/ethnicity. Eight studies were explicitly on Caucasians/whites, and two excluded ethnic minority groups from the whole or part of the study on the basis of language or birthplace criteria. Ten studies were designed to compare white and nonwhite populations, while five studies focused on one nonwhite racial/ethnic group; all 15 of these were performed in the US. Conclusions There is a shortage of information from cardiovascular cohort studies on racial/ethnic minority populations, although this has recently changed in the US. There is, particularly in Europe, an inequity resulting from a lack of research data in nonwhite populations. Urgent action is now required in Europe to address this disparity. PMID:16379500

Societal Ramifications of Ethnicity in the Suburbs.

ERIC Educational Resources Information Center

Femminella, Francis X.

The development of social science terminology about ethnicity in the United States is traced from colonial times to the present, and conflict among ethnic groups is examined in relation to contemporary problems in the suburbs of New York. Early in U.S. history, immigrating ethnic groups were thought to contribute to the melting pot character of…

The Relationship of Ethnicity-Related Stressors and Latino Ethnic Identity to Well-Being

ERIC Educational Resources Information Center

French, Sabine Elizabeth; Chavez, Noe R.

2010-01-01

Based on the risk and resilience model, the current study examined the effect of ethnicity-related stressors (perceived discrimination, stereotype confirmation concern, and own-group conformity pressure) and ethnic identity (centrality, private regard, public regard, and other-group orientation) on the well-being of 171 Latino American college…

Gardening with Huntington's disease clients--creating a programme of winter activities.

PubMed

Spring, Josephine Anne; Baker, Mark; Dauya, Loreane; Ewemade, Ivie; Marsh, Nicola; Patel, Prina; Scott, Adrienne; Stoy, Nicholas; Turner, Hannah; Viera, Marc; Will, Diana

2011-01-01

A programme of garden-related indoor activities was developed to sustain a gardening group for people with mid to late stage Huntington's disease during the winter. The activities were devised by the horticulturist, working empirically, involving the services occupational therapist, physiotherapist, occupational therapy art technician, computer room, recreation and leisure staff. The programme was strongly supported by the nursing and care staff. Feedback on the effectiveness of the activities was sought from the clients, team members and unit staff. The clients' interest in gardening was sustained by a multidisciplinary programme of indoor growing and using plant products in creative activities, computing and group projects. The clients enjoyed all activities except one that they said lacked contact with plants. The inexpensive programme of activities enabled creativity and self-expression, stimulated social contact and helped with therapeutic goals of the clients. In addition, it engaged the multi-disciplinary team and the unit staff, was practical and enhanced the environment.

Who Is Doing the Housework in Multicultural Britain?

PubMed Central

Kan, Man-Yee; Laurie, Heather

2016-01-01

There is an extensive literature on the domestic division of labour within married and cohabiting couples and its relationship to gender equality within the household and the labour market. Most UK research focuses on the white majority population or is ethnicity ‘blind’, effectively ignoring potentially significant intersections between gender, ethnicity, socio-economic position and domestic labour. Quantitative empirical research on the domestic division of labour across ethnic groups has not been possible due to a lack of data that enables disaggregation by ethnic group. We address this gap using data from a nationally representative panel survey, Understanding Society, the UK Household Longitudinal Study containing sufficient sample sizes of ethnic minority groups for meaningful comparisons. We find significant variations in patterns of domestic labour by ethnic group, gender, education and employment status after controlling for individual and household characteristics. PMID:29416186

Ethnic Density Effects on Physical Morbidity, Mortality, and Health Behaviors: A Systematic Review of the Literature

PubMed Central

Shaw, Richard; Nazroo, James; Stafford, Mai; Albor, Christo; Atkin, Karl; Kiernan, Kathleen; Wilkinson, Richard; Pickett, Kate

2012-01-01

It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. Most studies report a null association between ethnic density and health. Protective ethnic density effects are more common than adverse associations, particularly for health behaviors and among Hispanic people. Limitations of the literature include inadequate adjustment for area deprivation and limited statistical power across ethnic density measures and study samples. PMID:23078507

Therapeutic use of "prizing" and its effect on self-concept of elderly clients in nursing homes and group homes.

PubMed

Williams-Barnard, C L; Lindell, A R

1992-01-01

The purpose of this study was to ascertain the effect of nurse high prizing and nurse low prizing during group therapy in changing the self-concept of institutionalized aged persons. The hypothesis tested was that institutionalized aged clients participating in group therapy who receive nurse high prizing will show an increase in self-concept as measured by the Tennessee Self-Concept Scale (TSCS) when compared with those aged clients in the same settings participating in group therapy who receive nurse low prizing or those aged clients constituting the matched control groups. The study used an existing data source generated from the research of Williams and Lindell to conduct a secondary analysis of a variable not previously investigated. Mean difference scores from the posttest total self-concept score and subscales of the TSCS were analyzed in conjunction with the levels of prizing within the experimental and control groups. Using the Scale for Rating Prizing, two nurse raters judged the degree of prizing on 40 randomly extracted video segments. The findings indicated that 47.1% of those subjects who received low prizing decreased in self-concept; 68.4% of those who received high prizing increased in self-concept. No change in self-concept was noted in the control group. Findings were significant at the .0001 level. Investigating the effect of nurse high and low levels of prizing on client self-concept completes the Rogerian trilogy of therapist-offered conditions with this same sample of subjects. Extension of previous studies adds to the ever-growing body of nursing knowledge and increases the certitude, casualty, and generalizability of such investigations.

Trust and contact in diverse neighbourhoods: An interplay of four ethnicity effects.

PubMed

Tolsma, J; van der Meer, T W G

2018-07-01

Ethnically diverse neighbourhoods are generally less cohesive. A negative relationship between neighbourhood diversity and social cohesion is, however, neither a necessary nor a sufficient condition to conclude that neighbourhood diversity erodes intra-neighbourhood cohesion. This contribution shows - by using data collected during the second wave of the NEtherlands Longitudinal Lifecourse Study (NELLS) - that: (1) members of ethnic minority groups are more likely to report having contact with and trust their immediate neighbours than natives (ego ethnicity effect); (2) minority group residents are less likely to be contacted and trusted by their neighbours (alter ethnicity effect) and (3) all ethnic groups prefer to mix with coethnics (dyad ethnicity effect). Once we control for these three ethnic composition effects at the ego, alter and dyad-level, neighbourhood ethnic diversity is no longer related to less contact between neighbours. Previously identified negative relationships between neighbourhood diversity and cohesion should therefore be re-evaluated, as they may be the consequence of ethnic composition effects instead of a true neighbourhood diversity effect. Copyright © 2018. Published by Elsevier Inc.

Minority Rights and Majority Rule: Ethnic Tolerance in Romania and Bulgaria.

ERIC Educational Resources Information Center

McIntosh, Mary E.; And Others

1995-01-01

Analysis of data from national surveys of majority ethnic groups in Romania and Bulgaria examined the effects on tolerance toward minority groups of education, community ethnic composition, urbanism, age, gender, perceived threat to national security from the minority group's homeland, democratic values, and prevailing political ideology. Contains…

29 CFR 1607.4 - Information on impact.

Code of Federal Regulations, 2011 CFR

2011-07-01

... opportunities of persons by identifiable race, sex, or ethnic group as set forth in paragraph B of this section.... Applicable race, sex, and ethnic groups for recordkeeping. The records called for by this section are to be maintained by sex, and the following races and ethnic groups: Blacks (Negroes), American Indians (including...

The Influence of Ethnic Identity on Perceptions of Organizational Recruitment.

ERIC Educational Resources Information Center

Kim, Sandra S.; Gelfand, Michele J.

2003-01-01

A treatment group (70 whites, 49 nonwhites) and control group (69 whites, 50 nonwhites) evaluated employer recruitment brochures and completed ethnic identity measures. The treatment group's brochure addressed diversity initiatives. Regardless of race, those with higher ethnic identity were more positive about the organization and had greater job…

The role of dispositional traits in accounting for country and ethnic group differences on adjustment.

PubMed

Matsumoto, David; Nakagawa, Sanae; Estrada, Aaron

2009-02-01

Country and ethnic group differences on adjustment have been demonstrated numerous times, and the source of these differences has been typically interpreted as cultural. We report two studies in which country (Study 1) and ethnic group (Study 2) differences on depression, anxiety, optimism versus pessimism, well-being, and self-esteem are mediated by dispositional traits. These findings provide an alternative explanation for previously reported country and ethnic group differences on these variables and encourage researchers to consider multiple sources, including traits, in their models and studies.

Cervical cancer prevention-related knowledge and attitudes among female undergraduate students from different ethnic groups within China, a survey-based study.

PubMed

Wu, Enqi; Tiggelaar, Sarah M; Jiang, Tao; Zhao, Huanhu; Wu, Ritu; Wu, Rilige; Xu, Fangmei

2017-05-22

The purpose of this study was to understand cervical cancer prevention-related knowledge and attitudes among female undergraduate students from different ethnic groups within China. We conducted a survey among ethnically diverse female students from the Minzu University of China, in Beijing in October, 2014. Questionnaires from 493 participants aged from 16 to 26 years were included in the final database. The seven ethnic groups included in the final analysis were Han, Korean, Mongolian, Uyghur, Tibetan, Hui, and Tujia. Compared to the Han Chinese, the members of the other six ethnic groups had lower cervical cancer knowledge levels. The knowledge scores of Mongolian and Korean students were significantly lower than those of the Han Chinese. The willingness to accept cervical cancer prevention efforts also differed across different ethnic groups. After adjusting for age and place of residence, the acceptance of cervical cancer screening among the Tibetan, Uyghur, and Korean groups was significantly lower than among the Han Chinese, with different related decision-making factors in each group. Cervical cancer prevention-related public education is an urgent need in China. Extra consideration of ethnic differences should be taken into account when designing and improving new current cervical cancer prevention programs.

Ratings within and across ethnic boundaries of methods of one on one reading instruction.

PubMed

Badon, Linda C; Oller, John W; Oller, Stephen D

2005-01-01

Selected video segments of eight instructional sessions were evaluated by 39 speech language pathologists (SLPs). Each involved one of four first grade female students at-risk for academic difficulties being instructed by an African American SLP. In half the videos instruction was focused on story content (whole language) and in the other half on form (sound-symbol correspondence). Raters judged the child's comprehension, and the clinician's clarity and enthusiasm. Videos appeared in a random order. Raters received no advance information about the orientation of instruction or demography. Two of the children were African Americans, one was Caucasian, and one Hispanic. All used American English as their home language. With respect to efficacy of methods, ratings significantly favored the content (whole language) orientation in agreement with an independent count of miscues and scores for story retelling. However, ratings across ethnic boundaries differed with quantitative measures suggesting possible stereotyping. As a result of reading this article, participants will be able to (1) discuss factors that may color interactions with at-risk clients, (2) distinguish surface oriented (sound-symbol) approaches to reading instruction from content (meaning) oriented approaches, (3) describe influences of ethnicity on qualitative judgments crucial to clinical interactions.

Home and Community-Based Service Use by Vulnerable Older Adults.

PubMed

Weaver, Raven H; Roberto, Karen A

2017-06-01

The purpose of this study was to identify different types of clients who use home and community-based services. Enrollment characteristics of 76 clients at risk of nursing home placement and Medicaid spend-down who were enrolled in the Virginia Community Living Program were analyzed. Two-step cluster analysis identified 4 groups of service users. Enabling resources (caregiver relationship to participant, participant living arrangement, and length of time caregiver provided assistance to participant) and disability type (physical, cognitive, traumatic brain injury, or other) differentiated the client groups. Groups differed on average service cost per day and likelihood of nursing home placement if services were not provided. Findings point to the value of having practitioners assist vulnerable clients in tailoring services to meet different care needs and the need for refining policies guiding home and community-based care. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A group communication approach for mobile computing mobile channel: An ISIS tool for mobile services

NASA Astrophysics Data System (ADS)

Cho, Kenjiro; Birman, Kenneth P.

1994-05-01

This paper examines group communication as an infrastructure to support mobility of users, and presents a simple scheme to support user mobility by means of switching a control point between replicated servers. We describe the design and implementation of a set of tools, called Mobile Channel, for use with the ISIS system. Mobile Channel is based on a combination of the two replication schemes: the primary-backup approach and the state machine approach. Mobile Channel implements a reliable one-to-many FIFO channel, in which a mobile client sees a single reliable server; servers, acting as a state machine, see multicast messages from clients. Migrations of mobile clients are handled as an intentional primary switch, and hand-offs or server failures are completely masked to mobile clients. To achieve high performance, servers are replicated at a sliding-window level. Our scheme provides a simple abstraction of migration, eliminates complicated hand-off protocols, provides fault-tolerance and is implemented within the existing group communication mechanism.

Patterns of home and community care service delivery to culturally and linguistically diverse residents of rural Victoria.

PubMed

Ward, Bernadette M; Anderson, Karen S; Sheldon, Maria S

2005-12-01

To describe and compare patterns of Home and Community Care (HACC) utilisation among culturally and linguistically diverse (CALD) people and Australian-born residents of rural Victoria. The HACC Minimum Data Set provides information regarding levels of service provision and coverage in Victoria. Data from January to June 2002 were analysed to provide a profile of client characteristics and service usage in rural Victoria. Patterns of service utilisation were compared with the profile of the CALD population in the 2001 Census. The proportion of CALD residents who are HACC clients is consistent with demographic profiles. However, their extent of service usage is not consistent with patterns of use by Australian-born residents. HACC clients born in non-English-speaking countries, receive 35% less hours of HACC service than their Australian-born counterparts. HACC clients born overseas in English-speaking countries receive nine per cent less hours of HACC service than the Australian-born group (F = 8.9, P = 0.00). Both groups of overseas-born clients use a smaller range of HACC services (F = 1.9, P = 0.16). Planners and service providers need to monitor levels of HACC service delivery among population groups to ensure that CALD population groups receive equitable levels of HACC services. The HACC Minimum Data Set is one source of data that can assist in this process.

The effects of music on clients with learning disabilities: a literature review.

PubMed

Savarimuthu, Darren; Bunnell, Toni

2002-08-01

The aim of this paper was to promote the use of musical interventions with clients with learning disabilities. Musical interventions with this group of clients were found to be effective in reducing self-injurious behaviour, aggression and other behaviour, which challenge the service providers. Music was also found to have the potential to improve the communication skills of clients and to maintain their psychological well being. A review of the literature shows that music, though not widely used in the field of learning disabilities, can be an effective medium through which the quality of life of clients can be enhanced.

Influence of ethnicity on recreation and natural environment use patterns: Managing recreation sites for ethnic and racial diversity

NASA Astrophysics Data System (ADS)

Baas, John M.; Ewert, Alan; Chavez, Deborah J.

1993-07-01

Management of natural environment sites is becoming increasingly complex because of the influx of urbanized society into wildland areas. This worldwide phenomenon impacts a wide range of countries. In southern California ethnicity is often a major factor influencing recreation site use and behavior at sites in the wildland-urban interface. This study investigated the role of ethnicity and race on the use patterns, perception of environment, and recreation behaviors at an outdoor recreation site visited by an ethnically diverse population. Two research questions were asked: (1) What ethnic groups engage in outdoor recreation at this site, and (2) what differences can be assigned to these various groups? Data were collected from 250 recreationists during 1991. Three major ethnic groups were identified, and statistically significant differences were found in the importance of site attributes, activity participation, and in preferred and actual communication channels. Management implications and strategies based on group differences are discussed.

Ethnic differences in pain and pain management

PubMed Central

Campbell, Claudia M; Edwards, Robert R

2012-01-01

SUMMARY Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers’ treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes. PMID:23687518

Parental views of children's physical activity: a qualitative study with parents from multi-ethnic backgrounds living in England.

PubMed

Trigwell, Joanne; Murphy, Rebecca Catherine; Cable, Nigel Timothy; Stratton, Gareth; Watson, Paula Mary

2015-10-02

Guidelines recommend children and young people participate in at least 60 min of physical activity (PA) every day, however, findings from UK studies show PA levels of children vary across ethnic groups. Since parents play an instrumental role in determining children's PA levels, this article aims to explore parental views of children's PA in a multi-ethnic sample living in a large city in the North-West of England. Six single-ethnic focus groups were conducted with 36 parents of school-aged children (4 to 16 years) with a predominantly low socio-economic status (SES). Parents self-identified their ethnic background as Asian Bangladeshi (n = 5), Black African (n = 4), Black Somali (n = 7), Chinese (n = 6), White British (n = 8) and Yemeni (n = 6). Focus group topics included understanding of PA, awareness of PA guidelines, knowledge of benefits associated with PA and perceived influences on PA in childhood. Data were analysed thematically using QSR NVivo 9.0. Parents from all ethnic groups valued PA and were aware of its benefits, however they lacked awareness of PA recommendations, perceived school to be the main provider for children's PA, and reported challenges in motivating children to be active. At the environmental level, barriers to PA included safety concerns, adverse weather, lack of resources and lack of access. Additional barriers were noted for ethnic groups from cultures that prioritised educational attainment over PA (Asian Bangladeshi, Chinese, Yemeni) and with a Muslim faith (Asian Bangladeshi, Black Somali, Yemeni), who reported a lack of culturally appropriate PA opportunities for girls. Parents from multi-ethnic groups lacked awareness of children's PA recommendations and faced barriers to promoting children's PA out of school, with certain ethnic groups facing additional barriers due to cultural and religious factors. It is recommended children's PA interventions address influences at all socio-ecological levels, and account for differences between ethnic groups.

The In-Session and Long-Term Role of a Significant Other in Motivational Enhancement Therapy for Alcohol Use Disorders

PubMed Central

Bourke, Emilie; Magill, Molly; Apodaca, Timothy R.

2016-01-01

Objective To examine how significant other (SO) language in support of or against client abstinence from alcohol influences clients’ in-session speech and drinking behavior over the 9 months post-Motivational Enhancement Therapy (MET). Method Sequential analyses were used to examine the language of Project MATCH clients who invited an SO to participate in an MET session. Hierarchical regressions investigated the predictive relationship between SO language and clients’ post-treatment drinking behavior. A cohort analytic design compared the change language of these SO-involved participants against a matched group who chose client-only therapy. Results 'SO Support Change' language increased the odds of client Change Talk in the next utterance (p < .01). SO Support Change did not significantly predict reduced post-treatment drinking whereas 'SO Against Change' significantly predicted an increase in average drinks per drinking day (DDD) across months 7-9 post-MET (p = .04). In the matched comparison, the proportion of change-related client language was comparable across the SO-involved and client-only groups. Conclusions Motivational interviewing theory was supported by the sequential association between SO and client language as well as the predictive link between SO Against Change and client drinking intensity. Given the centrality of pro-sobriety language in the literature, it was surprising that SO Support Change did not predict alcohol use outcomes. Findings are discussed in relation to contemporary treatment process research and clinical practice. PMID:26951920

Reliability of the Raven Colored Progressive Matrices Test: Age and Ethnic Group Comparisons.

ERIC Educational Resources Information Center

Carlson, Jerry S.; Jensen, C. Mark

1981-01-01

Reliabilities for the Raven Colored Progressive Matrices Test (CPM) are reported for three age groups (ages 5 1/2- 6 1/2, 6 1/2-7 1/2, and 7 1/2-8 1/2 years) and three ethnic groups (Anglo, Black, and Hispanic). Results indicate CPM is not equally reliable for all age groups, but appears equally reliable for the three ethnic groups. (Author)

Jewish Israeli Social Work Students' Attitudes to the Prospect of Being Assigned an Israeli Arab Client

ERIC Educational Resources Information Center

Baum, Nehami

2010-01-01

This study attempts to examine implications of political conflicts in social work with clients from the rival group. Using an anonymous, open-ended questionnaire, this study examines responses of 78 Jewish Israeli social work students to the hypothetical prospect of treating an Israeli Arab client. The vast majority expected cultural and political…

The Views of Clients with Mild Intellectual Disabilities regarding Their Working Relationships with Caregivers

ERIC Educational Resources Information Center

Roeden, John M.; Maaskant, Marian A.; Curfs, Leopold M. G.

2011-01-01

Background: Research studies into the effect of therapies have shown that a good relationship between the client and his caregiver is a key factor in a positive treatment outcome. Methods: The nominal group technique (NGT) has been used in this study to discover what clients with intellectual disabilities feel contributes to a successful working…

Cultural Implications of a Global Context: The Need for the Reference Librarian To Ask Again "Who Is My Client?".

ERIC Educational Resources Information Center

McSwiney, Carolyn

Globalization provides the contextual framework for cultural changes in the library user group. In order to be more effective, and realistically, more client-focused, the reference librarian is challenged to ask again "Who is my client?" in this changing context. This paper presents a positive and practical response to cultural change…

Randomized Trial of Intensive Housing Placement and Community Transition Services for Episodic and Recidivist Homeless Families

PubMed Central

Mitchell, Kristen; Pareti, Lauren; DeGenova, Joe; Heller, Anne; Hannigan, Anthony; Gholston, Jennifer

2013-01-01

Objectives. We compared Home to Stay, a pilot of intensive housing placement and community transition services for episodic and recidivist homeless families, with a standard services approach. Methods. Using intention-to-treat analyses, we conducted a modified randomized trial of 138 Home to Stay client families and a control group of 192 client families receiving standard shelter services. Results. Home to Stay clients exited shelter more quickly than clients in the control group (Cox regression, P < .001), more commonly exited shelter with housing subsidies (75% vs 56%), stayed out of shelter longer (Cox regression, P = .011), and spent fewer total days in shelter (376 days vs 449 days). Home to Stay performed best with clients who entered shelter within 180 days of the pilot’s start date and had less impact on clients entering shelter before that time. Conclusions. Relative to standard services, Home to Stay services can accelerate exit from shelter and reduce return to shelter and total sheltered days for episodic and recidivist homeless families. Standard shelter services may be able to narrow this performance gap by incentivizing work with all episodic and recidivist homeless families. PMID:24148053

Case file audit of Lidcombe program outcomes in a student-led stuttering clinic.

PubMed

McCulloch, Julia; Swift, Michelle C; Wagnitz, Bianca

2017-04-01

The current study aimed to benchmark clinical outcomes for preschool-aged clients (2;0-5;11 years old) that attended a student-led clinic and undertook the Lidcombe Program. A case file audit was undertaken for all preschool clients who attended the clinic between February 2008 and February 2013 and commenced the Lidcombe Program. Clients were grouped according to Stage 1 completion. A mixed ANOVA was used to test for differences between the groups in initial and final percentage syllables stuttered (%SS). Associations between case variable factors and treatment duration were investigated using Pearson correlations. Clients who completed Stage 1 had final %SS and severity rating (SR) scores comparable to the literature; however, the median Stage 1 duration was greater. Over half of the clients (57%) withdrew prior to completing Stage 1. These clients had a significantly higher %SS at final treatment session than their completing peers. Initial %SS and SR scores were the only case variables associated with treatment duration. Students can achieve the same short-term treatment outcomes for children who stutter using the Lidcombe Program as the current published literature; however, treatment duration is greater and may impact completion. Implications of this for clinical education are discussed.

Ethnic diversity and pathways to care for a first episode of psychosis in Ontario.

PubMed

Archie, S; Akhtar-Danesh, N; Norman, R; Malla, A; Roy, P; Zipursky, R B

2010-07-01

To examine ethnic variations in the pathways to care for persons accessing early intervention (EI) services in Ontario. The pathways to care and the duration of untreated psychosis were assessed for first-episode psychosis patients who entered specialized EI services in Ontario. The sample was assigned to the following ethnic classifications: the White (Caucasian), Black (African descent), and Asian (ancestry from the continent) groups, plus all the "other ethnicities" group. There were 200 participants: 78% were male; 61% from the White, 15% Black, 13% Asian, and 11% were from the other ethnicities group. At the first point of contact, more participants used nonmedical contacts (12%), such as clergy and naturopathic healers, than psychologists (8%) or psychiatrists (7%). There were no ethnic differences for duration of untreated psychosis (median 22 weeks) or for initiation of help seeking by family/friends (53%), police (15%), or self (33%). After adjusting for relevant clinical and demographic factors, the Asian and other ethnicities groups were 4 and 3 times (respectively) more likely than the White or Black groups (P = .017) to use emergency room services as the first point of contact in the pathways to care. Participants from the Asian group experienced less involuntary hospitalizations (P = .023) than all the other groups. Yet overall, there were many more similarities than significant differences in the pathways to care. EI services should monitor the pathways to care for young people of diverse ethnic backgrounds to address any disparities in accessing care.

Discrimination and the incidence of psychotic disorders among ethnic minorities in The Netherlands.

PubMed

Veling, Wim; Selten, Jean-Paul; Susser, Ezra; Laan, Winfried; Mackenbach, Johan P; Hoek, Hans W

2007-08-01

It is well established now that the incidence of schizophrenia is extremely high for several ethnic minority groups in western Europe, but there is considerable variation among groups. We investigated whether the increased risk among these groups depends upon the degree to which they perceive discrimination based on race or ethnicity. We studied the incidence of psychotic disorders over 7 years in The Hague, a city with a large and diverse population of ethnic minorities. To compare the incidence of schizophrenic disorders (DSM IV: schizophrenia, schizophreniform disorder, schizoaffective disorder) in each ethnic minority group with the incidence in native Dutch, we computed incidence rate ratios (IRRs). Based on a population study and on rates of reported incidents of discrimination in The Hague, the degree of perceived discrimination of ethnic minority groups was rated: high (Morocco), medium (Netherlands-Antilles, Surinam and 'other non-western countries'), low (Turkey) or very low ('western or westernized countries'). The age- and gender-adjusted IRRs of schizophrenic disorders for ethnic minority groups exposed to high, medium, low, and very low discrimination were 4.00 (95% CI 3.00-5.35), 1.99 (1.58-2.51), 1.58 (1.10-2.27), and 1.20 (0.81-1.90), respectively. When not only schizophrenic, but all psychotic disorders were included in the analysis, the results were similar. These results suggest that discrimination perceived by ethnic minority groups in western Europe, or some factor closely related to it, may contribute to their increased risk of schizophrenia.

Haematological parameters, natural regulatory CD4 + CD25 + FOXP3+ T cells and γδ T cells among two sympatric ethnic groups having different susceptibility to malaria in Burkina Faso

PubMed Central

2012-01-01

Background Fulani ethnic group individuals are less susceptible than sympatric Mossi ethnic group, in term of malaria infection severity, and differ in antibody production against malaria antigens. The differences in susceptibility to malaria between Fulani and Mossi ethnic groups are thought to be regulated by different genetic backgrounds and offer the opportunity to compare haematological parameters, Tregs and γδT cell profiles in seasonal and stable malaria transmission settings in Burkina Faso. The study was conducted at two different time points i.e. during the high and low malaria transmission period. Results Two cross-sectional surveys were undertaken in adults above 20 years belonging either to the Fulani or the Mossi ethnic groups 1) at the peak of the malaria transmission season and 2) during the middle of the low malaria transmission season. Full blood counts, proportions of Tregs and γδ T cells were measured at both time-points. As previously shown the Fulani and Mossi ethnic groups showed a consistent difference in P. falciparum infection rates and parasite load. Differential white blood cell counts showed that the absolute lymphocyte counts were higher in the Mossi than in the Fulani ethnic group at both time points. While the proportion of CD4+CD25high was higher in the Fulani ethnic group at the peak of malaria transmission season (p = 0.03), no clear pattern emerged for T regulatory cells expressing FoxP3+ and CD127low. However CD3+γδ+ subpopulations were found to be higher in the Fulani compared to the Mossi ethnic group, and this difference was statistically significant at both time-points (p = 0.004 at low transmission season and p = 0.04 at peak of transmission). Conclusion Our findings on regulatory T cell phenotypes suggest an interesting role for immune regulatory mechanisms in response to malaria. The study also suggests that TCRγδ + cells might contribute to the protection against malaria in the Fulani ethnic group involving their reported parasite inhibitory activities. PMID:22283984

Group Projects Using Clients versus Not Using Clients: Do Students Perceive Any Differences?

ERIC Educational Resources Information Center

Parsons, Amy L.; Lepkowska-White, Elzbieta

2009-01-01

Today's educators are faced with the challenge of preparing undergraduate students to be productive employees who can communicate effectively, work well in teams, and solve problems, as well as demonstrate content knowledge. Group projects are one tool that educators can use to help students develop these key skills. Educators may be tempted to…

Integrating Narrative and Action Processes in Group Counseling Practice: A Multimodal Approach for Helping Clients

ERIC Educational Resources Information Center

Westwood, Marvin J.; Ewasiw, Joan F.

2011-01-01

The aim of this article is to introduce an integrated approach for helping clients. The approach combines and builds on two group-based interventions: guided autobiography and therapeutic enactment. Descriptions of the two interventions individually and a transtheoretical model for change are provided. How change occurs through the proposed…

Moral Problems Perceived by Industry in Collaboration with a Student Group: Balancing between Beneficial Objectives and Upholding Relations

ERIC Educational Resources Information Center

Vartiainen, Tero

2009-01-01

Industry-university partnerships are common in the IT field. This paper reports on moral problems perceived by client representatives collaborating with student groups taking part in a project course in information systems education in a Finnish university. Twenty-two client representatives from IT organizations were interviewed during the course…

Validity of body composition methods across ethnic population groups.

PubMed

Deurenberg, P; Deurenberg-Yap, M

2003-10-01

Most in vivo body composition methods rely on assumptions that may vary among different population groups as well as within the same population group. The assumptions are based on in vitro body composition (carcass) analyses. The majority of body composition studies were performed on Caucasians and much of the information on validity methods and assumptions were available only for this ethnic group. It is assumed that these assumptions are also valid for other ethnic groups. However, if apparent differences across ethnic groups in body composition 'constants' and body composition 'rules' are not taken into account, biased information on body composition will be the result. This in turn may lead to misclassification of obesity or underweight at an individual as well as a population level. There is a need for more cross-ethnic population studies on body composition. Those studies should be carried out carefully, with adequate methodology and standardization for the obtained information to be valuable.

Factors Associated With Volunteering Among Racial/Ethnic Groups: Findings From the California Health Interview Survey.

PubMed

Johnson, Kimberly J; Lee, S Hannah

2017-06-01

The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.

[The Dagestan gene pool: interethnic and intraethnic differentiation of eight aboriginal ethnic groups: analysis based on data on the AB0 and Rhesus erythrocyte antigen systems].

PubMed

Radzhabov, M O; Mamaev, I A; Shamov, I A; Gasaev, D G; Shneĭder, Iu V

2009-03-01

Analysis of the genetic variation of eight aboriginal Dagestan ethnic groups based on data on the AB0 and Rhesus blood groups has been carried out in a total sample of 18 348 subjects. The degree of genetic differentiation (G(ST)) and the levels of intraethnic (H(S) and interethnic (H(T)) variations of Dagestan ethnic groups have been estimated at two hierarchical levels of the population system. Prevalence of intraethnic diversity over interethnic one has been found in Dagestan populations. The parameters of subdivision of Dagestan populations were compared with those for the populations of all other regions of the Caucasus and the Pamir. The population subdivision of ethnic groups of Dagestan and other regions of the Caucasus is lower than that of Pamir ethnic groups.

The moderating role of centrality on associations between ethnic identity affirmation and ethnic minority college students' mental health.

PubMed

Brittian, Aerika S; Umaña-Taylor, Adriana J; Lee, Richard M; Zamboanga, Byron L; Kim, Su Yeong; Weisskirch, Robert S; Castillo, Linda G; Whitbourne, Susan Krauss; Hurley, Eric A; Huynh, Que-Lam; Brown, Elissa J; Caraway, S Jean

2013-01-01

Prior literature has shown that ethnic affirmation, one aspect of ethnic identity, is positively associated with mental health. However, the associations between ethnic affirmation and mental health may vary depending how much importance individuals place on their ethnic group membership (ie, centrality). Using path analysis, the current study examined the relations between ethnic affirmation and indices of mental health problems (ie, anxiety and depressive symptoms), and tested whether the process was moderated by ethnic centrality among 3,659 college students representing 3 ethnic groups (41% Latino/a, 35% Asian American, and 24% African American) who participated in a large, multisite university study. Results suggested that the associations between ethnic affirmation and mental health were stronger for Latino/a and Asian American students who reported higher levels of ethnic centrality. For African Americans, higher levels of ethnic affirmation predicted better mental health, but this association did not vary as a function of ethnic centrality.

Commodification of Transitioning Ethnic Enclaves

PubMed Central

Terzano, Kathryn

2014-01-01

This literature review examines the changing roles of ethnic enclaves, the question of their authenticity, and their value as commodified spaces, giving special attention to Little Italy neighborhoods in the United States. Understanding the roles of ethnic enclaves requires some understanding about immigrants’ identities. For some theorists, immigrants become blended into society over the course of generations; for other theorists, descendants of immigrants sometimes retain their cultural heritage and traits, helping form a multicultural or pluralist society. In the traditional sense, ethnic enclaves consist of both ethnic residents and ethnic businesses (such as restaurants, shops, and grocers). One way that ethnic enclaves change is when the area experiences a demographic shift, and people from outside the ethnic group move their residences and businesses to the neighborhood, resulting in the area becoming diversified in people and businesses. A second way that an ethnic enclave changes is when the ethnic group shrinks, but the shops and other businesses remain, resulting in the area becoming diversified in residents but not businesses. This latter situation may encourage commodification of the neighborhood’s ethnic identity, where a municipality or business association seeks to preserve an enclave’s ethnic reputation for tourism purposes. This commodification has implications for many individuals and groups within the enclave as well as outside of it. PMID:25431441

Marriage-Market Constraints and Mate-Selection Behavior: Racial, Ethnic, and Gender Differences in Intermarriage

PubMed Central

Choi, Kate H.; Tienda, Marta

2016-01-01

Despite theoretical consensus that marriage markets constrain mate selection behavior, few studies directly evaluate how local marriage market conditions influence intermarriage patterns. Using data from the American Community Survey, we examine what aspects of marriage markets influence mate selection; assess whether the associations between marriage market conditions and intermarriage are uniform by gender and across pan-ethnic groups; and investigate the extent to which marriage market conditions account for group differences in intermarriage patterns. Relative group size is the most salient and consistent determinant of intermarriage patterns across pan-ethnic groups and by gender. Marriage market constraints typically explain a larger share of pan-ethnic differences in intermarriage rates than individual traits, suggesting that scarcity of co-ethnic partners is a key reason behind decisions to intermarry. When faced with market constraints, men are more willing or more successful than women in crossing racial and ethnic boundaries in marriage. PMID:28579638

Medicaid care management: description of high-cost addictions treatment clients.

PubMed

Neighbors, Charles J; Sun, Yi; Yerneni, Rajeev; Tesiny, Ed; Burke, Constance; Bardsley, Leland; McDonald, Rebecca; Morgenstern, Jon

2013-09-01

High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals <90th percentile of AODTx expenditures (n=41,054); high-cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. Copyright © 2013 Elsevier Inc. All rights reserved.

Improved Health among People Living with HIV/AIDS Who Received Packages of Proven Preventive Health Interventions, Amhara, Ethiopia

PubMed Central

O’Reilly, Ciara E.; Taylor, Ethel V.; Ayers, Tracy; Fantu, Ribka; Abayneh, Sisay Alemayehu; Marston, Barbara; Molla, Yordanos B.; Sewnet, Tegene; Abebe, Fitsum; Hoekstra, Robert M.; Quick, Robert

2014-01-01

In 2009, basic care packages (BCP) containing health products were distributed to HIV-infected persons in Ethiopia who were clients of antiretroviral therapy clinics. To measure health impact, we enrolled clients from an intervention hospital and comparison hospital, and then conducted a baseline survey, and 7 bi-weekly home visits. We enrolled 405 intervention group clients and 344 comparison clients. Intervention clients were more likely than comparison clients to have detectable chlorine in stored water (40% vs. 1%, p<0.001), soap (51% vs. 36%, p<0.001), and a BCP water container (65% vs. 0%, p<0.001) at every home visit. Intervention clients were less likely than comparison clients to report illness (44% vs. 67%, p<0.001) or health facility visits for illness (74% vs. 95%, p<0.001), and had lower median illness scores (1.0 vs. 3.0, p<0.05). Participation in the BCP program appeared to improve reported health outcomes. PMID:25233345

Racial-Ethnic Identity in Mid-Adolescence: Content and Change as Predictors of Academic Achievement

ERIC Educational Resources Information Center

Altschul, Inna; Oyserman, Daphna; Bybee, Deborah

2006-01-01

Three aspects of racial-ethnic identity (REI)--feeling connected to one's racial-ethnic group (Connectedness), being aware that others may not value the in-group (Awareness of Racism), and feeling that one's in-group is characterized by academic attainment (Embedded Achievement)--were hypothesized to promote academic achievement. Youth randomly…

Creating Culturally Relevant Alzheimer's Support Groups for Racial and Ethnic Minorities.

ERIC Educational Resources Information Center

Henderson, Joseph Neil

Although data indicate that Alzheimer's disease occurs among all racial and ethnic populations, the Alzheimer's disease support group system is used nationally primarily by white, middle-class caregivers. Developing a model ethnic-specific support group for Hispanics requires delineation of formal and informal health care networks in the ethnic…

Building bridges: marketing managed care to ethnically diverse populations.

PubMed

Rosen, M B

1996-12-01

America's population "stew" creates specific challenges to health plans attempting to reach ethnically differentiated enrollee groups. In this article, the author provides snapshots of four ethnic groups, suggests some marketing considerations when preparing communications to these groups, and helps draw some conclusions about marketing managed care products to a culturally diverse population.

Do wealth disparities contribute to health disparities within racial/ethnic groups?

PubMed

Pollack, Craig Evan; Cubbin, Catherine; Sania, Ayesha; Hayward, Mark; Vallone, Donna; Flaherty, Brian; Braveman, Paula A

2013-05-01

Though wide disparities in wealth have been documented across racial/ethnic groups, it is largely unknown whether differences in wealth are associated with health disparities within racial/ethnic groups. Data from the Survey of Consumer Finances (2004, ages 25-64) and the Health and Retirement Survey (2004, ages 50+), containing a wide range of assets and debts variables, were used to calculate net worth (a standard measure of wealth). Among non-Hispanic black, Hispanic and non-Hispanic white populations, we tested whether wealth was associated with self-reported poor/fair health status after accounting for income and education. Except among the younger Hispanic population, net worth was significantly associated with poor/fair health status within each racial/ethnic group in both data sets. Adding net worth attenuated the association between education and poor/fair health (in all racial/ethnic groups) and between income and poor/fair health (except among older Hispanics). The results add to the literature indicating the importance of including measures of wealth in health research for what they may reveal about disparities not only between but also within different racial/ethnic groups.

Measurement Equivalence of the K6 Scale: The Effects of Race/Ethnicity and Language

PubMed Central

Kim, Giyeon; DeCoster, Jamie; Bryant, Ami N.; Ford, Katy L.

2017-01-01

This study examined the measurement equivalence of the K6 across diverse racial/ethnic and linguistic groups in the U.S. differential item functioning analyses using item response theory were conducted among 44,846 U.S. adults drawn from the California Health Interview Survey. Results show that four items (“nervous,” “restless,” “depressed,” and “everything an effort”) varied significantly across races/ethnicities and four items (“nervous,” “hopeless,” “restless,” and “depressed”) varied significantly across languages. In additional effect size analyses designed to separate effects of race/ethnicity from language, the structure of the White English group was substantially different from both the Hispanic/Latino English group and Hispanic/Latino Spanish group, whereas the Hispanic/Latino Spanish group was not different from the Hispanic/Latino English group. The findings suggest that there was evident measurement nonequivalence in the K6 among racially/ethnically and linguistically diverse adults and that the observed nonequivalence in the K6 appears to be driven by language rather than race/ethnicity. PMID:26282779

Over-the-counter sales of antibiotics from community pharmacies in Abu Dhabi.

PubMed

Dameh, Majd; Green, James; Norris, Pauline

2010-10-01

The aim of this study is to investigate over-the-counter sale of antibiotics from community pharmacies in Abu Dhabi city, focusing on the extent, demographic and socioeconomic determinants of this practice. The study was conducted in the capital of the United Arab Emirates, Abu Dhabi, and involved 17 randomly selected private pharmacies. A cross-sectional design using structured observations of 30 clients purchasing antibiotics from a pharmacy staff (either a pharmacist or pharmacy assistant) at each selected pharmacy. A total of 510 interactions were observed. Statistical analysis was performed using SPSS. The extent and types of antibiotics sold over-the-counter in Abu Dhabi city as observed in the selected sample of community pharmacies, and the demographic and socioeconomic factors that contributed to this practice. Sixty eight percent (68.4%) of the observed antibiotic sales were sold over-the-counter without prescriptions. Injection antibiotics constituted 2.2% of the antibiotics sold, 45.5% of which were sold over-the-counter. Combination of penicillins including β-lactamase inhibitors (34.0%), penicillins with extended spectrum (22.3%) and second generation cephalosporins (11.2%) were the mostly commonly sold antibiotic groups. Respiratory conditions (63.1%) were the most frequent reason for purchasing antibiotics. Over-the-counter sales of antibiotics were related to client ethnicity and age, gender of pharmacy staff and health complaint. Our study revealed high sales of over-the-counter antibiotics, despite this being illegal. The ineffectiveness of antibiotics in treating respiratory conditions of viral origin and effects of such practice on the emergence of bacterial resistance necessitates prompt action.

Partner selection and divorce in ethnic minorities: distinguishing between two types of ethnic homogamous marriages.

PubMed

Eeckhaut, Mieke C W; Lievens, John; Van de Putte, Bart; Lusyne, Patrick

2011-01-01

This article compares divorce risks according to marriage type. The common dichotomy between ethnic homogamous and ethnic heterogamous marriages is further elaborated by differentiating a third marriage type; ethnic homogamous marriages between individuals from an ethnic minority group and a partner from the country of origin. Based on the analysis of data concerning the Turkish and Moroccan minorities in Belgium, it has been confirmed that the divorce risk associated with these marriages is higher than that of other ethnic homogamous marriages. However, specific divorce patterns according to marriage type also indicate the importance of differences between the minority groups.

Effectiveness of a Dissonance-Based Eating Disorder Prevention Program for Ethnic Groups in Two Randomized Controlled Trials

PubMed Central

Stice, Eric; Marti, C. Nathan; Cheng, Zhen Hadassah

2014-01-01

Objective As young women from certain ethnic minority groups have reported less pursuit of the thin ideal and body dissatisfaction than European American young women we tested whether a dissonance-based prevention program designed to reduce thin-ideal internalization among women with body dissatisfaction is less effective for the former relative to the later groups. We also tested whether intervention effects are larger when participants from minority groups worked with a facilitator matched versus not matched on ethnicity. Method In Study 1, 426 female undergraduates (M age = 21.6, SD = 5.6) were randomized to clinician-led Body Project groups or an educational control group. In Study 2, 189 female undergraduates were randomized to peer-led Body Project groups or a waitlist control condition. Results Although there was some variation in risk factor scores across ethnic groups, ethnic minority participants did not demonstrate consistently higher or lower risk relative to European American participants. Intervention effects did not significantly differ for participants from minority groups versus European American participants in either trial. There was no evidence that effects were significantly larger when minority participants and facilitators were matched on ethnicity. Conclusions Results suggest that the Body Project is similarly effective for African American, Asian American, European American, and Hispanic female college students, and when participants and facilitators are matched or not on minority ethnicity status, implying that this prevention program can be broadly disseminated in this population. PMID:24655465

Effectiveness of a dissonance-based eating disorder prevention program for ethnic groups in two randomized controlled trials.

PubMed

Stice, Eric; Marti, C Nathan; Cheng, Zhen Hadassah

2014-04-01

As young women from certain ethnic minority groups have reported less pursuit of the thin ideal and body dissatisfaction than European American young women we tested whether a dissonance-based prevention program designed to reduce thin-ideal internalization among women with body dissatisfaction is less effective for the former relative to the later groups. We also tested whether intervention effects are larger when participants from minority groups worked with a facilitator matched versus not matched on ethnicity. In Study 1, 426 female undergraduates (M age=21.6, SD=5.6) were randomized to clinician-led Body Project groups or an educational control group. In Study 2, 189 female undergraduates were randomized to peer-led Body Project groups or a waitlist control condition. Although there was some variation in risk factor scores across ethnic groups, ethnic minority participants did not demonstrate consistently higher or lower risk relative to European American participants. Intervention effects did not significantly differ for participants from minority groups versus European American participants in either trial. There was no evidence that effects were significantly larger when minority participants and facilitators were matched on ethnicity. Results suggest that the Body Project is similarly effective for African American, Asian American, European American, and Hispanic female college students, and when participants and facilitators are matched or not on minority ethnicity status, implying that this prevention program can be broadly disseminated in this population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Who uses NHS Direct? Investigating the impact of ethnicity on the uptake of telephone based healthcare.

PubMed

Cook, Erica J; Randhawa, Gurch; Large, Shirley; Guppy, Andy; Chater, Angel M; Pang, Dong

2014-11-07

NHS Direct, a leading telephone healthcare provider worldwide, provided 24/7 health care advice and information to the public in England and Wales (1998-2014). The fundamental aim of this service was to increase accessibility, however, research has suggested a disparity in the utilisation of this service related to ethnicity. This research presents the first national study to determine how the diverse population in England have engaged with this service. NHS Direct call data from the combined months of July, 2010 October, 2010, January 2011 and April, 2011 was analysed (N = 1,342, 245) for all 0845 4647 NHS Direct core service calls in England. Expected usage of NHS Direct was determined for each ethnic group of the population by age and gender and compared by actual usage using Chi-square analysis. A one-way analysis of variance (ANOVA) was used to determine variations of uptake by ethnic group and Index for Multiple Deprivation (IMD) 2010 rank. Results confirmed that all mixed ethnic groups (White and Black Caribbean, White and Black African, White and Asian) had a higher than expected uptake of NHS Direct which held consistent across all age groups. Lower than expected uptake was found for Black (African/Caribbean) and Asian (Bangladeshi/Indian/Chinese) ethnic group which held consistent by age and gender. For the Pakistani ethnic group usage was higher than expected in adults aged 40 years and older although was lower than expected in younger age groups (0-39). Findings support previous research suggesting a variation in usage of NHS Direct influenced by ethnicity, which is evidenced on a national level. Further research is now required to examine the underlying barriers that contribute to the ethnic variation in uptake of this service.

Medical school applicants from ethnic minority groups: identifying if and when they are disadvantaged.

PubMed Central

McManus, I. C.; Richards, P.; Winder, B. C.; Sproston, K. A.; Styles, V.

1995-01-01

OBJECTIVE--To assess whether people from ethnic minority groups are less likely to be accepted at British medical schools, and to explore the mechanisms of disadvantage. DESIGN--Prospective study of a national cohort of medical school applicants. SETTING--All 28 medical schools in the United Kingdom. SUBJECTS--6901 subjects who had applied through the Universities' Central Council on Admissions in 1990 to study medicine. MAIN OUTCOME MEASURES--Offers and acceptance at medical school by ethnic group. RESULTS--Applicants from ethnic minority groups constituted 26.3% of those applying to medical school. They were less likely to be accepted, partly because they were less well qualified and applied later. Nevertheless, taking educational and some other predictors into account, applicants from ethnic minority groups were 1.46 times (95% confidence interval 1.19 to 1.74) less likely to be accepted. Having a European surname predicted acceptance better than ethnic origin itself, implying direct discrimination rather than disadvantage secondary to other possible differences between white and non-white applicants. Applicants from ethnic minority groups fared significantly less well in 12 of the 28 British medical schools. Analysis of the selection process suggests that medical schools make fewer offers to such applicants than to others with equivalent estimated A level grades. CONCLUSIONS--People from ethnic minority groups applying to medical school are disadvantaged, principally because ethnic origin is assessed from a candidate's surname; the disadvantage has diminished since 1986. For subjects applying before A level the mechanism is that less credit is given to referees' estimates of A level grades. Selection would be fairer if (a) application forms were anonymous; (b) forms did not include estimates of A level grades; and (c) selection took place after A level results are known. PMID:7888888

One size does not fit all: an examination of low birthweight disparities among a diverse set of racial/ethnic groups.

PubMed

Johnelle Sparks, P

2009-11-01

To examine disparities in low birthweight using a diverse set of racial/ethnic categories and a nationally representative sample. This research explored the degree to which sociodemographic characteristics, health care access, maternal health status, and health behaviors influence birthweight disparities among seven racial/ethnic groups. Binary logistic regression models were estimated using a nationally representative sample of singleton, normal for gestational age births from 2001 using the ECLS-B, which has an approximate sample size of 7,800 infants. The multiple variable models examine disparities in low birthweight (LBW) for seven racial/ethnic groups, including non-Hispanic white, non-Hispanic black, U.S.-born Mexican-origin Hispanic, foreign-born Mexican-origin Hispanic, other Hispanic, Native American, and Asian mothers. Race-stratified logistic regression models were also examined. In the full sample models, only non-Hispanic black mothers have a LBW disadvantage compared to non-Hispanic white mothers. Maternal WIC usage was protective against LBW in the full models. No prenatal care and adequate plus prenatal care increase the odds of LBW. In the race-stratified models, prenatal care adequacy and high maternal health risks are the only variables that influence LBW for all racial/ethnic groups. The race-stratified models highlight the different mechanism important across the racial/ethnic groups in determining LBW. Differences in the distribution of maternal sociodemographic, health care access, health status, and behavior characteristics by race/ethnicity demonstrate that a single empirical framework may distort associations with LBW for certain racial and ethnic groups. More attention must be given to the specific mechanisms linking maternal risk factors to poor birth outcomes for specific racial/ethnic groups.

Client satisfaction with the nutrition education component of the California WIC program.

PubMed

Nestor, B; McKenzie, J; Hasan, N; AbuSabha, R; Achterberg, C

2001-01-01

Past evaluation research has documented improved nutritional outcomes resulting from participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). However, these evaluations have not examined the program from the clients' perspective, nor have they examined the independent effect of the nutrition education component. The purpose of this study was to quantitatively and qualitatively examine client satisfaction with the nutrition education component of the California WIC program. The methodology consisted of two phases. During phase I of the study (the quantitative component), participants completed Client Satisfaction Surveys immediately following attendance of one nutrition class. During phase II (the qualitative component), four focus groups were conducted. All subjects were participants in the California WIC program. Client Satisfaction Surveys were completed by 2138 participants, and the focus groups included 29 participants. Results from both phases of the study indicated that client satisfaction with the nutrition education component of the California WIC program was high. Between 80% and 95% of participants responded positively to five satisfaction questions, and focus group participants unanimously agreed that the nutrition education was an essential component of the program. Hispanic participants were more likely than non-Hispanic Caucasians, Asians, or African Americans to respond positively to three of the five satisfaction questions. For two of the questions, the frequency of positive responses increased as age increased and decreased as education level increased. A small segment of clients reported some dissatisfaction by responding negatively to one or more of the satisfaction questions (4% to 20% of respondents). Some suggestions for improvement were made by survey respondents. Identification of some WIC participants who are not completely satisfied with the nutrition education that they have received, paired with differences in satisfaction across demographic variables, suggests the need for a personalized approach to WIC nutrition education.

45 CFR 1611.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... relevant to the client's legal problem(s) and counseling the client on the relevant law and/or suggested... supported with LSC funds from a recipient. The term does not include a group, corporation or association. (d...

[Contact and admixture-the relationship between Dongxiang population and their language viewed from Y chromosomes].

PubMed

Wen, Shao-Qing; Xie, Xiao-Dong; Xu, Dan

2013-06-01

Dongxiang is one of special ethnic groups of Gansu Province. Their language is one of the Mongolian languages of Altai language family. And their origin has long been controversial. The results of Cluster analyses (multidimensional scaling analysis, dendrograms, principal component analyses, and networks) of Dongxiang population and other ethnic groups indicated that Dongxiang people is much closer to the Central Asian ethnic groups than to the other Mongolian. Admixture analyses also confirmed the result. This suggests that Dongxiang people did not descend from Mongolian, but from the Central Asian ethnic groups that have spoken Persian or Turkic language. This mismatch between paternal genetic lineage and language classification might be explained by the elite-dominance model. The ancestral populations of Dongxiang could be the Central Asian ethnic groups assimilated by Mongolian in language and culture.

Form gene clustering method about pan-ethnic-group products based on emotional semantic

NASA Astrophysics Data System (ADS)

Chen, Dengkai; Ding, Jingjing; Gao, Minzhuo; Ma, Danping; Liu, Donghui

2016-09-01

The use of pan-ethnic-group products form knowledge primarily depends on a designer's subjective experience without user participation. The majority of studies primarily focus on the detection of the perceptual demands of consumers from the target product category. A pan-ethnic-group products form gene clustering method based on emotional semantic is constructed. Consumers' perceptual images of the pan-ethnic-group products are obtained by means of product form gene extraction and coding and computer aided product form clustering technology. A case of form gene clustering about the typical pan-ethnic-group products is investigated which indicates that the method is feasible. This paper opens up a new direction for the future development of product form design which improves the agility of product design process in the era of Industry 4.0.

Discrimination attributed to mental illness or race-ethnicity by users of community psychiatric services.

PubMed

Gabbidon, Jheanell; Farrelly, Simone; Hatch, Stephani L; Henderson, Claire; Williams, Paul; Bhugra, Dinesh; Dockery, Lisa; Lassman, Francesca; Thornicroft, Graham; Clement, Sarah

2014-11-01

This study assessed participants' experienced discrimination and their causal attributions, particularly to mental illness or race-ethnicity. In a cross-sectional study, 202 service users with severe mental illnesses were interviewed to assess their reported experiences of discrimination. The Major Experiences of Discrimination Scale assessed major experiences of discrimination and their recency and frequency across 12 life domains and perceived reasons (attributions). The Everyday Experiences of Discrimination Scale assessed ten types of everyday discrimination and attributions for these experiences. Most participants (88%) reported discrimination in at least one life domain, and 94% reported ever experiencing everyday discrimination. The most common areas of major discrimination were mental health care (44%), neighbors (42%), police (33%), employment (31%), and general medical care (31%). The most common attributions for major discrimination were mental illness (57%), race-ethnicity (24%), education or income (20%), or appearance (19%). Almost half (47%) attributed experiences of major discrimination to two or more causes. No differences were found between racial-ethnic groups in overall experienced discrimination or in main attributions to mental illness. However, compared with the mixed and white groups, participants in the black group were most likely to endorse race-ethnicity as a main attribution (p<.001). Mental illness-related discrimination was found to be a common issue across racial-ethnic groups, and discrimination based on race-ethnicity was prevalent for the mixed and black groups. There is a need for antidiscrimination strategies that combine efforts to reduce the experience of discrimination attributed to mental illness and to race-ethnicity for racial-ethnic minority groups.

Ethnicity in relation to incidence of oesophageal and gastric cancer in England.

PubMed

Coupland, V H; Lagergren, J; Konfortion, J; Allum, W; Mendall, M A; Hardwick, R H; Linklater, K M; Møller, H; Jack, R H

2012-11-20

This study investigated the variation in incidence of all, and six subgroups of, oesophageal and gastric cancer between ethnic groups. Data on all oesophageal and gastric cancer patients diagnosed between 2001 and 2007 in England were analysed. Self-assigned ethnicity from the Hospital Episode Statistics dataset was used. Male and female age-standardised incidence rate ratios (IRRs) were calculated for each ethnic group, using White groups as the references. Ethnicity information was available for 83% of patients (76 130/92 205). White men had a higher incidence of oesophageal cancer, with IRR for the other ethnic groups ranging from 0.17 95% confidence interval (CI) (0.15-0.20) (Pakistani men) to 0.58 95% CI (0.50-0.67) (Black Caribbean men). Compared with White women, Bangladeshi women (IRR 2.02 (1.24-3.29)) had a higher incidence of oesophageal cancer. For gastric cancer, Black Caribbean men (1.39 (1.22-1.60)) and women (1.57 (1.28-1.92)) had a higher incidence compared with their White counterparts. In the subgroup analysis, White men had a higher incidence of lower oesophageal and gastric cardia cancer compared with the other ethnic groups studied. Bangladeshi women (3.10 (1.60-6.00)) had a higher incidence of upper and middle oesophageal cancer compared with White women. Substantial ethnic differences in the incidence of oesophageal and gastric cancer were found. Further research into differences in exposures to risk factors between ethnic groups could elucidate why the observed variation in incidence exists.

Development and validation of the client engagement and service use scale: A pilot study.

PubMed

Kline, Emily R; DeTore, Nicole R; Keefe, Kristen; Seidman, Larry J; Srihari, Vinod H; Keshavan, Matcheri S; Guyer, Margaret

2018-05-12

Specialized treatment for first episode psychosis offers clients a menu of services coordinated within a specialized treatment team. To enhance the impact of these services, promoting engagement and preventing early treatment drop-out is critical. However, engagement is poorly tracked and typically quantified through proxy variables such as session attendance, medication adherence, or working alliance. The aim of this study is to introduce and pilot a new measure of engagement for first episode psychosis coordinated specialty care, the Client Engagement and Service Use Scale (CENSUS). The CENSUS was evaluated for reliability and validated against the Service Engagement Scale and an appointment count for a small sample (N = 10) of first episode clients. The measure was also evaluated for acceptability by a consumer advocacy group. Clinicians achieved high inter-rater reliability after minimal training. CENSUS items demonstrated medium to large correlations with other measures of engagement. Feedback from the consumer group emphasized that clinicians should ask questions in a way that is nonjudgmental and successfully elicits authentic client feedback about their service preferences. This pilot study yielded preliminary evidence of reliability and validity, suggesting that the CENSUS is a useful and novel tool for tracking and differentiating degrees of client engagement across multiple intervention components and for facilitating structured discussions regarding clients' service utilization and preferences. Copyright © 2018. Published by Elsevier B.V.

Mental illness beliefs in Malaysia: ethnic and intergenerational comparisons.

PubMed

Edman, J L; Koon, T Y

2000-01-01

Two groups of college students in Malaysia, ethnic Malay and ethnic Chinese, completed a mental illness attribution and help seeking questionnaire, and these responses were also compared with the responses of their mothers. As expected, ethnic Malays rated religious items, such as God and prayer, higher than the Chinese. However, both groups rated the social and psychological causes higher than religious, supernatural or physical causes. Contrary to our predictions, there were no intergenerational differences among either ethnic group. Medical pluralism was demonstrated, as a variety of apparently contradictory help seeking behaviors received quite high ratings including doctor/pharmacy, prayer, herbal medicine and traditional healers.

Correlates and Racial/Ethnic Differences in Bareback Sex Among Men Who Have Sex with Men with Unknown or Negative HIV Serostatus.

PubMed

Vosvick, Mark; Fritz, Sarah; Henry, Doug; Prybutok, Victor; Sheu, Shane; Poe, Jonathon

2016-12-01

Men who have sex with men (MSM), particularly racial/ethnic minority MSM, are disproportionately affected by HIV in the United States and Texas. Bareback sex or condomless anal intercourse (CAI) can be a high HIV risk behavior. Despite this, a majority of MSM continues to engage in barebacking. Research suggests racial/ethnic differences in barebacking exist; however, these conclusions remain unclear due to insufficient sample sizes to compare racial/ethnic groups. Our cross-sectional correlational design explores barebacking correlates (substance use during sex, safe sex fatigue, and optimistic HIV treatment beliefs) within and between racial/ethnic groups among 366 MSM. Regression models are significant for Latino and African-American MSM alone and for all MSM combined, though not significant for European-American and Other Race/Ethnicity MSM alone. Our findings suggest motivations and behaviors underlying barebacking among MSM vary by racial/ethnic membership with clinical implications for informing culturally sensitive HIV interventions and prevention programs for target racial/ethnic groups.

Clients of female sex workers in Nyanza province, Kenya: a core group in STD/HIV transmission.

PubMed

Voeten, Helene A C M; Egesah, Omar B; Ondiege, Mark Y; Varkevisser, Corlien M; Habbema, J Dik F

2002-08-01

Commercial sex plays an important role in the spread of HIV and AIDS in Africa, especially in beginning epidemics. The goal was to study the sociodemographic characteristics and sexual risk behavior of clients of female sex workers (FSWs) in Nyanza province, Kenya. In the town of Kisumu and the rural districts Siaya and Bondo, male clients of FSWs were identified in bars, nightclubs, and lodges. An informal conversation was held with 64 clients. The majority of clients were between 25 and 36 years old, were married, and had extramarital partners in addition to FSWs. Most clients had visited several (3-5) different FSWs in the previous year, of whom at least 2 were in long-term, steady client-FSW relationships. Clients visited FSWs an average of once or twice a week. Most clients were not consistently using condoms with FSWs; the main reason given was that they "trusted" their steady FSWs. Commercial sex in Nyanza frequently involves multiple steady relationships instead of rapidly changing one-time contacts. Information, education, and communication (IEC) campaigns aimed at risk reduction in commercial sex should promote condom use in steady FSW-client relationships.

Dietary intakes of essential nutrients among Arab and Berber ethnic groups on rural Tunisian island.

PubMed

Baroudi, Thouraya; Maiz, Hedi Ben; Abid, Hafaoua Kammoun; Benammar-Elgaaied, Amel; Alouane, Leila Trabelsi

2010-01-01

The dietary intake was investigated and food sources were identified among Tunisian ethnic groups from Jerba Island in the south of Tunisia. Ninety-four subjects of moderate socioeconomic status (47 Berbers and 47 Arabs) aged 32 to 64 y completed a 1-mo qualitative food-frequency questionnaire and a single 24-h dietary recall, and dietary intakes and demographic status were observed from 2006 to 2007. The prevalence of overweight and obesity was not significantly associated with Arab men compared with Berber men. Therefore, obesity was significantly associated with Berber women (P<0.001). Height was significantly different between Arab and Berber women (P<0.001). There were no significant differences in energy intake between men and women. Protein intake was not significantly different between ethnic groups. Milk and dairy products in the Berber group were significantly different from the Arab group. Intakes of calcium, zinc, iron, and folate were below recommended nutrient intakes in men and women in the two ethnic groups. Vitamin E intake was greater in Berbers than in Arabs (P<0.01). Ethnicity was significantly associated with dietary intakes in the two ethnic groups of Jerba Island.

The structure of ethnic attitudes: the effects of target group, region, gender, and national identity.

PubMed

Verkuyten, M

1997-08-01

The present study was an assessment of attitudes of 410 ethnically Dutch adolescents toward three ethnic minority groups living in the Netherlands. Stereotypes, symbolic beliefs, affective associations, and the evaluation of possible interactions were used to predict the global evaluation of ethnic outgroups and accounted for much of the variance in ethnic attitudes. The relative importance of the four predictors varied by target group and location. Gender differences were found in the structure of attitudes; symbolic beliefs played a greater role in the attitudes of boys, whereas emotions played a more central role in the attitudes of girls. The evaluation of Dutch identity was related to the favorability of ethnic attitudes and also to the underlying structure. Respondents with a positive national identity had less favorable ethnic attitudes, and emotions were more predictive of their attitudes, whereas symbolic beliefs were most predictive among respondents with a less positive national identity.

Comparing the Ethnic Identity and Well-Being of Adopted Korean Americans with Immigrant/U.S.-Born Korean Americans and Korean International Students

PubMed Central

Lee, Richard M.; Yun, Andrea Bora; Yoo, Hyung Chol; Nelson, Kim Park

2010-01-01

This study compared the ethnic identity and well-being of Korean Americans who were adopted internationally with immigrant/U.S.-born Korean Americans and Korean international students, as well as the relationship between ethnic identity and well-being for each group. One-hundred and seven college students completed measures of ethnic identity and subjective well-being. Immigrant/U.S.-born Korean Americans had higher ethnic identity scores than the other two groups. Immigrant/U.S.-born Korean Americans also had higher positive affect scores than international students. Ethnic identity was positively correlated with positive affect for all three groups (r’s = .27 – .34), but was negatively correlated with negative affect for international students (r = −.44). Overall, the results suggest that ethnic identity, although slightly lower than non-adopted peers, is relevant to the well-being of adopted Korean American college students. PMID:20694190

Habitat Variability and Ethnic Diversity in Northern Tibetan Plateau.

PubMed

Jia, Xin; Lee, Harry F; Cui, Mengchun; Liu, Chao; Zeng, Lin; Yue, Ricci P H; Zhao, Yang; Lu, Huayu

2017-04-20

There are 56 officially-recognized ethnic groups in China. However, the distinct geographic patterns of various ethnic groups in relation to the physical environment in China have rarely been investigated. Based on the geo-referenced physical environmental parameters of 455 Han, Tu, Hui, Salar, Mongolian, and Tibetan communities in Qinghai, we found that the communities could be statistically demarcated by temperature and aridity threshold according to their ethnicity, implying that the geographic distribution of each ethnic group is mediated by the physical environment. We also observed that the habitat of each ethnic group is ecologically compatible with current subsistence strategies. Tibetans settle in cold and humid high-altitude regions owing to the cultivation of highland barley and the breeding of yak, dzo, Tibetan sheep and Tibetan goat. Mongolians survive by animal husbandry in cold and dry grassland areas. Han and Tu people settle in the Huangshui River Valley, which offers relatively humid climate and flat land for agriculture. Hui and Salar people occupy the Yellow River Valley with its relatively arid environment and grassland vegetation suitable for animal breeding. Our findings offer a new perspective in explaining the geographic patterns and the varieties of ethnic groups in China and elsewhere.

The Role of Ethnic and National Identifications in Perceived Discrimination for Asian Americans: Toward a Better Understanding of the Buffering Effect of Group Identifications on Psychological Distress

PubMed Central

Huynh, Que-Lam; Devos, Thierry; Goldberg, Robyn

2013-01-01

A robust relationship between perceived racial discrimination and psychological distress has been established. Yet, mixed evidence exists regarding the extent to which ethnic identification moderates this relationship, and scarce attention has been paid to the moderating role of national identification. We propose that the role of group identifications in the perceived discrimination–psychological distress relationship is best understood by simultaneously and interactively considering ethnic and national identifications. A sample of 259 Asian American students completed measures of perceived discrimination, group identifications (specific ethnic identification stated by respondents and national or “mainstream American” identification), and psychological distress (anxiety and depression symptoms). Regression analyses revealed a significant three-way interaction of perceived discrimination, ethnic identification, and national identification on psychological distress. Simple-slope analyses indicated that dual identification (strong ethnic and national identifications) was linked to a weaker relationship between perceived discrimination and psychological distress compared with other group identification configurations. These findings underscore the need to consider the interconnections between ethnic and national identifications to better understand the circumstances under which group identifications are likely to buffer individuals against the adverse effects of racial discrimination. PMID:25258674

Child mental health differences amongst ethnic groups in Britain: a systematic review

PubMed Central

Goodman, Anna; Patel, Vikram; Leon, David A

2008-01-01

Background Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use. Methods A systematic search of bibliographic databases for population-based and clinic-based studies of children aged 0–19, including all ethnic groups and the main child mental disorders. We synthesised findings by comparing each minority group to the White British study sample. Results 31 population-based and 18 clinic-based studies met the inclusion criteria. Children in the main minority groups have similar or better mental health than White British children for common disorders, but may have higher rates for some less common conditions. The causes of these differences are unclear. There may be unmet need for services among Pakistani and Bangladeshi children. Conclusion Inter-ethnic differences exist but are largely unexplained. Future studies should address the challenges of cross-cultural psychiatry and investigate reasons for inter-ethnic differences. PMID:18655701

The Ethnic Identity, Other-Group Attitudes, and Psychosocial Functioning of Asian American Emerging Adults from Two Contexts

ERIC Educational Resources Information Center

Juang, Linda P.; Nguyen, Huong H.; Lin, Yunghui

2006-01-01

Drawing from two samples of Asian American emerging adults, one in an ethnically concentrated context (n = 108) and the other in an ethnically-dispersed, mainly White context (n = 153), we examined (a) how ethnic identity and other-group attitudes were related to psychosocial functioning (i.e., depression, self-esteem, and connectedness to…

An Institutional Assessment of Ethnic Conflict in China

DTIC Science & Technology

2008-12-01

from minority groups is forecasted under the institutional theory of ethnic conflict. Institutional theorists assert that when minorities are...outcome however, does align with the predictions made under an institutional theory of ethnic conflict. Two, during the Great Leap Forward and Cultural...intended. However, this exact response from minority groups is forecasted under the institutional theory of ethnic conflict. Institutional theorists

Ethnic Background and Genetic Variation in the Evaluation of Cancer Risk: A Systematic Review

PubMed Central

Jing, Lijun; Su, Li; Ring, Brian Z.

2014-01-01

The clinical use of genetic variation in the evaluation of cancer risk is expanding, and thus understanding how determinants of cancer susceptibility identified in one population can be applied to another is of growing importance. However there is considerable debate on the relevance of ethnic background in clinical genetics, reflecting both the significance and complexity of genetic heritage. We address this via a systematic review of reported associations with cancer risk for 82 markers in 68 studies across six different cancer types, comparing association results between ethnic groups and examining linkage disequilibrium between risk alleles and nearby genetic loci. We find that the relevance of ethnic background depends on the question. If asked whether the association of variants with disease risk is conserved across ethnic boundaries, we find that the answer is yes, the majority of markers show insignificant variability in association with cancer risk across ethnic groups. However if the question is whether a significant association between a variant and cancer risk is likely to reproduce, the answer is no, most markers do not validate in an ethnic group other than the discovery cohort’s ancestry. This lack of reproducibility is not attributable to studies being inadequately populated due to low allele frequency in other ethnic groups. Instead, differences in local genomic structure between ethnic groups are associated with the strength of association with cancer risk and therefore confound interpretation of the implied physiologic association tracked by the disease allele. This suggest that a biological association for cancer risk alleles may be broadly consistent across ethnic boundaries, but reproduction of a clinical study in another ethnic group is uncommon, in part due to confounding genomic architecture. As clinical studies are increasingly performed globally this has important implications for how cancer risk stratifiers should be studied and employed. PMID:24901479

Profession, market and class: nurse migration and the remaking of division and disadvantage.

PubMed

Smith, Pam; Mackintosh, Maureen

2007-12-01

This article aims to analyse the part played by successive waves of nurse migration in changing patterns of division and disadvantage within nursing. We argue that migration has in part acted to reinforce disadvantage based on class and gender, race and ethnicity and identify the influence of changes in nursing structure and commercialization of care in these processes. BACKGROUND, DESIGN AND METHODS: The historical analysis of division within nursing and the impact of migration are based on secondary sources (literature review) and primary research undertaken by ourselves and colleagues. The paper develops a concept of 'remaking' disadvantage drawing on analysis in social history of the interplay between agency and economic position in the 'making' of class. It uses the extended case method to focus on the residential care sector, showing how global and national influences operate at the frontline of service delivery. We show how social class and gender, race and ethnicity have interacted and are reflected in the division of labour within nursing. We demonstrate how the employment conditions of nurse migrants have reinforced patterns of disadvantage. The case study of the residential care home sector deepens our analysis of intersecting sources of professional disadvantage including aspects of commercialization, in a sector where they have severe effects for vulnerable staff and patients. In the UK, migrant professional nurses have repeatedly acted both as a highly valued labour force on whom patients and clients rely and as involuntary contributors to remaking disadvantage. This situation is sustained by the current international labour market and rising commercialization which facilitate nurse migration and the segmentation of care work based on a 'pecking order' of specialties that reinforce existing divisions of social class, gender and race within nursing. Migrant nurses play a key role in the delivery of 'frontline' care to patients. The role many currently play reinforces disadvantage within nursing in ways that are problematic for the profession, patients and clients. The recognition and valuing of their skills is critical to the promotion of their own morale which in turn has an impact on their relationship with colleagues and the delivery of patient and client care.

Increasing chlamydia test of re-infection rates using SMS reminders and incentives.

PubMed

Downing, Sandra Gaye; Cashman, Colette; McNamee, Heather; Penney, Debbie; Russell, Darren B; Hellard, Margaret E

2013-02-01

Clients diagnosed and treated for Chlamydia trachomatis are a recognised high-risk group for subsequent infection. An estimated 8% of clients treated for chlamydia at Cairns Sexual Health Service return for re-testing within the recommended 3-4-month period. There is no recall or reminder system in place. This study assesses the effectiveness of using short messaging service (SMS) reminders with and without incentive payments to increase re-testing rates. Eligible consenting clients were randomly allocated to one of three groups. Group 1 (controls) received the standard advice from the clinician to return for re-testing in 3-4 months. Group 2 received the standard advice and an SMS reminder at 10-12 weeks post-treatment. Group 3 received the standard advice and the SMS reminder, which also offered an incentive payment on clinic attendance. 32 participants were recruited to groups 1 and 2 and 30 participants to group 3. 62 SMS reminders were sent with 13 (21.0%) reported as undelivered. Re-testing rates were 6.3%, 28.1% and 26.7% for groups 1, 2 and 3, respectively. SMS reminders with or without an incentive payment increased re-testing rates in our clients who were diagnosed and treated for chlamydia. However, re-testing remained less than ideal, and the high rate of undelivered SMS reminders suggest that this intervention alone will not achieve desired re-testing rates and that a range of strategies will be required to increase re-testing in this population.

Ethnic Group Bias in Intelligence Test Items.

ERIC Educational Resources Information Center

Scheuneman, Janice

In previous studies of ethnic group bias in intelligence test items, the question of bias has been confounded with ability differences between the ethnic group samples compared. The present study is based on a conditional probability model in which an unbiased item is defined as one where the probability of a correct response to an item is the…

Ethnic Conflicts in Schools. Multicultural Issues.

ERIC Educational Resources Information Center

Banfield, Susan

This book for young readers explores ethnic conflict in the schools. Public schools in the United States are among some of the places where members of a country's different ethnic and racial groups are brought together and required to work together more closely. A racial group is a group of people who share certain physical traits and often share…

Status and Trends in the Education of Racial and Ethnic Groups 2017. NCES 2017-051

ERIC Educational Resources Information Center

Musu-Gillette, Lauren; de Brey, Cristobal; McFarland, Joel; Hussar, William; Sonnenberg, William; Wilkinson-Flicker, Sidney

2017-01-01

This report uses statistics to examine current conditions and changes over time in education activities and outcomes for different racial/ethnic groups in the United States. This report shows that over time, students in the racial/ethnic groups of White, Black, Hispanic, Asian, Native Hawaiian or Other Pacific Islander, American Indian/Alaska…

Ethnic variations in parental ethnic socialization and adolescent ethnic identity: a longitudinal study.

PubMed

Else-Quest, Nicole M; Morse, Emily

2015-01-01

Achievement of a positive ethnic identity has been linked to positive outcomes for ethnic minority youth and is fostered by parental ethnic socialization practices. In light of findings of variability in developmental trajectories and outcomes, we examined ethnic group variations in parents' ethnic socialization practices and adolescents' ethnic identity. Within a sample of 370 adolescents who self-identified as White, African American, Latino/a, or Asian American, and their parents, parental ethnic socialization practices (including preparation for bias, promotion of mistrust, and cultural socialization) and adolescent ethnic identity development (including identity exploration and commitment) were assessed at 10th and 11th grades. Consistent with predictions, African American youth reported higher levels of ethnic identity exploration and commitment than youth from other ethnic groups, and parents of African American youth tended to report higher levels of ethnic socialization than other parents. Parental cultural socialization significantly predicted adolescent ethnic identity exploration and commitment 1 year later; ethnicity did not moderate this link. Findings are discussed in the context of the schools and urban community from which the sample was recruited, highlighting the importance of sociocultural context in development. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

"Conical Hut": A Basic Form of House Types in Timor Island

NASA Astrophysics Data System (ADS)

Chen, Y. R.; Lim, Y. L.; Wang, M. H.; Chen, C. Y.

2015-08-01

Timor Island situates in the southeast end of Southeast Asia. The island accommodates many ethnic groups, which produce many diverse house types. As visiting East Timor in 2012 and Timor Island in 2014, we found the "Pair- House Type" widely spread over Timor Island. Uma Lulik (holy house), accommodating the ancestry soul, fireplace and elder's bed, and Uma Tidor (house for sleep), containing living, sleeping and working space, compose the pair-house. The research team visited 14 ethnic groups and their houses, some of which were measured and drawn into 3D models as back to Taiwan. Uma Tidors of each ethnic group are quite similar with rectangular volume and hip roof, however, one of the fourteen ethnic groups can build cylinder houses for Uma Tidor. Uma Luliks of different ethnic groups are diversified and special. One group of the Uma Luliks shows a rectangular or square volume sheltered by a hip roof. The other group of Uma Luliks presents a non-specific volume under a conical roof, that we called the "conical hut". Seven ethnic groups, Atoni, Weimua, Makassae, Mambai, Bunaq, Kemak and Bekais, have built "conical huts" for the use of Uma Lulik. People of the seven ethnic groups can construct a reasonable structural system to support the conical roof, and take good advantage of the space under the conical roof to meet their sacred needs and everyday life. "Conical Hut" may be regarded as the basic form of the house types adopted by the seven ethnic groups. It contains the basic spatial limits and the formal properties that the construction systems have to follow. Based on the concise rules of the basic form, people of each ethnic group use their talents, skills and building materials to generate variations of "conical hut", which are different in house scale, spatial layout, construction system and form. The "conical huts" contain the consistency that all the huts come from the basic form, meanwhile, they also present the diversification that each conical hut has differed. "Consistent but diversified", is one of the most interesting issues in typological study that we can observe in Timorese houses.

Conceptions of learning and approaches to studying among White and ethnic minority students in distance education.

PubMed

Richardson, John T E

2010-12-01

The attainment of White students at UK institutions of higher education tends to be higher than that of students from other ethnic groups, but the causes of this are unclear. This study compared White students and students from other ethnic groups in their conceptions of learning, their approaches to studying, and their academic attainment. A stratified sample of 1,146 White students and 1,146 students from other ethnic groups taking courses by distance learning with the UK Open University. The Mental Models section of the Inventory of Learning Styles and the Revised Approaches to Studying Inventory were administered in a postal survey. The students' questionnaire scores were contaminated by response bias, which varied across different ethnic groups. When adjusted to control for response bias, the scores on the two questionnaires shared 37.2% of their variance and made a significant contribution to predicting the students' attainment. White students were more likely to exhibit a meaning-directed learning pattern, whereas Asian and Black students were more likely to exhibit a reproduction-directed learning pattern. However, the variation in attainment across different ethnic groups remained significant when their questionnaire scores and prior qualifications were taken into account. There is a strong relationship between students' conceptions of learning and their approaches to studying, and variations in conceptions of learning in different ethnic groups give rise to variations in approaches to studying. However, factors other than prior qualifications and conceptions of learning are responsible for variation in attainment across different ethnic groups.

Ethnic Variations of Trajectories in Suicide Ideation and Attempt: From Middle School to High School.

PubMed

Kim, Jahun; Pike, Kenneth; McCauley, Elizabeth; Vander Stoep, Ann

2018-02-14

The purpose of this study was to compare patterns of suicide ideation and suicide attempt in three ethnic groups. We analyzed data from 463 students with ethnic backgrounds of African American (AA), Asian American (ASA), and European American (EA) for 6 years. The best fit model was a three-trajectory class model for all groups. The majority of adolescents belonged in the nonideators trajectory. The high level of ideation was found in the high ideators (4%), high-fluctuating ideators (8%), and high-decreasing ideators (4%) trajectory in AA, ASA, and EA, respectively. In the AA group, being a member of ideators was not a significant predictor of suicide attempt. In the ASA group, being a member of high-fluctuating ideators was a significant predictor. In the EA group, being a member of both ideators predicted suicide attempt. The timing of onset, patterns of change, and peak time in the ideators trajectories in the three ethnic groups were markedly different. The high level of attempts found in the ASA-AA group was not explained by having suicide ideation. Findings suggest the need for in-depth examination of suicide behaviors across ethnic groups and culturally adapted preventive efforts with distinct developmental timing for adolescents from different ethnic backgrounds. © 2018 The American Association of Suicidology.

Health care spending and utilization by race/ethnicity under the Affordable Care Act's dependent coverage expansion.

PubMed

Chen, Jie; Bustamante, Arturo Vargas; Tom, Sarah E

2015-07-01

We estimated the effect of the ACA expansion of dependents' coverage on health care expenditures and utilization for young adults by race/ethnicity. We used difference-in-difference models to estimate the impact of the ACA expansion on health care expenditures, out-of-pocket payments (OOP) as a share of total health care expenditure, and utilization among young adults aged 19 to 26 years by race/ethnicity (White, African American, Latino, and other racial/ethnic groups), with adults aged 27 to 30 years as the control group. In 2011 and 2012, White and African American young adults aged 19 to 26 years had significantly lower total health care spending compared with the 27 to 30 years cohort. OOP, as a share of health care expenditure, remained the same after the ACA expansion for all race/ethnicity groups. Changes in utilization following the ACA expansion among all racial/ethnic groups for those aged 19 to 26 years were not significant. Our study showed that the impact of the ACA expansion on health care expenditures differed by race/ethnicity.

Review: Prevalence and co-occurrence of addictions in US ethnic/racial groups: Implications for genetic research.

PubMed

Luczak, Susan E; Khoddam, Rubin; Yu, Sheila; Wall, Tamara L; Schwartz, Anna; Sussman, Steve

2017-08-01

We conducted a review of the prevalence and co-occurrence of 12 types of addictions in US ethnic/racial groups and discuss the implications of the results for genetic research on addictions. We utilized MEDLINE and PsycINFO databases to review the literature on alcohol, tobacco, marijuana, illicit drugs, gambling, eating/food, internet, sex, love, exercise, work, and shopping. We present results for each addiction based on total US prevalence, prevalence within ethnic groups, and co-occurrence of addictions among ethnic groups when available. This review indicates very little research has examined the interrelationships of addictive behaviors among US ethnic groups. The studies that exist have focused nearly exclusively on comorbidity of substances and gambling behaviors. Overall findings suggest differences among US ethnic groups in prevalence of addictions and in prevalence of addiction among those who use substances or engage in gambling. Almost no ethnic group comparisons of other addictive behaviors including eating/food, internet, love, sex, exercise, work, and shopping were identified in the literature. Despite large-scale research efforts to examine alcohol and substance use disorders in the United States, few studies have been published that examine these addictive behaviors among ethnic groups, and even fewer examine co-occurrence and comorbidity with other addictions. Even with the limited studies, these findings have implications for genetic research on addictive behaviors. We include a discussion of these implications, including issues of population stratification, disaggregation, admixture, and the interplay between genetic and environmental factors in understanding the etiology and treatment of addictions. (Am J Addict 2017;26:424-436). © 2016 American Academy of Addiction Psychiatry.

Race-ethnicity and gender differences in VA health care service utilization among U.S. veterans of recent conflicts.

PubMed

Koo, Kelly H; Madden, Erin; Maguen, Shira

2015-05-01

The purpose of this study was to compare health care utilization patterns by race-ethnicity and gender among veterans returning from Iraq and Afghanistan. A retrospective analysis was conducted with records from U.S. service members and veterans returning from Iraq and Afghanistan who enrolled in health care through the Veterans Health Administration, who received a psychiatric diagnosis, and who had used primary or mental health outpatient care between October 7, 2001, and December 31, 2012 (N=309,050). Racial-ethnic minority groups were first collapsed together and compared with whites and then separated by racial-ethnic group. Gender was also tested as a moderator of utilization. Although rates of mental health outpatient care, primary care, and emergency service utilization were relatively similar for racial-ethnic minority groups and whites, minority groups were admitted to psychiatric inpatient care at lower rates than whites. When veterans were separately categorized by specific racial-ethnic groups, some differences in utilization rates emerged; most notably, only black and Hispanic men were admitted less frequently to psychiatric inpatient care, and male and female Asian/Pacific Islander veterans used emergency services less, than their white counterparts. Gender moderated the association between race-ethnicity and mental health outpatient use, such that American Indian and Hispanic women used mental health outpatient services less than white women, but American Indian and Hispanic men showed the opposite pattern. Furthermore, black men were more likely than white men to use mental health outpatient services, but there was no difference between these women. Although service utilization rates between minority groups and whites were similar when minority groups were combined, examination of utilization by racial-ethnic groups and by men and women separately yielded more robust findings.

Insufficient evidence to support separate BMI definitions for obesity in children and adolescents from south Asian ethnic groups in the UK.

PubMed

Viner, R M; Cole, Tim J; Fry, T; Gupta, S; Kinra, S; McCarthy, D; Saxena, S; Taylor, S; Wells, J C K; Whincup, P; Zaman, M J S

2010-04-01

Re-evaluation of adult obesity thresholds in some ethnic groups has led to the questioning of childhood obesity thresholds. An expert group was convened to examine the representativeness of childhood obesity definitions, evidence for ethnic differences in body composition in UK children and the extent of misclassification of adiposity by current body mass index (BMI) thresholds in south Asian and black groups. The group concluded that the current International Obesity Task Force (IOTF) definitions remained the most appropriate for use in the United Kingdom, but further research was needed on the relationship of body shape, fat mass, metabolic markers and ethnicity in children and adolescents.

Ethnicity, Forms of Capital, and Educational Achievement

NASA Astrophysics Data System (ADS)

Driessen, Geert W. J. M.

2001-11-01

Bourdieu's cultural capital thesis is an attempt to explain how social class influences the transmission of educational inequality. In this article, the question of the extent to which various forms of capital also apply to ethnic minorities stands central. On the basis of Dutch and American research findings, a model is formulated and empirically tested with the aid of data from the Dutch Primary Education cohort study. Students from four ethnic groups are included: Dutch, Surinamese, Turkish, and Moroccan. The main variables are language and math test scores, socio-economic milieu, and a number of capital indicators, including financial resources, linguistic resources, parental reading behavior, and educational resources within the family. The results show no mediating effect of resources within the various ethnic groups. The findings also suggest that in research and practice it is relevant to not treat ethnic groups as one homogenous group, but to differentiate between the various groups.

Occupational therapists' perceptions of gender - a focus group study.

PubMed

Liedberg, Gunilla M; Björk, Mathilda; Hensing, Gunnel

2010-10-01

Women and men are shaped over the courses of their lives by culture, society and human interaction according to the gender system. Cultural influences on individuals' social roles and environment are described in occupational therapy literature, but not specifically from a gender perspective. The purpose of this qualitative study was to explore how a sample of occupational therapists perceives the 'gender' concept. Four focus group interviews with 17 occupational therapists were conducted. The opening question was: 'How do you reflect on the encounter with a client depending on whether it is a man or a woman?' The transcribed interviews were analysed and two main themes emerged: 'the concept of gender is tacit in occupational therapy' and 'client encounters'. The occupational therapists expressed limited theoretical knowledge of 'gender'. Furthermore, the occupational therapists seemed to be 'doing gender' in their encounters with the clients. For example, in their assessment of the client, they focussed their questions on different spheres: with female clients, on the household and family; with male clients, on their paid work. This study demonstrated that occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. There is a need to increase occupational therapists' awareness of their own behaviour of 'doing gender'. Furthermore, there is a need to investigate whether gendered perceptions will shorten or lengthen a rehabilitation period and affect the chosen interventions, and in the end, the outcome for the clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

UK ethnicity data collection for healthcare statistics: the South Asian perspective.

PubMed

Iqbal, Gulnaz; Johnson, Mark Rd; Szczepura, Ala; Wilson, Sue; Gumber, Anil; Dunn, Janet A

2012-03-27

Ethnicity data collection has been proven to be important in health care but despite government initiatives remains incomplete and mostly un-validated in the UK. Accurate self-reported ethnicity data would enable experts to assess inequalities in health and access to services and help to ensure resources are targeted appropriately. The aim of this paper is to explore the reasons for the observed gap in ethnicity data by examining the perceptions and experiences of healthy South Asian volunteers. South Asians are the largest ethnic minority group accounting for 50% of all ethnic minorities in the UK 2001 census. Five focus groups, conducted by trained facilitators in the native language of each group, recruited 36 South Asian volunteers from local community centres and places of worship. The topic guide focused on five key areas:1) general opinions on the collection of ethnicity, 2) experiences of providing ethnicity information, 3) categories used in practice, 4) opinions of other indicators of ethnicity e.g. language, religion and culture and 5) views on how should this information be collected. The translated transcripts were analysed using a qualitative thematic approach. The findings of this Cancer Research UK commissioned study revealed that participants felt that accurate recording of ethnicity data was important in healthcare with several stating the increased prevalence of certain diseases in minority ethnic groups as an appropriate justification to improve this data. The overwhelming majority raised no objections to providing this data when the purpose of data collection is fully explained. This study confirmed that the collection of patients' ethnicity data is deemed important by potential patients but there remains uncertainty and unease as to how the data may be used. A common theme running through the focus groups was the willingness to provide these data, strongly accompanied by a desire to have more information with regard to its use.

Policy for home or hospice as the preferred place of death from cancer: Scottish Health and Ethnicity Linkage Study population cohort shows challenges across all ethnic groups in Scotland.

PubMed

Sharpe, Katharine H; Cezard, Genevieve; Bansal, Narinder; Bhopal, Raj S; Brewster, David H

2015-12-01

Place of cancer death varies ethnically and internationally. Palliative care reviews highlight limited ability to demonstrate equal access due to incomplete or unreliable ethnicity data. To establish place of cancer death by ethnicity and describe patient characteristics. We linked census, hospital episode and mortality data for 117 467 persons dying of cancer, 2001-2009. With White Scottish population as reference, prevalence ratios (PR), 95% CIs and p values of death in hospital, home or hospice adjusted for sex and age were calculated by ethnic group. White Scottish group and minority ethnic groups combined constituted 91% and 0.4% of cancer deaths, respectively. South Asian, Chinese and African Origin patients were youngest at death (66, 66 and 65.9 years). Compared with the Scottish White reference, the White Irish (1.15 (1.10 to 1.22), p<0.0001) and Other White British (1.07 (1.02 to 1.12), p=0.003) groups were more likely to die at home. Generally, affluent Scottish White patients were less likely to die in hospital and more likely to die at home or in a hospice regardless of socioeconomic indicator used. Cancer deaths occur most often in hospital (52.3%) for all ethnic groups. Regardless of the socioeconomic indicator used, more affluent Scottish White patients were less likely to die in hospital; existing socioeconomic indicators detected no clear trend for the non-White population. Regardless of ethnic group, significant work is required to achieve more people dying at home or the setting of their choice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Experiencing maternity care: the care received and perceptions of women from different ethnic groups

PubMed Central

2013-01-01

Background According to the Office for National Statistics, approximately a quarter of women giving birth in England and Wales are from minority ethnic groups. Previous work has indicated that these women have poorer pregnancy outcomes than White women and poorer experience of maternity care, sometimes encountering stereotyping and racism. The aims of this study were to examine service use and perceptions of care in ethnic minority women from different groups compared to White women. Methods Secondary analysis of data from a survey of women in 2010 was undertaken. The questionnaire asked about women’s experience of care during pregnancy, labour and birth, and the postnatal period, as well as demographic factors. Ethnicity was grouped into eight categories: White, Mixed, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, and Other ethnicity. Results A total of 24,319 women completed the survey. Compared to White women, women from minority ethnic groups were more likely to be younger, multiparous and without a partner. They tended to access antenatal care later in pregnancy, have fewer antenatal checks, fewer ultrasound scans and less screening. They were less likely to receive pain relief in labour and, Black African women in particular, were more likely to deliver by emergency caesarean section. Postnatally, women from minority ethnic groups had longer lengths of hospital stay and were more likely to breastfeed but they had fewer home visits from midwives. Throughout their maternity care, women from minority ethnic groups were less likely to feel spoken to so they could understand, to be treated with kindness, to be sufficiently involved in decisions and to have confidence and trust in the staff. Conclusion Women in all minority ethnic groups had a poorer experience of maternity services than White women. That this was still the case following publication of a number of national policy documents and local initiatives is a cause for concern. PMID:24148317

Experiencing maternity care: the care received and perceptions of women from different ethnic groups.

PubMed

Henderson, Jane; Gao, Haiyan; Redshaw, Maggie

2013-10-22

According to the Office for National Statistics, approximately a quarter of women giving birth in England and Wales are from minority ethnic groups. Previous work has indicated that these women have poorer pregnancy outcomes than White women and poorer experience of maternity care, sometimes encountering stereotyping and racism. The aims of this study were to examine service use and perceptions of care in ethnic minority women from different groups compared to White women. Secondary analysis of data from a survey of women in 2010 was undertaken. The questionnaire asked about women's experience of care during pregnancy, labour and birth, and the postnatal period, as well as demographic factors. Ethnicity was grouped into eight categories: White, Mixed, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African, and Other ethnicity. A total of 24,319 women completed the survey. Compared to White women, women from minority ethnic groups were more likely to be younger, multiparous and without a partner. They tended to access antenatal care later in pregnancy, have fewer antenatal checks, fewer ultrasound scans and less screening. They were less likely to receive pain relief in labour and, Black African women in particular, were more likely to deliver by emergency caesarean section. Postnatally, women from minority ethnic groups had longer lengths of hospital stay and were more likely to breastfeed but they had fewer home visits from midwives. Throughout their maternity care, women from minority ethnic groups were less likely to feel spoken to so they could understand, to be treated with kindness, to be sufficiently involved in decisions and to have confidence and trust in the staff. Women in all minority ethnic groups had a poorer experience of maternity services than White women. That this was still the case following publication of a number of national policy documents and local initiatives is a cause for concern.

Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists' Observable Behaviors.

PubMed

Sotero, Luciana; Cunha, Diana; da Silva, José Tomás; Escudero, Valentín; Relvas, Ana Paula

2017-12-01

This study aimed to compare therapists' observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists' contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients' engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists' alliance-building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research. © 2016 Family Process Institute.

What health domains and items are important to patients with knee osteoarthritis? A focus group study in a multiethnic urban Asian population.

PubMed

Xie, F; Li, S-C; Fong, K-Y; Lo, N-N; Yeo, S-J; Yang, K-Y; Thumboo, J

2006-03-01

To determine important health-related quality of life (HRQoL) domains and items within each domain affected by knee osteoarthritis (OA), identify ethnic variations in the importance of these domains and items among three ethnic groups, and determine how identified domains and items mapped onto selected OA-specific HRQoL instruments. Focus groups were conducted among subjects with knee OA stratified by gender, ethnicity, and language spoken. All focus groups were audio-taped and transcribed verbatim, with subsequent translation into English for groups conducted in other languages. Data analysis was performed by combining the key elements of grounded theory and content analysis with the assistance of the qualitative software ATLAS/ti 5.0. Five domains (pain, physical disability, other symptoms of OA, mental health, and social health) were identified from the 74 items reported as important by at least one subject. These domains were important for subjects from all ethnic groups with the exception of social health, which was more often important for Malay subjects. Items more commonly reported as important in the pain, physical disability, and other symptoms of OA domains were generally similar across ethnic groups. In contrast, important items in the mental and social health domains differed among ethnic groups. The impact of knee OA on HRQoL is broadly similar in both Asian and Western socio-cultural contexts. Both similarities and differences in important domains and items were identified among subjects with knee OA from three major Asian ethnic groups.

Perceived Ethnic Discrimination by Teachers and Ethnic Minority Students' Academic Futility: Can Parents Prepare Their Youth for Better or for Worse?

PubMed

D'hondt, Fanny; Eccles, Jacquelynne S; Van Houtte, Mieke; Stevens, Peter A J

2016-06-01

This study focuses on the interplay of perceived ethnic discrimination by teachers, parents' ethnic socialization practices, and ethnic minority students' sense of academic futility. Since discrimination creates barriers beyond control of the individual, the first research goal is to examine the association of perceived ethnic discrimination by teachers with ethnic minority students' sense of academic futility. The second research goal is to focus on the role of perceived parental ethnic socialization (e.g., cultural socialization and preparation for bias) to get a better understanding of the interaction between family level factors and the potentially negative consequences of ethnic teacher discrimination. A multilevel analysis on 1181 ethnic minority students (50.6 % girls; mean age = 15.5), originating from migration, in 53 secondary schools in Flanders (Belgium) shows that the frequent perception of ethnic discrimination by teachers is associated with stronger feelings of academic futility, and if these students also received high levels of parents' ethnic socialization, they perceive even stronger feelings of futility. The group of ethnic minority students, who perceive frequent ethnic teacher discrimination, is a group at risk, and parents' ethnic socialization does not seem able to change this.

The Levels of Speech Usage rating scale: comparison of client self-ratings with speech pathologist ratings.

PubMed

Gray, Christina; Baylor, Carolyn; Eadie, Tanya; Kendall, Diane; Yorkston, Kathryn

2012-01-01

The term 'speech usage' refers to what people want or need to do with their speech to fulfil the communication demands in their life roles. Speech-language pathologists (SLPs) need to know about clients' speech usage to plan appropriate interventions to meet their life participation goals. The Levels of Speech Usage is a categorical scale intended for client self-report of speech usage, but SLPs may want the option to use it as a proxy-report tool. The relationship between self-report and clinician ratings should be examined before the instrument is used in a proxy format. The primary purpose of this study was to compare client self-ratings with SLP ratings on the Levels of Speech Usage scale. The secondary purpose was to determine if the SLP ratings differed depending on whether or not the SLPs knew about the clients' medical condition. Self-ratings of adults with communication disorders on the Levels of Speech Usage scale were available from prior research. Vignettes about these individuals were created from existing data. Two sets of vignettes were created. One set contained information about demographic information, living situation, occupational status and hobbies or social activities. The second set was identical to the first with the addition of information about the clients' medical conditions and communication disorders. Various communication disorders were represented including dysarthria, voice disorders, laryngectomy, and mild cognitive and language disorders. Sixty SLPs were randomly divided into two groups with each group rating one set of vignettes. The task was completed online. While this does not replicate typical in-person clinical interactions, it was a feasible method for this study. For data analysis, the client self-ratings were considered fixed points and the percentage of SLP ratings in agreement with the self-ratings was calculated. The percentage of SLP ratings in exact agreement with client self-ratings was 44.9%. Agreement was lowest for the less-demanding speech usage categories and highest for the most demanding usage category. There was no significant difference between the two groups of SLPs based on knowledge of medical condition. SLPs often need to document the speech usage levels of clients. This study suggests the potential for SLPs to misjudge how clients see their own speech demands. Further research is needed to determine if similar results would be found in actual clinical interactions. Until then, SLPs should seek the input of their clients when using this instrument. © 2012 Royal College of Speech and Language Therapists.

Ethnic disparities in educational and occupational gradients of estimated cardiovascular disease risk: The Healthy Life in an Urban Setting study.

PubMed

Perini, Wilco; Agyemang, Charles; Snijder, Marieke B; Peters, Ron J G; Kunst, Anton E

2018-03-01

European societies are becoming increasingly ethnically diverse. This may have important implications for socio-economic inequalities in health due to the often disadvantaged position of ethnic minority groups in both socio-economic status (SES) and disease, especially cardiovascular disease (CVD). The aim of this study was to determine whether the socio-economic gradient of estimated CVD risk differs between ethnic groups. Using the Healthy Life in an Urban Setting study, we obtained data on SES and CVD risk factors among participants from six ethnic backgrounds residing in Amsterdam. SES was measured using educational level and occupational level. CVD risk was estimated based on the occurrence of CVD risk factors using the Dutch version of the systematic coronary risk evaluation algorithm. Ethnic disparities in socio-economic gradients for estimated CVD risk were determined using the relative index of inequality (RII). Among Dutch-origin men, the RII for estimated CVD risk according to educational level was 6.15% (95% confidence interval [CI] 4.35-7.96%), indicating that those at the bottom of the educational hierarchy had a 6.15% higher estimated CVD risk relative than those at the top. Among Dutch-origin women, the RII was 4.49% (CI 2.45-6.52%). The RII was lower among ethnic minority groups, ranging from 0.83% to 3.13% among men and -0.29% to 5.12% among women, indicating weaker associations among these groups. Results were similar based on occupational level. Ethnic background needs to be considered in associations between SES and disease. The predictive value of SES varies between ethnic groups and may be quite poor for some groups.

Energy drink use, problem drinking and drinking motives in a diverse sample of Alaskan college students

PubMed Central

Skewes, Monica C.; DeCou, Christopher R.; Gonzalez, Vivian M.

2013-01-01

Background Recent research has identified the use of caffeinated energy drinks as a common, potentially risky behavior among college students that is linked to alcohol misuse and consequences. Research also suggests that energy drink consumption is related to other risky behaviors such as tobacco use, marijuana use and risky sexual activity. Objective This research sought to examine the associations between frequency of energy drink consumption and problematic alcohol use, alcohol-related consequences, symptoms of alcohol dependence and drinking motives in an ethnically diverse sample of college students in Alaska. We also sought to examine whether ethnic group moderated these associations in the present sample of White, Alaska Native/American Indian and other ethnic minority college students. Design A paper-and-pencil self-report questionnaire was completed by a sample of 298 college students. Analysis of covariance (ANCOVA) was used to examine the effects of energy drink use, ethnic group and energy drink by ethnic group interactions on alcohol outcomes after controlling for variance attributed to gender, age and frequency of binge drinking. Results Greater energy drink consumption was significantly associated with greater hazardous drinking, alcohol consequences, alcohol dependence symptoms, drinking for enhancement motives and drinking to cope. There were no main effects of ethnic group, and there were no significant energy drink by ethnic group interactions. Conclusion These findings replicate those of other studies examining the associations between energy drink use and alcohol problems, but contrary to previous research we did not find ethnic minority status to be protective. It is possible that energy drink consumption may serve as a marker for other health risk behaviors among students of various ethnic groups. PMID:23986901

Energy drink use, problem drinking and drinking motives in a diverse sample of Alaskan college students.

PubMed

Skewes, Monica C; Decou, Christopher R; Gonzalez, Vivian M

2013-01-01

Recent research has identified the use of caffeinated energy drinks as a common, potentially risky behavior among college students that is linked to alcohol misuse and consequences. Research also suggests that energy drink consumption is related to other risky behaviors such as tobacco use, marijuana use and risky sexual activity. This research sought to examine the associations between frequency of energy drink consumption and problematic alcohol use, alcohol-related consequences, symptoms of alcohol dependence and drinking motives in an ethnically diverse sample of college students in Alaska. We also sought to examine whether ethnic group moderated these associations in the present sample of White, Alaska Native/American Indian and other ethnic minority college students. A paper-and-pencil self-report questionnaire was completed by a sample of 298 college students. Analysis of covariance (ANCOVA) was used to examine the effects of energy drink use, ethnic group and energy drink by ethnic group interactions on alcohol outcomes after controlling for variance attributed to gender, age and frequency of binge drinking. Greater energy drink consumption was significantly associated with greater hazardous drinking, alcohol consequences, alcohol dependence symptoms, drinking for enhancement motives and drinking to cope. There were no main effects of ethnic group, and there were no significant energy drink by ethnic group interactions. These findings replicate those of other studies examining the associations between energy drink use and alcohol problems, but contrary to previous research we did not find ethnic minority status to be protective. It is possible that energy drink consumption may serve as a marker for other health risk behaviors among students of various ethnic groups.

Distribution of Helicobacter pylori cagA, cagE, oipA and vacA in different major ethnic groups in Tehran, Iran.

PubMed

Dabiri, Hossein; Maleknejad, Parviz; Yamaoka, Yoshio; Feizabadi, Mohammad M; Jafari, Fereshteh; Rezadehbashi, Maryam; Nakhjavani, Farrokh A; Mirsalehian, Akbar; Zali, Mohammad R

2009-08-01

There are geographical variations in Helicobacter pylori virulence genes; cagA, cagE, vacA and oipA. The present study compared the distribution of these genotypes in major ethnic groups residing in Tehran, Iran and their association with clinical outcomes. A total of 124 H. pylori-positive patients living in Tehran were enrolled in this study. The ethnic distribution was 74 Persians, 33 Turks and 17 other ethnics including Kurds, Lurs, Afghanis and Arabs. The presence of the cagA, cagE and oipA genes and vacA alleles (signal [s] and middle [m] region) were determined by polymerase chain reaction (PCR) from H. pylori DNA. The cagA-positive status was predominant in all three ethnic groups (e.g. 65% in Persians and 73% in Turks). In contrast, the cagE-positive status was less than half in Persians (47%) and Turks (30%), whereas it was 77% in other ethnicities (P = 0.008). The predominant vacA genotypes were s1 and m1 in all three ethnic groups (e.g. 68% in Persians and 70% in Turks were s1). There was no significant association between cagA and cagE status or vacA genotypes and clinical outcomes. The oipA-positive strains were more common in non-ulcer dyspepsia (NUD) (63%) than in peptic ulcer patients (15%) (P = 0.001) in Persians, but the association was not observed in other ethnic groups. There are some differences in the H. pylori genotypes among the ethnic groups in Iran. However, none of these markers seemed to be clinically helpful in predicting the clinical presentation of a H. pylori infection in Iran.

Ethnic disparities in educational and occupational gradients of estimated cardiovascular disease risk: The Healthy Life in an Urban Setting study

PubMed Central

Perini, Wilco; Agyemang, Charles; Snijder, Marieke B.; Peters, Ron J.G.; Kunst, Anton E.

2017-01-01

Background: European societies are becoming increasingly ethnically diverse. This may have important implications for socio-economic inequalities in health due to the often disadvantaged position of ethnic minority groups in both socio-economic status (SES) and disease, especially cardiovascular disease (CVD). Objective: The aim of this study was to determine whether the socio-economic gradient of estimated CVD risk differs between ethnic groups. Methods: Using the Healthy Life in an Urban Setting study, we obtained data on SES and CVD risk factors among participants from six ethnic backgrounds residing in Amsterdam. SES was measured using educational level and occupational level. CVD risk was estimated based on the occurrence of CVD risk factors using the Dutch version of the systematic coronary risk evaluation algorithm. Ethnic disparities in socio-economic gradients for estimated CVD risk were determined using the relative index of inequality (RII). Results: Among Dutch-origin men, the RII for estimated CVD risk according to educational level was 6.15% (95% confidence interval [CI] 4.35–7.96%), indicating that those at the bottom of the educational hierarchy had a 6.15% higher estimated CVD risk relative than those at the top. Among Dutch-origin women, the RII was 4.49% (CI 2.45–6.52%). The RII was lower among ethnic minority groups, ranging from 0.83% to 3.13% among men and −0.29% to 5.12% among women, indicating weaker associations among these groups. Results were similar based on occupational level. Conclusions: Ethnic background needs to be considered in associations between SES and disease. The predictive value of SES varies between ethnic groups and may be quite poor for some groups. PMID:28699411

The distributed annotation system.

PubMed

Dowell, R D; Jokerst, R M; Day, A; Eddy, S R; Stein, L

2001-01-01

Currently, most genome annotation is curated by centralized groups with limited resources. Efforts to share annotations transparently among multiple groups have not yet been satisfactory. Here we introduce a concept called the Distributed Annotation System (DAS). DAS allows sequence annotations to be decentralized among multiple third-party annotators and integrated on an as-needed basis by client-side software. The communication between client and servers in DAS is defined by the DAS XML specification. Annotations are displayed in layers, one per server. Any client or server adhering to the DAS XML specification can participate in the system; we describe a simple prototype client and server example. The DAS specification is being used experimentally by Ensembl, WormBase, and the Berkeley Drosophila Genome Project. Continued success will depend on the readiness of the research community to adopt DAS and provide annotations. All components are freely available from the project website http://www.biodas.org/.

Pathways to Male Transactional Sex in Mumbai, India.

PubMed

Srivastava, Ankur; Goldbach, Jeremy T

2017-10-27

The article explores pathways to male transactional sex, focusing on entering, soliciting practices, role of pimps, client characteristics, and negotiations. Little scientific literature exists regarding male transactional sex in India, who represent a high-risk group for HIV infection. Case studies with 10 men who engage in transactional sex were conducted, who were recruited using purposive snowball sampling and interviewed at a social service organization. Participants differed in their sexual identity, sex roles, soliciting practices, and clients. Most of them listed economic crisis as their reason for entering transactional sex. Strategies to find clients included self-solicitation and referrals, while pimps played a major role in solicitation, negotiations, and events of crisis. The relationship among men who engage in transactional sex, pimps, and clients involves points of negotiation, opportunities, and limitations. HIV prevention should focus on identifying and addressing the groups' unique needs and working with pimps on risk-reduction strategies and crisis interventions.

Correlates of condom use among female prostitutes and tourist clients in Bali, Indonesia.

PubMed

Thorpe, L; Ford, K; Fajans, P; Wirawan, D N

1997-04-01

This study examines the commercial sex activity of both tourist client and local prostitute groups in the host country of Indonesia. The study provides a profile of social and behavioural characteristics of foreign tourist men and Indonesian women engaging in commercial sex, using cross-sectional data gathered in the tourist resort town of Kuta, Bali. Univariate statistical analysis and multiple logistic regression are used to assess psychosocial and other factors associated with consistent condom use in commercial sex encounters, drawing from the Health Belief model and social cognitive theory. Results from both respondent groups indicate that condom use is high between tourist clients and female Indonesian sex workers, although not 100% consistent. Beliefs about condom efficacy and effects on pleasure, as well as susceptibility to STD infection were related to condom use for female sex workers. Beliefs about condoms being too much trouble, and self-efficacy were related to condom use for tourist clients.

Unravelling the impact of ethnicity on health in Europe: the HELIUS study

PubMed Central

2013-01-01

Background Populations in Europe are becoming increasingly ethnically diverse, and health risks differ between ethnic groups. The aim of the HELIUS (HEalthy LIfe in an Urban Setting) study is to unravel the mechanisms underlying the impact of ethnicity on communicable and non-communicable diseases. Methods/design HELIUS is a large-scale prospective cohort study being carried out in Amsterdam, the Netherlands. The sample is made up of Amsterdam residents of Surinamese (with Afro-Caribbean Surinamese and South Asian-Surinamese as the main ethnic groups), Turkish, Moroccan, Ghanaian, and ethnic Dutch origin. HELIUS focuses on three disease categories: cardiovascular disease (including diabetes), mental health (depressive disorders and substance use disorders), and infectious diseases. The explanatory mechanisms being studied include genetic profile, culture, migration history, ethnic identity, socio-economic factors and discrimination. These might affect disease risks through specific risk factors including health-related behaviour and living and working conditions. Every five years, participants complete a standardized questionnaire and undergo a medical examination. Biological samples are obtained for diagnostic tests and storage. Participants’ data are linked to morbidity and mortality registries. The aim is to recruit a minimum of 5,000 respondents per ethnic group, to a total of 30,000 participants. Discussion This paper describes the rationale, conceptual framework, and design and methods of the HELIUS study. HELIUS will contribute to an understanding of inequalities in health between ethnic groups and the mechanisms that link ethnicity to health in Europe. PMID:23621920

Disparities in type 2 diabetes prevalence among ethnic minority groups resident in Europe: a systematic review and meta-analysis.

PubMed

Meeks, Karlijn A C; Freitas-Da-Silva, Deivisson; Adeyemo, Adebowale; Beune, Erik J A J; Modesti, Pietro A; Stronks, Karien; Zafarmand, Mohammad H; Agyemang, Charles

2016-04-01

Many ethnic minorities in Europe have a higher type 2 diabetes (T2D) prevalence than their host European populations. The risk size differs between ethnic groups, but the extent of the differences in the various ethnic minority groups has not yet been systematically quantified. We conducted a meta-analysis of published data on T2D in various ethnic minority populations resident in Europe compared to their host European populations. We systematically searched MEDLINE (using PUBMED) and EMBASE for papers on T2D prevalence in ethnic minorities in Europe published between 1994 and 2014. The ethnic minority groups were classified into five population groups by geographical origin: South Asian (SA), Sub-Saharan African (SSA), Middle Eastern and North African (MENA), South and Central American (SCA), and Western Pacific (WP). Pooled odds ratios with corresponding 95 % confidence interval (CI) were calculated using Review Manager 5.3. Twenty articles were included in the analysis. Compared with the host populations, SA origin populations had the highest odds for T2D (3.7, 95 % CI 2.7-5.1), followed by MENA (2.7, 95 % CI 1.8-3.9), SSA (2.6, 95 % CI 2.0-3.5), WP (2.3, 95 % CI 1.2-4.1), and lastly SCA (1.3, 95 % CI 1.1-1.6). Odds ratios were in all ethnic minority populations higher for women than for men except for SCA. Among SA subgroups, compared with Europeans, Bangladeshi had the highest odds ratio of 6.2 (95 % CI 3.9-9.8), followed by Pakistani (5.4, 95 % CI 3.2-9.3) and Indians (4.1, 95 % CI 3.0-5.7). The risk of T2D among ethnic minority groups living in Europe compared to Europeans varies by geographical origin of the group: three to five times higher among SA, two to four times higher among MENA, and two to three times higher among SSA origin. Future research and policy initiatives on T2D among ethnic minority groups should take the interethnic differences into account.

Threat to Valued Elements of Life: The Experience of Dementia across Three Ethnic Groups

ERIC Educational Resources Information Center

Lawrence, Vanessa; Samsi, Kritika; Banerjee, Sube; Morgan, Craig; Murray, Joanna

2011-01-01

Purpose: There is a fundamental knowledge gap regarding the experience of dementia within minority ethnic groups in the United Kingdom and elsewhere. The present study examined the subjective reality of living with dementia from the perspective of people with dementia within the 3 largest ethnic groups in the United Kingdom. Design and Methods:…

An Intersectional Analysis of Gender and Ethnic Stereotypes: Testing Three Hypotheses

ERIC Educational Resources Information Center

Ghavami, Negin; Peplau, Letitia Anne

2013-01-01

We compared perceived cultural stereotypes of diverse groups varying by gender and ethnicity. Using a free-response procedure, we asked 627 U.S. undergraduates to generate 10 attributes for 1 of 17 groups: Asian Americans, Blacks, Latinos, Middle Eastern Americans, or Whites; men or women; or 10 gender-by-ethnic groups (e.g., Black men or Latina…

Differences in health insurance and health service utilization among Asian Americans: method for using the NHIS to identify unique patterns between ethnic groups.

PubMed

Ruy, Hosihn; Young, Wendy B; Kwak, Hoil

2002-01-01

The purpose of this study is to outline a method to identify the characteristics of socioeconomic variables in determining the differences in health insurance coverage and health services utilization patterns for different ethnic groups, using the behavioural model of health service utilization. A sample drawn from Asian American adult respondents to the 1992, 1993, and 1994 National Health Interview Surveys (NHIS) in the USA formed the data set. The results showed Asian Americans as not being homogeneous. There were distinctly different demographic and socioeconomic characteristics between six Asian American ethnic groups that affect health insurance coverage and health service utilization. The study method is useful for constructing health policy and services to address the general public need without adversely affecting smaller minority groups. Secondary analysis of well-constructed national data sets such as the specific Asian ethnic groups in NHIS, offers a rich method for predicting the differential impact of specific health policies on various ethnic groups.

A national online forum on ethnic differences in cancer pain experience.

PubMed

Im, Eun-Ok; Lee, Seung Hee; Liu, Yi; Lim, Hyun-Ju; Guevara, Enrique; Chee, Wonshik

2009-01-01

Cultural values and beliefs related to cancer and pain have been used to explain ethnic differences in cancer pain experience. Yet, very little is known about similarities and differences in cancer pain experience among different ethnic groups. The objective of this study was to explore similarities and differences in cancer pain experience among four major ethnic groups in the United States. A feminist approach by Hall and Stevens was used. This was a cross-sectional qualitative study among 22 White, 15 Hispanic, 11 African American, and 27 Asian patients with cancer recruited through both Internet and community settings. Four ethnic-specific online forums were conducted for 6 months. Nine topics related to cancer pain experience were used to guide the online forums. The collected data were analyzed using thematic analysis involving line-by-line coding, categorization, and thematic extraction. All participants across ethnic groups reported "communication breakdowns" with their healthcare providers and experienced "changes in perspectives." All of them reported that their cancer pain experience was "gendered experience." White patients focused on how to control their pain and treatment selection process, whereas ethnic minority patients tried to control pain by minimizing and normalizing it. White patients sought out diverse strategies of pain management; ethnic minority patients tried to maintain normal lives and use natural modalities for pain management. Finally, the cancer pain experience of White patients was highly individualistic and independent, whereas that of ethnic minority patients was family oriented. These findings suggest that nurses need to use culturally competent approaches to cancer pain management for different ethnic groups. Also, the findings suggest further in-depth cultural studies on the pain experience of multiethnic groups of patients with cancer.

A National Online Forum on Ethnic Differences in Cancer Pain Experience

PubMed Central

Im, Eun-Ok; Lee, Seung Hee; Liu, Yi; Lim, Hyun-Ju; Guevara, Enrique; Chee, Wonshik

2009-01-01

Background Cultural values and beliefs related to cancer and pain have been used to explain ethnic differences in cancer pain experience. Yet, very little is known about similarities and differences in cancer pain experience among different ethnic groups. Objectives To explore similarities and differences in cancer pain experience among four major ethnic groups in the United States. Methods A feminist approach by Hall and Stevens was used. This was a cross-sectional qualitative study among 22 White, 15 Hispanic, 11 African American, and 27 Asian cancer patients recruited through both Internet and community settings. Four ethnic-specific online forums were conducted for 6 months. Nine topics related to cancer pain experience were used to guide the online forums. The collected data were analyzed using thematic analysis involving line-by-line coding, categorization, and thematic extraction. Results All participants across ethnic groups reported “communication breakdowns” with their health care providers and experienced “changes in perspectives.” All of them reported that their cancer pain experience was “gendered experience.” White patients focused on how to control their pain and treatment selection process, while ethnic minority patients tried to control pain by minimizing and normalizing it. White patients sought out diverse strategies of pain management; ethnic minority patients tried to maintain normal lives and use natural modalities for pain management. Finally, the cancer pain experience of White patients was highly individualistic and independent, while that of ethnic minority patients was family-oriented. Discussion These findings suggest that nurses need to use culturally competent approaches to cancer pain management for different ethnic groups. Also, the findings suggest further in-depth cultural studies on the pain experience of multiethnic groups of cancer patients. PMID:19289929

Ethnic dependent differences in diagnostic accuracy of glycated hemoglobin (HbA1c) in Canadian adults.

PubMed

Booth, Ronald A; Jiang, Ying; Morrison, Howard; Orpana, Heather; Rogers Van Katwyk, Susan; Lemieux, Chantal

2018-02-01

Previous studies have shown varying sensitivity and specificity of hemoglobin A1c (HbA1c) to identify diabetes and prediabetes, compared to 2-h oral glucose tolerance testing (OGTT) and fasting plasma glucose (FPG), in different ethnic groups. Within the Canadian population, the ability of HbA1c to identify prediabetes and diabetes in First Nations, Métis and Inuit, East and South Asian ethnic groups has yet to be determined. We collected demographic, lifestyle information, biochemical results of glycemic status (FPG, OGTT, and HbA1c) from an ethnically diverse Canadian population sample, which included a purposeful sampling of First Nations, Métis, Inuit, South Asian and East Asian participants. Sensitivity and specificity using Canadian Diabetes Association (CDA) recommended cut-points varied between ethnic groups, with greater variability for identification of prediabetes than diabetes. Dysglycemia (prediabetes and diabetes) was identified with a sensitivity and specificity ranging from 47.1% to 87.5%, respectively in Caucasians to 24.1% and 88.8% in Inuit. Optimal HbA1c ethnic-specific cut-points for dysglycemia and diabetes were determined by receiver operating characteristic (ROC) curve analysis. Our sample showed broad differences in the ability of HbA1c to identify dysglycemia or diabetes in different ethnic groups. Optimal cut-points for dysglycemia or diabetes in all ethnic groups were substantially lower than CDA recommendations. Utilization of HbA1c as the sole biochemical diagnostic marker may produce varying degrees of false negative results depending on the ethnicity of screened individuals. Further research is necessary to identify and validate optimal ethnic specific cut-points used for diabetic screening in the Canadian population. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Ethnic differences in prediabetes and diabetes in the Suriname Health Study.

PubMed

Krishnadath, Ingrid S K; Nahar-van Venrooij, Lenny M; Jaddoe, Vincent W V; Toelsie, Jerry R

2016-01-01

Diabetes is increasing worldwide, and information on risk factors to develop targeted interventions is limited. Therefore, we analyzed data of the Suriname Health Study to estimate the prevalence of prediabetes and diabetes. We also explored whether ethnic differences in prediabetes or diabetes risk could be explained by biological, demographic, lifestyle, anthropometric, and metabolic risk factors. The study was designed according to the WHO Steps guidelines. Fasting blood glucose levels were measured in 3393 respondents, aged 15-65 years, from an Amerindian, Creole, Hindustani, Javanese, Maroon or Mixed ethnic background. Prediabetes was defined by fasting blood glucose levels between 6.1 and 7.0 mmol/L and diabetes by fasting blood glucose levels ≥7.0 mmol/L or 'self-reported diabetes medication use.' For all ethnicities, we analyzed sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index, waist circumference, hypertension, and the levels of triglyceride, total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol. The prevalence of prediabetes was 7.4%, while that of diabetes was 13 0%. From these diabetes cases, 39.6% were not diagnosed previously. No ethnic differences were observed in the prevalence of prediabetes. For diabetes, Hindustanis (23.3%) had twice the prevalence compared to other ethnic groups (4.7-14.2%). The associations of the risk factors with prediabetes or diabetes varied among the ethnic groups. The differences in the associations of ethnic groups with prediabetes or diabetes were partly explained by these risk factors. The prevalence of diabetes in Suriname is high and most elevated in Hindustanis. The observed variations in risk factors among ethnic groups might explain the ethnic differences between these groups, but follow-up studies are needed to explore this in more depth.

Using and joining a franchised private sector provider network in Myanmar.

PubMed

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor.

Using and Joining a Franchised Private Sector Provider Network in Myanmar

PubMed Central

O'Connell, Kathryn; Hom, Mo; Aung, Tin; Theuss, Marc; Huntington, Dale

2011-01-01

Background Quality is central to understanding provider motivations to join and remain within a social franchising network. Quality also appears as a key issue from the client's perspective, and may influence why a client chooses to use a franchised provider over another type of provider. The dynamic relationships between providers of social franchising clinics and clients who use these services have not been thoroughly investigated in the context of Myanmar, which has an established social franchising network. This study examines client motivations to use a Sun Quality Health network provider and provider motivations to join and remain in the Sun Quality Health network. Taken together, these two aims provide an opportunity to explore the symbiotic relationship between client satisfaction and provider incentives to increase the utilization of reproductive health care services. Methods and Findings Results from a series of focus group discussions with clients of reproductive health services and franchised providers shows that women chose health services provided by franchised private sector general practitioners because of its perceived higher quality, associated with the availability of effective, affordable, drugs. A key finding of the study is associated with providers. Provider focus group discussions indicate that a principle determinate for joining and remaining in the Sun Quality Health Network was serving the poor. PMID:22180781

Ethnicity Modifies Associations between Cardiovascular Risk Factors and Disease Severity in Parallel Dutch and Singapore Coronary Cohorts

PubMed Central

Gijsberts, Crystel M.; Seneviratna, Aruni; de Carvalho, Leonardo P.; den Ruijter, Hester M.; Vidanapthirana, Puwalani; Sorokin, Vitaly; Stella, Pieter; Agostoni, Pierfrancesco; Asselbergs, Folkert W.; Richards, A. Mark; Low, Adrian F.; Lee, Chi-Hang; Tan, Huay Cheem; Hoefer, Imo E.; Pasterkamp, Gerard; de Kleijn, Dominique P. V.; Chan, Mark Y.

2015-01-01

Background In 2020 the largest number of patients with coronary artery disease (CAD) will be found in Asia. Published epidemiological and clinical reports are overwhelmingly derived from western (White) cohorts and data from Asia are scant. We compared CAD severity and all-cause mortality among 4 of the world’s most populous ethnicities: Whites, Chinese, Indians and Malays. Methods The UNIted CORoNary cohort (UNICORN) simultaneously enrolled parallel populations of consecutive patients undergoing coronary angiography or intervention for suspected CAD in the Netherlands and Singapore. Using multivariable ordinal regression, we investigated the independent association of ethnicity with CAD severity and interactions between risk factors and ethnicity on CAD severity. Also, we compared all-cause mortality among the ethnic groups using multivariable Cox regression analysis. Results We included 1,759 White, 685 Chinese, 201 Indian and 224 Malay patients undergoing coronary angiography. We found distinct inter-ethnic differences in cardiovascular risk factors. Furthermore, the associations of gender and diabetes with severity of CAD were significantly stronger in Chinese than Whites. Chinese (OR 1.3 [1.1–1.7], p = 0.008) and Malay (OR 1.9 [1.4–2.6], p<0.001) ethnicity were independently associated with more severe CAD as compared to White ethnicity. Strikingly, when stratified for diabetes status, we found a significant association of all three Asian ethnic groups as compared to White ethnicity with more severe CAD among diabetics, but not in non-diabetics. Crude all-cause mortality did not differ, but when adjusted for covariates mortality was higher in Malays than the other ethnic groups. Conclusion In this population of individuals undergoing coronary angiography, ethnicity is independently associated with the severity of CAD and modifies the strength of association between certain risk factors and CAD severity. Furthermore, mortality differs among ethnic groups. Our data provide insight in inter-ethnic differences in CAD risk factors, CAD severity and mortality. PMID:26147693

Community Wise: paving the way for empowerment in community reentry.

PubMed

Windsor, Liliane Cambraia; Jemal, Alexis; Benoit, Ellen

2014-01-01

Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre-posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants' demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Relationships among identity, perceived discrimination, and depressive symptoms in eight ethnic-generational groups.

PubMed

Donovan, Roxanne A; Huynh, Que-Lam; Park, Irene J K; Kim, Su Yeong; Lee, Richard M; Robertson, Emily

2013-04-01

Examine whether personal identity confusion and ethnic identity, respectively, moderate and/or mediate the relationship between perceived discrimination (PD) and depressive symptoms (DS) in eight ethnic-generational groups. The sample consisted of 9665 students (73% women; mean age 20.31) from 30 colleges and universities from around the United States. Cross-sectional data were gathered through a confidential online survey. Across groups, PD and ethnic identity levels varied, while identity confusion levels were mostly similar. Neither identity confusion nor ethnic identity moderated the PD-DS relationship for any groups. However, identity confusion was a partial mediator for immigrant and nonimmigrant Hispanic/Latino(a) and White/European American participants. Identity confusion also suppressed the PD-DS relationship for Black/African American participants. Results highlight the need for additional research on identity confusion's role in the PD-distress link and the importance of addressing ethnicity and generation status when examining the effects of PD on college students' mental health. © 2012 Wiley Periodicals, Inc.

Group size and group income as influences on marriage patterns in Hawaii.

PubMed

Johnson, R C

1984-01-01

This paper analyzes the association of ethnic group size and median ethnic group income with the percentages of cross-ethnic marriages and combinations of marriages of each of the 5 major racial/ethnic groups in Hawaii. The data cover marriages that took place from 1975-1977 in Hawaii's 5 major ethnic groups: 1) Caucasian, 2) Chinese, 3) Filipino, 4) Japanese, and 5) Hawaiian or part-Hawaiian. The number of Caucasians marrying in Hawaii are severely inflated by military and tourist marriages. Chinese (highest median income) and Hawaiians or part-Hawaiians (lowest median income) show the highest percentages of outmarriage. The number of persons making up given groups appears to play a role; larger groups have lower outmarriage rates. Since 19 of 20 potential marriage partners a Chinese person meets are of another racial group, as compared to 2 of 3 for Caucasians or Japanese, it is hardly surprising that the Chinese outmarry more often than other groups. Data show a tendency to an East-West split; Chinese-Japanese marriages are overrepresented, and marriages of Japanese men to Caucasian women are underrepresented. However, marriages of Caucasian males to Chinese women are also overrepresented. Also, Puerto Ricans and Filipinos tend to be more representative of the West than Caucasians are. The authors conclude that cultural attributes likely to lead to a given level of income, rather than income per se, influence the probability of persons marrying a member of a given racial/ethnic group other than their own.

Molecular Epidemiology of Helicobacter pylori Infection in a Minor Ethnic Group of Vietnam: A Multiethnic, Population-Based Study.

PubMed

Binh, Tran Thanh; Tuan, Vo Phuoc; Dung, Ho Dang Quy; Tung, Pham Huu; Tri, Tran Dinh; Thuan, Ngo Phuong Minh; Tam, Le Quang; Nam, Bui Chi; Giang, Do Anh; Hoan, Phan Quoc; Uchida, Tomohisa; Trang, Tran Thi Huyen; Khien, Vu Van; Yamaoka, Yoshio

2018-03-01

The Helicobacter pylori -induced burden of gastric cancer varies based on geographical regions and ethnic grouping. Vietnam is a multiethnic country with the highest incidence of gastric cancer in Southeast Asia, but previous studies focused only on the Kinh ethnic group. A population-based cross-sectional study was conducted using 494 volunteers (18-78 years old), from 13 ethnic groups in Daklak and Lao Cai provinces, Vietnam. H. pylori status was determined by multiple tests (rapid urease test, culture, histology, and serology). cagA and vacA genotypes were determined by PCR-based sequencing. The overall H. pylori infection rate was 38.1%. Multivariate analysis showed that variations in geographical region, age, and ethnicity were independent factors associated with the risk of H. pylori acquisition. Therefore, multicenter, multiethnic, population based study is essential to assess the H. pylori prevalence and its burden in the general population. Only the E De ethnicity carried strains with Western-type CagA (82%) and exhibited significantly lower gastric mucosal inflammation compared to other ethnic groups. However, the histological scores of Western-type CagA and East-Asian-type CagA within the E De group showed no significant differences. Thus, in addition to bacterial virulence factors, host factors are likely to be important determinants for gastric mucosal inflammation and contribute to the Asian enigma.