Contributors to Patients’ Ratings of Quality of Care Among Ethnically Diverse Patients with Type 2 Diabetes

Abstract

We examined racial/ethnic differences in patients' ratings of components of interpersonal quality [participatory decision making (PDM) style, being treated as an equal partner, and feelings of trust], and evaluated the association between each of these components and patients' ratings of overall healthcare quality among non-Hispanic white (NHW), Vietnamese American, and Mexican American patients with type 2 diabetes. The findings indicated that although all three components were significantly associated with ratings of overall healthcare quality, the significant interactions between race/ethnicity and both PDM style (β = −0.09, p < 0.01) and equal partner (β = −0.06, p < 0.05) for the Vietnamese American patients suggested that the relationship between these components and patients' ratings of healthcare quality were less strong among Vietnamese American patients than among the NHW patients. Understanding racial/ethnic differences in the components of interpersonal quality that are associated with patients' ratings of overall healthcare quality is an important step for improving patients' experiences of their own care.

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A Case of Leprosy in Italy: A Multifaceted Disease Which Continues to Challenge Medical Doctors

Abstract

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, characterized by a very long incubation period, confounding signs and symptoms and difficulty to establish the onset time. Considering the stigma associated with the diagnosis and the difficulties in detecting asymptomatic leprosy, the incidence and prevalence of this disease are underestimated. In Italy, leprosy is currently included among the rare diseases and can occur as an imported pathology in native individuals or extra-EU immigrants. Currently, given its exceptional appearance in Italy, leprosy is extremely difficult to recognize. In fact, the incomplete knowledge by the medical class of geographical epidemiology and aetiology of tropical diseases including leprosy, often delays the definitive diagnosis. Due to the increasing rate of the migration flows, in Italy and in Europe, leprosy should be considered among the differential diagnosis in patients with cutaneous and neurological signs, especially when originating from endemic countries.

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Frequency and Perceptions of Herbal Medicine use Among Hmong Americans: a Cross Sectional Survey

Abstract

To determine the frequency and perceptions of herbal medicine use among Hmong Americans. Cross-sectional telephone survey. Sacramento, California Hmong community. Out of 118 subjects reached, 77 (65.3 %) reported lifetime use of herbal medicines. A majority of respondents agreed that herbal medicines were able to treat the body as a whole. Respondents felt that a leaflet of information indicating uses/side effects would be important to include for herbal medicines. Herbal medicine use was commonly reported among Hmong Americans. Thus, health care providers should be encouraged to discuss these alternative medicines with their Hmong American patients.

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Mortality by Cause of Death Among Immigrants and Natives in a South European Country: The Case of Greece, 2011

Abstract

The aim of the paper is to examine for the first time in Greece mortality by cause of death among immigrants. The analysis makes use of vital registration statistics for 2010–2012 and census data for 2011; standardised mortality ratios are estimated for four distinct groups: natives, migrants from EU-27 (excluding Greece), other Europeans (mainly Albanians) and those from all other countries (mainly Asia/Africa). All immigrants seem to experience favourable mortality from neoplasms but higher mortality from external causes in comparison to Greeks. The results regarding cardiovascular diseases are mixed. Persons originating in Asian/African regions exhibit higher mortality from infectious diseases and TB. The findings highlight the specificities of immigrant mortality which stem from pre-existing conditions in the country of origin as well as from the adverse socio-economic environment in the country of destination. As immigrants experience some excessive 'avoidable' mortality implementation of appropriate measures should be a social policy priority.

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A Qualitative Exploration of Less Acculturated Mexican Mothers’ Safety Perceptions of Herbs, Medicines, and Cleaners in the Home

Abstract

Childhood poisoning is a leading public health concern in our society. The death rate from unintentional poisonings among children has increased by 80 % from 2000 to 2009. Immigrant children are also at-risk. A qualitative study, consisting of a pile sort, was conducted among immigrant Mexican mothers to determine their safety perceptions of commonly used medicines, herbs, and cleaners. Participants (N = 35) were selected for semi-structured interviews from a pediatric primary care clinic in the Dallas/Fort Worth Metroplex. Some mothers over-estimated their children's ability to discern the dangers of substances, relied heavily on sensory skills of children, and perceived a medicine as safe after successful use in the past. Other mothers were more cognizant of allergic reactions, ingestion, and the need to store substances carefully. Brief interventions that incorporate culturally-appropriate safety messages are needed to assist Mexican mothers in creating a safe home environment.

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Tuberculosis Treatment Completion Rates in Southern New Mexico Colonias

Abstract

TB medication completion treatment rates for active TB patients living in impoverished US-Mexico border communities called colonias in southern New Mexico counties are unknown. It might be suspected that residents of colonias have lower completion rates than those living in incorporated and medically more accessible areas. A retrospective record review of closed TB case records from 1993 to 2010 of southern New Mexico border counties, was conducted using a modified version of the New Mexico Department of Health Tuberculosis Targeted Health Assessment/History form (Appendix 1). Study findings reveal that despite their unincorporated status, poorer living conditions and questionable legal status, colonia TB patients had a higher medication completion rate than their non-colonia counterparts. A robust New Mexico TB treatment program contributed to high completion rates with death being the number-one reason for treatment non-completion in both colonia and non-colonias.

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Self-Efficacy as a Mediator of the Relationship Between the Perceived Food Environment and Healthy Eating in a Low Income Population in Los Angeles County

Abstract

While previous studies have described psychosocial and environmental factors that contribute to healthy eating, much remains unknown about the interactions between them. We assessed the relationship between the perceived food environment, self-efficacy and fruit and vegetable consumption, using data from a sample of racially diverse, low-income adult clientele of five public health centers in Los Angeles County (n = 1503). We constructed a negative binomial regression model to examine the association between perceived food environment and the number of fruits and vegetables consumed. For every one point increase on the perceived food environment scale, individuals ate about 5 % more fruits and vegetables (95 % CI 1.007, 1.089), controlling for other covariates. Self-efficacy was shown to be a significant mediator (mediated effect = 0.010; 95 % CI 0.002, 0.020), accounting for 22.9 % of the effect. Efforts to increase access to healthy options may not only improve eating behaviors, but also influence individuals' beliefs that they can eat healthfully.

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