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Recommended Reading List
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No.
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Title
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Author
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Publisher
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Spec pop
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Year
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21
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Incorporating Multiculturalism into Oncology Nursing Research: The last decade
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Phillips, J.
Weekes, D.
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Oncol Nurs Forum. 29(5), 807-16.
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General
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2002
June
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PURPOSE/OBJECTIVES: To use the Oncology Nursing Society's cultural competence guidelines to review research studies conducted by oncology nurse researchers with racial and ethnic minorities and published in the Oncology Nursing Forum during 1990-2000. DATA SOURCES: Using selected key words (e.g., cultural competence, cultural diversity, multiculturalism, minorities, African American/Black American, Hispanic/Latino, Asian/Pacific Islander, Native American/Alaskan Natives) the authors identified 27 studies that met the inclusion criteria for review. Case studies, sponsored lectureships, review articles, commentaries, editorials, and the like were excluded. DATA SYNTHESIS: Within the context of the cultural competence guidelines, the primary strengths included sufficient background information and literature to establish the existence of the problem in the targeted culture, use of conceptual and theoretical frameworks to guide the study, identification of salient study limitations, and recommendations for dissemination of the findings to a general audience. Limitations included discussion of culture beyond the background and literature review, consideration of potential ethical concerns the target population may have about the methods to be used, inclusion of racial and ethnic minorities in the design and implementation of the study, and implications for oncology nursing education. CONCLUSIONS: Although much has been gleaned from previous oncology nursing research published from 1990-2000, more fully incorporated content related to cultural competence is needed. This is needed particularly in studies specifically targeting racial and ethnic minority populations. IMPLICATIONS FOR NURSING: Including cultural competence when designing and reporting research has a greater potential to inform oncology nursing practice, design future research studies, strengthen existing nursing curricula, and help to shape health policy related to racial and ethnic minority populations. The Oncology Nursing Society Multicultural Outcomes: Guidelines for Cultural Competence provides guidance for enhancing the next generation of oncology nursing research with ethnically and culturally diverse populations.
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22
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An Asian Perspective to the Problem of Osteoporosis
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Koh, L. K.
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Ann Acad Med Singapore, 31(1), 26-9. Asian American
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2002
Jan
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INTRODUCTION: Most research into the problem of osteoporosis has been carried out in Caucasian populations. This review highlights emerging data from research on osteoporosis among Asians, and some differences from Caucasian data. METHODS: A non-systematic review of the English-language literature on various aspects of osteoporosis among Asian populations was carried out. RESULTS: Compared to Caucasian populations, epidemiological trends in Asian populations appear to be developing along similar lines, although rates of hip fracture do differ by country and ethnicity, and are generally lower. Bone mineral density (BMD) carries similar relevance with regard to fracture risk, although hip geometry is also believed to have some impact. Risk factors for osteoporosis and fractures are somewhat similar, although dietary factors seem to play a larger role as reported in Asian studies. A uniquely Asian self-assessment tool based on clinical factors has been developed to assist in case-finding of osteoporotic patients. The few intervention trials with hormone replacement, alendronate and parathyroid hormone appear to show similar responses between Asians and Caucasians, although the response to vitamin D analogs in Asians appears better. Some differences in gene polymorphisms between Asians and Caucasians exist, and these may impact on BMD and fractures via different gene-environment relationships. CONCLUSIONS: Many aspects of osteoporosis in Asia appear similar to the West, but several interesting differences have emerged. These might lead to refinements in the strategies to manage osteoporosis within the Asian context.
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23
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Trichomonas Vaginalis, HIV, and African Americans
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Sorvillo, F.
Smith, L.
Kerndt, P.
Ash, L.
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Emerg Infect Dis., 7(6), 927-32.
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Gay/lesbians
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2001 Nov-Dec
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Trichomonas vaginalis may be emerging as one of the most important cofactors in amplifying HIV transmission, particularly in African-American communities of the United States. In a person co-infected with HIV, the pathology induced by T. vaginalis infection can increase HIV shedding. Trichomonas infection may also act to expand the portal of entry for HIV in an HIV-negative person. Studies from Africa have suggested that T. vaginalis infection may increase the rate of HIV transmission by approximately twofold. Available data indicate that T. vaginalis is highly prevalent among African-Americans in major urban centers of the United States and is often the most common sexually transmitted infection in black women. Even if T. vaginalis increases the risk of HIV transmission by a small amount, this could translate into an important amplifying effect since Trichomonas is so common. Substantial HIV transmission may be attributable to T. vaginalis in African-American communities of the United States.
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24
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Cancer and Men from Minority Ethnic Groups: An exploration of the literature
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Lees, S.
Papadopoulos, I.
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Eur J Cancer Care (Engl), 9(4), 221-9.
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General
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2000
Dec
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The authors reviewed literature which has been published in the last 20 years. Cancer is the second leading cause of death in developed countries and is expected to become a significant cause of death in developing countries. Whilst there are a large number of studies on cancer and men, there is a paucity of data on men from minority ethnic groups. In the USA, African Americans are more likely to develop cancer than any other ethnic group. Although cancer rates amongst minority ethnic groups in the UK are thought to be low, 11% of Indian and African men and 19% of Caribbean men died from cancer during 1979-1983. There is also further evidence in the USA that African American, Filipinos and Native Americans have the lowest cancer survival rates. Service utilization, especially tertiary care, is also thought to be low amongst minority ethnic groups from the USA and the UK. Reasons for these variations include artefactual, cultural, materialist and social selectivist explanations as well as the effects of migration, racism and genetic disposition. This area is under-researched, in particular cultural beliefs about cancer. Further research into this area should apply culturally competent methods to ensure valid data to inform cancer policy, education and practice.
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25
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Cancer Research Studies in Native Hawaiians and Pacific Islanders
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Hughes, C. K.
Tsark, J. U.
Kenui, C. K.
Alexander, G. A.
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Ann Epidemiol, 10(8 Suppl), S49-60.
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Native American Asian American
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2000
Nov
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PURPOSE: To review and assess published findings from relevant cancer research studies in Native Hawaiians and other Pacific Islanders and to develop strategies for designing and implementing successful cancer research studies in the future. METHODS: Data were collected primarily from MEDLINE and BIOSIS Preview searches of the English literature during a 30-year period for published reports of cancer surveillance studies and epidemiological and clinical cancer studies in the Native Hawaiian and Pacific Islander populations. The cancer burden was critically assessed in the retrieved citations for each of the indigenous groups from Hawai'i, American Samoa, Guam, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Republic of Palau, and the Republic of the Marshall Islands. RESULTS: A review of the published literature revealed a lack of systematic data collection on cancer incidence and mortality in Pacific Islanders. Wide variations were found regarding the status of cancer research among ethnic groups. It is estimated that Native Hawaiians represent 0.1% of subjects accrued to cancer prevention trials, and that Pacific Islanders represent 0.5% of subjects in a large cancer screening trial. CONCLUSION: The paucity of cancer data and clinical cancer research supports the need for increased attention to these indigenous populations to improve the quality of cancer care in Native Hawaiian and Pacific Island communities.
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26
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HIV Health Crisis and African Americans: A cultural perspective
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Plowden, K.
Miller, J. L.
James, T.
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ABNF J.,11(4), 88-93.
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African American
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2000
Jul-Aug
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While incidence of new HIV infections have decreased in the overall population, the numbers continue to rise in African-Americans creating a serious health emergency. Studies seem to imply that part of the rise is due to HIV beliefs and high risk behaviors among African Americans. Due to certain societal factors, African Americans appear to be at greater risk for contracting the virus. This article will examine these critical social factors and their impact on this current state of emergency in the African American community using Leininger's theory of Culture Care and Universality. Implications for health providers are also addressed.
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27
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Socioeconomic Factors and Breast Carcinoma in Multicultural Women
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Baquet, C. R.
Commiskey, P.
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Cancer, 88(5 Suppl), 1256-64.
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Special Pop.Women
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2000
Mar
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Breast carcinoma is the most common cancer in women in the U.S. and the second leading cause of cancer death in women. Furthermore, there are racial differences in breast carcinoma incidence, mortality, and survival rates. Social and economic factors within racial/ethnic groups are being examined as risk factors not only for breast carcinoma mortality and survival but also as determinants of the rate of incidence. Social and economic factors have been associated in the literature predominantly with cancer mortality and survival. When socioeconomic status (SES) is considered, certain studies suggest that racial disparities in breast carcinoma are smaller than when social and economic factors are examined alone, but these disparities still persist. Sources of data for this discussion include the National Cancer Institute (NCI) (the Surveillance, Epidemiology, and End Results [SEER] program, a group of population-based cancer registries that cover up to 14% of the U.S. population. SEER reports cancer incidence, mortality, and survival rates), the U.S. Bureau of the Census, the National Center for Health Statistics (NCHS), and numerous articles from the scientific literature. Socioeconomic factors or SES can be considered "cross-cutting risk factors" (i.e., they can be related to the risk of developing breast carcinoma [rate of incidence] as well as to the risk of dying [mortality] from this disease). They also are the risk factors that "cut across" racial and ethnic populations. Socioeconomic factors are related to breast carcinoma mortality and survival rates in multicultural women. Racial disparities in breast carcinoma mortality and survival rates can be explained partially by stage distribution at the time of diagnosis, which may be related to SES. For example, African-American women present with more advanced stage distributions for breast carcinoma than white women. Similarly, women of lower SES present with higher stage disease than women of upper SES who present with more localized breast carcinoma. The lack of data regarding the SES of cancer patients limits our understanding of the contributions of SES to cancer incidence and mortality rates. SES appears to be related to breast carcinoma incidence, mortality, and survival rates. Breast carcinoma mortality is higher in women of lower SES. Additional research on SES, race, culture, and the relation of these factors to cancer incidence rate is needed. Copyright 2000 American Cancer Society.
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28
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The Excess Burden of Breast Carcinoma in Minority and Medically Underserved Communities: Application, research, and redressing institutional racism
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Shinagawa, S. M.
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Cancer. 88(5 Suppl), 1217-23.
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General
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2000
Mar
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BACKGROUND: In 1998, the American Cancer Society, the National Cancer Institute, and the Centers for Disease Control and Prevention reported an overall downward trend in cancer incidence and mortality between 1990 and 1995 for all cancers combined. Many minority and medically underserved populations, however, did not share equally in these improvements. METHODS: A review of surveillance and other reports and recent literature on disparities in cancer incidence and mortality in minority and medically underserved communities was conducted 1) to ascertain the extent to which these communities bear an excess cancer burden, and 2) to explore the macrosocietal and microinstitutional barriers to equitable benefits in cancer health care delivery. RESULTS: Tragic disparities in cancer incidence and mortality in minority and medically underserved communities continue to be inadequately addressed. Overall improvements in U.S. cancer incidence and mortality rates are not shared equally by all segments of our society. While numerous individual and cultural barriers to optimal cancer control and care exist in minority and medically underserved communities, a major factor precluding these populations from sharing equally in advances in cancer research is prevailing societal and institutional racism. CONCLUSIONS: Immediate and equitable application of existing cancer control interventions and quality treatment options will significantly decrease cancer incidence and mortality. Enhanced surveillance efforts and a greater investment in targeted cancer research in those communities with the greatest disparities must be employed immediately if we are to achieve the goal of the president of the United States of eliminating racial and ethnic disparities in cancer and other diseases by 2010. Unless we acknowledge and redress institutionalized racism, the miscarriage of health justice will be perpetuated while celebrated advances in cancer research leading to declining incidence and mortality rates continue to evade our nation's minority and medically underserved communities. Copyright 2000 American Cancer Society.
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29
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Migration Patterns and Breast Carcinoma
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Kaur, J. S.
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Cancer. 88(5 Suppl), 1203-6.
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Special Pop.Women
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2000
Mar
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BACKGROUND: Many American Indian and Alaska Native women have lower incidence rates of breast carcinoma than other racial/ethnic groups in the United States. The rates in most areas, however, have increased in recent years. The author reviews the migration patterns and effects that might contribute to this change. METHODS: A review of the literature on migration and breast carcinoma incidence was conducted. RESULTS: Migration significantly impacts on breast carcinoma incidence in all groups of women studied. CONCLUSIONS: Research must be designed that will explore the components of host, life-styles, and environment on breast carcinoma rates in American Indian and Alaska Native women to elucidate mechanisms of breast carcinoma etiology. Copyright 2000 American Cancer Society.
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30
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Epidemiology, Stage at Diagnosis, and Tumor Biology of Breast Carcinoma in Multiracial and Multiethnic Populations
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Hunter, C. P.
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Cancer. 88(5 Suppl), 1193-202.
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Special Pop.Women
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2000
Mar
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All women, regardless of their racial or ethnic origin or heritage, are at risk of developing breast cancer. Variations in breast carcinoma incidence rates among multicultural populations suggest that etiologic factors differ in their biologic expression and impact on disease outcome. Key among those factors that affect breast carcinoma development are the roles of genetics and the environment, the reproductive experience and the effects of endogenous and exogenous hormones in women, the change in immune status and host vulnerability, and the biologic determinants of breast carcinoma. Cultural dynamics, sociodemographic differences, and behavioral characteristics across population subgroups modulate how biologic disease is expressed among different races and ethnic groups. These interactions contribute to the observed variations in breast carcinoma incidence, mortality, and survival. Stage, a measure of disease status, is used to assess prognosis, plan treatment, and evaluate outcome. Numerous studies have reported a more advanced stage of breast carcinoma at diagnosis in racial/ethnic subgroups, especially among women from African American, Hispanic, American Indian, and native Hawaiian cultures. Factors associated with advanced stage at diagnosis in multicultural populations range from changes in the basic biological characteristics at the molecular and cellular level, to more complex behavioral attributes unique to a particular multicultural population, to societal issues-such as access to care and socioeconomic conditions-all of which impact on the health measure called "stage at diagnosis." Rapid advancements in knowledge of cancer biology and of genetic markers and tumor products are providing new mechanisms for identifying etiologic pathways that can be utilized for better screening, detection, treatment and monitoring of disease. Further studies are needed that evaluate the biologic and molecular alterations in tumor development, progression, and response to therapy. Public health attention needs to be directed toward the societal influences that impact breast carcinoma development, as well as augmenting recognition of the need for culturally appropriate, broad-based behavioral changes at the community level. In addition, continued efforts are needed to ensure the inclusion of multicultural population subgroups and minority investigators in all aspects of research-basic, clinical and applied. Copyright 2000 American Cancer Society.
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