Labyrinths of love: Sexual propriety, family, and social reform in the Second Cuban Republic, 1933--1958.

This dissertation examines Cubans' struggles over the terms and meanings of sexual propriety, family, and social reform during a period of democratic renovation and collapse in Cuba from 1933 to 1959. I argue that legislators', professionals', and ordinary people's ideas about sexual propriety and family were integral to their efforts to create and live in a new democratic republic, a Cuba made for Cubans, throughout this period. To explore the relationship between elite and popular conceptions of sexual propriety and family and the parallel process of building what citizens hoped would be a democratic nation, I examine the words and actions of legislators and professionals and contrast them with the words and actions of ordinary Cubans. I take into consideration the viewpoints of multiple social actors by using sources such as the published debates of legislators; eugenists' radio show transcripts and serial publications; testimonies of petitioners, defendants, and witnesses from judicial cases; and professional and popular mass media publications. I found that Cuban legislators, bent upon creating a modern democratic nation, tried to excise what they deemed outdated and backward ideals of honor and sexual propriety built into their legal structures by centuries of Spanish rule and the strong influence of the Catholic Church. Nevertheless, legislators' own particular ideas about honor and sexual propriety remained an important aspect of social reform and nation building. Cuban professionals such as jurists, social workers, journalists, psychologists, and physicians widely publicized their views on the perceived consequences and effects of democratic ideologies and legal reforms---effects which many believed signaled the demise of the traditional family and even the nation as a whole. Ordinary Cuban citizens in search of personal retribution and financial restitution made use of the new or reformed laws by bringing cases of consensual unions, sexual crimes, and divorce to the courts. These citizens utilized a language of honor and sexual propriety based upon gender stereotypes to plead their cases.Ph.D.Cultural anthropologyLatin American historyScience historySocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/126356/2/3253212.pd

Abstract B07: Advocacy for an underserved minority: Patient navigation for Latino cancer survivors

Abstract Background: Latino cancer survivors experience an unequal burden of unmet needs following treatment. These include issues involving psychological issues, health care, wellness and ultimately, survival. Study Design: Redes En Acción: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a randomized control trial utilizing trained, bilingual, bicultural patient navigators to improve wellness and access to psychosocial services among non-metastatic Latino cancer survivors from Texas and Chicago. The trial tests the efficacy of patient navigation (PN) in improving general and disease-specific quality of life (QoL), treatment compliance, and identification of mechanisms that may promote quality of life. The study involves a 2 X 4 randomized repeated measures design with an experimental condition (combined PN over three months with access to the LIVESTRONG Cancer Navigation Center [LCNC] services [PN+LCNC]) versus a control condition (PN only) as the between-groups factor, and time-point (baseline/pre-randomization [T1]; post-PN [3-months post T1; T2], and 6 [T3] and 12 months [T4] follow up after T2) as the within groups factor. The unique combination of PN plus LCNC survivorship services is anticipated to show dramatic improvement in survivor-related measures. Results: LCNC provides free, bilingual support to U.S. cancer survivors throughout the cancer journey. It also refers survivors to services addressing their medical, economic and psychosocial needs, and monitors client contact and access outcomes. PN services are based on direct services provided by patient navigators, including but not limited to, securing transportation for clinic appointments, interpreting, completing complex medical forms, etc. Study implementation, needs assessment, community based participatory research, recruitment accrual to date, learned lessons, PN services offered, and referral to and effectiveness of the LCNC program and preliminary quality of life data analysis will be presented. Conclusions: Limited work has addressed the psychosocial needs of Latino cancer survivors. Culturally sensitive patient navigation (PN) could address these needs and significantly improve cancer survivorship. The results of the study will have immediate clinical relevance that could potentially highlight the importance of having patient navigators readily available to assist survivors within a clinic setting improving patients' overall health outcomes and screening compliance. Citation Format: Amelie Ramirez, Sandra L. San Miguel, Edgar Muñoz, Kip Gallion, Arely Perez, Leo Castillo, Sarah R. Arvey, Frank Penedo. Advocacy for an underserved minority: Patient navigation for Latino cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B07.</jats:p

Abstract P1-09-22: Improving quality of life among Latino breast cancer survivors: A national randomized control trial of patient navigators using LIVESTRONG's Cancer Navigation Center

Abstract Purpose: Latina breast cancer survivors experience an unequal burden of unmet needs after treatment, which compromise their health care and wellness, experts recommend providing psychological services as an integral part of quality cancer care. Methods: Redes En Accion: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a randomized control trial utilizing trained, bilingual, bicultural patient navigators to improve wellness and access to psychosocial services among non-metastatic Latino breast cancer survivors from Texas and Chicago. The trial tests the efficacy of patient navigation (PN) in improving general and disease-specific quality of life (QoL), treatment compliance, and identification of mechanisms that may promote quality of life. The study involves a 2 X 4 randomized repeated measures design with an experimental condition (combined PN over three months with access to the LIVESTRONG Cancer Navigation Center [LCNC] services [PN+LCNC]) versus a control condition (PN only) as the between-groups factor, and time-point (baseline/pre-randomization [T1]; post-PN [3-months post T1; T2], and 6 [T3] and 12 months [T4] follow up after T2) as the within groups factor. LCNC provides free, bilingual support to U.S. cancer survivors throughout the cancer journey. LCNC also refers to survivors to services addressing their medical, economic and psychosocial needs, and monitors client contact and access outcomes. Preliminary Results: A total of 128 Latina women with early stage breast cancer have been randomized into either our control (Standard Patient Navigation; PN) or our experimental (Enhanced Patient Navigation; EPN) conditions. Complete data for multiple regression analysis on 76 randomized Latina women who completed baseline and first follow up assessment is available. At baseline, we identified major stated needs by our participants. These included fear of recurrence, more information regarding their disease, and assistance in communicating with the medical team. The top three physical functioning concerns stated by our participants included lack of energy/fatigue, interference with daily routines and poor physical well-being. Consistent with prior work with Hispanic cancer survivors, our sample reported significantly lower (over 1.5 standard deviation below) general health related quality of life, physical well-being and emotional well-being as measured by the FACT-G. Exploratory analyses have begun to reveal that there are several significant moderators of the effects of the intervention across several outcomes. At conference, we will present quality of life data on breast cancer participants, exploratory analysis, and lessons learned. Discussion: Limited work has addressed the psychosocial needs of Latina breast cancer survivors. Culturally sensitive patient navigation (PN) could address these needs and significantly improve breast cancer survivorship. Citation Format: Amelie G Ramirez, Edgar Muñoz, Sandra San Miguel, Kip Gallion, Arely Perez, Leo Castillo, Sarah R Arvey, Frank Penedo. Improving quality of life among Latino breast cancer survivors: A national randomized control trial of patient navigators using LIVESTRONG's Cancer Navigation Center [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-22.</jats:p

HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women living on the Texas-Mexico Border

Background U.S., Hispanic women have higher cervical cancer incidence rates than non-Hispanic Whites and African Americans and lower rates of cervical cancer screening. Knowledge, attitudes, and cultural beliefs may play a role in higher rates of infection of HPV and decisions about subsequent diagnosis and treatment of cervical cancer. Study aim To explore the level of HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women on the Texas-Mexico border. Methodological Approach Informed by feminist ethnography, the authors used an interpretive approach to understand local respondents' concerns and interests. Focus group sessions were analyzed using thematic content analysis. Recruitment and sample Promotoras (lay health workers) recruited participants using convenience sampling methods. Group sessions were held in public service centers in Brownsville. Participants' ages ranged from 19 to 76 years. Methods analysis Focus group discussions were audio-recorded and transcribed in Spanish. Researchers read and discussed all the transcripts and generated a coding list. Transcripts were coded using ATLAS.ti 5.0. Key findings Participants had little understanding about HPV and its role in the etiology of cervical cancer. Attitudes and concerns differed by gender. Women interpreted a diagnosis of HPV as a diagnosis of cancer and expressed fatalistic beliefs about its treatment. Men initially interpreted a diagnosis of HPV as an indication of their partners' infidelity, but after reflecting upon the ambiguity of HPV transmission, attributed their initial reaction to cultural ideals of machismo. Men ultimately were interested in helping their partners seek care in the event of a positive diagnosis. Implications for practice Results suggest that understanding Hispanics' cultural norms and values concerning disease, sexuality, and gender is essential to the design and implementation of preventive interventions for HPV and cervical cancer.https://taylorandfrancis.co