Donde esten mis hijos alli que me entierren. the migration history of Aura Lila Callejas

Adonde esten mis hijos alli que me entierren, presents the migration history of my great-aunt Aura Lila Callejas. This work utilizes the oral history method to examine one woman\u27s migration experience in an attempt to identify various theoretical issues. Aura Lila\u27s immigration experience sheds light on a number of different issues, including the reasons why people migrate and how they adapt to an entirely new and often frightening set of circumstances in the country of arrival. The oral history method has proven useful in presenting some of the ways in which structural factors combine with personal motivations to provide the impetus for Aura Lila\u27s journey of international migration. My work with Aura Lila has also served to highlight some of the existing gaps in the current literature regarding Nicaraguans in the United States and the importance of the family within the overall process of migration. Finally, this work explores the nature of the relationship between the researcher and subject within the ethnographic process. While much of Aura Lila\u27s story remains unique and specific to her family\u27s history, her narrative can be related to the growing body of literature focusing on women\u27s life histories

Clostridium difficile Infections amongst Patients with Haematological Malignancies: A Data Linkage Study

OBJECTIVES: Identify risk factors for Clostridium difficile infection (CDI) and assess CDI outcomes among Australian patients with a haematological malignancy. METHODS: A retrospective cohort study involving all patients admitted to hospitals in Western Australia with a haematological malignancy from July 2011 to June 2012. Hospital admission data were linked with all hospital investigated CDI case data. Potential risk factors were assessed by logistic regression. The risk of death within 60 and 90 days of CDI was assessed by Cox Proportional Hazards regression. RESULTS: There were 2085 patients of whom 65 had at least one CDI. Twenty percent of CDI cases were either community-acquired, indeterminate source or had only single-day admissions in the 28 days prior to CDI. Using logistic regression, having acute lymphocytic leukaemia, neutropenia and having had bacterial pneumonia or another bacterial infection were associated with CDI. CDI was associated with an increased risk of death within 60 and 90 days post CDI, but only two deaths had CDI recorded as an antecedent factor. Ribotyping information was available for 33 of the 65 CDIs. There were 19 different ribotypes identified. CONCLUSIONS: Neutropenia was strongly associated with CDI. While having CDI is a risk factor for death, in many cases it may not be a direct contributor to death but may reflect patients having higher morbidity. A wide variety of C. difficile ribotypes were found and community-acquired infection may be under-estimated in these patients

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Contemporary Afro-Cuban Voices in Tampa: Reclaiming Heritage in “America’s Next Greatest City”

This dissertation presents findings from ethnographic research conducted with members of the Sociedad La Unión Martí-Maceo, established by segregated Black Cuban cigar workers in Ybor City in 1904. For decades, Tampa officials have initiated numerous urban revitalization projects aimed at developing a world-class tourist destination and metropolitan center. Often, these efforts have centered on highlighting the ethnic history of Ybor City, from which the participation of Black Cubans and the Martí-Maceo Society have been actively excluded or ignored. The main issues related to contemporary Afro- Cuban identity in Tampa and which will be examined in my dissertation, include the changing nature of the Afro-Cuban community in Tampa in light of increases in migration of Cubans and other Latinos of color to the area; Martí-Maceo members’ struggle to reclaim an Afro-Cuban heritage within Tampa’s larger historic preservation efforts over the past decade; and an examination of the Martí-Maceo Society as a voluntary association that appears to have outlived its usefulness in present-day Tampa despite efforts by elderly members to sustain and expand it

Rapid Ethnographic Assessment of Pandemic Restrictions in Child Welfare: Lessons from Parent and Provider Experiences

This paper analyzes policy and practice changes implemented by the child welfare system in Miami-Dade County in response to the COVID-19 crisis. Rapid ethnographic assessment (REA) was used to capture multiple perspectives during a rapidly unfolding pandemic. We identified system vulnerabilities and opportunities for lessening the impact of crises on vulnerable families with children in foster care. The assessment highlights how system fragmentation complicates effective responses to public health emergencies, while the transition to remote services provides insight into ways that traditional accessibility barriers may be alleviated beyond the pandemic. We provide recommendations for improving family experiences and preparing for future crises, envisioning ways that peer specialists, in particular, may offer a model for enhanced family support. This study emphasizes the unique benefits of anthropological theory and applied methods in assessing and improving public sector systems

Latinos’ Views of Chronic Disease and Minor Depression

Background: There are notable health disparities among Latinos in the US associated with chronic diseases (e.g., diabetes) and depression. Further, chronic diseases and minor depression tend to co-occur among Latino populations. This paper reports findings from a community-based participatory research study using dyadic focus groups with Latinos who have chronic disease and minor depression and their family members. The goal of this study was to better understand barriers and facilitators to chronic disease self-management among underserved Latinos living with both chronic illness and minor depression and their families using a socio-ecological approach.Methods: In total, five focus groups were conducted with individuals with chronic disease (n=25) and four with nominated family members (n=17). All focus groups were digitally recorded and transcribed by a professional transcription agency in Spanish. Transcripts were imported into Atlas.ti V 6.2 software program and analyzed in Spanish by a team of bilingual researchers using content analysis. Qualitative results are presented thematically by level of analysis or behavioral influence (i.e., individual, family, and community levels) and barriers and facilitators are discussed within each level.Results: Results revealed individual, family, and community level barriers (e.g., transportation, expressed emotion, and lack of health care providers) and facilitators to managing chronic disease and minor depression (e.g., acceptance, family support, and Spanish speaking support groups). Conclusion: Findings have important implications for the understanding of chronic disease management for Latinos and emphasize the need to use evidence based approaches that address barriers and facilitators across the social-ecological continuum

A Mixed-Methods Design Informed by CBPR for the Adaptation of an EBI for Latinos with Minor Depression and Chronic Disease

Background: A mixed methods design informed by community-based participatory research (CBPR) offers advantages to a single research approach by engaging community and academic partners in collecting context-rich and empirical data to inform the translation of evidence-based interventions (EBI). Purpose: This multiphase study sought to translate research findings for the adaptation of an EBI, self-management program (Tomando) for Latino individuals with chronic illness and minor depression (ICD). This presentation focuses on the mixed methods, CPPR approach used to guide phase I of the research. Methods: Mixed methods employed include: a) focus groups with ICD and family members and b) key stakeholder semi-structured interviews followed by a survey. A community-academic team informed key decisions about research design, recruitment, and presentation of findings. Results: Methodological issues arose regarding the heterogeneity of focus group members (e.g., rural versus urban, combining genders) and presence of illness in family members. Recruitment efforts indicated that depression was not well understood or endorsed by potential participants who exhibited depressive symptomatology. Other challenges include the limited health literacy of participants, the need for bi-lingual/bi-cultural staff to conduct and analyze research, and the need for a more diverse community sampling frame. Community partners; however, provided an insider perspective to overcome methodological challenges and the impact of stigma associated with depression on recruitment. Conclusion: This CBPR approach allowed for the identification of practical solutions to methodological challenges while demonstrating important strategies for informing and influencing the translation of EBIs aimed at reducing or eliminating health disparities into practice

Minor Depression and Chronic Disease Among Latinos: Translating Research Into Practice

Problem: Evidence based chronic disease self-management programs (CDSMPs) have reported success in improving health outcomes. Yet few attempt to address the complex issues associated with the co-occurrence of minor depression and chronic illness. With co-occurrence rates of depression and chronic illnesses (e.g. CVD, diabetes) reported as high as 30%, translation of health behavior research into practice is vital to improved health outcomes. This multiphase, community-based participatory research study was designed to better understand the needs and preferences of Latinos living with chronic illness and minor depression (ICDs), their families, and key stakeholders (i.e. service providers). Methods: This study employed a mixed methods design including: a) focus groups with ICDs (n=5) and family members (n=4) and b) semi-structured interviews followed by a survey with key stakeholders (n=31) to obtain views on living with chronic illness, barriers and facilitators to self-management, and the potential for adapting an evidence based CDSMP. Thematic analysis allowing for emergent themes was employed for qualitative data. Descriptive statistics were performed to summarize survey data. Results: Analysis identified perspectives on the needs of Latinos suffering from the co-occurrence of chronic illness and minor depression in managing their illnesses. Results suggested necessary elements for the successful adoption of CDSMP, including delivery by trusted community partners and cultural relativity for encouraging sustainable health promoting practices. Additionally, results indicate challenges and risks to adoption by key stakeholders that must be addressed. Conclusion: Findings will guide the adaptation of \u27Tomando,\u27 an evidence based CDSMP, for Latinos with chronic illness and minor depression