ABSTRACT
Our study traces the pernicious whiteness of coloniality in elementary science classrooms in El Sur de Tejas, Aztlán. Our research method was an ethnographic case study that enabled us to explore participants' identities within bioregional contexts. In our findings, we emphasize the pernicious whiteness of coloniality via the participants' personal and professional identity tensions. Through our analysis, we subjunctively begin to outline what we call the multigenerationality of subtractive schooling.
Nuestro estudio rastrea la blanquitud perniciosa de la colonialidad en las aulas de las escuelas primarias de ciencia en el Sur de Téjas, Aztlán. Enmarcamos nuestro estudio enfatizando las literaturas recientes de la blanquitud y la teoría crítica de raza Latina. Nuestro método de investigación es un estudio de caso etnográfico que nos permite explorar las identidades de los participantes dentro de contextos biorregionales. Nuestros hallazgos enfatizan la perniciosa blanquitud de la colonialidad a través de las tensiones de identidad personal y profesional de los participantes. A través de nuestro análisis, comenzamos a delinear subjuntivamente lo que llamamos la multigeneracionalidad de la escolarización subtractiva.
ABSTRACT
BACKGROUND: As the older U.S. population becomes more ethnically diverse, there will be an increased need for culturally sensitive hospice care services. Hispanics often experience multiple barriers to quality end-of-life care services. OBJECTIVE: To address the underlying disparities in the cultural, emotional, and spiritual aspects of hospice care, the objective of the present qualitative study was to examine the emotional and spiritual needs of Hispanic patients' families while in hospice. METHOD: Semistructured in-person interviews were conducted with 29 Hispanic patients' families regarding their perceived experience of the hospice-based emotional and spiritual support received. Demographic information was collected on both the family member and the patient. Interviews were digitally recorded, transcribed, and analyzed using thematic content analysis. RESULTS: Participant narratives fell into five main themes: (1) the influence of Hispanic culture in the relationship with hospice care providers; (2) types of social support received from hospice; (3) barriers to receiving support; (4) lack of health literacy regarding hospice care; and (5) cultural preferences for religious/spiritual support in hospice. SIGNIFICANCE OF RESULTS: Our results provide insight into the specific emotional and spiritual needs of Hispanic families receiving hospice services. Our findings highlight that cultural values play an important role in the hospice care experiences of Hispanic families.
ABSTRACT
The Hispanic older adult population is increasing rapidly and past research suggests that this demographic group underutilizes hospice services, highlighting the need to improve our understanding of their needs in end of life. This study relied upon information from the family evaluation of hospice care survey provided by 2980 caregivers, 152 of whom cared for a Hispanic patient and 2828 who cared for a non-Hispanic patient. Caregivers of Hispanic patients were more likely to report that hospice was inconsistent with the patient's wishes, and that they received more attention than desired for emotional issues. Caregivers of Hispanic patients were also more likely to express that emotional/spiritual forms of support were insufficient. Similar levels of satisfaction were reported for caregivers of Hispanics and non-Hispanics regarding dignity/respect, information received, care coordination, and overall satisfaction.
Subject(s)
Caregivers/psychology , Family/psychology , Hispanic or Latino/psychology , Hospice Care/psychology , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Patient Satisfaction , Sex Factors , Socioeconomic FactorsABSTRACT
OBJECTIVE: The Family Evaluation of Hospice Care (FEHC) survey is widely employed by hospices, and several studies have examined this information to help inform and enhance end-of-life services. However, these studies have largely focused on examining relatively straightforward associations between variables and have not tested larger models that could reveal more complex effects. The present study aimed to examine the direct and mediating (i.e., via information/education, patient care, and family support) effects of demographic factors, length of stay, timing of referral, patient symptom severity, location of services, and relationship to caregiver on two outcome variables: overall satisfaction and caregiver confidence. METHOD: Surveys were collected from 3226 participants who had lost a loved one who received hospice services. Structural equation modeling was employed to examine the direct and mediating effects of the independent variables on the two outcomes of interest. RESULTS: Participants reporting on racial minority patients, patients with more symptoms, and those referred too late or too early were the most likely to express some discontentment with hospice services. The information/education these individuals received was the only mediating factor significantly associated with caregiver confidence. More positive perceptions of patient care and information/education were both significantly related to greater overall satisfaction. SIGNIFICANCE OF RESULTS: These findings help to (1) pinpoint those most at risk for being less satisfied with hospice, (2) identify which aspects of care may be most strongly related to overall outcomes, and (3) provide a model for examining complex associations among FEHC variables that may be employed by other researchers.
Subject(s)
Evaluation Studies as Topic , Family , Hospice Care/standards , Neoplasms/therapy , Personal Satisfaction , Bereavement , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
BACKGROUND: Although many veterans are progressing into older adulthood and a substantive subset of people who die each year in the United States served in the military, there is limited evidence on the role of military service at the end of life. OBJECTIVE: The objective of the study was to examine differences in caregivers' perceptions of sadness and anxiety at the end of life between veteran and nonveteran patients and levels of contentment with the emotional support provided to the patient and family by hospice staff. METHODS: This cross-sectional study used clinical information from the Family Evaluation of Hospice Care (FEHC) survey administered to caregivers of a patient who received hospice services. The sample in this study included 560 individuals who completed the FEHC survey (from December 2007 to April 2013) after receiving services at a large hospice in an urban southwestern U.S. city. Caregivers responded to questions on the FEHC survey about demographic information, perceptions of the patient's level of sadness/anxiety, and the emotional support the patient and family received from hospice staff. In addition, information regarding veteran status was obtained from patients' medical records. RESULTS: Caregivers of veterans were significantly more likely to report that the patient experienced sadness/anxiety at the end of life, as well as a desire for more emotional support for the family from hospice staff after the death. CONCLUSIONS: Results provide preliminary evidence for veteran status being a risk factor for emotional distress at the end of life, highlighting the possible need for augmented support services for veterans and their families in hospice and palliative care.
Subject(s)
Anxiety , Caregivers/psychology , Family/psychology , Grief , Hospice Care/psychology , Social Support , Veterans/psychology , Aged , Consumer Behavior , Cross-Sectional Studies , Evaluation Studies as Topic , Humans , Logistic Models , Male , Middle Aged , Professional-Family Relations , Professional-Patient Relations , Southwestern United States , United StatesABSTRACT
Introducción: La isquemia arterial aguda periférica (IAAP) es lainterrupción brusca del aporte sanguíneo a una determinada partedel organismo mediante: la obstrucción, el debilitamiento de las paredesarteriales o daño de las válvulas de las venas, teniendo comoetiología las causas de tipo orgánica y funcional. Objetivo: Determinarla incidencia y describir las causas de la isquemia arterialaguda periférica en pacientes pediátricos como consecuencia de unprocedimiento cardiovascular percutáneo. Metodología: Se realizóun estudio transversal y retrospectivo de 17 pacientes sometidos aintervencionismo, de N = 621 pacientes atendidos en los Serviciosde Hemodinámica y Cardiopediatría del Instituto Nacional de CardiologíaIgnacio Chávez, del 1 de enero de 2008 al 31 de mayo de2009. Se incluyeron pacientes de 0 a 2 años a los que les realizócateterismo cardíaco diagnóstico y terapéutico, que presentaronisquemia arterial aguda periférica. El análisis de datos se realizómediante el programa estadístico SPSS v. 17, los resultados se expresaronmediante medidas de resumen; y se utilizó la correlaciónde Spearman para el número de punciones y causas de isquemiaarterial aguda. Resultados: La muestra (n = 17) representa unaincidencia de 2.73%, predominando el sexo masculino en un 53% yafectando a los pacientes de 0 a 4 meses de edad. Las causas encontradasson el traumatismo en el 35.29%, la trombosis en el 29.41%,la embolia en el 17.64%. Existe una correlación de Spearman positivaentre número de punciones y las causas de IAAP. Conclusión:Los factores relacionados a la IAA son en su mayoría prevenibles,por lo que es necesario una adecuada detección de factores de riesgopara prevenir complicaciones vasculares periféricas.
Introduction: Acute peripheral arterial ischemia (APAI) consistsof the sudden interruption of blood supply to certain part of thehuman body through: obstruction, artery-wall weakening or veinvalveharm, being the etiology produced by organic- or functionaltypecauses. Objective: To determine the incidence of acute peripheralarterial ischemia over pediatric patients as a consequence of apercutaneous cardiovascular procedure. Methodology: A transversaland retrospective study was carried out on seventeen patientssubjected to interventionism, from N = 621 patients attendedat the Hemodynamics and Cardiopediatrics Services in the «IgnacioChávez¼ National Institute of Cardiology, from January the 1st,2008, to may 31st, 2009. The study included patients ranging from0 to 2 years old, who were practiced diagnostic and therapeuticcardiac catheterization, and presented Acute Peripheral ArterialIschemia. The data analysis was performed through the SPSS v.17 statistical program, the results were expressed by means of summarymeasurements. Spearmans Correlation was employed forpuncture number and causes of Acute Arterial Ischemia. Results:The sample (n = 17) represents an incidence of 2.73%, prevailingthe male sex in a 53%, and affecting pediatric patients from 0 to 4months old. It was found a positive Spermans Correlation betweennumber of punctures and APAI causes. Conclusion: The factors relatedto APAI are mostly preventable, so proper risk-factor detectionis necessary in order to prevent peripheral vascular complications.
Subject(s)
Humans , Cardiac Catheterization/nursing , Nurses, Pediatric/statistics & numerical data , Intensive Care Units, Pediatric/statistics & numerical data , Health Services ResearchABSTRACT
El control de calidad se efectuó sobre los valores obtenidos, relativos y absolutos, de linfocitos T y de sus subpoblaciones CD4+ y CD8+ en muestras de sangre de pacientes infectados con el virus de la inmunodeficiencia humana (HIV). El estudio incluyó dieciocho centros: diez utilizaron citómetros de flujo de Becton Dickinson, tres de Coulter y 5 de Ortho que representan a 17 laboratorios de Argentina y a uno de Uruguay. Los siguientes programas se utilizaron para analizar los datos : SimulSET, Paint a Gate (Becton Dickinson), Profile II, XL System (Coulter), ImmunoCount Trio y Combo Cytoron (Ortho). Se obtuvieron muestras de sangre periférica en horas de la mañana (8 a 10 hs) de 10 voluntarios normales (por serología y hemograma) y de 10 pacientes HIV positivos con valores previos de CD4 que variaron entre 200-350 células por microlito y fueron procesadas dentro de las 12 horas. Cada centro obtuvo los valores relativos con el procedimiento técnico habitual y el de los valores absolutos utilizando el hemograma propio. Además, en un contador hematológico Cell-Dyn 3500 se obtuvo para cada muestra el hemograma correspondiente considerado de referencia. Los valores absolutos medios, obtenidos en cada centro con el hemograma propio, para los linfocitos T y los de sus subpoblaciones fueron significativamente diferentes. No hubo diferencias significativas para los valores porcentuales entre los diferentes centros ni para los valores absolutos obtenidos con el hemograma de referencia. Concluimos que las diferencias en los valores absolutos de los linfocitos T y sus subpoblaciones dependen del recuento hematológico empleado. (AU)
Subject(s)
Humans , Male , Female , Adult , Flow Cytometry/methods , Multicenter Studies as Topic , Quality Control , Lymphocyte Subsets , CD4-Positive T-Lymphocytes , CD8-Positive T-Lymphocytes , HIV , Data Interpretation, Statistical , Blood Specimen Collection , CD4 Lymphocyte Count/methodsABSTRACT
El control de calidad se efectuó sobre los valores obtenidos, relativos y absolutos, de linfocitos T y de sus subpoblaciones CD4+ y CD8+ en muestras de sangre de pacientes infectados con el virus de la inmunodeficiencia humana (HIV). El estudio incluyó dieciocho centros: diez utilizaron citómetros de flujo de Becton Dickinson, tres de Coulter y 5 de Ortho que representan a 17 laboratorios de Argentina y a uno de Uruguay. Los siguientes programas se utilizaron para analizar los datos : SimulSET, Paint a Gate (Becton Dickinson), Profile II, XL System (Coulter), ImmunoCount Trio y Combo Cytoron (Ortho). Se obtuvieron muestras de sangre periférica en horas de la mañana (8 a 10 hs) de 10 voluntarios normales (por serología y hemograma) y de 10 pacientes HIV positivos con valores previos de CD4 que variaron entre 200-350 células por microlito y fueron procesadas dentro de las 12 horas. Cada centro obtuvo los valores relativos con el procedimiento técnico habitual y el de los valores absolutos utilizando el hemograma propio. Además, en un contador hematológico Cell-Dyn 3500 se obtuvo para cada muestra el hemograma correspondiente considerado de referencia. Los valores absolutos medios, obtenidos en cada centro con el hemograma propio, para los linfocitos T y los de sus subpoblaciones fueron significativamente diferentes. No hubo diferencias significativas para los valores porcentuales entre los diferentes centros ni para los valores absolutos obtenidos con el hemograma de referencia. Concluimos que las diferencias en los valores absolutos de los linfocitos T y sus subpoblaciones dependen del recuento hematológico empleado.
