Differences in ethnic beliefs about the perceived need for local anesthesia for tooth drilling and childbirth labor were surveyed among Anglo-Americans, Mandarin Chinese, and Scandinavians (89 dentists and 251 patients) matched for age, gender, and occupation. Subjects matched survey questionnaire items selected from previously reported interview results to estimate (a) their beliefs about the possible use of anesthetic for tooth drilling and labor pain compared with other possible remedies and (b) the choice of pain descriptors associated with the use of nonuse of anesthetic, including descriptions of injection pain. Multidimensional scaling, Gamma, and Chi-square statistics as well as odds ratios and Spearman's correlations were employed in the analysis. Seventy-seven percent of American informants reported the use of anesthetics as possible remedies for drilling and 51% reported the use of anesthetics for labor pain compared with 34% that reported the use of anesthetics among Chinese for drilling and 5% for labor pain and 70% among Scandinavians for drilling and 35% for labor pain. Most Americans and Swedes described tooth-drilling sensations as sharp, most Chinese used descriptors such as sharp and "sourish" (suan), and most Danes used words like shooting (jagende). By rank, Americans described labor pain as cramping, sharp, and excruciating, Chinese used words like sharp, intermittent, and horrible, Danes used words like shooting, tiring, and sharp, and Swedes used words like tiring, "good," yet horrible. Preferred pain descriptors for drilling, birth, and injection pains varied significantly by ethnicity. Results corroborated conclusions of a qualitative study about pain beliefs in relation to perceived needs for anesthetic in tooth drilling. Samples used to obtain the results were estimated to approach qualitative representativity for these urban ethnic groups.
As part of a cross-sectional study, carried out among Turkish mother-infant pairs, the mothers of 269 infants living in Istanbul and 30 living in Stockholm were asked their opinions as to the advantages and/or disadvantages of breastfeeding. The answers were categorized according to the attributes mentioned, quantified and related to the socio-economic status of the area of residence, maternal education, origin, current infant feeding practice and contraceptive method. In Istanbul, 63% of the responses stressed some advantage and 31% some disadvantage of breastfeeding. The contraceptive effect was considered the major advantage and the possibility of milk insufficiency the major disadvantage. In Stockholm, the nutritional value of breastfeeding was considered the most important advantage. No disadvantage was mentioned in Stockholm, despite the fact that breastfeeding durations among the immigrant group was shorter than that of the group in Istanbul. The implications of the responses are analyzed. It is hypothesized that mother-centered advantages, such as the birth-spacing effect of breastfeeding, may be more important motivators for continuing breastfeeding among women living under less-advantaged social conditions, and that, if this is true for some groups of mothers, the infant-centered emphasis in the breastfeeding promotional messages may need modification to include the interests of the mothers, as well.
To identify specific alcohol use beliefs and behaviors among local high school students; to determine whether relationships exist between alcohol use and various sociodemographic and lifestyle behaviors; and to assist in the development and implementation of alcohol abuse prevention programs.
This cross-sectional study involved the completion of a questionnaire by 1236 Grade 9-13 students (86% response rate) from 62 randomly selected classrooms in three Canadian urban schools. Data analyzed here are part of a larger lifestyle survey.
A total of 24% of students reported never having tasted alcohol, 22% have tasted alcohol but do not currently drink, 39% are current moderate drinkers, 11% are current heavy drinkers (five or more drinks on one occasion at least once a month), and 5% did not answer. Reasons stated most often for not drinking were "bad for health" and "upbringing," while reasons stated most often for drinking were "enjoy it" and "to get in a party mood." Student drinking patterns were significantly related to gender, ethnicity, grade, and the reported drinking habits of parents and friends. Older male adolescents who describe their ethnicity as Canadian are at higher risk for heavy drinking than students who are younger or female, or identify their ethnicity as European or Asian. Current heavy drinkers are at higher risk than other students for engaging in other high-risk behaviors such as drinking and driving, being a passenger in a car when the driver is intoxicated, and daily smoking.
Heavy alcohol use in adolescents remains an important community health concern. Older self-described Canadian and Canadian-born male adolescents are at higher risk for heavy drinking. Current and heavy drinking rises significantly between Grades 9 and 12. Students who drink heavily are more likely to drink and drive, to smoke daily, and to have friends and parents who drink alcohol.
American Indian and Alaska Native men experience poorer sexual health than white men. Barriers related to their sex and racial identity may prevent them from seeking care; however, little is known about this population's use of sexual health services.
Sexual health service usage was examined among 923 American Indian and Alaska Native men and 5,322 white men aged 15-44 who participated in the 2006-2010 National Survey of Family Growth. Logistic regression models explored differences in service use by race and examined correlates of use among American Indians and Alaska Natives.
Among men aged 15-19 and those aged 35-44, men with incomes greater than 133% of the federal poverty level, men with private insurance, those living in the Northeast and those living in rural areas, American Indians and Alaska Natives were more likely than whites to use STD or HIV services (odds ratios, 1.5-3.2). The odds of birth control service use did not differ by race. Differences in service use were found among American Indian and Alaska Native men: For example, those with a usual source of care had elevated odds of using sexual health services (1.9-3.4), while those reporting no recent testicular exam had reduced odds of using these services (0.3-0.4).
This study provides baseline data on American Indian and Alaska Native men's use of sexual health services. Research exploring these men's views on these services is needed to help develop programs that better serve them.
In this study, a series of focus groups were conducted to gain an understanding of the nature of stress among Canadian Aboriginal women and men living with diabetes. Specifically, attention was given to the meanings Aboriginal peoples with diabetes attach to their lived experiences of stress, and the major sources or causes of stress in their lives. The key common themes identified are concerned not only with health-related issues (i.e. physical stress of managing diabetes, psychological stress of managing diabetes, fears about the future, suffering the complications of diabetes, and financial aspects of living with diabetes), but also with marginal economic conditions (e.g. poverty, unemployment); trauma and violence (e.g. abuse, murder, suicide, missing children, bereavement); and cultural, historical, and political aspects linked to the identity of being Aboriginal (e.g. 'deep-rooted racism', identity problems). These themes are, in fact, acknowledged not as mutually exclusive, but as intertwined. Furthermore, the findings suggest that it is important to give attention to diversity in the Aboriginal population. Specifically, Métis-specific stressors, as well as female-specific stressors, were identified. An understanding of stress experienced by Aboriginal women and men with diabetes has important implications for policy and programme planning to help eliminate or reduce at-risk stress factors, prevent stress-related illnesses, and enhance their health and life quality.
In a phenomenological research study with a purposeful sample, 6 Ojibwa and Cree indigenous women healers from Canada and the United States shared their experience of being a traditional healer. Using stories obtained during open-ended, unstructured interviews, in this article I depict the lives, backgrounds, and traditional healing practices of women who, in the past, have not been afforded an opportunity to dialogue about their healing art and abilities. The methods of these women healers, their arts and their gifts, are different from those of Western conventional medicine because of dissimilar world views related to health and illness. An increased awareness of health care providers related to the ancient art of traditional healing currently practiced in communities by gifted women who provide culturally specific holistic healing and health care is essential.
Canada's Aboriginal peoples face a number of social and health issues. Research shows that Aboriginal youths are over-represented in the criminal justice system and youth forensic psychiatric programmes. Within the literature on sex offending youth, there appears to be no published data available to inform clinicians working with adjudicated Aboriginal youth. Therefore, the present study examines the background, offence characteristics, and criminal outcomes of Aboriginal (n = 102) and non-Aboriginal (n = 257) youths who engaged in sexual offending behaviour and were ordered to attend a sexual offender treatment programme in British Columbia between 1985 and 2004. Overall, Aboriginal youths were more likely than non-Aboriginal youths to have background histories of fetal alcohol spectrum disorders (FASD), substance abuse, childhood victimization, academic difficulties, and instability in the living environment. Both Aboriginal and non-Aboriginal youths had a tendency to target children under 12-years-old, females, and non-strangers. Aboriginal youths were more likely than non-Aboriginal youths to use substances at the time of their sexual index offence. Outcome data revealed that Aboriginal youths were more likely than their non-Aboriginal counterparts to recidivate sexually, violently, and non-violently during the 10-year follow-up period. Furthermore, the time between discharge and commission of all types of re-offences was significantly shorter for Aboriginal youths than for non-Aboriginal youths. Implications of these findings are discussed with regards to the needs of Aboriginal youth and intervention.
Understanding the beliefs and knowledge related to women's sexuality is important when working with unique religious groups in order to provide culturally appropriate care. An exploratory, descriptive qualitative study generated knowledge, beliefs, and practices related to menstruation, ovulation, and family planning among Low German-speaking (LGS) Mennonite women (n = 38). There is a pervasive silence that surrounds sexuality among this group, who have a limited understanding of the physiological changes they experience. Honoring religious principles and family and community expectations through acceptable female behavior is essential. Adherence to religious principles varies by family but is not shared with the group to avoid disfavor.
Unparalleled challenges currently face the Native American health care system. These challenges are a result of several factors, including (a) external pressures to reduce the overall cost of health care in the United States, (b) increased assumption of responsibility for delivery of health care by tribal governments, (c) decreased direct supervision by the Indian Health Service (IHS), (d) insufficient funding for Indian health care, and (e) increased interest of managed care to contract with tribal service units for health care. This article explores the opportunities and challenges facing Native American health care delivery and examines nursing policy issues pertinent to the current state of the IHS.