The later evolution of modern sport in Latin America: the North American influence

American impact on modern sports in Latin America overlaps geographically and chronologically with the European, especially British, impact. Principally baseball in the Caribbean basin, more recently basketball and volleyball across the hemisphere and occasionally American football in more limited areas illustrate a north-to-south movement executed by businessmen, educators, missionaries, military personnel, returning travelers (often students), sports entrepreneurs and television. Often initially supported by promoters of development within Latin America, this transfer has altered local recreational patterns and attracted Latin athletes to pursue careers in North America, provoking accusations of cultural imperialism and exploitation.

Breast cancer size and stage in Hispanic American women, by birthplace: 1992-1995

OBJECTIVES

This study examined whether Hispanic women with breast cancer have tumor characteristics associated with delayed detection and whether these characteristics vary by birthplace.

METHODS

Surveillance, Epidemiology, and End Results program data were used in examining breast cancer size and stage by racial/ethnic group and birthplace.

RESULTS

Hispanic women with breast cancer had a higher percentage of tumors larger than 1 cm (77.7%) than--non-Hispanic Whites (70.3%), as well as a higher percentage of tumors larger than 2 cm (45.9% vs 33.0%). Furthermore, in comparison with Hispanic women born in the United States, Hispanic American women born in Latin America had higher percentages of tumors larger than 1 cm (82.2% vs 75.2%) and larger than 2 cm (54.1% vs 41.7%).

CONCLUSIONS

These findings suggest that Hispanic women with breast cancer, especially first-generation Hispanic Americans, have a relative delay in the timeliness of their cancer diagnosis. First-generation Hispanic American women should be targeted in interventions designed to increase the use of breast cancer screening.

Trauma and extended separation from family among Latin American and African refugees in Montreal

Although the vast majority of refugees have suffered trauma and extended separation from their families in exile, little is known about the interactions between these two types of experience. The qualitative and quantitative analyses of data gathered from 113 refugees from Latin America and Africa suggest that the joint occurrence of trauma and separation has a significant impact on emotional distress and confirm that the family plays a key role as an anchor of emotion and identity.

Antibodies to the E2 protein of GB virus C/hepatitis G virus: prevalence and risk factors in different populations in Italy

BACKGROUND

Many aspects of the epidemiology of GB virus C/hepatitis G virus (GBV-C) infection have not been fully elucidated. The purpose of this study was to assess the prevalence of GBV-C antibodies and risk factors in different subjects living in Italy.

MATERIALS AND METHODS

A total of 1,005 sera were tested for the presence of antibodies to the of GBV-C E2 protein using a recently developed enzyme immunoassay.

RESULTS

A high prevalence of GBV-C antibodies was found in healthy blood donors (12.6%). Hemodialysis patients and drug users showed higher rates of GBV-C seropositivity (22% and 39%, respectively). Immigrants from sub-Saharan Africa and South Asia had anti-GBV-C prevalence comparable to that found in Italian blood donors, whereas higher and lower rates were detected in immigrants from Latin America and the Caribbean (19.5%) and from Mediterranean Africa (5.6%).

CONCLUSION

GBV-C infections are widespread in the general population in Italy and particularly common in risk groups. The different prevalence of GBV-C antibodies detected in third world immigrants is likely to reflect the prevalence in the countries of origin. However, the observation that the length of residency in Italy is a significant risk factor may suggest that at least some GBV-C infections are contracted in Italy.

Hegemony, emancipation and mythology

This epilogue offers a critical overview of some current interpretations of modern sport's origins and evolution in Latin America by certain European and North American commentators. These analyses still adhere to the tradition of the New World's creation. They seldom refer to primary sources. Conclusions are often born out of patronizing compassion and exotic impression. Latin American sources, if any, are mostly quoted when they serve a pessimistic historical bias cultivated by outsiders. In fact, Latin American sport represents a mirror image of more developed areas and indeed a reinvention of sport in specific cases of community isolation and self-development.

Sport in Latin America from past to present: a European perspective

This chapter examines sport in Latin America in its social, cultural, and political contexts. An analysis of the development of sport in Latin America suggests that there have been a number of distinct phases influenced by the cultures of the Spanish, British and French. More recently, the games and pastimes of the United States have made a significant impact. It is suggested that the further development of sport in Latin America is hindered by a number of significant problems. It concludes that the problems faced by some countries are immense and that governments and international organizations in the developed world should offer help where appropriate.

The early evolution of modern sport in Latin America: a mainly English middle-class inspiration

In any consideration of cultural diffusion, what matters is not only what happens to a cultural form when it arrives, but that it arrives. In the twentieth century, Latin America, like too many other areas of the world, has been a place of diplomatic turmoil, social inequality, political paranoia, capitalist exploitation and class conflict. However, despite all this, and through all this, it may be stated factually and without sentimentality, that it has also been a place where people have survived and thrived, worked, loved and played. Modern sport has brought to their play both unhappy moments of disillusion and disappointment and marvellous opportunities for illusion and pleasure. Modern sport, with its beauty spots and warts, is the reality and while there are things to criticize, there are also many things to applaud. Along with others, the English middle class played a not insignificant part in the arrival of modern sport in Latin America.

Emergency department presentations of typhoid fever

Typhoid fever, a systemic infectious disease caused by Salmonella typhi, is classically characterized by fever, paradoxical bradycardia, abdominal pain, and a rose colored rash. This was a retrospective review of 21 confirmed cases over a 5-year period. Mean age was 32.6 years (range 2-60 years), and Mexico (7/21) and El Salvador (3/21) represented the most common countries of origin. Recent travel to an endemic area was noted in 14 patients. The most common complaints were fever (15/21), headache (10/21), abdominal pain (9/21), and diarrhea (6/21). Average duration of symptoms before presentation to the Emergency Department (ED) was 7.9 days. High fever associated with bradycardia was noted in 12 patients. Leukopenia was present in 7 patients. Blood culture was the most sensitive confirmatory test while the Widal test was positive in 7 out of 11 cases. Fever of unknown origin (12/21), followed by presumed typhoid fever (3/21) were the most common ED diagnoses. It is important to recognize that patients with typhoid fever may present to EDs in the US and this disease should be included in the differential diagnosis of febrile patients from Latin America or those with a history of recent travel to endemic countries.

Health problems among Latin-American and middle-eastern refugees in The Netherlands: relations with violence exposure and ongoing sociopsychological strain

In two studies (n = 480; n = 156), the health problems (somatic, psychological, and migration-related complaints) of refugees were examined, in relation to violence, demographic, and asylum variables (ongoing sociopsychological strain). High frequencies for torture events and a substantial number of medical complaints were reported, but few cases of diagnosable Posttraumatic Stress Disorder (PTSD) were identified (Study I: 6%; Study II: 11%). Not only reported violence, but also the current social situation contributed to the experiencing of ongoing health complaints. Refugees attributed their somatic and psychological complaints to illness (48%) and to torture (29%) and psychological complaints, in particular, to worries related to the postmigration situation (40%). Paying attention only to health complaints and to past violent experiences is too limited an approach in responding to the needs of refugees.

Traumatic life events in primary care patients: a study in an ethnically diverse sample

OBJECTIVE

To examine among immigrants and others seeking primary care: (1) the prevalence, types, and predictors of traumatic life events; and (2) the relations among traumatic life events, psychiatric disorders, and utilization of primary care services.

DESIGN

Survey with structured diagnostic interview.

SETTING

Community-based, university-affiliated primary care clinic in southern California.

PARTICIPANTS

Fourteen hundred fifty-six adult patients representing 4 ethnic groups (Mexican immigrants, Central American immigrants, US-born Latinos of Mexican descent, and US-born non-Latino whites).

DEPENDENT MEASURES

Rates of traumatic events measured with the Posttraumatic Stress Disorder section of the Diagnostic Interview Schedule; psychiatric disorders identified by the Composite International Diagnostic Interview using Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria; physical functioning (Short Form Health Survey); and the number of medical clinic visits during a 6-month period.

RESULTS

Nearly 10% of patients had experienced a traumatic event in the previous year, and 57% had experienced at least 1 during their lifetimes. The most common forms of trauma were interpersonal violence occurring outside the family (21%), acute losses or accidents (17%), witnessing death or violence (13%), and domestic violence (12%). When compared with the US-born non-Latino whites, Mexican immigrants were half as likely, and Central American immigrants were 76% more likely, to report having experienced a traumatic event. Married individuals were significantly less likely to report traumas. Traumatic experiences, female gender, and non-Latino ethnicity were associated with the presence of a psychiatric disorder. One-year and lifetime psychiatric disorders were associated with poorer physical functioning and an increased number of clinic visits during a 6-month period.

CONCLUSIONS

Traumatic life events are common and associated with psychiatric disorders other than posttraumatic stress disorder in an ethnically diverse sample of primary care patients. Psychiatric disorders, in turn, are strongly associated with poor physical functioning and higher rates of primary care utilization. Screening for traumatic experiences should accompany assessments of psychiatric disorders to ensure adequate treatment of patients seeking primary care services.

[Structure of hair on the head and other parts fo body in Latin Americans]

The structure of hairs from the head, chest, armpits, and pubis of residents of Latin America (Bolivia, Salvador, Panama, Ecuador, Chile, Nicaragua, Venezuela, Peru, Brasil, and Mexico) has been studied. New data on macro- and microscopic characteristics of hairs of the population of the above countries were obtained (color, shape, length, thickness of hair; number of cuticle lines; characteristics of hair layers, shapes of transverse sections, etc.).

Intercountry adoption of Latin American children: the importance of early bilingual/bicultural services

Because of major worldwide demographic changes, many Latin American children are frequently adopted in the U.S. This article presents an overview of the historical and contemporary circumstances and controversies surrounding intercountry adoptions (ICAs), and a review of possible risk factors for later child or adolescent maladjustment. Although a number of follow-up studies indicate a 70-80% positive outcome, some ICAs end in painful family-child disruptions. There is, therefore, a growing need for bilingual/bicultural mental health services to improve the initial adjustment process and to facilitate a positive long-term outcome. These services are especially needed when the child is older at arrival and the adopting family lives in a mostly homogeneous community. Suggested prearrival, arrival, and follow-up interventions with the family, the child, and the school are described. A case illustration of the interventions offered to a U.S. family and their recently adopted Latin American child is provided.

Migration and atopic disorder in Swedish conscripts

We have studied asthma and allergic rhinitis prevalence in Swedish conscripts born 1973-1977 according to the military service conscription register in relation to the socio-economic status and country of birth of the conscripts and their parents, and age when granted residency in Sweden. There was an increase in prevalence of asthma and allergic rhinitis over time in all groups irrespective of country of birth or ethnic origin. Conscripts who themselves were born in Africa, Asia, Latin America and the Mediterranean had a significantly lower risk for asthma and allergic rhinitis than Swedish-born conscripts. The risk of atopic disorder among the foreign-born conscripts increased with time of residency in Sweden. Conscripts with mothers from Latin America, Asia and Africa were identified as having the highest risk for atopic disorder among Swedish-born conscripts with high socio-economic status; the adjusted risk ratio (RR) for asthma was 2.6 (95% CI 1.7-4.0) and that for allergic rhinitis was 2.0 (1.5-2.6). The conscripts with mothers from the Mediterranean had the lowest risk for atopic disorders of the Swedish-born conscripts with low socio-economic status; the RR for asthma was 0.43 (0.34-0.56) and that for allergic rhinitis was 0.84 (0.76-0.93). This study demonstrates that factors related to migration and ethnicity are important determinants of atopic disorder among Swedish conscripts.

[Mental disorder and the use of public psychiatric services in the foreign population in the Canton Ticino region]

OBJECTIVE

To verify if the foreign population resident in the Canton Ticino, differs in the use of public psychiatric services and in the type of mental disorder presented, with respect to the Swiss population.

DESIGN

Research completed on subjects Swiss and foreign, over 19 years old, and resident in the Canton Ticino, who during 1995 spent at least one day admitted at the psychiatric hospital or had at least one contact with the out-patient services.

SETTING

Public psychiatric services of the Canton's sociopsychiatric organisation.

MAIN OUTCOME MEASURES

For the Swiss, Italian and other non-Italian foreigners, the standardised annual rates of in- and outpatient prevalence and first admission and first outpatient contact were calculated, both totals and per diagnostic categories (ICD-10).

RESULTS

The group of non-Italian foreigners presents higher total standardised annual rates of in-patient prevalence and first admission and above all, of first admission, with respect to the Swiss and Italian groups; furthermore, with respect to the other two groups it presents higher first admission rates for the schizophrenic syndromes (F2) in men and for mental disorders due to psychoactive substances (F1) in women. Whereas for first outpatient contacts the other foreigners present higher rates in neurotic syndromes (F4) in men, and affective syndromes (F3) in women.

CONCLUSIONS

The results seem to confirm the presence of higher levels of mental disorder in non-Italian foreigners, above all for certain nationalities, with respect to Swiss and Italians. It is possible that the presence of a substantial offer of psychiatric services from the private sector may have caused an underestimation of the actual rate of mental disorder above all in the Swiss group and to a minor extent in that of the Italians.

Sex in the New World: an empowerment model for HIV prevention in Latina immigrant women

In 1996, nearly 60% of U.S. AIDS cases among Latinas were attributed to unprotected sex with men. Economic disadvantage, language barriers, and strong cultural gender norms regarding sex exacerbate the risk for HIV infection among Latina immigrant women. Through a collaboration among scientists and providers, this study was designed to evaluate the impact of a multifaceted empowerment program for Latina immigrant women on HIV risk behaviors. Women (N = 74) were followed for the first 6 months of their participation and attended up to nine distinct types of activities (e.g., information meetings, friendship circles, and workshops). Although the program was not developed to specifically target HIV risk behaviors, women showed significant increases in sexual communication comfort, were less likely to maintain traditional sexual gender norms, and reported changes in decision-making power. Targeting broader sociocultural issues may increase the necessary skills for Latina women to prevent HIV infection from their sexual partners. Successful collaborations between scientists and providers are critical in developing effective, community-relevant interventions.

Trypanosoma cruzi in a low- to moderate-risk blood donor population: seroprevalence and possible congenital transmission

BACKGROUND

Several recent studies documented the seroprevalence of Trypanosoma cruzi in blood donors at high risk for infection, but little information is available regarding donors with lower levels of risk. Thus, the present study was designed to measure the seroprevalence of T. cruzi in a donor population with a low to moderate risk for infection.

STUDY DESIGN AND METHODS

During a 10-month period, donations from all allogeneic blood donors in the American Red Cross Southwest Region were tested for T. cruzi antibodies by enzyme immunoassay, and results were confirmed by radioimmunoprecipitation. Confirmed-seropositive donors were counseled and lookback investigations were initiated for those who were repeat donors.

RESULTS

A total of 100,089 donations were tested: 150 were repeatably reactive, and 3 (0.003%) were confirmed as positive for T. cruziantibodies. All three seropositive donors were from the Waco, TX, area, where the estimated seroprevalence rate was 1 in 7700. Two of these three donors reported no risk factors; both were born in the United States and had not traveled to an endemic area. Both had extensive familial histories of cardiac disease and complications.

CONCLUSION

Blood donors seropositive for T. cruzi are present in populations with low to moderate risk, albeit at lower rates. The presence of seropositive blood donors without the usual identifiable risk factors argues against the use of a geographic screening question and also suggests that other routes of transmission, including the congenital route, should be considered in efforts to increase blood safety.

Travelling with "excess baggage": health problems of refugee women in Western Australia

Refugee women face problems during resettlement in host countries that are often worse than those faced by voluntary migrants. Although these problems are generally thought to be related to previous traumatic experiences, this may not always be the case; there are many refugee women who may not have personally experienced torture or trauma but who nonetheless express needs that suggest a perception of profound marginalisation from the mainstream society. This paper summarises the health problems identified in a needs assessment of refugee women from Latin America resident in Perth, Western Australia and discusses some of the issues that create "excess baggage" for refugee women.

Physician perceptions of barriers to care for inner-city Latino children with asthma

This article describes physician perspectives on barriers to quality primary care experienced by inner-city children with asthma and presents policy recommendations to reduce these barriers. The authors interviewed 30 physicians who take care of children with asthma in an inner-city Latino neighborhood, conducted a qualitative analysis of interview themes, and used a consensus group method to recommend policy actions. Inner-city physicians described significant access, quality of care, and other barriers in providing state-of-the-art primary care for asthma. Physicians recommended that eliminating financial barriers to care, including lack of health insurance and/or comprehensive health coverage for necessary medications and equipment, is the most important required policy action. In addition, inner-city physicians recommended that medical care and public health programs provide bilingual education for children with asthma and their families and train primary care physicians about how to provide effective asthma care to children with asthma in the inner city.

Witchcraft, sexuality, and colonization in the early modern world

Thinking with demons: the idea of witchcraft in early modern Europe. By Stuart Clark. Oxford: Oxford University Press, 1997. Pp. xvii+827. ISBN 0–19–820001–3. £75.00.

The darker side of the Renaissance: literacy, territoriality, and colonization. By Walter D. Mignolo. Ann Arbor: University of Michigan Press, 1995. Pp. xxii+426. ISBN 0–472–10327. $39.50.

Oedipus and the devil: witchcraft, sexuality, and religion in early modern Europe. By Lyndal Roper. London: Routledge, 1995. Pp. ix+254. ISBN 0–415–10581–1. £13.99.

As Professor Richard Evans's spirited In defence of history attests, postmodernism continues to arouse strong passions and suspicions among distinguished practitioners of the discipline. This is hardly surprising: in their most extreme and undiluted form, the theories of Jacques Derrida, Michel Foucault, Hayden White, and more particularly their many disciples, are stubbornly corrosive of the ethos and rationale of history as conventionally taught and written. To insist that the production of knowledge is inherently – indeed insidiously – political, and to claim that the veil of language which divides us from the past can never be pierced is to unsettle many traditional epistemological assumptions. And yet postmodernism and the so-called ‘linguistic turn’ have posed timely and fundamental questions about truth, discourse, and objectivity which historians can ill afford to ignore. They have also helped to generate some of the most innovative and provocative historical writing in recent years. In different ways, each of the books under review engages with and reacts to the swirling debate about this influential and controversial body of ideas. All three make strenuous demands upon their readers; all three challenge us to reflect critically upon the methodologies we employ and the categories, concepts, polarities, and narrative paradigms to which we instinctively resort. Taken together they highlight both the potential strengths and weaknesses, the rewards and dangers of injecting theory into the study of witchcraft, sexuality, and colonization in early modern Europe and the New World.

Identifiers of predominantly Spanish-speaking children with language impairment

The purpose of this study was to identify a set of measures that would discriminate 31 predominantly Spanish-speaking children with normal language (NL children) from 31 children with language impairment (LI children). The LI children were identified as such by experienced, bilingual (Spanish/English), ASHA-certified, speech-language pathologists who were currently seeing the children in their caseloads. Children ranged in age from 5 to 7 years and were matched for age, gender, and school. Additionally, nonverbal cognitive measures assured that they did not differ significantly intellectually. Measures of vocabulary, novel bound-morpheme learning skills, and language form were randomly administered to all children. Further, parents responded to questions about their perceptions of their children's speech and language skills and family history of speech and language problems. A stepwise discriminant analysis indicated that 4 measures discriminated the groups of children with a sensitivity of 91.3% and a specificity of 100% (p < .0001): parental report of the child's speech and language skills, number of errors per T-unit, mean length per T-unit, and family history of speech and language problems. A second discriminant analysis indicated that the sensitivity and specificity could be maintained when only the first 2 measures were included. Confirmatory discriminant analyses of the 2- and 4-measure models indicated that the discriminant accuracy was stable on an independent sample.

Patient attitudes about mandatory reporting of domestic violence. Implications for health care professionals

As of January 1994, California physicians are required to report to police all patients who are suspected to be victims of domestic violence. This article describes the results from a focus group study of abused women (n = 51) that explored their experiences with and perspectives on medical care. The eight focus groups included two Latina (total n = 14), two Asian (total n = 14), two African-American (total n = 9), and two Caucasian (total n = 14) groups of women who had been the victims of domestic abuse within the previous 2 years. The women were recruited through community-based organizations in the San Francisco Bay Area. With regard to physician reporting of domestic violence to police, five themes were identified: fear of retaliation by the abuser, fear of family separation, mistrust of the legal system, desire for police protection, and preference for confidentiality and autonomy in the patient-health professional relationship. Our results indicate that mandatory reporting may pose a threat to the safety and well-being of abused women and may create barriers to their seeking help and communicating with health care professionals about domestic violence.