West Central States Research Articles

Are there racial differences in patients' shared decision-making preferences and behaviors among patients with diabetes?

In the United States, African Americans are more likely to experience lower quality patient/provider communication and less shared decision making (SDM) than whites, which may be an important contributor to racial health disparities. Patient factors have not been fully explored as a potential contributor to communication disparities. The authors analyzed cross-sectional data from a survey of 974 patients with diabetes seen at 34 community health centers (HC) in 17 midwestern and west-central states. They used ordinal and logistic regression models to investigate racial differences in patients' preferences for SDM and in patients' behaviors that may facilitate SDM (initiating discussions about diabetes care). The response rate was 67%. In bivariate and multivariate analyses, race was not associated with patient preference for a shared role in the 3 measured SDM domains: agenda setting (odds ratio [OR]: 1.13 [0.86, 1.49]), information sharing (OR: 1.26 [0.97, 1.64]), or decision making (OR: 1.16 [0.85, 1.59]). African Americans were more likely to report initiating discussions with their physicians about 4 of 6 areas of diabetes care-blood pressure measurement (66% v. 52%, P < 0.001), foot examination (54% v. 47%, P = 0.04), eye examination (57% v. 46%, P = 0.002), and microalbumin testing (38% v. 29%, P = 0.01)-but not HbA1c testing (39% v. 43%, P = 0.31) or cholesterol testing (53% v. 51%, P = 0.52). In multivariate analysis, African Americans were still more likely to report initiating conversations about diabetes care (OR: 1.78 [1.10, 2.89]). The authors found that African Americans in this study preferred shared decision making as much as whites and were more likely to report initiating more discussions with their doctors about their diabetes care. This research suggests that, among diabetes patients receiving care at community health centers, patient preference or patient behaviors may be an unlikely cause of racial differences in shared decision making.

Not Just Mexico's Problem: Labor Migration from Mexico to the United States (1900 - 2000)

IntroductionEbbs and flows in Mexican migration to the U.S. correspond not with economic underdevelopment or stagnation, but with the vagaries of neoliberal economic development itself. This article will review the history of Mexico-U.S. labor migration using phases in Mexico's political economy as a guide. This history begins with the first steps toward modernization established at the turn of the twentieth century by Porfirio Diaz and ends at the present period. At every juncture, I address the political and economic trends of the period, the impact of these trends on Mexican workers and agrarians, major patterns of movement and demographic characteristics of migrants, and the implications of the period for future migrations. I also discuss the social and political trends in the United States that shape the direction, flow, and perceptions of labor migration from Mexico. Finally, I examine how political rhetoric surrounding transmigration has produced a politics of exclusion in the United States, and I consider the implications of this exclusion for current and future Mexican workers in the U.S.1876 - 1910: El PorfiriatoIn 1860, about half of rural Mexico was controlled by ejidos, corporate local communities engaged in subsistence and local-market production (Weaver 2000, 51). By the end of the thirty-four year reign of President Porfirio Diaz (1876-1910), 5 million rural Mexican had lost their land rights (Pedraza and Rumbaut 1996, 254); by 1910 less than 5% of rural households retained control over land and large haciendas increasingly dominated the countryside (Cardoso 1980, 7). The development strategy of Porfirio Diaz was based on liberal economic policies that promoted direct foreign investment in Mexico's agriculture, industry, mining, petroleum, and infrastructure (Kirkwood 2000: Massey et al. 2002). Capital investment in agriculture accelerated production, and the new large-scale plantations converted cultivation from subsistence goods for local markets to cash-crops for export (Cardoso 1980; Kirkwood 2000; Massey et al. 2002).The impact of liberal development on Mexico's peasantry was manifold. Without land, peasants were no longer self-sufficient in food. Mechanization of agricultural production reduced the demand for labor and further depressed wages for sharecroppers on the large haciendas, a main source of work for landless peasants (Cardoso 1980). Domestic craft production was undermined by the introduction of mass-produced wares to local markets (Massey 1988; Massey et al. 2002). Simultaneously, the costs of living had increased because Mexico was now importing basic foodstuffs (Massey et al. 2002). The penetration of capital development into rural Mexico destabilized traditional communal subsistence practices (Foster 1979 [1967]) and, through the new railroads, provided cheap access to industrializing centers in the cities (Cardoso 1980). Mexico's burgeoning urban sector swelled with rural migrants after 1900. While only 9.3% of the Mexican population lived in urban areas in 1900, that number had grown to 15.6% by 1930 (Weaver 2000, 129). Large reserves of displaced labor put downward pressure on wages in the cities, resulting in violent labor strikes between 1905 and 1910 (Kirkwood 2000; Massey et al. 2002, 30).The railroads had an additional impact on rural Mexico: they provided labor recruiters from the United States with passage into Mexico's interior (Cardoso 1980; Cornelius 1981; Gutierrez 1995). As Mexico's industrial labor market quickly became saturated, growers in the southern and western United States found themselves experiencing a severe labor shortage brought on by restrictive immigration policies that cut off migrant labor supplies from Asia in 1907 (Gutierrez 1995; Massey et al. 2002). Labor recruiters (enganchadores) used the new rail system to travel from the southwest U.S. into the fertile west-central states of Guanajuato, Jalisco, Michoacan, and Zacatecas (the region known as el Bajio), where they employed notoriously coercive means of recruiting workers to go north. …

Malaria in India with particular reference to two West-Central States.

Abstract Malaria has plagued India since antiquity. In the 20th century both man-made and physical environments have contributed to the establishment of different malaria intensity zones. A 1948-Malaria Distribution Map of India indicated Malaria-free, Endemic and Variable Endemic zones. The Malaria-free zone was associated with higher elevations, e.g. the Himalayas and coastal lands. The Endemic zone was considered to be places where the average annual rainfall exceeded 80cm. A malaria control program was started in India immediately after independence in 1947. Spraying of Anopheles -killing insecticides was the main control activity. Although, the disease was largely controlled by 1965, resurgence took place from several pockets. Now, two west-central states, Gujarat and Madhya Pradesh are also showing signs of resurgence. Monsoon rains, higher humidity, vegetation, tribal habitats and rice-cultivation have definitive associations with the disease in those two states. Eradication will have to await the discovery of an effective vaccine, but the disease can be drastically controlled by the mid-eighties with the existing techniques.

THE RELATION OF HUMAN ENCEPHALITIS TO ENCEPHALOMYELITIS IN HORSES

In 1931 Meyer, Haring and Howitt 1 reported the discovery of a virus as the cause of an epizootic of encephalomyelitis among horses and mules in the San Joaquin Valley of California during the summer of 1930. Since that time the disease has occurred in several Western and Midwestern states. Similar epizootics have occurred during the past seventy years, especially in the West Central states, but have been confused with other equine diseases. In 1933 the disease appeared in Maryland, Delaware, Virginia and New Jersey. In this year Ten Broeck and Merrill 2 and Giltner and Shahan 3 reported the isolation of an eastern strain of virus of equine encephalomyelitis which, though similar to the western strain, differed serologically. The disease in the horse was more acute and fatal, and the virus appeared to be more virulent for laboratory animals. The viruses of equine encephalomyelitis differ immunologically from the viruses

Pennsylvanian Overlap in United States

This is a regional study of one of the great unconformities of the geologic record. Cross sections show the wedging-out of the formations above and below the basal Pennsylvanian unconformity as the center of the United States is approached. This is further shown by isopachous maps of the deposits of Pottsville age and of the rocks of Upper Mississippian age. An areal map of the pre-Pennsylvanian rocks shows that as the Pennsylvanian seas covered the country, the pre-Pennsylvanian rocks had the general form of a great arch extending from New Mexico northeast into Minnesota and the pre-Cambrian shield of Canada. Along this axis, pre-Cambrian rocks were exposed and, farther from the axis, both east and west, progressively younger systems were exposed to the advancing Pennsyl anian seas, so that, at the margins of the country, rocks of Upper Mississippian age were in contact with rocks of lower Pottsville age. The principal results of the study are the evidence about the presence and nature of this continental arch in the west-central states; the thinning of the rocks of Pottsville age as the axis is approached, due chiefly to progressive overlap in this direction; the thinning of the Upper Mississippian rocks in the same direction, due chiefly to progressively deeper erosion as the axis is approached; the character and position of the folds present in pre-Pennsylvanian time; the probable connection of the Pottsville from Pennsylvanian to West Texas; and the source of a substantial amount of the Pottsville sediments through the erosion of the pre-Pennsylvanian rocks from the crest of this continental arch.