[Review of] StevenJ. Gold. Refugee Communities: A Comparative Field Study

This fascinating and insightful book is a comparative ethnographic study of Vietnamese and Soviet Jewish refugees. While a voluminous refugee and immigrant literature exists, much research follows a narrow, policy-driven focus rather than an independent academic tradition. Authors also tend to concentrate on specific ethnic groups rather than examining parallels or contrasts between groups. Gold, however, asks the broader question of how refugees create ethnic communities which facilitate accomodation [accommodation] without assimilation (Gibson 1988). In the process of comparison, he produces novel conclusions as well as hypotheses for further testing

[Review of] Hsiang-Shui Chen. Chinatown No More: Taiwan Immigrants in Contemporary New York

This book is a recent addition to the Anthropology of Contemporary Issues series edited by Roger Sanjek. The author, now an Associate Professor of Anthropology at the National Tsing Hua University in Taiwan, worked as a research assistant on Sanjek\u27s New Immigrants and Old Americans Project in Elmhurst-Corona during the mid-1980s. This was the pilot study for what later became the Ford Foundation\u27s Changing Relations Project, a national study of the impact of post-1965 immigration on American society. Chen, a graduate student from Taiwan himself, noticed a sudden increase in Chinese immigration to New York City after 1982. He chose to conduct his field work in this emerging overseas Chinese community. As an observer who shares the newcomers\u27 broad cultural and linguistic traditions, and who is a recent immigrant himself, Chen presents a fresh and valuable perspective

[Review of] Virginia Yans-McLaughlin, ed. Immigration Reconsidered: History, Sociology, and Politics

Immigration Reconsidered presents the latest paradigm of immigration studies from some of the leading scholars in three disciplines. Contributors include historians Samuel Baily, Sucheng Chan, Philip Curtin, Kerby Miller, and Virginia Yans-McLaughlin; sociologists Suzanne Model, Alejandro Portes, Ewa Morawska, and Charles Tilly; and political scientists Lawrence Fuchs and Aristide Zolberg. Several individuals have degrees or interests in more than one field. This book is the outcome of a conference held to celebrate the Statue of Liberty\u27s Centenary. The papers are carefully chosen, of high individual quality, and integrated more than most collections of essays by scholars\u27 responses to each other and the editor\u27s analytical overview

[Review of] Alejandro Portes and Ruben G. Rumbaut. Immigrant America: A Portrait

The subtitle of this book is apt. Its authors paint a rich and varied portrait of recent and turn-of-the-century immigrants to America: Vietnamese and Cuban refugees, Mexican, Chinese, Polish and Irish laborers, Indian professionals, Korean entrepreneurs. Unlike many works which focus on a particular nationality or type of immigrant, Portes and Rumbaut attempt a broad comparative sketch. The result is an enlightening synthesis of a very large literature. The authors discuss origins -- who the immigrants are and why they come; the context of exit, or conditions under which people leave home; issues of adaptation (economic, social, and psychological); and contexts of incorporation, such as local labor markets, affecting immigrants\u27 integration into American society

Three Models ofSocial Planning for Human Services in Energy-Impacted Communities

Human service workers encounter many challenges as they face energy boom town situations in the Western United States. Currently, they respond following one of two models, corresponding to the role reserved for human services in the conservative laissez-faire and liberal enlightened capitalism models of American corporate behavior

Costs of alternative treatments for incomplete abortion

Unsafely performed abortion is one of the five leading causes of maternal deaths worldwide. Many women who have undergone unsafe abortions enter the healthcare system to seek help for the resulting complications, including incomplete abortion. This human and financial cost of this health problem is tremendous, especially in the developing world. This study examined the potential for reducing costs to healthcare systems by changing the standard method of treatment for incomplete abortion. Vacuum aspiration (VA) has been shown to be safer than dilation and curettage (D&C) for uterine evacuation; the World Health Organization includes VA as an essential service at the first referral level. The technique most commonly used for treating first-trimester incomplete abortion in developing countries, however, is D&C. This study examined the hypothesis that use of manual vacuum aspiration (MVA) - a variation of VA - would be less costly than D&C and thus advantageous to healthcare systems with limited resources. The purpose of the study was to identify and, where possible, to explain the factors that contributed to cost differences between MVA and D&C for treatment of first-trimester incomplete abortion. To achieve this objective, researchers observed patient management and documented resource use at hospital sites in Ecuador, Kenya, and Mexico. In most cases, treatment with MVA required a shorter patient stay and fewer hospital resources than D&C, as the two techniques were practiced at the various study sites. The policy decision to adopt MVA, supported by procurement of instruments and incorporation of training in its use, is the chief prerequisite for achieving these improvements. But the full advantages of MVA are realized only if it is introduced in conjunction with certain changes in patient-management practices, such as offering outpatient treatment of incomplete abortion. Further, decentralizing MVA services can maximize the benefits of the technique, facilitating (hospitals'and) healthcare systems'efforts to decrease the cost of delivery service and improve the quality of care.Health Monitoring&Evaluation,Gender and Health,Health Systems Development&Reform,Information Technology,Business Environment

Evolution of the Alpha-1 Antitrypsin Muscle Gene Therapy: Translation from Clinical Trial to Benchtop and Back Again

Alpha-one antitrypsin (AAT) deficiency is a genetic disease affecting the lungs due to inadequate anti-protease activity in the pulmonary interstitium. On-going human trials use intra-muscular delivery of adeno-associated virus (rAAV1), allowing expressing myofibers to secrete normal (M)AAT protein. In the Phase IIa trial, patients in the highest dose cohort (6x1012vg/kg) were given 100 intra-muscular (IM) injections of undiluted vector, with serum AAT levels still substantially below target levels. Previous work has shown that delivering rAAV vector to the musculature via limb perfusion leads to widespread gene expression in myofibers. We hypothesize that widespread delivery would result in an overall increase in serum AAT levels with the same dose of AAV gene therapy vector and allow for increased volume and thereby dose of vector. In macaques, similar serum myc-tagged rhAAT was produced using regional venous infusion when compared to direct IM delivery at the same total vg dose with either rAAV1 or rAAV8, while not being limited to a small volume as with IM injection. These data prove the concept that a 30-fold expanded volume of rAAV-AAT could be delivered to myofibers using limb perfusion without loss of potency on a per vg basis, thereby enabling potential achievement of therapeutic AAT levels in patients. This will allow us to proceed to a phase IIb clinical trial in AAT patients employing venous limb perfusion

Serum Levels of Alpha-1 Antitrypsin following Vascular Limb or Intra-Muscular Delivery of AAV1 or AAV8 Gene Therapy Vectors in Rhesus Macaques

Alpha-one antitrypsin (AAT) deficiency is a genetic disease that results in both lung disease and potentially liver failure in affected patients. In un-affected people AAT is produced in the liver and secreted to act as an anti-protease (primarily counteracting the effects of neutrophil elastase) in the lung. On-going human clinical trials have focused on intra-muscular delivery of adeno-associated virus (AAV1) to patients. The goal of delivery to the muscle is to have the myocytes serve as bio-factories to produce normal AAT protein and secrete it into the blood where it can exert its normal function in the lung. In the last Phase II trial patients in the highest dose cohort were given 100 intra-muscular (IM) injections with serum AAT levels still below therapeutic thresholds. Previous work has shown that delivering AAV vector to the musculature of the limb via the vasculature, while blood flow is obstructed using a tourniquet, leads to wide-spread gene expression in myocytes. We hypothesize that local delivery via IM injection results in saturated AAT expression within the myocytes surrounding the injection sight and that a more widespread delivery would result in an overall increase in serum AAT levels with the same dose of AAV gene therapy vector due to production by a larger overall number of myocytes. We have been able to show that we can attain similar or slightly higher (573.0 ng/ml versus 562.5 ng/nl) serum AAT levels using a vascular delivery method in rhesus macaques when compared to IM delivery. These results have been obtained using AAV1. Animals receiving either AAV1 or AAV8 show a decrease in muscle immune cell infiltrates following intra-vascular delivery versus IM delivery, which may improve long-term expression. Serum AAT data from animals dosed using AAV8, a serotype shown to better target muscle following vascular delivery, are currently being processed

Aortic arch baroreceptor stimulation in an experimental goat model: a novel method to lower blood pressure

The effect of aortic baroreceptor stimulation on blood pressure manipulation was assessed using the goat species Capra aegagrus hircus. The aim of this study was to manipulate blood pressure with future intention to treat high blood pressure in humans. The ages of the animals ranged from 6 months to 2 years. A standard anesthesia protocol was used. A lateral thoracotomy was performed to gain access to the aortic arch. Data was collected with the Vigileo system. Pre stimulation blood pressure was compared with maximum post stimulation blood pressure values. Results were analyzed with the Wilcoxon signed rank test. In the study 38 animals were enrolled. Baroreceptor stimulation was performed for each animal using 3 different electrodes each of which emits an electrical impulse. In the pilot phase of the study, the median baseline blood pressure prior to stimulation of the baroreceptors was 110.8 mmHg. After stimulation the median blood pressure decreased to 88 mmHg. The average decrease in blood pressure was 22.8 mmHg. This decrease of blood pressure after stimulation of the baroreceptors is statistically significant (p < 0.0001) and the proof of concept was shown. During the extended phase all three probes had a significant effect on blood pressure lowering (p < 0.0001). The study confirmed that aortic baroreceptor stimulation has an effect on blood pressure lowering. This is a novel field of blood pressure manipulation. The hemodynamic effects of long-term aortic baroreceptor stimulation are unknown. Further investigations need to be done to determine whether a similar effect can be induced in different species such as primates and humans