Tuberculosis Treatment Completion in a United States/Mexico Binational Context

Background: Tuberculosis (TB) remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region. Methods: Retrospective study of data extracted from medical charts (n = 439) from Yuma County Health Department (YCHD) (n = 160) and Centro de Salud San Luis Rio Colorado (n = 279). Patients currently accessing TB treatment at either facility were excluded from the study. Chi-square, unadjusted odds ratios, and logistic regression were utilized to identify characteristics associated with successful TB treatment in this population. Findings: The study population was predominantly male (n = 327). Females were more likely to complete TB treatment (OR = 3.71). The absence of drug use and/or the absence of an HIV positive diagnosis were found to be predictors of TB treatment completion across both clinical sites. Forty-four percent (43.59%) (n = 85) TB patients treated at CDS San Luis did not complete treatment versus 40.35% (n = 49) of TB patients who did not complete treatment at YCHD. Moving from the area or being deported was the highest category (20.78%) for incomplete TB treatment in the population (n = 64) across both clinical sites.Open Access Journal.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Emergent Public Health Issues in the US-Mexico Border Region

US-Mexico border region area has unique social, demographic and policy forces at work that shape the health of its residents as well as serves as a microcosm of migration health challenges facing an increasingly mobile and globalized world. This region reflects the largest migratory flow between any two nations in the world. Data from the Pew Research Center shows over the last 25 years there has never been lower than 140,000 annual immigrants from Mexico to the United States (with peaks over 700,000). This migratory route is extremely hazardous due to natural (e.g., arid and hot desert regions) and human made barriers as well as border enforcement practices tied to socio-political and geopolitical pressures. Also, reflecting the national interdependency of public health and human services needs, during the most recent five year period surveyed the migratory flow between the US and Mexico has equaled that of the flow of Mexico to the US--both around 1.4 million persons. Of particular public health concern, within the US-Mexico region of both nations there is among the highest disparities in income, education, infrastructure and access to health care--factors within the World Health Organization’s conceptualization of the Social Determinants of Health, and among the highest rates of chronic disease. For instance obesity and diabetes rates in this region are among the highest of those monitored in the world, with adult population estimates of the former over 40% and estimates in some population sub-groups for the latter over 20%. The publications reflected in this Research Topic, all reviewed from experts in the field, addressed many of the public health issues in the US Mexico Border Health Commission’s Healthy Border 2020 objectives. Those objectives-- broad public health goals used to guide a diverse range of government, research and community-based stakeholders--include Non Communicable Diseases (including adult and childhood obesity-related ones; cancer), Infectious Diseases (e.g., tuberculosis; HIV; emerging diseases--particularly mosquito borne illnesses), Maternal and Child Health, Mental Health Disorders, and Motor Vehicle Accidents. Other relevant public health issues affecting this region, for example environmental health, binational health services coordination (e.g., immunization), the impact of migration throughout the Americas and globally in this region, health issues related to the physical climate, access to quality health care, discrimination/mistreatment and well-being, acculturative/immigration stress, violence, substance use/abuse, oral health, respiratory disease, and well-being from a social determinants of health framework, are critical areas addressed in these publications or for future research. Each of these Research Topic publications presented applied solutions (e.g., new programs, technology or infrastructure) and/or public health policy recommendations relevant to each public health challenge addressed

The Leaders across Borders Certification Program—A Systemic Multiple Level Observation of Groups Analysis Approach to Measure Effective Leadership: A Case Study

Leadership measurement, feedback, and development have grown in importance for the field of management. The Mexico–US Border defined as the area of land within 100 km (62.5 miles) north and south of the international boundary, shares common challenges, and requires the development of multicultural change agents who conduct binational actions toward the improvement of public health and quality of life of the population in the region. Leaders across Borders (LaB) was established in 2010 as an advanced certified binational leadership development program aimed at building the capacity of public health, health care, and other community sector leaders working to improve the health of the communities in the Mexico–US Border region. Leadership as a social interaction process requires leader skills development to achieve goals promoting unity and reducing polarization to optimize interactions between all resources, thus improving teamwork. Therefore, measurement and feedback model of general values and beliefs that guide effective behavior, not only individual personality assessments need to drive a proactive learning and action plan development to improve interactions in a team, thus optimizing leadership. Starting 2014, we administered a new model named Systemic Multiple Level Observation of Groups (SYMLOG) to measure the values and beliefs that guide the behavior of learners and team facilitators. We also evaluated the effectiveness of each team of the program and established benchmarks and action plans to optimize interactions and communication between all the learners during the 8-month program. This leads to a stronger systemic network upon graduation from the program. The SYMLOG approach measured initial and improved situations of individual leadership and team performance effectiveness because of the LaB Program training and skills development sessions. The SYMLOG also provided positive feedback to each participant, which had a direct impact on the optimization of members’ interactions of all teams, as well as developing effective leadership values and behaviors of participants. This study presents a case study of this application, the challenges in the design and implementation of the SYMLOG measurement model, and the results obtained for last three cohorts 2014–2016 of LaB Program

Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care Program

While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud-Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.Open Access Journal.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Perspectives on a US–Mexico Border Community’s Diabetes and “Health-Care” Access Mobilization Efforts and Comparative Analysis of Community Health Needs over 12 Years

This paper describes a community coalition-university partnership to address health needs in an underserved US-Mexico border, community. For approximately 15 years, this coalition engaged in community-based participatory research with community organizations, state/local health departments, and the state's only accredited college of public health. Notable efforts include the systematic collection of health-relevant data 12 years apart and data that spawned numerous health promotion activities. The latter includes specific evidence-based chronic disease-preventive interventions, including one that is now disseminated and replicated in Latino communities in the US and Mexico, and policy-level changes. Survey data to evaluate changes in a range of health problems and needs, with a specific focus on those related to diabetes and access to healthcare issues-identified early on in the coalition as critical health problems affecting the community-are presented. Next steps for this community and lessons learned that may be applicable to other communities are discussed.Arizona Prevention Research Center (AzPRC); Mexico Section of the United-States Mexico Border Health Commission; Mel & Enid Zuckerman College of Public Health's Partner in Public Health Fund; Centers for Disease Control and Prevention [U48DP001925]Open Access Journal.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

I Jornadas de Innovación Docente de la Facultad de Ciencias del Trabajo de la Universidad de Granada

Conjunto de aportaciones derivadas de las I Jornadas de Innovación Docente, celebradas en la Facultad de Ciencias del Trabajo de la Universidad de Granada el 23 de febrero de 2012.Contributed papers from the First Conference of Educational Innovation, held at the Faculty of Labour Sciences of the University of Granada on February 23, 2012.Vicerrectorado para la Garantía de la Calida