Migration and the Transformation of Work Processes: Voices of Chinese Immigrant Women in Canada

Using feminist conceptual framework and methodology, this study examines the experience of thirty Chinese immigrant women in Canada. It demonstrates how their subjective experiences are articulated to the larger social, economic, and political relations in the form of institutional and organizational processes. In particular, it investigates how the differences in the social organization of paid work and household work in Canada vis-à-vis their home country have tremendous impact on them, transforming their everyday lives.Utilisant la méthodologie et Ie cadre conceptuel féministes, cette étude examine l'expérience de vie au Canada de trente immigrantes d'origine chinoise. On montre en quoi l'expérience subjective de ces immigrantes s'articule à un ensemble plus large de relations sociales, économiques, et politiques se manifestant sous la forme de processus institutionnels et organisationnels. Spécifiquement, on étudie comment les différences dans l'organisation sociale du travail salarie et du travail domestique au Canada, par rapport au pays d'origine de ces immigrantes, ont un impact majeurs sur elles en transformant radicalement la nature de leur vie quotidienne

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Transnationalism, gender, and civic participation: Canadian case studies of Hong Kong immigrants

It is widely claimed that recent migration trends show increasing levels of transnational activity, but there is a need for a more detailed understanding of the relationship between transnationalism and citizenship participation, particularly from a gendered perspective. A study of immigrants from Hong Kong to Vancouver and Toronto, the largest group of immigrants to Canada in the period 1989 to 1997, shows that, although migration occurred in a context of anticipated political instability around reunification with the People’s Republic of China, the most significant justification for emigration was to further the interests of the family, particularly children’s education. Gender differences are subtle, but women tend to focus more strongly on family considerations, whereas men are somewhat more concerned with economic and political issues. Transnational activities focus around ties of family and friendship, rather than around political or economic ties. Women and men both seek formal rights of citizenship, and are beginning to express a desire for more participation in Canadian society. Contrary to theories of hypermobility among Hong Kong emigrants, transnationalism and citizenship participation are seen as a basis for settlement. Gendered approaches to transnationalism need to understand how the concept of citizenship, and citizenship participation, develops as a result of wider social relations that are structured differently for women and men.