Impact of Gender on Separation-Reunification Experiences of Latino Adolescent Immigrants

Many Latino immigrants who enter the US in late childhood or adolescence are reunifying with parents after lengthy separations, and yet there is limited research on this process from their point of view. This article discusses the impact of gender relations on family re-engagement and immigrant adaptation of young men and young women. Young people were interviewed as part of a grounded theory study exploring the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration. Focus groups, individual interviews and participant observation were used to gather data from 20 Mexican and Central American immigrant adolescents, 12 young men and 8 young women. Participants reported a range of personal and family beliefs about gender roles and their impact on separation and reunification, Young men reported greater exposure to violence, generally had less access to health care, and reported more emotional isolation from families and peers than young women. Fathers and adult male role models were missing from most of their lives, and this absence was particularly difficult for young men. Young women reported greater skills and persistence in emotional re-engagement with their families in the United States.Beaucoup d'immigrés latinos entrés aux Etats-Unis à la fin de l'enfance ou au début de l'adolescence retrouvent leurs parents après une longue période de séparation, et pourtant il n'existe que très peu d'études sur ce sujet relatant leur point de vue. Cet article traite de l'impact des rapports de genre sur le regroupement familial et l'adaptation des jeunes hommes et femmes immigrés. Des jeunes ont été interrogés dans le cadre d'une étude basée sur la théorie ancrée qui analysait le processus de séparation et de regroupement familial chez les adolescents immigrés latinos qui avaient été séparés de leurs parents pendant au moins quatre ans durant la période d'immigration. Des groupes cibles, des entretiens individuels et l'observation des participants ont permis de recueillir des données auprès de 20 adolescents immigrés originaires du Mexique et d'Amérique Centrale, dont 12 jeunes hommes et 8 jeunes femmes. Les participants ont décrit un ensemble de croyances personnelles et familiales sur les rôles sexuels, et leur impact sur la séparation et le regroupement familial. Les jeunes hommes ont ainsi déclaré être plus exposés à la violence, avoir généralement un accès aux soins plus limité, et souffrir d'une plus grande isolation émotionnelle vis-à-vis de leurs familles et de leurs pairs que les jeunes femmes. Les pères et les modèles adultes masculins étaient pour la plupart absents de leur vie, et cette absence était particulièrement difficile à vivre pour les jeunes hommes. Les jeunes femmes ont quant à elles montré plus de capacités et de persévérance dans le réengagement émotionnel avec leurs familles aux Etats-Unis.Muchos inmigrantes latinos que entran en Estados Unidos al final de su infancia o en su adolescencia  se reunifican con sus padres después de largos periodos de separación. Sin embargo, existen muy pocos estudios sobre este proceso desde su punto de vista. Este artículo analiza el impacto de las relaciones de género en la reunificación familiar y la adaptación como inmigrantes de hombres y mujeres jóvenes. Se entrevistó a chicos y chicas en el marco de un estudio de teoría fundamentada que explora el proceso de la separación familiar y su posterior reunificación en el caso de inmigrantes latinos adolescentes que han sido separados de sus padres durante al menos cuatro años en el transcurso de la inmigración. Se utilizaron reuniones de grupo, entrevistas individuales y observaciones para recabar datos de 20 inmigrantes adolescentes mexicanos y centroamericanos, 12 chicos y 8 chicas. Los participantes reflejaban diversas creencias personales y familiares sobre los roles de género y su impacto en la separación y reunificación. Los chicos reflejaron una mayor exposición a la violencia, un acceso más limitado en general a la asistencia sanitaria y un mayor aislamiento emocional de sus familias y compañeros que las chicas. En sus familias no había referencias paternas o de adultos masculinos y esta ausencia resultaba especialmente difícil para los chicos. Las chicas, en cambio, mostraron mayores habilidades y persistencia en la reunificación emocional con sus familias en suelo estadounidense

Impact of Gender on Separation-Reunification Experiences of Latino Adolescent Immigrants

Many Latino immigrants who enter the US in late childhood or adolescence are reunifying with parents after lengthy separations, and yet there is limited research on this process from their point of view. This article discusses the impact of gender relations on family re-engagement and immigrant adaptation of young men and young women. Young people were interviewed as part of a grounded theory study exploring the process of family separation and reunification for Latino immigrant adolescents who have been separated from their parents for at least four years during immigration. Focus groups, individual interviews and participant observation were used to gather data from 20 Mexican and Central American immigrant adolescents, 12 young men and 8 young women. Participants reported a range of personal and family beliefs about gender roles and their impact on separation and reunification, Young men reported greater exposure to violence, generally had less access to health care, and reported more emotional isolation from families and peers than young women. Fathers and adult male role models were missing from most of their lives, and this absence was particularly difficult for young men. Young women reported greater skills and persistence in emotional re-engagement with their families in the United States.Beaucoup d'immigrés latinos entrés aux Etats-Unis à la fin de l'enfance ou au début de l'adolescence retrouvent leurs parents après une longue période de séparation, et pourtant il n'existe que très peu d'études sur ce sujet relatant leur point de vue. Cet article traite de l'impact des rapports de genre sur le regroupement familial et l'adaptation des jeunes hommes et femmes immigrés. Des jeunes ont été interrogés dans le cadre d'une étude basée sur la théorie ancrée qui analysait le processus de séparation et de regroupement familial chez les adolescents immigrés latinos qui avaient été séparés de leurs parents pendant au moins quatre ans durant la période d'immigration. Des groupes cibles, des entretiens individuels et l'observation des participants ont permis de recueillir des données auprès de 20 adolescents immigrés originaires du Mexique et d'Amérique Centrale, dont 12 jeunes hommes et 8 jeunes femmes. Les participants ont décrit un ensemble de croyances personnelles et familiales sur les rôles sexuels, et leur impact sur la séparation et le regroupement familial. Les jeunes hommes ont ainsi déclaré être plus exposés à la violence, avoir généralement un accès aux soins plus limité, et souffrir d'une plus grande isolation émotionnelle vis-à-vis de leurs familles et de leurs pairs que les jeunes femmes. Les pères et les modèles adultes masculins étaient pour la plupart absents de leur vie, et cette absence était particulièrement difficile à vivre pour les jeunes hommes. Les jeunes femmes ont quant à elles montré plus de capacités et de persévérance dans le réengagement émotionnel avec leurs familles aux Etats-Unis.Muchos inmigrantes latinos que entran en Estados Unidos al final de su infancia o en su adolescencia  se reunifican con sus padres después de largos periodos de separación. Sin embargo, existen muy pocos estudios sobre este proceso desde su punto de vista. Este artículo analiza el impacto de las relaciones de género en la reunificación familiar y la adaptación como inmigrantes de hombres y mujeres jóvenes. Se entrevistó a chicos y chicas en el marco de un estudio de teoría fundamentada que explora el proceso de la separación familiar y su posterior reunificación en el caso de inmigrantes latinos adolescentes que han sido separados de sus padres durante al menos cuatro años en el transcurso de la inmigración. Se utilizaron reuniones de grupo, entrevistas individuales y observaciones para recabar datos de 20 inmigrantes adolescentes mexicanos y centroamericanos, 12 chicos y 8 chicas. Los participantes reflejaban diversas creencias personales y familiares sobre los roles de género y su impacto en la separación y reunificación. Los chicos reflejaron una mayor exposición a la violencia, un acceso más limitado en general a la asistencia sanitaria y un mayor aislamiento emocional de sus familias y compañeros que las chicas. En sus familias no había referencias paternas o de adultos masculinos y esta ausencia resultaba especialmente difícil para los chicos. Las chicas, en cambio, mostraron mayores habilidades y persistencia en la reunificación emocional con sus familias en suelo estadounidense

The female condom: Dynamics of use in urban Zimbabwe

In July 1997, Population Services International (PSI), at the request of the Zimbabwe National AIDS Coordination Programme, launched a social marketing program for the female condom in Zimbabwe. To avoid stigma associated with condoms and STI prevention, the female condom was marketed as a family planning product or “contraceptive sheath” under the brand name “Care.” It was initially sold through pharmacies and clinics at a heavily subsidized retail price of US $0.24 for two; distribution has since expanded to other urban outlets, including supermarkets and convenience stores. Approximately one year after the start of the social marketing program, the Horizons Project and PSI conducted a descriptive, cross-sectional study of female condom users, male condom users, and nonusers of either barrier method. The goal is to increase understanding of the patterns and dynamics of female condom use to inform policymakers and program planners involved in decisions about promotion and distribution in Zimbabwe. In total, 493 female condom users, 633 male condom users, and 624 nonusers are included in the analyses upon which this report is based

Tumor Microvessel Density as a Prognostic Marker in High-Risk Renal Cell Carcinoma Patients Treated on ECOG-ACRIN E2805

Purpose—Increased vascularity is a hallmark of renal cell carcinoma (RCC). Microvessel density (MVD) is one measurement of tumor angiogenesis; however, its utility as a biomarker of outcome is unknown. ECOG-ACRIN 2805 (E2805) enrolled 1,943 resected high-risk RCC patients randomized to adjuvant sunitinib, sorafenib, or placebo. We aimed to determine the prognostic and predictive role of MVD in RCC. Experimental Design—We obtained pretreatment primary RCC nephrectomy tissues from 822 patients on E2805 and constructed tissue microarrays. Using quantitative immunofluorescence, we measured tumor MVD as the area of CD34-expressing cells. We determined the association with disease-free survival (DFS), overall survival (OS), treatment arm, and clinicopathologic variables. Results—High MVD (above the median) was associated with prolonged OS for the entire cohort (p = 0.021) and for patients treated with placebo (p = 0.028). The association between high MVD and OS was weaker in patients treated with sunitinib or sorafenib (p = 0.060). MVD was not associated with DFS (p = 1.00). On multivariable analysis, MVD remained independently associated with improved OS (p = 0.013). High MVD correlated with Fuhrman grade 1–2 (p \u3c 0.001), clear cell histology (p \u3c 0.001), and absence of necrosis (p \u3c 0.001) but not with gender, age, sarcomatoid features, lymphovascular invasion, or tumor size. Conclusions—High MVD in resected high-risk RCC patients is an independent prognostic, rather than predictive, biomarker of improved OS. Further studies should assess whether incorporating MVD into clinical models will enhance our ability to predict outcome and if low MVD can be used for selection of high-risk patients for adjuvant therapy trials

What have our patients learnt after being hospitalised for an acute myocardial infarction?

Background: Education for hospitalised patients is an important aspect of care for people who have an acute cardiovascular event. Objective: To investigate the cardiovascular risk factor behaviours of patients together with their acute coronary syndrome (ACS) knowledge, attitudes and beliefs following admission to hospital for an acute myocardial infarction. Methods: Patients diagnosed with an acute myocardial infarction participated in an observational study. Patients completed a questionnaire consisting of cardiovascular risk factor behaviour questions and the ACS Response Index prior to discharge and at follow-up 10 weeks later. Results: Of the 135 participants enrolled, 114 (84%) completed follow-up, 70% were males; mean age was 63 (±11.6) years. The median length of hospital stay was 3 days (IQR 1) and the time to follow-up after discharge was 10 weeks. Self-reported risk factor behaviours improved significantly for diet (p < 0.001) and smoking cessation (p = 0.023) following discharge. At discharge 39% of patients had inadequate knowledge of ACS symptoms. The ACS Response Index improved significantly after discharge for attitudes (p = 0.004) and beliefs (p = 0.008). Despite 85% of patients indicating they would attend cardiac rehabilitation only 30% had commenced a programme at follow-up. Conclusion: Patients reported implementing a number of healthy lifestyle changes following discharge including smoking cessation and healthy eating. Attitudes and beliefs regarding ACS showed a significant improvement following discharge. More than one third of patients had inadequate knowledge at discharge, suggesting current education practices may not be meeting the needs of patients with a myocardial infarction

Voluntary Medical Male Circumcision: Translating Research into the Rapid Expansion of Services in Kenya, 2008–2011

Zebedee Mwandi and colleagues discuss Kenya's scale-up of voluntary medical male circumcision services, highlighting government leadership, a clear implementation strategy, and program flexibility and innovation as keys to Kenya's success

Additive genetic variation in schizophrenia risk is shared by populations of African and European descent

Previous studies have emphasized ethnically heterogeneous human leukocyte antigen (HLA) classical allele associations to rheumatoid arthritis (RA) risk. We fine-mapped RA risk alleles within the major histocompatibility complex (MHC) in 2782 seropositive RA cases and 4315 controls of Asian descent. We applied imputation to determine genotypes for eight class I and II HLA genes to Asian populations for the first time using a newly constructed pan-Asian reference panel. First, we empirically measured high imputation accuracy in Asian samples. Then we observed the most significant association in HLA-DRβ1 at amino acid position 13, located outside the classical shared epitope (Pomnibus = 6.9 × 10(-135)). The individual residues at position 13 have relative effects that are consistent with published effects in European populations (His > Phe > Arg > Tyr ≅ Gly > Ser)--but the observed effects in Asians are generally smaller. Applying stepwise conditional analysis, we identified additional independent associations at positions 57 (conditional Pomnibus = 2.2 × 10(-33)) and 74 (conditional Pomnibus = 1.1 × 10(-8)). Outside of HLA-DRβ1, we observed independent effects for amino acid polymorphisms within HLA-B (Asp9, conditional P = 3.8 × 10(-6)) and HLA-DPβ1 (Phe9, conditional P = 3.0 × 10(-5)) concordant with European populations. Our trans-ethnic HLA fine-mapping study reveals that (i) a common set of amino acid residues confer shared effects in European and Asian populations and (ii) these same effects can explain ethnically heterogeneous classical allelic associations (e.g. HLA-DRB1*09:01) due to allele frequency differences between populations. Our study illustrates the value of high-resolution imputation for fine-mapping causal variants in the MHC

Voluntary Medical Male Circumcision: Strategies for Meeting the Human Resource Needs of Scale-Up in Southern and Eastern Africa

Kelly Curran and colleagues conducted a program review to identify human resource approaches that are being used to improve voluntary medical male circumcision volume and efficiency, identifying several innovative responses to human resource challenges