Multi-generation genetic contributions of immigrants reveal cryptic elevated and sex-biased effective gene flow within a natural meta-population

Impacts of immigration on micro-evolution and population dynamics fundamentally depend on net rates and forms of resulting gene flow into recipient populations. Yet, the degrees to which observed rates and sex ratios of physical immigration translate into multi-generational genetic legacies have not been explicitly quantified in natural meta-populations, precluding inference on how movements translate into effective gene flow and eco-evolutionary outcomes. Our analyses of three decades of complete song sparrow (Melospiza melodia) pedigree data show that multi-generational genetic contributions from regular natural immigrants substantially exceeded those from contemporary natives, consistent with heterosis-enhanced introgression. However, while contributions from female immigrants exceeded those from female natives by up to three-fold, male immigrants' lineages typically went locally extinct soon after arriving. Both the overall magnitude, and the degree of female bias, of effective gene flow therefore greatly exceeded those which would be inferred from observed physical arrivals, altering multiple eco-evolutionary implications of immigration.

Impact of the 2016 Presidential election and restrictive immigration climate on the work and wellbeing of Bangladeshi immigrant community frontline workers in New York City, U.S.A

Community-based organizations (CBOs) are key players in mitigating the impact of restrictive policy changes on immigrant communities. The ability of these organizations to help diffuse the stress caused by restrictive, rapidly changing immigration policies depends, in part, on the capacity and health of their workforce. This study presents findings from a qualitative study conducted with 10 Bangladeshi community frontline workers working in various CBOs and advocacy organizations to understand their experience navigating a heightened anti-immigrant, anti-Muslim climate. Through thematic analyses, we inferred that the 2016 presidential election increased stress and mobilization among community frontline workers, with a meaningful distinction between participants working for immigration-focused institutions versus those in institutions where immigration issues were not the primary focus (e.g. health services, cultural programming). For those working in immigration-focused institutions, work burden increased due to challenges in managing misinformation, making sense of policy changes, and meeting the needs of families impacted by deportation. A toll on frontline workers' own physical health and mental health was discussed, as well as the need for culturally congruent mental health supports for the South Asian community.

Incidence of atrial fibrillation and flutter in Denmark in relation to country of origin: a nationwide register-based study

BACKGROUND

Atrial fibrillation and flutter (AF) is the most common sustained arrhythmia with an increasing prevalence in Western countries. However, little is known about AF among immigrants compared to non-immigrants.

AIM

To examine the incidence of hospital-diagnosed AF according to country of origin.

METHOD

Immigrants were defined as individuals born outside Denmark by parents born outside Denmark. AF was defined as first-time diagnosis of AF. All individuals were followed from the age of 45 years from 1998 to 2017. The analyses were adjusted for sex, age, comorbidity, contact with the general practitioner and socioeconomic variables. Adjustment was conducted using standardised morbidity ratio weights, standardised to the Danish population in a marginal structural model.

RESULTS

The study population consisted of 3,489,730 Danish individuals free of AF and 108,914 immigrants free of AF who had emigrated from the 10 most represented countries. A total of 323,005 individuals of Danish origin had an incident hospital diagnosis of AF, among the immigrants 7,300 developed AF. Adjusted hazard rate ratios (HRRs) of AF for immigrants from Iran (0.48 [95%CI:0.35;0.64]), Turkey (0.74 [95%CI:0.67;0.82]) and Bosnia-Herzegovina (0.42 [95%CI:0.22;0.79]) were low compared with Danish individuals. Immigrants from Sweden, Germany and Norway had an adjusted HRR of 1.13 [95%CI:1.03;1.23], 1.12 [95%CI:1.05;1.18] and 1.11 [95%CI:1.03;1.21], respectively (Danish individuals as reference).

CONCLUSIONS

Substantial variation in the incidence of hospital-diagnosed AF according to country of origin was observed. The results may reflect true biological differences but could also reflect barriers to AF diagnosis for immigrants. Further efforts are warranted to determine the underlying mechanisms.

The Health Needs of Sexual and Gender Minority Migrant Women in the United States: A Scoping Review

Purpose: This scoping review characterizes the peer-reviewed evidence on the health of first-generation sexual and gender minority (SGM) migrant women to the United States and identifies research gaps and future priorities. Methods: On February 1, 2022, the following databases were searched: PubMed (MEDLINE), Embase, CINAHL Plus with Full Text, APA PsycINFO, and PAIS Index. Primary research studies based in the United States, in English, on first-generation SGM migrants (i.e., immigrants, refugees, asylum seekers) were included. Gray literature and review articles were excluded. Health outcome data were not extracted from nonbinary populations nor transgender men. Themes were generated using qualitative content analysis. Results: Thirty-three studies were reviewed, most were qualitative, and 11 focused on transgender women migrants (especially from Latin America), while only one was exclusively on sexual minority women (SMW) migrants. Premigration experiences of violence and discrimination were linked to high prevalence rates of post-traumatic stress disorder, depression, and anxiety. Postmigration stressors included lack of educational and employment opportunities, reduced access to social services, and experiences of stigma and discrimination, which were also associated with the development of depressive symptoms. Transgender women migrants reported not seeking formal medical care, given a lack of gender-affirming services and insurance resulting in reliance on unsafe informal care networks for hormone therapy and feminization procedures. Conclusion: Future interventions should focus on fostering social support networks of SGM migrant women to help improve their mental health outcomes. Research priorities should include studies on SMW migrants and more quantitative research that could identify additional health needs (i.e., sexual health) of SGM migrant women.

Industrialized human gut microbiota increases CD8+ T cells and mucus thickness in humanized mouse gut

Immigration to a highly industrialized nation has been associated with metabolic disease and simultaneous shifts in microbiota composition, but the underlying mechanisms are challenging to test in human studies. Here, we conducted a pilot study to assess the differential effects of human gut microbiota collected from the United States (US) and rural Thailand on the murine gut mucosa and immune system. Colonization of germ-free mice with microbiota from US individuals resulted in an increased accumulation of innate-like CD8 T cells in the small intestine lamina propria and intra-epithelial compartments when compared to colonization with microbiota from Thai individuals. Both TCRγδ and CD8αα T cells showed a marked increase in mice receiving Western microbiota and, interestingly, this phenotype was also associated with an increase in intestinal mucus thickness. Serendipitously, an accidentally infected group of mice corroborated this association between elevated inflammatory response and increased mucus thickness. These results suggest that Western-associated human gut microbes contribute to a pro-inflammatory immune response.

The Immigrant Backstories of Asian American Surgeons

The stories of Asian immigrants have both shared themes and ones that are unique to the histories of their homelands. Their labor was essential to the settlement and economic development of America, yet their presence incited riots and official restrictions to their rights to immigration and citizenship. Chinese laborers mined the Gold Country, built the transcontinental railroad, and reclaimed tillable land in the Central Valley. Yet they were denied the immense bounty they created, and their immigration was blocked by the Chinese Exclusion Act of 1882.Japanese, Asian Indians, and Filipinos replaced them on farms as migrant laborers. As foreign nationals they were not allowed to own land, but they thrived as independent farmers on leased plots. Their success attracted discrimination and racist violence. They, too, were barred from immigration and citizenship (Johnson-Reed Act, 1924).World War II was a watershed event for Asians in America. Japanese Americans, ethnically identical to the enemy, were imprisoned in concentration camps in the American interior. China, the Philippines, and India, all allies of the US, were rewarded with naturalization rights for their nationals. In 1965 Congress liberalized immigration quotas and reversed the 1924 restrictions, with priority given to those with advanced technical ability in science, including medicine. Asians from Taiwan and India took advantage of the new regulations and predominated among the newcomers. After the fall of Saigon in 1975, America accommodated yet another Asian population in the country, the tens of thousands of refugees from Southeast Asia.

Asian American Surgery: A Short History of Immigration, Naturalization, and Refugee Laws and Policies that Brought Asians to America

Chinese immigration in America in the mid-nineteenth century incited violence and governmental sanctions to restrict Asian immigration and reject citizenship rights. In 1870, Chinese strikebreakers in Massachusetts ignited nationwide demonstrations against Chinese immigration, which ended altogether with the Chinese Exclusion Act (1882). Japanese schoolchildren in San Francisco public schools sparked rioting in 1907, leading Japan to unilaterally limit emigration to the United States (Gentlemen's Agreement, 1908). Congress responded to anti-Punjabi riots (Bellingham, WA, 1907) by refusing naturalization rights to Asians (Barred Zone Act, 1917), policies supported by the Supreme Court (Ozawa, 1922; Thind, 1923). All immigration from Asia was soon prohibited (Johnson-Reed Act, 1924). Anti-Asian measures peaked in 1942 with imprisonment of Japanese in concentration camps, including those with birthright citizenship. Anti-Asian policies unwound in the last half of the 20th century, culminating in sweeping changes in US immunization policy. Naturalization rights were granted to wartime allies against Japan (China, 1943; the Philippines and India, 1946) and the Japanese themselves (1952). Asian women marrying American servicemen were allowed entry into the country (1945, 1950). Prohibitions against Asian immigration were lifted in 1965 (Hart-Celler Act), with preference for those trained in science, technology, and medicine. The refugee crisis that followed the fall of Saigon (1975) drove humanitarian policies that brought evacuees from Southeast Asia and others from throughout the world seeking freedom from persecution (Refugee Act, 1980). Hundreds of thousands from China, South Asia, the Philippines, and Southeast Asia thus settled in the United States, changing American society and medicine.

Environmental Influences on Individuals with Autistic Spectrum Disorders with Special Emphasis on Seasonality: An Overview

This paper offers an in-depth exploration of the intricate relationship between environmental factors and autism spectrum disorder (ASD), with a special emphasis on seasonality. It reviews existing research, providing a comprehensive summary of findings and highlighting the multifaceted dimensions of several environmental factors influencing the etiology of ASD. The discussion encompasses various elements, including birth months, maternal health, dietary choices, and vitamin D deficiency, delving into the intricate interplay of seasonality with environmental influences such as viral infections and solar radiation. The present study raises essential questions regarding the timing of environmental influences and the factors contributing to the rising prevalence of ASD. Ultimately, it underscores the need for future epidemiological research to incorporate more extensive investigations of environmental risk factors and employ advanced statistical analyses. This comprehensive overview contributes to a deeper understanding of how environmental factors, particularly seasonality, may be linked to the occurrence of ASD and its increasing prevalence, recognizing the multifaceted and diverse nature of these interactions.

Tweets don't vote - Twitter discourse from Wales and England during Brexit

The Welsh vote for "leave" in the Brexit referendum surprised some academics and analysts due to its strong preference for Labor and its close financial ties to the EU. It also brought up a debate about apparent differences in Welsh and English attitudes towards race, ethnicity, and migration, with the former often claiming to have a more positive stance regarding the presence of ethnic minorities and foreign nationalities. This paper proposes to analyze discourse posted on Twitter during June 2016, specifically targeting Wales and England with the aim to offer insight into the perceptions and beliefs of Welsh and English individuals on the platform and if attitudes on race, ethnicity, and migration played a significant role. Counterfactuals are checked with posts from the first few weeks of the refugee crisis in Afghanistan in 2021, the war on Ukraine, and the announcement of the Rwanda policy. The current discussion of Welsh national identity includes its claims as a "nation of sanctuary" and that understands oppression and marginalization. Thus, Welsh perspectives on Brexit become an interesting viewpoint to comprehending ethnic minorities and foreigners as it creates a possible conflict between the institutional discourse, cultural views, and perceived economic needs. In this context, this paper takes the view that Twitter is an area where individuals post their thoughts uninhibited, and where we can conduct an aggregate analysis of that public sentiment.

Sex differences in COVID-19 deaths in the early months of the pandemic in Canada: An examination with an immigration lens

Background

At the onset of the COVID-19 pandemic, there was an overrepresentation of males in COVID-19 deaths worldwide, with Canada reporting more female COVID-19 deaths. This paper examines the overrepresentation of female COVID-19 deaths in Canada, with an immigration lens.

Data and methods

Data were extracted from the COVID-19 Sex-Disaggregated Data Tracker to compare the sex distribution of COVID-19 deaths in Canada with that of other countries. A linkage of deaths to the Longitudinal Immigration Database (IMDB) allows for the comparison of sex-specific COVID-19 death rates by immigrant status for age and geography, as well as by major employment sector among immigrants, using the tax data from the IMDB.

Results

While there were proportionately more female than male COVID-19 deaths in Canada in the early months of the pandemic, this trend was mainly a phenomenon among non-immigrants aged 85 and older. In addition, COVID-19-specific death rates for males were higher than those for females across age groups by immigrant status, except for those aged 85 and older among the non-immigrant population. Among immigrants, the death rate among health care and social assistance workers was higher among males than among females (10.7 vs. 2.9 per 100,000 population). The initially observed overrepresentation of female COVID-19 deaths to male COVID-19 deaths in Canada evened out in the summer of 2021.

Interpretation

The higher proportion of female COVID-19 deaths was likely related to the high concentration of COVID-19 deaths in long-term care facilities, where a lower institutionalization rate for immigrants had been observed. Since the implementation of vaccination targeting long-term care facility residents in Canada, the overrepresentation of female COVID-19 deaths ceased.

Between agency and systemic barriers: Pathways to medicine and health sciences among Black students with immigrant parents from the Caribbean or Sub-Saharan Africa in Quebec, Canada

This qualitative study, based on life stories, documents the pathways to medicine and health sciences of Black students with immigrant parents from the Caribbean or Sub-Saharan Africa in Quebec, Canada. The aim of this study is to investigate the factors that shape their educational pathways using Doray's framework. Even among students from families with substantial levels of education, the educational pathways to medicine or health sciences may be described as non-linear. Several obstacles can arise along these pathways, depending on various social markers. Many of the interviewees first enroll in a program other than their desired program, either to ensure their financial security or to improve their grades for a limited-enrollment program. Medicine and pharmacy studies remain a dream for most participants and their parents. However, in some cases, this dream is not coming true, and interviewees' aspirations are sometimes stifled. These results shed light on the possible changes to be made within certain programs' admissions policies. Nevertheless, the students (n = 12) demonstrate agency in facing a seemingly unfair admissions system for highly selective programs. We conclude with recommendations on how to better accommodate the so-called non-traditional pathways of Black students with immigrant parents from the Caribbean or Sub-Saharan Africa.[Box: see text].

Linking internal and international migration over the life course: A sequence analysis of individual migration trajectories in Europe

Because internal and international migration are typically conceptualized and measured separately, empirical evidence on the links between these two forms of population movement remains partial. This paper takes a step towards integration by establishing how internal and international migration precede one another in various sequenced relationships from birth to age 50 in 20 European countries. We apply sequence and cluster analysis to full retrospective migration histories collected as part of the Survey of Health, Ageing and Retirement in Europe in 2008-09 and 2017, for individuals born between 1950 and 1965. The results show that nearly all international migrants engage in internal mobility at some point in their lives. However, individual migration trajectories are delineated by the order of internal and international moves, the duration and timing of stays abroad, and the extent to which individuals engage in return international migration. Institutional and economic conditions shape the diversity of migration experiences.

Experiences of racial microaggression among immigrant and Canadian-born young adults: Effects of double stigma on mental health and service use

BACKGROUND

Significant disparities in utilization of mental health services exist among immigrant and Canadian-born populations. These gaps may be associated with a 'double stigma' - stigma related to being from a racialized background exacerbated by mental health stigma. Immigrant young adults may be particularly susceptible to this phenomenon, given developmental and social transitions from adolescence to adulthood.

AIMS

To investigate the joint effects of racial microaggression and mental health stigma on mental health and service use among first-generation immigrant and Canadian-born university students.

METHOD

We conducted an online cross-sectional study among first-generation immigrant and Canadian-born university students (N = 1,280, Mage = 19.10, SD = 1.50).

RESULTS

Despite no differences in anxiety or depression symptoms, first-generation (foreign-born) immigrants were less likely to have received therapy and to have taken medication for mental health issues compared to Canadian-born participants. First-generation immigrants also reported experiencing higher levels of racial microaggression and stigma toward service use. Results suggest the presence of a double stigma, mental health stigma and racial microaggression, each explained significant additional variance in symptoms of anxiety and depression and medication use. No effects of double stigma for therapy use were found - while higher mental health stigma predicted lower use of therapy, racial microaggression did not predict unique variance in therapy use.

CONCLUSIONS

Our findings highlight the joint effects of racial microaggression and stigma toward mental health and service as barriers to help-seeking among immigrant young adults. Mental health intervention and outreach programmes should target overt and covert forms of racial discrimination while incorporating culturally sensitive anti-stigma approaches to help reduce disparities in mental health service use among immigrants in Canada.

Toward an emerging model of healthcare access: A theoretical framework

AIM

To conceptualize an emerging framework of healthcare access for foreign-born persons based on well-known access models in the United States.

BACKGROUND

The COVID-19 outbreak significantly impacted all global communities, disproportionately affecting people of color and highlighting preexisting health disparities. Health and immigration policies concerning healthcare access for foreign-born people were examined. Regarding access to social benefits in the United States, the Affordable Care Act underscored initial restrictions imposed by the Deficit Reduction Act of 2005 and the Personal Responsibility and Work Opportunity Reconciliation Act in 1996 on certain underserved groups.

METHODS

Guided by the study's aim, electronic databases, including Scopus, PubMed, Web of Science, and CINAHL, were queried for relevant nursing-related literature published on Penchansky's and Andersen's models from 1968 to 2022. Compared with Penchansky's model, Andersen's model outcome measures have evolved over the years in response to dynamic health policy issues.

RESULTS

Penchansky's model has five constructs in its original form, whereas Andersen's model has three. The current study shows that each existing access model provides a unique method for evaluating various policies. In some cases, the studies are limited to a simple application of the original model with few modifications in studies specific to foreign-born groups in the United States.

DISCUSSION

There is a dearth of systematic theorization of access that incorporates social justice and health equity. Health disparities were further explained using metrics from existing access models.

CONCLUSIONS

An emerging access model conceptualizing existing access models was proposed, using constructs framed within the basic tenets of health equity and social justice.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Applying the emerging model's constructs to future studies is anticipated to highlight opportunities for stakeholders such as policymakers, healthcare providers, nursing professionals, and community leaders to support programs that could further reduce health disparities.

Commonalities and Differences in the Experiences of Visible Minority Transnational Carer-Employees: A Qualitative Study

This qualitative study explored the commonalities and differences among the experiences of visible minority Transnational Carer-Employees (TCEs) before and after COVID-19. TCEs are immigrants who live and work in the country of settlement while providing caregiving across international borders. Purposive and snowball sampling resulted in the participation of 29 TCEs of Pakistani, Syrian, African, and South American origin living in London, Ontario. Thematic analysis of the dataset using the ATLAS.ti software, Version 23.2.1., generated three themes: (1) feelings associated with transnational care; (2) employment experiences of TCEs; and (3) coping strategies for well-being. The results of the secondary analysis conducted herein suggested that there are more similarities than differences across the four cohorts. Many participants felt a sense of satisfaction at being able to fulfill their care obligations; however, a different outlook was observed among some Syrian and African origin respondents, who disclosed that managing care and work is overwhelming. Most TCEs also reported facing limited job options because of language barriers. While various interviewees experienced a lack of paid work and reduced income after COVID-19, a distinct perspective was noted from African descent TCEs as they expressed facing increased work demands after the pandemic. Participants additionally revealed four common coping strategies such as keeping busy, praying, family support, and staying active. Study implications include the promotion of Carer-Friendly Workplace Policies (CFWPs) that can facilitate the welfare of unpaid caregivers. This research is important as it may inform policymakers to create opportunities that may not only foster economic stability of TCEs and the Canadian economy, but also contribute towards a more equitable society.

Reasons for migration, parental acculturation, and language: the case of Chinese American and Mexican American parents and dual language learners

Migration is a complex process associated with a range of social, economic, and political reasons. In the U.S., almost one-quarter of the total population of parents are immigrant parents of children ages 0-10. Immigrant parents transmit values from their culture of origin as well as their language to their children. Additionally, they may undergo a process of cultural and psychological change known as acculturation. Research has shown that acculturation can be linked to parenting styles and adolescents' psychological well-being and behavioral problems. However, little is known about the associations among immigrant parents' acculturation, their home language and literacy practices, and their bilingual children's language skills. This study explores the relationships among reasons for migration, parental acculturation, home language and literacy practices, and child expressive vocabulary in English and their heritage language (HL). A group of 190 Spanish-English (N = 66) and Chinese-English (N = 124) dual language learners (DLLs) (mean age = 48.98 months) and their Chinese and Mexican parents (mean age of migration = 18.57 and 21.38 years old respectively participated. Frequency counts revealed that Mexican American families migrated to the U.S. mostly for multiple reasons, including joining family members, getting married, and looking for better education or job opportunities, whereas most Chinese American families migrated for family reasons only. Path analysis models showed that, for both cultural groups, language input in Spanish and Chinese mediated the relationship between parents' cultural orientations and DLLs' HL expressive vocabulary. These findings emphasize that despite the heterogeneity of immigrant families and the variability in DLLs' vocabulary skills in preschool, there exist some similarities across immigrant parents and bilingual children. A deeper understanding of acculturation practices and home language use can help educators better support children from diverse backgrounds and promote cultural awareness and sensitivity in the classroom.

The Effectiveness of a Parents as Teachers Home Visitation Program on School Readiness: An Application of Complier Average Causal Effect Analysis

PURPOSE

The purpose of this study is to evaluate an encouragement trial of a Parents as Teachers (PAT) home visitation intervention on the school readiness of preschool children using an innovative analysis to address issues of selective enrollment.

METHOD

Families were given the opportunity to enroll in a PAT program through a randomized lottery. The PAT program is assessed using standardized measures of school readiness before and after the two-year program. A comparison of three different analyses is used to evaluate the program - Average Treatment Effect (ATE) analysis, Intent-to-Treat (ITT) analysis, and Complier Average Causal Effect (CACE) analysis. CACE is an innovative analysis developed specifically to diagnose bias arising from selective enrollment in the context of an encouragement trial.

RESULT

All three analyses (ATE, ITT, and CACE) provide statistically significant evidence of an effective PAT program. However, the effect sizes for the CACE analysis are over twice as large as the other two analyses. The Cohen's D for CACE is .934 compared to .424 for ATE and .381 for ITT.

CONCLUSION

This study provides evidence of an effective PAT program. The comparison of ATE, ITT, and CACE analyses reveals the potential for meaningful under-reporting of the program's impact if selective enrollment is ignored. CACE analysis demonstrates how selective enrollment can bias evaluations of home visitation interventions in general.

Changes in the epidemiological pattern of chronic B hepatitis amongst inmates in Catalonia: current prevalence and predictive variables

BACKGROUND

The epidemiology of chronic hepatitis B (CHB) in Spain has changed due to migratory movements and the implementation of vaccination programs. The objective is to determine if prevalence has also changed amongst in Catalonia and the potential predictive variables of the infection.

MATERIAL AND METHOD

Observational cross-sectional multi-centre study of CHB prevalence. Epidemiological and clinical variables were included, and their predictive capacity is analysed by means of a multivariable logistic regression model.

RESULTS

A total of 6508 prisoners were studied. CHB prevalence was 1.7%, much less than in studies carried out in previous years. In inmates from North Africa, Asia, Eastern Europe, and Sub-Saharan Africa the CHB rate was 2.8, 4.2, 4.9 and 16.2 times higher, respectively, than amongst those born in Spain, which was 0.6%, the same as in the general population. CHB was associated with: a) being an immigrant [2.6%; OR: 4.18 (CI: 2.50-6.90; P <0.001); b) being unvaccinated (3.1%; OR: 0.13; CI: 0.06-0.26; P <0.001); and c) being infected by the human immunodeficiency virus (HIV) [3.9%; OR: 3.23; CI: 1.24-8.40; P = 0.016].

CONCLUSION

Vaccination against HBV (hepatitis B virus) has greatly reduced CHB prevalence in inmates over the past 30 years but remains high in immigrants and those with HIV. We recommend: a) maintaining HBV screening amongst inmates; b) continuing with vaccination programmes; and c) referring CHB cases to specialized programs for further study and treatment if needed.

The Lived Experiences of Female Immigrant Carers in Madrid, Spain: A Phenomenological Study

BACKGROUND

Immigration and population ageing represent circumstances with important sociocultural and economic repercussions.

METHODS

A qualitative study using interpretative phenomenological analysis was conducted to understand the daily lives and the work of immigrant women dedicated to caring for older citizens. In-depth interviews and discussion groups were carried out in a group of 40 immigrant carers. Data were analysed via the constant comparative method.

RESULTS

Three qualitative themes emerged from the data: 'difficult lives', 'working in the home', and 'the vision of the other'. This study highlights the many difficulties encountered by this population. A sense of vulnerability was described while fulfilling their professional duties due to their migrant condition, experiences of gender inequality, and work status. An emotional connection is necessary to provide care, which is impossible in cases of discrimination.

DISCUSSION

Administrative regularisation is necessary to improve the quality of immigrant carers' working conditions.

Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study

Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.

Exploring the Association Between Detention Conditions, Detention-Related Abuse, and Mental Health Among Deported Mexican Migrants

Migration, detention, and deportation are often rife with violence. This study sought to examine associations between pre-migration experiences, detention conditions, and mental health among Mexicans deported from the U.S. to Mexico between 2020 and 2021. Data from the Migrante Project (N=306, weighted N=14,841) were analyzed using descriptive statistics and unadjusted and adjusted multivariate regression models. The prevalence of a lifetime mental health diagnosis was 18.5%. Exposure to adverse conditions in detention (adjusted odds ratio [AOR]=17.56, p<.001) and having been detained in both immigration and non-immigration facilities (AOR=9.70, p=.042) were significantly associated with increased odds of experiencing abuse during migrants' most recent detention. Experiencing abuse during migrants' most recent detention was, in turn, associated with increased odds of a lifetime mental health diagnosis (AOR=4.72, p<.005). Targeted, trauma-informed mental health services are needed for deported Mexican migrants.

The Volunteer State: Latinx youth and the making of membership in Nashville, Tennessee

Volunteering has long held a vaunted position in the United States, which has only increased in the wake of welfare reform and the retraction of the state from the provision of public goods. This article explores how immigrant-origin Latinx youth in Nashville, Tennessee, who are active community volunteers linked volunteering to moral personhood and their claims to national membership. This linkage is based on an internalized deficit perception of the Latinx immigrant person as an immoral national interloper and a stigmatization and racialization of economic need. However, youth also engaged in a reframing of the meanings of membership and volunteering rooted in their relational commitments to each other and their undocumented peers' blocked paths to citizenship. These socially reproductive and more transformative understandings of volunteering, and their links to self-as-citizen, reveal the contingent value of civic engagement for immigrant-origin Latinx youth. It also reveals their central roles in defining the parameters of membership in an era of increased nativist racism and decreased state social service provision in the United States.

Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: I. Clinical Outcomes

BACKGROUND

Social determinants of health (SDoHs) are receiving growing attention and are particularly relevant to persons with schizophrenia-spectrum psychotic disorders (SSPDs), considering their heightened risk of comorbidities, cognitive and functional decline, and early mortality. Yet, we did not find any comprehensive review of multiple SDoHs in SSPD.

STUDY DESIGN

We conducted a scoping review of meta-analyses and systematic reviews of nine major SDoHs in SSPD.

STUDY RESULTS

Childhood abuse, parental psychopathology, parental communication problems, bullying, and urban settings with lower socioeconomic status were major risk factors for the greater incidence of SSPD and/or worse health. Social network size was inversely associated with overall psychopathology and negative symptoms. Experiences of racial/ethnic discrimination correlated with the prevalence of psychotic symptoms and experiences. Compared to native populations, the risk of psychosis was higher in immigrants, refugees, and asylees. Social fragmentation was associated with an increased prevalence of schizophrenia. Homeless populations had a 30-fold higher prevalence of schizophrenia than the general population. Seriously mentally ill people were 2.7 times more likely to report food insecurity than controls. The prevalence of non-affective psychosis in prisoners was 2.0%-6.5%, compared to 0.3% in the general population. Certain potentially positive factors like family and community resilience remain poorly studied.

CONCLUSIONS

SDoHs are associated with higher rates of and worse outcomes in SSPD. Well-designed longitudinal studies are needed to understand SDoHs' contribution to health in persons with SSPD, to develop interventions, and to implement changes in clinical care and public health policies that would reduce adverse health impacts of SDoHs. Positive SDoHs deserve greater attention.

Children of immigrants: Racial assortative mating and the transition to adulthood

Few studies have followed immigrant-origin individuals from adolescence to adulthood or examined their spousal choices. Using longitudinal data from Add Health, we present a life-course model that examines the differences in racial assortative mating between children of immigrants and non-immigrants. The results reveal substantial variation in racial endogamy from generation to generation. Racial endogamy was highest in the third generation, but this is due entirely to high racial endogamy among whites. Out-marriage was most pronounced among first- and second-generation immigrants. Our life-course approach shows that the effects of race and generation on intermarriage were mediated by family background (e.g. language proficiency and residence) and educational attainment (at time of marriage), a finding largely indicative of processes of marital assimilation that unfold over time and generation. Evidence of acculturation and structural assimilation, however, could not fully account for the large, persistent, and uneven effects of race and generation on interracial marriage.

Transformative impacts of a civic leadership program created by and for refugees and immigrants

Immigrants and refugees are severely underrepresented at all levels of political decision-making in the United States. These groups face significant barriers to civic and political participation and leadership, despite a frequent commitment to community care and engagement. There is an urgent need to address immigrant integration and underrepresentation through transformative means that go beyond voting to create a more inclusive and socially just society. We investigated outcomes associated with participation in an immigrant integration program designed to increase immigrants' access to civic engagement through a community-based participatory research and action process that centered the voices, experiences, and wisdom of refugees and immigrants. Thirty immigrants and refugees representing at least eight different communities participated in semi-structured interviews. Results illustrate how the program assisted in transforming participants' consciousness, skills, and relationships related to meaningful civic engagement and realizing their voice, power, and rights. These results emphasize the impact and potential of community based participatory research to transform individual and collective efficacy, consciousness, and capabilities-a vital first step in transformative justice.