The Border Health Consortium of the Californias-Forming a Binational (California-Baja California) Entity to Address the Health of a Border Region: A Case Study

The Body in the Mirror: Breast Cancer, Liminality and Borderlands

Breast cancer is the most common cancer among women worldwide, and has a high mortality rate in northern Mexico. Its high rates present one of the principal health challenges of the California-Baja California border region. We employed "entangled" ethnography and interpretative phenomenological methods to explore breast cancer experiences among a group of Mexican immigrant women living on the US side of this border. We explore their trajectory from biographical disruption to biographical renewal. The entangled ethnographic approach includes reflections of the first author's experience as a genetic breast cancer survivor.

Trends in Teen Births in Mexico Spanning 25 Years: A Need for Regionally-directed Preventive Strategies

AIM OF THE STUDY

We aimed to explore national and regional trends in teen births in Mexico from 1992-2016, ranking the states with the highest rates in 2016.

METHODS

A cross-sectional analysis was conducted and the data on the total number of live births to teenage mothers were analyzed. The age-standardized rates (ASRs) per 1,000 adolescent girls were obtained and the annual percent changes (APCs) with 95% confidence intervals (CIs) were calculated using the Poisson regression models.

RESULTS

The national ASRs during the study period dropped from 2.11-1.74 in girls aged 10-14 years and from 86.04-70.82 in adolescents aged 15-19 years. Higher APC rates were documented for teenage girls under 15 years of age (‒0.6, 95% CI:-1.0, -0.3), when compared with older girls (-0.3, 95% CI:-0.6, -0.04). Heterogeneous APCs were observed in the stratified analysis and the overall declines were higher from 2011-2016. States with significantly increasing trends in teen births were also documented. The highest ASRs (per 1,000 girls aged 10-19 years) in 2016 were registered in the states of Coahuila de Zaragoza (49.45), Chiapas (46.24), and Guerrero (44.94).

CONCLUSIONS

Teen birth rates decreased over the period of time analyzed. However, that decline has not been monotonic or homogeneous across Mexico, and recent (2011-2016) increasing rates were observed in some states in girls aged 14 years and younger. Teenage parenthood can negatively affect multiple dimensions of health, and therefore, regionally directed efforts focusing on its reduction must be strengthened.

12 years active surveillance for pediatric pleural empyema in a Mexican hospital: effectiveness of pneumococcal 13-valent conjugate vaccine, and early emergence of methicillin-resistant Staphylococcus aureus

Background:

Previous publications have proved the effectiveness of the 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal pleural empyema (PnPE) in children, with little emergence of other pathogens. We searched the literature to establish whether PCV13 reduces PnPE, and to identify other pathogens causing pleural empyemas (PEs).

Material and methods:

From October 2005 to January 2018 (12.3 years) we performed active surveillance for all cases of PE at the General Hospital of Tijuana, Mexico. Isolates from pleural fluid (PF) were identified by conventional culture, and since 2014, polymerase chain reaction (PCR) was added for all culture-negative PFs. Streptococcus pneumoniae serotypes were detected by either Quellung reaction (Statens Serum Institute®) or PCR. Clinical, imagenological, laboratorial and microbiological evaluation was performed on each patient. Statistical analysis was purely descriptive.

Results:

A total of 64 PEs were identified (5.28/year). Median age was 51 months (1–191), hospitalization days 18 (4–35). Decortication was performed in 42%, and two children died (3.2%). Bacterial identification was obtained from 51 (80%). S. pneumoniae was the leading cause (29 = 56.8%), followed by Staphylococcus aureus (14 = 27.4%), Streptococcus pyogenes (3–5 = 9%) and others (5 = 9.8%). PCV13 was initiated in May 2012, and its impact on serotype-specific PnPE was 81% (much fewer than serotype 3) and for all PnPE 56.1%; however, for all PE −2.1% due to an increase of PE caused by S. aureus for all but one methicillin-resistant S. aureus (MRSA).

Conclusions:

Following 12.3 years of active surveillance, PCV13 has shown impact on both serotype-specific and all PnPEs; however, an increase of PEs by MRSA has emerged. Continuous surveillance is crucial to establish whether this epidemiological finding is transitory or not.

'Killing Me Softly With His/Her Song': How Leaders Dismantle Followers' Sense of Work Meaningfulness

Leaders influence followers' meaning and play a key role in shaping their employees' experience of work meaningfulness. While the dominant perspective in theory and in empirical work focuses on the positive influence of leaders on followers' work meaningfulness, our conceptual model explores conditions in which leaders may harm followers' sense of meaning. We introduce six types of conditions: leaders' personality traits, leaders' behaviors, the relationship between leader and follower, followers' attributions, followers' characteristics, and job design under which leaders' meaning making efforts might harm or 'kill' followers' sense of work meaningfulness. Accordingly, we explore how these conditions may interact with leaders' meaning making efforts to lower levels of followers' sense of meaning, and in turn, lead to negative personal outcomes (cynicism, lower well-being, and disengagement), as well as negative organizational outcomes (corrosive organizational energy, higher turnover rates, and lower organizational productivity). By doing so, our research extends the current literature, enabling a more comprehensive understanding of leaders' influence on followers' work meaningfulness, while considering the dark side of meaning making.