Malaria chemoprophylaxis recommendations for immigrants to Europe, visiting relatives and friends--a Delphi method study.

BACKGROUND: Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs. METHODS: European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis. RESULTS: The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe. CONCLUSIONS: Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics.

Screening for latent tuberculosis infection among undocumented immigrants in Swiss healthcare centres; a descriptive exploratory study.

BACKGROUND: Migration is one of the major causes of tuberculosis in developed countries. Undocumented patients are usually not screened at the border and are not covered by a health insurance increasing their risk of developing the disease unnoticed. Urban health centres could help identify this population at risk. The objective of this study is to assess the prevalence of latent tuberculosis infection (LTBI) and adherence to preventive treatment in a population of undocumented immigrant patients. METHODS: All consecutive undocumented patients that visited two urban healthcare centres for vulnerable populations in Lausanne, Switzerland for the first time were offered tuberculosis screening with an interferon-gamma assay. Preventive treatment was offered if indicated. Adherence to treatment was evaluated monthly over a nine month period. RESULTS: Of the 161 participants, 131 (81.4%) agreed to screening and 125 had complete examinations. Twenty-four of the 125 patients (19.2%; CI95% 12.7;27.2) had positive interferon-gamma assay results, two of which had active tuberculosis. Only five patients with LTBI completed full preventive treatments. Five others initiated the treatment but did not follow through. CONCLUSION: Screening for tuberculosis infection in this hard-to-reach population is feasible in dedicated urban clinics, and the prevalence of LTBI is high in this vulnerable population. However, the low adherence to treatment is an important public health concern, and new strategies are needed to address this problem.

Inmigrantes menores de edad en Cataluña: un reto para las instituciones educativas

La llegada de menores inmigrantes procedentes principalmente de África, ha comportado que en España, y concretamente en Cataluña, las instituciones públicas y privadas se planteen cómo atenderles. La respuesta dada desde la administración catalana se ha caracterizado por una evolución desde el uso de las estructuras existentes hasta la propuesta más reciente de creación de nuevos centros ante la dificultad de dar una respuesta adecuada con lo existente. El artículo que presentamos analiza, a partir de grupos de discusión con los profesionales de los centros que acogían a estos menores, cómo se ha vivido esta presencia y qué retos estructurales (adaptación a las demandas, idoneidad de crear centros específicos para estos menores y/o contar con la presencia de educadores que pertenezcan o conozcan la cultura de origen de estos menores, etc.) y formativos ha planteado.

Noves i velles migracions: dimensions de la integració sociocultural dels immigrants a Lleida

En aquest article sobre Noves i velles migracions: dimensions de la integració sociocultural dels immigrants a Lleida (1999), s'analitza de forma concisa aquest fenòmen per identificar les principals característiques diferenciadores dels immigrants de la zona lleidatana. L'article consta de tres apartats. En el primer, la introducció, es resumeixen breument els continguts del treball que donen títol a l'article. El segon apartat tracta sobre la integració dels immigrants i comença per una breu reflexió sobre els canvis d'enfocament a l'hora d'estudiar el fenòmen migratori que ajuda a entendre, per exemple, perquè avui parlem d'integració i no d'assimilació. Posteriorment, s'analitza el model migratori català del qual destaca la inexistència de fractura social malgrat l'elevada arribada d'immigrants a Catalunya, i valora els diferents nivells d'integració assolida en cada onada immigratòria del segle XX. Finalment, es detallen els diferents factors relacionats amb la integració sociocultural (impacte en el creixement demogràfic, sistema educatiu, integració en el mercat laboral i adopció de la llengua catalana) de la població immigrada a la ciutat de Lleida i comarques. El treball conclou que el repte és trobar el model d'integració sociocultural adient per al col•lectiu extracomunitari que integra, majoritàriament, l'onada migratòria iniciada en la dècada dels noranta.

Joves immigrants i persistència acadèmica: què ens diuen les seves xarxes personals?

L'estudi que es presenta forma part d'un projecte de recera de tipus longitudinal que busca detrminar en quina mesura les xarxes personals i socials de l'alumnat immigrant poden apoderar les seves trajectòries acadèmiques tot incidint en la seva persistència i èxit escolar. L'estudi introdueix un nou nivell de comprensió tant de les trajectòries d'èxit com de la vulnerabilitat de l'alumnat immigrant a la secundària utilitzant l'enfocament egocèntric de l'anàlisi de xarxes socials. Aquest article mostra les potencialitats d'aquest enfocament, el qual ha desenvolupat uns processos metodològics i de creació d'instrumentació propis per al mesurament i analisi de les estructures, patrons i formes d'interacció que emergeixen dels vincles entre actors diversos. Els resultats mostren que els sistemes relacionals de l'alumnat (família, escola i comunitat) constitueixen un nivell intemedi en el qual s'expressa la naturalesa dinàmica i articulada de les funcions de socialització, connexió i presa de decisions de les seves xarxes personals i socials, i permeten valorar la seva incidència en les trajectòries acadèmiques dels estudiants.

Health care usage among immigrants and native-born elderly populations in eleven European countries: results from SHARE

Differences in health care utilization of immigrants 50 years of age and older relative to the native-born populations in eleven European countries are investigated. Negative binomial and zero-inflated Poisson regression are used to examine differences between immigrants and native-borns in number of doctor visits, visits to general practitioners, and hospital stays using the 2004 Survey of Health, Ageing, and Retirement in Europe database. In the pooled European sample and in some individual countries, older immigrants use from 13 to 20% more health services than native-borns after demographic characteristics are controlled. After controlling for the need for health care, differences between immigrants and native-borns in the use of physicians, but not hospitals, are reduced by about half. These are not changed much with the incorporation of indicators of socioeconomic status and extra insurance coverage. Higher country-level relative expenditures on health, paying physicians a fee-for-service, and physician density are associated with higher usage of physician services among immigrants.

Salaris i ocupacions dels immigrants en el mercat de treball

Els immigrants cobren salaris inferiors que els natius perquè ocupen llocs de treball menys qualificats i treballen en empreses de salaris baixos. En arribar pateixen una degradació ocupacional perquè el seu capital humà no està adaptat al nostre mercat de treball. Així, han d"acceptar feines per a les quals estan sobreeducats i pateixen una penalització salarial molt intensa pels estudis que no poden fer valer. La transferibilitat limitada del capital humà dels immigrants fa que les empreses valorin poc tant els estudis com l"experiència laboral adquirits en origen. Disposar d"una feina a Espanya, però, els permet acumular experiència adaptada a les necessitats de les empreses. Així milloren el capital humà, progressen en termes d"ocupació, redueixen la sobreeducació i augmenten els seus salaris. Ara bé, la millora és lenta i limitada a alguns col·lectius.

The skill paradox: Explaining and reducing employment discrimination against skilled immigrants

Using a social identity theory approach, we theorized that recruiters might be particularly biased against skilled immigrant applicants. We refer to this phenomenon as a skill paradox, according to which immigrants are more likely to be targets of employment discrimination the more skilled they are. Furthermore, building on the common ingroup identity model, we proposed that this paradox can be resolved through human resource management (HRM) strategies that promote inclusive hiring practices (e.g., by emphasizing fit with a diverse clientele). The results from a laboratory experiment were consistent with our predictions: Local recruiters preferred skilled local applicants over skilled immigrant applicants, but only when these applicants were qualified for a specific job. This bias against qualified and skilled immigrant applicants was attenuated when fit with a diverse clientele was emphasized, but not when fit with a homogeneous clientele was emphasized or when the hiring strategy was not explained. We discuss the implications of our findings for research on employment discrimination against skilled immigrants, including the role of inclusiveness for reducing discriminatory biases.

The Impact of Supervisor's Advice, Codes of Conduct, Accountability and Moral Attentiveness of Individuals on Discriminatory Behaviour Against Immigrants.

Past studies on the personnel selection demonstrated that a supervisor's advice to discriminate can lead to compliant behaviours. This study had the aim to extend past findings by examining what can overcome the powerful influence of the hierarchy. 50 Swiss managers participated to an in-basket exercise. The main task was to evaluate Swiss candidates (in-group) and foreigners (out-groups: Spanish and Kosovo Albanians) and to select two applicants for a job interview. Main results were the effect of codes of conduct to prevent discrimination against out-group applicants in the presence of a supervisor's advice to prefer in-group members. But, when participants were accountable to an audience, this beneficial effect disappears because participants followed the supervisor's advice. The second aim was to assess if the difference in responses between participants was related to their difference in moral attentiveness. Results showed some significant relationships but not always in the direction expected.