962 resultados para immigrant physicians
Resumo:
This study tests Ogbu and Simons' Cultural-Ecological Theory of School Performance using data from the Progress in International Reading Literacy Study of 2001 (PIRLS), a large-scale international survey and reading assessment involving fourth grade students from 35 countries, including the United States. This theory argues that Black immigrant students outperform their non-immigrant counterparts, academically, and that achievement differences are attributed to stronger educational commitment in Black immigrant families. Four hypotheses are formulated to test this theory: Black immigrant students have (a) more receptive attitudes toward reading; (b) a more positive reading self-concept; and (c) a higher level of reading literacy. Furthermore, (d) the relationship of immigrant status to reading perceptions and literacy persists after including selected predictors. These hypotheses are tested separately for girls and boys, while also examining immigrant students' generational status (i.e., foreign-born or second-generation). ^ PIRLS data from a subset of Black students (N=525) in the larger U.S. sample of 3,763 are analyzed to test the hypotheses, using analysis of variance, correlation and multiple regression techniques. Findings reveal that hypotheses a and b are not confirmed (contradicting the Cultural-Ecological Theory) and c and d are partially supported (lending partial support to the theory). Specifically, immigrant and non-immigrant students did not differ in attitudes toward reading or reading self-concept; second-generation immigrant boys outperformed both non-immigrant and foreign-born immigrant boys in reading literacy, but no differences were found among girls; and, while being second-generation immigrant had a relatively stronger relationship to reading literacy for boys, among girls, selected socio-cultural predictors, number of books in the home and length of U.S. residence, had relatively stronger relationship to reading self-concept than did immigrant status. This study, therefore, indicates that future research employing the Cultural-Ecological Theory should: (a) take gender and generational status into account (b) identify additional socio-cultural predictors of Black children's academic perceptions and performance; and (c) continue to build on this body of evidence-based knowledge to better inform educational policy and school personnel in addressing needs of all children. ^
Resumo:
This article examines factors that affect interethnic relations in Miami, Florida. The theoretical frame- work, based on the ‘contact hypothesis’ argues that better interethnic relations stem from not only contact, but also contact in which individuals from opposing groups share equal status and a stake in outcomes, and when contact activities require cooperation. The contact hypothesis, however, does not address the factors that produce inequality in social relations. To address these factors ideas from inter- national migration research are used to argue that those with power must create structures in which other groups feel welcome rather than rejected and that leaders must emphasize similarities rather than differences among groups.
Do immigrant outflows lead to native inflows? An empirical analysis of the migratory responses to US
Resumo:
Around the world borders are militarized, states are stepping up repressive anti-immigrant controls, and native publics are turning immigrants into scapegoats for the spiraling crisis of global capitalism. The massive displacement and primitive accumulation unleashed by free trade agreements and neo-liberal policies, as well as state and “private” violence has resulted in a virtually inexhaustible immigrant labor reserve for the global economy. State controls over immigration and immigrant labor have several functions for the system: 1) state repression and criminalization of undocumented immigration make immigrants vulnerable and deportable and therefore subject to conditions of super-exploitation, super-control and hyper-surveillance; 2) anti-immigrant repressive apparatuses are themselves ever more important sources of accumulation, ranging from private for-profit immigrant detention centers, to the militarization of borders, and the purchase by states of military hardware and systems of surveillance. Immigrant labor is extremely profitable for the transnational corporate economy; 3) the anti-immigrant policies associated with repressive state apparatuses help turn attention away from the crisis of global capitalism among more privileged sectors of the working class and convert immigrant workers into scapegoats for the crisis, thus deflecting attention from the root causes of the crisis and undermining working class unity. This article focuses on structural and historical underpinnings of the phenomenon of immigrant labor in the new global capitalist system and on how the rise of a globally integrated production and financial system, a transnational capitalist class, and transnational state apparatuses, have led to a reorganization of the world market in labor, including deeper reliance on a rapidly expanding reserve army of immigrant labor and a vicious new anti-immigrant politics. It looks at the United States as an illustration of the larger worldwide situation with regard to immigration and immigrant justice. Finally, it explores the rise of an immigrant justice movement around the world, observes the leading role that immigrant workers often play in worker’s struggles and that a mass immigrant rights movement is at the cutting edge of the struggle against transnational corporate exploitation. We call for replacing the whole concept of national citizenship with that of global citizenship as the only rallying cry that can assure justice and equality for all.
Resumo:
This study examined immigrant minority students' perceptions of race relations and of the chances for social mobility in the United States (U.S.) using cohort samples of West Indian (N=173) and Haitian (N=191) students. The Students' responses collected during the 6th and 7th, 8th and 9th grades were analyzed to determine whether perceptions of racial mistrust, teacher derogation and social mobility varied depending on the student's length of stay in the U.S. or self-concept. Quantitative methodology was applied to data extrapolated from a larger epidemiological longitudinal study consisting of 7, 386 middle school students in Miami (Vega and Gil, 1998). Results show that West Indian and Haitian students' perceptions of racial mistrust, teacher derogation and social mobility were associated more with student's self-concept than length of stay. Students with more favorable self-concepts reported greater optimism toward social mobility than those with less favorable self-concepts. Results also indicate that in the context of parental education and SES that racial mistrust is the strongest predictor of these students' level of optimism towards social mobility.
Resumo:
Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
Resumo:
This dissertation consists of three separate studies that examine patterns of immigrant incorporation in the United States. The first study tests competing hypotheses derived from conflicting theoretical frameworks−transnational perspective and cross-national framework− to determine whether transnational engagement and incorporation are concurrent processes among Chinese, Indian, and Mexican immigrants. This study measures transnational engagement and incorporation as home and home country asset ownership using multi-panel, nationally representative data from the New Immigrant Survey (NIS) collected in 2003 and 2007. Results support a cross-border framework and indicate that transnational asset ownership decreases among all immigrant groups, while U.S. asset ownership increases. Findings from this study also indicate that due to disadvantaged pre-migration SES and low human capital, Mexican immigrants are less likely than other immigrants to own home country assets during the year after receiving their green card.
The second study examines the doubly disadvantaged position of elderly immigrants in the U.S. wealth distribution by applying the life course perspective to the dominance-differentiation theory of immigrant wealth stratification. I analyze elderly immigrant wealth in respect to U.S.-born seniors and younger immigrant cohorts using two data sets: the Survey of Income and Program Participation (SIPP) and the New Immigrant Survey (NIS). The Survey of Income and Program Participation (2001 to 2005) is a nationally representative survey of U.S. households. The first series of analyses reveals a significant wealth gap between U.S.- and foreign-born seniors which is most pronounced among the wealthiest households in my sample; however, U.S. tenure explains much of this difference. The second series of analyses suggests that elderly immigrants experience greater barriers to incorporation compared to their younger counterparts.
In the third study, I apply a transnational lens to the forms-of-capital and opportunity structure models of entrepreneurship in order to analyze the role of foreign resources in immigrant business start-ups. I propose that home country property use represents financial, social, and class resources that facilitate immigrant entrepreneurship. I test my hypotheses using survey data on Latin American immigrants from the Comparative Immigrant Entrepreneurship Project. Findings from these analyses suggest that home country asset ownership provides financial and social capital that is related to an increased likelihood of immigrant entrepreneurship.
Resumo:
In Western industrialized countries, it is well established that legally competent individuals may choose a surrogate healthcare decision-maker to represent their interests should they lose the capacity to do so themselves. There are few limitations on who they may select to fulfill this function. However, many jurisdictions place restrictions on or prohibit the patient's attending physician or other provider involved with an individual's care to serve in this role. Several authors have previously suggested that respect for the autonomy of patients requires that there be few (if any) constraints on whomever they may appoint as a proxy. In this essay we revisit this topic by first providing a survey of current state laws governing this activity. We then analyze the clinical and ethical circumstances in which potential difficulties could arise. We take a more nuanced and circumspect view of prior suggestions that patients should have virtually unfettered liberty to choose their healthcare proxies. We suggest a strategy to balance the freedom of patients' right to choose their surrogates with fiduciary duty of the state as regulator of medical practice. We identify six domains of possible concern with such relationships and suggest straightforward methods of mitigating their potential negative effects that could be plausibly be incorporated into physician practice.
Resumo:
While using the brand names seems like a trivial issue at the outset, using these names is inherently problematic. Cardiovascular drugs remain the most commonly prescribed drugs by the physicians. The junior doctors are likely to introject practices of their seniors and consequently to reciprocate from the experiences learnt from their preceptors. Using the generic names may be one way to facilitate prescription of the generic drugs who have a better cost profile and similar efficacy than the more expensive branded drugs. In this editorial, we have outlined several arguments to suggest the importance of using the generic names in academic discussions and clinical documentation.
Resumo:
The successful use of helminths as therapeutic agents to resolve inflammatory disease was first recorded 40 years ago. Subsequent work in animal models and in humans has demonstrated that the organisms might effectively treat a wide range of inflammatory diseases, including allergies, autoimmune disorders and inflammation-associated neuropsychiatric disorders. However, available information regarding the therapeutic uses and effects of helminths in humans is limited. This study probes the practices and experiences of individuals 'self-treating' with helminths through the eyes of their physicians. Five physicians monitoring more than 700 self-treating patients were interviewed. The results strongly support previous indications that helminth therapy can effectively treat a wide range of allergies, autoimmune conditions and neuropsychiatric disorders, such as major depression and anxiety disorders. Approximately 57% of the self-treating patients observed by physicians in the study had autism. Physicians reported that the majority of patients with autism and inflammation-associated co-morbidities responded favourably to therapy with either of the two most popular organisms currently used by self-treaters, Hymenolepis diminuta and Trichuris suis. However, approximately 1% of paediatric patients experienced severe gastrointestinal pains with the use of H. diminuta, although the symptoms were resolved with an anti-helminthic drug. Further, exposure to helminths apparently did not affect the impaired comprehension of social situations that is the hallmark of autism. These observations point toward potential starting points for clinical trials, and provide further support for the importance of such trials and for concerted efforts aimed at probing the potential of helminths, and perhaps other biologicals, for therapeutic use.
Resumo:
BACKGROUND: Fluid resuscitation is a cornerstone of intensive care treatment, yet there is a lack of agreement on how various types of fluids should be used in critically ill patients with different disease states. Therefore, our goal was to investigate the practice patterns of fluid utilization for resuscitation of adult patients in intensive care units (ICUs) within the USA. METHODS: We conducted a cross-sectional online survey of 502 physicians practicing in medical and surgical ICUs. Survey questions were designed to assess clinical decision-making processes for 3 types of patients who need volume expansion: (1) not bleeding and not septic, (2) bleeding but not septic, (3) requiring resuscitation for sepsis. First-choice fluid used in fluid boluses for these 3 patient types was requested from the respondents. Descriptive statistics were performed using a Kruskal-Wallis test to evaluate differences among the physician groups. Follow-up tests, including t tests, were conducted to evaluate differences between ICU types, hospital settings, and bolus volume. RESULTS: Fluid resuscitation varied with respect to preferences for the factors to determine volume status and preferences for fluid types. The 3 most frequently preferred volume indicators were blood pressure, urine output, and central venous pressure. Regardless of the patient type, the most preferred fluid type was crystalloid, followed by 5 % albumin and then 6 % hydroxyethyl starches (HES) 450/0.70 and 6 % HES 600/0.75. Surprisingly, up to 10 % of physicians still chose HES as the first choice of fluid for resuscitation in sepsis. The clinical specialty and the practice setting of the treating physicians also influenced fluid choices. CONCLUSIONS: Practice patterns of fluid resuscitation varied in the USA, depending on patient characteristics, clinical specialties, and practice settings of the treating physicians.
Resumo:
Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
Resumo:
Background Many breast cancer survivors continue to have a broad range of physical and psychosocial problems after breast cancer treatment. As cancer centres move forward with earlier discharge of stable breast cancer survivors to primary care follow-up it is important that comprehensive evidence-based breast cancer survivorship care is implemented to effectively address these needs. Research suggests primary care providers are willing to provide breast cancer survivorship care but many lack the knowledge and confidence to provide evidence-based care. Purpose The overall purpose of this thesis was to determine the challenges, strengths and opportunities related to implementing comprehensive evidence-based breast cancer survivorship guidelines by primary care physicians and nurse practitioners in southeastern Ontario. Methods This mixed-methods research was conducted in three phases: (1) synthesis and appraisal of clinical practice guidelines relevant to provision of breast cancer survivorship care within the primary care practice setting; (2) a brief quantitative survey of primary care providers to determine actual practices related to provision of evidence-based breast cancer survivorship care; and (3) individual interviews with primary care providers about the challenges, strengths and opportunities related to provision of comprehensive evidence-based breast cancer survivorship care. Results and Conclusions In the first phase, a comprehensive clinical practice framework was created to guide provision of breast cancer survivorship care and consisted of a one-page checklist outlining breast cancer survivorship issues relevant to primary care, a three-page summary of key recommendations, and a one-page list of guideline sources. The second phase identified several knowledge and practice gaps, and it was determined that guideline implementation rates were higher for recommendations related to prevention and surveillance aspects of survivorship care and lowest related to screening for and management of long-term effects. The third phase identified three major challenges to providing breast cancer survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden; and three major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles. A better understanding of these challenges, strengths and opportunities will inform development of targeted knowledge translation interventions to provide support and education to primary care providers.
Resumo:
A correlation between age at immigration and earnings is observed in Canadian census data. The evidence supports three underlying sources of the effect; first, work experience in the source country yields virtually no return in the host country; second, the return to education varies with age at immigration, and, finally, an “acculturation” effect is observed for immigrants who are visible minorities or whose mother tongue is not English. Further, it is found that educational attainment, and relatedly earnings, vary systematically across age at immigration with those arriving around age 15 to 18 obtaining fewer years of education. JEL codes: J61, J31.