Zeitschriftenartikel zum Thema „Native men – canada – social conditions“

Using eleven cross-sectional surveys spanning 1981–92, the authors compare the earnings of immigrant and native-born men in Canada. Apparently, recent immigrant cohorts have suffered no decline in earnings. Job tenure is found to be a strongly significant determinant of earnings; previous estimates of immigrant earnings differentials, which have not incorporated job tenure information, may partly reflect differences in tenure between immigrants and the native-born. When the sample is restricted to pairs of surveys that are close to the Census survey years, the estimates of cohort effects are sensitive to the choice of survey years. One possible explanation for that sensitivity is suggested by the finding that macroeconomic conditions are a statistically significant determinant of the rate of assimilation of recent immigrants.

SummaryA growing body of research often indicates that immigrant populations in Western countries enjoy a lower level of mortality in relation to their native-born host populations. In this literature, sex differences in mortality are often reported but substantive analyses of the differences are generally lacking. The present investigation looks at sex differences in life expectancy with specific reference to immigrant and Canadian-born populations in Canada during 1971 and 2001. For these two populations, sex differences in expectation of life at birth are decomposed into cause-of-death components. Immigrants in Canada have a higher life expectancy than their Canadian-born counterparts. In absolute terms, immigrant females enjoy the highest life expectancy. Inrelativeterms, however, immigrant men show a larger longevity advantage, as their expectation of life at birth exceeds that of Canadian-born men by a wider margin than do foreign-born females in relation to Canadian-born females. It is also found that immigrants have a smaller sex differential in life expectancy as compared with the Canadian born. Decomposition analysis shows this is a function of immigrants having smaller sex differences in death rates from heart disease and cancer. Factors thought to underlie these differentials between immigrants and the Canadian born are discussed and suggestions for further research are given.

Although previous studies have explored the role of gender on stalking victimization, we know very little about how female and male immigrants are exposed to stalking victimization over time after their arrival to their host society. To address this void in the literature, we use the 2014 Canada General Social Survey to compare stalking victimization among native-born individuals, recent immigrants (those who have been in Canada for fewer than 10 years), and established immigrants (those who have been in Canada for 10 years or more) separately for women and men. Applying gender-specific complementary log-log models, we find that female (OR = 0.63, p < 0.05) and male (OR = 0.46, p < 0.01) recent immigrants are less likely to experience stalking victimization than their native-born counterparts. We also find that female established immigrants (OR = 0.65, p < 0.05) are less likely to experience stalking victimization than their native-born counterparts although there is no significance difference for male established immigrants (OR = 1.01, p > 0.05). Overall, this study points to the importance of understanding the intersection between immigrants’ length of residence and gender in the context of stalking victimization in Canada. Based on these findings, we discuss several implications for policymakers and directions for future research.

This paper enquires into the nexus of migration with sexual health among gay Latino migrants in Canada. Interviews with 25 Spanish-speaking interviewees are examined in light of models developed from studies of Latinos in the United States. Canadian immigration policy appears to result in a somewhat different selection of immigrants compared to the United States. Migrants come from a wide range of national and regional backgrounds intersected by race, generation, and social class that influence their perceptions of and adjustment to Canadian society. Pre-migration HIV knowledge varied strongly by generation with older men recalling public panic concerning HIV and younger men receiving formal education about it. Migration enters into the mix of conditions as kin ties can be less confidently relied on among gay men compared to their heterosexual counterparts and by exacerbating vulnerability among those seeking to develop new social and sexual networks.

The number and relative proportion of older Native people in Canada are both increasing rapidly. So also is a social problems discourse asserting that informal care of older Native people by family and kin is traditional, and highly appropriate today. However, neither this discourse nor previous research satisfactorily address the informal care requirements of older Native people nor the gendered implications that high levels of informal care provision may have for Native caregivers. Informal care is provided to Canada's non-Native elderly people primarily by resident wives and non-resident daughters, and secondarily by husbands and sons. Data from the pan-provincial Alberta Native Seniors Study demonstrate that Native people aged 50 or more have comparatively high overall care requirements. Older Native Albertans are poor, and make extensive use of some government income support programmes. They also make moderate use of medical services. Extensive dependence on informal care, institutional barriers and local service unavailability lead Native seniors to under-utilise other formal programmes aimed generically at the older provincial population. Native seniors are much more likely to live with kin than are other Canadians. Informal care appears equally available to older women and men, and is provided chiefly by resident daughters, sons and spouses, and by non-resident daughters, sisters and sons. Extensive elderly caregiving requirements may impose a growing, double burden on many, who are also providing care for dependent children. Without further support, current and future requirements may significantly limit the options of caregiving women and men.

Through the analysis of 22 European countries and Canada, this article seeks to investigate the assumption that political macro level variables such as welfare state systems and immigration regimes shape the conditions encountered by young immigrants and thus have an impact on their school performance. The results show that native students benefit from social-democratic welfare states and immigration-friendly integration regimes, whereas immigrant students underperform under these types of regimes. Thus, while the finding for native students supports the argument found in the body of literature, claiming that social-democratic welfare states lead to a reduction in inequality and to less stratification, the findings for immigrant students suggest that positive discrimination may under some circumstances lead to a counterproductive result. The argument is tested with a multilevel modelling procedure on three levels (student, school and country) based on different data sources.

The progress of indigenous women is very important for poverty abolition, attainment of justifiable development and the fight against gender-based violence. Unfortunately, gender discrimination and violence on women is a common problem in every part of the world. In spite of the various developments in all walks of life, cruelty on women is a continuing grief. Destructions of their cultural rights tend to create spiritual violence against aboriginal women. While the Declaration on the Rights of Indigenous Peoples drew special consideration to the requirements and mainly, constitutional rights of indigenous women are called for action to defend them from violence. In spite of, more than one in three aboriginal women are assaulted during their lifetime. Lee Maracle, a world-renowned Native woman writer of Canada, had authored innumerable critically acclaimed literary works which brings out the tribulations faced by the Canadian native women. In her writings, she addresses issues concerning aboriginal women of North America. Through her writings she attempts to achieve liberation of women from the age-old power and tyranny by men. In her biography I Am Woman, she focuses on male- domination and Native women’s subjugation. They lose their individuality and identity and protest for their colour and voices of the people. There is a social prejudice between the Canadian natives and white people. Maracle emphases the Canadian aboriginal legitimacy. She says about the final journey of Native people which ends with liberation. She is one among the Natives whois brutally attacked by the intruders. Maracle concludes the Indigenous People need to rejoice their past because in doing so, it helps to raise their cultures. Celebrating their history stimulates selfimportance in being Indigenous.

National vital statistics in the United States present data in terms of race, sex, and age, treated as biological variables. Some races are clearly of more interest than others: data are usually available for whites and blacks, and increasingly for Hispanics, but seldom for Native Americans or Asians and Pacific Islanders. These data indicate that white men and women generally have the best health and that men and women, within each racial/ethnic group, have different patterns of disease. Obviously, the health status of men and women differs for conditions related to reproduction, but it differs for many nonreproductive conditions as well. In national health data, patterns of disease by race and sex are emphasized while social class differences are ignored. This article discusses how race and sex became such all-important, self-evident categories in 19th and 20th century biomedical thought and practice. It examines the consequences of these categories for knowledge about health and for the provision of health care. It then presents alternative approaches to understanding the relationship between race/ethnicity, gender, and health, with reference to the neglected category of social class.

This study examines a population of spouse abusers undertaking a treatment program. Its purpose was to identify the variables associated with dropout and completion of treatment and to build a predictive model. Data were collected on 286 men who began group treatment in one of eight community programs in the province of Quebec, Canada. Results show that men who complete treatment are older, better educated and have better economic conditions than men who drop out. They also have a more stable family life, have been in a relationship for a longer period of time and have more children with their actual spouse. Men who completed treatment showed more commitment, better working capacities and a higher level of agreement with their therapists, thus developing a stronger therapeutic alliance. Support provided by people in the environment was significantly related to treatment completion. Social and judicial pressures were not related to completion.

ABSTRACT:Objective: To develop a detailed profile of individuals living with migraine in Canada. Such a profile is important for planning and administration of services. Methods: The 2011–2012 Survey of Living with Neurological Conditions in Canada (SLNCC), a cross-sectional community-based survey, was used to examine a representative sample of migraineurs (N = 949) aged 15 years and older. Several health-related variables were examined (e.g., general health, health utility index (HUI) [a measure of health status and health-related quality of life, where dead = 0.00 and perfect health = 1.00], stigma, depression, and social support). Respondents were further stratified by sex, age, and age of migraine onset. Weighted overall and stratified prevalence estimates and odds ratios, both with 95% CIs, were used to estimate associations. Results: Overall, males had poorer health status compared with females (e.g., mean HUI was 0.67 in males vs. 0.82 in females; men had over two times the odds of their migraine limiting educational and job opportunities compared with females). Poorer health-related variables were seen in the older age groups (35–64 years/≥65 years) compared with the 15–34-year age group. There were no differences between those whose migraine symptoms began before versus after the age of 20 years. Conclusions: In this Canadian sample, migraine was associated with worse health-related variables in men compared with women. However, both men and women were significantly affected by migraine across various health-related variables. Thus, it is important to improve clinical and public health interventions addressing the impact of migraine across individuals of all ages, sexes, and sociodemographic backgrounds.

ABSTRACTPrevious research unequivocally shows that immigrants are less successful in the labour market than the native-born population. However, little is known about whether ethnic inequality persists after retirement. We use data on 16 Western European countries from the European Union Statistics on Income and Living Conditions (EU-SILC, 2004–2013) to provide the first comparative study of ethnic inequalities among the population aged 65 and older. We focus on the retirement income gap (RIG) between immigrants from non-European Union countries and relate its magnitude to country differences in welfare state arrangements. Ethnic inequality after retirement is substantial: after adjusting for key characteristics including age, education and occupational status, the average immigrant penalty across the 16 countries is 28 per cent for men and 29 per cent for women. Country-level regressions show that income gaps are smaller in countries where the pension system is more redistributive. We also find that easy access to long-term residence is associated with larger RIGs, at least for men. There is no clear evidence that immigrants’ access to social security programmes, welfare state transfers to working-age households or the strictness of employment protection legislation affect the size of the RIG.

Relatively little attention has been paid in the literature to strategies promoting the health of Native Hawaiian and other Pacific Islander (NHPI) men. To fill this void, a Native Hawaiian cancer survivor and a Marshallese minister in Orange County, California, founded the Kane Group to promote men’s health information and support. This group is comprised of 10 to 15 NHPI men, ages 35 to 83, with a diverse background of experiences in the U.S. healthcare system and health conditions, including multiple site cancer survivors and/or co-morbidity and chronic condition, like high blood pressure, diabetes. The Kane Group provides social support and engages in discussions, using the island tradition of “talk story”, to relate a variety of men’s health issues from prostate cancer to physical fitness to end-of-life decision making in a supportive and safe environment. The group weaves Pacific Islander culture and values into the process and conduct of the support groups. This community commentary describes the innovative strategies, successes, and challenges that emerged with the development of the group that were designed to celebrate Pacific Islander men’s health, provide information, fellowship, and support for the many who are facing health crises.

ObjectiveTo evaluate the pattern of frailty across several of social stratifiers associated with health inequalities.Design, setting and participantsCross-sectional baseline data on 51 338 community-living women and men aged 45–85 years from the population-based Canadian Longitudinal Study on Aging (collected from September 2011 to May 2015) were used in this study.Primary outcomes and measuresA Frailty Index (FI) was constructed using self-reported chronic conditions, psychological function and cognitive status and physical functioning variables. Social stratifiers were chosen based on the Pan-Canadian Health Inequalities Reporting Initiative, reflecting key health inequalities in Canada. Unadjusted and adjusted FIs and domain-specific FIs (based on chronic conditions, physical function, psychological/cognitive deficits) were examined across population strata.ResultsThe overall mean FI was 0.13±0.08. It increased with age and was higher in women than men. Higher mean FIs were found among study participants with low income (0.20±0.10), who did not complete secondary education (0.17±0.09) or had low perceived social standing (0.18±0.10). Values did not differ by Canadian province of residence or urban/rural status. After simultaneously adjusting for population characteristics and other covariates, income explained the most heterogeneity in frailty, especially in younger age groups; similar patterns were found for men and women. The average frailty for people aged 45–54 in the lowest income group was greater than that for those aged 75–85 years. The heterogeneity in the FI among income groups was greatest for the psychological/cognitive domain.ConclusionsOur results suggest that especially in the younger age groups, psychological/cognitive deficits are most highly associated with both overall frailty levels and the gradient in frailty associated with income. If this is predictive of later increases in the other two domains (and overall frailty), it raises the question whether targeting mental health factors earlier in life might be an effective approach to mitigating frailty.

“No nation is supposed to be so advanced as the British nation, no race so progressive as the white”, declared Cotton's Weekly, the newspaper of the Social Democratic Party of Canada. “BUT HERE IN TORONTO NO CHINESE, NO HINDOOS, NO JAPS, NO INDIANS, NO BLACKS, NO FOREIGNERS NEED BE IMPORTED. WHITE GIRLS AND MEN OF BRITISH BIRTH BREAK THE STRIKES.” It was 1911. The newspaper was commenting on strike-breaking by “white” workers during a strike at a Toronto garment factory where male and female Jews had walked out. The newspaper compared this with cases out West: “In British Columbia when miners rise up in rebellion against the shameful conditions, Chinese are brought into the mines. In this and other western provinces, Japs, Hindoos, and Indians fill the places of the white toilers because they live on cheaper food and under such intolerable conditions no white people can stand it.”

Sleep disorders have been related to body weight, social conditions, and a number of comorbidities. These include high blood pressure and type 2 diabetes, both of which are prevalent in the First Nations communities. We explored relationships between obstructive sleep apnea (OSA) and risk factors including social, environmental, and individual circumstances. An interviewer-administered survey was conducted with adult participants in 2018–2019 in a First Nations community in Saskatchewan, Canada. The survey collected information on demographic variables, individual and contextual determinants of sleep health, and objective clinical measurements. The presence of OSA was defined as an apnea–hypopnea index (AHI) ≥5. Multiple ordinal logistic regression analysis was conducted to examine relationships between the severity of OSA and potential risk factors. In addition to the survey, 233 men and women participated in a Level 3 one-night home sleep test. Of those, 105 (45.1%) participants were reported to have obstructive sleep apnea (AHI ≥ 5). Mild and moderately severe OSA (AHI ≥ 5 to <30) was present in 39.9% and severe OSA (AHI ≥ 30) was identified in 5.2% of participants. Being male, being obese, and snoring loudly were significantly associated with severity of OSA. The severity of OSA in one First Nation appears relatively common and may be related to mainly individual factors such as loud snoring, obesity, and sex.

The study of migrants has generated interesting hypotheses on the etiology of different types of cancer. In particular, it has been suggested that both colon and breast cancer could be related to living conditions, including diet, in the country of immigration. Considerable internal migration occurred in Italy in the sixties. We studied a random sample of 1,400 subjects living in the city of Torino and the province of Varese. They were interviewed with a detailed questionnaire about their dietary habits, and the consumption of several nutrients was considered according to the area of birth and social class. The hypothesis we tested was whether, after controlling for social class, there were different dietary habits among the migrants and the native population, and whether such differences could help in the formulation of etiologic hypotheses on cancer. We found that the intake of saturated fatty acids and cholesterol was lower among the migrants from the south, whereas they consumed higher levels of vegetables than people born in the north. The different intake of saturated fatty acids and cholesterol seemed to be attributable mainly to the consumption of butter, for which the south/north ratio was as low as 0.47 in men and 0.56 in women. Important gradients by social class were also suggested for several nutrients.

Females are more likely than males to participate in evidence-based health promotion and disease prevention programs targeted for middle-aged and older adults. Despite the availability and benefits of Stanford’s Chronic Disease Self-Management Education (CDSME) programs, male participation remains low. This study identifies personal characteristics of males who attended CDSME program workshops and identifies factors associated with successful intervention completion. Data were analyzed from 45,375 male CDSME program participants nationwide. Logistic regression was performed to examine factors associated with workshop attendance. Males who were aged 65–79 (OR = 1.27, p < .001), Hispanic (OR = 1.22, p < .001), African American (OR = 1.13, p < .001), Asian/Pacific Islander (OR = 1.26, p < .001), Native Hawaiian (OR = 3.14, p < .001), and residing in nonmetro areas (OR = 1.26, p < .001) were more likely to complete the intervention. Participants with 3+ chronic conditions were less likely to complete the intervention (OR = 0.87, p < .001). Compared to health-care organization participants, participants who attended workshops at senior centers (OR = 1.38, p < .001), community/multipurpose facilities (OR = 1.21, p < .001), and faith-based organizations (OR = 1.37, p < .001) were more likely to complete the intervention. Men who participated in workshops with more men were more likely to complete the intervention (OR = 2.14, p < .001). Once enrolled, a large proportion of males obtained an adequate intervention dose. Findings highlight potential strategies to retain men in CDSME programs, which include diversifying workshop locations, incorporating Session Zero before CDSME workshops, and using alternative delivery modalities (e.g., online).

ABSTRACTOlder adults are the largest group of wheelchair users yet there are no peer-reviewed studies on the national profile of older wheelchair users in Canada. We investigated the characteristics of wheelchair users in a national sample of community-dwelling older adults from the Canadian Study of Health and Aging (CSHA-2). Questions on the use of assistive technology were asked of 5395 Canadians (over 64), and 4.6 per cent reported using a wheelchair. Logistic regression was used to model the factors associated with wheelchair use. Controlling for age, gender, and cognitive impairment, older adults who reported greater dependence in basic self-care and instrumental activities of daily living were more likely to use a wheelchair. However, the effects of self-care dependence on wheelchair use varied by gender, with men more likely than women to use wheelchairs with increasing self-care dependence. The number of chronic health conditions and being unmarried also increased the odds of wheelchair use. This paper quantifies the risk of wheelchair use according to critical factors that can be used to project use and plan for services.The data reported in this paper were collected as part of the Canadian Study of Health and Aging. The core study was funded by the Seniors' Independence Research Program, through the National Health Research and Development Program (NHRDP) of Health Canada (project no. 6606-3954-MC[S]). Additional funding was provided by Pfizer Canada Incorporated through the Medical Research Council/Pharmaceutical Manufacturers Association of Canada Health Activity Program, NHRDP (project no. 6603-1417–302[R]), Bayer Incorporated, and the British Columbia Health Research Foundation (projects no. 38[93-2] and no. 34[96-1]). The study was coordinated through the University of Ottawa and the Division of Aging and Seniors, Health Canada. Additional funds for the preparation of this manuscript were made available from the Opportunities Fund of the M-THAC Research Unit (from Medicare to Home and Community) at the University of Toronto, and from a post-doctoral fellowship awarded to the first author by the Social Sciences and Humanities Research Council of Canada.

OBJECTIVES: The aims of the present study were to estimate the prevalence of second-hand smoke exposure in Canada, to identify sociodemographic risk factors for second-hand smoke exposure, and to examine the relationship between second-hand smoke exposure and respiratory and cardiovascular diseases.METHODS: Data from the 2000/2001 Statistics Canada Canadian Community Health Survey (n=130,880, aged 12 years or older) were analyzed. Second-hand smoke exposure was based on self-report within the past month. The presence of chronic health conditions was also based on self-report. Because ex-smokers would be expected a priori to have poorer health than never-smokers, the analysis was stratified by previous smoking status.RESULTS: Approximately 25% of never-smokers and 30% of ex-smokers self-reported recent second-hand smoke exposure. The following factors were identified as risk factors for second-hand smoke exposure: men; residences in Quebec, Atlantic Canada and the Territories; younger ages; nonimmigrant status; low education and income levels; social assistance receipt; and households without children younger than 12 years of age. After controlling for potential confounders, both never- and ex-smokers exposed to second-hand smoke had significantly higher odds of self-reporting asthma (20% to 30%) and chronic bronchitis (50%) than those not exposed to secondhand smoke. Among ex-smokers, those exposed to second-hand smoke also had significantly higher odds of self-reporting hypertension (20%) than those not exposed to second-hand smoke. No associations were observed between second-hand smoke exposure and emphysema or heart disease.CONCLUSIONS: Self-reported recent second-hand smoke exposure in Canada in 2000/2001 was high, and was associated with asthma, chronic bronchitis and hypertension in never- and ex-smokers. Potential causal associations and public health implications warrant additional research.

The article highlights the trends of the present world, the informatization of society, the intensive development of innovative technologies entails a rethinking of values in art and language environment. Learning a language certainly includes considering a whole range of external circumstances in which it really develops and actively functions: the society that uses the language, its social structure, age difference between native speakers, social status, level of culture and education, place of residence, as well as differences in their speech behavior depending on the language situation. The relevance of the study is determined by the change in human consciousness during the postmodern cultural era, a feature of which is the rethinking of values, the definition of specific trends in the philosophical essence of the postmodern. The study presents the theoretical foundations of postmodern reflection in the social manifestation of speech. Postmodern forms a value attitude to progress as a single unchanging constant, formed throughout historical development. The article examines the conditions of equality of social factors between men and women who choose different strategies of speech behavior, manifested in the models of text construction, use of linguistic means, associations arising in both sexes as one of the aspects of postmodern semantic representation. In the course of the study the concept of "ethnicity" is defined, replacing the concept of "ethnos" and denoting the existence of separate ethnic groups. The study is based on the method of analysis and synthesis, the research, descriptive and scientific method was used to determine the postmodern aspect of the social factor of language variation. The results of the study are the basis for determining the social factor of speech in the context of postmodern society.

Existing research has established the detrimental effects of food insecurity on health. However, understanding of the social conditions that may moderate this relationship remains limited. To address this gap, the study investigates two questions: First, does marital status moderate the association between food insecurity and self-rated health? Second, if such moderation exists, does its impact vary based on gender? Data from the 2017-2018 Canadian Community Health Survey, a nationally representative survey conducted by Statistics Canada (n =101 647), were utilized for this investigation. The findings demonstrated that individuals living in food-insecure households reported poorer self-rated mental and general health. However, the negative impact of food insecurity on both health outcomes was less pronounced among married individuals than among their unmarried counterparts. Furthermore, the stress-buffering role of marriage was found to be more substantial among men than among women. In light of the significant stress-buffering role of marriage revealed in this study, it is crucial for policies to aim at providing comparable coping resources to unmarried individuals, particularly women.

The scope of social policy today is extensive. With the changing global scenario there is a rediscovery of “social” in it. Indubitably, there is a gender perspective on social policy globally. The world Economic Forum states that there are only six countries in the world (Belgium, Denmark, France, Latvia, Luxembourg and Sweden) where women have equal work rights to men. It is noted that the situation in different countries vary when it comes to the working benefits of different genders whether for native or expatriate workers in those places. Though there are rooms to enjoy attractive income and favorable working conditions such as job security, generous retirement plan, and other welfare benefits, there are still various factors that might lead to gender-based differences or gender discrimination in the unique labor market context of the GCC countries. The scenario is distinct in many Scandinavian nations like Sweden. Those countries are often considered as the role model for gender equal work allowances. When it comes to India there is still disparity and difference in many areas despite of the social security system the country offers in its policies. This paper aims at a descriptive and qualitative study on the causes, consequences and conclusion of the gender disparity in employee allowances of these nations. The study would imply simple random method of interrogations to examine gender differences empirically within the labor market of the mentioned nations. The economic benefits of a gender equal nation in the framing of social policy will be emphasized and focused.

Occupational therapy is a female-dominated profession with only 5.8% of all clinicians being men. Traditionally, occupational therapy education programmes have had limited success in recruiting men and those men who do become therapists tend to work in the profession for only short periods of time. The purpose of this study was to identify the factors that have an impact on male occupational therapists. Specifically, role strain due to community, colleagues and patients, three types of role stress (role ambiguity, role conflict and role overload) and the demographic characteristics of male occupational therapists in Canada were examined. Role strain is a subjective state of emotional arousal (such as increased level of awareness, general emotional arousal, distress, anxiety or frustration) in response to the external conditions of social stress. Community role strain was considered to arise from the negative attitudes of people outside the immediate work environment. Colleague role strain was considered to arise from the attitudes and behaviours of co-workers and others employed in the work environment. Patient role strain was considered to arise from the acts and attitudes of patients and their families. Role stress is a social structural condition in which role obligations are vague, irritating, difficult, conflicting or impossible to meet. Role ambiguity was defined as vagueness or a lack of clarity of role expectation. Role conflict was defined as role expectations that are incompatible. Role overload was defined as too much expected in the time available. A questionnaire was posted to all male therapists who were members of the Canadian Association of Occupational Therapists (n = 199). Eighty-three per cent of the sample responded. The survey instruments consisted of a demographic questionnaire, the Egeland and Brown Rating Scale, the Rizzo, House and Lirtzman Scale and the Beehr, Walsh and Taber Scale. As a group, male occupational therapists reported a moderate level of community role strain, colleague role strain and patient role strain. Similarly, male occupational therapists also reported a moderate degree of role conflict and role overload, but had a low level of role ambiguity.

During the season of sugarcane cutting, men and women seasonally migrate toward the sugar belt. Drought conditions in their native districts are always highlighted as the reasons for seasonal migration. However, existing literature on sugarcane cutters emphasizes that mostly poor, lower caste, landless, small landholders, and resourceless people migrate to the sugar belt. Even pregnant or lactating mothers are not an exception for seasonal migration and the work of sugarcane cutting. In Maharashtra, issues like poor work conditions, labor rights, financial exploitation, hysterectomy among women, citizenship status, education, and health of sugarcane cutters are already in the discussion forums. After migration, these workers live without housing, sanitation facilities, and drinking water. For women, there is no social, economic, labor, and personal security. Workers have to bathe, defecate openly, and drink untreated water. Specifically, women have special health needs, and there should not be a compromise while accessing essential health services. Considering the background information, this article considers questions like why women migrate in adversity and do women work for the Sugar Belt without facing any hardship? People at large relate the phenomenon of migration to human development or economic development. Similarly, it is possible to study internal migration or seasonal migration. Nevertheless, the analysis argues that seasonal migration of the poor, unskilled, illiterate, lower caste, landless, resourceless, and vulnerable cannot be connected to human development. Instead, we can relate it to survival at large. Significantly, the ignorance of the state towards these workers and their needs can be seen from the perspective of social exclusion.

Although automated vehicles (AVs) are rapidly being developed, the public sector continues to learn what this technology could mean for transportation policy. As reducing auto-based commute distances is one common planning objective, understanding the conditions under which individuals may adopt AVs to commute further is important. To that end, this study uses data from a 2016 survey of residents in Southern Ontario, Canada, to estimate the characteristics and motivations of individuals indicating the most interest in commuting further using AVs. Comparing findings with existing research on commute lengths and AV adoption, this study identifies how AV adoption may shape long-distance commuting, focusing on commuters who already drive to work. Results suggest significant potential for longer commutes and that longer AV-based commutes are expected to be taken by younger, higher educated, and tech-savvy individuals who already travel by car for regular daily trips, and by older individuals residing in urban neighborhoods. Findings on longer commutes, gender, and domestic responsibilities suggest that longer commutes could reinforce existing disparities in commuting distances between men and women but may be valuable to individuals with occasional chauffeuring responsibilities—suggesting potential for broader impacts in household social roles. Those expected benefits from AVs anticipated to motivate longer commutes include multitasking, safety improvements, better reliability, improved parking, and reduced traffic—suggesting that should AV technologies deliver in these realms, select commuters may derive significant utility. Paradoxically, several of the benefits expected to deliver the most consumer value may be undermined should additional AVs increase traffic significantly.

ABSTRACTThe population of people aged 50 and over represents a significant proportion of people living with HIV in Western nations. While the number of older people living with HIV is rapidly increasing in Canada, research originating in this country remains relatively scarce. This article therefore proposes to describe the impact of the intersection of HIV and ageing on the identities and lived experiences of people living with HIV of 50 and over (PLHIV50+), both on an individual and social level, in order to offer a picture of their lived experience. Using a phenomenological approach, nine semi-structured individual interviews with PLHIV50+ (men and women) were undertaken. Data analysis identified several central themes which constituted the essence of their experience of the intersection of HIV and ageing, such as the experience of premature ageing, the impact of HIV on intergenerational relationships, the shrinking of one's social network, rejection experienced by the older population, a difficult return to work and a deterioration in living conditions. The results of this research highlight the many challenges faced by PLHIV50+, on physical, relational, work and economic levels. Even though some of the problems faced by PLHIV50+ were related to the experience of corporal changes and a deterioration of health, our research was able to highlight the societal and structural factors underlying the stigma of HIV and ageing.

The modern legal status of a Russian woman and the establishment of conditions for achieving equality between men and women have been in the focus of the state and society. In this regard, the study and generalization of the historical experience of gender regulation in Soviet Russia (1917–1991), especially in the late 1920s – early 1930s, is of undoubted scientific and practical interest, by the end of which the authorities announced the solution to the “women’s question”. The issues of the legal status of the Russian women are reflected in works of native, as well as regional and foreign experts. Modern historiographical groundwork, new sources (starting from the normative and record-keeping documents to materials of periodicals and ego-documents), the use of the principle of historicism, systematic and anthropologic approaches, comparative-historical, comparative-legal and descriptive methods allow to reveal the legal status of women-highlanders of Dagestan. The study aims to demonstrate how in the conditions of the polyethnic region the Soviet legislation of the first decades of Soviet power, making adjustments to the rights and obligations of a highland woman who was under the great influence of Islam and the historically established traditions of Dagestan society, changed its position and provided new opportunities for implementation women’s aspirations in everyday, economic, professional, political and cultural life. The paper provides estimations on some “traditional” practices of women, who were discontented with policies carried out by the Soviet power and who organized public marches. As a result of the study, the authors come to the conclusion that the Soviet authorities viewed women as their ally in socialist transformations, and the legal and economic equality of men and women, recorded in Soviet laws, created conditions for the involvement of women in all spheres of life of the Dagestan society. At the same time, during the period under review, the predominance of the traditional form of the family continued to be ensured by the strictest social control.

S carlet fever is one of the most common nosological forms of group A streptococcal infection (SGA). In recent years, there has been an increase in the incidence of this infection in the countries of Europe and Asia, the USA and Canada. The analysis of professional publications of different countries of the world regarding the manifestations of the epidemic process of scarlet fever was carried out, as well as information on epidemiological studies conducted by the authors was provided. It has been established that children remain the leading risk group for scarlet fever, men are more often affected among adults, but the role of young women who care for children as a source of infection is increasing. The aerosol-aspiration mechanism of transmission of the causative agent of scarlet fever is realized by airborne and contact-household ways of its transmission. There is an intensification of the contact-household way of transmission of the pathogen. An atypical course of scarlet fever is observed with manifestations of co-infection, in particular, gastroenterocolitis, chicken pox and respiratory infections. A significant number of publications are devoted to the influence of environmental factors on the course of the epidemic process of scarlet fever. The authors note a direct correlation between the incidence of scarlet fever and atmospheric air pollutants, meteorological factors, as well as the influence of social and economic factors on the epidemic situation of this infection. Long-term use of antibiotics has contributed to the development of antibiotic resistance to the most common drugs, which prompts scientists to develop vaccines against iSGA. So, scarlet fever is characterized by widespread distribution, impression of mainly children, co-infection, atypical clinical course, especially in immunocompromised persons, and implementation of the contact-household way of transmission of the pathogen. The influence of social, natural and environmental factors on the course of the epidemic process of scarlet fever has been established, which is important to consider when conducting epidemiological surveillance of this infection. The introduction of vaccination against iSGA will contribute to the reduction of antibiotic resistance, which is currently a global problem for humanity. We consider it necessary to include scarlet fever and other iSGA in the list of infectious diseases subject to registration in Ukraine. Key words: scarlet fever, incidence, risk groups, ways of pathogen transmission, atypical course, co-infection, environmental factors, antibiotic resistance.

In the context of globalization and internationalization of culture, the problems of ethnic groups development and preservation of their identity and originality, especially their native language, are of particular relevance. Traditional forms of native language development, cognition and direct communication include reading, writing, oral counting, live communication at home and in social events, as well as collective forms of leisure. Both urban and rural residents began to turn to books and periodicals less often that naturally led to narrowing of the vocabulary, the general outlook of people, as well as to the decrease in their cultural level and loss of ethnic identity. As sociological studies show, there is decrease in interest in the book in general and in the library in particular. This tendency is clearly manifested in the attitude to the printed word in the Chuvash language. Rural libraries, being the leading institutions in the socio-cultural centre of rural settlement and promoting books and reading to the masses, are the fighters for the purity of their native language, for the preservation of age-old traditions and, in general, the ethnoculture of the people. The paper shows the forms of cultural and educational activities of rural libraries of Chuvashia at various stages of modern history. Special attention is paid to the development of the network and the deepening of the content of their educational and social mobilization work in direct connection with collective farm construction. The author notes with regret that due to the collapse of the USSR (1991), the destruction of collective farms, the growth of unemployment, the departure of able-bodied men to find work elsewhere, there was a sharp discrepancy in the income level of the majority of villagers. Market relations have led to the expansion of paid services, including education and culture. In such conditions, libraries with free access to their book collections have become the only centres of rural culture. Instead of the traditional “place of lending books”, they have turned into publicly accessible socio-cultural centres of the village, into keepers of the language and ethnoculture of the people. Computer technologies and Internet access attract readers to rural libraries, which have again proved to be in demand. The article is based on the analysis of published sources, Internet resources, current library archives, using the comparative historical method.

Chinese arrival in Java was encouraged with significant factors both internal and external. Chinese in Java eventually brought shifting in economical, social, and political aspect of Java under Dutch realm. In 19th century, Chinese in Java were differed into two clusters, known as peranakan and totok. These two terms possed different languange, culture, economical conditions. This study aimed to determine the role of Chinese merchants of Java during 19th century. The study engaged literature study which includes planning, selection, extraction, and excution. Literature review tries to review several books, scholarly articles, and other relevant sources which focused on particular area. Under Dutch realm, Chinese in Java portrayed many different roles, such as moneylenders, middlemen, kapitan, opium traders, and etec. Chinese were considered active in and around Java as the settled in Netherland Indies trade withi coastal shipping. Chinese possess priviledge spot under Dutch colonial policy, due to their advance skill in business and their independency of local rulers. In term of trade, the Chinese were ubiquitous and essential, since everyone commited trade in Java had to do business with Chinese. Java’s Chinese men and unknown number of peranakan and native Javanese women whom they married or related were almost all participated in the money economy.

At the turn of the 21st century, an occupational disease epidemic began to unfold in Sarnia, Ontario, home to the petrochemical complex known as Canada's 'Chemical Valley.' Given the long latency periods for these diseases, the hazardous exposures that produced them would have occurred over a period of decades during the latter 20th century. This suggests a paradox: what accounts for unionized Canadian men working for decades in conditions that posed such grave risks to their health? Or, put in terms of Ulrich Beck's compelling and influential model: given that Chemical Valley during the second half of the 20th century constituted a quintessential "risk society" of the modern West, where were the forces of "political reflexivity" – resistance leading to change – typically provoked by the excesses of such societies? In this article, I seek to resolve this paradox with a political ecology approach that focuses on workers' embodied experience in the micro-environment of their workplace and community, as well as on the material and social emplacement of petrochemical facilities in the region. The analysis reveals a 'perfect storm' of converging ecological, cultural, political, and economic conditions that allowed local corporations to achieve extraordinary power. Consequently, even as activism for occupational and environmental justice was effecting change in similar industrial centers throughout Ontario and the Great Lakes region, these changes failed to take hold in Chemical Valley. The article concludes by suggesting that those 20th century power dynamics have continued into the 21st century, where reflexivity delayed might well have atrophied into reflexivity denied.Keywords: embodiment, emplacement, risk society, petrochemical corporations, industrial workers, Canada, Great Lakes region

Blood transfusion service and its social component – donorship must be the priority areas of the state policy because the results of its work are of paramount importance. The main task of the blood transfusion service is supply of high quality components for blood transfusion therapy. Quality of blood components is compliance of properties and specifications of the blood component supplied to the recipient with the set standards. Strict order of conformance with the approved regulations and procedures is important at all technological states and is a cornerstone of blood transfusion service products quality. All actions, planned and implemented, starting with planning donorship and ending with the finished product manufacturing and storage conditions, are important for ensuring the quality as the final result. The purpose of the study was to determine the content of total, platelet and free serotonin in the plasma of primary and active blood donors for further use of the studied parameters to assess the quality of platelet concentrate. Materials and methods. 160 blood donors (118 men and 42 women) were examined, including 110 active donors (85 men and 25 women) who donated blood regularly at least 3 times a year and 50 primary reserve donors (32 men and 18 women), who donated blood for the first time. Primary reserve donors formed a control group. For the convenience of systematization and reproduction of scientific research results, objectification in comparing research data, all examined active donors, depending on the duration of donor experience and, accordingly, increasing the probability of occurrence of hidden platelet metabolism disorder, were divided into three subgroups: subgroup I – 51 donors (39 men and 12 women), whose donor experience lasted from 2 to 5 years; subgroup II – 31 donors (24 men and 7 women), duration of donor experience which ranged from 6 to 9 years; subgroup III – 28 donors (22 men and 6 women), whose donor experience lasted 10 years or more. The method of fractional determination of biological amines – serotonin – is presented in preliminarily dried biostrate specimens. The method described includes some extraction procedures with optimal controlled pH values necessary for isolating serotonin, producing fluorophors in accordance with orthophtaldialdehide and ninhydrin, the subsequent fluorimetric estimation of their levels being performed on the native fluorometer «БИАН». Results and discussion. It was found that active donors compared to control, have a level of free serotonin in peripheral blood platelets which was significantly higher. Biochemical shifts were revealed in the background of certain morphological changes of platelets. Possible pathophysiological mechanisms of the detected changes are discussed in the article. Conclusion. Active blood donation is accompanied by significant changes in the morphological parameters of platelets and the content of free serotonin in peripheral blood platelets. Further study of platelet hematopoiesis of active blood donors is required

Many risk factors can potentially influence sperm quality. Telomeres confer stability on the chromosome and their dysfunction has been implicated in conditions such as cancer, aging, and lifestyle. The impact of lifestyle on sperm cell telomeres is unclear. The objectives of this study were to evaluate the impact of lifestyle behaviors on telomere length in sperm and to follow the correlation with pregnancy outcomes in patients undergoing in vitro fertilization (IVF). In this prospective observational study, sperm was analyzed for telomere length (TL). Men were asked to report lifestyle behaviors including occupation (physical or sedentary), smoking duration and amount, physical activity, dietary habits, and where they keep their cellular phone (bag, pants, or shirt pocket). Correlations among semen analysis, TL, men’s habits, and embryo quality and pregnancy outcomes were evaluated. Among 34 patients recruited, 12 had longer TL and 13 shorter TL. Sperm motility was negatively correlated with TL (Pearson correlation = −.588, p = .002). Smoking adversely affected native sperm motility (53% motility in nonsmokers vs. 37% in smokers; p = .006). However, there was no significant impact on TL. The group with longer telomeres demonstrated significant association with healthy diet (10/12 vs. 6/13; p = .05) and a trend toward more sports activity, weekly (16/84 vs. 7/91; p = .04) compared with the shorter telomeres group. This study suggests that lifestyle, healthy diet, and sports activity are associated with long telomeres in sperm. Sperm quality is also influenced by patients’ habits. The study strongly recommends maintaining a healthy lifestyle to preserve general health and fertility.

An important role in the formation of modern Lithuanian society was played by pharmacists who at the beginning of the 20th century were one of the most numerous parts of Lithuanian intelligentsia. They chose a job in a pharmacy not as a mission of life but due to political, social, and economic reasons. The majority of pharmacists were children of peasants who had refused to obey their parents and study in the seminary of priests. Those people who had been ousted from gymnasiums because of an anticzarist activity or those who had not finished school due to the lack of money also became pharmacists. Young men who had chosen a way of self-support left to the biggest cities of Russia and started the practice of an apprentice in a pharmacy. Later, they took examinations to become an assistant of a pharmacist, and after two years of studies at university, they took examinations of a pharmacist at last. Having got a diploma, they usually did not return to their motherland because there was a large network of pharmacies; thus, business conditions were harder, of course. They established pharmacies in various provinces of Russia most often, and it is supposed that only 10% of Lithuanian pharmacists worked in their native country. Living and working in a Russian environment, however, they enshrined national patriotic ideas, were active participants in social activities, published a Lithuanian professional newspaper “Farmaceutų reikalai” (translation, “Matters of pharmacists“), and attempted to unite all Lithuanians living in czarist Russia to struggle against denationalization, to encourage people to return to their motherland, and to work for its good. This article deals with the path for a career of Lithuanian pharmacists in czarist Russia and their national patriotic activity.

Objective.Our aim was to assess prior use of core recommended non-surgical treatment among patients with knee osteoarthritis (OA) scheduled for total knee arthroplasty (TKA), and to assess potential patient-level correlates of underuse, if found.Methods.This was a cross-sectional study of patients undergoing TKA for primary knee OA at 2 provincial central intake hip and knee clinics in Alberta, Canada. Standardized questionnaires assessed sociodemographic characteristics, social support, coexisting medical conditions, OA symptoms and coping, and previous non-surgical management. Multivariable logistic regression was used to assess the patient-level variables independently associated with receipt of recommended non-surgical knee OA treatment, defined as prior use of pharmacotherapy for pain, rehabilitation strategies (exercise or physiotherapy), and weight loss if overweight or obese (body mass index ≥ 25 kg/m2).Results.There were 1273 patients included: mean age 66.9 years (SD 8.7), 39.9% male, and 44.1% had less than post-secondary education. Recommended non-surgical knee OA treatment had been used by 59.7% of patients. In multivariable modeling, the odds of having received recommended non-surgical knee OA treatment were significantly and independently lower among individuals who were older (OR 0.97, 95% CI 0.95–0.99), male (OR 0.33, 0.25–0.45), and who lacked post-secondary education (OR 0.70, 0.53–0.93).Conclusion.In a large cross-sectional analysis of knee OA patients scheduled for TKA, 40% of individuals reported having not received core recommended non-surgical treatments. Older individuals, men, and those with less education had lower odds of having used recommended non-surgical OA treatments.

Background: There is not a time in the history when epidemics did not loom large: infectious diseases have always had civilisation and evolution-altering consequences. Throughout history, there have been a number of pandemics: cholera, bubonic plague, influenza, smallpox are some of the most brutal killers in human history. Historical accounts of pandemics clearly demonstrate that war, unhygienic conditions, social and health inequality create conditions for the transmission of infectious diseases, and existing health disparities can contribute to unequal morbidity and mortality. The Renaissance was a period of European cultural, artistic, political and economic “rebirth” following the Middle Ages, but it was also the time when new infectious disease appeared, such as Syphilis. The epidemic spread of Syphilis began between the late 15th century and early 16th century due to the increased migration of peoples across Europe. The rapid spread of venereal syphilis throughout Europe suggests the introduction of a disease into a population that had not previously been exposed. Syphilis is a type of treponematosis, which includes syphilis, bejel, yaws, and pinta, but, while syphilis is venereal disease, the others are nonvenereal. Syphilis was, at the beginning, a disease of great severity due to its novelty, as the population had no time to gain any immunity against this venereal disease. Methods: The purpose of this study is to investigate the origin of syphilis and the evolution of the treatments from the empiric means to the discovery of penicillin, but also to understand how this venereal disease has largely influenced human lifestyle and evolution. Conclusions: The first of the three hypotheses about its origins is the Columbian hypothesis, which states that Columbus's crew acquired syphilis from Native Americans and carried it back to Europe in 1493 A. D. On the contrary, the second hypothesis (pre-Columbian) asserts that syphilis was present in Europe long before Columbus's voyage and was transferred to the New World by Columbus's men. The Unitarian theory argues that syphilis, bejel, yaws, and pinta are not separate diseases but they represent syndromes caused by slightly different strains of one organism. Nowadays, Syphilis’ origin is still uncertain and remains controversial. However, the large impact on the social behavior and international public health is an important reason to investigate about its origins and how to prevent the transmission.

ObjectiveTo explore experiences participating in a group-based physiotherapist (PT)-led exercise programme among people living with HIV and complex multimorbidity.DesignWe conducted a qualitative descriptive study using semistructured interviews.Recruitment and settingWe recruited community-dwelling adults living with HIV who engaged in a group-based PT-led exercise programme within an HIV-specialty hospital in Toronto, Canada. Interviews were conducted in-person or by telephone.ParticipantsEight men and two women with a median age of 58 years and median of six concurrent conditions in addition to HIV, who had attended ≥2 classes of the exercise programme.Data collectionInterviews explored (1) reasons for engaging in the programme, (2) experiences with exercise prior to and after joining the programme, (3) facilitators and barriers to engagement and (4) perceived impacts of participation on health and disability. We administered the HIV Disability Questionnaire and a demographic questionnaire.ResultsExperiences spanned perspectives prior to, during and after the PT-led exercise programme. Reasons for engaging in the programme included addressing health-related goals. Participants identified accessibility, the flexible schedule, interprofessional staff and the HIV-specific, group-based environment as facilitators to engagement. Participants reported high attendance rates, but identified episodic health challenges and overcrowded space as potential barriers to attending exercise classes. Perceived impacts on health and disability outcomes included improved physical, mental, social and cognitive health, and activities of daily living. Anticipated or actual experiences transitioning to independent exercise included facilitators (supportive programme leaders) and barriers (challenges motivatiing self to exercise alone).ConclusionsFeatures of the programme that facilitated engagement included the interprofessional, group-based environment that offered tailored exercise in an HIV-specific facility, whereby participants perceived benefits in domains of health and disability. However, challenges transitioning to independent exercise remain. Group-based PT-led exercise programmes may facilitate engagement in exercise among adults living with HIV and complex multimorbidity.

ImportanceThe impact of cumulative exposure to neighborhood factors on psychosis, depression, and anxiety symptom severity prior to specialized services for psychosis is unknown.ObjectiveTo identify latent neighborhood profiles based on unique combinations of social, economic, and environmental factors, and validate profiles by examining differences in symptom severity among individuals with first episode psychosis (FEP).Design, Setting, and ParticipantsThis cohort study used neighborhood demographic data and health outcome data for US individuals with FEP receiving services between January 2017 and August 2022. Eligible participants were between ages 14 and 40 years and enrolled in a state-level coordinated specialty care network. A 2-step approach was used to characterize neighborhood profiles using census-tract data and link profiles to mental health outcomes. Data were analyzed March 2023 through October 2023.ExposuresEconomic and social determinants of health; housing conditions; land use; urbanization; walkability; access to transportation, outdoor space, groceries, and health care; health outcomes; and environmental exposure.Main Outcomes and MeasuresOutcomes were Community Assessment of Psychic Experiences 15-item, Patient Health Questionnaire 9-item, and Generalized Anxiety Disorder 7-item scale.ResultsThe total sample included 225 individuals aged 14 to 36 years (mean [SD] age, 20.7 [4.0] years; 152 men [69.1%]; 9 American Indian or Alaska Native [4.2%], 13 Asian or Pacific Islander [6.0%], 19 Black [8.9%], 118 White [55.1%]; 55 Hispanic ethnicity [26.2%]). Of the 3 distinct profiles identified, nearly half of participants (112 residents [49.8%]) lived in urban high-risk neighborhoods, 56 (24.9%) in urban low-risk neighborhoods, and 57 (25.3%) in rural neighborhoods. After controlling for individual characteristics, compared with individuals residing in rural neighborhoods, individuals residing in urban high-risk (mean estimate [SE], 0.17 [0.07]; P = .01) and urban low-risk neighborhoods (mean estimate [SE], 0.25 [0.12]; P = .04) presented with more severe psychotic symptoms. Individuals in urban high-risk neighborhoods reported more severe depression (mean estimate [SE], 1.97 [0.79]; P = .01) and anxiety (mean estimate [SE], 1.12 [0.53]; P = .04) than those in rural neighborhoods.Conclusions and RelevanceThis study found that in a cohort of individuals with FEP, baseline psychosis, depression, and anxiety symptom severity differed by distinct multidimensional neighborhood profiles that were associated with where individuals reside. Exploring the cumulative effect of neighborhood factors improves our understanding of social, economic, and environmental impacts on symptoms and psychosis risk which could potentially impact treatment outcomes.

Background: The hospital-to-home transition for older adults with stroke is often fragmented, resulting in hospital readmissions and reduced quality of life, patient satisfaction and safety. There is limited evidence for strategies to improve transitions in care for older adults with stroke and multimorbidity. This study aimed to test, in real-world clinical practice, the effectiveness of the Transitional Care Stroke Intervention (TCSI) versus usual care on health outcomes, patient experience, and health and social service use costs in older adults (> 55 years) with stroke and multimorbidity (> 2 chronic conditions). Methods: This pragmatic randomized controlled trial was conducted among older adults with a stroke and multimorbidity discharged from the hospital to the community using outpatient stroke rehabilitation services in two communities in Ontario, Canada. Participants were randomized 1:1 to usual care (control group) or usual care plus the 6-month TCSI (intervention group). The TCSI was delivered virtually by an interprofessional team from hospital-based outpatient stroke rehabilitation clinics (Physiotherapist, Occupational Therapist, Speech Language Pathologist, Registered Nurse, and Social Worker). The TCSI is a complex, integrated intervention which includes care coordination/system navigation support, phone/video visits, monthly interprofessional case conferences, and an online resource to support system navigation. Data analysis was performed by intention to treat. The primary outcome was risk of hospital readmission (all-cause) after 6 months. Secondary outcomes were mental and physical functioning, depressive symptoms, stroke self-management, patient experience, number of hospital days and readmissions, number of ED visits, survival rates to first hospital and ED visit, risk of ED visits, and health and social service use costs. Older adults with stroke were engaged as co-investigators and informed the research design, implementation, and evaluation through participation in the Patient Partner Advisory and the TCSI Steering Committees. Results: Ninety participants were enrolled (44 intervention, 46 control); 11 (12%) participants were lost to follow-up, leaving 79 (39 intervention, 40 control). Most participants were men (60%), with an average of 7 comorbid conditions, and 78% had experienced their first-ever stroke. No significant group differences were seen for the baseline to six-month risk of hospital readmission (all-cause). However, stroke survivors in the intervention group reported higher levels of physical functioning (SF-12 Physical Component Summary Score mean difference: 5.10; 95% CI: 1.58-8.62, p=0.005), stroke self-management (Southampton Stroke Self-Management Questionnaire mean difference: 6.00; 95% CI: 0.51—11.50, p=0.03), and patient experience (Person-Centred Coordinated Care Experiences Questionnaire mean difference: 2.64, 95% CI: 0.81, 4.47, p=0.005) compared with the usual care group. No significant group differences were seen for the other secondary outcomes. Discussion: The TCSI improved physical functioning, stroke self-management and patient experience in older adults with stroke and multimorbidity without increasing total healthcare costs compared to usual care. Conclusion:The results provide evidence for the effectiveness of an integrated intervention to optimize transitional care outcomes for older adults with stroke and multimorbidity receiving outpatient stroke rehabilitation services. Suggestions for future research: Future research is needed to further evaluate this intervention in diverse settings and populations, with a larger sample size and a full economic evaluation.

Introduction. Despite recent achievements in medicine, many issues in the diagnosis and treatment of infective endocarditis (IE) remain outstanding. This is mainly due both to an increase in the incidence and changes in the clinical picture of this nosology. An important factor here is the continuing presence of existing principles governing the approach to the surgical treatment of infective endocarditis, including prosthetic endocarditis.Objective: to evaluate the effectiveness of an integrated approach to the treatment of infective endocarditis in patients with valvular heart disease on the basis of 37 years of experience.Materials and methods. An analysis of the surgical treatment of 1097 patients with infectious lesions of the valvular heart apparatus was carried out. The mean age of the sample was 35.1 ± 9.7 years (from 4 months to 68 years); 67.2 % were men, while women made up 32.8 %. Additionally, 122 patients had infectious lesions affecting 2 or more valves. In 109 cases, valvular prosthetic endocarditis was diagnosed; in 37 patients, IE was detected against the background of congenital heart defects. 99 patients had perianular abscesses. Of all surgical interventions carried out, 18 were repeated, including those with non-valvular congenital heart defects.Results and discussion. Overall hospital mortality was 4.3 % (47 patients). In patients with IE complicated by a congenital heart defect (CHD), mortality was 14.7 %; with endocarditis of mechanical heart valves — 13.2 %; in drug-dependent patients — 4.5 %; with infectious destruction of native heart valves — 2.8 %; in patients with a background of electrodeinduced endocarditis, no deaths during hospitalisation were observed.Conclusions. The effectiveness of surgical intervention of infective endocarditis can reach 85.4 %. When supplemented with pathogenetic and etiotropic therapy, surgical correction of affected heart structures contributes to the rapid and reliable sanitation of all infection foci, as well as to a reduction in multiple organ failure. Timely surgery significantly reduces the degree of heart failure and improves the NYHA functional class. In the long term, reconstructive interventions contribute to a better heart recovery than prosthetic operations. It should be noted that the proposed treatment approach for this group of patients creates conditions for adequate labour and social rehabilitation in a distant postoperative period.

В статье рассматриваются вопросы передачи родного языка следующим поколениям у населения Горно-Бадахшанской автономной области Таджикистана в ситуации активных языковых контактов: в местах фрагментированного распространения миноритарных памирских языков (ваханский, ишкашимский и др.), смешанных с зонами таджикского языка, где фрагментация населения усугубляется социокультурными практиками и брачными моделями; и при проживании в условиях внутренней и внешней миграции. В основу статьи положены материалы, собранные в ходе полевых исследований в Таджикистане и России методами наблюдения и интервью, в частности по методу фокус-групп, а также на основе анализа данных социальных сетей на памирских языках и публикаций по вопросам родного языка и лингвокультурной идентичности. Анализ языковых ситуаций проводится на основе типологической модели Эдвардса с выделением социолингвистических и демографических факторов, влияющих на жизнеспособность языковой группы. Мы рассматриваем формы передачи родного языка следующим поколениям у членов этих этнических групп в условиях двуязычия при традиционных моделях компактного проживания, а также в условиях многоязычия в ходе миграции. Установлено, каким образом стратегии жизнеобеспечения семьи, такие как тип расселения и брачные модели или выбор определенного типа миграции, оказывают влияние на стратегии и приемы передачи языковых навыков детям, а также на выбор и предпочтение языков родителями, а затем и самими детьми. Выявляются языковые предпочтения определенных групп на уровне семьи и этнической группы, их причины и приемы их поддержания. Кроме того, отмечен недавний поворот от нейтрально-позитивного отношения молодежи к родным (памирским) языкам к лингвистическому активизму и продвижению их в цифровом пространстве, а также созданию на них образовательных продуктов. The article is focused on the transmission of native languages to the next generation among the population of the Mountainous-Badakhshan Autonomous Region, Tajikistan. The article is based on data collected during field research in Tajikistan and Russia, using observational methods and interviews, in particular focus groups. It also draws on monitoring of social media in the Pamir languages and on publications addressing the mother tongues and linguacultural identity of the Pamir ethnic groups. Particular attention is given to the areas where language contacts are especially active. First, the steadily shrinking fragmented zones of distribution of various minority Pamir languages (Wakhan, Ishkashim) mixed with the Tajik language; here, fragmentation of the population in the contact zones is aggravated by socio-cultural practices and intensified by specific marriage patterns, whereby men marry women from neighbouring villages speaking languages other than their own. Another area where language contact and linguistic shift are most apparent concerns members of these ethnic groups who undertake internal or external migration. The analysis of linguistic situations is based on Edwards’ typological model employing a set of sociolinguistic and demographic factors which affect the viability of a language group. We examine the ways in which mother tongues are transmitted to the next generation among members of these ethnic groups in conditions of compact residence; we consider their specific bilingual model, when the native language turns to be a father’s language. We also trace multilingual models in the context of increasing translocal and transnational migration, with its variety of approaches. It has been established how family life support strategies, such as the type of settlement and marriage patterns or the choice of a certain type of migration, influence the transfer of language skills to children, as well as the choice and preference of languages by parents, and later by children themselves. Among our outcomes, we reveal the types of bilingualism of certain groups (passive/early bilingualism, multilingualism), the reasons for this bilingualism and the specific means of its maintenance (such as settlement and marriage patterns). We reveal a recent development whereby a neutral attitude towards native (Pamir) languages has given way, among the younger generation, to linguistic activism, the promotion of these languages in the digital space and the creation of educational products on them.

The occurrence of dental fluorosis is facilitated by a violation of enamel mineralization caused by fluorides, which enter the human body in excess during its development and formation and have a toxic effect on enamel blasts. However, the molecular mechanisms involved in the pathogenesis of fluorosis are not fully understood. Enamel formation is a complex process involving cell proliferation and differentiation through epithelial-mesenchymal sequential secretion of matrix proteins, tissue-specific transport of ions including calcium and fluoride, and precipitation and alignment of enamel crystals through interactions between organic and inorganic molecules. Understanding the morphological features of enamel changes during fluoride intoxication of the human body in the endemic region allows us to clearly understand the need for a comprehensive solution to this medical and social problem. The aim was to study the morphological features of enamel in fluorosis in residents of the endemic region of Ukraine, in particular the Poltava region. The work examines different groups of teeth (both intact and affected by fluorosis) removed for orthodontic or clinical indications in men and women aged 17 to 40 years. Morphological signs were studied first on native, and later on histochemically stained sections. It was established that the violation of the structure of the enamel layer of the teeth in mild and severe fluorosis is characterized by both partial and complete violation of the movement of the enamel prisms with signs of destruction. Fragmentation and homogeneity throughout the entire thickness were found in some areas of the enamel. When evaluating histochemically stained sections of teeth affected by fluorosis, it was established that dystrophic changes in the enamel structure and accumulation of acidic glycosaminoglycans in the lesions are more characteristic of mild and moderate forms. Under the conditions of a severe form of fluorosis, complete destruction of the prisms, fragmentation of the lamella, homogenization of areas on the entire enamel layer, which is due to the uneven distribution of acidic mucopolysaccharides, have been established. Morphologically and histochemically dystrophic changes in the areas of the affected enamel are confirmed by uneven distribution and accumulation of acidic glycosaminoglycans. An assessment of the effect of fluoride intoxication on the state of tooth enamel was carried out, which will allow to expand the possibilities of preventive measures for related specialists, as well as to create and develop additional treatment methods that will contribute to the improvement of physical and aesthetic indicators of teeth. dental health.

The article is an attempt to define a very special role of women in society, inherent in only Ukrainian historical realities. In particular, a somewhat non-trivial approach to the formation of a source base for the study allowed referring to works of fiction. Most attention is paid to the issue of women entering society medium in the times of the Cossacks. Among the conclusions – contrary to national, gender and social oppression for several centuries – Ukrainian women have maintained their commitment to universal human and Christian ideals and virtues. The role and place that women take in the social structure is an extremely significant criterion for assessing the level of civilizing development of one or other society. It was the words “Equal among equals” that one could quite accurately define the positions of Ukrainian women in the glorious and tragic times of the national history – during the emergence and heyday of the Cossacks. It was a time when Ukrainian women, not only a gentry, but also a simple Cossack women, invariably felt not imaginary but sincere self-respect both in the family and in the society. However, not only in Cossack times, but throughout the turbulent history of our country, Ukrainian women did not just “walk alongside of” their men, they often stepped forward, and their actions were decisive for the further course of events for many years to come. Unfortunately, there are reasons to consider the current (as of 2019) stage of research in the format of scientific inquiry, which directly relates to Ukrainian women in the historical and cultural context, only as an initial one. With this in mind, the aim of the proposed work is to begin filling in quite substantial gaps in the civilizing history of Ukraine. It was they, Ukrainian women – even from renowned Princess Olha – who became the worthy examples to follow for their compatriots. There are countless names of women, by whom Ukraine is proud of and who are respected all over the world – from the poetess Lesia Ukrainka, folk paintress Yekateryna Bilokour, opera vocalist Solomiia Krushelnytska up to bright personalities already from the contemporary generation of Ukrainian women. They did never and under no circumstances bow to a slavish worldview. In this regard the observation of a well-known European writer, made by him as far back as in the last century, is very accurate: “The Ukrainian woman is the Spanish woman of the East ... At every opportunity, her irrepressible Cossack nature flares up in her soul that does not know any repressor ...”. And further: “They are always ready to change ploughshares for spears, they live in small republican communities, as equals among equals ...”. We discover all this for ourselves in the “Female Images from Galicia” by Leopold von Sacher-Masoch. Paul of Aleppo, known also as Paul Zaim, an Arab traveller, who visited Ukraine twice in the middle of the XVII century, testified: “... Throughout the Cossack land we saw a strange thing – they all are, with few exceptions, literate; even most of their women and daughters can read and know the procedure of church service ... Ukrainian women are well dressed, busy with their own affairs, and no one casts sassy glances at them.” Numerous documents have survived, indicating that the wives of the Cossack Starshyna not only knew writing and reading well but were also able, when the need arose, to help their husbands in solving the most important political problems. The material, which is no less important in its cognitive weight from documentary evidence, also provides imaginative literature, where the realities of bygone times are reflected through the author’s creative imagination. These are the dramatic poem “Boyaryna” by Lesia Ukrainka, and “Hanna Montovt”, the story written by a famous Ukrainian historian and writer Orest Levytskyi, as well as “Aeneid”, a burlesque and tranny poem written by Ivan Kotliarevskyi; the latter literary work can be considered as a kind of encyclopaedia of Olde Ukrainian life. In “Boyarina”, the comparison of the “civil society” (using the modern definition) of the Ukrainian Cossack State with the conditions prevailing in neighbouring Muscovy is especially striking. A young girl of Ukrainian noble descent, who left her motherland for the sake to be with her beloved man, met in a foreign land very different ideas about human truths, class-specific and inherent female virtues, which are significantly different from those truly Christian and deeply democratic principles of life that she was used to since childhood in her native Ukraine. And, becoming a Boyarina, although she obeyed fate, however, she was no longer able to get used to her new life. The fate of poor Princess Hannа from the story by Orest Levytskyi was formed in a different manner. However, not at all because of the imperfection of the then social system, but solely because of her own frivolity and inability to execise her (tremendous) rights. But in “Aeneid” by Ivan Kotliarevskyi, where antique plots were whimsically intertwined with the signs of Cossack life, the remark: “Like a lady of certain sotnyk ...” became virtually the highest mark for one of the goddesses. As the expression goes, it speaks for itself, and the irony about the mention of the sotnyk will be completely inappropriate, given the trace that Bohdan Khmelnytskyi, the former Chygyryn sotnyk and subsequently a Hetman of Ukraine, left in the history of Ukrainian nationality! In the times of Cossacks, men have the opportunity to spend more or less long time with their families too rarely. But they went to a military campaign with peace of mind because from this moment their faithful wives took active roles in all matters – and not only household, but the domesticities too. And, say, not the eldest of their sons, but she herself took part, when necessary, in resolving property or other disputes, defended the interests of their families before the society, and even in court. Moreover, their wives could often ride horses with arms in hands to defend their native homes. Unfortunately, then-Muscovy have introduced serfdom in its most despotic form on intaken Ukrainian lands, combined with her absolutist system of government and public relations which immediately changed the state of Ukrainian women for the worst. And this applied not only to the impoverished and enslaved people, but also to the wealthy and influential sections of the then population. And subsequently Taras Shevchenko became the most sincere voice of a deeply tragic female fate ... Conclusions. Even when then Ukrainians were slowly forgetting about the previous rights and privileges of their women, undeniable documentary and literary evidence remained the mention of them, which in one way or another were connected with the times of Cossacks. So, Ukrainian women of those, already far from us times was not only faithful wives, caring mothers and teachers for their children, real Bereginias of the families, but also a self-sufficient persons, conscious in their place in the society.

OBJECTIVES/SPECIFIC AIMS: Stigma has been recognized as a major impediment to accessing mental health care among Vietnamese and Asian Americans (Leong and Lau, 2001; Sadavoy et al., 2004; Wynaden et al., 2005; Fong and Tsuang, 2007). The underutilization of mental health care, and disparities in both access and outcomes have been attributed to a large extent to stigma and cultural characteristics of this population (Wynaden et al., 2005; Jang et al., 2009; Leung et al., 2010; Spencer et al., 2010; Jimenez et al., 2013; Augsberger et al., 2015). People with neurotic or behavioral disorders may be considered “bad” as many Vietnamese people believe it is a consequence of one’s improper behavior in a previous life, for which the person is now being punished (Nguyen, 2003). Mental disorders can also been seen as a sign of weakness, which contributes to ambivalence and avoidance of help-seeking (Fong and Tsuang, 2007). Equally important is the need to protect family reputation; having emotional problems often implies that the person has “bad blood” or is being punished for the sins of his/her ancestors (Herrick and Brown, 1998; Leong and Lau, 2001), which disgraces the entire family (Wynaden et al., 2005). In these cases, public stigma (as opposed to internal stigma) is the primary reason for delays in seeking help (Leong and Lau, 2001). Other research has also highlighted the influences of culture on how a disorder may be labeled in different settings, although the presentation of symptoms might be identical (see Angel and Thoits, 1987). In Vietnamese culture, mental disorders are often labeled điên (literally translated as “madness”). A điên person and his or her family are often severely disgraced; consequently the individuals and their family become reluctant to disclose and seek help for mental health problems for fear of rejection (Sadavoy et al., 2004). Despite the critical role of stigma in accessing mental health care, there has been little work in trying to understand how stigmatizing attitudes towards mental illness among Vietnamese Americans manifest themselves and the influences of acculturation on these attitudes. Some previous work indicated a significant level of mental illness stigma among Vietnamese Americans, and experiences of living in the United States might interact with the way stigma manifests among this population (Do et al., 2014). Stigma is a complex construct that warrants a deeper and more nuanced understanding (Castro et al., 2005). Much of the development of stigma-related concepts was based on the classic work by Goffman (1963); he defined stigma as a process by which an individual internalizes stigmatizing characteristics and develops fears and anxiety about being treated differently from others. Public stigma (defined by Corrigan, 2004) includes the general public’s negative beliefs about specific groups, in this case individuals and families with mental illness concerns, that contribute to discrimination. Public stigma toward mental illness acts not only as a major barrier to care, but can also exacerbate anxiety, depression, and adherence to treatment (Link et al., 1999; Sirey et al., 2001; Britt et al., 2008; Keyes et al., 2010). Link and Phelan (2001) conceptualized public stigma through four major components. The first component, labeling, occurs when people distinguish and label human differences that are socially relevant, for example, skin color. In the second component, stereotyping, cultural beliefs link the labeled persons to undesirable characteristics either in the mind or the body of such persons, for example people who are mentally ill are violent. The third component is separating “us” (the normal people) from “them” (the mentally ill) by the public. Finally, labeled persons experience status loss and discrimination, where they are devalued, rejected and excluded. Link and Phelan (2001) emphasized that stigmatization also depends on access to social, economic, and political power that allows these components to unfold. This study aims to answer the following research questions: (1) how does public stigma related to mental illness manifest among Vietnamese Americans? and (2) in what ways does acculturation influence stigma among this population? We investigate how the 4 components of stigma according to Link and Phelan (2001) operationalized and how they depend on the level of acculturation to the host society. Vietnamese Americans is the key ethnic minority group for this study for several reasons. Vietnamese immigration, which did not start in large numbers until the 1970s, has features that allow for a natural laboratory for comparisons of degree of acculturation. Previous research has shown significant intergenerational differences in the level of acculturation and mental health outcomes (e.g., Shapiro et al., 1999; Chung et al., 2000; Ying and Han, 2007). In this study, we used age group as a proxy indicator of acculturation, assuming that those who were born and raised in the United States (the 18–35 year olds) would be more Americanized than those who were born in Vietnam but spent a significant part of their younger years in the United States (the 36–55 year olds), and those who were born and grew up in Vietnam (the 56–75 year olds) would be most traditional Vietnamese. The language used in focus group discussions (FGDs) reflected some of the acculturation, where all FGDs with the youngest groups were done in English, and all FGDs with the oldest groups were done in Vietnamese. METHODS/STUDY POPULATION: Data were collected through a set of FGDs and key informant interviews (KIIs) with experts to explore the conceptualization and manifestation of mental illness public stigma among Vietnamese Americans in New Orleans. Six FGDs with a total of 51 participants were conducted. Participants were Vietnamese American men and women ages 18–75. Stratification was used to ensure representation in the following age/immigration pattern categories: (1) individuals age 56–75 who were born and grew up in Vietnam and immigrated to the United States after age 35; (2) individuals age 36–55 who were born in Vietnam but spent a significant part of their youth in the United States; and (3) individuals age 18–35 who were born and grew up in the United States. These groups likely represent different levels of acculturation, assuming that people who migrate at a younger age are more likely to assimilate to the host society than those who do at a later age. Separate FGDs were conducted with men and women. Eleven KIIS were conducted with 6 service providers and 5 community and religious leaders. In this analysis, we focused on mental illness public stigma from the FGD participants’ perspectives. FGDs were conducted in either English or Vietnamese, whichever participants felt more comfortable with, using semistructured interview guides. All interviews were audio recorded, transcribed and translated into English if conducted in Vietnamese. Data coding and analysis was done using NVivo version 11 (QSR International, 2015). The analysis process utilized a Consensual Qualitative Research (CQR) approach, a validated and well-established approach to collecting and analyzing qualitative data. CQR involves gathering textual data through semistructured interviews or focus groups, utilizing a data analysis process that fosters multiple perspectives, a consensus process to arrive at judgments about the meaning of data, an auditor to check the work of the research team, and the development of domains, core-ideas, and cross-analysis (Hill et al., 2005). The study was reviewed and approved by Tulane University’s Internal Review Board. RESULTS/ANTICIPATED RESULTS: Components of public stigma related to mental illness. The 4 components of public stigma manifest to different extents within the Vietnamese Americans in New Orleans. Labeling was among the strongest stigma components, while the evidence of the other components was mixed. Across groups of participants, Vietnamese Americans agreed that it was a common belief that people with mental disorders were “crazy,” “acting crazy,” or “madness.” “Not normal,” “sad,” and “depressed” were among other words used to describe the mentally ill. However, there were clear differences between younger and older Vietnamese on how they viewed these conditions. The youngest groups of participants tended to recognize the “craziness” and “madness” as a health condition that one would need to seek help for, whereas the oldest groups often stated that these conditions were short term and likely caused by family or economic problems, such as a divorce, or a bankruptcy. The middle-aged groups were somewhere in between. The evidence supporting the second component, stereotyping, was not strong among Vietnamese Americans. Most FGD participants agreed that although those with mental disorders may act differently, they were not distinguishable. In a few extreme cases, mentally ill individuals were described as petty thefts or being violent towards their family members. Similarly to the lack of strong evidence of stereotyping, there was also no evidence of the public separating the mentally ill (“them”) from “us”. It was nearly uniformly reported that they felt sympathetic to those with mental disorders and their family, and that they all recognized that they needed help, although the type of help was perceived differently across groups. The older participants often saw that emotional and financial support was needed to help individuals and families to pass through a temporary phase, whereas younger participants often reported that professional help was necessary. The last component, status loss and discrimination, had mixed evidence. While nearly no participants reported any explicit discriminatory behaviors observed and practiced towards individuals with mental disorders and their families, words like “discrimination” and “stigma” were used in all FGDs to describe direct social consequences of having a mental disorder. Social exclusion was common. Our older participants said: “They see less of you, when they see a flaw in you they don’t talk to you or care about you. That’s one thing the Vietnamese people are bad at, spreading false rumors and discrimination” (Older women FGD). One’s loss of status seemed certain if their or their loved one’s mental health status was disclosed. Shame, embarrassment, and being “frowned upon” were direct consequences of one’s mental health status disclosure and subsequently gossiped about. Anyone with mental disorders was certain to experience this, and virtually everyone in the community would reportedly do this to such a family. “You get frowned upon. In the Vietnamese culture, that’s [a family identified as one with mental health problems] the big no-no right there. When everybody frowns upon your family and your family name, that’s when it becomes a problem” (Young men FGD). This is tied directly to what our participants described as Vietnamese culture, where pride and family reputation were such a high priority that those with mental disorders needed to go to a great extent to protect—“We all know what saving face means” as reported by our young participants. Even among young participants, despite their awareness of mental illness and the need for professional help, the desire to avoid embarrassment and save face was so strong that one would think twice about seeking help. “No, you just don’t want to get embarrassed. I don’t want to go to the damn doctor and be like ‘Oh yeah, my brother got an issue. You can help him?’ Why would I do that? That’s embarrassing to myself…” (Young men FGD). Our middle-aged participants also reported: “If I go to that clinic [mental health or counseling clinic], I am hoping and praying that I won’t bump into somebody that I know from the community” (Middle-aged women FGD). Vietnamese people were also described as being very competitive among themselves, which led to the fact that if a family was known for having any problem, gossips would start and spread quickly wherever they go, and pretty soon, the family would be looked down by the entire community. “I think for Vietnamese people, they don’t help those that are in need. They know of your situation and laugh about it, see less of you, and distant themselves from you” (Older women FGD). Culture and mental illness stigma, much of the described stigma and discrimination expressed, and consequently the reluctance to seek help, was attributed to the lack of awareness of mental health and of mental health disorders. Many study participants across groups also emphasized a belief that Vietnamese Americans were often known for their perseverance and resilience, overcoming wars and natural disasters on their own. Mental disorders were reportedly seen as conditions that individuals and families needed to overcome on their own, rather than asking for help from outsiders. This aspect of Vietnamese culture is intertwined with the need to protect one’s family’s reputation, being passed on from one generation to the next, reinforcing the beliefs that help for mental disorders should come from within oneself and one’s family only. Consequently persons with mental health problems would be “Keeping it to themselves. Holding it in and believing in the power of their friends” (Middle-aged FGD) instead of seeking help. Another dimension of culture that was apparent from FGDs (as well as KIIs) was the mistrust in Western medicine. Not understanding how counseling or medicines work made one worry about approaching service providers or staying in treatment. The habit of Vietnamese people to only go see a doctor if they are sick with physical symptoms was also a hindrance to acknowledging mental illness and seeking care for it. Challenges, including the lack of vocabulary to express mental illness and symptoms, in the Vietnamese language, exaggerated the problem, even among those who had some understanding of mental disorders. It was said in the young men FGD that: “when you classify depression as an illness, no one wants to be sick,… if you call it an illness, no one wants to have that sort of illness, and it’s not an illness that you can physically see…” (Young men FGD). Another young man summarized so well the influence of culture on mental illness stigma: “Us Southeast Asian, like, from my parents specifically has Vietnam War refugees. I think the reason why they don’t talk about it is because it’s a barrier that they have to overcome themselves, right? As refugees, as people who have been through the war… [omitted]They don’t want to believe that they need help, and so the trauma that they carry when they give birth to us is carried on us as well. But due to the language barrier and also the, like, they say with the whole health care, in Vietnam I know that they don’t really believe in Western and Eurocentric medicine. So, from their understanding of how, like from their experience with colonization or French people, and how medicine works, they don’t believe in it” (Young men FGD). One characteristic of the Vietnamese culture that was also often mentioned by our FGD participants (as well as KIIs) was the lack of sharing and openness between generations, even within a family. Grandparents, parents, and children do not usually share and discuss each other’s problems. Parents and grandparents do not talk about problems because they need to appear strong and good in front of their children; children do not talk about problems because they are supposed to do well in all aspects, particularly in school. The competitiveness of Vietnamese and high expectations of younger generations again come into play here and create a vicious cycle. Young people are expected to do well in school, which put pressure on them and may result in mental health problems, yet, they cannot talk about it with their parents because they are not supposed to feel bad about school, and sharing is not encouraged. The Asian model minority myth and the expectations of parents that their children would do well in school and become doctors and lawyers were cited by many as a cause of mental health problems among young people. “Our parents are refugees, they had nothing and our parents want us to achieve this American Dream…. [omitted] It set expectations and images for us…. It was expected for all the Asians to be in the top 10, and for, like a little quick minute I thought I wasn’t going to make it, I was crying” (Yong men FGD). As a result, the mental health problems get worse. “If you’re feeling bad about something, you don’t feel like you can talk about it with anyone else, especially your family, because it is not something that is encouraged to be talked about anyway, so if you are feeling poorly and you don’t feel like you could talk to anybody, I think that just perpetuates the bad feelings” (Middle-aged women FGD). Acculturation and mental illness stigma Acculturation, the degree of assimilation to the host society, has changed some of the understanding of mental illness and stigmatizing attitudes. Differences across generations expressed in different FGDs indicated differences in perceptions towards mental illness that could be attributed to acculturation. For example, the young generation understood that mental illness was a health problem that was prevalent but less recognized in the Vietnamese community, whereas a prominent theme among the older participants was that mental illness was a temporary condition due to psychological stress, that it was a condition that only Caucasians had. Some of the components of public stigma related to mental illness seemed to vary between generations, for example the youngest participants were less likely to put a label on a person with mental health problems, or to stereotype them, compared to the oldest and middle-aged participants. This was attributed to their education, exposure to the media and information, and to them “being more Americanized.” However, there was no evidence that acculturation played an important role in changing the other components of public stigma, including stereotyping, separating, and status loss and discrimination. For example, the need to protect the family reputation was so important that our young participants shared: “If you damage their image, they will disown you before you damage that image” (Young men FGD). Young people, more likely to recognize mental health problems, were also more likely to share within the family and to seek help, but no more likely than their older counterparts to share outside of the family—“maybe you would go to counseling or go to therapy, but you wouldn’t tell people you’re doing that” (Young women FGD). The youngest participants in our study were facing a dilemma, in which they recognized mental health problems and the need for care, yet were still reluctant to seek care or talk about it publicly because of fears of damaging the family reputation and not living up to the parents’ expectations. Many young participants reported that it actually made it very difficult for them to navigate mental health issues between the 2 cultures, despite the awareness of the resources available. “I think it actually makes it harder. Only because you know to your parents and the culture, and your own people, it’s taboo, and it’s something that you don’t talk about. Just knowing that you have the resources to go seek it… You want advice from your family also, but you can’t connect the appointment to your family because you’re afraid to express that to your parents, you know? So I think that plays a big part, and knowing that you are up and coming, but you don’t want to do something to disappoint your family because they are so traditional” (Young men FGD). Some participants felt more comfortable talking about mental health problems, like depression, if it was their friend who experienced it and confided in them, but they would not necessarily felt open if it was their problem. Subtle cultural differences like this are likely overlooked by Western service providers. One older participant summarized it well “They [the young generation] are more Americanized. They are more open to other things [but] I think that mental health is still a barrier.” DISCUSSION/SIGNIFICANCE OF IMPACT: This study investigated how different components of public stigma related to mental illness manifest among Vietnamese Americans, a major ethnic group in the United States, and how acculturation may influence such stigma. The findings highlighted important components of public stigma, including labeling and status loss, but did not provide strong evidence of the other components within our study population. Strong cultural beliefs underlined the understanding of mental health and mental illness in general, and how people viewed people with mental illness. Several findings have been highlighted in previous studies with Asian immigrants elsewhere; for example, a study from the perspectives of health care providers in Canada found that the unfamiliarity with Western biomedicine and spiritual beliefs and practices of immigrant women interacted with social stigma in preventing immigrants from accessing care (O’Mahony and Donnelly, 2007). Fancher et al. (2010) reported similar findings regarding stigma, traditional beliefs about medicine, and culture among Vietnamese Americans. Acculturation played a role in changing stigmatizing attitudes as evidenced in intergenerational differences. However, being more Americanized did not equate to being more open, having less stigmatizing attitudes, or being more willing to seek care for mental health issues. Consistent with previous studies (Pedersen and Paves, 2014), we still found some level of stigma among young people aged 18–35, although some components were lessened with an increased level of acculturation. There was also a conflict among the younger generation, in which the need for mental health care was recognized but accessing care was no easier for them than for their parent and grandparent generations. The study’s findings are useful to adapt existing instruments to measure stigma to this population. The findings also have important program implications. One, they can be directly translated into basic supports for local primary and behavioral health care providers. Two, they can also be used to guide and inform the development and evaluation of an intervention and an additional study to validate the findings in other immigrant ethnic groups in the United States. Finally, based on results of the study, we can develop a conceptual framework that describes pathways through which social, cultural, and ecological factors can influence stigma and the ways in which stigma acts as a barrier to accessing mental health care among Vietnamese Americans. The guiding framework then can be validated and applied in future programs aimed to improve mental health care utilization among ethnic minorities.

Purpose The spread of the Internet has transformed the dating landscape. Given the increasing popularity of online dating and rising immigration to Canada, this study takes an intersectional lens to examine nativity and gender differentials in heterosexual online dating. Design/methodology/approach In 2018, a random-digit-dial telephone survey was conducted in Canada. Logistic regression models were used to analyze original data from this survey (N = 1,373). Findings Results show that immigrants are more likely than native-born people to have used online dating in Canada, possibly because international relocation makes it more difficult for immigrants to meet romantic partners in other ways. In online-to-offline transitions, both native-born and immigrant online daters follow gendered scripts where men ask women out for a first date. Finally, immigrant men, who likely have disadvantaged positions in offline dating markets, also experience the least success in finding a long-term partner online. Originality/value Extending search theory of relationship formation to online dating, this study advances the understanding of change and continuity in gendered rituals and mate-selection processes in the digital and globalization era. Integrating search theory and intersectionality theory, this study highlights the efficiency of using the Internet to search for romantic partners and the socially constructed hierarchy of desirability as interrelated mechanisms that produce divergent online dating outcomes across social groups. Internet dating, instead of acting as an agent of social change, may reproduce normative dating practices and existing hierarchies of desirability.

Framed by Bourdieu’s work, this article focuses on the intersections between language learning experiences, capital, and identities of Syrian refugees now living in Regina, Saskatchewan. In this qualitative study, data were collected during a series of focus groups with Syrian women and men. Based on the study findings, we contend that the participants’ multiple identities as hard-working, employed, independent, Muslim mothers or fathers, and wives or husbands developed in Syria were gradually eroded or altered by the realities they experienced in Canada, yet they had a strong desire to re-establish their identity constructions from back home in the new context. We assert that the loss of their linguistic capital from back home limited their employment prospects, impacted their abilities to form social relationships with native English speakers, and led to a shift in traditional gender roles. It is imperative to adapt language training programs in order to support refugees in re-establishing themselves in their professional fields and daily living activities.

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or “non-ideal” contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18–30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men’s alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla’s non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: careful connections, watering it down, and blurred lines. In careful connections young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in watering it down young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized blurred lines through a continuum of consent and of “meeting (masculine) expectations” when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.