Barriers to Disclosure of Intimate Partner Violence Among Undocumented Spanish-Speaking Immigrants in the United States.

Undocumented monolingual Spanish-speaking immigrants are one of the most vulnerable and marginalized groups to experience intimate partner violence (IPV) in the United States. This paper explores the barriers that prevent IPV disclosure in healthcare settings. Qualitative interviews (n = 14) were conducted with previously undocumented Spanish-speaking legal clients of a community domestic violence agency. The major barriers expressed by the interviewees regarding IPV screening and disclosure include limited opportunities for IPV screening, misinformation about legal rights from abusers, fear of deportation and separation from children, and lack of knowledge about resources.

COVID-19 and Intimate Partner Violence: A Call to Action.

The COVID-19 pandemic has escalated the risks and dangers for victims of Intimate Partner Violence (IPV). This article aims to describe the current state of IPV in Rhode Island as well as best practices for IPV screening and intervention using telehealth. We highlight the particular plight of undocumented immigrant victims of IPV and how healthcare providers can be responsive to their unique vulnerabilities and needs.

Addressing Global Human Rights Violations in Rhode Island: The Brown Human Rights Asylum Clinic.

The Brown Human Rights Asylum Clinic (BHRAC) is a medical student-led organization affiliated with Physicians for Human Rights that collaborates with medical and mental health clinicians, lawyers, and community organizations to provide pro bono medical affidavits to undocumented individuals seeking legal status in the United States. Affidavits can document and corroborate the physical and psychological evidence of trauma alleged by asylum seekers, leading to better legal outcomes. This article describes our innovative program, partnerships, and workflow, as well as demographics and statistics from our past seven years of operation. Since its founding in 2013, BHRAC has conducted 55 medical evaluations, the majority involving Spanish-speaking female-identifying individuals from Guatemala, El Salvador, and the Dominican Republic. Thirteen individuals have been granted legal status, one individual was denied status, and the rest of the cases are pending. BHRAC has experienced a marked increase in affidavit requests. This paper serves as a call to action for medical professionals to become involved in this work.

Pyk2 and Megakaryocytes Regulate Osteoblast Differentiation and Migration Via Distinct and Overlapping Mechanisms.

Osteoblast differentiation and migration are necessary for bone formation during bone remodeling. Mice lacking the proline-rich tyrosine kinase Pyk2 (Pyk2-KO) have increased bone mass, in part due to increased osteoblast proliferation. Megakaryocytes (MKs), the platelet-producing cells, also promote osteoblast proliferation in vitro and bone-formation in vivo via a pathway that involves Pyk2. In the current study, we examined the mechanism of action of Pyk2, and the role of MKs, on osteoblast differentiation and migration. We found that Pyk2-KO osteoblasts express elevated alkaline phosphatase (ALP), type I collagen and osteocalcin mRNA levels as well as increased ALP activity, and mineralization, confirming that Pyk2 negatively regulates osteoblast function. Since Pyk2 Y402 phosphorylation is important for its catalytic activity and for its protein-scaffolding functions, we expressed the phosphorylation-mutant (Pyk2(Y402F) ) and kinase-mutant (Pyk2(K457A) ) in Pyk2-KO osteoblasts. Both Pyk2(Y402F) and Pyk2(K457A) reduced ALP activity, whereas only kinase-inactive Pyk2(K457A) inhibited Pyk2-KO osteoblast migration. Consistent with a role for Pyk2 on ALP activity, co-culture of MKs with osteoblasts led to a decrease in the level of phosphorylated Pyk2 (pY402) as well as a decrease in ALP activity. Although, Pyk2-KO osteoblasts exhibited increased migration compared to wild-type osteoblasts, Pyk2 expression was not required necessary for the ability of MKs to stimulate osteoblast migration. Together, these data suggest that osteoblast differentiation and migration are inversely regulated by MKs via distinct Pyk2-dependent and independent signaling pathways. Novel drugs that distinguish between the kinase-dependent or protein-scaffolding functions of Pyk2 may provide therapeutic specificity for the control of bone-related diseases.

Adaptation of the Psychological-Behavioral Acculturation Scale to a Community of Urban-based Mexican Americans in the United States.

OBJECTIVE: To report the psychometric properties of the Psychological-Behavioral Acculturation Scale (P-BAS), a tool gauging behavioral and psychological acculturation after adapting it through formative research to people of Mexican origin in the United States. METHODS: We analyzed data from adapted P-BAS questionnaires in the TalaSurvey study, using standard methods to establish internal consistencies (Cronbach's alpha), construct validity, and ascertain if the value orientation profile differed by ethnic group. RESULTS: In 2012-13, 505 respondents (mean age 45.2 ± 14.1, 56% female) participated: 250 European Americans (EA) and 255 people of Mexican origin (MA). CONCLUSIONS: Although internal consistencies of 15 value orientation measures were occasionally low, overall results were encouraging. A weighted combination of value orientation scores strongly discriminated between EA and MA. Additionally, the pattern of relationships among MAs identified between acculturation scores and the validity contrasts supported the construct validity of the proposed dual framework. The trend was particularly evident for most behavioral variables.

Qualitative description of dental hygiene practices within oral health and dental care perspectives of Mexican-American adults and teenagers.

OBJECTIVES: The objectives of this study were to identify dental hygiene themes voiced by adults and teenagers of Mexican origin [or Mexican Americans (MAs)] and place these themes within the larger landscape of oral health and dental care perceptions. METHODS: Interviews with urban-based MAs were analyzed to identify barriers, beliefs, and behaviors influencing engagement in dental hygiene practices. RESULTS: Adult (n = 16, ages 33-52) and teenage (n = 17, ages 14-19) MAs reported themes pertaining to structural factors (financial and economic-related barriers, the dual challenges of reduced access to care vis-à-vis successfully navigating the dental care system, and the effects of reduced social support derived from migration) and to individual factors (different agendas between MAs and health systems for dental care utilization and indications for oral self-care, including limited dental hygiene instruction from professionals and larger impacts from school-based and mass media). Also, prior experiences with dental hygiene, prevention, and associated themes were characterized by a range of attitudes from fatalistic to highly determined agency. Good family upbringing was instrumental for appropriate dental hygiene, anteceding good oral health; and outlining a loose structure of factors affecting oral health such as diet, having "weak" teeth, or personal habits. CONCLUSIONS: Themes from adults and teenagers in the Midwest United States were generally similar to other groups of MA parents and younger children. Dental hygiene was not salient relative to other oral health and dental care matters. Several opportunities for improvement of knowledge and enhancing motivation for dental hygiene practices were identified, both within and outside professional resources.