Abstract P145: Who Are We Missing? False Call Rates Decline for Stroke Code Activations During Early Phase of Covid-19 Pandemic

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Lindsay Olson-Mack ◽  
Jessica Burley ◽  
Robin Calara ◽  
Robert Claycomb ◽  
Linda Couts ◽  
...  
Keyword(s):  
Homeland Security ◽  
Southern California ◽  
True Positive Rate ◽  
Time Period ◽  
Number Of Patients ◽  
The Us ◽  
Stroke Diagnosis ◽  
Mexico Border ◽  
The Impact ◽  
Us Mexico Border

Introduction: To slow the spread of the novel coronavirus (COVID-19), the Department of Homeland Security restricted access across the US-Mexico border in March 2020. During the same time period hospitals throughout the US began reporting declines in emergency department (ED) visits, especially related to stroke. As a stroke receiving center and largest hospital within a Southern California border county serving a binational population, we sought to understand the impact COVID-19 and closure of an international border might have on stroke code activations (SCA) and discharges at our facility. Methods: A retrospective analysis involving 417 cases presenting to a tertiary hospital consisting of two campuses near the US-Mexico border in Southern California was performed. Inclusion criteria: all cases with SCA in the ED arriving from March 1, 2020 to June 30, 2020 and March 1, 2019 to June 30, 2019. Exclusion criteria: cases arriving to the ED that did not have SCA and cases for which stroke codes were initiated after hospitalization. Results: Pedestrian and private auto passenger border crossings decreased by over 5 million people between April and May 2020 compared to the same period in 2019. From March to June 2020, there were 162 ED SCA compared to 255 during the same period in 2019; a 36.5% decrease in SCA in 2020. Additionally, there was a significant increase in the percentage of ED SCA resulting in actual stroke discharge diagnoses during this period. In early 2020, 68.5% of ED SCA were discharged with a stroke diagnosis compared to 60.4% in 2019, X 2 (1, N = 162) = 4.467, p < .05. However, despite the increased true positive rate, there was an overall decrease in the total number of patients with SCA who were diagnosed with stroke (111 in 2020 vs 154 in 2019). Conclusion: As the overall number of SCA decreased during the early months of the COVID-19 pandemic, so did the total number of patients discharged with a stroke diagnosis. This suggests that fewer patients with acute stroke presented as a SCA during the early COVID-19 pandemic in comparison to the same time period in 2019. It is critically important as a stroke center serving a large, binational population to ensure the population we serve is seeking appropriate and timely care for serious and complex diseases.

The 2,000 Mile Wall in Search of a Purpose: Since 2007 Visa Overstays have Outnumbered Undocumented Border Crossers by a Half Million

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Robert Warren ◽  
Donald Kerwin
Keyword(s):  
United States ◽  
Homeland Security ◽  
Large Scale ◽  
The United States ◽  
Immigration Enforcement ◽  
Border Patrol ◽  
The Us ◽  
Mexico Border ◽  
Border Crossers ◽  
Us Mexico Border

The Trump administration has made the construction of an “impregnable” 2,000-mile wall across the length of the US-Mexico border a centerpiece of its executive orders on immigration and its broader immigration enforcement strategy. This initiative has been broadly criticized based on: Escalating cost projections: an internal Department of Homeland Security (DHS) study recently set the cost at $21.6 billion over three and a half years; Its necessity given the many other enforcement tools — video surveillance, drones, ground sensors, and radar technologies — and Border Patrol personnel, that cover the US-Mexico border: former DHS Secretary Michael Chertoff and other experts have argued that a wall does not add enforcement value except in heavy crossing areas near towns, highways, or other “vanishing points” (Kerwin 2016); Its cost-effectiveness given diminished Border Patrol apprehensions (to roughly one-fourth the level of historic highs) and reduced illegal entries (to roughly one-tenth the 2005 level according to an internal DHS study) (Martinez 2016); Its efficacy as an enforcement tool: between FY 2010 and FY 2015, the current 654-mile pedestrian wall was breached 9,287 times (GAO 2017, 22); Its inability to meet the administration’s goal of securing “operational control” of the border, defined as “the prevention of all unlawful entries to the United States” (White House 2017); Its deleterious impact on bi-national border communities, the environment, and property rights (Heyman 2013); and Opportunity costs in the form of foregone investments in addressing the conditions that drive large-scale migration, as well as in more effective national security and immigration enforcement strategies. The Center for Migration Studies (CMS) has reported on the dramatic decline in the US undocumented population between 2008 and 2014 (Warren 2016). In addition, a growing percentage of border crossers in recent years have originated in the Northern Triangle states of Central America (CBP 2016). These migrants are fleeing pervasive violence, persecution, and poverty, and a large number do not seek to evade arrest, but present themselves to border officials and request political asylum. Many are de facto refugees, not illegal border crossers. This report speaks to another reason to question the necessity and value of a 2,000-mile wall: It does not reflect the reality of how the large majority of persons now become undocumented. It finds that two-thirds of those who arrived in 2014 did not illegally cross a border, but were admitted (after screening) on non-immigrant (temporary) visas, and then overstayed their period of admission or otherwise violated the terms of their visas. Moreover, this trend in increasing percentages of visa overstays will likely continue into the foreseeable future. The report presents information about the mode of arrival of the undocumented population that resided in the United States in 2014. To simplify the presentation, it divides the 2014 population into two groups: overstays and entries without inspection (EWIs). The term overstay, as used in this paper, refers to undocumented residents who entered the United States with valid temporary visas and subsequently established residence without authorization. The term EWI refers to undocumented residents who entered without proper immigration documents across the southern border. The estimates are based primarily on detailed estimates of the undocumented population in 2014 compiled by CMS and estimates of overstays for 2015 derived by DHS. Major findings include the following: In 2014, about 4.5 million US residents, or 42 percent of the total undocumented population, were overstays. Overstays accounted for about two-thirds (66 percent) of those who arrived (i.e., joined the undocumented population) in 2014. Overstays have exceeded EWIs every year since 2007, and 600,000 more overstays than EWIs have arrived since 2007. Mexico is the leading country for both overstays and EWIs; about one- third of undocumented arrivals from Mexico in 2014 were overstays. California has the largest number of overstays (890,000), followed by New York (520,000), Texas (475,000), and Florida (435,000). Two states had 47 percent of the 6.4 million EWIs in 2014: California (1.7 million) and Texas (1.3 million). The percentage of overstays varies widely by state: more than two-thirds of the undocumented who live in Hawaii, Massachusetts, Connecticut, and Pennsylvania are overstays. By contrast, the undocumented population in Kansas, Arkansas, and New Mexico consists of fewer than 25 percent overstays.  

scholarly journals The 2,000 Mile Wall in Search of a Purpose: Since 2007 Visa Overstays have Outnumbered Undocumented Border Crossers by a Half Million

2017 ◽  
Vol 5 (1) ◽  
pp. 124-136 ◽  
Author(s):  
Robert Warren ◽  
Donald Kerwin
Keyword(s):  
United States ◽  
Homeland Security ◽  
Large Scale ◽  
The United States ◽  
Immigration Enforcement ◽  
Border Patrol ◽  
The Us ◽  
Mexico Border ◽  
Border Crossers ◽  
Us Mexico Border

The Trump administration has made the construction of an “impregnable” 2,000-mile wall across the length of the US-Mexico border a centerpiece of its executive orders on immigration and its broader immigration enforcement strategy. This initiative has been broadly criticized based on: • Escalating cost projections: an internal Department of Homeland Security (DHS) study recently set the cost at $21.6 billion over three and a half years; • Its necessity given the many other enforcement tools — video surveillance, drones, ground sensors, and radar technologies — and Border Patrol personnel, that cover the US-Mexico border: former DHS Secretary Michael Chertoff and other experts have argued that a wall does not add enforcement value except in heavy crossing areas near towns, highways, or other “vanishing points” (Kerwin 2016); • Its cost-effectiveness given diminished Border Patrol apprehensions (to roughly one-fourth the level of historic highs) and reduced illegal entries (to roughly one-tenth the 2005 level according to an internal DHS study) (Martinez 2016); • Its efficacy as an enforcement tool: between FY 2010 and FY 2015, the current 654-mile pedestrian wall was breached 9,287 times (GAO 2017, 22); • Its inability to meet the administration's goal of securing “operational control” of the border, defined as “the prevention of all unlawful entries to the United States” (White House 2017); • Its deleterious impact on bi-national border communities, the environment, and property rights (Heyman 2013); and • Opportunity costs in the form of foregone investments in addressing the conditions that drive large-scale migration, as well as in more effective national security and immigration enforcement strategies. The Center for Migration Studies (CMS) has reported on the dramatic decline in the US undocumented population between 2008 and 2014 (Warren 2016). In addition, a growing percentage of border crossers in recent years have originated in the Northern Triangle states of Central America (CBP 2016). These migrants are fleeing pervasive violence, persecution, and poverty, and a large number do not seek to evade arrest, but present themselves to border officials and request political asylum. Many are de facto refugees, not illegal border crossers. This report speaks to another reason to question the necessity and value of a 2,000-mile wall: It does not reflect the reality of how the large majority of persons now become undocumented. It finds that two-thirds of those who arrived in 2014 did not illegally cross a border, but were admitted (after screening) on non-immigrant (temporary) visas, and then overstayed their period of admission or otherwise violated the terms of their visas. Moreover, this trend in increasing percentages of visa overstays will likely continue into the foreseeable future. The report presents information about the mode of arrival of the undocumented population that resided in the United States in 2014. To simplify the presentation, it divides the 2014 population into two groups: overstays and entries without inspection (EWIs). The term overstay, as used in this paper, refers to undocumented residents who entered the United States with valid temporary visas and subsequently established residence without authorization. The term EWI refers to undocumented residents who entered without proper immigration documents across the southern border. The estimates are based primarily on detailed estimates of the undocumented population in 2014 compiled by CMS and estimates of overstays for 2015 derived by DHS. Major findings include the following: • In 2014, about 4.5 million US residents, or 42 percent of the total undocumented population, were overstays. • Overstays accounted for about two-thirds (66 percent) of those who arrived (i.e., joined the undocumented population) in 2014. • Overstays have exceeded EWIs every year since 2007, and 600,000 more overstays than EWIs have arrived since 2007. • Mexico is the leading country for both overstays and EWIs; about one-third of undocumented arrivals from Mexico in 2014 were overstays. • California has the largest number of overstays (890,000), followed by New York (520,000), Texas (475,000), and Florida (435,000). • Two states had 47 percent of the 6.4 million EWIs in 2014: California (1.7 million) and Texas (1.3 million). • The percentage of overstays varies widely by state: more than two-thirds of the undocumented who live in Hawaii, Massachusetts, Connecticut, and Pennsylvania are overstays. By contrast, the undocumented population in Kansas, Arkansas, and New Mexico consists of fewer than 25 percent overstays.

The Impact of Promotoras on Social Support and Glycemic Control Among Members of a Farmworker Community on the US-Mexico Border

2007 ◽  
Vol 33 (S6) ◽  
pp. 172S-178S ◽  
Author(s):  
Maia Ingram ◽  
Emma Torres ◽  
Flor Redondo ◽  
Gail Bradford ◽  
Chin Wang ◽  
...  
Keyword(s):  
Social Support ◽  
Glycemic Control ◽  
The Us ◽  
Mexico Border ◽  
The Impact ◽  
Us Mexico Border

scholarly journals Fenced Out: The Impact of Border Construction on US-Mexico Migration

2020 ◽  
Vol 12 (3) ◽  
pp. 106-139
Author(s):  
Benjamin Feigenberg
Keyword(s):  
United States ◽  
Survey Data ◽  
The United States ◽  
Government Investment ◽  
The Us ◽  
Us Government ◽  
Border Fence ◽  
Mexico Border ◽  
The Impact ◽  
Us Mexico Border

This paper estimates the impact of the US-Mexico border fence on US-Mexico migration by exploiting variation in the timing and location of US government investment in fence construction. Using Mexican survey data and data I collected on fence construction, I find that construction in a municipality reduces migration by 27 percent for municipality residents and 15 percent for residents of adjacent municipalities. In addition, construction reduces migration by up to 35 percent from non-border municipalities. I also find that construction induces migrants to substitute toward alternative crossing locations, disproportionately deters low-skilled migrants, and reduces the number of undocumented Mexicans in the United States. (JEL J15, J24, J61, K37, O15)

Borders and walls

2018 ◽  
pp. 9-36
Author(s):  
Mary Gilmartin ◽  
Patricia Burke Wood ◽  
Cian O’Callaghan
Keyword(s):  
United States ◽  
Northern Ireland ◽  
The United States ◽  
Relative Lack ◽  
Republic Of Ireland ◽  
The Us ◽  
Mexico Border ◽  
The Republic ◽  
The Impact ◽  
Us Mexico Border

This chapter considers how the dominant performance of borders and bordering is being reworked through Brexit and the Trump presidency. The impact of Brexit has brought renewed attention and anxiety to the 310-mile land border between the Republic of Ireland and Northern Ireland, while also unsettling the norms around the EU's external borders. In the United States, President Trump campaigned on the promise to ‘build a wall’ between Mexico and the United States and, not incidentally, to ‘make Mexico pay for it’. Since his election, the US–Mexico border has been intensely politicised and racialised. In contrast, there is a relative lack of anxiety regarding the US–Canada border. The chapter considers the ways in which borders are discursively invoked and materially reconfigured such that particular types of migrants are constructed as a threat and specific borders in need of securitisation.

scholarly journals Crossing Borders: The Impact of the California Tobacco Control Program on Both Sides of the US–Mexico Border

2008 ◽  
Vol 98 (2) ◽  
pp. 258-267 ◽  
Author(s):  
Ana P. Martínez-Donate ◽  
Melbourne F. Hovell ◽  
C. Richard Hofstetter ◽  
Guillermo J. González-Pérez ◽  
Anu Kotay ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Control Program ◽  
Tobacco Control Program ◽  
The Us ◽  
Mexico Border ◽  
The Impact ◽  
Us Mexico Border

California

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Roberto Alvarez
Keyword(s):  
The State ◽  
Social Cartography ◽  
Family Network ◽  
The Family ◽  
The Us ◽  
Mexico Border ◽  
Police Surveillance ◽  
Us Mexico Border

I utilize my situated position as anthropologist, academician, and citizen to argue not only that we should “think” California, but also that we should “rethink” our state—both its condition and its social cartography. To be clear, I see all my research and endeavors—my research on the US/Mexico border; my time among the markets and entrepreneurs I have worked and lived with; my focus on those places in which I was raised: Lemon Grove, Logan Heights; the family network and my community ethnographic work—as personal. I am in this academic game and the telling of our story because it is personal. When Lemon Grove was segregated, it was about my family; when Logan Heights was split by the construction of Interstate 5 and threatened by police surveillance, it was about our community; when the border was sanctioned and militarized it again was about the communities of which I am a part. A rethinking California is rooted in the experience of living California, of knowing and feeling the condition and the struggles we are experiencing and the crises we have gone through. We need to rethink California, especially the current failure of the state. This too is ultimately personal, because it affects each and every one of us, especially those historically unrepresented folks who have endured over the decades.

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