The disruption of the care chain: why do Lithuanian migrant home care workers return to their home country?

This study examined reasons for return migration among Lithuanian migrant home care workers who provided care to older adults abroad. In total, 13 interviews were conducted with a diverse sample of returnees. Using constant comparison, three major themes were identified. The first theme described the undocumented nature of the job as a reason to return. The emotional consequences of the job as well as its physically demanding aspects also were portrayed. The third theme addressed the increased awareness to possible losses and care needs brought by the job. Our findings stress the importance of the job characteristics of the worker as a push factor that results in the return of migrant workers to their home. The importance of the documentation status of the job and its precarious nature are discussed.

Caring for Patients Without Documentation Status: What Motivates Us and Sustains Us

Restrictive policies and limited resources create challenges for care delivery for patients without documentation status (PWDS). This study explores the motivators and sustainers for healthcare providers serving PWDS. Twenty-four direct providers in public and private sectors were interviewed using semi-structured, in-depth interviews. Two members of the research team independently coded interviews using inductive thematic analysis. Four major themes emerged illustrating intrinsic and extrinsic sources that motivated and sustained providers: (1) a sense of calling to serve their community; (2) solidarity is sustaining; (3) organizational culture as a key element for provider engagement; (4) insight into necessary change. Providers who care for PWDS are driven and sustained by internal motivations and a sense of solidarity in working towards better care access for their marginalized patients. Findings illustrate the importance of recruiting and retaining providers with histories of recent migration. Immigration and healthcare policy reform may improve provider workflow.

Optimism and the American Dream: Latino Perspectives on Opportunities and Challenges Toward Reaching Personal and Family Goals

Trends in positive psychology suggest optimism is an important trait related to happiness and well-being and that through the teaching of optimism, well-being can be enhanced (Sin & Lyubomirsky, 2009). The purpose of this study was to identify areas of optimism within the context of the American Dream among Hispanic/Latino/as and to understand factors that create barriers to having an optimistic outlook on achieving the American Dream. Data for this study came from research designed to identify sources of acculturation related stress among Hispanic/Latino/as. A sample ( n = 93) of Hispanic/Latino/a adults were recruited for focus groups in California and Massachusetts. Results indicate that participants were optimistic in achieving their dreams, which included financial achievements, ownership, educational opportunities, and more. Some participants acknowledged that these expectations were unrealistic and were challenged by discrimination, limited skills, and lack of legal documentation status. Studies of psychological interventions that foster optimism among Hispanic/Latino/as are needed.

Immigrant faceism: documentation statuses evoke racialized mental representations

Politicized U.S. immigration discourse has spurred interest in characterizing who illegalized immigrants are or perceived to be. What are the associated visual representations of migrant illegality? Across two studies with undergraduate and online samples (N = 686), we used face- based reverse correlation and spatial arrangement to capture representations of illegalized immigrant men and their differentiation from U.S. citizen or documented immigrant representations. Documentation statuses were differentially racialized. Immigrant representations were dark-skinned and classified as non-white, while citizen representations were light-skinned, evaluated positively, and classified as white. Legality further differentiated immigrant representations: documentation conjured positive representations, illegality conjured threatening representations. In a similarity task, participants used faces’ pixel luminance (e.g., skin color) and perceived American-ness to sort unlabeled faces by documentation status, confirming their representational distinctions. Illegalized immigrants were uniquely racialized as dark-skinned un- American threats, highlighting the continued impact of U.S. imperial projects and colorism in shaping representations of migrant illegality.

Documentation of Prognostication Discussion

Background: Our organization is a NGO that provides palliative and supportive care at outpatient (OP), home visits and inpatient (IP), and Hospice settings. During patient encounter at different settings, documentation of discussion on prognostication was not done on the patients’ case sheets. This had created communication gap between the professionals, the patients and their family members. Due to this, there was a mismatch between the patients’ expectations and the services provided. Aims: The aim of the study was to implement A3 protocol and to increase the documentation status from zero to 75% by the end of five months after the commencement of the project. Settings and Design: OP - Department of Palliative Care Clinic A3 method. Material and Methods: The process map of the newly registered patients was followed. Root cause analysis was done using the Ishikawa Diagram. The main cause was that there was no specific format for documentation of prognostication. The professionals also felt some difficulty in disclosing the information as they were not following any prognostication tools upon which such discussions can be made. The key drivers were identified. Interventions were focused with specific contributors. A run chart was maintained to assess the progress of the interventions Statistical Analysis Used: Percentage calculation. Results: This endeavor has resulted in raising the documentation status from 0 to 80%. Conclusion: A3 protocol has been successful in developing the format for documentation of prognostication. Our team has gained confidence in implementing the A3 in other domains too.

Environmental Health Threats to Latino Migrant Farmworkers

Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.