"It Seems Like a Bad Thing": US South Asian Youths' Perspectives About the Use of Hospice Care

BACKGROUND

South Asians are one of the fastest growing populations in the US. Family based decision making is common among this population. Little is known about their knowledge and attitudes towards hospice use.

OBJECTIVE

This study explored US South Asian youths' knowledge of, and attitudes towards hospice care.

DESIGN

Qualitative study, using focus group discussions.

METHODS

Thirty-six university students of South Asian heritage participated in ten focus group discussions. Data were coded inductively and deductively. Thematic analysis was performed. Disagreements were resolved through discussion.

RESULTS

Participants were in consensus that if patients had an incurable, fatal condition, keeping them comfortable was important. Several participants were unaware of the terms 'hospice' and 'palliative care'. After these terms were explained, most opposed hospice care for reasons of 'desire for a normal life', 'cultural incompatibility', 'concerns about the hospice environment' and 'preference for home as the place of death'. Some were opposed to even home hospice fearing that it would continuously remind the family and patient about impending death. Concerns were also expressed about having a 'stranger' in the home to provide hospice care. One participant said she would support hospice use if it aligned with the patient's values. Others cited financial reasons and quality of life as considerations in choosing hospice care.

CONCLUSIONS

Research is needed on culturally-appropriate modes of palliative care education and advocacy for South Asian populations in the US, especially youth, that are often the decision makers for the care of older family members.

Anthroponymy evolution of Javanese diaspora names in Malaysia (social onomastics study)

The personal name of the Malaysian Javanese Diaspora (MJD) grows and develops along with the history of dynamic life, thought, social, and cultural developments. This research specifically aims to reveal and explain the process of anthroponymy evolution of the Javanese-Malaysia diaspora personal name system from historical, social, cultural, and linguistic characteristics aspects and the meaning of personal names that developed due to the cultural shifts and changes. This research utilizes data sources from lists of names of Javanese diaspora communities and efforts to extract names from MJD people who are in the locations of the states of Johor, Selangor, and Melaka in Peninsular Malaysia. Data were collected using content analysis techniques and in-depth interviews through discussions and Focus Group Discussions (FGD) as well as informal meetings directly at the research location. The results of the study show that the forms of names that appear in MJD society are strongly influenced by historical, social, and cultural phenomena that developed in the era before and after Malaysia's independence. This phenomenon affects the characteristics of personal names so that it can be seen that there are phases of MJD people's names, namely the initial arrival phase, the transition phase, the modern phase, and the latest phase. The results of this study can be used to find out the development of thought, spirit of life, and cultural traditions of a large MJD collective in Peninsular Malaysia.

The resilience of Jewish communities living in the diaspora: a scoping review

Introduction

Throughout history, Jewish communities have been exposed to collectively experienced traumatic events. Little is known about the role that the community plays in the impact of these traumatic events on Jewish diaspora people. This scoping review aims to map the concepts of the resilience of Jewish communities in the diaspora and to identify factors that influence this resilience.

Methods

We followed the Joanna Briggs Institute (JBI) methodology. Database searches yielded 2,564 articles. Sixteen met all inclusion criteria. The analysis was guided by eight review questions.

Results

Community resilience of the Jewish diaspora was often described in terms of coping with disaster and struggling with acculturation. A clear definition of community resilience of the Jewish diaspora was lacking. Social and religious factors, strong organizations, education, and communication increased community resilience. Barriers to the resilience of Jewish communities in the diaspora included the interaction with the hosting country and other communities, characteristics of the community itself, and psychological and cultural issues.

Discussion

Key gaps in the literature included the absence of quantitative measures of community resilience and the lack of descriptions of how community resilience affects individuals' health-related quality of life. Future studies on the interaction between community resilience and health-related individual resilience are warranted.

[Health of foreign students - representatives of diasporas as a social problem]

The article is devoted to the analysis of modern approaches to the problem of the health of foreign students who are educational migrants and need medical care, taking into account their current social status and status in the territory of the Russian Federation. The undermining of health, significant psycho-emotional tension and, in general, worries about maintaining health can affect the learning process, therefore it is necessary to determine in whose area of responsibility the health of educational migrants is: whether they themselves are obliged to monitor their condition and organize medical care, whether the university should participate in the organization of medical commissions and examinations, or diasporas, whose members are often foreign students, may have these powers.

Exiled lives on the stage: Support networks and programs for artists at risk from Turkey in Germany

This article analyses the support and self-care strategies of artists from Turkey who have left their country from considerable risk regarding their country's political and economic instability since 2013 and have relocated to Germany. It maps the support networks, programs and institutions as well as consider questions of sustainability and risk (self-) assessment. The study is based on interviews with Turkish and Kurdish artists in Germany and an analysis of the activities by the Maxim Gorki Theater, Apartment Projekt, bi'bak, Hafiza Merkezi Berlin, as well as support systems like artistic research fellowships, art residencies, artist networks and supportive theatres. The guiding questions of this study examine the longer-term orientation of the support of artists at risk. The findings show three deficiencies. Despite the variety of available support systems, artists who left Turkey experience difficulties integrating in the artistic labour market. The output-oriented, meritocratic basis on which programs select candidates often fail to help artists in a holistic way. The intergenerational disparity in the migrant communities create the infrastructures, solidarity discourses and networks for newly arriving artists, but also creates ideological tensions which limits inter-communitarian solidarity. Specific self-organized programs extend the solidarity to artists from other affected regions, which limits chances to support artists at risk from Turkey. There are generational disadvantages of newcomers in an overburdened, professionalized independent art scene that has struggled to break free from the social work and socio-cultural stigmas. The latter masks artists with a non-German background from positive discrimination initiatives. The study proposes improvement in support systems through a coordinated effort, encourages to relieve programs from a need for identity representation as an expectation or requirement, and advises a shift in support systems from output orientation towards enhancement of individuals through self-care, for greater autonomy and self-development in their art practices and new life.

"We have that strong R, you know": the enregisterment of a distinctive use of rhotics in Santomean Portuguese

This study examines how the use of rhotics in Santomean Portuguese is becoming enregistered as a feature that marks Santomeans' national identity. It is based on ethnographic fieldwork and semistructured interviews with Santomeans living on São Tomé Island and in Portugal. The qualitative analysis of the data reveals the process that leads to the use and awareness of the rhotic feature among Santomeans. This increasing awareness is analysed in terms of orders of indexicality. The author suggests that awareness of this rhotic feature among Santomeans is contingent on having contact with Portuguese speakers of non-Santomean origin, as they only become aware of their distinctive use of rhotics when they are in contact with speakers of another variety of Portuguese on the island, in the diaspora, or online. Also, even if this feature is perceived negatively by many, it remains available for identity-driven use to express a connection to São Tomé and Príncipe.

Africa rising: Opportunities for advancing theory on people, institutions, and the nation state in international business

Africa is rising, but IB scholars have largely failed to take notice. We argue that this is a missed opportunity. Not only is Africa a dynamic and distinctive region, but its rise presents a number of puzzles for international business (IB) research, with phenomena that seem to challenge fundamental assumptions underlying IB theories. In order to unravel these puzzles and better explain business dynamics on the continent, we contend that there is a need for IB theorizing to place greater emphasis on the role of people, to balance IB's traditional emphasis on institutions, location-specific assets, and other macro-level attributes. We explore how this conceptual shift presents new avenues for inquiry into issues that are of importance for IB but have received limited attention to date. Such issues include entrepreneurial human capital, social networks, institutional co-evolution, and the informal economy. As such, we argue that, while extant theories in IB inform explanations and predictions regarding business activity across the continent, Africa's diverse and distinctive characteristics offer the potential to serve as a context for testing and developing generalizable, cutting-edge IB theory.

Supplementary Information

The online version contains supplementary material available at 10.1057/s41267-022-00581-z.

A match made in heaven - "Indian matchmaking" in contemporary times

The Indian subcontinent is ubiquitous with some social factors such as caste, gender (discrimination), poverty. One particular factor that has taken up the imaginations of the Netflix-watching audience of late is the practice of arranged marriages. A series called Indian Matchmaking catapulted the notion of arranged marriages into the drawing rooms of both people who are highly aware of the notion (probably having been through it themselves), as well as people who have a very vague idea about it. Nevertheless, it has become a highly talked about television show across the Anglophone world. A little before its release, another English-language reality show, What the Love! with Karan Johar was released by Netflix. This explores the world of romantic connections with a few chosen people from India. While placing itself on the opposite side of the spectrum when compared to Indian Matchmaking, in many ways, it lends itself to similar tropes, albeit under a progressive garb. This paper delves into the portrayal of people from India or of Indian origin in the reality shows Indian Matchmaking and What the Love! with Karan Johar. I examine the two shows through the lens of postfeminism and how, while raising several social issues that plague Indian society, both citizens and the diaspora, they inadvertently propagate a certain self-policing and conservatism that people, particularly women, are expected to adhere to.

'You don't just do it because someone else said so': Menstrual practices and women's agency in the Hindu diaspora of Trinidad

Meanings of menstruation are deeply embedded in culture and religion. The current dominant narrative presents menstrual practices as restrictions and often describes Hindu women as 'subjected to' these practices, characterising them as the oppressed victims of their religion. This article seeks to complicate this oversimplified narrative by exploring women's motivations, choices and decisions related to menstrual practices in a small-scale study based on semi-structured interviews and focus groups with women in the Hindu-Trinidadian diaspora. Our findings indicate that the women we interviewed exercise agency in the cognitive, emotional, religious and socio-cultural spheres. Many of them accept the ritual 'impurity' but overwhelmingly restrict this label to the spiritual sphere and separate it from their menstruating bodies. Many reject the idea that the practices are restrictive or stigmatising. They do not understand religion as the source of menstrual stigma but instead value or accept menstrual practices as part of what it means to be a Hindu woman-motivated by religious observance and/or the desire to be part of a community that upholds tradition. These varied manifestations of women's agency challenge the understanding of menstrual practices as necessarily-and-always oppressive and call for acknowledging the nuance and complexity of women's lives.

Genetic Variants of APOL1 Are Major Determinants of Kidney Failure in People of African Ancestry With HIV

Introduction

Variants of the APOL1 gene are associated with chronic kidney disease (CKD) in people of African ancestry, although evidence for their impact in people with HIV are sparse.

Methods

We conducted a cross-sectional study investigating the association between APOL1 renal risk alleles and kidney disease in people of African ancestry with HIV in the UK. The primary outcome was end-stage kidney disease (ESKD; estimated glomerular filtration rate [eGFR] of <15 ml/min per 1.73 m2, chronic dialysis, or having received a kidney transplant). The secondary outcomes included renal impairment (eGFR <60 ml/min per 1.73 m2), albuminuria (albumin-to-creatinine ratio [ACR] >30 mg/mmol), and biopsy-proven HIV-associated nephropathy (HIVAN). Multivariable logistic regression was used to estimate the associations between APOL1 high-risk genotypes (G1/G1, G1/G2, G2/G2) and kidney disease outcomes.

Results

A total of 2864 participants (mean age 48.1 [SD 10.3], 57.3% female) were genotyped, of whom, 354 (12.4%) had APOL1 high-risk genotypes, and 99 (3.5%) had ESKD. After adjusting for demographic, HIV, and renal risk factors, individuals with APOL1 high-risk genotypes were at increased odds of ESKD (odds ratio [OR] 10.58, 95% CI 6.22-17.99), renal impairment (OR 5.50, 95% CI 3.81-7.95), albuminuria (OR 3.34, 95% CI 2.00-5.56), and HIVAN (OR 30.16, 95% CI 12.48-72.88). An estimated 49% of ESKD was attributable to APOL1 high-risk genotypes.

Conclusion

APOL1 high-risk genotypes were strongly associated with kidney disease in people of African ancestry with HIV and accounted for approximately half of ESKD cases in this cohort.

Pandemic-Amplified Material Hardship and Community-Led Support among Marshallese Diasporic Communities in the United States

This article explores the experiences of Marshallese diasporic migrants in the United States (U.S.) during the COVID-19 pandemic in relation to material hardship and community-led relief efforts. Focus groups with 53 Marshallese migrants in three states revealed that material hardship, including food and housing insecurity, inadequate healthcare, and difficulty paying bills, intensified among their communities during the pandemic. In response, Marshallese community-based groups provided relief to their fellow community members, including food, cash assistance, and personal protective equipment. The findings fit a pattern of intensified hardship and community-led relief among marginalized communities in the U.S. during the COVID-19 pandemic.

Diaspora engagement: a scoping review of diaspora involvement with strengthening health systems of their origin country

BACKGROUND

Diaspora communities are a growing source of external aid and resources to address unmet needs of health systems of their homelands. Although numerous articles have been published, these endeavors as a whole have not been systematically assessed.

OBJECTIVE

Examine the available literature to assess activities through which diasporas engage with the health system in their origin country and what barriers they face in their interventions.

METHODS

This is a scoping review from 1990-2018 using the PRISMA-Scr framework to examine both peer-reviewed and gray literature on (1) specific activities through which diasporas contribute to the health system in their origin country; (2) major health needs diasporas have tried to address; and (3) barriers faced by diaspora healthcare efforts.

RESULTS

The initial search identified 119 articles, of which 45 were eligible after excluding non-relevant studies. These were case studies of diaspora contributions to health systems in their origin country (13), interviews (13), literature reviews (9), general articles on the topic (4), and correspondences or presentations (6). The healthcare needs diasporas have sought to address include health workforce emigration ('brain drain') (10), capacity building for research and training (10), inadequate infrastructure (5), and finances (4). Specific activities included short-term missions (11), establishing partnerships (9), emigration back to country of origin (8), specific research and training programs (8), and financial remittances (5). Specific barriers identified were most commonly financial need within the origin country (8), lack of sustainability (6), communication issues (6), lack of intention to return to the origin country (5), infrastructure (4), and political concerns (3).

CONCLUSION

Further research on how to expand the scope of and reduce barriers to diaspora engagement is needed to optimize the effectiveness of diaspora contributions to their origin countries. Metrics and standards should be developed for assessing impact of diaspora engagement and interventions.

Moving towards the centre or the exit? Migration in population studies and in Population Studies 1996-2021

This paper examines the position of migration in population studies, focusing on the period 1996-2021. It considers the reasons why migration remains problematic for demographers, but also how approaches to migration have changed over the last 25 years. While it has arguably become more important to both demography and population studies because of the transition to low fertility and mortality, migration has metamorphosed into a complex field in its own right, almost independently from changes in demography. Both internal and international migration form the subject of this examination and four main themes are pursued: data and measurement; theories and approaches; migration and development; and migration and political demography. The papers published in the journal Population Studies are used to provide a mirror through which to view these changes over the last 25 years. This paper concludes by looking at likely future directions in migration studies, demography, and population studies.

Prevalence of HIV/hepatitis B and HIV/hepatitis C coinfection among people of East, South, Central and West African ancestry in the United Kingdom

Regional variability in the prevalence of hepatitis B (HBV) and C (HCV) is reported in sub-Saharan Africa, although data for people with HIV are sparse. We determined the prevalence of HBV/HCV in 2473 people of African ancestry with HIV in the UK. Overall, 6.2% were co-infected with HBV and 1.3% with HCV. Central [adjusted odds ratio (aOR) 2.40 (95% confidence interval (CI) 1.23--4.67) and West [2.10 (1.29-3.41)] African ancestry was associated with HBV and Central [6.98 (2.00-24.43)] African ancestry with HCV.

"Take Me Back to My Homeland Dead or Alive!": The Myth of Return Among London's Turkish-Speaking Community

In classical diaspora literature, the "myth of return" has major significance. It is believed that the "myth of return" is embedded in the minds of immigrants from their arrival. This paper examines post-migration mobilities of the Turkish-speaking community in North London as well as the shift in narratives of homeland among diaspora communities; from the "myth of return" to ritual-like visits or mundane pilgrimages. My ethnographic study analyses the post-migration homeland visiting patterns of the Turkish-speaking community into four categories. I discuss how narratives of episodic homeland visits and the desire to be buried in the homeland have replaced the myth of return.

The Successes and Failures of the Initial COVID-19 Pandemic Response in Romania

In the context of the COVID-19 pandemic, countries around the world varied in the strength and timeliness of their responses. In Romania, specific challenges were faced with regards to managing the spread and limiting the impact of the disease, ranging from healthcare infrastructure to demographic and sociocultural aspects. As the country has a sizeable diaspora, major difficulties were faced when large numbers of individuals from highly affected areas returned to Romania. However, the fast implementation of control measures successfully averted a surge in the number of COVID-19 cases. This delayed the overburdening of an already challenged healthcare system during the initial phases of the epidemic. Furthermore, early control was facilitated by the exploitation of communication channels that penetrated all layers of society, from ordinary citizens to governmental authorities and high-ranking religious figures. The management of the COVID-19 crisis in Romania illustrates the importance of a fast initial response which takes into account the role played by sociocultural aspects in the context of an epidemic. As the challenges faced by Romania are not unique, these results could inform future public health strategies worldwide.

Inflammatory bowel disease and the South Asian diaspora

Migration is associated with changes in the incidence of diseases, often linked to new environmental exposures or movement away from such exposures. Studies are complicated by the time and length of migration and also by differences in the experience of second‐ and third‐generation migrants. South Asian people have migrated across the world. In this review, the incidence and prevalence of inflammatory bowel disease in these communities is considered, along with their potential role in future investigative studies of the diseases’ etiology.

Diaspora linkages benefit both sides: a single partnership experience

The emigration of physicians and scientists from resource-constrained countries decreases the country's ability to undertake research. Re-establishing research environments and increasing capacity reduced by these losses are important, particularly in the health sciences. One mechanism for re-establishing strong health sciences research is the introduction of an Alumni Diaspora Fellowship Programme. We define the beneficial effects of a successful single partnership in an Alumni Diaspora Programme. This Host/Alumnus collaboration demonstrates that bi-directional advantages have accrued for both the Host Institution situated in a resource-constrained country and the Alumni's Institution, located in a high-income country. In addition to expanding research in the resource-constrained country, collaborations expanded to other faculty beyond the Alumnus in the sending Institution, in multiple fields including those not readily available in the high-income country (HIV, TB, malaria). The environment at the host Institution in the resource-constrained country has been enriched by increased research publications, training of young scholars (over 200 trained in manuscript and grant application writing), and substantial advances in biomedical informatics. There has been considerable knowledge exchange and development between both Institutions, showing that 'brain circulation' and Diaspora Programmes are valuable strategies for expanding research.

Group-Based Relative Deprivation Explains Endorsement of Extremism Among Western-Born Muslims

Although jihadist threats are regarded as foreign, most Islamist terror attacks in Europe and the United States have been orchestrated by Muslims born and raised in Western societies. In the present research, we explored a link between perceived deprivation of Western Muslims and endorsement of extremism. We suggest that Western-born Muslims are particularly vulnerable to the impact of perceived relative deprivation because comparisons with majority groups' peers are more salient for them than for individuals born elsewhere. Thus, we hypothesized that Western-born, compared with foreign-born, Muslims would score higher on four predictors of extremism (e.g., violent intentions), and group-based deprivation would explain these differences. Studies 1 to 6 ( Ns = 59, 232, 259, 243, 104, and 366, respectively) confirmed that Western-born Muslims scored higher on all examined predictors of extremism. Mediation and meta-analysis showed that group-based relative deprivation accounted for these differences. Study 7 ( N = 60) showed that these findings are not generalizable to non-Muslims.

Similar Mediterranean diet adherence but greater central adiposity is observed among Greek diaspora adolescents living in Istanbul, compared to Athens

OBJECTIVE

The aim of this case-control study was to compare Mediterranean diet (MD) adherence and anthropometry between Greek diaspora adolescents living in Istanbul and Greek adolescents, inhabitants of Athens.

DESIGN

A total of 206 adolescents (103 from each site), aged 10.0-19.0 years old, all of Greek origin, were recruited from schools in Athens and minority schools in Istanbul, for the present case-control study. Participants at each site were age and sex-matched. Anthropometric measurements were performed, and diet adherence was assessed with the KIDMED score.

RESULTS

Breakfast skipping, decreased dairy and increased commercially baked good/pastries consumption for breakfast, fast-food intake and consumption of several sweets each day was more prevalent in Istanbul, but, on the other hand, students from Athens reported eating fewer fruit, vegetables and nuts. The adoption of unhealthy eating habits in each site was counterbalanced by a more 'healthy' dietary element, resulting in an overall similar MD adherence between both sites. Additionally, although weight status was indifferent between the two cities, higher rates of abdominal obesity were recorded in Istanbul, when the weight-to-height ratio was used for diagnosis.

CONCLUSIONS

Differences in several domains of the KIDMED score were recorded among cities, possibly as results of food availability and prices. However, MD adherence and weight status appeared similar, indicating that the dietary transition and acculturation experienced by the remnants is actually very slow and minimal during the 93 years since population exchange.

Human phylogeography and diversity

Homo sapiens phylogeography begins with the species' origin nearly 200 kya in Africa. First signs of the species outside Africa (in Arabia) are from 125 kya. Earliest dates elsewhere are now 100 kya in China, 45 kya in Australia and southern Europe (maybe even 60 kya in Australia), 32 kya in northeast Siberia, and maybe 20 kya in the Americas. Humans reached arctic regions and oceanic islands last-arctic North America about 5 kya, mid- and eastern Pacific islands about 2-1 kya, and New Zealand about 700 y ago. Initial routes along coasts seem the most likely given abundant and easily harvested shellfish there as indicated by huge ancient oyster shell middens on all continents. Nevertheless, the effect of geographic barriers-mountains and oceans-is clear. The phylogeographic pattern of diasporas from several single origins-northeast Africa to Eurasia, southeast Eurasia to Australia, and northeast Siberia to the Americas-allows the equivalent of a repeat experiment on the relation between geography and phylogenetic and cultural diversity. On all continents, cultural diversity is high in productive low latitudes, presumably because such regions can support populations of sustainable size in a small area, therefore allowing a high density of cultures. Of course, other factors operate. South America has an unusually low density of cultures in its tropical latitudes. A likely factor is the phylogeographic movement of peoples from the Old World bringing novel and hence, lethal diseases to the New World, a foretaste, perhaps, of present day global transport of tropical diseases.

Belonging and Mental Wellbeing Among a Rural Indian-Canadian Diaspora: Navigating Tensions in "Finding a Space of Our Own"

Belonging is linked to a variety of positive health outcomes. Yet this relationship is not well understood, particularly among rural immigrant diasporas. In this article, we explore the experiences of community belonging and wellbeing among a rural Indian-Canadian diaspora in the Interior of British Columbia, Canada, our central research questions being, "What are the experiences of belonging in this community? How does a sense of belonging (or lack of) shape mental health and wellbeing among local residents?" Using a situational analysis research approach, our findings indicate that local residents must navigate several tensions within an overarching reality of finding a space of our own. Such tensions reveal contradictory experiences of tight-knitedness, context-informed notions of cultural continuity, access/acceptability barriers, particularly in relation to rural agricultural living, and competing expectations of "small town" life. Such tensions can begin to be addressed through creative service provision, collaborative decision making, and diversity-informed program planning.

States of emergence: Writing African female same-sex sexuality

Tracing a series of intertextually linked short stories from the 1990s to the present by women writers from Nigeria and its diaspora-Chimamanda Ngozi Adichie, Unoma Azuah, Chinelo Okparanta, and Lola Shoneyin-I suggest that although the figure of the African lesbian appears "new" in the context of heightened contemporary attention to the issue of homosexuality, this figure has a literary history. Ghanaian Ama Ata Aidoo's novel Our Sister Killjoy: Or, Reflections From A Black-Eyed Squint (1977) inaugurates this formation, in which the imagining of female same-sex desire is entangled with articulating the experience of migration under the shadow of imperial histories. In these short stories, the emphasis on the difficulties of love in puritanical times and transnational places produces the figure of the African lesbian as a symbol of appealingly human vulnerability, resilience, and complexity.

Undoing female genital cutting: perceptions and experiences of infibulation, defibulation and virginity among Somali and Sudanese migrants in Norway

This paper explores the dynamics of change in meaning-making about female genital cutting among migrants from Somalia and Sudan residing in Norway. In both countries, female genital cutting is almost universal, and most women are subjected to the most extensive form - infibulation - which entails the physical closure of the vulva. This closure must later be re-opened, or defibulated, to enable sexual intercourse and childbirth. Defibulation can also ease other negative health consequences of the practice. In Norway, surgical defibulation is provided on demand by the public health services, also beyond the traditional contexts of marriage and childbirth. This study explores experiences and perceptions of premarital defibulation. It explores whether Somali and Sudanese men and women understand defibulation as a purely medical issue or whether their use of the services is also affected by the cultural meaning of infibulation. This study analyses data from in-depth interviews with 36 women and men of Somali and Sudanese origin as well as participant observation conducted in various settings during 2014-2015. It reports that although all of the informants displayed negative attitudes towards infibulation, cultural meanings associated with virginity and virtue constitute a significant barrier to the uptake of premarital defibulation.

The biology and treatment of oligometastatic cancer

Clinical reports of limited and treatable cancer metastases, a disease state that exists in a transitional zone between localized and widespread systemic disease, were noted on occasion historically and are now termed oligometastasis. The ramification of a diagnosis of oligometastasis is a change in treatment paradigm, i.e. if the primary cancer site (if still present) is controlled, or resected, and the metastatic sites are ablated (surgically or with radiation), a prolonged disease-free interval, and perhaps even cure, may be achieved. Contemporary molecular diagnostics are edging closer to being able to determine where an individual metastatic deposit is within the continuum of malignancy. Preclinical models are on the outset of laying the groundwork for understanding the oligometastatic state. Meanwhile, in the clinic, patients are increasingly being designated as having oligometastatic disease and being treated owing to improved diagnostic imaging, novel treatment options with the potential to provide either direct or bridging therapy, and progressively broad definitions of oligometastasis.

Niche inheritance: a cooperative pathway to enhance cancer cell fitness through ecosystem engineering

Cancer cells can be described as an invasive species that is able to establish itself in a new environment. The concept of niche construction can be utilized to describe the process by which cancer cells terraform their environment, thereby engineering an ecosystem that promotes the genetic fitness of the species. Ecological dispersion theory can then be utilized to describe and model the steps and barriers involved in a successful diaspora as the cancer cells leave the original host organ and migrate to new host organs to successfully establish a new metastatic community. These ecological concepts can be further utilized to define new diagnostic and therapeutic areas for lethal cancers. 115: 1478–1485, 2014. © 2014 Wiley Periodicals, Inc.

Latitudes: new Indian transnational cinema

This article examines films and video art that speak to conditions of exile and displacement, including the work of Mona Hatoum, Sonali Gulati, and Onir. It proposes the term "latitude" to interrogate the aesthetic and formal properties of these artworks, seeking to understand how lesbian and same-sex eroticism and identities are central to their efficacy.

Current research on transcultural psychiatry in the Anglophone Caribbean: epistemological, public policy, and epidemiological challenges

In this article, we review recent research on mental health in the Caribbean. Three major themes emerge: (a) the effects of colonialism on the Caribbean psyche; (b) decolonization of psychiatric public policy, including innovative treatment approaches, deinstitutionalization, and community and policy responses to mental health issues; and (c) the nature and epidemiology of psychiatric pathology among contemporary Caribbean people, with particular focus on migration, genetic versus social causation of psychosis and personality disorders, and mechanisms of resilience and social capital. Caribbean transcultural psychiatry illustrates the principles of equipoise unique to developing countries that protect the wellness and continued survival of postcolonial Caribbean people.