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Building health research expertise in developing countries often requires personnel to receive training beyond national borders. For research funding agencies that sponsor this type of training, a major goal is to ensure that trainees return to their country of origin: attaining this objective requires the use of proactive strategies. The strategies described were developed under the extramural acquired immunodeficiency syndrome (AIDS) International Training and Research Program (AITRP) funded by the Fogarty International Center (FIC) at the National Institutes of Health, United States. This programme supports universities in the United States that provide research training to scientists from developing countries to enable them to address the global epidemic of human immunodeficiency virus (HIV)/AIDS and the related tuberculosis (TB) epidemic. This paper describes the strategies employed to discourage brain drain by the principle investigators (PIs) of five of the longest-funded AITRPs (funded for 15 years). Long-term trainees in these programmes spent from 11 to 96 months (an average of 26 months) studying. Using scientific, political and economic strategies that address brain drain issues, PIs working in AITRPs have attained an average rate of return home for their trainees of 80%. [ABSTRACT FROM AUTHOR]

Introduction: Relative to socially privileged groups, socially marginalized people experience weaker health effects of household income and other economic resources, a pattern known as Minorities' Diminished Returns (MDRs). These MDRs are frequently seen in racial and ethnic minorities, but less is known about the relevance of such MDRs in immigrant families. To investigate the MDRs of household income on children's depression as a function of immigration, we compared non-immigrant and immigrant children for the effect of household income on children's depressive symptoms. Methods: This cross-sectional study was conducted across multiple cities in the United States. Baseline data from the Adolescent Brain Cognitive Development (ABCD) study collected in 2018 was used. A total of 6,412 children between the ages of 9-10 years old were included. The predictor variable was household income. The primary outcome was children's depression measured by the Child Behavior Checklist (CBCL). Race, ethnicity, age, sex, parental marital status, parental employment, and financial difficulties were the covariates. Immigration status was the effect modifier. Results: Overall, high household income was associated with lower children's depressive symptoms. Immigration status showed a statistically significant interaction with household income on children's depression. This interaction term suggested that high household income has a smaller protective effect against depression for immigrant children than non-immigrant children. Conclusion: The protective effect of household income against children's depression is diminished for immigrant than non-immigrant children. [ABSTRACT FROM AUTHOR]

Rationale: The etiology of recurrent tuberculosis is typically presumed to be reactivation of residual Mycobacterium tuberculosis infection, but reinfection may account for a greater proportion of recurrent tuberculosis than previously recognized.Objective: To use M. tuberculosis genotyping to characterize the etiology of recurrent tuberculosis occurring 12 months or more after treatment completion.Methods: The study population for this national population-based cohort was drawn from the estimated 3,039 persons reported to the National Tuberculosis Surveillance System with two episodes of tuberculosis in the United States during 1993-2011, 194 of whom had genotyping results from both the initial and subsequent episode. We analyzed the proportion of recurrent tuberculosis attributable to and risk factors associated with reinfection.Measurements and Main Results: Among 136 recurrences meeting inclusion criteria, genotypes between episodes were the same for 116 (85%) recurrences during 1996-2011; the 20 (15%) with differing genotypes were categorized as reinfections. Using exact logistic regression, factors associated with reinfection included Mexican birth with both TB episodes diagnosed in the United States within 12 years of immigration (adjusted odds ratio, 10.7; 95% confidence interval, 1.7-86.3) and exclusive use of directly observed therapy for treatment of the first episode (adjusted odds ratio, 4.5; 95% confidence interval, 1.0-29.2).Conclusions: Reinfection was the cause of 15% of late recurrent tuberculosis cases in this U.S. cohort. The proportion caused by reinfection increased to 60% in certain subpopulations, such as recent immigrants from Mexico, suggesting that, despite successful treatment for tuberculosis during their first episode, these individuals remain in a social environment where they are reexposed to M. tuberculosis. Public health interventions to prevent novel reinfection might require a broader focus in these communities. [ABSTRACT FROM AUTHOR]

The authors analyzed the association between downward social mobility in subjective social status among 3,056 immigrants to the United States and the odds of a major depressive episode. Using data from the National Latino and Asian American Study (2002–2003), the authors examined downward mobility by comparing immigrants’ subjective social status in their country of origin with their subjective social status in the United States. The dependent variable was the occurrence of a past-year episode of major depression defined according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Logistic regression models were used to control for a variety of sociodemographic and immigration-related characteristics. Analyses suggested that a loss of at least 3 steps in subjective social status is associated with increased risk of a depressive episode (odds ratio = 3.0, 95% confidence interval: 1.3, 6.6). Other factors independently associated with greater odds of depression included Latino ethnicity, female sex, having resided for a longer time in the United States, and being a US citizen. The findings suggest that immigrants who experience downward social mobility are at elevated risk of major depression. Policies or interventions focused only on immigrants of low social status may miss another group at risk: those who experience downward mobility from a higher social status. [ABSTRACT FROM PUBLISHER]

As Mexican-American women and men migrate to the United States and/or become more acculturated, their diets may become less healthy, increasing their risk of cardiovascular disease. Data from the Third National Health and Nutrition Examination Survey (1988–1994) were used to compare whether energy, nutrient, and food intakes differed among three groups of Mexican-American women (n = 1,449) and men (n = 1,404) aged 25–64 years: those born in Mexico, those born in the United States whose primary language was Spanish, and those born in the United States whose primary language was English. Percentages of persons who met the national dietary guidelines for fat, fiber, and potassium and the recommended intakes of vitamins and minerals associated with cardiovascular disease were also compared. In general, Mexican Americans born in Mexico consumed significantly less fat and significantly more fiber; vitamins A, C, E, and B6; and folate, calcium, potassium, and magnesium than did those born in the United States, regardless of language spoken. More women and men born in Mexico met the dietary guidelines or recommended nutrient intakes than those born in the United States. The heart-healthy diets of women and men born in Mexico should be encouraged among all Mexican Americans living in the United States, especially given the increasing levels of obesity and diabetes among this rapidly growing group of Americans. Am J Epidemiol 2000;152:548–57. [ABSTRACT FROM PUBLISHER]