BHUTANESE REFUGEES: ON UNDERSTANDING THE LINKS BETWEEN TRAUMA, DISPLACEMENT, AND COMMUNITY RESILIENCE

Through a unique community based participatory action research project with Bhutanese refugees and immigrants in the Triad area of North Carolina (Greensboro, High Point, and Winston-Salem), the authors explore the links between trauma, displacement, and community resilience. The social experience of displacement and relocation create impacts felt in the entire community. How do we understand and map these impacts and use them to transform community ills? While limited understanding of trauma and displacement among both the newly arrived and long-time citizens acts to limit the pro-social opportunities that trauma creates, the lack of mental health services and support for refugees allows post-traumatic growth in refugee communities to atrophy. While reviving trauma may seem counter-intuitive, we argue that the engagement of collective historical memory is a critical necessity for achieving change. As the United States’ largest community of South Asian refugees, the Bhutanese refugee experience, replete with a high rate of suicide, heart disease, and diabetes is a story largely left untold. This article aims to give voice to the experience of Bhutanese refugees so as to co-create community driven solutions to this community’s unique problems

In utero exposure to threat of evictions and preterm birth: evidence from the United States

OBJECTIVE: To estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States. DATA SOURCES: Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction case filing data obtained from The Eviction Lab (2008-2016). Additional economic and demographic data were obtained from the United States Census Bureau and Bureau of Labor Statistics. STUDY DESIGN: We conducted a retrospective cohort analysis using 7.3 million births from 1,633 counties. We defined threatened eviction exposures as the z-score of average case filings over the pregnancy and by trimester. Our primary outcome was an indicator for preterm birth (born < 37 completed weeks of gestation). Secondary outcomes included a continuous measure for gestational length, a continuous measure for birth weight, and an indicator for low birth weight (born < 2500 g). We estimated within-county associations controlling for individual- and time-varying county-level characteristics, state-of-residence-year-and-month-of-conception fixed effects, and a county-specific time trend. DATA COLLECTION/EXTRACTION: We merged birth records with threatened eviction data at the county-month-year level using mother's county of residence at delivery and month-year of conception. We supplemented these data with information on county-level annual 18-and-over population, annual poverty rate, and monthly unemployment rate. PRINCIPAL FINDINGS: Increased levels of eviction case filings over a pregnancy were associated with an increased risk of prematurity and low birth weight. These associations appeared to be sensitive to exposure in the second and third trimesters. Associations with secondary outcomes and within various population subgroups were, in general, imprecisely estimated. CONCLUSIONS: Higher exposure to eviction case filings within counties, particularly in the latter stages of a pregnancy, was associated with an increased risk of adverse birth outcomes. Future research should identify the causal effect of threatened evictions on maternal and child health outcomes

Теоретичні основи безпосереднього народовладдя

Розглядаються такі форми безпосереднього народовладдя, як мітинги, збори, демонстрації. Подано пропозиції щодо удосконалення чинного законодавства, яке регулює проведення зборів, мітингів, демонстрацій в Україні.Рассматриваются такие формы непосредственного народовластия, как митинги, собрания, демонстрации. Поданы предложения по совершенствованию действующего законодательства, регулирующего проведение собраний, митингов, демонстраций в Украине.Such forms of democracy as mass meeting, collections, demonstrations are examined in this article. Insufficiency of set problem was emphasized. Suggestions are given concerning current legislation improvement related to collections, mass meeting, demonstrations realization in Ukraine

Are Birth-preparedness Programmes Effective? Results From a Field Trial in Siraha District, Nepal

The birth-preparedness package (BPP) promotes active preparation and decision-making for births, including pregnancy/postpartum periods, by pregnant women and their families. This paper describes a district-wide field trial of the BPP implemented through the government health system in Siraha, Nepal, during 2003–2004. The aim of the field trial was to determine the effectiveness of the BPP to positively influence planning for births, household-level behaviours that affect the health of pregnant and postpartum women and their newborns, and their use of selected health services for maternal and newborn care. Community health workers promoted desired behaviours through inter-personal counselling with individuals and groups. Content of messages included maternal and newborn-danger signs and encouraged the use of healthcare services and preparation for emergencies. Thirty-cluster baseline and endline household surveys of mothers of infants aged less than one year were used for estimating the change in key outcome indicators. Fifty-four percent of respondents (n=162) were directly exposed to BPP materials while pregnant. A composite index of seven indicators that measure knowledge of respondents, use of health services, and preparation for emergencies increased from 33% at baseline to 54% at endline (p=0.001). Five key newborn practices increased by 19 to 29 percentage points from baseline to endline (p values ranged from 0.000 to 0.06). Certain key maternal health indicators, such as skilled birth attendance and use of emergency obstetric care, did not change. The BPP can positively influence knowledge and intermediate health outcomes, such as household practices and use of some health services. The BPP can be implemented by government health services with minimal outside assistance but should be comprehensively integrated into the safe motherhood programme rather than implemented as a separate intervention

Measurement of two independent phase-shifts using coupled parametric amplifiers

In this article, we demonstrate a scheme capable of two-phase measurement, i.e. the simultaneous measurement of the two phase-shifts occurring in two independent Mach-Zehnder interferometers using one intensity detector. Our scheme utilizes dark-state-enhanced coupled parametric amplifiers in an atomic medium to mix the multiple fields probing the various arms of the interferometers in parallel. The two phase-differences are then encoded in separate continuous-variable parameters in the spectral waveform of the parametrically amplified atom-radiated signal field, which can be directly decoupled in a single intensity measurement. Besides resolving two phase differences in parallel, this method can also be used to increase the channel capacity in optical and quantum communication by the simultaneous use of phase-modulation and amplitude-modulation.Comment: 8 pages, 4 figure

Water rights, conflict and policy: Proceedings of a workshop held in Kathmandu, Nepal, January 22-24, 1996

IrrigationIrrigation managementWater rightsWater lawConflictFarmers' associations

Village Baseline Study: Site Analysis Report for Khulna - Morrelganj, Bangladesh

The Gabgachhia village is located in the coastal region of Bangladesh’s Khulna district. The population is rising and living with high levels of poverty and food insecurity. Local resources that are not critically strained from climate change and poor resource management are few, beyond mosques, roads and schools. The community has seen dramatic changes in resources, as early as 1990, which they attribute to increased population pressures and climate change impacts. Forests have been depleted, rivers are full of silt and lacking life, farmlands have low productivity due to rising salinity, flooding and inappropriate varieties, drinking water is insufficient to meet human, crop and animal needs, and infrastructure is weak and unable to withstand the environmen

Papua New Guinea vision-specific quality of life questionnaire: A new patient-reported outcome instrument to assess the impact of impaired vision

Background: The aim of this study was to develop and validate a new vision-specific quality of life (VS QoL) instrument and to assess the impact of vision impairment and eye disease on the quality of life of adults in Papua New Guinea (PNG). Design: This study was designed as community based cross-sectional. Participants: Six hundred fourteen adults aged 18 and above were included in this study. Methods: Focus groups and interviews guided development of a 41-item instrument. Two valid subscales of the instrument were obtained using pilot data after an iterative item reduction process guided by Rasch-based parameters. The person measures (in logits) of 614 participants were used to assess quality of life using univariate and multivariate regression analysis. Main Outcome Measures: Rasch logits. Results: Rasch analysis confirmed a 17-item instrument containing an 8-item activity limitation subscale and a 9-item well-being subscale. Both subscales were unidimensional and demonstrated good fit statistics, measurement precisions and absence of significant differential item functioning. A consistent deterioration in vision-specific quality of life was independently and significantly associated with levels of vision. Severity of vision impairment and ocular morbidity were independently associated with activity limitation and emotional well-being. Participants with refractive error had lower quality of life score than those with no ocular abnormality but higher score than those with cataract and other eye diseases. Conclusions: The 17-item PNG-VS QoL instrument is a valid and reliable instrument for the assessment of impact of impaired vision on quality of life in PNG. Vision-specific quality of life was significantly worse among participants who were older and less-educated, had lower income and have had ocular morbidities

An experimental study on the effect of isoniazid on the efficacy, plasma concentration and toxicity of paracetamol in Albino rats

Background: Paracetamol is used for symptomatic treatment of fever and pain with isoniazid and other anti-tubercular drugs in patients of tuberculosis. Literature has conflicting data regarding their interaction. Some studies show that isoniazid increases oxidative metabolism of paracetamol whereas some other suggest that isoniazid has an inhibitory effect. The present study was conducted to find out the possible interaction between paracetamol and isoniazid.Methods: The study was undertaken on Wistar strain of Albino rats. Group I and Group II animals were treated with paracetamol (500 mg/kg) and the combination of paracetamol (500 mg/kg) and isoniazid (30 mg/kg) respectively for 2 months. Blood samples were taken before and during the study for biochemical and histopathological studies of liver and renal functions and plasma paracetamol concentration was also evaluated.Results: Isoniazid decreased the plasma paracetamol concentration without affecting its analgesic activity. However, the hepatotoxic and nephrotoxic effects of paracetamol were found to be further aggravated by isoniazid co-administration.Conclusion: Isoniazid potentiates the hepatotoxic and nephrotoxic effects of paracetamol possibly due to hepatic enzyme induction by isoniazid

Price variation among different brands of anticancer medicines available in hospital pharmacies of Nepal.

Objective:To assess the variation in price among different brands of anticancer medicines available in hospital pharmacies at Nepalese cancer hospitals. Methods:The price of different brands of the same anticancer medicines available in the hospital pharmacies of two cancer hospitals was assessed. Prices of different dosage forms such as a single tablet, capsule and vial were calculated. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical industries was determined, and the percentage variation in price was calculated. The prices of medicines (brands) were also compared with the price determined by the government where available. Results:Price variation was assessed for 31 anticancer medicines belonging to six broad categories. Prices were found to vary maximally among the following medicines, each belonging to separate categories: among alkylating agents, the price of temozolomide 100 mg capsule varied 308%; among antimetabolite agents, the price of pemetrexed 500 mg injection varied 134%; among hormonal drugs, the price of letrozole 2.5 mg tablet varied 200%; among antibody class, the price of trastuzumab 440 mg injection varied 73%; among natural products, the price of irinotecan 100 mg injection varied 590%; and among miscellaneous agents, the price of bortezomib 2 mg injection varied 241%. There was a significant difference in the mean MRP of the alkylating agents with the antimetabolites (p-value 0.006) and the monoclonal antibody (p-value <.001). Antimetabolites, natural products, hormonal therapy all had significant mean differences in their MRPs with the monoclonal antibodies. (p-value <.001) and the monoclonal antibodies had a significant mean difference in the MRP with the miscellaneous agents. (p-value <.001). Conclusions:There was a considerable variation in the price of different brands of anticancer medicines available in the Nepalese market. The Government of Nepal has regulated the prices of some medicines, including anticancer medicine. However, it is not enough as prices of the majority of anticancer medicines are still not regulated. Therefore, further strategies are needed to address the variation in the prices of anticancer medicines available in the Nepalese market