Constructing an imagined path to peace during conflict: a critical discourse analysis of human rights education in Gaza, Palestine

Human Rights Education (HRE) for Palestinian refugees in Gaza Strip is integrated in a context where history, culture and collective memory are priorities in the local discourses of right-hood and justice. Palestinian learners are citizens of a non-recognized imagined community, existing through the processes of collective remembering, and the local discourses on rights. This study examines UNRWA’s special HRE curriculum for Palestinian refugees in Gaza Strip. I analyse UNRWA’s HRE policy and a sample of secondary level textbooks. This results in forming my original contribution to the field of human rights and HRE in a context of conflict. That is giving voice to a “collective” counter-hegemonic response to UNRWA’s model of HRE, which marginalizes the local discourse of right-hood. Collective, not in the sense of generalization, but in recognition of Palestinians’ legal and political status, which is a major obstacle for human rights and HRE in the context of the Palestinian-Israeli conflict. For this, I use qualitative document analysis and a dialectical-relational approach to Critical Discourse Analysis (CDA) to examine the materials in relation to the wider geo-political and socio-cultural context. The research outcomes reveal that UNRWA promotes a discourse of Human Rights, Conflict Resolution and Tolerance (HRCRT) through a model of HRE which promotes a standardized culture of human rights. The study suggests that, at the level of conflict resolution, UNRWA’s discourse of HRCRT overlooks vital political and legal issues that hinder HRE in Gaza Strip. The curriculum is highly de-politicized and knowledge-based that it prescribes a de-contextualized curriculum, which represents the world as it “ought to be” rather than what “it is”. Therefore, the study argues that the way forward for HRE resides in directly addressing the complex components of the conflict and acknowledging the importance of the local discourses and collective memory for HRE for Palestinian

Research4Life (R4L) Scholar Program: New Initiative to Promote Diversity, Equity, and Inclusion in Medicine through a Bottom-Up Approach

Purpose and background: According to the Pew Research Center, Hispanics are 17% of the workforce but only represent 8% of people in a science, technology, engineering and math (STEM) position. African Americans are 11% of the workforce but hold 9% of STEM jobs. The Research4Life (R4L) program is designed to increase the number of minority students who pursue medical education and careers in Medicine and research. A formalized mentorship and clinical research program is one pipeline to increase representation of underrepresented groups in medicine and academic medical careers.(1) Description of Innovative Practice: The R4L scholar program is a structured summer scholar program offered by the Department of Internal Medicine (DOIM) at VCU and consists of an 8 to 10-week structured medical research experience combined with clinical shadowing experience for undergraduate students from underrepresented minority (URM) groups and minoritized communities. There is an unmet need to increase the presence of URM groups in the medical workforce.Primary goals:*Increase the students’ interest in Internal Medicine and academic careers and enhance the visibility of Internal Medicine.*Increase representation of URM groups in various medical fields by starting from early stages of college education.*Mitigate obstacles and increase access to high impact clinical research opportunities for students from URM groups.*Support the mission of the university to attract and retain a talented and diverse student body that will not only graduate at a high rate but will also go on to contribute to a highly skilled workforce.*Provide a model for other departments, institutions and universities to adopt and to promote diversity, equity and inclusion in medicine and academia.*Increase engagement of URM students in medical research and create a culture that reinforces their identity and a sense of belonging in the medical and academic fields. *Support undergraduates and medical students’ participation in community-based experiences through involvement in mentored scholarly activities and clinical training opportunities. Results/Impact: The primary outcomes of this project:-Increase the student’s interest in Internal Medicine, research and academic careers. The program requires completing a pre- and post- program survey to evaluate for change in students’ levels of interest in Medicine and academia due to participation in R4L program. Also, the post program survey includes questions about whether the student applied or got accepted to medical school or graduate studies to measure the program’s impact.-The program will help establish a future diverse inclusive workforce and close equity gaps in representation of minority groups in academic careers.-The R4L program creates a formal pathway for clinical training and research learning, sponsored by the Department of Internal Medicine.-The curriculum developed in this program will expand opportunities for students in many ways.-The program will provide a model for adoption by other departments and institutions for promotion of diversity, equity and inclusion through a structured clinical+research learning experience. Conclusion/Future Directions:-The R4L program will provide a model for other departments and institutions to adopt and replicate to promote diversity, equity and inclusion through a structured clinical+research learning experience.-The R4L program has a great generalizability potential as it can be applied to different settings, populations, communities, cultures, health systems, and countries.-This program can be applied in outpatient settings or low resource settings, and in diverse populations/communities. It can be implemented globally and can be modified easily to accommodate the different educational and health systems.-The R4L program will be expanded to increase the number of students participating in future offerings of the program, provide equitable opportunities to medical students (in addition to undergraduate students), and include students (undergraduates and medical students) from other colleges in Richmond especially the non-academic colleges/schools

Predicted impacts of land use change on groundwater recharge of the upper Berg catchment, South Africa

Land use change is a major factor influencing catchment hydrology and groundwater resources. In South Africa, the management of scarce water resources is a big concern. The study area, the upper Berg catchment, Western Cape, South Africa, contains strategic water resources. The catchment has undergone many changes in recent years, not least of all the construction of a dam on the upper reach. To reduce water loss due to evapotranspiration, non-native hill slope vegetation upstream of the Berg River Dam was cut down. It was hypothesised that recharge has been increased due to this change in vegetation. The objectives of this study were to determine land use changes in upper Berg catchment using multi-temporal Landsat images from 1984, 1992, 2002, and 2008, and to predict the impact of these land use changes on groundwater recharge. For the simulation of groundwater recharge the distributed hydrological model WetSpa was used. Forest plantations lost 72% (18.8 km2) of their areal extent between 1984 and 2008, due to deforestation as part of a plan to implement the ecological Reserve as required by national water policy; the area of barren land increased by 15.7 km2 in the same period. The high increase in precipitation, especially in the period of 2005–2009, combined with the change in land use in the study area resulted in a highly increased (278%) predicted mean groundwater recharge. Simulated groundwater recharge shows strong spatial differences for each evaluated year. The effect of the rapid clearing of non-native hill slope vegetation upstream of the Berg River Dam for the land use scenario of 2008 was tested to check if clearing is an important factor in the increase of groundwater recharge. Hence, we simulated the whole time-series from 1984–2004 (21 years) with the land use map from 2008 instead of the land use maps for 1984, 1992 and 2002. A systematic increase of about 8% per year for the 21-year period, due to the change in land use from the different years to that of 2008, is predicted , which confirms that the clearing of the non-native hill slope vegetation is of considerable importance for the increase in groundwater recharge.Keywords: Berg catchment, ecological Reserve, WetSpa, remote sensin

Fibrosis-4 index is associated with the risk of hepatocellular carcinoma in patients with cirrhosis and nonalcoholic steatohepatitis

Background and aimsIdentification of high-risk patients for hepatocellular carcinoma (HCC) is essential for long term monitoring of nonalcoholic steatohepatitis (NASH) cirrhosis progression. We sought to evaluate the association between Fibrosis-4 (FIB-4) index and incidence of HCC risk among patients with NASH cirrhosis.MethodsWe conducted a retrospective cohort study of adult patients with NASH cirrhosis (n= 1,338) who were evaluated in a single medical center between 2005 and 2015. Those who developed HCC were identified through electronic medical records using International Classification of Diseases (ICD) 9 and 10 codes until the end of September 2021.ResultsDuring a median follow-up time of 3.7 years, 157 (11.7%) patients with NASH cirrhosis developed HCC. At index visit, the study population had a median age 57 years, 43% males, 78.8% White, and mean FIB-4 index 4.2. The final multivariable Cox regression model revealed that male sex, BMI 25-29.9 kg/m2, and hypertension were independent factors associated with development of HCC in patients with NASH cirrhosis. Compared to patients with FIB-4 ¾ 1.45, patients with FIB-4 between 1.45-3.25 had a similar hazard of HCC (Hazard Ratio [HR] 1.12, 95% CI: 0.67-1.86, p=0.670), whereas patients with FIB-4 >3.25 had a 1.93 (95% CI: 1.22-3.05, p=0.005) increased hazard of HCC.ConclusionFIB-4 > 3.25 was an independent factor associated with increased HCC risk among NASH cirrhosis patients. FIB-4 index is a promising tool for determining high-risk patients and may be used in routine clinical practice to monitor risk of HCC in patients with NASH cirrhosis

Recent advances in understanding and managing non-alcoholic fatty liver disease [version 1; referees: 2 approved]

Non-alcoholic fatty liver disease is a leading cause of chronic liver disease that can lead to cirrhosis, hepatocellular cancer, and end-stage liver disease, and it is linked to elevated cardiovascular- and cancer-related morbidity and mortality. Insulin resistance related to metabolic syndrome is the main pathogenic trigger that, in association with adverse genetic, lifestyle, and other factors, precipitates the development of non-alcoholic fatty liver disease. Biochemical markers and radiological imaging, along with liver biopsy in selected cases, help in the disease’s diagnosis and prognostication. Weight loss is the cornerstone treatment of non-alcoholic fatty liver disease; however, it is difficult to achieve and maintain, so pharmacotherapy was developed. The remarkable evolution in understanding disease pathogenesis has led to the development of new medical therapies and even the modification of currently available ones. This review summarizes recent advances in understanding the epidemiology, natural history, pathogenesis, diagnosis, and management of non-alcoholic fatty liver disease

Fibrosis Progression Rate in Biopsy-Proven Nonalcoholic Fatty Liver Disease Among People With Diabetes Versus People Without Diabetes: A Multicenter Study

Background & aimsThere are limited data regarding fibrosis progression in biopsy-proven nonalcoholic fatty liver disease (NAFLD) in people with type 2 diabetes mellitus (T2DM) compared with people without T2DM. We assessed the time to fibrosis progression in people with T2DM compared with people without T2DM in a large, multicenter, study of people with NAFLD who had paired liver biopsies.MethodsThis study included 447 adult participants (64% were female) with NAFLD who had paired liver biopsies more than 1 year apart. Liver histology was systematically assessed by a central pathology committee blinded to clinical data. The primary outcome was the cumulative incidence of a ≥1-stage increase in fibrosis in participants with T2DM compared with participants without T2DM.ResultsThe mean (SD) age and body mass index (calculated as weight in kilograms divided by the square of the height in meters) were 50.9 (11.5) years and 34.7 (6.3), respectively. The median time between biopsies was 3.3 years (interquartile range, 1.8-6.1 years). Participants with T2DM had a significantly higher cumulative incidence of fibrosis progression at 4 years (24% vs 20%), 8 years (60% vs 50%), and 12 years (93% vs 76%) (P = .005). Using a multivariable Cox proportional hazards model adjusted for multiple confounders, T2DM remained an independent predictor of fibrosis progression (adjusted hazard ratio, 1.69; 95% CI, 1.17-2.43; P = .005). The cumulative incidence of fibrosis regression by ≥1 stage was similar in participants with T2DM compared with participants without T2DM (P = .24).ConclusionsIn this large, multicenter cohort study of well-characterized participants with NAFLD and paired liver biopsies, we found that fibrosis progressed faster in participants with T2DM compared with participants without T2DM. These data have important implications for clinical practice and trial design

Application of multi‑method approach to assess groundwater–surface water interactions, for catchment management

Globally, the dependence of river systems to delayed discharge of subsurface water to augment flows during dry seasons is well documented. Discharge of fresh subsurface water can dilute concentrated river flow quality during reduced flow. Observed and reported results on the Berg River’s declining water quantity and quality are a concern to the regions socio-economic growth and environmental integrity. Understanding the role of subsurface water discharges on the quantity and quality of receiving surface water courses can improve their management during dry periods. A case study was designed and implemented in the upper Berg River catchment in the Western Cape Province of South Africa to assess the influence of groundwater–surface water interaction on water quantity and quality. This study aimed to quantify and characterize the quality of subsurface water available in the upper catchment to improve observed declining water quality downstream. Hydrograph separation provided estimates of water fluxes during 2012–2014 low and high flow periods, while hydrochemical analysis provided insights on impacts of major land use activity in this catchment on water resources. Hydrograph separation analysis indicated that the Berg River is 37.9% dependent on subsurface water discharges annually. Dominant Na–Cl-type water indicates the quality of water from the upper Berg River is largely affected by natural processes including short residence times of aquifer water, rock–water interactions and atmospheric deposition of NaCl ions. These results provide insights for suggesting management options to be implemented to protect subsurface water for continued dilution and water resources management in the lower catchments

Towards a decolonial curriculum of human rights education in Palestine

The politics of knowledge economy have long governed the process of spreading the United Nation's universal culture of human rights into diverse contexts. This article examines the strategies utilized in introducing and operationalizing the UN's normative discourse of human rights through integrating an ideological model of Human Rights Education in the Gaza Strip. This is through the United Nations Relief and Work Agency for Palestinian refugees in the Near East (UNRWA) and its education provision services in Gaza. In particular, I apply an abridged version of Foucauldian Discourse Analysis, from a discursive psychological viewpoint, to generate an understanding of identity construction within the wider context of the continuing Israeli settler-colonial project in Palestine. The aim is to challenge the particular subject position of Palestinian learners as advocates for human rights, which they cannot claim through the UN's highly bureaucratic and standardized tools. In this context, a decolonial response is indispensable for addressing the role of the politics of knowledge production of human rights in regulating the learners’ subjectivities while ignoring the intricate geopolitical and historical factors that shape the learners’ identities. Therefore, the article contributes to decolonial research by examining the UNRWA as a modern and hegemonic institution that guards and delivers a decontextualized HRE curriculum in Gaza

Effect of substructure stiffness on the performance of integral abutment bridges under thermal loads

This research investigates the effect of substructure stiffness on the performance of short and medium span length Integral Abutment Bridges (IABs) subjected to thermal load. Various parameters such as foundation soil stiffness, pile orientation, pile type, and abutment geometry on the performance of IABs, are considered. Three-dimensional (3D) Finite Element (FE) models were developed using the FE software LUSAS to capture the behavior of IABs including the variations in displacement and rotation in the transverse direction for the various components of the superstructure as well as the substructure. Field measurements from a recently constructed two-span steel girder IAB were utilized to validate the 3D FE models. Using the validated model, a parametric study was carried out to study the effect of the above parameters on the performance of IABs under thermal loading using AASHTO-LRFD temperature ranges. The study shows that among the investigated parameters, the foundation soil stiffness stands as the most important factor that affects the performance of IABs. In general, the bridge behavior is more sensitive to the foundation soil stiffness during bridge contraction. The results from the study show considerable variations in displacement and rotation in the transverse direction for the various components of the superstructure and the substructure in relatively wide IABs. This research suggests that Prestressed Concrete Piles can be a viable alternative to steel H-Piles for short span bridges. It was also noticed that the stress level due to thermal loading in the various components of the bridge can be significantly reduced by enclosing the top part of the pile in an enclosure filled with crushed stone or loose sand. Moreover, the research suggests that the pile orientation has a minimum effect on the behavior of IABs. It also suggests that a slight increase in the abutment height can significantly reduce the displacement and rotation along the piles during bridge expansion. The research also suggests that 3D models are necessary to capture the behavior of IABs especially during bridge expansion. The research provides simple equations and charts to help bridge engineers calculate the displacement and rotation along the substructure.Ph. D.Includes bibliographical referencesIncludes vitaby Suhail Albhais