Reforming the family justice system initiative

Family breakdown is common and brings with it many challenges for parents and their children. These challenges are compounded by the current family justice system, which is adversarial in nature, complex and costly for families. Over the years, the justice community has tried isolated interventions to improve access to justice, and while these projects, reforms and programs have achieved some good, they have not created the system-wide change we desire. We’ve learned from past experience that the only way to bring about meaningful, systemic change is to have a broad collaboration of all the participants in the justice system come together to work collectively to create the change we desire. In the RFJS initiative, we are exploring systemic design processes to address complex problems through systemic change. This case study includes a description of the steps taken to bring together a collaborative alliance made up of approximately 200 individuals and organizations representing ten sectors that work within the broadly defined family justice system. Over the past year, we have held four workshops designed to build community and relationships among the collaborators; to gather information about the focus of concern within our collaborative alliance; to develop an understanding of systemic change and innovative lab processes; and to ensure that there is a shared commitment to change. The main technique and method used throughout this process was Causal Layered Analysis (CLA) developed by Sohail Inayatullah, a futures studies researcher. While our current family justice system is characterized by a focus on family breakdown and legal responses, the space created through CLA enables us to consider solutions that might exist entirely outside the current understanding. Additionally, the language of the mental model and Theory of Change help us to understand and talk about the system in new ways that are much more focused on helping families to thrive, and recognize that family justice issues are primarily social and relationship problems which contain a legal element. This initiative is increasing the knowledge and capacity for systemic change among all participants in the RFJS. We are building an awareness and understanding of innovative approaches, developmental evaluation and collaborative action that has not previously existed among these participants. This project is opening up a space to enable stakeholders (clients, families, and those who work within the system) to reframe the problems that they encounter in family justice. We are creating a culture of learning that allows us to learn as we go forward, and will support continued improvement in the family justice system

Prevalence and Characteristics of Self-Reported Hypothyroidism and Its Association with Nonorgan-Specific Manifestations in US Sarcoidosis Patients: A Nationwide Registry Study

Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis. We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with nonorgan-specific manifestations. 14% of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multiorgan sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal gland involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR) 1.3, 95% CI 1.01–1.6), antidepressant use (aOR 1.3, 95% CI 1.1–1.7), obesity (aOR 1.7, 95% CI 1.4–2.1), sleep apnoea (aOR 1.7, 95% CI 1.3–2.2), chronic fatigue syndrome (aOR 1.5, 95% CI 1.2–2) and was borderline associated with fibromyalgia (aOR 1.3, 95% CI 1–1.8). Physical impairment was more common in patients with hypothyroidism. Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multiorgan sarcoidosis, fatigue and depression

Skunk River Review Fall 2001, vol 13

https://openspace.dmacc.edu/skunkriver/1022/thumbnail.jp

Exploring an Africentric High School Cohort from the Parents’ Perspectives

In Canada, the Black population is the third-largest racially visible group, yet students of African descent continue to face inequities in Canadian school systems. Students of African descent can benefit from learning from an Africentric perspective that cultivates their well-being and achievement while centring their lived experience as a person of African descent. As research demonstrates the significance of parental involvement in Africentric education, the purpose of this study was to explore an Africentric High School Cohort from the perspective of parents of the students of African descent in this Cohort. Based on the conceptual framework of Nguzo Saba, the theoretical framework of Africentric education, and critical race theory, a thematic analysis of the findings was conducted. The findings are discussed under the themes of parental engagement, positive youth development, and addressing challenges. Recommendations are suggested for future Africentric cohorts.Au Canada, la population noire constitue le troisième groupe de minorités visibles. Cependant, les étudiants d’ascendance africaine continuent de faire face à des inégalités dans le système scolaire canadien. Les étudiants d’ascendance africaine peuvent tirer profit d’un apprentissage fondé sur une perspective africaine qui favorise leur bien-être et leur réussite tout en mettant l’accent sur leur expérience vécue en tant qu’individu d’ascendance africaine. La recherche ayant démontré l’importance de la participation des parents dans l’éducation afrocentrique, l’objectif de cette étude est d’explorer, du point de vue de leurs parents, une cohorte d’étudiants d’une école secondaire afrocentrique. Sur la base du cadre conceptuel de Nguzo Saba, du cadre théorique de l’éducation afrocentrique et de la théorie critique de la race, une analyse thématique des résultats a été effectuée. Les thèmes suivants ont servi de base à l’analyse : l’engagement parental, le développement positif des jeunes et les défis à relever. Enfin, l’article propose quelques suggestions pour les cohortes afrocentriques futures

Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.

BackgroundHypogonadism is reported to occur in non-alcoholic fatty liver disease (NAFLD), but earlier studies used low-sensitivity diagnostic techniques (CT, ultrasound), for NAFLD diagnosis. We hypothesized that if hypogonadism was due to NAFLD, and not solely attributable to underlying obesity/diabetes, it would be more severe in the presence of steatohepatitis (NASH). To examine the influence of liver disease on testosterone in males with type 2 diabetes mellitus (T2DM), we used gold-standard liver imaging with MR-spectroscopy (1H-MRS), and performed liver biopsies to grade/stage the NAFLD.MethodsIn this cross-sectional study, we measured in 175 males with T2DM total and free testosterone, markers of insulin resistance, and intrahepatic triglyceride content (IHTG) by 1H-MRS. Those with NAFLD on imaging underwent a liver biopsy.ResultsTotal testosterone was higher in the group without NAFLD ("No-NAFLD"; n = 48) compared to isolated steatosis (IS; n = 62) or NASH (n = 65) (385 ± 116 vs. 339 ± 143 vs. 335 ± 127 ng/ml, ptrend 0.03). Testosterone was also lower in obese vs. non-obese subjects in both the No-NAFLD and IS groups (p = 0.06 and p = 0.11, respectively), but not in obese vs. non-obese patients with NASH (p = 0.81). IHTG was independently associated with total testosterone (ß = -4.8, p = 0.004). None of the liver histology characteristics were associated with lower testosterone.ConclusionsNAFLD is linked to lower total testosterone in patients with T2DM, but likely given a common soil of insulin resistance/obesity and not from the severity of liver necroinflammation or fibrosis. Nevertheless, clinicians should consider screening patients with T2DM and NAFLD for hypogonadism