Public Mediations of Accountability in the #MeToo Era

Tarana Burke initially launched the Me Too movement to cultivate solidarity among sexual assault survivors in 2006, and public appropriations of this effort have resulted in a kairotic moment of accountability in sexual assault cases. Particularly, the 2017 hashtag, #MeToo populates media platforms as the public invokes it to make sense of sexual assault cases, bearing witness to victim-survivors, assigning blame, or disavowing culpability. Challenging legacies of public denial, #MeToo marks a cultural shift in which victim-survivors are not only speaking out, they are also being heard and believed. I argue that accountability is rhetorically-constructed, negotiated, and imposed through public mediation, filtered through ideological structures. I read public discourses, including news coverage and documentary series, to trace the changing contours of accountability in the #MeToo era. Specifically, I look at three high-profile cases in which the alleged abusers resisted labels of monstrosity. Whereas public mediations of Harvey Weinstein’s accountability cast him as a monster, the public mediated the accountability of Brett Kavanaugh, Jeffrey Epstein, and Robert “R.” Kelly through different tropes. Instead, they were cast as innocent men of the law, embodiments of self-made masculinity, and the promise of post-racial, neoliberal America, respectively. As such, these men evaded accountability for decades. Public mediations of their accountability traded in tropological economies that mobilized white masculine lability to sustain and reinforce white masculine sovereignty, abject hegemony, and supremacy in the face of threats thereto in the #MeToo era, illustrating that white masculine hegemony, anti-victimism, and rape culture persist in the #MeToo era. Advisor: Dr. Kristen Hoer

Association of home hygienic practice and diarrhoeal presence in low-cost housing in Cape Town, South Africa

Global Health: Epidemiology and Biostatistic

UM ESTUDO SOBRE A RELAÇÃO ENTRE O PERFIL INDIVIDUAL E AS FINANÇAS PESSOAIS DOS ALUNOS DE UMA INSTITUIÇÃO DE ENSINO SUPERIOR DE SANTA CATARINA

O presente trabalho foi desenvolvido através de pesquisas com acadêmicos dos cursos de Administração e Ciências Contábeis de uma Instituição de Ensino Superior – IES de Brusque, Santa Catarina, com a intenção de avaliar o conhecimento e interesse dos mesmos em relação às finanças pessoais. Sendo este um assunto que está relacionado ao cotidiano de todas as pessoas, justifica-se sua importância. Por meio de uma pesquisa aplicada, descritiva e quantitativa, foi aplicada análise descritiva, análises de diferenças de variâncias e Análise Fatorial para analisar os dados da pesquisa. Como resultados, foram encontradas diferenças significativas entre os diferentes cursos, além do semestre em que estão matriculados para o constructo Educação Financeira. Além disso, a idade dos alunos, sua renda pessoal e a formação dos pais se mostraram relevantes ao constructo Endividamento e geraram resultados significativamente diferentes entre si. Por fim, o gênero dos entrevistados, demonstrou ser relevante no que diz respeito às aplicações financeiras

Bone loss and aggravated autoimmune arthritis in HLA-DRβ1-bearing humanized mice following oral challenge with Porphyromonas gingivalis

BACKGROUND: The linkage between periodontal disease and rheumatoid arthritis is well established. Commonalities among the two are that both are chronic inflammatory diseases characterized by bone loss, an association with the shared epitope susceptibility allele, and anti-citrullinated protein antibodies. METHODS: To explore immune mechanisms that may connect the two seemingly disparate disorders, we measured host immune responses including T-cell phenotype and anti-citrullinated protein antibody production in human leukocyte antigen (HLA)-DR1 humanized C57BL/6 mice following exposure to the Gram-negative anaerobic periodontal disease pathogen Porphyromonas gingivalis. We measured autoimmune arthritis disease expression in mice exposed to P. gingivalis, and also in arthritis-resistant mice by flow cytometry and multiplex cytokine-linked and enzyme-linked immunosorbent assays. We also measured femoral bone density by microcomputed tomography and systemic cytokine production. RESULTS: Exposure of the gingiva of DR1 mice to P. gingivalis results in a transient increase in the percentage of Th17 cells, both in peripheral blood and cervical lymph nodes, a burst of systemic cytokine activity, a loss in femoral bone density, and the generation of anti-citrullinated protein antibodies. Importantly, these antibodies are not produced in response to P. gingivalis treatment of wild-type C57BL/6 mice, and P. gingivalis exposure triggered expression of arthritis in arthritis-resistant mice. CONCLUSIONS: Exposure of gingival tissues to P. gingivalis has systemic effects that can result in disease pathology in tissues that are spatially removed from the initial site of infection, providing evidence for systemic effects of this periodontal pathogen. The elicitation of anti-citrullinated protein antibodies in an HLA-DR1-restricted fashion by mice exposed to P. gingivalis provides support for the role of the shared epitope in both periodontal disease and rheumatoid arthritis. The ability of P. gingivalis to induce disease expression in arthritis-resistant mice provides support for the idea that periodontal infection may be able to trigger autoimmunity if other disease-eliciting factors are already present

A Combined Field and Numerical Approach to Understanding Dilute Pyroclastic Density Current Dynamics and Hazard Potential: Auckland Volcanic Field, New Zealand

The most dangerous and deadly hazards associated with phreatomagmatic eruption in the Auckland Volcanic Field (AVF; Auckland, New Zealand) are those related to volcanic base surges - dilute, ground-hugging, particle laden currents with dynamic pressures capable of severe to complete structural damage. We use the well-exposed base surge deposits of the Maungataketake tuff ring, (Manukau coast, Auckland) to reconstruct flow dynamics and destructive potential of base surges produced during the eruption. The initial base surge(s) snapped trees up to 0.5 m in diameter near their base as far as 0.7-0.9 km from the vent. Beyond this distance the trees were encapsulated and buried by the surge in growth position. Using the tree diameter and yield strength of the wood we calculate that dynamic pressures (Pdyn) in excess of 12–35 kPa are necessary to cause the observed damage. Next we develop a quantitative model for flow of and sedimentation from a radiallyspreading, dilute pyroclastic density currents (PDCs) to determine the damage potential of the base surges produced during the early phases of the eruption and explore the implications of this potential on future eruptions in the region. We find that initial conditions with velocities on the order of 65 m s- 1, bulk density of 38 kg m-3 and initial, near-vent current thicknesses of 60 m reproduce the fieldbased Pdyn estimates and runout distances. A sensitivity analysis revealed that lower initial bulk densities result in shorter run-out distances, more rapid deceleration of the current and lower dynamic pressures. Initial velocity does not have a strong influence on run-out distance, although higher initial velocity and slope slightly decrease runout distance due to higher rates of atmospheric entrainment. Using this model we determine that for base surges with runout distances of up to 4 km, complete destruction can be expected within 0.5 km from the vent, moderate destruction can be expected up to 2 km, but much less damage is expected up to the final runout distance of 4 km. For larger eruptions (base surge runout distance 4–6 km), Pdyn of \u3e 35 kPa can be expected up to 2.5 km from source, ensuring complete destruction within this area. Moderate damage to reinforced structures and damage to weaker structures can be expected up to 6 km from source. In both cases hot ash may still cause damage due to igniting flammable materials in the distal-most regions of a base surge. This work illustrates our ability to combine field observations and numerical models to explore the depositional mechanisms, macroscale current dynamics, and potential impact of dilute PDCs. Thus, this approach may serve as a tool to understand the damage potential and extent of previous and potential future eruptions in the AVF

Emergency medicine training in the Netherlands, essential changes needed

Since 2008, training for emergency physicians (EPs) in the Netherlands has been based on a national 3-year curriculum. However, it has become increasingly evident that it needs to expand beyond its initial foundations. The training period does not comply with European regulations of a minimum of 5 years. Adjusting to this European standard is a logical step. Experience with the 3-year Dutch training scheme has led to the general conclusion that this training period is too short. Recommendations for essential changes and the basis for their development are presented

From programme theory to logic models for multispecialty community providers: a realist evidence synthesis

BackgroundThe NHS policy of constructing multispecialty community providers (MCPs) rests on a complex set of assumptions about how health systems can replace hospital use with enhanced primary care for people with complex, chronic or multiple health problems, while contributing savings to health-care budgets.ObjectivesTo use policy-makers’ assumptions to elicit an initial programme theory (IPT) of how MCPs can achieve their outcomes and to compare this with published secondary evidence and revise the programme theory accordingly.DesignRealist synthesis with a three-stage method: (1) for policy documents, elicit the IPT underlying the MCP policy, (2) review and synthesise secondary evidence relevant to those assumptions and (3) compare the programme theory with the secondary evidence and, when necessary, reformulate the programme theory in a more evidence-based way.Data sourcesSystematic searches and data extraction using (1) the Health Management Information Consortium (HMIC) database for policy statements and (2) topically appropriate databases, including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Applied Social Sciences Index and Abstracts (ASSIA). A total of 1319 titles and abstracts were reviewed in two rounds and 116 were selected for full-text data extraction. We extracted data using a formal data extraction tool and synthesised them using a framework reflecting the main policy assumptions.ResultsThe IPT of MCPs contained 28 interconnected context–mechanism–outcome relationships. Few policy statements specified what contexts the policy mechanisms required. We found strong evidence supporting the IPT assumptions concerning organisational culture, interorganisational network management, multidisciplinary teams (MDTs), the uses and effects of health information technology (HIT) in MCP-like settings, planned referral networks, care planning for individual patients and the diversion of patients from inpatient to primary care. The evidence was weaker, or mixed (supporting some of the constituent assumptions but not others), concerning voluntary sector involvement, the effects of preventative care on hospital admissions and patient experience, planned referral networks and demand management systems. The evidence about the effects of referral reductions on costs was equivocal. We found no studies confirming that the development of preventative care would reduce demands on inpatient services. The IPT had overlooked certain mechanisms relevant to MCPs, mostly concerning MDTs and the uses of HITs.LimitationsThe studies reviewed were limited to Organisation for Economic Co-operation and Development countries and, because of the large amount of published material, the period 2014–16, assuming that later studies, especially systematic reviews, already include important earlier findings. No empirical studies of MCPs yet existed.ConclusionsMultidisciplinary teams are a central mechanism by which MCPs (and equivalent networks and organisations) work, provided that the teams include the relevant professions (hence, organisations) and, for care planning, individual patients. Further primary research would be required to test elements of the revised logic model, in particular about (1) how MDTs and enhanced general practice compare and interact, or can be combined, in managing referral networks and (2) under what circumstances diverting patients from in-patient to primary care reduces NHS costs and improves the quality of patient experience.Study registrationThis study is registered as PROSPERO CRD42016038900.FundingThe National Institute for Health Research (NIHR) Health Services and Delivery Research programme and supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula

Acute Downregulation but Not Genetic Ablation of Murine MCU Impairs Suppressive Capacity of Regulatory CD4 T Cells

By virtue of mitochondrial control of energy production, reactive oxygen species (ROS) generation, and maintenance of Ca2+ homeostasis, mitochondria play an essential role in modulating T cell function. The mitochondrial Ca2+ uniporter (MCU) is the pore-forming unit in the main protein complex mediating mitochondrial Ca2+ uptake. Recently, MCU has been shown to modulate Ca2+ signals at subcellular organellar interfaces, thus fine-tuning NFAT translocation and T cell activation. The mechanisms underlying this modulation and whether MCU has additional T cell subpopulationspecific effects remain elusive. However, mice with germline or tissue-specific ablation of Mcu did not show impaired T cell responses in vitro or in vivo, indicating that ‘chronic’ loss of MCU can be functionally compensated in lymphocytes. The current work aimed to specifically investigate whether and how MCU influences the suppressive potential of regulatory CD4 T cells (Treg). We show that, in contrast to genetic ablation, acute siRNA-mediated downregulation of Mcu in murine Tregs results in a significant reduction both in mitochondrial Ca2+ uptake and in the suppressive capacity of Tregs, while the ratios of Treg subpopulations and the expression of hallmark transcription factors were not affected. These findings suggest that permanent genetic inactivation of MCU may result in compensatory adaptive mechanisms, masking the effects on the suppressive capacity of Tregs

Acupuncture and reflexology for patients undergoing chemotherapy : a cohort study

Purpose: Around three quarters of individuals undergoing chemotherapy self-report multiple symptoms. There is clinical trial evidence of effectiveness for acupuncture for commonly experienced symptoms, and emerging evidence for reflexology, but little is known about the effects of these therapies on multiple symptoms when implemented in a real world setting during active chemotherapy treatment. Methods: This was a cohort study of participants receiving reflexology and/or acupuncture while attending chemotherapy. Participants received a 20 minute reflexology treatment or a 20 minute acupuncture treatment or a combination of both. Patient reported outcome measures were administered before and after the treatment using the Edmonton Symptom Assessment Scale (ESAS). Results: During the study period, 330 unique patients received a total of 809 acupuncture and/or reflexology treatments. Participants had, on average, 5.3 symptoms each which they reported as moderate to severe (≥4/10) using the ESAS at baseline. Following treatment, participants reported 3.2 symptoms as moderate to severe. The symptom change for all participant encounters receiving any therapy was statistically significant for all symptoms, and clinically significant (a reduction of more than 1) for all symptoms except financial distress, appetite, and memory. Clinically significant levels of global distress (<3) were reduced in 72% of all participants receiving either therapy. No adverse events were recorded. Conclusions: The results indicate that acupuncture and reflexology administered alongside chemotherapy may reduce patient reported symptom burden and patient global symptom related distress. Future research would include an active control group, and consider confounding factors such as chemotherapy stage and medication

Orally administered extract from \u3ci\u3ePrunella vulgaris\u3c/i\u3e attenuates spontaneous colitis in mdr1a\u3csup\u3e-/-\u3c/sup\u3e mice

AIM: To investigate the ability of a Prunella vulgaris (P. vulgaris) ethanolic extract to attenuate spontaneous typhlocolitis in mdr1a-/- mice. METHODS: Vehicle (5% ethanol) or P. vulgaris ethanolic extract (2.4 mg/d) were administered daily by oral gavage to mdr1a-/- or wild type FVBWT mice from 6 wk of age up to 20 wk of age. Clinical signs of disease were noted by monitoring weight loss. Mice experiencing weight loss in excess of 15% were removed from the study. At the time mice were removed from the study, blood and colon tissue were collected for analyses that included histological evaluation of lesions, inflammatory cytokine levels, and myeloperoxidase activity. RESULTS: Administration of P. vulgaris extracts to mdr1a-/- mice delayed onset of colitis and reduced severity of mucosal inflammation when compared to vehicle-treated mdr1a-/- mice. Oral administration of the P. vulgaris extract resulted in reduced (P \u3c 0.05) serum levels of IL-10 (4.6 ± 2 vs 19.4 ± 4), CXCL9 (1319.0 ± 277 vs 3901.0 ± 858), and TNFα (9.9 ± 3 vs 14.8 ± 1) as well as reduced gene expression by more than two-fold for Ccl2, Ccl20, Cxcl1, Cxcl9, IL-1 α, Mmp10, VCAM-1, ICAM, IL-2, and TNFα in the colonic mucosa of mdr1a-/- mice compared to vehicle-treated mdr1a-/- mice. Histologically, several microscopic parameters were reduced (P \u3c 0.05) in P. vulgaris -treated mdr1a-/- mice, as was myeloperoxidase activity in the colon (2.49 ± 0.16 vs 3.36 ± 0.06, P \u3c 0.05). The numbers of CD4+ T cells (2031.9 ± 412.1 vs 5054.5 ± 809.5) and germinal center B cells (2749.6 ± 473.7 vs 4934.0 ± 645.9) observed in the cecal tonsils of P. vulgaris - treated mdr1a-/- were significantly reduced (P \u3c 0.05) from vehicle-treated mdr1a-/- mice. Vehicle-treated mdr1a-/- mice were found to produce serum antibodies to antigens derived from members of the intestinal microbiota, indicative of severe colitis and a loss of adaptive tolerance to the members of the microbiota. These serum antibodies were greatly reduced or absent in P. vulgaris -treated mdr1a-/- mice. CONCLUSION: The anti-inflammatory activity of P. vulgaris ethanolic extract effectively attenuated the severity of intestinal inflammation in mdr1a-/- mice