Urban Refugee Education: Strengthening Policies and Practices for Access, Quality, and Inclusion

The number of forcibly displaced people across the globe has increased dramatically in the past two decades, exceeding 65 million in 2016--a level not seen since the period directly following World War II. The image of refugees living together in camps is no longer the norm. Sixty percent of today’s refugees live scattered and embedded across large urban areas. The urbanization of refugees is creating new obstacles for refugee children who find it difficult or impossible to attend school, even though they are entitled by international law to do so. According to the United Nations High Commissioner for Refugees, half the world’s displaced people are children under 18. Half of refugee children are enrolled in primary school, 22 percent in secondary school and only one percent in higher education. Adding to the complications of urbanization, longer conflicts have increased the average worldwide duration of refugee status to 20 years. Millions of refugee children are spending their entire childhoods in exile without ever attending school, despite their right to obtain an education. Despite much public discussion of the global refugee crisis in wealthy, westernized nations, 86 percent of all displaced people reside in the “Global South,” in poor, developing countries, often in countries adjacent to their homelands. That is where we focused our study. This report presents findings of our survey of 190 professionals involved in the delivery of educational services to refugees in 16 countries, including an in-depth studies of refugee education in three cities--Beirut, Lebanon; Nairobi, Kenya; and Quito, Ecuador. The report includes policy recommendations based on our findings

Radial shortening following a fracture of the proximal radius: Degree of shortening and short-term outcome in 22 proximal radial fractures

Background and purpose: The Essex-Lopresti lesion is thought to be rare, with a varying degree of disruption to forearm stability probable. We describe the range of radial shortening that occurs following a fracture of the proximal radius, as well as the short-term outcome in these patients. Patients and methods Over an 18-month period, we prospectively assessed all patients with a radiographically confirmed proximal radial fracture. Patients noted to have ipsilateral wrist pain at initial presentation underwent bilateral radiography to determine whether there was disruption of the distal radio-ulnar joint suggestive of an Essex-Lopresti lesion. Outcome was assessed after a mean of 6 (1.5-12) months using clinical and radiographic results, including the Mayo elbow score (MES) and the short musculoskeletal function assessment (SMFA) questionnaire. One patient with a Mason type-I fracture was lost to follow-up after initial presentation. Results 60 patients had ipsilateral wrist pain at the initial assessment of 237 proximal radial fractures. Radial shortening of ≥ 2mm (range: 2-4mm) was seen in 22 patients (mean age 48 (19-79) years, 16 females). The most frequent mechanism of injury was a fall from standing height (10/22). 21 fractures were classified as being Mason type-I or type-II, all of which were managed nonoperatively. One Mason type-III fracture underwent acute radial head replacement. Functional outcome was assessed in 21 patients. We found an excellent or good MES in 18 of the 20 patients with a Mason type-I or type-II injury. Interpretation The incidence of the Essex-Lopresti lesion type is possibly under-reported as there is a spectrum of injuries, and subtle disruptions often go unidentified. A full assessment of all patients with a proximal radial fracture is required in order to identify these injuries, and the index of suspicion is raised as the complexity of the fracture increases.</p

Novel expression of coat proteins from thermophilic bacteriophage ΦIN93 and evaluation for assembly into virus-like particles

Virus-like particles (VLPs) have the potential to be used as display platforms to develop vaccines against infectious and non-infectious agents. However, most VLPs used as vaccine display platforms are derived from viruses that infect humans; unfortunately, most humans already have pre-existing antibodies against these platforms and thus, the immunogenicity of these vaccines may be compromised. VLP platforms derived from viruses that infect bacteria (bacteriophages), especially bacteriophages that infect bacteria, which do not colonize humans are less likely to have pre-existing antibodies against the platforms in the human population. In this study, we assessed whether two putative coat proteins (ORF13 and ORF14) derived from a thermophilic bacteriophage (ΦIN93) can be expressed and purified from a mesophilic bacterium such as E. coli. We also assessed whether expressed coat proteins can assemble to form VLPs. Truncated versions of ORF13 and ORF14 were successfully co-expressed in bacteria; the co-expressed truncated proteins formed oval structures that look like VLPs, but their sizes were less than those of an authentic ΦIN93 virus

Fetal death sex ratios: a test of the economic stress hypothesis.

The ratio of male to female live births (i.e. the sex ratio) reportedly falls when populations suffer rare and extreme ambient stressors such as the collapse of national economies. This association has been attributed to the death of male fetuses and to reduced conception of males. We assess the validity of the first of these mechanisms by testing the hypothesis that the fetal death sex ratio varies positively over time with the unemployment rate. Using the unemployment rate also allows us to determine if ambient economic stressors less extreme than collapsing national economies affect the fetal death sex ratio.We test our hypotheses by applying time-series methods to monthly counts of fetal deaths and the unemployment rate from the state of California beginning January 1989 and ending December 2001. The methods control for trends, seasonal cycles, and other forms of autocorrelation that could induce spurious associations.Results support the fetal death mechanism in that male fetal deaths increased above the values expected from female deaths and from history in months in which the unemployment rate also increased over its expected value.Our findings suggest that ambient stressors as common as increasing unemployment elevate the risk of fetal death among males. We discuss the social, economic, and health costs borne by parents and communities afflicted with these fetal deaths

Fetal death sex ratios: a test of the economic stress hypothesis

The ratio of male to female live births (i.e. the sex ratio) reportedly falls when populations suffer rare and extreme ambient stressors such as the collapse of national economies. This association has been attributed to the death of male fetuses and to reduced conception of males. We assess the validity of the first of these mechanisms by testing the hypothesis that the fetal death sex ratio varies positively over time with the unemployment rate. Using the unemployment rate also allows us to determine if ambient economic stressors less extreme than collapsing national economies affect the fetal death sex ratio.We test our hypotheses by applying time-series methods to monthly counts of fetal deaths and the unemployment rate from the state of California beginning January 1989 and ending December 2001. The methods control for trends, seasonal cycles, and other forms of autocorrelation that could induce spurious associations.Results support the fetal death mechanism in that male fetal deaths increased above the values expected from female deaths and from history in months in which the unemployment rate also increased over its expected value.Our findings suggest that ambient stressors as common as increasing unemployment elevate the risk of fetal death among males. We discuss the social, economic, and health costs borne by parents and communities afflicted with these fetal deaths

Sex ratios in California following the terrorist attacks of September 11, 2001.

Natural and man-made disasters as well as declining economies appear to coincide with reduced odds of male live births among humans (i.e. lower secondary sex ratio). This association has been attributed to excess death of males in gestation and to reduced conception of males. We attempt to empirically discriminate between these two attributions by testing the hypotheses that the attacks of September 11, 2001 were followed in California first by higher fetal death sex ratios and later by lower sex ratios among very low weight births and total live births.We apply interrupted time-series methods to the fetal death, very low birth weight, and secondary sex ratios. The methods control for trends, seasonal cycles, and other forms of autocorrelation that could induce spurious associations.Findings support the excess death explanation in that the fetal death sex ratio reached its highest level in the 6 year test period in October and November of 2001, while the very low weight birth sex ratio dropped to its lowest level in 14 years in December of 2001. The secondary sex ratio exhibited its second lowest value in 14 years in December of 2001. No support was found for the reduced conception explanation in that the sex ratio did not differ from expected values 9, 10 or 11 months after the attacks.We infer support for the excess death explanation at the expense of the reduced conception explanation. We also describe the implications of our findings for public health planning

Sex ratios in California following the terrorist attacks of September 11, 2001

Natural and man-made disasters as well as declining economies appear to coincide with reduced odds of male live births among humans (i.e. lower secondary sex ratio). This association has been attributed to excess death of males in gestation and to reduced conception of males. We attempt to empirically discriminate between these two attributions by testing the hypotheses that the attacks of September 11, 2001 were followed in California first by higher fetal death sex ratios and later by lower sex ratios among very low weight births and total live births.We apply interrupted time-series methods to the fetal death, very low birth weight, and secondary sex ratios. The methods control for trends, seasonal cycles, and other forms of autocorrelation that could induce spurious associations.Findings support the excess death explanation in that the fetal death sex ratio reached its highest level in the 6 year test period in October and November of 2001, while the very low weight birth sex ratio dropped to its lowest level in 14 years in December of 2001. The secondary sex ratio exhibited its second lowest value in 14 years in December of 2001. No support was found for the reduced conception explanation in that the sex ratio did not differ from expected values 9, 10 or 11 months after the attacks.We infer support for the excess death explanation at the expense of the reduced conception explanation. We also describe the implications of our findings for public health planning