Consultants and ICT4D consultants as intermediaries and mediators in the construction of information and communication technologies for development

This article considers the role of one actor that is in the ascendancy in the development sector, namely the multinational management consulting organization. Drawing on science and technology studies concepts, we argue that such consultants are increasing and important, yet relatively invisible intermediaries and mediators in the development sphere that justify critical examination. Empirically, we draw on secondary data relating to the shape and nature of consulting in the development sector and focus speciªcally on a report by a multinational consulting organization to illustrate our argument. Our discussion argues that consultants can be treated both as intermediaries, relays in a network of development provision, and as highly political mediators that seek to expand and stabilize their position in the development network and, in so doing, actively shape what we take development to be. Overall, we suggest that understanding the ways in which such actors engage in the development sphere are important to current and future discussions and developments in information and communication technologies for development (ICT4D)

Four Corners: Reflections of Trans and Nonbinary (TNB) Communities Navigating The COVID-19 Pandemic

This report is part of a rapid response research project designed to better understand some of the experiences of trans and nonbinary (TNB) people during the COVID-19 pandemic. This preliminary report is based on our initial stages of analysis. The process of reducing abundant and dynamic narratives into a research report is difficult and always partial. We start with who we are, how we did our research, what we found, and what curiosities we have moving forward with our TNB-led health research. We honor each and every person that took the time to share their stories with us and feel deeply interconnected to each participant. There are many ways to interpret and tell these stories, and this is one of them

Four Corners: Health Research Priorities Among TNB Communities

Transgender and nonbinary (TNB) people experience striking inequities in health and healthcare. In the United States, these inequities are amplified among TNB Black, Indigenous people of color (BIPOC) and TNB people with disabilities, highlighting the need for all TNB health equity initiatives to recognize racism, ableism, and other intersecting forms of oppression. Despite a recent increase in TNB health research, there is a lack of peer-reviewed literature that considers priority issues and accountable research practices from the perspectives of TNB people, and particularly TNB BIPOC and people with disabilities.In 2018, four federally qualified health centers (FQHCs) specializing in LGBTQ care across the United States: Howard Brown Health in Chicago, Whitman-Walker Institute in the District of Columbia, Los Angeles LGBT Center in Los Angeles, and Legacy Community Health in Houston, partnered to form the Four Corners: TNB Health Research Advisory Network. Four Corners is a 16-member network consisting of one researcher, one clinician, and two TNB community members from each FQHC, all of which reside in a geographically distinct region and serve a highly diverse TNB patient panel. Four Corners envisions a world where all TNB people have access to safe, relevant, and equitable healthcare and aims to advance health research by involving TNB community members, researchers, and clinicians as equal partners in the research process.In the summer of 2019, Four Corners conducted eight focus groups, two in each city of participating sites, in order to explore health and research priorities, participants' prior experiences with research, and preferences for research dissemination. Focus groups were facilitated by two TNB project staff and included 65 participants, all of whom were at least eighteen years of age and selfidentified as transgender, nonbinary, or gender nonconforming. Participants were recruited via flyers posted at the four FQHCs and social media advertisements. Focus groups were audio recorded and transcribed

A Best Practice Guide for Community Based Participatory Research (CBPR) in Transgender and Nonbinary (TNB) Health

This guide describes best practices for community-based participatory research (CBPR) with transgender and nonbinary (TNB) communities. We hope it will be a resource for people involved or interested in TNB health research and will make CBPR approachable, actionable and compelling. We anticipate readers of this guide will hold varying identities, experiences, and expertise, including their understanding of or familiarity with research and TNB communities. It is important to explicitly recognize that there are TNB people of varying cultural/language backgrounds already doing this work and to avoid reinforcing assumptions that researchers are not TNB, Black, Indigenous, people of color (BIPOC), or TNB BIPOC. While we believe the best people to initiate and practice TNB health CBPR are TNB people, we also recognize that the majority of people involved in TNB health research are not TNB themselves. This guide is designed to offer insight to all audiences. Our goal is to provide an overview of themes we believe are important and best practices to collaboratively develop and carry-out research with TNB communities

Guía de mejores prácticas para la investigación participativa basada en la comunidad (Community-Based Participatory Research - CBPR) sobre la salud de personas transgénero y no binarias (Transgender and Nonbinary - TNB)

Esta guía describe las mejores prácticas para la investigación participativa basada en la comunidad (CBPR, por sus siglas en inglés) con comunidades transgénero y no binarias (TNB, por sus siglas en inglés). Esperamos que sea un recurso para las personas involucradas o interesadas en la investigación de la salud en la comunidad TNB y que haga que la CBPR sea accesible, factible y convincente. Anticipamos que les lectores de esta guía tendrán diferentes identidades, experiencias y conocimientos, además de comprender y estar familiarizades con las investigaciones y las comunidades TNB. Es importante reconocer explícitamente que hay personas TNB de diversos orígenes culturales/lingüísticos que ya están haciendo este trabajo y evitar reforzar suposiciones de que les investigadores no son TNB, negres, indígenas, personas racializadas (BIPOC, por sus siglas en inglés), o BICOP TNB. Aunque creemos que las mejores personas para iniciar y llevar a cabo la CBPR sobre la salud en la comunidad TNB son las personas TNB, también reconocemos que la mayoría de las personas involucradas en la investigación sobre salud en la comunidad TNB no son ellas mismas TNB. Esta guía está diseñada para ofrecer una comprensión a todo el público. Nuestra meta es proporcionar una visión general de los temas que consideramos importantes y las mejores prácticas para desarrollar y llevar a cabo la investigación en colaboración con las comunidades TN

Repeatability of Foveal Measurements Using Spectralis Optical Coherence Tomography Segmentation Software

PURPOSE: To investigate repeatability and reproducibility of thickness of eight individual retinal layers at axial and lateral foveal locations, as well as foveal width, measured from Spectralis spectral domain optical coherence tomography (SD-OCT) scans using newly available retinal layer segmentation software. METHODS: High-resolution SD-OCT scans were acquired for 40 eyes of 40 young healthy volunteers. Two scans were obtained in a single visit for each participant. Using new Spectralis segmentation software, two investigators independently obtained thickness of each of eight individual retinal layers at 0°, 2° and 5° eccentricities nasal and temporal to foveal centre, as well as foveal width measurements. Bland-Altman Coefficient of Repeatability (CoR) was calculated for inter-investigator and inter-scan agreement of all retinal measurements. Spearman's ρ indicated correlation of manually located central retinal thickness (RT0) with automated minimum foveal thickness (MFT) measurements. In addition, we investigated nasal-temporal symmetry of individual retinal layer thickness within the foveal pit. RESULTS: Inter-scan CoR values ranged from 3.1μm for axial retinal nerve fibre layer thickness to 15.0μm for the ganglion cell layer at 5° eccentricity. Mean foveal width was 2550μm ± 322μm with a CoR of 13μm for inter-investigator and 40μm for inter-scan agreement. Correlation of RT0 and MFT was very good (ρ = 0.97, P 0.05); however this symmetry could not be found at 5° eccentricity. CONCLUSIONS: We demonstrate excellent repeatability and reproducibility of each of eight individual retinal layer thickness measurements within the fovea as well as foveal width using Spectralis SD-OCT segmentation software in a young, healthy cohort. Thickness of all individual retinal layers were symmetrical at 2°, but not at 5° eccentricity away from the fovea

Triple-negative breast cancers are increased in black women regardless of age or body mass index

INTRODUCTION. We investigated clinical and pathologic features of breast cancers (BC) in an unselected series of patients diagnosed in a tertiary care hospital serving a diverse population. We focused on triple-negative (Tneg) tumours (oestrogen receptor (ER), progesterone receptor (PR) and HER2 negative), which are associated with poor prognosis. METHODS. We identified female patients with invasive BC diagnosed between 1998 and 2006, with data available on tumor grade, stage, ER, PR and HER2 status, and patient age, body mass index (BMI) and self-identified racial/ethnic group. We determined associations between patient and tumour characteristics using contingency tables and multivariate logistic regression. RESULTS. 415 cases were identified. Patients were racially and ethnically diverse (born in 44 countries, 36% white, 43% black, 10% Hispanic and 11% other). 47% were obese (BMI > 30 kg/m2). 72% of tumours were ER+ and/or PR+, 20% were Tneg and 13% were HER2+. The odds of having a Tneg tumour were 3-fold higher (95% CI 1.6, 5.5; p = 0.0001) in black compared with white women. Tneg tumours were equally common in black women diagnosed before and after age 50 (31% vs 29%; p = NS), and who were obese and non-obese (29% vs 31%; p = NS). Considering all patients, as BMI increased, the proportion of Tneg tumours decreased (p = 0.08). CONCLUSIONS. Black women of diverse background have 3-fold more Tneg tumours than non-black women, regardless of age and BMI. Other factors must determine tumour subtype. The higher prevalence of Tneg tumours in black women in all age and weight categories likely contributes to black women's unfavorable breast cancer prognosis.LaPann Fund; Research Enhancement Fun

Ophthalmology

PURPOSE: To investigate systemic and ocular determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) in the European population. DESIGN: Cross-sectional meta-analysis. PARTICIPANTS: A total of 16 084 European adults from 8 cohort studies (mean age range, 56.9+/-12.3-82.1+/-4.2 years) of the European Eye Epidemiology (E3) consortium. METHODS: We examined associations with pRNFLT measured by spectral-domain OCT in each study using multivariable linear regression and pooled results using random effects meta-analysis. MAIN OUTCOME MEASURES: Determinants of pRNFLT. RESULTS: Mean pRNFLT ranged from 86.8+/-21.4 mum in the Rotterdam Study I to 104.7+/-12.5 mum in the Rotterdam Study III. We found the following factors to be associated with reduced pRNFLT: Older age (beta = -0.38 mum/year; 95% confidence interval [CI], -0.57 to -0.18), higher intraocular pressure (IOP) (beta = -0.36 mum/mmHg; 95% CI, -0.56 to -0.15), visual impairment (beta = -5.50 mum; 95% CI, -9.37 to -1.64), and history of systemic hypertension (beta = -0.54 mum; 95% CI, -1.01 to -0.07) and stroke (beta = -1.94 mum; 95% CI, -3.17 to -0.72). A suggestive, albeit nonsignificant, association was observed for dementia (beta = -3.11 mum; 95% CI, -6.22 to 0.01). Higher pRNFLT was associated with more hyperopic spherical equivalent (beta = 1.39 mum/diopter; 95% CI, 1.19-1.59) and smoking (beta = 1.53 mum; 95% CI, 1.00-2.06 for current smokers compared with never-smokers). CONCLUSIONS: In addition to previously described determinants such as age and refraction, we found that systemic vascular and neurovascular diseases were associated with reduced pRNFLT. These may be of clinical relevance, especially in glaucoma monitoring of patients with newly occurring vascular comorbidities

Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future

Purpose Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. Design Meta-analysis of prevalence data. Participants A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. Methods AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). Main Outcome Measures Prevalence of early and late AMD, BCVA, and number of AMD cases. Results Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%–5.0%) in those aged 55–59 years to 17.6% (95%