Resettlement stressors for women of refugee background resettled in regional australia

Women of Refugee Background (WoRB) have been repeatedly identified as an extremely vulnerable population. Within an Australian context, WoRB are increasingly resettled to non-metropolitan locations, otherwise known as regional locations. Despite this, to date, no research has focused on the lived experience and challenges associated with the resettlement of WoRB to regional contexts. This study aimed to address this gap in the literature by investigating the resettlement experience of WoRB resettled in Tasmania—a state in Australia classified as a rural and regional location. Qualitative interviews were conducted with a group of 21 individuals (nine WoRB and 12 service providers). Thematic analysis identified four overarching themes—Communication Barriers and Lack of Fluency in English, Challenges Accessing Everyday Basic Needs, Loss of Connection to Culture of Origin and Inability to Access Mainstream Mental Health Services for Help. Participants also highlighted a number of unique gender-related vulnerabilities experienced during resettlement, which were exacerbated in regional locations due to health services being overstretched and under-resourced. Results of the current study are discussed in regard to policy and practical implications, taking into consideration the unique vulnerabilities experienced by WoRB, which, to date, are often overlooked.</p

The physiology of paragliding flight at moderate and extreme altitudes

This is the author accepted manuscript. The final version is available from Mary Ann Liebert via the DOI in this recordThe physiology of paragliding flight at moderate and extreme altitudes. High Alt Med Biol 00:000–000, 2017.—Paragliding is a form of free flight, with extreme-altitude paragliding being an emerging discipline. We aimed to describe the physiological demands and the impact of environmental stressors of paragliding at moderate and extreme altitudes. We recorded oxygen consumption (VO2), heart rate (HR), respiratory frequency (fR), tidal volume (VT), oxygen saturation, accelerometry (G), and altitude in 9.3 hours of flight at moderate altitudes (to 3073 m, n = 4), 19.3 hours at extreme altitude (to 7458 m, n = 2), and during high-G maneuvers (n = 2). We also analyzed HR data from an additional 17 pilots (138 hours) using the Flymaster Live database to corroborate our findings. All pilots were male. Overall energy expenditure at moderate altitude was low [1.7 (0.6) metabolic equivalents], but physiological parameters were notably higher during takeoff (p < 0.05). Pilots transiently reached ∼7 G during maneuvers. Mean HR at extreme altitude [112 (14) bpm] was elevated compared to moderate altitude [98 (15) bpm, p = 0.048]. Differences in pilots' VT and fR at moderate and extreme altitudes were not statistically significant (p = 0.96 and p = 0.058, respectively). Thus, we conclude that physical exertion in paragliding is low, suggesting that any subjective fatigue felt by pilots is likely to be cognitive or environmental. Future research should focus on reducing mental workload, enhancing cognitive function, and improving environmental protection.Equipment for the study was provided by the University of Portsmouth Department of Sports Science, the University of Exeter Link Fund Award and Research QR uplift fund. We gratefully acknowledge the assistance of Dr Juliana Pugmire (University of Glasgow) for review of the manuscript and advice regarding statistical analysis; Professor Adrian Thomas, Professor Sue Ward, Dr Pete Hodkinson, Dr Bonnie Posselt, Dr Tom Yeoman, Dr Ellie Heath; The Free Flight Physiology Project; CASE Medicine; Escape Paragliding, Ozone Chabre Open, SEARCH Projects, Flyeo, Flymaster Avionics and all the pilots who kindly volunteered to take part

Development of an evidence-based complex intervention for community rehabilitation of patients with hip fracture using realist review, survey and focus groups

Objectives To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture. Design Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys and focus groups of patients and rehabilitation teams. Setting North Wales. Participants Surveys of therapy managers (n=13), community and hospital-based physiotherapists (n=129) and occupational therapists (n=68) throughout the UK. Focus groups with patients (n=13), their carers (n=4) and members of the multidisciplinary rehabilitation teams in North Wales (n=13). Results The realist review provided understanding of how rehabilitation interventions work in the realworld context and three programme theories were developed: improving patient engagement by tailoring the intervention to individual needs; reducing fear of falling and improving self-efficacy to exercise and perform activities of daily living; and coordination of rehabilitation delivery. The survey provided context about usual rehabilitation practice; focus groups provided data on the experience, acceptability and feasibility of rehabilitation interventions. An intervention to enhance usual rehabilitation was developed to target these theory areas comprising: a physical component consisting of six additional therapy sessions; and a psychological component consisting of a workbook to enhance self-efficacy and a patient-held goal-setting diary for self-monitoring. Conclusions A realist approach may have advantages in the development of evidence-based interventions and can be used in conjunction with other established methods to contribute to the development of potentially more effective interventions. A rehabilitation intervention was developed which can be tested in a future randomised controlled trial (MRC framework phases II and III)

Systemic diffuse large B-cell lymphoma involving the central nervous system have high rates of defective antigen presentation and immune surveillance

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A Combination of Preliminary Electroweak Measurements and Constraints on the Standard Model, 1996

This note presents a combination of published and preliminary electroweak results from the four LEP collaborations and the SLD collaboration which were prepared for the 1996 summer conferences. Averages of the results concerning electroweak physics are presented. They are derived from the measurements of hadronic and leptonic cross sections, the leptonic forward-backward asymmetries, the $\tau$ polarisation asymmetries, the \bb and \cc partial widths and forward-backward asymmetries and the \qq charge asymmetry. Almost every measurement including the LEP beam energy calibration has been updated with respect to the summer 1995 conferences. The results are compared to precise electroweak measurements from other experiments. The parameters of the Standard Model are evaluated, first using the combined LEP electroweak measurements, and then using the full set of precise electroweak results

TGF-ß Sma/Mab Signaling Mutations Uncouple Reproductive Aging from Somatic Aging

Female reproductive cessation is one of the earliest age-related declines humans experience, occurring in mid-adulthood. Similarly, Caenorhabditis elegans' reproductive span is short relative to its total life span, with reproduction ceasing about a third into its 15–20 day adulthood. All of the known mutations and treatments that extend C. elegans' reproductive period also regulate longevity, suggesting that reproductive span is normally linked to life span. C. elegans has two canonical TGF-ß signaling pathways. We recently found that the TGF-ß Dauer pathway regulates longevity through the Insulin/IGF-1 Signaling (IIS) pathway; here we show that this pathway has a moderate effect on reproductive span. By contrast, TGF-ß Sma/Mab signaling mutants exhibit a substantially extended reproductive period, more than doubling reproductive span in some cases. Sma/Mab mutations extend reproductive span disproportionately to life span and act independently of known regulators of somatic aging, such as Insulin/IGF-1 Signaling and Dietary Restriction. This is the first discovery of a pathway that regulates reproductive span independently of longevity and the first identification of the TGF-ß Sma/Mab pathway as a regulator of reproductive aging. Our results suggest that longevity and reproductive span regulation can be uncoupled, although they appear to normally be linked through regulatory pathways

Evaluation of PSA and PSA Density in a Multiparametric Magnetic Resonance Imaging-Directed Diagnostic Pathway for Suspected Prostate Cancer: The INNOVATE Trial.

Objectives: To assess the clinical outcomes of mpMRI before biopsy and evaluate the space remaining for novel biomarkers. Methods: The INNOVATE study was set up to evaluate the validity of novel fluidic biomarkers in men with suspected prostate cancer who undergo pre-biopsy mpMRI. We report the characteristics of this clinical cohort, the distribution of clinical serum biomarkers, PSA and PSA density (PSAD), and compare the mpMRI Likert scoring system to the Prostate Imaging-Reporting and Data System v2.1 (PI-RADS) in men undergoing biopsy. Results: 340 men underwent mpMRI to evaluate suspected prostate cancer. 193/340 (57%) men had subsequent MRI-targeted prostate biopsy. Clinically significant prostate cancer (csigPCa), i.e., overall Gleason ≥ 3 + 4 of any length OR maximum cancer core length (MCCL) ≥4 mm of any grade including any 3 + 3, was found in 96/195 (49%) of biopsied patients. Median PSA (and PSAD) was 4.7 (0.20), 8.0 (0.17), and 9.7 (0.31) ng/mL (ng/mL/mL) in mpMRI scored Likert 3,4,5 respectively for men with csigPCa on biopsy. The space for novel biomarkers was shown to be within the group of men with mpMRI scored Likert3 (178/340) and 4 (70/350), in whom an additional of 40% (70/178) men with mpMRI-scored Likert3, and 37% (26/70) Likert4 could have been spared biopsy. PSAD is already considered clinically in this cohort to risk stratify patients for biopsy, despite this 67% (55/82) of men with mpMRI-scored Likert3, and 55% (36/65) Likert4, who underwent prostate biopsy had a PSAD below a clinical threshold of 0.15 (or 0.12 for men aged <50 years). Different thresholds of PSA and PSAD were assessed in mpMRI-scored Likert4 to predict csigPCa on biopsy, to achieve false negative levels of ≤5% the proportion of patients whom who test as above the threshold were unsuitably high at 86 and 92% of patients for PSAD and PSA respectively. When PSA was re tested in a sub cohort of men repeated PSAD showed its poor reproducibility with 43% (41/95) of patients being reclassified. After PI-RADS rescoring of the biopsied lesions, 66% (54/82) of the Likert3 lesions received a different PI-RADS score. Conclusions: The addition of simple biochemical and radiological markers (Likert and PSAD) facilitate the streamlining of the mpMRI-diagnostic pathway for suspected prostate cancer but there remains scope for improvement, in the introduction of novel biomarkers for risk assessment in Likert3 and 4 patients, future application of novel biomarkers tested in a Likert cohort would also require re-optimization around Likert3/PI-RADS2, as well as reproducibility testing