76 research outputs found
Migration and the epidemiological transition: insights from the Agincourt sub-district of northeast South Africa
KIMBACKGROUND: Migration and urbanization are central to sustainable development and health, but data on temporal trends in defined populations are scarce. Healthy men and women migrate because opportunities for employment and betterment are not equally distributed geographically. The disruption can result in unhealthy exposures and environments and income returns for the origin household.
OBJECTIVES: The objectives of the paper are to describe the patterns, levels, and trends of temporary migration in rural northeast South Africa; the mortality trends by cause category over the period 2000-2011; and the associations between temporary migration and mortality by broad cause of death categories.
METHOD: Longitudinal, Agincourt Health and Demographic Surveillance System data are used in a continuous, survival time, competing-risk model.
FINDINGS: In rural, northeast South Africa, temporary migration, which involves migrants relocating mainly for work purposes and remaining linked to the rural household, is more important than age and sex in explaining variations in mortality, whatever the cause. In this setting, the changing relationship between temporary migration and communicable disease mortality is primarily affected by reduced exposure of the migrant to unhealthy conditions. The study suggests that the changing relationship between temporary migration and non-communicable disease mortality is mainly affected by increased livelihood benefits of longer duration migration.
CONCLUSION: Since temporary migration is not associated with communicable diseases only, public health policies should account for population mobility whatever the targeted health risk. There is a need to strengthen the rural health care system, because migrants tend to return to the rural households when they need health care
Families, children, migration and AIDS
Migration is very often a family affair, and often involves children, directly or indirectly. It may give rise to better quality of life for an entire family, or to bitter disappointment, and may also increase vulnerability to HIV and AIDS. This review, carried out for the Joint Learning Initiative on Children and AIDS, links the literature on âmigrationâ, on âHIV and AIDSâ and on âfamiliesâ. Three themes are sketched: (1) As both HIV prevalence and circular migration increase, former migrant workers affected by AIDS may return to their families for care and support, especially at the end of life, often under crisis conditions. Families thus lose promising members, as well as sources of support. However, very little is known about the children of such migrants. (2) Following patterns of migration established for far different reasons, children may have to relocate to different places, sometimes over long distances, if their AIDS-affected parents can no longer care for them. They face the same adaptation challenges as other children who move, but complicated by loss of parent(s), AIDS stigma, and often poverty. (3) The issue of migrant families living with HIV has been studied to some extent, but mainly in developed countries with a long history of migration, and with little attention paid to the children in such families. Difficulties include involuntary separation from family members, isolation and lack of support, disclosure and planning for children's care should the parent(s) die and differences in treatment access within the same family. Numerous research and policy gaps are defined regarding the three themes, and a call is made for thinking about migration, families and AIDS to go beyond description to include resilience theory, and to go beyond prevention to include care
Sporting embodiment: sports studies and the (continuing) promise of phenomenology
Whilst in recent years sports studies have addressed the calls âto bring the body back inâ to theorisations of sport and physical activity, the âpromise of phenomenologyâ remains largely under-realised with regard to sporting embodiment. Relatively few accounts are grounded in the âfleshâ of the lived sporting body, and phenomenology offers a powerful framework for such analysis. A wide-ranging, multi-stranded, and interpretatively contested perspective, phenomenology in general has been taken up and utilised in very different ways within different disciplinary fields. The purpose of this article is to consider some selected phenomenological threads, key qualities of the phenomenological method, and the potential for existentialist phenomenology in particular to contribute fresh perspectives to the sociological study of embodiment in sport and exercise. It offers one way to convey the âessencesâ, corporeal immediacy and textured sensuosity of the lived sporting body. The use of Interpretative Phenomenological Analysis (IPA) is also critically addressed.
Key words: phenomenology; existentialist phenomenology; interpretative phenomenological analysis (IPA); sporting embodiment; the lived-body; Merleau-Pont
The abolition of the General Teaching Council for England and the future of teacher discipline
With the abolition of the General Teaching Council for England in the 2011 Education Act, this article considers the future of teacher discipline in England. It provides a critique of the changes to the regulation of teacher misconduct and incompetence that draws on a Foucauldian framework, especially concerning the issue of public displays of discipline and the concomitant movement to more hidden forms. In addition, the external context of accountability that accompanies the reforms to teacher discipline are considered including the perfection of the panoptic metaphor presented by the changes to Ofsted practices such as the introduction of zero-notice inspections. The article concludes that the reforms will further move teachers from being occupational professionals to being organisational professionals marking them apart from comparable professions in medicine and law
Ultrarelativistic black hole in an external electromagnetic field and gravitational waves in the Melvin universe
We investigate the ultrarelativistic boost of a Schwarzschild black hole
immersed in an external electromagnetic field, described by an exact solution
of the Einstein-Maxwell equations found by Ernst (the ``Schwarzschild-Melvin''
metric). Following the classical method of Aichelburg and Sexl, the
gravitational field generated by a black hole moving ``with the speed of
light'' and the transformed electromagnetic field are determined. The
corresponding exact solution describes an impulsive gravitational wave
propagating in the static, cylindrically symmetric, electrovac universe of
Melvin, and for a vanishing electromagnetic field it reduces to the well known
Aichelburg-Sexl pp-wave. In the boosting process, the original Petrov type I of
the Schwarzschild-Melvin solution simplifies to the type II on the impulse, and
to the type D elsewhere. The geometry of the wave front is studied, in
particular its non-constant Gauss curvature. In addition, a more general class
of impulsive waves in the Melvin universe is constructed by means of a
six-dimensional embedding formalism adapted to the background. A coordinate
system is also presented in which all the impulsive metrics take a continuous
form. Finally, it is shown that these solutions are a limiting case of a family
of exact gravitational waves with an arbitrary profile. This family is
identified with a solution previously found by Garfinkle and Melvin. We thus
complement their analysis, in particular demonstrating that such spacetimes are
of type II and belong to the Kundt class.Comment: 11 pages, REVTeX
Grasping the phenomenology of sporting bodies
The last two decades have witnessed a vast expansion in research and writing on the sociology of the body and on issues of embodiment. Indeed, both sociology in general and the sociology of sport specifically have well heeded the long-standing and vociferous calls âto bring the body back inâ to social theory. It seems particularly curious therefore that the sociology of sport has to-date addressed this primarily at a certain abstract, theoretical level, with relatively few accounts to be found that are truly grounded in the corporeal realities of the lived sporting body; a âcarnal sociologyâ of sport, to borrow Crossleyâs (1995) expression. To portray and understand more fully this kind of embodied perspective, it is argued, demands engaging with the phenomenology of the body, and this article seeks to contribute to a small but growing literature providing this particular form of âembodiedâ analysis of the body in sport. Here we identify some useful intellectual resources for developing a phenomenology of sporting experience, specifically its sensory elements, and also subsequently examine the potential for its evocative portrayal and effective analysis via different kinds of textual forms.
Key words: phenomenology; sociology of the sporting body; embodiment; the sense
An investigation of the clinical impact and therapeutic relevance of a DNA damage immune response (DDIR) signature in patients with advanced gastroesophageal adenocarcinoma
Background: An improved understanding of which gastroesophageal adenocarcinoma (GOA) patients respond to both chemotherapy and immune checkpoint inhibitors (ICI) is needed. We investigated the predictive role and underlying biology of a 44-gene DNA damage immune response (DDIR) signature in patients with advanced GOA. Materials and methods: Transcriptional profiling was carried out on pretreatment tissue from 252 GOA patients treated with platinum-based chemotherapy (three dose levels) within the randomized phase III GO2 trial. Cross-validation was carried out in two independent GOA cohorts with transcriptional profiling, immune cell immunohistochemistry and epidermal growth factor receptor (EGFR) fluorescent in situ hybridization (FISH) (n = 430). Results: In the GO2 trial, DDIR-positive tumours had a greater radiological response (51.7% versus 28.5%, P = 0.022) and improved overall survival in a dose-dependent manner (P = 0.028). DDIR positivity was associated with a pretreatment inflamed tumour microenvironment (TME) and increased expression of biomarkers associated with ICI response such as CD274 (programmed death-ligand 1, PD-L1) and a microsatellite instability RNA signature. Consensus pathway analysis identified EGFR as a potential key determinant of the DDIR signature. EGFR amplification was associated with DDIR negativity and an immune cold TME. Conclusions: Our results indicate the importance of the GOA TME in chemotherapy response, its relationship to DNA damage repair and EGFR as a targetable driver of an immune cold TME. Chemotherapy-sensitive inflamed GOAs could benefit from ICI delivered in combination with standard chemotherapy. Combining EGFR inhibitors and ICIs warrants further investigation in patients with EGFR-amplified tumours
An investigation of the clinical impact and therapeutic relevance of a DNA damage immune response (DDIR) signature in patients with advanced gastroesophageal adenocarcinoma
BackgroundAn improved understanding of which gastroesophageal adenocarcinoma (GOA) patients respond to both chemotherapy and immune checkpoint inhibitors (ICI) is needed. We investigated the predictive role and underlying biology of a 44-gene DNA damage immune response (DDIR) signature in patients with advanced GOA.Materials and methodsTranscriptional profiling was carried out on pretreatment tissue from 252 GOA patients treated with platinum-based chemotherapy (three dose levels) within the randomized phase III GO2 trial. Cross-validation was carried out in two independent GOA cohorts with transcriptional profiling, immune cell immunohistochemistry and epidermal growth factor receptor (EGFR) fluorescent in situ hybridization (FISH) (n = 430).ResultsIn the GO2 trial, DDIR-positive tumours had a greater radiological response (51.7% versus 28.5%, P = 0.022) and improved overall survival in a dose-dependent manner (P = 0.028). DDIR positivity was associated with a pretreatment inflamed tumour microenvironment (TME) and increased expression of biomarkers associated with ICI response such as CD274 (programmed death-ligand 1, PD-L1) and a microsatellite instability RNA signature. Consensus pathway analysis identified EGFR as a potential key determinant of the DDIR signature. EGFR amplification was associated with DDIR negativity and an immune cold TME.ConclusionsOur results indicate the importance of the GOA TME in chemotherapy response, its relationship to DNA damage repair and EGFR as a targetable driver of an immune cold TME. Chemotherapy-sensitive inflamed GOAs could benefit from ICI delivered in combination with standard chemotherapy. Combining EGFR inhibitors and ICIs warrants further investigation in patients with EGFR-amplified tumours
AssemblĂŠias de peixes associados Ă s macrĂłfitas aquĂĄticas em ambientes alagĂĄveis do Pantanal de PoconĂŠ, MT, Brasil
Steroid-sparing agents in giant cell arteritis
Background:
Giant cell arteritis is the commonest form of medium-to-large vessel vasculitis, requiring long-term corticosteroid therapy. The short- and long-term side effects of corticosteroids are many, including weight gain, psychological effects, osteoporosis, cardiometabolic complications, and infections.
Materials and Methods:
Various agents used in place of or in combination with corticosteroids to reduce corticosteroid-related side effects were reviewed. However, considerable variation in practice was identified giving unclear guidance. This review included the most recent evidence on methotrexate, mycophenolate mofetil, azathioprine, cyclophosphamide, abatacept, and tocilizumab
Results and Discussion:
Also discussed are encouraging results with tocilizumab in GCA patients. Amongst the agents available for steroid-sparing effects, tocilizumab demonstrated the most robust data and is consequently recommended as the agent of choice for steroid-sparing, for remission induction, remission maintenance, and treating relapsing and refractory cases of GCA.Published versio
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