Letter from Lucy R. Connell to D. M. Featherston. 18 October 1900

Letter sent from New Orleans; regarding asking Featherston to let his daughter live with her mother.https://egrove.olemiss.edu/ciwar_corresp/1299/thumbnail.jp

Letter from L. R. Connell to D. M. Featherston. 14 August 189

Letter sent from New Orleans; regarding Featherston divorce. Envelope.https://egrove.olemiss.edu/ciwar_corresp/1290/thumbnail.jp

Letter from L. R. Connell to D. M. Featherston. 9 August 1899

Letter sent from New Orleans; regarding annulment of Featherston\u27s marriage. Envelope.https://egrove.olemiss.edu/ciwar_corresp/1289/thumbnail.jp

Victimes oubliées: La vie féminine sous l’occupation 14-18

La Première Guerre Mondiale marque l’apparition de la guerre totale, où l’effort de guerre nécessite la volonté de la population entière . L’ampleur de la violence touche consciemment la population civile pour la première fois ; plus de douze millions d’habitants en Belgique et dans le nord de la France, dont la majorité sont des femmes, passent quatre années de guerre en zones occupées. Pourtant, l’expérience de cette population traditionnellement non-combattante manque d’une représentation dans l’histoire de la guerre. Malgré les histoires d’atrocités qui se produisent pendant la guerre, les premiers historiens de la guerre ignorent les témoins civils. Cette méfiance de l’expérience civile est la conséquence de la propagande ainsi que des opinions rigides concernant la position de civils dans l’historiographie de la guerre. Afin de décrire la vie des femmes en zones occupées, ce mémoire utilise leurs journaux intimes écrits lors de l’occupation.The First World War is the first example of total warfare, where the war effort is both supported and endured by the entire population. Violence usually confined to the battlefield would for the first time target civilians in Belgium and northern France. Millions of civilians, predominantly women, would spend the duration of the war living under occupation; however the wartime experience of these traditional non-combatants is poorly represented in the historiography. With the exception of atrocity propaganda that originated during the war, the experience of civilians has been largely ignored by historians. The cynicism regarding occupied civilian experience is largely attributed to the entrenchment of propaganda as well as the traditional view of what constitutes a victim of war. Through the study of primary sources, most notably diaries written during the occupation, this thesis is a contribution towards determining the reality of women’s lives under occupation

Risk factors for prevalent tuberculosis in HIV-infected patients attending a fee-for-service HIV clinic in inner city Johannesburg, South Africa

A research report submitted in partial fulfillment of the requirements for the degree of Master of Science in Epidemiology and Biostatistics University of the Witwatersrand, Faculty of Health Sciences, School of Public Health May, 2014Introduction HIV-associated TB is curable with standard TB therapy and yet it is the leading cause of illness and death in patients infected with HIV. Coinfection with HIV poses considerable challenges to early diagnosis of TB in HIV-infected people and diagnostic delay and the rapidly progressive TB associated with HIV results in rapid clinical deterioration and increased mortality. There is an urgent need for research to identify risk factors for TB in HIV-infected people in order to refine diagnostic algorithms for the early and accurate diagnosis of tuberculosis in HIV-positive patients. The aim of this study was to determine the prevalence of TB, and identify factors associated with prevalent TB in HIV-infected adults paying a subsidized, all-inclusive monthly fee for HIV care in a private setting in downtown Johannesburg – a unique sub-population. Material and Methods This study was a retrospective, cross-sectional, secondary analysis of data extracted from the routine electronic medical records of HIV-infected adults who attended ZuziMpilo from August 2009 to December 2011. The outcome of interest was prevalent TB at the time of enrollment into care and exposures included age, sex, ethnicity, CD4 count, WHO Clinical Stage, BMI, alcohol and tobacco use history, level of education, employment status, monthly income, monthly cell phone expenditure, medical insurance status, source of funding for HIV care and source of knowledge about ZuziMpilo Medical Centre. Multivariable logistic regression modeling was used to determine risk factors for prevalent TB at the time of enrollment. Results Approximately 8 out of every 100 HIV-infected adults enrolling at ZuziMpilo from August 2009 to December 2011 had prevalent TB disease (8.24%). Significant predictors for prevalent TB included BMI categorised as non-obese, CD4 count <350 cells/mm3 and duration on HAART of less than six months. With respect to BMI, individuals who were not obese had greater risk of prevalent TB, the risk increasing in a dose response fashion as the BMI decreased. Compared to obese patients, overweight patients were 2.8 times as likely (aOR = 2.83, CI 1.06 – 7.52, p = 0.037), normal weight patients were more than 3.7 times more likely (aOR = 3.72, CI 1.44 – 9.60, p = 0.007) and underweight patients were more than 6.4 times more likely to have prevalent TB (aOR = 6.42, CI 2.33 – 17.70, p = 0.000). A CD4 count of < 200 cells/mm3 predicted an 11.3 times increased risk of prevalent TB relative to CD4 count greater than 350 cells/mm3 (aOR = 11.27, CI 4.84 – 26.28, p = 0.000). Patients treated with HAART for longer than 6 months were significantly less likely to have prevalent TB than HAART-naïve patients (aOR = 0.47, CI 0.23 – 0.98, p = 0.043). Conclusion and Recommendations This study corroborates the growing body of evidence that underpins several key recommendations that have the potential to reduce mortality from TB in those people infected with HIV; vigilant and regular routine TB screening in HIV-infected patients at all CD4 counts and especially in those with profound immunosuppression and in the first three to four months following HAART initiation, the urgent development and distribution of more sensitive and point of care diagnostic tests for TB in HIV-infected patients at all levels of health care (most especially primary health care facilities) and the importance of initiation of HAART before CD4 counts drop below 350 cells/mm3. This study highlights that BMI is a useful proxy marker of TB risk among HIV-positive individuals. Height and weight are easily assessed anthropomorphic measures and should be conducted routinely in all patients at regular intervals. This study has described a unique population with the capacity to pay a subsidised monthly fee for their HIV care and thus the results may not be generalisable to the large population of HIV-infected adults in South Africa, who receive free-of-charge health care in public sector facilities. However, they may certainly be generalisable to other clinics that provide services for a fee and this information may be especially important if this model is replicated and scaled up in private and semi-private facilities around the country

Vital Access: How Policymakers Can Streamline the Cancer Care Journey

Patients' odds of surviving blood cancer often hinge on their ability to access specialists who can evaluate, diagnose, and treat them with optimal treatments as quickly as possible. But too often, patients encounter roadblocks that prevent them from accessing the best care and, in some cases, benefiting from incredible advancements. Recent data reveal continued disparities in outcomes for minority populations in particular.Accessing medically necessary and high-quality blood cancer care in the United States is a process that remains overly complex and contingent on factors that are steeped in systemic, socioeconomic, and racial disparities. Numerous factors impact access, but a fragmented insurance system and similarly fragmented federal and state policies that set the rules for that insurance system are major contributors. Studies have noted the impact of narrow networks, which can restrict access to some specialty care providers such as hospitals designated as "cancer centers" or "comprehensive cancer centers" by the National Cancer Institute (NCI). Narrow networks are increasingly common in commercial insurance plans in the individual and group markets and in Medicaid-managed care organizations (MCOs). Studies have also shown that cancer patients with certain types of insurance, such as Medicaid–which covers low-income people, a disproportionate share of whom are people of color–are more likely to experience worse mortality rates. These disparities in coverage and access contribute to significant inequities by income, race, ethnicity, and other factors.In the past three-plus decades, we have seen an explosion of new therapies, including immunotherapy (such as CAR T-cell) and other personalized medicine approaches that target therapies to an individual based on a range of phenotypic and genomic factors.The policy frameworks that govern insurance have not kept pace with advances in cancer treatment, and they continue to contribute to systemic inequities that prevent access to high-quality blood cancer care. Recent efforts by federal regulators to update access-related standards still fall short of ensuring equitable access to quality blood cancer care for all. And some elements of these frameworks have remained largely unchanged for decades. Meaning consumers still struggle to navigate their options when purchasing a plan and access medically appropriate treatment when a diagnosis is received.This report offers nine recommendations in five reform pathways for state and federal policymakers to consider, as they work toward developing insurance regulations that advance a more equitable system of care–one that enables patients with blood cancer to access appropriate treatment and that maximizes the potential for long-term survival. Each of these reform pathways addresses specific deficiencies in the current insurance policy frameworks, and each is critical to pursue in order to ensure a more equitable coverage landscape for patients and familie

Mental health deserves better:resisting the dilution of specialist pre‐registration mental health nurse education in the United Kingdom

This article aims to draw attention to increasing genericism in nurse education in the United Kingdom, which sees less specialist mental health education for mental health nursing students and offers opposition to such direction. In 2018, the Nursing and Midwifery Council produced the ‘Future Nurse’ standards which directed changes to pre‐registration nurse education. This led to dissatisfaction from many mental health nurses, specifically regarding reduced mental health content for students studying mental health nursing. Concerns have been raised through public forum and evolved into a grassroots national movement ‘Mental Health Deserves Better’ (#MHDeservesBetter). This is a position paper which presents the perspective of many mental health nurse academics working at universities within the United Kingdom. Mental health nurse academics collaborated to develop ideas and articulate arguments and perspectives which present a strong position on the requirement for specialist pre‐registration mental health nurse education. The key themes explored are; a conflict of ideologies in nursing, no parity of esteem, physical health care needs to be contextualized, the unique nature of mental health nursing, ethical tensions and values conflict, implications for practice, necessary improvements overlooked and the dangers of honesty and academic ‘freedom’. The paper concludes by asserting a strong position on the need for a change of direction away from genericism and calls on mental health nurses to rise from the ashes to advocate for a quality education necessary to ensure quality care delivery. The quality of mental health care provided by mental health nurses has many influences, yet the foundation offered through pre‐registration education is one of the most valuable. If the education of mental health nurses does not attend to the distinct and unique role of the mental health nurse, standards of mental health care may diminish without assertive action from mental health nurses and allies

Rice farming systems in Southern Lao PDR: Interpreting farmers’ agricultural production decisions using Q methodology

© 2017 The agricultural sector in Lao PDR is forecast to move from subsistence rice production to a more modernized and market-oriented sector with greater focus on commercialization of agricultural production. Intensification of agricultural production in the southern and central rice growing regions of Lao PDR is problematic as dryland farmers rely on rainfall and soils are poor, yet rural households have been experiencing rapid change in their farming and livelihood systems. This paper employs Q methodology techniques to explore 35 farmers' viewpoints when contemplating their production goals and potential to adopt technologies to improve productivity. Findings describe the two emerging viewpoints among farmers as ‘labour saving productivity maximization’ and ‘traditional labour productivity using improved techniques’. The two viewpoints describe the different issues currently guiding production decisions. While the Lao Government forecasts substantial increases in rice production in the southern plains, farmers will require specialized and tailored support, accounting for their envisaged livelihood and production goals, to allow the sector transformation that many stakeholders currently envisage

Measurement of myocardial blood flow by cardiovascular magnetic resonance perfusion: comparison of distributed parameter and Fermi models with single and dual bolus

Background Mathematical modeling of cardiovascular magnetic resonance perfusion data allows absolute quantification of myocardial blood flow. Saturation of left ventricle signal during standard contrast administration can compromise the input function used when applying these models. This saturation effect is evident during application of standard Fermi models in single bolus perfusion data. Dual bolus injection protocols have been suggested to eliminate saturation but are much less practical in the clinical setting. The distributed parameter model can also be used for absolute quantification but has not been applied in patients with coronary artery disease. We assessed whether distributed parameter modeling might be less dependent on arterial input function saturation than Fermi modeling in healthy volunteers. We validated the accuracy of each model in detecting reduced myocardial blood flow in stenotic vessels versus gold-standard invasive methods. Methods Eight healthy subjects were scanned using a dual bolus cardiac perfusion protocol at 3T. We performed both single and dual bolus analysis of these data using the distributed parameter and Fermi models. For the dual bolus analysis, a scaled pre-bolus arterial input function was used. In single bolus analysis, the arterial input function was extracted from the main bolus. We also performed analysis using both models of single bolus data obtained from five patients with coronary artery disease and findings were compared against independent invasive coronary angiography and fractional flow reserve. Statistical significance was defined as two-sided P value <0.05. Results Fermi models overestimated myocardial blood flow in healthy volunteers due to arterial input function saturation in single bolus analysis compared to dual bolus analysis (P < 0.05). No difference was observed in these volunteers when applying distributed parameter-myocardial blood flow between single and dual bolus analysis. In patients, distributed parameter modeling was able to detect reduced myocardial blood flow at stress (<2.5 mL/min/mL of tissue) in all 12 stenotic vessels compared to only 9 for Fermi modeling. Conclusions Comparison of single bolus versus dual bolus values suggests that distributed parameter modeling is less dependent on arterial input function saturation than Fermi modeling. Distributed parameter modeling showed excellent accuracy in detecting reduced myocardial blood flow in all stenotic vessels