An Institutional Examination of the Local Implementation of the DACA Program

In June 2012, President Barack Obama created the Deferred Action for Childhood Arrivals (DACA) program to offer qualified young undocumented immigrants a two-year renewable stay of deportation and the ability to apply for a work permit. DACA is a federal administrative directive, not a congressional law, and unlike the last major legalization program in 1986, no federal resources have been allocated for its implementation. The case of DACA thus raises questions about how new rights granted by executive prosecutorial discretion are actually implemented in local communities and how they are experienced by the intended beneficiaries in different localities. More specifically, how have different stakeholders, including local government officials, legal service providers, advocacy organizations, funders, consulates, and labor unions, integrated (or not) DACA into their mission, programming, and resource allocation? What collaborations have formed between these different stakeholders around the DACA program? What challenges do they face along the way and how are they addressing these challenges

How Local Stakeholders are Implementing the Deferred Action for Childhood Arrivals Program

In June 2012, President Obama instituted the Deferred Action for Childhood Arrivals program, which suspended deportations and authorized work permits for an estimated 1.76 million eligible young undocumented immigrants. As one of the most significant recent shifts in policy, this executive immigration action has been hotly contested. Conservatives decry it as presidential overreach, while immigrant advocates say it does too little to stop deportations. Broader congressional solutions have been elusive and the U.S. Supreme Court has blocked a 2014 policy that would have protected more undocumented immigrants, including the parents of U.S. citizens and legal permanent residents. As arguments over immigration reach new levels of toxicity in the 2016 elections, it is important to consider how the implementation of Deferred Action is faring. An array of stakeholders has worked hard to carry out this program, especially local governments, nonprofit service providers, unions, advocacy organizations, and foreign consulates. How have these stakeholders managed implementation and what lessons do their experiences hold for future immigration reform initiatives? We found answers by interviewing about 270 institutional informants in the San Francisco Bay Area, the Greater Houston Area, and the New York City Metro Area

Helping the Growing Ranks of Poor Immigrants Living in America’s Suburbs

Ask Americans to draw a mental map of who lives where, and they will likely say that immigrants and the poor live in large cities such as New York, Chicago, Los Angeles, and San Francisco, while middle-class whites make their homes in the surrounding suburbs. But these mental maps are often inaccurate. Today, more poor people live in suburbs than in central cities, and more than half of all metropolitan-area immigrants reside in suburbs. Immigration, job growth, and residential choices are making our nation’s suburbs more economically and culturally diverse. How are suburban leaders responding to disadvantaged immigrants in their communities? Are they doing as much to support immigrant residents as leaders in traditional gateway cities? We explored these issues by tracking flows of public money through four local governments in the San Francisco Bay Area. A key federal government initiative, the Community Development Block Grant program, allocates millions of dollars to help municipalities improve services and support for low and moderate-income residents. When Bay Area municipalities put these funds to use, do big central cities and suburbs do equally well at helping poor immigrants

Closing the open abdomen

The baseline treatment of Abdominal Compartment Syndrome is lparostomy. While this is a life saving procedure, the resulting open abdomen (OA) introduces its own challenges, mainly enteric fistula and complex ventral hernia. We propose that the incidence of these complications is proportional tothe length of time the abdomen remains open. The corollary is that OA wounds should be closed as soon as practicable. We examine the different models of abdominal wound healing, and how they can be exploited and modified to obtain early closure of the open abdomen

Funding Immigrant Organizations: Suburban Free Riding and Local Civic Presence

The authors argue that taken-for-granted notions of deservingness and legitimacy among local government officials affect funding allocations for organizations serving disadvantaged immigrants, even in politically progressive places. Analysis of Community Development Block Grant data in the San Francisco Bay Area reveals significant inequality in grants making to immigrant organizations across central cities and suburbs. With data from 142 interviews and documentary evidence, the authors elaborate how a history of continuous migration builds norms of inclusion and civic capacity for public-private partnerships. They also identify the phenomenon of “suburban free riding” to explain how and why suburban officials rely on central city resources to serve immigrants, but do not build and fund partnerships with immigrant organizations in their own jurisdictions. The analysis affirms the importance of distinguishing between types of immigrant destinations, but argues that scholars need to do so using a regional lens

Massive abdominal wall defect: an exercise in patience and preparation

Thankfully managing the patient with a large abdominal wall defect is a rare scenario for most surgeons. This type of situation may manifest as a result of trauma, infection or various other insults. We present a case of large abdominal wall tissue loss resulting from necrotising infection as a complication of Caesarean section. As this case highlights, patience and careful planning are the key ingredients to a successful outcome. Methods used to reconstruct this patient's abdominal wall combined temporary closure strategies, hernia repair methods and simple plastic surgical techniques to achieve a functional and cosmetically satisfactory result

Ultrastructural Features of Human Reissner\u27s Membrane

Ultrastructural features of human Reissner\u27 s membrane were investigated in two groups of similarly aged patients. Five patients had age-related normal hearing (ARNH) and four patients had acquired sensorineural hearing loss (SNHL) from causes other than age. The membrane consisted of a mesothelium facing the perilymph and an epithelium facing the endolymph. The two cell layers were separated by a basement membrane. The mesothelium was formed by wide spread thin cells with a smooth surface. The epithelial cells assumed two different shapes, flat and rounded. Both epithelial cell types were covered with many short microvilli. In all specimens, the rounded cells were arranged in bands, strands, whorls and clusters. The size of bands and whorls was larger in the lower half of the basal turn and decreased gradually towards the apex. Bands and whorls were both larger in specimens from patients with SNHL than in those with ARNH and expanded up to the middle turn. In patients with SNHL, some flat cells had relatively few long microvilli. The epithelium showed more pronounced cellular changes in patients with SNHL than in those with ARNH and these alterations are discussed in relation to sensorineural degeneration

Effects of acute fatigue on the volitional and magnetically-evoked electromechanical delay of the knee flexors in males and females

Neuromuscular performance capabilities, including those measured by evoked responses, may be adversely affected by fatigue; however, the capability of the neuromuscular system to initiate muscle force rapidly under these circumstances is yet to be established. Sex-differences in the acute responses of neuromuscular performance to exercise stress may be linked to evidence that females are much more vulnerable to ACL injury than males. Optimal functioning of the knee flexors is paramount to the dynamic stabilisation of the knee joint, therefore the aim of this investigation was to examine the effects of acute maximal intensity fatiguing exercise on the voluntary and magnetically-evoked electromechanical delay in the knee flexors of males and females. Knee flexor volitional and magnetically-evoked neuromuscular performance was assessed in seven male and nine females prior to and immediately after: (i) an intervention condition comprising a fatigue trial of 30-seconds maximal static exercise of the knee flexors, (ii) a control condition consisting of no exercise. The results showed that the fatigue intervention was associated with a substantive reduction in volitional peak force (PFV) that was greater in males compared to females (15.0%, 10.2%, respectively, p < 0.01) and impairment to volitional electromechanical delay (EMDV) in females exclusively (19.3%, p < 0.05). Similar improvements in magnetically-evoked electromechanical delay in males and females following fatigue (21%, p < 0.001), however, may suggest a vital facilitatory mechanism to overcome the effects of impaired voluntary capabilities, and a faster neuromuscular response that can be deployed during critical times to protect the joint system

The value of early CT in bowel obstruction

There is increasing use of CT in intestinal obstruction to delineate those patients requiring expeditious surgical intervention from those in whom conservative management is appropriate. We sought to assess the accuracy of CT in predicting those patients for whom conservative management would suffice. A mixed prospective-retrospective series had 75 patients with a clinical diagnosis of intestinal obstruction and a CT performed within 24 hours of hospital admission. Patients were excluded if there was an immediate indication for surgery eg peritoneal irritation or shock. A positive diagnosis was defined as suitability for conservative management based on CT absence of an obstructing lesion and/or progression of contrast. A negative diagnosis was defined as a high-grade obstruction, signs of strangulation or a lesion requiring operation eg volvulus or tumour. Sixty-two cases (82.7%) had a history of abdominal surgery. Forty-one (54.7%) underwent operative intervention during their index admission. Diagnostic accuracy measures for CT in predicting successful conservative management were: sensitivity 91.4%, specificity 77.5%, positive predictive value 78% and negative predictive value 91.2%. In those with prior abdominal surgery, these results were 96.7%, 71.9%, 76.3% and 95.8% respectively. CT is highly effective in detecting bowel obstruction cases that do not require operation and also in predicting those cases that actually do. These measures are slightly improved when selecting patients with previous abdominal surgery. CT scanning may therefore be incorporated into a diagnostic algorithm for acute bowel obstruction. Future studies may benefit from more standardised assessment criteria and cost-effectiveness analyses

Performance of transition metal-doped CaCO3 during cyclic CO2 capture-and-release in low-pressure H2O vapour and H2O plasma

The effects of transition metal doping of calcium carbonate on the subsequent performance of the material during CO2 release and recapture have been evaluated for calcination under low-pressure (~0.1 mbar) water vapour and water plasma conditions. The initial samples were prepared by precipitation method from analytical grade carbonate, calcium and transition metal (Fe, Co, Zn, Cu and Ni) containing precursors. The release-recapture properties of the sorbents were monitored over five cycles involving calcination at 1200 K and carbonation at 825 K. The most noteworthy effects were observed for the Zn-doped samples, which exhibited rapid CO2 recapture. Calcination in H2O plasma was tested to evaluate the potential for in-situ material processing as a means to counteract material degradation. The impact of plasma exposure during calcination on the looping performance was mixed and dependent on the specific sample composition. The performance of the Zn-doped CaCO3 was consistently improved by plasma calcination, yielding high uptake and better retention of carrying capacity over the five cycles. All samples exhibited a deterioration in carrying capacity over repeated cycles. The Zn-doped samples also performed best in this respect (least loss of carrying capacity). The beneficial effects of Zn-doping were dependent on the Zn-content of the precursor solutions used for material synthesis.</p