Diferencia e influencia de la fe: asistencia a los refugiados en Ghana y Kenia

Un estudio de caso de Ghana evalúa la importancia de una respuesta religiosa a los desplazamientos en África occidental, mientras que un ejemplo de Kenia pone de relieve los problemas que pueden surgir en la colaboración entre organizaciones seculares y religiosas

Racial disparity in educational punishment

There is a growing epidemic of children of color being disproportionately and inappropriately disciplined due to recommendations for exclusionary educational discipline practices such as suspension and expulsion. Throughout the literature, SES, level of ability, gender, and skin color were essential factors in evaluating students’ suspension risk. The most salient of these factors is race. Implicit bias towards darker-skinned students is the main factor for the discipline gap. This literature review explores the causes and rates that middle school and high school students of color are disproportionately recommended for suspension and expulsion and the consequences of racially discriminatory discipline practices. Exclusionary punishment criminalizes youth and leads to worse life outcomes. Expulsion and suspension lead to higher rates of youth crime in the community, and they are contributing factors to the school-to-prison pipeline. As zero-tolerance policies grow more popular for non-criminal offenses in the school setting, the circumstances around the behaviors leading to mandatory suspension and expulsion are no longer considered. Students’ involvement in the school, positive student-teacher relationships, and students’ individuation are critical protective factors in reducing racial bias in discipline. This literature synthesizes and critically analyzes the body of literature in this field. Recommendations for additional research regarding intersectionality between race and gender need to be funded, zero-tolerance policies need to be abolished and school administrators dedicated to positive student outcomes need to be hired

Deployment of Early Diagnosis and Mefloquine- Artesunate Treatment of Falciparum Malaria in Thailand: The Tak Malaria Initiative

BACKGROUND: Early diagnosis and treatment with artesunate-mefloquine combination therapy (MAS) have reduced the transmission of falciparum malaria dramatically and halted the progression of mefloquine resistance in camps for displaced persons along the Thai-Burmese border, an area of low and seasonal transmission of multidrug-resistant Plasmodium falciparum. We extended the same combination drug strategy to all other communities (estimated population 450,000) living in five border districts of Tak province in northwestern Thailand. METHODS AND FINDINGS: Existing health structures were reinforced. Village volunteers were trained to use rapid diagnostic tests and to treat positive cases with MAS. Cases of malaria, hospitalizations, and malaria-related deaths were recorded in the 6 y before, during, and after the Tak Malaria Initiative (TMI) intervention. Cross-sectional surveys were conducted before and during the TMI period. P. falciparum malaria cases fell by 34% (95% confidence interval [CI], 33.5–34.4) and hospitalisations for falciparum malaria fell by 39% (95% CI, 37.0–39.9) during the TMI period, while hospitalisations for P. vivax malaria remained constant. There were 32 deaths attributed to malaria during, and 22 after the TMI, a 51.5% (95% CI, 39.0–63.9) reduction compared to the average of the previous 3 y. Cross-sectional surveys indicated that P. vivax had become the predominant species in Thai villages, but not in populations living on the Myanmar side of the border. In the displaced persons population, where the original deployment took place 7 y before the TMI, the transmission of P. falciparum continued to be suppressed, the incidence of falciparum malaria remained low, and the in vivo efficacy of the 3-d MAS remained high. CONCLUSIONS: In the remote malarious north western border area of Thailand, the early detection of malaria by trained village volunteers, using rapid diagnostic tests and treatment with mefloquine-artesunate was feasible and reduced the morbidity and mortality of multidrug-resistant P. falciparum

DNA sequence variants in the LOXL1 gene are associated with pseudoexfoliation glaucoma in a U.S. clinic-based population with broad ethnic diversity

<p>Abstract</p> <p>Background</p> <p>Pseudoexfoliation syndrome is a major risk factor for glaucoma in many populations throughout the world. Using a U.S. clinic-based case control sample with broad ethnic diversity, we show that three common SNPs in LOXL1 previously associated with pseudoexfoliation in Nordic populations are significantly associated with pseudoexfoliation syndrome and pseudoexfoliation glaucoma.</p> <p>Methods</p> <p>Three LOXL1 SNPs were genotyped in a patient sample (206 pseudoexfoliation, 331 primary open angle glaucoma, and 88 controls) from the Glaucoma Consultation Service at the Massachusetts Eye and Ear Infirmary. The SNPs were evaluation for association with pseudeoexfoliation syndrome, pseudoexfoliation glaucoma, and primary open angle glaucoma.</p> <p>Results</p> <p>The strongest association was found for the G allele of marker rs3825942 (G153D) with a frequency of 99% in pseudoexfoliation patients (with and without glaucoma) compared with 79% in controls (p = 1.6 × 10^-15; OR = 20.93, 95%CI: 8.06, 54.39). The homozygous GG genotype is also associated with pseudoexfoliation when compared to controls (p = 1.2 × 10^-12; OR = 23.57, 95%CI: 7.95, 69.85). None of the SNPs were significantly associated with primary open angle glaucoma.</p> <p>Conclusion</p> <p>The pseudoexfoliation syndrome is a common cause of glaucoma. These results indicate that the G153D LOXL1 variant is significantly associated with an increased risk of pseudoexfoliation and pseudoexfoliation glaucoma in an ethnically diverse patient population from the Northeastern United States. Given the high prevalence of pseudooexfoliation in this geographic region, these results also indicate that the G153D LOXL1 variant is a significant risk factor for adult-onset glaucoma in this clinic based population.</p

SuRVoS: Super-Region Volume Segmentation workbench

Segmentation of biological volumes is a crucial step needed to fully analyse their scientific content. Not having access to convenient tools with which to segment or annotate the data means many biological volumes remain under-utilised. Automatic segmentation of biological volumes is still a very challenging research field, and current methods usually require a large amount of manually-produced training data to deliver a high-quality segmentation. However, the complex appearance of cellular features and the high variance from one sample to another, along with the time-consuming work of manually labelling complete volumes, makes the required training data very scarce or non-existent. Thus, fully automatic approaches are often infeasible for many practical applications. With the aim of unifying the segmentation power of automatic approaches with the user expertise and ability to manually annotate biological samples, we present a new workbench named SuRVoS (Super-Region Volume Segmentation). Within this software, a volume to be segmented is first partitioned into hierarchical segmentation layers (named Super-Regions) and is then interactively segmented with the user's knowledge input in the form of training annotations. SuRVoS first learns from and then extends user inputs to the rest of the volume, while using Super-Regions for quicker and easier segmentation than when using a voxel grid. These benefits are especially noticeable on noisy, low-dose, biological datasets

Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review

<p>Abstract</p> <p>Background</p> <p>Interest in measuring functional status among nondisabled older adults has increased in recent years. This is, in part, due to the notion that adults identified as 'high risk' for functional decline portray a state that is potentially easier to reverse than overt disability. Assessing relatively healthy older adults with traditional self-report measures (activities of daily living) has proven difficult because these instruments were initially developed for institutionalised older adults. Perhaps less evident, are problems associated with change scores and the potential for 'construct under-representation', which reflects the exclusion of important features of the construct (e.g., disability). Furthermore, establishing a formal hierarchy of functional status tells more than the typical simple summation of functional loss, and may have predictive value to the clinician monitoring older adults: if the sequence task difficulty is accelerated or out of order it may indicate the need for interventions.</p> <p>Methods</p> <p>This review identified studies that employed item response theory (IRT) to examine or revise functional status scales. IRT can be used to transform the ordinal nature of functional status scales to interval level data, which serves to increase diagnostic precision and sensitivity to clinical change. Furthermore, IRT can be used to rank items unequivocally along a hierarchy based on difficulty. It should be noted that this review is not concerned with contrasting IRT with more traditional classical test theory methodology.</p> <p>Results</p> <p>A systematic search of four databases (PubMed, Embase, CINAHL, and PsychInfo) resulted in the review of 2,192 manuscripts. Of these manuscripts, twelve met our inclusion/exclusion requirements and thus were targeted for further inspection.</p> <p>Conclusions</p> <p>Manuscripts presented in this review appear to summarise gerontology's best efforts to improve construct validity and content validity (i.e., ceiling effects) for scales measuring the early stages of activity restriction in community-dwelling older adults. Several scales in this review were exceptional at reducing ceiling effects, reducing gaps in coverage along the construct, as well as establishing a formal hierarchy of functional decline. These instrument modifications make it plausible to detect minor changes in difficulty for IADL items positioned at the edge of the disability continuum, which can be used to signal the onset of progressive type disability in older adults.</p

Photo-affinity labelling and biochemical analyses identify the target of trypanocidal simplified natural product analogues

This work was supported by the Leverhulme Trust (Grant number RL2012-025). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Current drugs to treat African sleeping sickness are inadequate and new therapies are urgently required. As part of a medicinal chemistry programme based upon the simplification of acetogenin-type ether scaffolds, we previously reported the promising trypanocidal activity of compound 1 , a bis-tetrahydropyran 1,4-triazole (B-THP-T) inhibitor. This study aims to identify the protein target(s) of this class of compound in Trypanosoma brucei to understand its mode of action and aid further structural optimisation. We used compound 3 , a diazirine- and alkyne-containing bi-functional photo-affinity probe analogue of our lead B-THP-T, compound 1 , to identify potential targets of our lead compound in the procyclic form T. brucei. Bi-functional compound 3 was UV cross-linked to its target(s) in vivo and biotin affinity or Cy5.5 reporter tags were subsequently appended by Cu(II)-catalysed azide-alkyne cycloaddition. The biotinylated protein adducts were isolated with streptavidin affinity beads and subsequent LC-MSMS identified the FoF1-ATP synthase (mitochondrial complex V) as a potential target. This target identification was confirmed using various different approaches. We show that (i) compound 1 decreases cellular ATP levels (ii) by inhibiting oxidative phosphorylation (iii) at the FoF1-ATP synthase. Furthermore, the use of GFP-PTP-tagged subunits of the FoF1-ATP synthase, shows that our compounds bind specifically to both the α- and β-subunits of the ATP synthase. The FoF1-ATP synthase is a target of our simplified acetogenin-type analogues. This mitochondrial complex is essential in both procyclic and bloodstream forms of T. brucei and its identification as our target will enable further inhibitor optimisation towards future drug discovery. Furthermore, the photo-affinity labeling technique described here can be readily applied to other drugs of unknown targets to identify their modes of action and facilitate more broadly therapeutic drug design in any pathogen or disease model.Publisher PDFPeer reviewe

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

The Inhumanity of Humanitarian Aid: Gender and Violence in a Kenyan Refugee Camp

Humanitarian action constitutes the primary response to refugee crises. Through an in-depth exploration of the lived experiences of refugee women, this dissertation seeks to illuminate the consequences of humanitarian action and challenges relevant actors to critically rethink approaches to problems facing refugees. By examining humanitarian interventions through the lens of those who are positioned as humanitarian subjects—refugees, I show how structural violence is embedded within humanitarian projects and the social fields of the refugee camp. Drawing on long-term ethnographic research in Kakuma Refugee Camp in Kenya that began in 2008, I first explore how humanitarian interventions and refugee policy shape the everyday lives of refugees. I trace the history of international refugee policy to illuminate the state of refugee law today. I discuss the history and rationale behind Kenyan refugee policy, especially encampment policies, as well as how these policies impact the political economy of Kakuma. Because world governments insist on restricting immigration of refugees and humanitarian relief budgets are limited, humanitarian commodities like aid, asylum, and resettlement are scarce resources in high demand. Aid agencies are tasked with determining who is truly ‘deserving’ of these scarce resources. This dissertation explores how the scrutiny involved in delivering humanitarian aid (particularly as it relates to resettlement—as the scarcest and most highly prized aid resource) permeates the humanitarian aid system in Kakuma. In particular, I outline how humanitarian interventions impact refugee women who have experienced sexual and gender based violence, specifically intimate partner abuse and sexual violence, in the camp. First, I discuss how the refugee resettlement process shapes women’s reactions to intimate partner abuse and influences their decisions about if, when, and how to leave an abusive partner. Their decisions are compounded by structural barriers exhibited by overburdened, highly scrutinizing, and inconsistent bureaucratic processes plagued with corruption and manipulation. I found that many refugee women who experience intimate partner abuse are forced to decide between two undesirable outcomes: to leave an abuser and prolong confinement in the camp, or to remain with an abuser in the hope of quickly being resettled to a third country. I examine the ways in which refugee women maneuver kinship relationships and navigate diverse legal systems in reaction to these constraints. I show that the refugee resettlement system binds individual refugees into case files, and in the process, subverts women’s autonomy and ignores their suffering. Within this complex bureaucratic system, women’s abuse is reinforced and their bodies are bound to spaces of violence. Next, I examine humanitarian responses to sexual violence in Kakuma, in particular the way aid and law enforcement employees’ beliefs about sexual violence influence the quality of services provided. I show that a culture of disbelief and patterns of victim-blaming give rise to techniques of scrutiny that are used to analyze claims for special protection and assistance to vulnerable groups. In the case of sexual assault claims, this process is dehumanizing and can often lead to case rejections and thus inaction. Narratives of negative interactions between victims of sexual assault and humanitarian workers are shared among refugee women and deter women from reporting abuse and seeking help from humanitarian organizations. I demonstrate how the humanitarian and legal systems in place to manage refugees can become perpetrators of a ‘second or social rape’ against refugee women. Just like women who experience IPA, women who experience sexual violence are doubly victimized, first by their abusers/assaulters, and then by a humanitarian system obsessed with determining legitimacy and deservingness. Finally, I reexamine humanitarian concepts of ‘vulnerability’, which shape aid programs and the targeted recipients. Humanitarian organizations use the term ‘particularly vulnerable persons’ to identify groups of people in need of additional or specialized assistance. Aid organizations conceptualize vulnerability as based in membership within a pre-set category, such as gender, age, ability, sexuality, ethnicity, etc. I argue for an expanded definition of vulnerability within refugee populations, i.e., vulnerability rooted in the inability to successfully obtain aid from humanitarian agencies, which I term humanitarian-driven vulnerability. Because humanitarian aid is often necessary to survive and thrive as a refugee, the inability to access and receive aid makes refugees extremely vulnerable. The humanitarian system, that itself requires vulnerable bodies to justify its existence, becomes a cause of vulnerability for those same bodies

The clash and clout of faith: refugee aid in Ghana and Kenya

A case-study from Ghana assesses the importance of a faith-based response to displacement in West Africa, while an example from Kenya highlights problems that can arise in collaborations between secular and faith-based organisations