Restitution for Haiti, Reparations for All: Haiti’s Place in the Global Reparations Movement

Haiti’s claim for restitution of the debt coerced by France in exchange for Haiti’s 1804 independence has unique legal advantages that can open the door to broader reparations for the descendants of all people harmed by slavery. But in order to assert the claim, Haiti first needs help reclaiming its democracy from a corrupt, repressive regime propped up by the powerful countries that prospered through slavery and overthrew the Haitian President who dared to assert his country’s legal claim. This article explores Haiti’s Independence Debt, and the fight for restitution of it, in the context of two centuries of continued struggle between Haitians asserting their independence and countries enriched by slavery trying to limit the power of Haiti’s example

A Delphi process to address medication appropriateness for older persons with multiple chronic conditions

BACKGROUND: Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens. METHODS: Modified Delphi method involving iterative rounds of input from panel members. Panelists (n = 9) represented the disciplines of nursing, medicine and pharmacy. Included among the physicians were two geriatricians, one general internist, one family practitioner, one cardiologist and two nephrologists. They participated in 3 rounds of web-based anonymous surveys. RESULTS: The panel reached consensus on a set of markers to identify problems with medication regimens, including patient/caregiver report of non-adherence, medication complexity, cognitive impairment, medications identified by expert opinion as inappropriate for older persons, excessively tight blood sugar and blood pressure control among persons with diabetes mellitus, patient/caregiver report of adverse medication effects or medications not achieving desired outcomes, and total number of medications. The panel also reached consensus on approaches to address these problems, including endorsement of strategies to discontinue medications with known benefit if necessary because of problems with feasibility or lack of alignment with patient goals. CONCLUSIONS: The results of the Delphi process provide the basis for an algorithm to improve medication regimens among older persons with MCCs. The algorithm will require assessment not only of medications and diagnoses but also cognition and social support, and it will support discontinuation of medications both when risks outweigh benefits and when regimens are not feasible or do not align with goals

Are Autistic Traits in Youth Meaningful? A Replication study in Non-referred Siblings of Youth with and without Attention-Deficit/Hyperactivity Disorder

Background: We previously described the high prevalence and burden of significant autistic traits (ATs) in youth with attention-deficit/hyperactivity disorder (ADHD). These traits are associated with significantly greater impairment in psychopathological, interpersonal, educational, and neuropsychological functioning. Because the sample consisted of referred ADHD youth, uncertainty remained regarding whether these findings are generalizable to non-referred populations of youths with and without ADHD. Objective: The aim of the current study was to assess the prevalence and implications of ATs in a non-referred population of siblings of probands with and without ADHD. Method: Participants were non-referred siblings of probands with ADHD (N = 257) and control probands (N = 234) of longitudinal, case-control family studies conducted at Massachusetts General Hospital. Assessments included measures of psychiatric, psychosocial, educational, and cognitive functioning. The presence of significant ATs was operationalized using the Child Behavior Checklist AT profile, which consists of combined aggregate T-scores of ≥ 195 on the Withdrawn, Social, and Thought Problems subscales. Results: ATs were significantly more prevalent among the siblings of probands with ADHD as compared with siblings of control probands (6% vs. 1%; P = .02). Siblings of probands with ADHD with a positive AT profile (N = 15) were significantly more impaired than those without an AT profile (N = 242) with regard to psychopathological, interpersonal, educational, and neuropsychological functioning. Conclusions: The current study reports a higher-than-expected prevalence of ATs in a non-referred sample of siblings of youth with ADHD, which is consistent with previous findings regarding ATs in a referred sample of youth with ADHD. The presence of ATs is associated with higher levels of morbidity and dysfunction

Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations

Malnutrition is a well-known complication in cystic fibrosis (CF). There is good evidence that maintaining a normal body-weight correlates well with improved survival in CF. Energy intake in excess of 120% of the estimated average requirement (EAR) has been advised since 1980s.To investigate the nutritional intake and status in the adult Scandinavian CF-population.A cross-sectional multi-centre study was used to investigate the nutritional status of 456 adult CF-patients (2003 2006). Height and weight were measured and body mass index (BMI) and z-scores were calculated. Pulmonary function was examined by dynamic spirometry. A 7-day pre-coded food record (FR) obtained energy and nutrient intake data in 180 patients.The mean energy intake was 114 (SD 30.0)% of EAR and thus significantly lower than the target of 120% EAR (p< 0.001) for patients with pancreatic insufficiency (PI) (n=136). Mean BMI was 22.0 (SD 2.9), the prevalence of BMI <18 was 13% and the prevalence of BMI ≥25 was 15% (n = 136). Mean BMI was 20.8 (SD 2.4) in PI-patients with FEV1 <70% and 23.2% (SD 3.0), in PI-patients with FEV1 ≥70%, mean difference 2.4, (95% CI: 1.5, 3.3) (p<0.001), but there was no difference in energy intake. BMI ≥18.5 and a reported energy intake <120% were revealed in 54% of the PI-patients.The energy intake did not reach the recommended 120% EAR, but the prevalence of underweight was lower than reported in other studies. The recommendation may exceed the requirement for a number of CF-patients. The nutritional status must still be closely monitored and nutritional advice and intervention should be individualised and adjusted to actual needs

Economic Value of Dengue Vaccine in Thailand

With several candidate dengue vaccines under development, this is an important time to help stakeholders (e.g., policy makers, scientists, clinicians, and manufacturers) better understand the potential economic value (cost-effectiveness) of a dengue vaccine, especially while vaccine characteristics and strategies might be readily altered. We developed a decision analytic Markov simulation model to evaluate the potential health and economic value of administering a dengue vaccine to an individual (≤ 1 year of age) in Thailand from the societal perspective. Sensitivity analyses evaluated the effects of ranging various vaccine (e.g., cost, efficacy, side effect), epidemiological (dengue risk), and disease (treatment-seeking behavior) characteristics. A ≥ 50% efficacious vaccine was highly cost-effective [< 1× per capita gross domestic product (GDP) ($4,289)] up to a total vaccination cost of$60 and cost-effective [< 3× per capita GDP ($12,868)] up to a total vaccination cost of$200. When the total vaccine series was $1.50, many scenarios were cost saving

Differential Recognition of P. falciparum VAR2CSA Domains by Naturally Acquired Antibodies in Pregnant Women from a Malaria Endemic Area

Plasmodium falciparum infected red blood cells (iRBC) express variant surface antigens (VSA) of which VAR2CSA is involved in placental sequestration and causes pregnancy-associated malaria (PAM). Primigravidae are most susceptible to PAM whereas antibodies associated with protection are often present at higher levels in multigravid women. However, HIV co-infection with malaria has been shown to alter this parity-dependent acquisition of immunity, with more severe symptoms as well as more malaria episodes in HIV positive women versus HIV negative women of a similar parity.Using VAR2CSA DBL-domains expressed on the surface of CHO-745 cells we quantified levels of DBL-domain specific IgG in sera from pregnant Malawian women by flow cytometry. Dissociations constants of DBL5epsilon specific antibodies were determined using a surface plasmon resonance technique, as an indication of antibody affinities.VAR2CSA DBL5epsilon was recognized in a gender and parity-dependent manner with anti-DBL5epsilon IgG correlating significantly with IgG levels to VSA-PAM on the iRBC surface. HIV positive women had lower levels of anti-DBL5epsilon IgG than HIV negative women of similar parity. In primigravidae, antibodies in HIV positive women also showed significantly lower affinity to VAR2CSA DBL5epsilon.Pregnant women from a malaria-endemic area had increased levels of anti-DBL5epsilon IgG by parity, indicating this domain of VAR2CSA to be a promising vaccine candidate against PAM. However, it is important to consider co-infection with HIV, as this seems to change the properties of antibody response against malaria. Understanding the characteristics of antibody response against VAR2CSA is undoubtedly imperative in order to design a functional and efficient vaccine against PAM

Developing web solutions with usability methods

Restaurangen Knäppingen – Stadsmuseets Café &amp; Kök i Norrköping var i stort behov av en marknadsförande och informativ webbsida med en administrativ del. Syftet med detta arbete var skapa en webbsida med användbarhet enligt Usability Engineerings arbetspunkter. Användbarhet innebär att ett system är ändamålsenligt, effektivt och tillfredsställande. Förutom beställarnas krav hade vi ganska stor frihet att utforma det första designförslaget. Därefter fortsatte utvecklingen av webbsidan utifrån användarnas behov och åsikter. Användarnas behov och åsikter erhölls genom upprepningar av olika användartest och utvärderingar på flera prototyper. För att komplettera användarnas utvärderingar utfördes ett antal expertutvärderingar. Efter arbetets slut kan vi konstatera utifrån resultatet att webbsidan uppfyller beställarnas krav och våra förväntningar. Genom ett resonemang har vi uppskattat om användbarhetsmålen och användarnas behov är uppfyllda.Restaurant Knäppingen – Stadsmuseets Café &amp; Kök (the City Museum restaurant) in Norrköping was in need of marketing in form of a website. The purpose of this project was to create a website according to Usability Engineering methodology. Usability involves that a system is suited to the purpose, efficient and satisfactory. Besides the requirements of the company who provided the assignment, we were given much space to create the first design of the website. The developing of the website continued on the basis of the users’ needs and opinions. The needs and opinions of the users were obtained through iterations of tests and evaluations on several prototypes. To complement the tests, several heuristics evaluations were conducted. After completion of the project we have been able to establish the fact that the website fulfills the requirements of the company and our expectations. We also discuss to what extent the usability goals and users’ needs are met

Restitution for Haiti, Reparations for All: Haiti’s Place in the Global Reparations Movement

Haiti’s claim for restitution of the debt coerced by France in exchange for Haiti’s 1804 independence has unique legal advantages that can open the door to broader reparations for the descendants of all people harmed by slavery. But in order to assert the claim, Haiti first needs help reclaiming its democracy from a corrupt, repressive regime propped up by the powerful countries that prospered through slavery and overthrew the Haitian President who dared to assert his country’s legal claim. This article explores Haiti’s Independence Debt, and the fight for restitution of it, in the context of two centuries of continued struggle between Haitians asserting their independence and countries enriched by slavery trying to limit the power of Haiti’s example