The Effects of the COVID-19 Pandemic “Crisis” on Unaccompanied Minors Navigating US Removal Proceedings

Unaccompanied minors are among the most vulnerable undocumented immigrants facing removal proceedings in US immigration court. To avoid being sent back to violence and deprivation in their home countries, unaccompanied minors may apply for asylum or deportation relief for abandoned, abused, or neglected children. The COVID-19 pandemic represented a crisis for American society that also had key impacts on immigrants’ lives and their ability to interact with state systems to apply for legal status and claim rights. This paper asks: (1) How did the COVID-19 pandemic affect unaccompanied minors’ social vulnerabilities in the US?; and (2) How did the COVID-19 pandemic impact the US immigration bureaucracy and the work of nonprofit advocates who broker unaccompanied minors’ interactions with these state systems? Findings show that the pandemic exacerbated unaccompanied minors’ social vulnerabilities, with especially adverse effects on indigenous youths, those in legal limbo, unrepresented youths, and those experiencing job loss. The pandemic also disrupted the US immigration bureaucracy and, consequently, the work of advocates who broker immigrants’ interactions with these systems, making it more difficult to interact with traumatized youths to obtain necessary information for their cases, meet strict deadlines, and identify their needs. This case study provides lessons on how states and civil society strategically manage a “crisis” and discusses the implications for immigrants’ rights and vulnerabilities

Emotion regulation strategies and psychosocial well-being in adolescence

To study whether and how emotion regulation strategies are associated with adolescents' well-being, 633 Italian adolescents completed a survey that measured, using the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003), the strategies of cognitive reappraisal (CR) and expressive suppression (ES), and their relationship with several well-being measures. Factor analysis and reliability results confirmed the validity of ERQ to assess adolescents' regulation strategies. Correlation and regression results showed that a greater reliance on CR was positively associated with better well-being outcomes for most indicators, especially Life satisfaction, Social support perception and Positive affect; greater preference for ES conversely was associated with lower well-being level for all indicators, including Psychological health, Emotional loneliness, and Negative affect. Neither gender nor age differences were observed for CR nor ES; CR and ES were positively correlated with each other. Both analysis of variance and regression results showed gender to be a significant factor for well being indicators (e.g., males' higher Positive affect and Life satisfaction than females'), whereas age was associated with differences in Psychological health only, with 16-year olds reporting the lowest health, and 14-year olds the highest. The findings overall show that adolescents' well-being is related to preferred emotion regulation strategies, mirroring associations found in the adult population. The study results also suggest the need to further explore this relationship in adolescence

Research of current postgraduate nursing training courses in ICU: a systematic review.

INTRODUCTION Critical care nurses need the ability to integrate advanced theoretical knowledge and practical skills to meet the needs of critical patient care. OBJECTIVE The study presented in this paper wants to research the postgraduate training courses for critical care nurses the techniques that improve more their knowledge and skills. METHODS The authors conducted a systematic review lasting 7 months on three different databases. A search string was placed, based on the selected PICO. A PRISMA flow chart was drawn up. The inclusion and exclusion criteria were established. Several quality assessment tools were used. Results: the search string yielded 506 articles. After the removal of duplicates, the selection with the inclusion and exclusion criteria and the qualitative evaluation; the review included 41 studies. DISCUSSION AND CONCLUSIONS The survey affirms the importance to continuously update the knowledge and skills of the staff who give assistance in high care complexity situations. A lack of uniformity in the definition of standardized training courses emerged from the study. Australian research has given the possibility to develop a tool to evaluate the expected practice level after a training program. Simulation is identified as the best teaching strategy for postgraduate courses in the critical area

Immunoscintigraphy for therapy decision making and follow-up of biological therapies

With the availability of new biological therapies there is the need of more accurate diagnostic tools to noninvasively assess the presence of their targets. In this scenario nuclear medicine offers many radiopharmaceuticals for SPECT or PET imaging of many pathological conditions. The availability of monoclonal antibodies provides tools to target specific antigens involved in angiogenesis, cell cycle or modulation of the immune systems. The radiolabelling of such therapeutic mAbs is a promising method to evaluate the antigenic status of each cancer lesion or inflamed sites before starting the therapy. It may also allow to perform follow-up of such biological therapies. In the present review we provide an overview of the most studied radiolabelled antibodies for therapy decision making and follow-up of patients affected by cancer and other pathological conditions

SUSTAINABLE CROP MANAGEMENT MODEL IN SYRIAN STRATEGIC CROPS THE EXPERIENCE OF THE COOPERATION PROJECT RATIONALIZATION OF RAS EL AIN IRRIGATION SYSTEMS

N° ISBN - 978-2-7380-1284-5International audienceThis paper reports the main results of an integrated initiative of international technical cooperation in agriculture financed by the Italian Ministry of Foreign Affairs and jointly implemented by the CIHEAM MAI Bari and the Syrian Ministries of Irrigation and of Agriculture and Agrarian Reform. The project entitled: “Rationalization of Ras El Ain Irrigation Systems” started in January 2005 and ended in March 2008. The project was aimed at addressing the problem of water resources scarcity in the project area of Ras El Ain, around the springs of Al Khabour, located in the Hassakeh province (North Mesopotamia) of the Syrian Arab Republic. During the project implementation, a real field experience was carried out involving national and international researchers, local officers and technicians, and local farmers as direct beneficiaries. An appropriate sustainable model concerning the crop management practice was elaborated to save both water resources and production inputs for cotton and wheat. In this paper the main results of this innovative cooperation approach in a multiethnic context are presented

Improving basic skills in celiac-like disease diagnosis. A case report

Background: The diagnosis of Coeliac disease (CD) requires a combination of sign/symptoms, positivity of specific antibodies and duodenal histological evidence of villous atrophy. Duodenal villous atrophy, despite representing the CD landmark, is not specific since it is found in many gastrointestinal disorders. Giardiasis is one of the most common human intestinal protozoan infestations in industrialized countries whose histological duodenal mucosa damage could mimic that of CD. The present report shows how a wise clinical and laboratory assessment led us shortly to a correct diagnosis. Case presentation: A 42-year-old outpatient woman without previous significant gastrointestinal diseases, was referred with dyspeptic symptoms, fatigue and mild diarrhea from 4 months. Her first investigations including immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (anti-tTG) and stool parasitological and cultural analysis were negative. An esophagogastroduodenoscopy (EGDS) showed no mucosal alteration. But histology demonstrated a Helicobacter Pylori (HP) pan-gastritis while duodenal mucosa showed villous atrophy consistent with a diagnosis of CD Marsh type 3b. While on gluten-free diet (GFD) the patient didn't experience any improvement of symptoms. Duodenal biopsies were then reviewed showing the presence of trophozoites of Giardia on the luminal surface of the duodenal wall and at the same time, a second stool examination revealed the presence of trophozoites and cysts of Giardia. Treated with metronidazole, 500 mg twice daily for 6 days the patient reduced diarrhea after few days. After about 2 months of GFD she was invited to discontinue it. At the same time stool examination was repeated with negative results. She subsequently performed eradication for Hp with triple therapy (Pylera®). Around 6 months later, the patient did not complain any gastrointestinal symptoms. Serological tests were normal and at a follow-up EGDS, duodenal mucosa had normal histology with normal finger-like villi and absence of Giardia trophozoites. Conclusion: This case report shows how CD diagnosis can sometimes be manifold. Intestinal villous atrophy alone may not automatically establish a diagnosis of CD. In the present case the clinical scenario could be fully explained by giardiasis. Indeed, different diagnostic tools and a multi-step approaches have been used to determine the final correct diagnosis

Study of Cardiac Features in Adults with Down Syndrome

Down Syndrome (DS) has a significant impact on the development of many tissues, most notably in the heart and in the brain. According to the clinical need to better investigate these aspects, the main aim of this study was to make an overview on the cardiac features in adult individuals with DS. The following data of 37 individuals with DS (range: 18-60 years) were collected and analysed: age, gender, height, weight, waist to height ratio (WHER), smoking history and cardiac parameters (heart rate and blood pressure), blood glucose level or glycaemia, cholesterol (total, high-density lipoprotein – HDL - and low-density lipoprotein - LDL - cholesterol) and triglycerides. In addition, their gait pattern were quantified with 3D Gait Analysis. BMI, WHER and cholesterol HDL results were above the upper limits of the recommended range in people with DS; on the contrary, blood pressure, heart rate, glycaemia, cholesterol-LDL and triglycerides were within the recommended range. Comparing males and females in the DS group, the females showed statistically different values for cholesterol-total, and triglycerides values, with lower values in comparison to males. In motor performance, people with DS presented abnormal gait patterns. Some significant correlations were found: age with LDL, WHER with weight and BMI, systolic with diastolic blood pressure, total cholesterol with LDL and triglycerides. Our results showed that adults with DS suffer from a high prevalence of physical disorders, including overweight and obesity, and abnormal cholesterol values, together with abnormal gait pattern

The management of large vessel vasculitides

Giant cell arteritis (GCA) and Takayasu arteritis (TAK) represent the most common large vessel vasculitides (LVV). An early recognition of these conditions is crucial in order to start a prompt treatment to prevent severe ischemic complications, such as irreversible visual loss in GCA and cardiovascular or cerebrovascular accidents in TAK. Isolated glucocorticoids (GCs) still remain the cornerstone of GCA therapy. However, long-term treatment with GCs is burdened by an important toxicity. Furthermore, relapses are frequent during the follow-up period and relapsing patients have to cope with a longer duration of the GC therapy and a higher cumulative GC dose. On the other hand, TAK treatment usually relies on immunosuppressors in addition to GCs from the beginning. Also, since TAK patients are in general young women with a progressive disease, it is essential to treat this vasculitis with steroidsparing drugs in order to avoid excessive GC exposure. For this reason, efforts have been made to discover new therapeutic options able to reduce the cumulative GC dose that is strictly related to GC-toxicity. In recent years, new advances in the management of LVV have become available and have changed the therapeutic approach to these diseases. The aim of this review is to report new evidence of treatment efficacy and safety in LVV

EULAR guidelines on ANCA-associated vasculitis in the real life

Anti-neutrophil cytoplasmic antibodies-associated vasculitides (AAVs) are a heterogenous group of inflammatory diseases which primarily involve small vessels and include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). They present heterogeneous clinical manifestations, while their diagnosis and management still remain a challenge for clinicians. Nowadays, the treatment is based on two different regimens: the remission-induction treatment and the remission-maintenance treatment. The therapeutic armamentarium has grown over the years, with the aim to lessen adverse effects, improve quality of life of patients and maintain the disease under control. Biological treatments are the future: they act on different pathogenic pathways and may offer in the future a personalized management approach tailored to actual clinical manifestations. The latest guidelines were published in 2015 by the European League Against Rheumatism (EULAR) and still represent the vade mecum for the management of AAVs. In this review, we will focus on the principal strategies to treatAAVs. We discuss the remission-induction therapy and the remission-maintenance therapy; we have also distinguished the management of GPA and MPA from that of EGPA, because of their different clinical picture