Slipping Through the Cracks: Receptivity of healthcare professionals to an electronic screening tool for human trafficking

Introduction: Human trafficking is the exploitation of an individual through force or coercion, for labor or services, including commercial sex. Healthcare providers are uniquely positioned to encounter trafficked people. Prior research has found a need for increased sensitivity in identifying trafficked persons in healthcare settings, and for provider education about the issue.https://scholarworks.uvm.edu/comphp_gallery/1227/thumbnail.jp

Research on the Human Dimensions of Climate Change in Nunavut, Nunavik, and Nunatsiavut: A Literature Review and Gap Analysis

Research on the human dimensions of climate change (HDCC) in the Canadian Arctic has expanded so rapidly over the past decade that we do not have a clear grasp of the current state of knowledge or research gaps. This lack of clarity has implications for duplication of climate policy and research, and it has been identified as a problem by communities, scientists, policy makers, and northern organizations. Our review of current knowledge about the HDCC in Nunavut, Nunavik, and Nunatsiavut indicates that the effects of climate change on subsistence harvesting and other land-based activities and the determinants of vulnerability and adaptation to such changes are well understood. However, the effects of climate change on health are less known. In the nascent research on this topic, studies on food security and personal safety dominate, and little peer-reviewed scholarship focuses on the business and economic sector. Published research shows a strong bias toward case studies in smaller communities, especially communities in Nunavut. Such studies have focused primarily on negative impacts of climate change, present-day vulnerabilities, and adaptive capacity, but studies proposing opportunities for adaptation intervention are beginning to emerge. While documenting the serious risks posed by climate change, they also highlight the adaptability of northern populations and the effects of economic-political stresses on vulnerability to changing climate. We note the absence of studies that examine how Northerners can benefit from new opportunities that may arise from climate change, or assess how the interaction of future climatic and socio-economic changes (specifically, resource development and enhanced shipping) will affect their experience of and response to climate change, or discuss the broader determinants of vulnerability and adaptation.L’étude des dimensions humaines du changement climatique (DHCC) dans l’Arctique canadien a pris de l’ampleur ces dix dernières années au point où nous n’avons pas une idée claire de l’état actuel des connaissances ou des lacunes en matière de recherche. Cette absence de précision a des incidences sur le plan du dédoublement des politiques et des études sur le climat, ce qui est considéré comme problématique par les collectivités, les scientifiques, les décisionnaires et les organi­sations se trouvant dans le Nord. Nous avons passé en revue les connaissances actuelles en matière de DHCC au Nunavut, au Nunavik et au Nunatsiavut, ce qui nous a permis de constater que les effets du changement climatique sur les récoltes de subsistance et sur d’autres activités rattachées aux ressources naturelles sont bien compris, tout comme le sont les déterminants de la vulnérabilité et de l’adaptation à ces changements. Cela dit, les effets du changement climatique sur la santé sont moins bien connus. Dans le cadre des recherches à l’état naissant à ce sujet, les études portant sur l’innocuité alimentaire et la sécurité personnelle dominent, et peu d’études évaluées par les pairs sont axées sur le secteur commercial et économique. Les travaux de recherche dont les résultats ont été publiés indiquent un fort penchant pour des études de cas visant de plus petites collectivités, surtout les collectivités du Nunavut. Ces études portent principalement sur les incidences négatives du changement climatique, sur les vulnérabilités actuelles et sur la capacité d’adaptation, quoi que des études proposant des possibilités d’intervention adaptative commencent à faire surface. Bien que des études se trouvent à documenter les risques sérieux que pose le changement climatique, elles font également ressortir l’adaptabilité des populations nordiques et les effets des stress politiques et économiques sur la vulnérabilité au climat changeant. Nous avons aussi remarqué l’absence d’études qui examinent comment les gens du Nord peuvent bénéficier des retombées du changement climatique, d’études qui évaluent comment l’interaction des changements climatiques et socioéconomiques futurs (plus précisément en ce qui a trait à la mise en valeur des ressources et à l’amélioration des voies d’expédition) toucheront leur expérience du changement climatique et leur réaction à celui-ci, ou d’études qui discutent des plus grands déterminants de la vulnérabilité et de l’adaptation

HRC-I/Chandra X-ray observations towards sigma Orionis

Aims: We investigated the X-ray emission from young stars and brown dwarfs in the sigma Orionis cluster (tau~3 Ma, d~385 pc) and its relation to mass, presence of circumstellar discs, and separation to the cluster centre by taking advantage of the superb spatial resolution of the Chandra X-ray Observatory. Methods: We used public HRC-I/Chandra data from a 97.6 ks pointing towards the cluster centre and complemented them with X-ray data from IPC/Einstein, HRI/ROSAT, EPIC/XMM-Newton, and ACIS-S/Chandra together with optical and infrared photometry and spectroscopy from the literature and public catalogues. On our HRC-I/Chandra data, we measured count rates, estimated X-ray fluxes, and searched for short-term variability. We also looked for long-term variability by comparing with previous X-ray observations. Results: Among the 107 detected X-ray sources, there were 70 cluster stars with known signposts of youth, two young brown dwarfs, 12 cluster member candidates, four field dwarfs, and two galaxies with optical-infrared counterpart. The remaining sources had extragalactic nature. Based on a robust Poisson-chi^2 analysis, nine cluster stars displayed flares or rotational modulation during the HRC-I observations, while other eight stars and one brown dwarf showed long-term X-ray flux variations. We constructed a cluster X-ray luminosity function from O9.5 (~18 Msol) to M6.5 (~0.06 Msol). We found: a tendency of early-type stars in multiple systems or with spectroscopic peculiarities to display X-ray emission, that the two detected brown dwarfs and the least-massive star are among the sigma Orionis objects with the highest L_X/L_J ratios, and that a large fraction of known classical T Tauri stars in the cluster are absent in this and other X-ray surveys. We concluded that dozens X-ray sigma Orionis stars and brown dwarfs are still to be detected [abridged].Comment: A&A, in pres

Routine HIV Testing in Botswana: A Population-Based Study on Attitudes, Practices, and Human Rights Concerns

BACKGROUND: The Botswana government recently implemented a policy of routine or “opt-out” HIV testing in response to the high prevalence of HIV infection, estimated at 37% of adults. METHODS AND FINDINGS: We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana to assess knowledge of and attitudes toward routine testing, correlates of HIV testing, and barriers and facilitators to testing, 11 months after the introduction of this policy. Most participants (81%) reported being extremely or very much in favor of routine testing. The majority believed that this policy would decrease barriers to testing (89%), HIV-related stigma (60%), and violence toward women (55%), and would increase access to antiretroviral treatment (93%). At the same time, 43% of participants believed that routine testing would lead people to avoid going to the doctor for fear of testing, and 14% believed that this policy could increase gender-based violence related to testing. The prevalence of self-reported HIV testing was 48%. Adjusted correlates of testing included female gender (AOR = 1.5, 95% CI = 1.1–1.9), higher education (AOR = 2.0, 95% CI = 1.5–2.7), more frequent healthcare visits (AOR = 1.9, 95% CI = 1.3–2.7), perceived access to HIV testing (AOR = 1.6, 95% CI = 1.1–2.5), and inconsistent condom use (AOR = 1.6, 95% CI = 1.2–2.1). Individuals with stigmatizing attitudes toward people living with HIV and AIDS were less likely to have been tested for HIV/AIDS (AOR = 0.7, 95% CI = 0.5–0.9) or to have heard of routine testing (AOR = 0.59, 95% CI = 0.45–0.76). While experiences with voluntary and routine testing overall were positive, 68% felt that they could not refuse the HIV test. Key barriers to testing included fear of learning one's status (49%), lack of perceived HIV risk (43%), and fear of having to change sexual practices with a positive HIV test (33%). CONCLUSIONS: Routine testing appears to be widely supported and may reduce barriers to testing in Botswana. As routine testing is adopted elsewhere, measures should be implemented to assure true informed consent and human rights safeguards, including protection from HIV-related discrimination and protection of women against partner violence related to testing

Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference

EFSA BIOHAZ Panel (EFSA Panel on Biological Hazards), 2013. Scientific Opinion on the public health hazards to be covered by inspection of meat (bovine animals).

A risk ranking process identified Salmonella spp. and pathogenic verocytotoxin-producing Escherichia coli (VTEC) as current high-priority biological hazards for meat inspection of bovine animals. As these hazards are not detected by traditional meat inspection, a meat safety assurance system for the farm-to-chilled carcass continuum using a risk-based approach was proposed. Key elements of the system are risk-categorisation of slaughter animals for high-priority biological hazards based on improved food chain information, as well as risk-categorisation of slaughterhouses according to their capability to control those hazards. Omission of palpation and incision during post-mortem inspection for animals subjected to routine slaughter may decrease spreading and cross-contamination with the high-priority biological hazards. For chemical hazards, dioxins and dioxin-like polychlorinated biphenyls were ranked as being of high potential concern; all other substances were ranked as of medium or lower concern. Monitoring programmes for chemical hazards should be more flexible and based on the risk of occurrence, taking into account the completeness and quality of the food chain information supplied and the ranking of chemical substances, which should be regularly updated to include new hazards. Control programmes across the food chain, national residue control programmes, feed control and monitoring of environmental contaminants should be better integrated. Meat inspection is a valuable tool for surveillance and monitoring of animal health and welfare conditions. Omission of palpation and incision would reduce detection effectiveness for bovine tuberculosis and would have a negative impact on the overall surveillance system especially in officially tuberculosis free countries. The detection effectiveness for bovine cysticercosis, already low with the current meat inspection system, would result in a further decrease, if palpation and incision are removed. Extended use of food chain information could compensate for some, but not all, the information on animal health and welfare lost if only visual post-mortem inspection is applied

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)