Understanding Refugees\u27 Perspectives on Health Care

Introduction. Burlington, Vermont accepts refugees from around the world. These individuals face unique barriers to accessing healthcare due to language, culture and finances. Research suggests that cultural beliefs about healthcare can affect ability or willingness to seek medical care. Gaining a better understanding of refugee perspectives of the healthcare system may offer insight into how to rectify this issue. Objectives. The goal of this study was to learn about refugee perspectives of the healthcare system and assess their use of services. Methods. We surveyed a convenience sample of 24 refugees to learn more about thoughts and practices surrounding healthcare and the use of the medical system. Results. Survey findings suggested that refugees who had been living in the US for longer than one year access healthcare resources differently from more recent arrivals. Most respondents agreed that reasons for going to a healthcare provider revolved around the diagnosis and treatment of current ailments. Regardless of time spent in the U.S., most respondents were unlikely to seek out preventive care. Refugees who had been in the U.S. longer than one year were less likely to seek out emergency services for acute symptoms that would be better served by a visit with their PCP. Conclusions. Recent arrivals used the emergency room for primary care needs more than those living in the U.S. longer than one year, suggesting the efficacy of provided health education. Study data suggests an important area for improvement may be increased education for refugees about the importance of preventive care.https://scholarworks.uvm.edu/comphp_gallery/1250/thumbnail.jp

Artificial Perches as a Technique for Enhancing Tropical Forest Restoration: A Case Study From the Dominican Republic

Recovering secondary forests on degraded agricultural lands represents a promising opportunity to offset global carbon emissions as well as increasing local biodiversity and ecosystem services. In the insular tropical forests of the Caribbean, frugivorous birds are the primary seed dispersers for most native woody plants and have a large influence on regeneration dynamics during forest succession. In 2017, we initiated an experimental forest restoration program incorporating artificial perches on private farms within the Rio Yaque del Norte watershed in La Vega province, Dominican Republic. Five restoration plots (0.15–0.25 ha) were constructed in pastures near deforested streams. In each plot, 6-12 artificial perches, each 5 m in height, were constructed from bamboo poles fitted with crossbars. We remotely monitored perch use by birds using video cameras and evaluated the effects of perches on the establishment of woody plants in seedling quadrats both below perches and in open spaces. During the summer of 2019, we conducted a behavioral experiment using audio broadcasts of bird sound to test the effect of different avian taxa and feeding guilds on attracting seed dispersers. Eleven avian species were recorded visiting perches, with the most common being Northern Mockingbird and Gray Kingbird. Broadcasting bird sounds led to a significantly greater number of avian visits to the plot. We documented 1,171 seeds from 31 distinguishable species collected from seed traps below perches during the study. Most seedling regeneration in our plots was from exotic non-bird-dispersed taxa which grew equally in perches and control quadrats. Native plant seedlings were infrequent (i.e. beneath 4 of 36 perches) but grew exclusively beneath perches. We conclude that artificial perches are an effective method for augmenting the natural seed bank but are likely to be most effective when used in tandem with planting trees that readily grow to produce shade and litter.https://digitalcommons.odu.edu/gradposters2020_sciences/1004/thumbnail.jp

Local Avian Density Influences Risk of Mortality from Window Strikes

Up to a billion birds die per year in North America as a result of striking windows. Both transparent and reflective glass panes are a cause for concern, misleading birds by either acting as invisible, impenetrable barriers to desired resources, or reflecting those resources over a large surface area. A high number of window strikes occur during migration, but little is known about the factors of susceptibility, or whether particular avian taxa are more vulnerable than others. We report on a study of window strikes and mist-netting data at the Virginia Zoological Park (Norfolk, Virginia, USA), conducted in the autumn of 2013 and 2014. We focused on three factors likely to contribute to an individual\u27s predisposition to collide with windows: (i) taxonomic classification, (ii) age, and (iii) migrant vs. resident status. Thrushes, dominated by the partial migrant American Robin (Turdus migratorius), were significantly less likely to strike glass than be sampled in mist nets (χ2 = 9.21, p = 0.002), while wood-warblers (Parulidae) were more likely to strike than expected (χ2 = 13.55, p \u3c 0.001). The proportion of juveniles striking windows (45.4%) was not significantly different (χ2 = 0.05, p = 0.827) than the population of juvenile birds naturally occurring at the zoo (48.8%). Migrants, however, were significantly more susceptible to window strikes than residents (χ2 = 6.35, p = 0.012). Our results suggest that resident birds are able to learn to avoid and thus reduce their likelihood of striking windows; this intrinsic risk factor may help explain the apparent susceptibility of certain taxa to window strikes

Histopathologic and Biochemical Responses in Arctic Marine Bivalve Molluscs Exposed to Experimentally Spilled Oil

Following two experimental spills of chemically dispersed and undispersed crude oil in shallow bays on the northwest coast of Baffin Island, Canadian Arctic, the bivalve molluscs Mya truncata and Macoma calcarea accumulated significant amounts of petroleum hydrocarbons in bays receiving dispersed oil and in those receiving crude oil alone (Boehm et all., 1987). Following the spills, Mya released accumulated hydrocarbons more rapidly than Macoma. ... The results of the biochemical analyses indicate that Mya from the four bays were not severely stressed by either dispersed oil or oil alone. Immediately after the spill, clams from the dispersal oil bays were nearly normal, while those from the bay receiving oil alone appeared stressed. These results seem to corroborate results from analytical chemistry and histopathology: that the acute effects of dispersed oil are greater than those of undispersed oil, but effects of undispersed oil on infaunal molluscs develop more slowly and persist longer than those from dispersed oil.Key words: oil spill, dispersant, Mya truncata, Macoma calcarea, histopathology, biochemistry, neoplasia, free amino acids, glycogen, parasitesMots clés: marée noire, agent de dispersion, Mya truncata, Macoma calcarea, histopathologie, biochimie, néoplasme, acides aminés libres, glycogène, parasite

Two females with mutations in USP9X highlight the variable expressivity of the intellectual disability syndrome

The genetic causes of intellectual disability (ID) are heterogeneous and include both chromosomal and monogenic etiologies. The X-chromosome is known to contain many ID-related genes and males show a marked predominance for intellectual disability. Here we report two females with syndromic intellectual disability. The first individual was relatively mild in her presentation with mild-moderate intellectual disability, hydronephrosis and altered pigmentation along the lines of Blaschko without additional congenital anomalies. A second female presented shortly after birth with dysmorphic facial features, post-axial polydactyly and, on follow-up assessment, demonstrated moderate intellectual disability. Chromosomal studies for Individual 1 identified an X-chromosome deletion due to a de novo pericentric inversion; the inversion breakpoint was associated with deletion of the 5′UTR of the USP9X, a gene which has been implicated in a syndromic intellectual disability affecting females. The second individual had a de novo frameshift mutation detected by whole-exome sequencing that was predicted to be deleterious, NM_001039590.2 (USP9X): c.4104_4105del (p.(Arg1368Serfs*2)). Haploinsufficiency of USP9X in females has been associated with ID and congenital malformations that include heart defects, scoliosis, dental abnormalities, anal atresia, polydactyly, Dandy Walker malformation and hypoplastic corpus callosum. The extent of the congenital malformations observed in Individual 1 was less striking than Individual 2 and other individuals previously reported in the literature, and suggests that USP9X mutations in females can have a wider spectrum of presentation than previously appreciated

An Ethical Framework for Global Psychiatry

Existing literature addresses the ethical considerations of global health work and how medical school curricula can help prepare students for them, but little has been written regarding an ethical approach to global psychiatry. In this paper we summarize prominent ethical issues that arise in global health psychiatry in order to provide a foundation for a framework in global health psychiatry. These issues include obtaining informed consent in the face of language barriers, diagnosing and treating for mental illnesses while navigating communities where such conditions are heavily stigmatized, and justifying the cessation of proving care to current patients for the sake of providing care to new patients abroad. To help prepare psychiatrists and students for work that engages these issues, we propose a multi-step process to assist the practicing global psychiatrist in recognizing ethical dilemmas and evaluating potential courses of action based on their respective ethical merits

White Matter Microstructure and the General Psychopathology Factor in Children

Objective: Co-occurrence of behavioral and emotional problems in childhood is widespread, and previous studies have suggested that this reflects vulnerability to experience a range of psychiatric problems, often termed a general psychopathology factor. However, the neurobiological substrate of this general factor is not well understood. We tested the hypothesis that lower overall white matter microstructure is associated with higher levels of the general psychopathology factor in children and less with specific factors. Method: Global white matter microstructure at age 10 years was related to general and specific psychopathology factors. These factors were estimated using a latent bifactor model with multiple informants and instruments between ages 6 and 10 years in 3,030 children from the population-based birth cohort Generation R. The association of global white matter microstructure and the psychopathology factors was examined with a structural equation model adjusted for sex, age at scan, age at psychopathology assessment, parental education/income, and genetic ancestry. Results: A 1-SD increase of the global white matter factor was associated with a β = −0.07SD (standard error [SE] = 0.02, p < .01) decrease in general psychopathology. In contrast, a 1-SD increase of white matter microstructure predicted an increase of β = +0.07 SD (SE = 0.03, p < .01) specific externalizing factor levels. No association was found with the specific internalizing and specific attention factor. Conclusion: The results suggest that general psychopathology in childhood is related to white matter structure across the brain and not only to specific tracts. Taking into account general psychopathology may also help reveal neurobiological mechanisms behind specific symptoms that are otherwise obscured by comorbidity

Living in rural New England amplifies the risk of depression in patients with HIV

<p>Abstract</p> <p>Background</p> <p>The importance of depression as a complication of HIV infection is increasingly understood, and people living in rural areas are at increased risk for depression. However, it is not known whether living in rural areas amplifies the risk of depression in patients with HIV.</p> <p>Methods</p> <p>We compared the prevalence of depression between rural and metropolitan HIV patients seen at the Dartmouth-Hitchcock HIV Program in a retrospective cohort study. Using the validated Rural-Urban Commuting Area Score, we categorized patients as living in small town/rural areas, micropolitan or metropolitan towns. Then, using a multivariate logistic regression model to adjust for demographic factors that differed between rural and metropolitan patients, we estimated the impact of living in rural areas on the odds of depression.</p> <p>Results</p> <p>Among 646 patients with HIV (185 small town/rural, 145 micropolitan, 316 metropolitan), rural patients were older, white, male, and men who have sex with men (ANOVA, F-statistic < 0.05). The prevalence of depression was highest in rural patients (59.5 vs. 51.7 vs. 41.2%, F statistic < 0.001), particularly rural patients on antiretroviral therapy (72.4 vs. 53.5 vs. 38.2%, F-statistic < 0.001. A multivariate logistic regression model showed that the odds of depression in rural patients with HIV were 1.34 (P < 0.001).</p> <p>Conclusion</p> <p>HIV-infected patients living in rural areas, particularly those on antiretroviral therapy, are highly vulnerable to depression.</p