All Feathers and Attitude

This collection of essays and prose poems seeks to examine the elements of an identity: how memories, culture, work, place, family, and brain chemistry simultaneously create and undermine a sense of self. How the sense of self is not contiguous, or smooth. How hope and regret wrestle. While deeply personal, All Feathers and Attitude is not a memoir, but rather an assemblage of interpretations based on actual events. The individual pieces are gathered into sections that correlate somewhat to the themes mentioned above, but the sections are not labeled as such. The readers may draw whatever conclusions they wish regarding the sections. Things overlap

Affordable Infill

This graduate research field study delves into the design of land use and municipal policies aimed at fostering the creation of entry-level homeownership opportunities in Bellingham, Washington. Drawing upon recommendations from the Final Report of the Washington Department of Commerce Homeownership Disparities Working Group and the American Planning Association\u27s Planning for Equity Policy Guide, this study prioritizes affordable homeownership. Methodologically, it incorporates insights from a thorough literature review, an analysis of diverse case studies across North America, and guidance from the Incremental Development Alliance. Furthermore, it integrates proposed modifications to Bellingham\u27s municipal code, as advocated by the Kulshan Community Land Trust and the Whatcom Business Advisory Council in 2022. By aligning local policy recommendations with insights gleaned from case studies, the study develops a preliminary draft of proposed policy amendments, which subsequently serve as the basis for stakeholder interviews. Through ongoing engagement and dialogue with stakeholders and community allies, the study culminates in a comprehensive set of local policy adjustments aimed at bolstering the production of entry-level homeownership opportunities through urban infill development in Bellingham, Washington

Conflict of Interest in Science Communication: More than a Financial Issue Report from Esteve Foundation Discussion Group, April 2009

A systematic review and meta-analysis suggests that around 2% of scientists admit to have falsified research at least once (1). Up to 33% admit other questionable practices such as plagiarism, duplicate publication, undisclosed changes in pre-research protocols or dubious ethical behavior (1). There can be no doubt that discovered cases of research and publication misconduct represent a tip of an iceberg and many cases go unreported (2). Experienced biomedical journal editors are aware of a “rogues’ gallery” of major fraudsters, such as Schoen, Hwang, Sudbo, Poehlman, Singh, and Chandra (3-8). Much more common are the less dramatic, because more subtle but probably more dangerous, examples; these are more dangerous because they remain undiscovered so may feed into meta-analyses and guidelines. A seminar organized by the Esteve Foundation, held in Sitges in April 2009, concentrated on conflicts of interest (COI, sometimes also referred to as Competing Interests, CI), which underlie so much research and publication misconduct. All attendants of the meeting agreed that there were many sources of COI in the general process of scientific communication (Figure 1). The meeting was mainly focused on non-financial COI. Three introductory presentations highlighted some of the topics related to COI in the contemporary scientific publishing enterprise

Better reporting of interventions : template for intervention description and replication (TIDieR) checklist and guide

Peer reviewedPublisher PD

Conflict of interest in science communication: more than a financial issue. Report from Esteve Foundation discussion group, April 2009

A systematic review and meta-analysis suggests that around 2% of scientists admit to have falsified research at least once. Up to 33% admit other questionable practices such as plagiarism, duplicate publication, undisclosed changes in pre-research protocols or dubious ethical behavior. There can be no doubt that discovered cases of research and publication misconduct represent a tip of an iceberg and many cases go unreported

Cancer Incidence Among Those Initiating Insulin Therapy With Glargine Versus Human NPH Insulin

OBJECTIVE To add to the evidence on comparative long-term effects of insulin analog glargine versus human NPH insulin on the risk for cancer. RESEARCH DESIGN AND METHODS We identified cohorts of initiators of glargine and human NPH without an insulin prescription during the prior 19 months among patients covered by the Inovalon Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry) between January 2003 and December 2010. Patients were required to have a second prescription of the same insulin within 180 days and to be free of cancer. We balanced cohorts on risk factors for cancer outcomes based on comorbidities, comedication, and health care use during the prior 12 months using inverse probability of treatment weighting. Incident cancer was defined as having two claims for cancer (any cancer) or the same cancer (breast, prostate, colon) within 2 months. We estimated adjusted hazard ratios (HRs) and their 95% CI using weighted Cox models censoring for stopping, switching, or augmenting insulin treatment, end of enrollment, and mortality. RESULTS More patients initiated glargine (43,306) than NPH (9,147). Initiators of glargine (NPH) were followed for 1.2 (1.1) years and 50,548 (10,011) person-years; 993 (178) developed cancer. The overall HR was 1.12 (95% CI 0.95–1.32). Results were consistent for breast cancer, prostate cancer, and colon cancer; various durations of treatment; and sensitivity analyses. CONCLUSIONS Patients initiating insulin glargine rather than NPH do not seem to be at an increased risk for cancer. While our study contributes significantly to our evidence base for long-term effects, this evidence is very limited mainly based on actual dynamics in insulin prescribing

Values and preferences of contraceptive methods: a mixed-methods study among sex workers from diverse settings

There is limited information on contraceptive values and preferences of sex workers. We conducted a mixed-method study to explore contraceptive values and preferences among sex workers. We conducted an online survey with individuals from 38 countries (n = 239), 6 focus group discussions (FGD, n = 68) in Zimbabwe, and 12 in-depth phone interviews (IDI) across 4 world regions, in June and July of 2019. Participants were asked about awareness of contraceptives, methods they had used in the past, and the determinants of their choices. Differences between respondents from high-, low- and middle- income countries were examined. Qualitative data were analysed thematically. Survey participants reported an awareness of modern contraceptive methods. FGDs found that younger women had lower awareness. Reports of condomless sex were common and modern contraceptive use was inconsistent. Determinants of contraceptive choices differed by setting according to results of the survey, FGD, and IDI. Regardless of country income level, determinants of contraceptive choices included ease of use, ease of access to a contraceptive method, and fewer side effects. Healthcare provider attitudes, availability of methods, and clinic schedules were important considerations. Most sex workers are aware of contraceptives, but barriers include male partners/clients, side effects, and health syste

Groundwater : the world's neglected defence against climate change

Currently, millions of people across the globe don’t have safe water to drink. As climate change continues to wreak havoc, communities will see their homes and means of survival washed away, their drinking water contaminated or dry up, their crops wither and fail, their health devastated by infectious diseases, and their children forced out of school. Communities need sustainable and safe water and sanitation to have the best chance of combatting the devastating impacts of extreme weather, like heatwaves, droughts and floods. Yet one in four people across the globe do not have safely managed water in their homes. However, new analysis by the British Geological Survey (BGS) and WaterAid, reveals that many countries in Africa – including most parts of subSaharan Africa – and parts of Asia, have enough water to meet everyone’s daily needs. And this hidden resource is often right under our feet – groundwater. Groundwater – which exists almost everywhere underground, in gaps within soil, sand and rock – has the potential to save hundreds of thousands of lives and be the world’s insurance policy against climate change. It would help communities cope with slow onset climate impacts like drought and irregular rainfall, and provide broader resilience after floods by ensuring there is safe water available for all. But groundwater will only be able to lessen the impacts of climate change if it is carefully managed and if we invest in mechanisms to ensure that it gets to the people who need it most. All too often, this is not the case. In some regions, there isn’t enough investment in the services needed to find, capture, treat, manage and distribute groundwater – so it remains largely untouched. In others, we see rampant over-extraction with far too much groundwater being used, particularly by the agricultural sector. In both cases, only a limited amount of this life-saving resource gets to those who need it most. BGS and WaterAid assessed data on the amount of groundwater there is, how quickly it is replenished by rain, and how much the rocks can store. Our experts concluded that, on a national level, most countries in Africa have sufficient groundwater for people to not only survive, but to thrive. This includes countries such as Ethiopia and Madagascar, where only half the population have clean water close to home, and large parts of Mali, Niger and Nigeria. Although, on a sub-national level, there are some places where groundwater is more difficult to get to or is contaminated, our research estimated that today’s total groundwater on the continent could provide people with enough drinking water for at least five years in the event of a drought – and in some cases even decades. This calculation is based on 130 litres of domestic water use a day per capita, which would provide people with more than enough to drink, cook and wash with.i What’s more, as groundwater is below the surface, it is more resilient to extreme weather than other water sources – such as lakes, rivers, streams and dams – and is largely protected from evaporation and less susceptible to pollution. This means that even if our weather becomes more extreme and unpredictable, there is enough groundwater stored in aquifersii to provide a buffer for many years to come for the millions of people living on the frontline of climate change. For them, daily life is already a struggle simply because they do not have access to sustainable and safe water and sanitation

Nineteen novel NPHS1 mutations in a worldwide cohort of patients with congenital nephrotic syndrome (CNS)

Background. Recessive mutations in the NPHS1 gene encoding nephrin account for ∼40% of infants with congenital nephrotic syndrome (CNS). CNS is defined as steroid-resistant nephrotic syndrome (SRNS) within the first 90 days of life. Currently, more than 119 different mutations of NPHS1 have been published affecting most exons. Methods. We here performed mutational analysis of NPHS1 in a worldwide cohort of 67 children from 62 different families with CNS. Results. We found bi-allelic mutations in 36 of the 62 families (58%) confirming in a worldwide cohort that about one-half of CNS is caused by NPHS1 mutations. In 26 families, mutations were homozygous, and in 10, they were compound heterozygous. In an additional nine patients from eight families, only one heterozygous mutation was detected. We detected 37 different mutations. Nineteen of the 37 were novel mutations (∼51.4%), including 11 missense mutations, 4 splice-site mutations, 3 nonsense mutations and 1 small deletion. In an additional patient with later manifestation, we discovered two further novel mutations, including the first one affecting a glycosylation site of nephrin. Conclusions. Our data hereby expand the spectrum of known mutations by 17.6%. Surprisingly, out of the two siblings with the homozygous novel mutation L587R in NPHS1, only one developed nephrotic syndrome before the age of 90 days, while the other one did not manifest until the age of 2 years. Both siblings also unexpectedly experienced an episode of partial remission upon steroid treatmen