Women as American Family's health advocate, guide, or guardian: a health communication practitioners' perspective

American women are often in the role of being a health advocate, guide, or guardian for family and friends. An examination of gender differences is virtually absent from American-focused health communication literature. I review the topic from an international, professional, and historical perspective and include qualitative data from health communication professional interviews to document and explore this role. Explanatory themes of nature and nurture, as well as collectivism and having the ability to keep track of details, are explored as reasons why women take on these roles to a far greater degree than men. Suggestions for future research are included to encourage more health researchers to add to the academic literature

The Commercial Sexual Exploitation and Sex Trafficking of Minors in the Boston Metropolitan Area: Experiences and Challenges Faced by Front-Line Providers and Other Stakeholders

Objectives: The commercial sexual exploitation of children (CSEC), including sex trafficking of minors, is considered a severe form of abuse and violence against minors. We use a public health lens to examine perceptions regarding the context and process of CSEC and sex trafficking of minors in the Boston area, the response of the health care sector, and opportunities to improve the health and well-being of exploited/trafficked minors. Methods: Using case study methodology, we conducted 22 semi-structured qualitative interviews of 25 key anti-trafficking stakeholders active in the Boston area. Results: Key informants identified CSEC involving boys, girls, and transgender youth as a local problem. Many social and economic factors facilitate sex trafficking, including child sexual abuse, domicile instability, and financial insecurity. The health needs of commercially sexually exploited minors are numerous, and local health care services are variable, particularly in the realm of mental health. Various factors function as barriers to a greater health care sector response, including low awareness of CSEC and sex trafficking of minors among health care providers. Gaps in CSEC prevention and response include early recognition of signs and symptoms, CSEC-knowledgeable trauma-sensitive health care services, and emergency shelter. Conclusions: CSEC, including sex trafficking of minors, is a recognized occurrence in the Boston area that requires a multidisciplinary response across multiple sectors. A more robust health care system response in coordination with other active stakeholders could help enhance the overall impact of local anti-CSEC/trafficking efforts. Increased health trainings, policy advocacy, and the use of multidisciplinary teams may be an effective way to partner across sectors and ensure wraparound services for exploited youth

RENTABILIDAD FINANCIERA Y SU INCIDENCIA EN LA TOMA DE DECISIONES DEL TALLER AUTOMOTRIZ TELLO

El Taller Automotriz “Tello” del cantón Manta enfrenta una problemática significativa debido al ineficiente análisis detallado de rentabilidad que revele su situación financiera real, lo cual es esencial para la toma de decisiones eficientes y el manejo eficaz de los recursos económicos. Por lo tanto, el objetivo de este estudio fue analizar la rentabilidad financiera y su incidencia en la toma de decisiones del taller. Para alcanzar este objetivo, se utilizó una metodología cuantitativa de tipo inductivo, recurriendo tanto a la investigación bibliográfica como a la de campo, incluyendo entrevistas con el gerente y el contador. Los resultados mostraron que, aunque la rentabilidad financiera se encuentra estable y se utilizan análisis financieros para la toma de decisiones, la falta de capacitaciones formales sobre rentabilidad financiera es una limitación importante. Además, se identificó que los indicadores financieros, como el ROI y la rentabilidad por cliente, afectan la rentabilidad cuando no se aplican correctamente

A Theoryâ based Didactic Offering Physicians a Method for Learning and Teaching Others About Human Trafficking

Emergency clinicians are on the frontlines of identifying and caring for trafficked persons. However, most emergency providers have never received training on trafficking, and studies report a significant knowledge gap involving this important topic. Workshops often employ a â trainâ theâ trainerâ model to address cliniciansâ knowledge gaps involving various topics (including trafficking). By offering participants knowledge and skills needed to both understand relevant content and teach this content to future learners, this model aims at promoting widespread dissemination of essential information. However, current trainâ theâ trainer workshops typically involve full or multiday sessions and employ multimodal instructional techniques, making them time and resource intensive for both participants and facilitators.To address these challenges, we created a 50â minute trainâ theâ trainer workshop to teach emergency clinicians the knowledge and skills needed to recognize and care for trafficked patients while providing instructional techniques to teach learners this content in the clinical environment. Learning theory and principles informed the choice of instructional methods and were employed when designing the paperâ based learning guides that functioned as this intervention’s primary instructional resource. Guides contained detailed scripts used to perform roleâ playing exercises. These â scripted guidesâ were designed for participants to learn important content while simultaneously practicing techniques to teach this content to one another. They provided the scaffolding necessary to independently direct learning during the workshop (with minimal facilitator intervention), while also being carefully formatted and organized to create an accessible tool for future use during clinical teaching.The session was implemented at the 2018 Society for Academic Emergency Medicine Annual Meeting in Indianapolis, Indiana. Based on participantsâ selfâ assessment using a retrospective preâ post test, the workshop was successful in creating a trainâ theâ trainer model that is brief, requiring minimal facilitator resources and offers instruction on both content knowledge and instructional methods to disseminate this knowledge to future learners.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147170/1/aet210206_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147170/2/aet210206.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147170/3/aet210206-sup-0001-DataS1.pd

An International Comparative Public Health Analysis of Sex Trafficking of Women and Girls in Eight Cities: Achieving a More Effective Health Sector Response

Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders

SAEM Response to the National Institutes of Health request for information: Future directions in violence against women research

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Association of Inventory to Measure and Assess imaGe Disturbance - Head and Neck Scores With Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors

Objective: The Inventory to Measure and Assess imaGe disturbance - Head and Neck (IMAGE-HN) is a validated patient-reported outcome measure of head and neck cancer-related body image-related distress (BID). However, the IMAGE-HN score corresponding to clinically relevant BID is unknown. The study objective is to determine the IMAGE-HN cutoff score that identifies head and neck cancer patients with clinically relevant BID. Methods: We conducted a cross-sectional study at six academic medical centers. Individuals ≥18 years old with a history of head and neck cancer treated with definitive intent were included. The primary outcome measure was the IMAGE-HN. A Receiver Operating Characteristic curve analysis was performed to identify the IMAGE-HN score that maximized sensitivity and specificity relative to a Body Image Scale score of ≥10 (which indicates clinically relevant BID in a general oncology population). To confirm the validity of the IMAGE-HN cutoff score, we compared the severity of depressive [Patient Health Questionnaire-9 (PHQ-9)] and anxiety symptoms [Generalized Anxiety Disorder-7 (GAD-7)], and quality of life [University of Washington-QOL (UW-QOL)] in patients with IMAGE-HN scores above and below the cutoff. Results: Of the 250 patients, 70.4% were male and the mean age was 62.3 years. An IMAGE-HN score of ≥22 was the optimal cutoff score relative to a Body Image Scale score of ≥10 and represents a clinically relevant level of head and neck cancer-related BID. Relative to those with an IMAGE-HN score of \u3c22, patients with IMAGE-HN scores of ≥22 had a clinically meaningful increase in symptoms of depression (mean PHQ-9 score difference = 5.8) and anxiety (mean GAD-7 score difference = 4.1) as well as worse physical (mean UW-QOL score difference = 18.9) and social-emotional QOL (mean UW-QOL score difference = 21.5). Using an IMAGE-HN cutoff score ≥22, 28% of patients had clinically relevant BID. Conclusion: An IMAGE-HN score of ≥22 identifies patients with clinically relevant head and neck cancer-related BID. This score may be used to detect patients who could benefit from strategies to manage their distress, select patients for studies evaluating interventions to manage head and neck cancer-related BID, and improve our understanding of the underlying epidemiology of the disorder

Green Bank and Effelsberg Radio Telescope Searches for Axion Dark Matter Conversion in Neutron Star Magnetospheres

Axion dark matter (DM) may convert to radio-frequency electromagnetic radiation in the strong magnetic fields around neutron stars. The radio signature of such a process would be an ultra-narrow spectral peak at a frequency determined by the mass of the axion particle. We analyze data we collected from the Robert C. Byrd Green Bank Telescope in the L-band and the Effelsberg 100-m Telescope in the L-Band and S-band from a number of sources expected to produce bright signals of axion-photon conversion, including the Galactic Center of the Milky Way and the nearby isolated neutron stars RX J0720.4-3125 and RX J0806.4-4123. We find no evidence for axion DM and are able to set some of the strongest constraints to-date on the existence of axion DM in the highly-motivated mass range between ~5-11 $\mu$eV.Comment: 7+20 pages, 2+17 figures, Supplementary Data at http://github.com/joshwfoster/RadioAxionSearc

Metabolite and lipoprotein profiles reveal sex-related oxidative stress imbalance in de novo drug-naive Parkinson's disease patients

Parkinson's disease (PD) is the neurological disorder showing the greatest rise in prevalence from 1990 to 2016. Despite clinical definition criteria and a tremendous effort to develop objective biomarkers, precise diagnosis of PD is still unavailable at early stage. In recent years, an increasing number of studies have used omic methods to unveil the molecular basis of PD, providing a detailed characterization of potentially pathological alterations in various biological specimens. Metabolomics could provide useful insights to deepen our knowledge of PD aetiopathogenesis, to identify signatures that distinguish groups of patients and uncover responsive biomarkers of PD that may be significant in early detection and in tracking the disease progression and drug treatment efficacy. The present work is the first large metabolomic study based on nuclear magnetic resonance (NMR) with an independent validation cohort aiming at the serum characterization of de novo drug-naive PD patients. Here, NMR is applied to sera from large training and independent validation cohorts of German subjects. Multivariate and univariate approaches are used to infer metabolic differences that characterize the metabolite and the lipoprotein profiles of newly diagnosed de novo drug-naive PD patients also in relation to the biological sex of the subjects in the study, evidencing a more pronounced fingerprint of the pathology in male patients. The presence of a validation cohort allowed us to confirm altered levels of acetone and cholesterol in male PD patients. By comparing the metabolites and lipoproteins levels among de novo drug-naive PD patients, age- and sex-matched healthy controls, and a group of advanced PD patients, we detected several descriptors of stronger oxidative stress

Heterogeneity of prodromal Parkinson symptoms in siblings of Parkinson disease patients

Abstract: A prodromal phase of Parkinson’s disease (PD) may precede motor manifestations by decades. PD patients’ siblings are at higher risk for PD, but the prevalence and distribution of prodromal symptoms are unknown. The study objectives were (1) to assess motor and non-motor features estimating prodromal PD probability in PD siblings recruited within the European PROPAG-AGEING project; (2) to compare motor and non-motor symptoms to the well-established DeNoPa cohort. 340 PD siblings from three sites (Bologna, Seville, Kassel/Goettingen) underwent clinical and neurological evaluations of PD markers. The German part of the cohort was compared with German de novo PD patients (dnPDs) and healthy controls (CTRs) from DeNoPa. Fifteen (4.4%) siblings presented with subtle signs of motor impairment, with MDS-UPDRS-III scores not clinically different from CTRs. Symptoms of orthostatic hypotension were present in 47 siblings (13.8%), no different to CTRs (p = 0.072). No differences were found for olfaction and overall cognition; German-siblings performed worse than CTRs in visuospatial-executive and language tasks. 3/147 siblings had video-polysomnography-confirmed REM sleep behavior disorder (RBD), none was positive on the RBD Screening Questionnaire. 173/300 siblings had <1% probability of having prodromal PD; 100 between 1 and 10%, 26 siblings between 10 and 80%, one fulfilled the criteria for prodromal PD. According to the current analysis, we cannot confirm the increased risk of PD siblings for prodromal PD. Siblings showed a heterogeneous distribution of prodromal PD markers and probability. Additional parameters, including strong disease markers, should be investigated to verify if these results depend on validity and sensitivity of prodromal PD criteria, or if siblings’ risk is not elevated