Obstacles at every turn: Barriers to political participation faced by Native American voters

In 2017-2018, the Native American Voting Rights Coalition held nine public hearings to better understand how Native Americans are systemically and culturally kept from fully exercising their right to vote. More than 120 witnesses testified from dozens of tribes across the Midwest, Southwest, West Coast, and Alaska. This report is the product of those hearings and provides detailed evidence that Native people face obstacles at every turn in the electoral process: from registering to vote, to casting votes, to having votes counted

The Mental Health Burden of Patients with Colorectal Cancer Receiving Care during the COVID-19 Pandemic: Results of the PICO-SM Study

The COVID-19 pandemic has resulted in unprecedented changes to the lives of patients with cancer. To evaluate the impact of the COVID-19 pandemic on the mental health and well-being of patients with colorectal cancer, we conducted a prospective longitudinal questionnaire study at a UK tertiary cancer centre. In total, 216 participants were included: mean age 65 years, 57% (n = 122) male, 92% (n = 198) of white ethnicity. Amongst participants who completed the screening psychometric questionnaire, 24% (n = 48/203) reported anxiety (GAD-7 ≥ 5), 15% (n = 31/204) depressive symptoms (PHQ-9 ≥ 10), 3% (n = 5/190) probable post-traumatic stress disorder (PC-PTSD-5 ≥ 4), and 31% (n = 66/213) poor well-being (WHO-5 n = 95/216, 44%) who consented to and completed a follow-up survey 6 months later, there was a significant increase in the number of participants at risk of depression (4% vs. 13%, p = 0.021). Self-reported concern about the COVID-19 pandemic impacting one’s mental health is associated with increased likelihood of anxiety, depression, and poor well-being, in respective multivariate analyses. In conclusion, screening for the mental health impact of the COVID-19 pandemic is essential to ensure timely action from all key stakeholders and to avoid potentially longer-term detrimental consequences

Oxygen cost of exercise hyperpnoea is greater in women compared with men

This is the accepted version of the following article: [Dominelli, P. B., Render, J. N., Molgat-Seon, Y., Foster, G. E., Romer, L. M. and Sheel, A. W. (2015), Oxygen cost of exercise hyperpnoea is greater in women compared with men. The Journal of Physiology. doi: 10.1113/jphysiol.2014.285965], which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2014.285965/abstract;jsessionid=3BAFE2D4AF921CDEC14CB1DB9F32011C.f03t03We compared the oxygen cost of breathing (V˙ O2RM) in healthy men and women over a wide range of exercise ventilations (V˙ E). Eighteen subjects (9 women) completed four days of testing. First, a step-wise maximal cycle exercise test was completed for the assessment of spontaneous breathing patterns. Next, subjects were familiarized with the voluntary hyperpnoea protocol used to estimate V˙ O2RM. During the final two visits, subjects mimicked multiple times (4-6) the breathing patterns associated with 5-6 different exercise stages. Each trial lasted 5 min and on-line pressure- and flow-volume loops were superimposed on target loops obtained during exercise to accurately replicate the work of breathing. At ~55 l min-1 V˙ E, V˙ O2RM was significantly greater in women. At maximum ventilation, the absolute V˙ O2RM was not different (P>0.05) between the sexes, but represented a significantly greater fraction of whole-body V˙ O2 in women (13.8±1.5 vs. 9.4±1.1% V˙ O2). During heavy exercise at 92 and 100% V˙ O2max, the unit cost of V˙ E was +0.7 and +1.1 mlO2 l-1 greater in women (P<0.05). At V˙ O2max, men and women who developed expiratory flow limitation had a significantly greater V˙ O2RM than those who did not (435±44 vs. 331±30 mlO2 min-1). In conclusion, women have a greater V˙ O2RM for a given V˙ E and this represents a greater fraction of whole-body V˙ O2. The greater V˙ O2RM in women may have implications for the integrated physiological response to exercise

Umbilical Cord Milking vs Delayed Cord Clamping and Associations with In-Hospital Outcomes among Extremely Premature&nbsp;Infants

ObjectiveTo compare in-hospital outcomes after umbilical cord milking vs delayed cord clamping among infants &lt;29&nbsp;weeks of gestation.Study designMulticenter retrospective study of infants born &lt;29&nbsp;weeks of gestation from 2016 to 2018 without congenital anomalies who received active treatment at delivery and were exposed to umbilical cord milking or delayed cord clamping. The primary outcome was mortality or severe (grade III or IV) intraventricular hemorrhage (IVH) by 36&nbsp;weeks of postmenstrual age (PMA). Secondary outcomes assessed at 36&nbsp;weeks of PMA were mortality, severe IVH, any IVH or mortality, and a composite of mortality or major morbidity. Outcomes were assessed using multivariable regression, incorporating mortality risk factors identified a priori, confounders, and center. A prespecified, exploratory analysis evaluated severe IVH in 2 gestational age strata, 22-246/7 and 25-286/7&nbsp;weeks.ResultsAmong 1834 infants, 23.6% were exposed to umbilical cord milking and 76.4% to delayed cord clamping. The primary outcome, mortality or severe IVH, occurred in 21.1% of infants: 28.3% exposed to umbilical cord milking and 19.1% exposed to delayed cord clamping, with an aOR that was similar between groups (aOR 1.45, 95% CI 0.93, 2.26). Infants exposed to umbilical cord milking had higher odds of severe IVH (19.8% umbilical cord milking vs 11.8% delayed cord clamping, aOR 1.70 95% CI 1.20, 2.43), as did the 25-286/7&nbsp;week stratum (14.8% umbilical cord milking vs 7.4% delayed cord clamping, aOR 1.89 95% CI 1.22, 2.95). Other secondary outcomes were similar between groups.ConclusionsThis analysis of extremely preterm infants suggests that delayed cord clamping is the preferred practice for placental transfusion, as umbilical cord milking exposure was associated with an increase in the adverse outcome of severe IVH.Trial registrationClinicalTrials.gov: NCT00063063