2,379 research outputs found

    Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia

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    <p>Abstract</p> <p>Background</p> <p>Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI) in Zambia.</p> <p>Methods</p> <p>The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves.</p> <p>Results</p> <p>Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition.</p> <p>Conclusions</p> <p>This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services.</p

    Modern Languages and the Digital: The Shape of the Discipline

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    This article is the result of a Writing Sprint that was scheduled to celebrate Academic Book Week in November 2015. The article brings together scholars who use digital tools for their research, for online publishing, and/or who research the field of Digital Humanities. The debate within the article focuses on how digital technologies are changing the shape of Modern Languages research and teaching. The main questions explored in the article include data-driven projects in Modern Languages, digital archives in Modern Languages, the digital as object of study, digital ethnography, users and interfaces, and finally the Modern Languages research process

    The Prevalence of Lesbian, Gay, Bisexual, and Transgender Health Education and Training in Emergency Medicine Residency Programs: What Do We Know?

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    Background The Institute of Medicine, The Joint Commission, and the U.S. Department of Health and Human Services all have recently highlighted the need for cultural competency and provider education on lesbian, gay, bisexual, and transgender ( LGBT ) health. Forty percent of LGBT patients cite lack of provider education as a barrier to care. Only a few hours of medical school curriculum are devoted to LGBT education, and little is known about LGBT graduate medical education. Objectives The objective of this study was to perform a needs assessment to determine to what degree LGBT health is taught in emergency medicine ( EM ) residency programs and to determine whether program demographics affect inclusion of LGBT health topics. Methods An anonymous survey link was sent to EM residency program directors ( PD s) via the Council of Emergency Medicine Residency Directors listserv. The 12‐item descriptive survey asked the number of actual and desired hours of instruction on LGBT health in the past year. Perceived barriers to LGBT health education and program demographics were also sought. Results There were 124 responses to the survey out of a potential response from 160 programs (response rate of 78%). Twenty‐six percent of the respondents reported that they have ever presented a specific LGBT lecture, and 33% have incorporated topics affecting LGBT health in the didactic curriculum. EM programs presented anywhere from 0 to 8 hours on LGBT health, averaging 45 minutes of instruction in the past year (median = 0 minutes, interquartile range [ IQR ] = 0 to 60 minutes), and PD s support inclusion of anywhere from 0 to 10 hours of dedicated time to LGBT health, with an average of 2.2 hours (median = 2 hours, IQR  = 1 to 3.5 hours) recommended. The majority of respondents have LGBT faculty (64.2%) and residents (56.2%) in their programs. The presence of LGBT faculty and previous LGBT education were associated with a greater number of desired hours on LGBT health. Conclusions The majority of EM residency programs have not presented curricula specific to LGBT health, although PD s desire inclusion of these topics. Further curriculum development is needed to better serve LGBT patients. Resumen Introducción El Institute of Medicine, la Joint Commission y el Department of Health and Human Services han subrayado recientemente la necesidad en la competencia cultural y la educación sanitaria de los profesionales sanitarios sobre lesbianas, gays, bisexuales y transexuales ( LGBT ). El 40% de los pacientes LGBT reconoce una falta de formación de los sanitarios como una barrera en la atención médica. Sólo unas pocas horas del programa universitario de medicina está dedicada a la formación en LGBT , y se sabe poco sobre la formación médica de postgrado sobre LGBT . Objetivos El objetivo de este estudio fue evaluar qué grado de formación sanitaria sobre LGBT se enseña en los programas de residencia de Medicina de Urgencias y Emergencias ( MUE ) y determinar si las características de las personas que realizan el programa afectan a la inclusión de temas sanitarios sobre LGBT . Metodología Se envió un enlace de encuesta anónima a los directores del programa de residencia de la MUE a través de la lista del servidor del Council of Emergency Medicine Residency Directors. La encuesta descriptiva de 12 ítems preguntó el número de horas reales y deseadas de formación saniataria sobre LGBT en el pasado año. También se buscaron las barreras percibidas para la educación sanitaria sobre LGBT y la demografía del programa. Resultados Hubo 124 respuestas a la encuesta de una respuesta potencial de 160 programas (porcentaje de respuesta del 78%). Un 26% de los encuestados contest que nunca había presentado una clase específica sobre LGBT , y un 33% ha incorporado temas que afectan a la salud de LGBT en el plan de estudios. Los programas de MUE presentaron en cualquier lugar de 0–8 horas de formación sanitaria sobre LGBT , con un promedio de 45 minutos de formación en el pasado año (mediana de 0 minutos, RIC 0 a 60 minutos), y los directores del programa apoyan la inclusión en cualquier lugar de 0 a 10 horas de tiempo dedicado a la formacion sanitaria sobre LGBT , con un promedio recomendado de 2,2 horas (mediana 2, RIC de 1 a 3,5 horas). La mayoría de los encuestados tienen profesores (64,2%) y residentes (56,2%) LGBT en sus programas. La presencia de profesores LGBT y la formación sanitaria previa sobre LGBT se asociaron con un mayor número de horas deseadas sobre formación sanitaria sobre LGBT . Conclusiones La mayoría de los programas de residencia en MUE no ha presentado un plan de estudios específico para formación sanitaria sobre LGBT , aunque los directores del programa desean la inclusión de estos temas. Es necesario el desarrollo de un programa futuro para atender mejor a los pacientes LGBT .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106813/1/acem12368.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/106813/2/acem12368-sup-0001-DataSupplementS1.pd

    A Convenient Model of Severe, High Incidence Autoimmune Gastritis Caused by Polyclonal Effector T Cells and without Perturbation of Regulatory T Cells

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    Autoimmune gastritis results from the breakdown of T cell tolerance to the gastric H+/K+ ATPase. The gastric H+/K+ ATPase is responsible for the acidification of gastric juice and consists of an α subunit (H/Kα) and a β subunit (H/Kβ). Here we show that CD4+ T cells from H/Kα-deficient mice (H/Kα−/−) are highly pathogenic and autoimmune gastritis can be induced in sublethally irradiated wildtype mice by adoptive transfer of unfractionated CD4+ T cells from H/Kα−/− mice. All recipient mice consistently developed the most severe form of autoimmune gastritis 8 weeks after the transfer, featuring hypertrophy of the gastric mucosa, complete depletion of the parietal and zymogenic cells, and presence of autoantibodies to H+/K+ ATPase in the serum. Furthermore, we demonstrated that the disease significantly affected stomach weight and stomach pH of recipient mice. Depletion of parietal cells in this disease model required the presence of both H/Kα and H/Kβ since transfer of H/Kα−/− CD4+ T cells did not result in depletion of parietal cells in H/Kα−/− or H/Kβ−/− recipient mice. The consistency of disease severity, the use of polyclonal T cells and a specific T cell response to the gastric autoantigen make this an ideal disease model for the study of many aspects of organ-specific autoimmunity including prevention and treatment of the disease

    Truly reconciled? A dyadic analysis of post-conflict social reintegration in Northern Uganda

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    In the aftermath of civil war or violent internal conflict, one of the key peacebuilding challenges is the reconciliation of former enemies who are members of the same small-scale societies. A failure of social reintegration may contribute to what is known as a conflict trap. To detect lingering hostile attitudes among a community’s various factions is crucial, but the approaches adopted in previous studies tend to focus on the impact of conflict on one or other aggregated indicator of social cohesion rather than on how violence-affected individuals regard and act towards their fellow community members. Here we demonstrate the value of concentrating on this latter dyadic component of social interactions and we use behavioural experiments and a social tie survey to assess, in an appropriately disaggregated manner, social cohesion in a post-conflict setting in northern Uganda. Whereas in self-reported surveys, ex-combatants appear to be well-connected, active members of their communities, the experiments unveil the continued reluctance of other community members to share or cooperate with them; fewer resources are committed to ex-combatants than to others, which is statistically significant. The dyadic nature of our analysis allows us to detect which groups are more prone to discriminate against ex-combatants, which may help facilitate targeted interventions

    The Democratic Biopolitics of PrEP

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    PrEP (Pre-Exposure Prophylaxis) is a relatively new drug-based HIV prevention technique and an important means to lower the HIV risk of gay men who are especially vulnerable to HIV. From the perspective of biopolitics, PrEP inscribes itself in a larger trend of medicalization and the rise of pharmapower. This article reconstructs and evaluates contemporary literature on biopolitical theory as it applies to PrEP, by bringing it in a dialogue with a mapping of the political debate on PrEP. As PrEP changes sexual norms and subjectification, for example condom use and its meaning for gay subjectivity, it is highly contested. The article shows that the debate on PrEP can be best described with the concepts ‘sexual-somatic ethics’ and ‘democratic biopolitics’, which I develop based on the biopolitical approach of Nikolas Rose and Paul Rabinow. In contrast, interpretations of PrEP which are following governmentality studies or Italian Theory amount to either farfetched or trivial positions on PrEP, when seen in light of the political debate. Furthermore, the article is a contribution to the scholarship on gay subjectivity, highlighting how homophobia and homonormativity haunts gay sex even in liberal environments, and how PrEP can serve as an entry point for the destigmatization of gay sexuality and transformation of gay subjectivity. ‘Biopolitical democratization’ entails making explicit how medical technology and health care relates to sexual subjectification and ethics, to strengthen the voice of (potential) PrEP users in health politics, and to renegotiate the profit and power of Big Pharma
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