Disabilities among Refugees and Conflict-affected Populations

Around the world, an estimated 3.5 million displaced people live with disabilities in refugee camps and urban slum settlements. The Women's Commission for Refugee Women and Children, with the support of the United Nations High Commissioner for Refugees, undertook a six-month research project to assess the situation of those with disabilities among refugee and conflict-affected populations. Using our field research in five countries, Ecuador, Jordan, Nepal, Thailand and Yemen, the Women's Commission sought to map existing services for displaced persons with disabilities, identify gaps and good practices and make concrete recommendations on how to improve services, protection and participation for displaced persons with disabilities.Key Findings- Refugees with disabilities are among the most hidden, neglected and socially excluded of all displaced people in the world.- They are excluded from or unable to access mainstream assistance programs as a result of attitudinal, physical and social barriers and are forgotten in the establishment of specialized and targeted services.- Refugees with disabilities are more isolated following their displacement than they were in their home communities and their potential to contribute and participate is seldom recognized

Aboriginal Men’s Business: A Literature Review of Factors Affecting Aboriginal Men Accessing Sexual Health Services

Introduction: Aboriginal men are relatively young, with a median age of 22 years, nearly half that of their non-Aboriginal counterparts. Aboriginal men also have the highest mortality rates and have the lowest life expectancy. Sexually Transmissible Infection (STI) rates are extremely overrepresented in lower socio-economic groups, including minority populations. STI rates among Aboriginal communities are significantly higher when compared to the non-Aboriginal population. Aims: In the context of multiple factors impinging on the sexual health of Aboriginal men, we sought to conduct a comprehensive review of the literature for the purpose of developing a framework through which needs and actions to improve sexual health could be identified and understood. Methods: A targeted, comprehensive search strategy was developed using keywords and synonyms related to the aims of the project. The search included scholarly peer reviewed academic literature available and grey literature from the Wollongong Hospital and the NSW Health library. The search was made more efficient by entering search terms into the Deakin University EBSCOhost search engine, and Google Scholar was searched separately. Grey literature searching was conducted with Clinical Information Access Portal (CIAP), Informit and the Commonwealth Scientific and Industrial Research Organisation (CSIRO). Results: The search produced a total number of 385 papers from peer reviewed publications and grey literature. A total of 95 duplicates were removed, leaving 290 papers. After incorporating the screening process, exclusion and inclusion criteria, the total number of articles selected for review was 31 articles. Discussion: The thematic analysis identified that cultural considerations of Aboriginal ‘Men’s business’ involving traditional lifestyle, cultural practices and the impact of colonisation were only briefly covered in the included studies. The findings of the literature review indicated that Aboriginal men’s health is deeply influenced by their socio-economic status and cultural wellbeing. This review provided limited findings relating to service provision support for Aboriginal men. Conclusion: Overall, this review presented several concerning factors and evidence of the difficulties for Aboriginal and Torres Strait Islander men accessing sexual health services. Literature identified the long-standing health statistics and deterioration of health and social and emotional wellbeing for Aboriginal and Torres Strait Islander men. While both mainstream health and non-government services are offering limited provision of culturally safe and appropriate healthcare pathways

Practical utility and reliability of whole-room calorimetry in young children

The use of whole-room calorimetry (WRC) in young children can increase our understanding of children's energy balance. However, studies using WRC in young children are rare due to concerns about its feasibility. To assess the feasibility of WRC in young children, forty children, aged 4-6 years, were asked to follow a graded activity protocol while in a WRC. In addition, six children participated in two additional resting protocols to examine the effect of diet-induced thermogenesis on resting energy expenditure (REE) measures and the reliability of REE measurement. Refusals to participate and data loss were quantified as measures of practical utility, and REE measured after an overnight fast and after a 90-min fast were compared. In addition, both were compared to predicted BMR values using the Schofield equation. Our results showed that thirty (78·9 %) participants had acceptable data for all intensities of the activity protocol. The REE values measured after a 90-min fast (5·07 (sd 1·04) MJ/d) and an overnight fast (4·73 (sd 0·61) MJ/d) were not significantly different from each other (P = 0·472). However, both REE after an overnight fast and a 90-min fast were significantly higher than predicted BMR (3·96 (sd 0·18) MJ/d) using the Schofield equation (P = 0·024 and 0·042, respectively). We conclude that, with a developmentally sensitive approach, WRC is feasible and can be standardised adequately even in 4- to 6-year-old children. In addition, the effect of a small standardised breakfast, approximately 90 min before REE measurements, is likely to be small

How do the movement patterns of homeless youth affect their information seeking behaviors within the systems provided to them

This work provides a reflection on the relationship between movement patterns, homeless youth, and their information seeking behaviors within the information systems they have access to in order to find help. While understudied, the relationship between the movement patterns of the homeless youth population could be used to build information systems that are customized to the way this population looks for and uses resources. We propose a two phase user study focused on homeless youth that consists of a semi-structured interview as well as a user study on a tool they use to locate resources for help

Predictive validity and classification accuracy of actigraph energy expenditure equations and cut-points in young children

Objectives: Evaluate the predictive validity of ActiGraph energy expenditure equations and the classification accuracy of physical activity intensity cut-points in preschoolers. Methods: Forty children aged 4–6 years (5.3±1.0 years) completed a ~150-min room calorimeter protocol involving age-appropriate sedentary, light and moderate-to vigorous-intensity physical activities. Children wore an ActiGraph GT3X on the right mid-axillary line of the hip. Energy expenditure measured by room calorimetry and physical activity intensity classified using direct observation were the criterion methods. Energy expenditure was predicted using Pate and Puyau equations. Physical activity intensity was classified using Evenson, Sirard, Van Cauwenberghe, Pate, Puyau, and Reilly, ActiGraph cut-points. Results: The Pate equation significantly overestimated VO2 during sedentary behaviors, light physical activities and total VO2 (P<0.001). No difference was found between measured and predicted VO2 during moderate-to vigorous-intensity physical activities (P = 0.072). The Puyau equation significantly underestimated activity energy expenditure during moderate-to vigorous-intensity physical activities, light-intensity physical activities and total activity energy expenditure (P<0.0125). However, no overestimation of activity energy expenditure during sedentary behavior was found. The Evenson cut-point demonstrated significantly higher accuracy for classifying sedentary behaviors and light-intensity physical activities than others. Classification accuracy for moderate-to vigorous-intensity physical activities was significantly higher for Pate than others. Conclusion: Available ActiGraph equations do not provide accurate estimates of energy expenditure across physical activity intensities in preschoolers. Cut-points of ≤25counts⋅15 s−1 and ≥420 counts⋅15 s−1 for classifying sedentary behaviors and moderate-to vigorous-intensity physical activities, respectively, are recommended

Managing the merger of archives and special collections : setting our own agenda.

At the University of Louisville a merger of archives and special collections had been discussed for decades, but for a variety of reasons, always dismissed. There were practical reasons in favor of it, but there were some significant internal barriers that made it easier to keep things as they were. But in 2012 things changed. Heightened appreciation for the traditional and emerging roles of special collections in university libraries, institutional budget concerns, key retirements and gradual replacement of people resistant to change, and an inclusive approach to planning, all aligned to make the merger seem like a natural progression for the departments. After years of waiting, when we acted, we acted relatively quickly, creating the new unit in less than a year. Knowing our planning period was short, we also tried to put in place mechanisms and procedures for ironing out the kinks that we knew would crop up. Although we still are identifying and addressing those kinks, each member of our staff, our institutional colleagues, and, most importantly, our users, express confidence that the merger is a success. We believe that part of that success was driven by the level of control we, as a group, exerted over the planning and execution of the merger. Our change was internally driven, but we think our experience has value for departments who face a variety of motivations for coming together

Overcoming legacy processing in photographic collections through collaboration and digital technologies.

In the 1960s, a Louisville photography studio began donating its negatives, prints, and invoices to the University of Louisville Photographic Archives. The Caufield & Shook Collection remains a significant primary source for local history and a prime candidate for digitization. Unfortunately, on its receipt non-archivists processed the collection with little documentation of original order or organizational decision making. Additionally, workflow choices were determined largely by the desire to maximize student labor. In 2017, the Digital Initiatives Librarian worked with in-house application developers and archives staff to create a workflow that has significantly sped up the process of making this valuable photographic collection accessible online. This article describes how archivists recovered from the poor processing decisions, used technology to enhance the digitization workflow, and developed a list of best practices for future processing and digitization of large photographic collections

How do we evaluate the cost of nosocomial infection? The ECONI protocol: an incidence study with nested case-control evaluating cost and quality of life

Introduction Healthcare-associated or nosocomial infection (HAI) is distressing to patients and costly for the National Health Service (NHS). With increasing pressure to demonstrate cost-effectiveness of interventions to control HAI and notwithstanding the risk from antimicrobial-resistant infections, there is a need to understand the incidence rates of HAI and costs incurred by the health system and for patients themselves. Methods and analysis The Evaluation of Cost of Nosocomial Infection study (ECONI) is an observational incidence survey with record linkage and a nested case-control study that will include postdischarge longitudinal follow-up and qualitative interviews. ECONI will be conducted in one large teaching hospital and one district general hospital in NHS Scotland. The case mix of these hospitals reflects the majority of overnight admissions within Scotland. An incidence survey will record all HAI cases using standard case definitions. Subsequent linkage to routine data sets will provide information on an admission cohort which will be grouped into HAI and non-HAI cases. The case-control study will recruit eligible patients who develop HAI and twice that number without HAI as controls. Patients will be asked to complete five questionnaires: the first during their stay, and four others during the year following discharge from their recruitment admission (1, 3, 6 and 12 months). Multiple data collection methods will include clinical case note review; patient-reported outcome; linkage to electronic health records and qualitative interviews. Outcomes collected encompass infection types; morbidity and mortality; length of stay; quality of life; healthcare utilisation; repeat admissions and postdischarge prescribing. Ethics and dissemination The study has received a favourable ethical opinion from the Scotland A Research Ethics Committee (reference 16/SS/0199). All publications arising from this study will be published in open-access peer-reviewed journal. Lay-person summaries will be published on the ECONI website. Trial registration number NCT03253640; Pre-results

‘Even though you hate everything that\u27s going on, you know they are safer at home’: The role of Aboriginal and Torres Strait Islander families in methamphetamine use harm reduction and their own support needs

Introduction: First Nations people who use methamphetamine are overrepresented in regional and remote Australia and more likely to turn to family for support. This can place strain on families. The support needs of family members of individuals using methamphetamine are poorly understood. Methods: We conducted 19 focus groups and seven interviews with mostly First Nations community, family members and service providers. In total, 147 participants across six sites participated as part of a larger study investigating First Nations perspectives of how to address methamphetamine use and associated harms. We applied a social and emotional wellbeing framework to examine support needs and role of family in mitigating methamphetamine harms. Results: Findings highlighted the importance of families in providing support to people using methamphetamine and in reducing associated harms, often without external support. The support provided encompassed practical, social, emotional, financial, access to services and maintaining cultural connection. Providing support took a toll on family and negatively impacted their own social and emotional wellbeing. Discussion and Conclusions: First Nations families play an important and under-recognised role in reducing methamphetamine-related harms and greater efforts are required to support them. Professional resources are needed to deal with impacts of methamphetamine on families; these should be pragmatic, accessible, targeted and culturally appropriate. Support for families and communities should be developed using the social and emotional wellbeing framework that recognises wellbeing and healing as intrinsically connected to holistic health, kinship, community, culture and ancestry, and socioeconomic and historical influences on peoples\u27 lives

Pseudohomozygous dysfibrinogenemia

Abstract Hypodysfibrinogenemia (HD) is a heterogeneous disorder in which plasma fibrinogen antigen and function are both reduced but discordant. This report addresses the key clinical question of whether genetic analysis enables clinically useful subclassification of patients with HD. We report a new case and identify a further eight previously documented cases that have the laboratory features of HD but biallelic inheritance of quantitative and qualitative fibrinogen gene variants. The cases displayed both bleeding and thrombosis and sometimes had undetectable fibrinogen activity. In all cases, the predicted effect of the coinherited variants is reduced levels of circulating fibrinogen that is all dysfunctional. We propose the term pseudohomozygous dysfibrinogenemia for this subtype of recessively inherited HD that is distinct from the more commonly recognized monoallelic HD caused by a single fibrinogen gene variant