452 research outputs found

    Experiences of gender-based violence in women asylum seekers from Honduras, El Salvador and Guatemala

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    Introduction: Every year, thousands of women flee gender-based violence in Honduras, El Salvador, and Guatemala (sometimes collectively referred to as the Northern Triangle) in an attempt to seek asylum in the United States. Once in the United States, their legal teams may refer them for a psychological evaluation as part of their application for asylum. Licensed clinicians conduct in-depth interviews in order to document the psychological impact of the reported human rights violations. Method: Using archival de-identified data from a human rights program, this study gathered the experiences of gender-based violence reported by 70 asylum-seeking women from Honduras, El Salvador, and Guatemala who participated in pro bono psychological evaluation. Descriptive data were analyzed using a modified consensual qualitative research (CQR-M) method.Results: These asylum seekers reported exposure to systemic violence, including severe intimate partner violence, as well as physical and sexual assaults, and threats of death by organized criminal groups in their communities. Additionally, over a third of women reported experiences of violence during their migration. The majority of asylum seekers endorsed symptoms associated with anxiety (80%) and depression (91%), as well as trauma-and stressor-related symptoms (80%). Discussion: The results of this study elucidate the manyforms of gender-based violence experienced by women in this region, the physical and psychological sequelae of this persecution, and the systemic forces that prevent them from remaining in their countries of origin. The research results also highlight the potential impact of trauma on the women’s ability to testify effectively during asylum legal hearings, elucidate factors that may contribute to their resilience in light of the human rights violations they survived, and suggest implications for clinical practice

    A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol.

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    INTRODUCTION: Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery. METHODS AND ANALYSIS: The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods. ETHICS AND DISSEMINATION: The CPCSSN is committed to high ethical standards when dealing with individual data collected, and this work is reviewed and approved by the Network Scientific Committee. The results will be published in peer-reviewed journals and presented at relevant national and international scientific meetings

    VLA Imaging of H I-bearing Ultra-diffuse Galaxies from the ALFALFA Survey

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    Ultra-diffuse galaxies have generated significant interest due to their large optical extents and low optical surface brightnesses, which challenge galaxy formation models. Here we present resolved synthesis observations of 12 H i-bearing ultra-diffuse galaxies (HUDs) from the Karl G. Jansky Very Large Array (VLA), as well as deep optical imaging from the WIYN 3.5-meter telescope at Kitt Peak National Observatory. We present the data processing and images, including total intensity H i maps and H i velocity fields. The HUDs show ordered gas distributions and evidence of rotation, important prerequisites for the detailed kinematic models in Mancera PiËœna et al. (2019b). We compare the H i and stellar alignment and extent, and find the H i extends beyond the already extended stellar component and that the H i disk is often misaligned with respect to the stellar one, emphasizing the importance of caution when approaching inclination measurements for these extreme sources. We explore the H i mass-diameter scaling relation, and find that although the HUDs have diffuse stellar populations, they fall along the relation, with typical global H i surface densities. This resolved sample forms an important basis for more detailed study of the H i distribution in this extreme extragalactic population

    Comparison of Trihalomethanes in Tap Water and Blood: A Case Study in the United States

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    Background: Epidemiological studies have used various measures to characterize trihalomethane (THM) exposures, but the relationship of these indicators to exposure biomarkers remains unclear

    Ethical choices behind quantifications of fair contributions under the Paris Agreement

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    The Parties to the UNFCCC and Paris Agreement agreed to act on the basis of equity to protect the climate system. Equitable effort sharing is an irreducibly normative matter, yet some influential studies have sought to create quantitative indicators of equitable effort that claim to be value-neutral (despite evident biases). Many of these studies fail to clarify the ethical principles underlying their indicators, some mislabel approaches that favour wealthy nations as ‘equity approaches’ and some combine contradictory indicators into composites we call derivative benchmarks. This Perspective reviews influential climate effort-sharing assessments and presents guidelines for developing and adjudicating policy-relevant (but not ethically neutral) equity research

    Gender and sexual orientation differences in cognition across adulthood : age is kinder to women than to men regardless of sexual orientation

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    Despite some evidence of greater age-related deterioration of the brain in males than in females, gender differences in rates of cognitive aging have proved inconsistent. The present study employed web-based methodology to collect data from people aged 20-65 years (109,612 men; 88,509 women). As expected, men outperformed women on tests of mental rotation and line angle judgment, whereas women outperformed men on tests of category fluency and object location memory. Performance on all tests declined with age but significantly more so for men than for women. Heterosexuals of each gender generally outperformed bisexuals and homosexuals on tests where that gender was superior; however, there were no clear interactions between age and sexual orientation for either gender. At least for these particular tests from young adulthood to retirement, age is kinder to women than to men, but treats heterosexuals, bisexuals, and homosexuals just the same

    Impairments in Attention in Occasionally Snoring Children: An Event-Related Potential Study

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    Objective—To determine whether minimal snoring is benign in children. Procedure—22 rarely snoring children (mean age=6.9 years, 11 females) and age- and sexmatched controls participated in an auditory oddball task wearing 128-electrode nets. Parents completed Conner’s Parent Rating Scales-Revised Long (CPRS-R:L). Results—Snorers scored significantly higher on 4 CPRS-R:L subscales. Stepwise regression indicated that two ERP variables from a region of the ERP that peaked at 844 ms post-stimulus onset predicted CPRS-R:L ADHD Index scores. Conclusions—Occasional snorers according to parental report do exhibit ADHD-like behaviors. Basic sensory processing is longer than in controls, suggesting that delayed frontal activation requires more effort in snorers

    Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus

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    Abstract Background Chronic obstructive pulmonary disease (COPD) has been classically divided into blue bloaters and pink puffers. The utility of these clinical subtypes is unclear. However, the broader distinction between airway-predominant and emphysema-predominant COPD may be clinically relevant. The objective was to define clinical features of emphysema-predominant and non-emphysematous COPD patients. Methods Current and former smokers from the Genetic Epidemiology of COPD Study (COPDGene) had chest computed tomography (CT) scans with quantitative image analysis. Emphysema-predominant COPD was defined by low attenuation area at -950 Hounsfield Units (LAA-950) ≥10%. Non-emphysematous COPD was defined by airflow obstruction with minimal to no emphysema (LAA-950 < 5%). Results Out of 4197 COPD subjects, 1687 were classified as emphysema-predominant and 1817 as non-emphysematous; 693 had LAA-950 between 5–10% and were not categorized. Subjects with emphysema-predominant COPD were older (65.6 vs 60.6 years, p < 0.0001) with more severe COPD based on airflow obstruction (FEV1 44.5 vs 68.4%, p < 0.0001), greater exercise limitation (6-minute walk distance 1138 vs 1331 ft, p < 0.0001) and reduced quality of life (St. George’s Respiratory Questionnaire score 43 vs 31, p < 0.0001). Self-reported diabetes was more frequent in non-emphysematous COPD (OR 2.13, p < 0.001), which was also confirmed using a strict definition of diabetes based on medication use. The association between diabetes and non-emphysematous COPD was replicated in the ECLIPSE study. Conclusions Non-emphysematous COPD, defined by airflow obstruction with a paucity of emphysema on chest CT scan, is associated with an increased risk of diabetes. COPD patients without emphysema may warrant closer monitoring for diabetes, hypertension, and hyperlipidemia and vice versa. Trial registration Clinicaltrials.gov identifiers: COPDGene NCT00608764 , ECLIPSE NCT00292552 .http://deepblue.lib.umich.edu/bitstream/2027.42/109496/1/12890_2014_Article_599.pd
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