Experiencing West Africa: What a Semester on the Mission Field Taught Me

During the spring of my junior year of college, I had the opportunity to spend five months on the mission field in West Africa through the International Mission Board\u27s Hands-On semester, a program where college-aged students spend approximately five months abroad working with career missionaries in their ministries. I had no idea what to expect going into the program, and I had very little understanding of what missionary life really looked like. I spent time researching the spirituality and history of the area I would be living and working in in the months before I left; I wanted to go into the semester with a foundational understanding of the culture, religious backgrounds, and people that I would be interacting with and living among. My research was helpful in giving me a historical understanding of West Africa and a general picture of what life there would be like, but I also realized that a lot of what I had learned through my studies was not accurate to what I would encounter during my time there. In this paper, I will discuss the different topics I studied in my pre-trip research and recount my experiences during my Hands-On semester in order to communicate the things I wished I would have known going into the program, the parts of my research that were beneficial in helping me adjust to and understand West Africa, and the lessons I took away from the whole experience

What is Social Justice?: A Personal Manifesto

This paper explores and defines Social Justice by looking through the lens of Christianity

Internal derangement of the knee joint: a pathological and clinical study

The term "Internal Derangement" which is employed as the title of this Thesis has become classical, and was first used by that distinguished surgeon,Mr Hey of Leeds in the year 1803 in a paper forming the subject of Chapter 8 in the first Edition of his "Practical Observations in Surgery". It has been thought advisable therefore, to retain this term which however has now a wider signification than that given to it by Mr Hey. The term sufficiently explains itself,implying that there is some disturbance of the internal component parts of the joint, producing certain symptoms to be afterwards enumerated, and leading one to suspect the existence of some internal lesion in the joint.A very brief summary from Hey's paper enables us to appreciate his definition of the title."This joint is not unfrequently affected with an "internal derangement of its component parts,and that "sometimes in consequence of trifling accidents. The disease is,indeed,now and then removed,as suddenly as it "is produced,by the natural motions of the joint without "surgical assistance,but it may remain for weeks or months "and will then become a serious misfortune,as it causes "a considerable degree of lameness."This disorder may happen with or without contusion. "In the former, the symptoms are equivocal till the effects of the contusion are removed. When no contusion "has happened, or the effects of it are removed, the joint "with respect to its shape appears to be uninjured. If "there Is any difference from its usual appearance, it is "that the ligament of the patella appears more relaxed "than in the sound limb. The leg is readily bent or extended by the hands of the surgeon, and without pain to "the patient at most,the degree of uneasiness caused by "this flexion or extension is trifling. But the patient "himself cannot freely bend or perfectly extend the limb "in walking; he is. compelled to walk with an invariable "and small degree of flexion. '"The complaint which I have described may be brought "on, I apprehend,by any such alteration in the state of "the joint as will prevent the condyles of the os femoris from moving truly in the hollow formed by the semi-lunar cartilages and articular depressions of the tibia. "An unequal tension of the lateral or ,cross ligaments of "the joint,or some slight derangement of the semi-lunar "cartilages may probably be sufficient to bring on the "complaint".It is evident then that Hey regarded the complaint as one due to some interference with the proper movement of the femoral condyles upon the tibial articular surfaces, and that such interference might "be due, inter alia, to some derangement of the semi-lunar cartilages and he was unquestionably right, though he had no opportunity of examining the interior of joints so affected.Symptoms closely resembling those produced by derangement of one or other semi-lunar cartilage may be dependent upon entirely different lesions,so much so,that it becomes often very difficult to diagnose the exact condition before the joint is opened for the purpose of treatment. Consequently I have preferred to give a wider bearing to the title "Internal Derangement" than that indicated by Hey and for purposes of description have divided this essay into two parts from the pathological side, thus grouping all the morbid conditions which may give rise to symptoms more or less similar and which should be associated with this term "Internal Derangement"I. A lesion of one or other Semi-lunar Cartilage. II. Loose and pedunculated bodies,hypertrophied synovial fringes,new growths etc.The subject cannot be so divided clinically because One lesion in some of its symptoms so frequently corresponds with, another, rendering an exact diagnosis sometimes very difficult. This is not a matter of very much importance so far as immediate treatment is concerned, though the prognosis may be affected by what is found. If any attempt be made to divide the subject clinically, a division into traumatic and non-traumatic lesions would be of considerable value to the clinician,because with the exception of certain loose bodies which might be traumatic, but whose origin from injury is disputed, the morbid conditions in group I are produced by traumatism, those in group II are not. Undoubtedly, the condition is one of very considerable surgical importance, as a person may become more or less permanently disabled, he may require to give up his occupation altogether or only be able to work for short periods,and in the young it may be necessary to withhold from all active exercise in the shape of football, cricket, cycling, and other forms of athletics.An attempt will be made to give a succinct account of the various pathological conditions that may occur, to define as clearly as possible the symptoms,endeavouring to differentiate by them the lesion that exists, to discuss the different methods of treatment, and to show what benefit may be derived therefrom.Such results have been arrived at by a study of the literature of the subject,by the examination of pathological material which has been put at my disposal,and by the study of a series of cases which have come under my own observation, and I would take this opportunity of acknowledging my indebtedness to Professor Annandale for the kind way in which he has allowed me to make use of the patients under his care,and for the valuable assistance I have thus obtained, and at the same time to thank Professor Sir William Turner for leave to examine the material bearing upon this subject in the Anatomical Museum of the University of Edinburgh.The work has been carried on in the University Clinical Surgery department of the Royal Infirmary, and part I in a less extended form has already been the subject matter of a short paper in the Edinburgh Hospital Reports, vol.II,1894

Using nurse-led patient monitoring to avoid medicines-related harm

Effective medicines optimisation involves the use of medicines to control disease while ensuringthat adverse effects are kept to a minimum. However, medicines-related harm and symptommismanagement represent significant risks to patients, particularly those with long-term conditions.These risks are accentuated by inadequate patient monitoring, with some nurses and other healthcareprofessionals being unaware of their responsibility to monitor patients and avoid medicines-relatedharm. This article explores strategies that will enable nurses to take an increasingly active role inmedicines optimisation

The seeds of the black ghetto were sown in the 1880s, longbefore the Great Migration

More than a year after the tragic shooting death of Michael Brown in Ferguson Missouri by a white police officer, the influence and legacy of historic racial segregation still looms large in the US. In new research, John R. Logan, Weiwei Zhang, Richard Turner, and Allison Shertzer argue that the process of black ghettoization in Northern cities has roots in the 1880s – much farther back than has been previously thought. Making use of census data covering smaller areas than traditional census tracts, they find that ’embryonic ghettos’ were present in many cities more than 50 years before the Great Migration, helping to make possible the extreme form of the ghetto that existed in 1940 and beyond

Clinical Impact of Implementing a Nurse-Led Adverse Drug Reaction Profile in Older Adults Prescribed Multiple Medicines in UK Primary Care: A Study Protocol for a Cluster-Randomised Controlled Trial

(1) Aims: Adverse drug reactions (ADRs) particularly affect older people prescribed multiple medicines. The professional bodies of nursing, medicine and pharmacy have issued guidelines on identification and management of ADRs; however, ADRs continue to account for ~10% unplanned hospital admissions in the UK. Current methods of ADR identification and management could be improved by multidisciplinary collaboration involving nurses. The aim of this study is to examine the impact of implementing the nurse-led Adverse Drug Reaction (ADRe) Profile in UK primary care. (2) Design: A pragmatic cluster-randomised controlled trial (RCT) followed by qualitative interviews in a sequential mixed-methods study. (3) Methods: For the cluster RCT, 60 patients aged ≥65 prescribed ≥5 regular medicines for long-term conditions will be recruited, 10 in each of 6 general practices. The intervention arm (n = 30) will complete the ADRe Profile, whilst the control participants (n = 30) continue to receive usual, standard care. Primary outcomes will include clinical impact on patients, benefit and prescription changes. On completion of the RCT, participants will be invited to semi-structured qualitative interviews, to evaluate the impact of the ADRe Profile from stakeholders’ perspectives, and to describe the contextual factors relevant to ADRe implementation. (4) Results: The findings of this study will evaluate the effectiveness of the ADRe Profile in identifying and resolving potential ADRs in primary care. Trial registration: This study was registered in ClinicalTrials.gov, registration number NCT04663360, date of registration—29 November 2021 (date of initial registration: 26 November 2020), protocol version 2, dated 8 January 202

Understanding Technology Fit Among People with HIV Based on Intersections of Race, Sex, and Sexual Behavior: An Equitable Approach to Analyzing Differences Across Multiple Social Identities

HIV disproportionately impacts individuals based on intersecting categories (e.g. gender, race/ethnicity, behavior), with groups most at-risk deemed priority populations. Using weighted effects coding to account for differential group sizes, this study used multilevel mixed logistic models to investigate differences in eHealth use and willingness to use eHealth for HIVrelated information among priority populations. Compared to the sample average, Black men who had sex with women were less likely to use all technologies except cellphones with text-messaging and less likely to be willing to use computers and tablets. White and Hispanic men who had sex with men were more likely to use all technologies. No significant differences existed for use or willingness to use cellphones with text-messaging. Future research should consider approaches used here to account for equity and multiple intersecting social identities; practitioners may use these findings or similar local data to ensure fit between eHealth programs and priority populations

Selecting a comparison group for 5-year oral and pharyngeal cancer survivors: Two methods

BACKGROUND: To assess potential long-term consequences of cancer treatment, studies that include comparison groups are needed. These comparison groups should be selected in a way that allows the subtle long-range effects of cancer therapy to be detected and distinguishes them from the effects of aging and other risk factors. The purpose of this investigation was to test two methods of recruiting a comparison group for 5-year oral and pharyngeal cancer survivors (peer-nominated and listed sample) with emphasis on feasibility and the quality of the match. METHODS: Participants were drawn from a pool of 5-year survivors treated at a large Southeastern hospital. A peer-nominated sample was solicited from the survivors. A listed sample matched on sex, age, and zip code was purchased. Telephone interviews were conducted by a professional call center. RESULTS: The following represent our key findings: The quality of matching between survivors and listed sample was better than that between survivors and peer-nominated group in age and sex. The quality of matching between the two methods on other key variables did not differ except for education, with the peer method providing a better match for the survivors than the listed sample. The yield for the listed sample method was greater than for the peer-nominated method. The cost per completed interview was greater for the peer-nominated method than the listed sample. CONCLUSION: This study not only documents the methodological challenges in selecting a comparison group for studies examining the late effects of cancer treatment among older individuals but also documents challenges in matching groups that potentially have disproportionate levels of comorbidities and at-risk health behaviors