Second-Class Care: How Immigration Law Transforms Clinical Practice in the Safety Net.

This article examines how U.S. immigration law extends into the health care safety net, enacting medical legal violence that diminishes noncitizens' health chances and transforms clinical practices. Drawing on interviews with health care workers in three U.S. states from 2015 to 2020, I ask how federal citizenship-based exclusions within an already stratified health care system shape the clinical trajectories of noncitizens in safety-net institutions. Focusing specifically on cancer care, I find that increasingly anti-immigrant federal policies often reshape clinical practices toward noncitizens with a complex, life-threatening condition as they approach a "specialty care cliff" by (1) creating time penalties that keep many noncitizens in a protracted state of injury and (2) deterring noncitizens from seeking care through threats of immigration enforcement. Through these processes, medical legal violence also creates the potential for moral injury among health care workers, who must adapt clinical practices in response to socio-legal boundaries of belonging

Wyoming v. Zinke

In Wyoming v. Zinke, the Bureau of Land Management attempted to update a regulation governing hydraulic fracturing from the 1980s, but oil and gas industry companies opposed, and brought suit. The district court held in favor of the industry petitioners, and the Bureau of Land Management and citizen group intervenors appealed. In the wake of appeal, Donald J. Trump became President of the United States. The administration change caused the Bureau of Land Management to alter its position and align with the new administration. Secretary of the Interior, Ryan Zinke, via executive order, began rescinding the new fracking regulation, which rendered the issues prudentially unripe for review

Navajo Nation v. Department of the Interior

In Navajo Nation v. Department of the Interior, the Navajo Nation challenged the Department of the Interior’s 2001 and 2008 water allocation guidelines and asserted that under NEPA and the APA the guidelines violated the Navajo Nation’s water rights. The Navajo Nation also asserted a breach of trust claim against the United States. After nearly a decade of attempted settlement negotiations, the Navajo Nation reasserted its complaints. The District Court for the District of Arizona denied the Navajo Nation’s motions, and the Navajo Nation appealed to the Ninth Circuit Court of Appeals, which determined the Navajo Nation lacked standing, leaving the Navajo Nation’s water rights unadjudicated and unquantified

Family engagement practices of part C early interventionists in Indiana : a quantitative study

Access to thesis permanently restricted to Ball State community onlyFamily engagement in early intervention has been identified as a critical element to a child’s development, especially those with disabilities and delays. Several recommended practices have been identified as contributing to family engagement. These recommended practices include providing services in the natural environment, utilizing natural learning opportunities, providing services in a family-centered manner, and employing coaching strategies to facilitate family engagement. Based on national and state recommended practice publications, Part C service providers in Indiana are expected to provide services using these recommended practices, however several bodies of research have identified a gap between the research and actual practice. The purpose of this study was to determine the differences in training, perceived knowledge, perceived effectiveness and implementation of the recommended practices that lead to family engagement of IDEA Part C service providers based on trainings on these practices and type of profession. Findings were discussed in light of current evidence and suggestions for future research were made.Department of Special EducationThesis (D. Ed.

Association of Retinal Vascular Caliber and Age-Related Macular Degeneration in Patients With the Acquired Immunodeficiency Syndrome.

PurposeTo evaluate the relationship between retinal vascular caliber and AMD in patients with AIDS.MethodsParticipants enrolled in the Longitudinal Study of the Ocular Complications of AIDS had retinal photographs taken at enrollment. Retinal vascular caliber (central retinal artery equivalent [CRAE] and central retinal vein equivalent [CRVE]) and intermediate-stage AMD were determined from these retinal photographs. Photographs were evaluated by graders at a centralized reading center, using the Age-Related Eye Disease Study grading system for AMD and semiautomated techniques for evaluating retinal vascular caliber.ResultsOf the 1171 participants evaluated, 110 (9.4%) had AMD and 1061 (90.6%) did not. Compared with participants without AMD, participants with AMD had larger mean CRAEs (151 ± 16 μm versus 147 ± 16 μm; P = 0.009) and mean CRVEs (228 ± 24 μm versus 223 ± 25 μm; P = 0.02). The unadjusted differences were: CRAE, 4.3 μm (95% confidence interval [CI] 1.1-7.5; P = 0.009) and CRVE, 5.5 μm (95% CI 0.7-10.3; P = 0.02). After adjustment for age, race/ethnicity, sex, human immunodeficiency syndrome (HIV) transmission category, smoking, enrollment and nadir CD4+ T cells, and enrollment and maximum HIV load, the differences between patients with and without AMD were as follows: CRAE, 5.4 μm (95% CI 2.3-8.5; P = 0.001) and CRVE, 6.0 μm (95% CI 1.4-10.6; P = 0.01).ConclusionsIn patients with AIDS, AMD is associated with greater retinal arteriolar and venular calibers, suggesting a role for shared pathogenic mechanisms, such as persistent systemic inflammation

Vertical structure models of T Tauri and Herbig Ae/Be disks

In this paper we present detailed models of the vertical structure (temperature and density) of passive irradiated circumstellar disks around T Tauri and Herbig Ae/Be stars. In contrast to earlier work, we use full frequency- and angle-dependent radiative transfer instead of the usual moment equations. We find that this improvement of the radiative transfer has strong influence on the resulting vertical structure of the disk, with differences in temperature as large as 70 %. However, the spectral energy distribution (SED) is only mildly affected by this change. In fact, the SED compares reasonably well with that of improved versions of the Chiang & Goldreich (CG) model. This shows that the latter is a reasonable model for the SED, in spite of its simplicity. It also shows that from the SED alone, little can be learned about the vertical structure of a passive circumstellar disk. The molecular line emission from these disks is more sensitive to the vertical temperature and density structure, and we show as an example how the intensity and profiles of various CO lines depend on the adopted disk model. The models presented in this paper can also serve as the basis of theoretical studies of e.g. dust coagulation and settling in disks.Comment: 12 pages, 15 figures, accepted for publication in A&

Grain growth and dust settling in a brown dwarf disk: Gemini/T-ReCS observations of CFHT-BD-Tau 4

We present accurate mid-infrared observations of the disk around the young, bona-fide brown dwarf CFHT-BD-Tau 4. We report GEMINI/T-ReCS measurements in the 7.9, 10.4 and 12.3 micron filters, from which we infer the presence of a prominent, broad silicate emission feature. The shape of the silicate feature is dominated by emission from 2 micron amorphous olivine grains. Such grains, being an order of magnitude larger than those in the interstellar medium, are a first proof of dust processing and grain growth in disks around brown dwarfs. The object's spectral energy distribution is below the prediction of the classical flared disk model but higher than that of the two-layer flat disk. A good match can be achieved by using an intermediate disk model with strongly reduced but non-zero flaring. Grain growth and dust settling processes provide a natural explanation for this disk geometry and we argue that such intermediate flaring might explain the observations of several other brown dwarf disks as well.Comment: Accepted for publication in Astronomy & Astrophysics Letters, 4.5 pages with 1 figur

Accretion Rates in Herbig Ae stars

Accretion rates from disks around pre-main sequence stars are of importance for our understanding of planetary formation and disk evolution. We provide in this paper estimates of the mass accretion rates in the disks around a large sample of Herbig Ae stars. We obtained medium resolution 2 micron spectra and used the results to compute values of Macc from the measured luminosity of the Br_gamma emission line, using a well established correlation between L(Br_gamma) and the accretion luminosity Lacc. We find that 80% of the stars, all of which have evidence of an associated circumstellar disk, are accreting matter, with rates 3x10^{-9} < Macc} < 10^{-6} Msun/yr; for 7 objects, 6 of which are located on the ZAMS in the HR diagram, we do not detect any line emission. Few HAe stars (25%) have Macc>10^{-7} Msun/yr. In most HAe stars the accretion rate is sufficiently low that the gas in the inner disk, inside the dust evaporation radius, is optically thin and does not prevent the formation of a puffed-up rim, where dust is directly exposed to the stellar radiation. When compared to the Macc values found for lower-mass stars in the star forming regions Taurus and Ophiuchus, HAe stars have on average higher accretion rates than solar-mass stars; however, there is a lack of very strong accretors among them, probably due to the fact that they are on average older.Comment: To be published in Astronomy & Astrophysic