Refugee Rights and Wrongs: Global Cultural Diffusion among the Congolese in South Africa

Every day the media is filled with examples of the ways in which contemporary social, economic, and political life transcends national borders. Some researchers argue that these dynamics attest to the emergence of a global civil society, based on a set of universal norms and practices that works in tandem with or may even supercede national politics. Yet we know little about the ways in which global institutions resonate with the everyday lives of individuals and with the organizations that actually serve people on the ground. How do ordinary people learn about and conceptualize these universal rights and how do they claim them? To what extent do NGOs articulate comparable notions about rights, pursue common strategies to achieve them, and by so doing, contribute to this emerging architecture of transnational governance? This paper uses the case of Congolese refugees in South Africa to explore these questions. It examines how individuals learn about and use global norms and practices and how this learning process varies in their home and host-country context. It also explores the extent to which organizations operating both locally and internationally are exposed to a set of global approaches and expectations and how these influence how things get done

Patient and Physician Perceptions of Dimensions of Necessity of Medical Utilization

The goal of this research was to understand better the perspectives held by physicians and patients regarding what factors determine the appropriateness of medical visits. We also wished to create a convenient measure of those perspectives. In our first study, we conducted focus groups separately composed of 22 physicians and 16 patients to determine their respective views. In our second study, a 40-item measure derived from Study 1 themes was administered to a sample of 202 patients. Study 1 identified 20 themes, collapsing into 6 dimensions. Physicians held views that some patients were manipulative when seeking medical care. Study 2 revealed factors of Symptom Experience and Doctor Expertise. The two studies revealed that the perception of medical utilization varies between patients and physicians, but both groups share many similar beliefs

African American and Caucasian Perceptions and Attitudes Toward Colorectal Cancer Screening: A Qualitative Study

This study examined the attitudes held by both African Americans and Caucasians regarding colorectal cancer screening and the reasons why they avoid screenings even when clinically indicated by their physicians. Colorectal cancer (CRC) is one of the most common and easily preventable types of cancer in the United States. If diagnosed and treated early prior to metastasis, the five-year colorectal cancer survival rate is approximately 90%. However, many patients avoid screening procedures for colorectal cancer due to a number of reasons. Qualitative data was gathered from focus groups and found four major themes that emerged in both groups: (1) reported barriers to screening, (2) level of knowledge about CRC, (3) knowledge of risk factors for CRC, and (4) suggested strategies for improving CRC screening. African Americans and Caucasians reported differential concerns for each of those themes, including on physician vs. access issues (barriers), environmental vs. hereditary diseases (risk factors), community vs. physician-based interventions (strategies), and substantial differences with regard to CRC knowledge

The All of Us Research Program: Engaging the Community for the Future of Health

The All of Us Research Program (AoURP), funded by the National Institutes of Health, is an ambitious ten-year effort to enroll over one million participants across the country. The AoURP is a key part of the Precision Medicine Initiative and seeks to build a national cohort collecting self-reported health data, medical record data, biospecimen samples and physical measurements to accelerate precision medicine. Precision Medicine is an emerging approach for healthcare treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. Researchers at the Meyers Primary Care Institute and the University of Massachusetts Medical School have partnered with Reliant Medical Group to enroll over 10,000 participants in 5 years. The Meyers/Reliant team is actively working to engage the local community, educational institutions, and community organizations to increase awareness of the program and encourage participation. Our efforts have focused specifically on populations previously underrepresented in biomedical research, including older adults, racial and ethnic minority group members, and others. We are hoping to grow new relationships and build strong community partnerships to help us achieve our enrollment goals and communicate the great potential of the AoU Research Program to change the future of medical research with a focus on precision medicine

Association of Pyrethroid Pesticide Exposure With Attention-Deficit/Hyperactivity Disorder in a Nationally Representative Sample of U.S. Children

Background Pyrethroid pesticides cause abnormalities in the dopamine system and produce an ADHD phenotype in animal models, with effects accentuated in males versus females. However, data regarding behavioral effects of pyrethroid exposure in children is limited. We examined the association between pyrethroid pesticide exposure and ADHD in a nationally representative sample of US children, and tested whether this association differs by sex. Methods Data are from 8–15 year old participants (N = 687) in the 2001–2002 National Health and Nutrition Examination Survey. Exposure was assessed using concurrent urinary levels of the pyrethroid metabolite 3-phenoxybenzoic acid (3-PBA). ADHD was defined by either meeting Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria on the Diagnostic Interview Schedule for Children (DISC) or caregiver report of a prior diagnosis. ADHD symptom counts were determined via the DISC. Multivariable logistic regression examined the link between pyrethroid exposure and ADHD, and poisson regression investigated the link between exposure and ADHD symptom counts. Results Children with urinary 3-PBA above the limit of detection (LOD) were twice as likely to have ADHD compared with those below the LOD (adjusted odds ratio [aOR] 2.42; 95 % confidence interval [CI] 1.06, 5.57). Hyperactive-impulsive symptoms increased by 50 % for every 10-fold increase in 3-PBA levels (adjusted count ratio 1.50; 95 % CI 1.03, 2.19); effects on inattention were not significant. We observed possible sex-specific effects: pyrethroid biomarkers were associated with increased odds of an ADHD diagnosis and number of ADHD symptoms for boys but not girls. Conclusions We found an association between increasing pyrethroid pesticide exposure and ADHD which may be stronger for hyperactive-impulsive symptoms compared to inattention and in boys compared to girls. Given the growing use of pyrethroid pesticides, these results may be of considerable public health import

Development of esophageal squamous cell cancer in patients with FAMMM syndrome: Two clinical reports

Familial atypical multiple mole melanoma (FAMMM) syndrome is a hereditary syndrome characterized by multiple dysplastic nevi and melanoma. Patients with FAMMM may have a heterozygous, inactivating, pathogenic germline variant in the CDKN2A gene, especially the NM_000077.4: c.225_243del19 (p.p75fs) variant, also known as p16-Leiden variant. Patients with this variant are at high risk for developing melanomas and pancreatic cancer due to somatic inactivation of the wild-type CDKN2A allele. The combination of an inactivating germline CDKN2A mutation and somatic inactivation of the wild-type CDKN2A allele in the same cell results in tumor formation. It has been suggested that carriers of a germline CDKN2A mutation are also at increased risk for several other cancer types, including esophageal cancer. Here, we describe two unrelated patients with the p16-Leiden variant who developed esophageal squamous cell cancer. Evidence of loss of the wild-type CDKN2A allele was obtained in the tumor tissue of both patients indicating biallelic inactivation of p16 in the tumor cells. These results suggest that these patients developed esophageal squamous cell cancer in the context of FAMMM syndrome

Phenotyping in the era of genomics: MaTrics—a digital character matrix to document mammalian phenotypic traits

A new and uniquely structured matrix of mammalian phenotypes, MaTrics (Mammalian Traits for Comparative Genomics) in a digital form is presented. By focussing on mammalian species for which genome assemblies are available, MaTrics provides an interface between mammalogy and comparative genomics. MaTrics was developed within a project aimed to find genetic causes of phenotypic traits of mammals using Forward Genomics. This approach requires genomes and comprehensive and recorded information on homologous phenotypes that are coded as discrete categories in a matrix. MaTrics is an evolving online resource providing information on phenotypic traits in numeric code; traits are coded either as absent/present or with several states as multistate. The state record for each species is linked to at least one reference (e.g., literature, photographs, histological sections, CT scans, or museum specimens) and so MaTrics contributes to digitalization of museum collections. Currently, MaTrics covers 147 mammalian species and includes 231 characters related to structure, morphology, physiology, ecology, and ethology and available in a machine actionable NEXUS-format*. Filling MaTrics revealed substantial knowledge gaps, highlighting the need for phenotyping efforts. Studies based on selected data from MaTrics and using Forward Genomics identified associations between genes and certain phenotypes ranging from lifestyles (e.g., aquatic) to dietary specializations (e.g., herbivory, carnivory). These findings motivate the expansion of phenotyping in MaTrics by filling research gaps and by adding taxa and traits. Only databases like MaTrics will provide machine actionable information on phenotypic traits, an important limitation to genomics. MaTrics is available within the data repository Morph·D·Base (www.morphdbase.de)

Antimigraine medication use and associated health care costs in employed patients

Migraine is under diagnosed and suboptimally treated in the majority of patients, and also associated with decreased productivity in employees. The objective of this retrospective study is to assess the antimigraine medication use and associated resource utilization in employed patients. Patients with primary diagnosis of migraine or receiving antimigraine prescription drugs were identified from an employer-sponsored health insurance plan in 2010. Medical utilization and health care costs were determined for the year of 2010. Generalized linear regression was applied to evaluate the association between health care costs and the use of antimigraine medications by controlling covariates. Of 465 patients meeting the study criteria, nearly 30% that had migraine diagnosis were prescribed antimigraine medications, and 20% that had migraine diagnosis were not prescribed antimigraine medications. The remaining 50% were prescribed antimigraine medications but did not have migraine diagnosis. Patients with antimigraine medication prescriptions showed lower frequency of emergency department visits than those without antimigraine medication prescriptions. Regression models indicated an increase in migraine-related health care costs by 86% but decreases in all-cause medical costs and total health care costs by 42 and 26%, respectively, in the antimigraine medication use group after adjusting for covariates. Employed patients experienced inadequate pharmacotherapy for migraine treatment. After controlling for covariates, antimigraine prescription drug use was associated with lower total medical utilization and health care costs. Further studies should investigate patient self-reported care and needs to manage headache and develop effective intervention to improve patient quality of life and productivity

An overview of the first decade of PollyNET: An emerging network of automated Raman-polarization lidars for continuous aerosol profiling

A global vertically resolved aerosol data set covering more than 10 years of observations at more than 20 measurement sites distributed from 63° N to 52° S and 72° W to 124° E has been achieved within the Raman and polarization lidar network PollyNET. This network consists of portable, remote-controlled multiwavelength-polarization-Raman lidars (Polly) for automated and continuous 24/7 observations of clouds and aerosols. PollyNET is an independent, voluntary, and scientific network. All Polly lidars feature a standardized instrument design with different capabilities ranging from single wavelength to multiwavelength systems, and now apply unified calibration, quality control, and data analysis. The observations are processed in near-real time without manual intervention, and are presented online at http://polly.tropos.de/. The paper gives an overview of the observations on four continents and two research vessels obtained with eight Polly systems. The specific aerosol types at these locations (mineral dust, smoke, dust-smoke and other dusty mixtures, urban haze, and volcanic ash) are identified by their Ångström exponent, lidar ratio, and depolarization ratio. The vertical aerosol distribution at the PollyNET locations is discussed on the basis of more than 55 000 automatically retrieved 30 min particle backscatter coefficient profiles at 532 nm as this operating wavelength is available for all Polly lidar systems. A seasonal analysis of measurements at selected sites revealed typical and extraordinary aerosol conditions as well as seasonal differences. These studies show the potential of PollyNET to support the establishment of a global aerosol climatology that covers the entire troposphere