The temporary anatomical structures prominent in the first trimester may be fulfilling exchange functions assigned to the placenta in the second and third trimester

The extra-embryonic coelom (EEC) and secondary yolk sac are prominent structures in the gestational sac during the first trimester of human pregnancy, at a time before the definitive placental circulation becomes established. We propose that the EEC and yolk sac play a critical role in the nutrition of early pregnancy, fulfilling exchange functions which are assumed by the placenta at a later stage

The Impact of U.S. Refugee Policy Change & Political Rhetoric on Nonprofit Service Providers’ Emotional Well-Being

This study examines how U.S. refugee policy changes from 2014 to 2018 affected the emotional well-being of nonprofit service providers. Elements identified by participants as emotionally significant were funding cuts, the “bans”, the unpredictable nature of policy change, and most impactful, negative political rhetoric. Emotional wellbeing was negatively affected and included an increase in stress, anger, sadness, despair, depression, helplessness, frustration, and caution. Negative impacts were also felt with regard to professional identities and to relationships with family, friends, and strangers. Importantly, impact on emotional wellbeing differed by level of organization at which the participant worked and by organizational characteristics

Strategies to Mitigate the Effects of Negative Political Rhetoric on Service Providers: A Study in Two Refugee-Serving Organizations

This paper explores the strategies that staff at two refugee-serving organizations found helpful in mitigating their increased distress from negative political rhetoric aimed at their clients. Results point to the importance of organizational acknowledgement of the distress. Additionally, staff perceived that intentionally focused organizational interventions can mitigate the emotional impacts of negative rhetoric. Finally, strategies employees used to lessen their distress and regain a sense of efficacy included recommitment to the mission, advocacy for refugees among family and friends, strong reliance on religious faith in coping, and an avoidance of the rhetoric by decreasing engagement with news and social media

Natural preconditioning and iterative methods for saddle point systems

The solution of quadratic or locally quadratic extremum problems subject to linear(ized) constraints gives rise to linear systems in saddle point form. This is true whether in the continuous or the discrete setting, so saddle point systems arising from the discretization of partial differential equation problems, such as those describing electromagnetic problems or incompressible flow, lead to equations with this structure, as do, for example, interior point methods and the sequential quadratic programming approach to nonlinear optimization. This survey concerns iterative solution methods for these problems and, in particular, shows how the problem formulation leads to natural preconditioners which guarantee a fast rate of convergence of the relevant iterative methods. These preconditioners are related to the original extremum problem and their effectiveness---in terms of rapidity of convergence---is established here via a proof of general bounds on the eigenvalues of the preconditioned saddle point matrix on which iteration convergence depends

Our roles are not at ease: The work of engaging a youth advisory council in a mental health services delivery organization

Objectives: There is growing policy impetus for including youth voices in health services research and health system reform. This article examines the perspectives of professionals in a mental healthcare organization charged with engaging young people as advisors in service transformation. Methods: An institutional ethnography of a youth mental health services organization in Ontario, Canada, was conducted. Fieldwork consisted of twelve months of observation of meetings, interviews with youth advisors and adult service providers, with subsequent text analysis of engagement training and policy materials. The present article reports data from six adult professionals and related field observations. Results: Service providers’ efforts to engage youth were observed in three areas: a) supporting youth\u27s development as advisors, b) retaining and deepening youth participation while waiting for organizational change and c) embedding relationships between youth and adults at various levels within the system of care. This work denotes existing tensions between the values and ideals of youth engagement and the everyday demands of services delivery. Conclusion: In this setting, a fundamental dimension of this work consisted of negotiating tensions between the policy enthusiasm for engagement and its realization in a health services context. In describing these contextual challenges, we outline implications for consideration by other youth mental health services. Engagement efforts that are authentic and sustained require resources and flexibility, and leadership commitment to instil service users’ perspectives throughout multiple levels within the organization

Evaluation of sex differences in health-related quality of life outcomes associated with child abuse: Results from the Ontario Child Health Study

Aims. Despite the advances in child maltreatment research, there is still the need for comprehensive information about how abuse affects a broad range of categories of young adult functioning, and the extent to which these vary by sex. We examined the associations between child physical abuse (PA) and sexual abuse (SA) and six areas of functioning (mental health, physical health, life satisfaction, illegal substance use, alcohol problems and daily smoking). Methods. Data were obtained from the 1983 Ontario Child Health Study and follow-up in 2000/2001 (n = 1893). Multilevel regression estimated the adjusted associations for PA (with severity) and SA with each of the outcomes. Estimates with an entire sample were presented with sex-by-abuse interactions to examine sex differences and then presented separately by sex. Results. In the adjusted model, severe PA and SA were associated with impairment in mental health, and both forms of PA (severe and non-severe) and SA were associated with low life satisfaction. In addition, severe PA was associated with illegal substance use. Child abuse variables were not associated with poor physical health, alcohol problems or smoking. Although sex-stratified analyses revealed different patterns, there was no significant sex difference in the integrated sample. Conclusions. This is among the first community-based studies to show a strong association between child PA and SA and low life satisfaction in young adults. The abuse effects were similar for both sexes

Towards Improving Engagement of Youth of Color in Cross-Age Mentoring Programs in High Poverty, High Crime Neighborhoods

This study examines predictors of attendance in a cross-age youth mentoring program offered in four high-poverty, high-crime communities. Youth in greatest need of after school and summer interventions are those residing in such communities, but programs are scarce. More specific to mentoring programs that do exist, past research has demonstrated the significance of attendance as a predictor of positive outcomes. Two datasets were combined for this study: The Saving Lives, Inspiring Youth (SLIY) mentoring program dataset and a neighborhood database. OLS regression results show that for all participants, traveling from a lower-crime home area to a program in a higher-crime area was negatively related to attendance, as was age. In addition to crime, variables related to attendance for mentors included stress, perceived family resources, and race, whereas age and having a sister were related to attendance for mentees. Implications for program designers and policymakers are discussed

Talk, trust and time: a longitudinal study evaluating knowledge translation and exchange processes for research on violence against women

<p>Abstract</p> <p>Background</p> <p>Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates.</p> <p>Methods</p> <p>A longitudinal cross-sectional design, applying concurrent mixed data collection methods (surveys, interviews, and focus groups), was used to evaluate the utility of specific KTE strategies, including a series of workshops and a day-long Family Violence Knowledge Exchange Forum, on research sharing, uptake, and use.</p> <p>Results</p> <p>Participants valued the opportunity to meet with researchers, provide feedback on key messages, and make personal connections with other stakeholders. A number of factors specific to the knowledge itself, stakeholders' contexts, and the nature of the knowledge gap being addressed influenced the uptake, sharing, and use of the research. The types of knowledge use changed across time, and were specifically related to both the types of decisions being made, and to stage of decision making; most reported use was conceptual or symbolic, with few examples of instrumental use. Participants did report actively sharing the research findings with their own networks. Further examination of these second-order knowledge-sharing processes is required, including development of appropriate methods and measures for its assessment. Some participants reported that they would not use the research evidence in their decision making when it contradicted professional experiences, while others used it to support apparently contradictory positions. The online wiki-based 'community of interest' requested by participants was not used.</p> <p>Conclusions</p> <p>Mobilizing knowledge in the area of VAW practice and policy is complex and resource-intensive, and must acknowledge and respect the values of identified knowledge users, while balancing the objectivity of the research and researchers. This paper provides important lessons learned about these processes, including attending to the potential unintended consequences of knowledge sharing.</p