Risk Reduction Regarding Stigmatized and Marginalized Communities

While there are several perspectives on marginalization, there are multiple marginalized individuals, social groups, and communities globally. This process of marginalization produces individuals, groups and communities which are refused complete privileges, rights, and power within the broader political and social framework. Social, cultural, biological, and economic factors can thus be used as yardsticks to marginalize individuals and communities. Marginalization can be based on gender, race and ethnicity, social class, and sexuality, among others. Clearly, marginalized communities face poorer health outcomes and these outcomes are sometimes linked to risky behaviors more prevalent in such demographics. Marginalization is associated with reduced health outcomes and can limit the agency of marginalized communities. However, even within sites of marginalization, affected communities make significant attempts to mitigate health risks and retain agency. For example, marginalized men who have sex with men in China face severe discrimination which affects their health outcomes. Even within such contexts, these men still encourage peers to receive sexually transmitted infection testing. I explore how marginalized communities reduce health risks likely produced by marginalization and retain agency through doing so. I explore sexually transmitted infection testing and related issues in Chinese men who have sex with men, the United States legal cannabis industry, and medication for those with opioid use disorder. In doing so, I will provide understanding on risk reduction of health behaviors in marginalized communities, building a knowledge base to aid overall health outcomes. In the first chapter, I detailed a range of cannabis-centric studies. First, I detailed cannabis usage preferences among United States cannabis users. I put forth that frequent cannabis use may increase risk of health harms and highlighted the need to minimize problematic use. I also explored sociodemographic indicators and their association with likelihood for cannabis-related emergency department admissions in New York City. Results suggested that cannabis use may further burden marginalized groups. I investigated large cannabis firms’ motivations for participating in the cannabis space. I put forth that policymakers be aware that non-profits and for-profits both seek to expand cannabis access and consider the groups as a unified whole. In the second chapter I explored concerns regarding sexually transmitted infection testing in the Chinese men who have sex with men environment. I first detailed factors associated with sexually transmitted infection testing. Results detailed the role of altruism in a sexually transmitted infection testing intervention. Expressions of altruism may promote contributions toward public health initiatives in marginalized communities. In the same vein, I detailed the association between men who have sex with men community-centric behaviors and contributions toward others’ sexually transmitted infection testing. I proposed that community-oriented behaviors may be related with a reduction in testing service costs. Then, I evaluated whether men who have sex with men selected a sexually transmitted infection test appropriate for their sexual behavior. I suggested that disclosing sexual identity to treatment providers can improve men who have sex with men sexually transmitted infection prevalence estimates. I also detailed the correlates of antisocial behavior on the world\u27s largest gay dating app among Chinese men who have sex with men. I suggested that age, condom use, and number of social ties may be associated with antisocial behavior, with implications for the design of online sexual health interventions. Finally, I assessed if same-sex sexual behavior disclosure of Chinese men who have sex with men was related to number of HIV self-testing kits requested, and number of test results successfully uploaded by alters in a network-based HIV self-testing intervention. Findings had implications for the development of network-based interventions for key populations. In the final chapter I detailed that various forms of social network support may influence medication for opioid use disorder treatment outcomes. Failure to implement successful social network support programs within medication for opioid use disorder treatment settings may represent an important missed opportunity to engage patients at risk of treatment failure. While the topics here are broad, they all share similar thematic arcs. Low sexually transmitted infection testing uptake, opioid use disorder and cannabis use are issues often disproportionately faced by marginalized communities. Establishing marginalization as the causal factor behind these concerns is often complex, but there is significant work indicating that problematic patterns of drug use and poor sexual health outcomes are engendered by marginalization. Marginalization is associated with conditions inimical to health and well-being, creating a host of health risks. Such marginalization limits the agency of affected communities. However, even within these sites of marginalization, men who have sex with men seek testing and opioid use disorder patients seek medication, mitigating health risks borne from marginalization. I advance that marginalized communities are not completely helpless considering reduced health outcomes, indicating how agency is reclaimed. Finally, I indicated other cases where fostering agency in marginalized communities needs to be carefully considered

Case report: a case of pericardial effusion presenting to primary care

This is a rare but interesting case of Mr. MZ who had a life threatening pericardial effusion presenting to the primary care clinic. Through great clinical acumen and prudent targeted investigations, diagnosis of this rare condition was reached and urgent referral made to the cardiology team which performed an emergency pericardiocentesis which proved to be life -saving. However, the hovering poor prognosis of Mr. MZ may prompt for a referral to the palliative care team to provide quality end of life care for this unfortunate patient

The difficult rheumatology diagnosis

Background Rheumatoid arthritis is a devastating condition. More so, the diagnosis of seronegative rheumatoid arthritis is often fraught off with much uncertainty and that leads to further suffering to the unfortunate patient. Case Details This is a case of Madam A, who presented with many non-specific symptoms and signs involving many systems which was finally diagnosed as seronegative rheumatoid arthritis. This case explores the challenges in reaching this uncommon diagnosis and how anti-inflammatory drugs can bring a miraculous relief to the patient's suffering. Conclusion The diagnosis of seronegative rheumatoid arthritis often presents a real challenge to the medical practitioner and often requires multiple visits and/or shared multidisciplinary care for confirmation of the diagnosis. Once diagnosed and treated with disease modifying anti- rheumatic drugs, often there is a miraculous relief to the patient's suffering

The effect of intellectual capital on Malaysian banks financial performances: Comparative study on conventional and Islamic banks

In ultra competitive banking industry nowadays, banks could not solely rely on monetary capital for competitive advantage. In this respect, intellectual capital (intangible asset) emerged as viable resources for banks. AFAS (ASEAN Framework Agreement on Services) which will commence in 2020 has put prominence on intellectual capital. This research aims to examine relationship between intellectual capital and financial performances of 32 Malaysian banks (conventional and Islamic) for eight years from 2008 to 2015. In this respect, comparative study between conventional and Islamic banks are undertaken. Value added intellectual coefficient (VAIC) technique is utilised to compute banks’ value added performances. Profitability proxies such as return on asset, return on equity, and data envelopment analysis’ efficiency are used. The banks intellectual capital (human capital, structural capital) and physical capital (capital employed) effect on banks financial performances had been computed by utilisation of panel data estimation method. The results of this research study showed relationships between intellectual capital and banks financial performances between Malaysian conventional and Islamic banks are varied. Moreover, study findings implied intellectual capital is crucial for banks competitive advantage. This study findings can assist banks decision makers and investors in analysing intellectual capital position of Malaysian financial institution

Osteoarthritis treatment - the newer treatment options

Osteoarthritis of the knee is a common condition in the elderly. However, active participation in sports and trauma may also lead to premature osteoarthritis. This case report looks at a 60 years old woman who had severe osteoarthritis of her knees and what treatment options were helpful for her

Study on Relationship between Selected Independent Variables with Knowledge of the Mobile Agro-Advisory Services Using Farmers of Udupi District of Karnataka

The present study was conducted during 2016-17 in the Udupi district of Karnataka. Mobile phones play an important role in accessing the information about improved cultivation practices. In this study, we had analysed the relationship between independent variable and knowledge level of the farmers. We had selected total 13 independent variables for the study, three variables viz., education, achievement motivation and risk orientation showed positive and significant relationship at one per cent level of probability. Whereas, six variables viz., annual income, extension contact, scientific orientation,extension participation, mass media participation and innovativeness showed positive and significant relation at five per cent level of probability with knowledge level. The remaining four variables namely, age, family type, occupation and land holding and did not showed any significant relationship with knowledge leve