‘At some points you feel awful because you are going to start again’: The ambiguous role of education in highly skilled refugee women’s integration experiences

Helen Baillot - ORCID: 0000-0003-2848-023X https://orcid.org/0000-0003-2848-023XMarcus Fernandes - ORCID: 0009-0009-4840-1093 https://orcid.org/0009-0009-4840-1093In refugee and migration studies, education has been situated as both a marker of integration and a facilitator of progress in other domains. This paper draws on the accounts of three highly skilled women who have experienced forced migration to highlight some of the ambiguities of education’s role in pathways to social and economic inclusion. A case study approach allows for a detailed and contextual exploration of how intersections of age, caring responsibilities and immigration status influence women’s ability to engage with education. Participants’ accounts confirm that accessing desired and appropriate educational provision can propel people towards their longer-term goals. However, provision that is inaccessible or perceived to be below women’s skill levels can be experienced as exclusionary and demoralising, with attendant impact on women’s perceptions of integration and hopes for the future. Women deploy several strategies to overcome these obstacles, including leveraging existing social connections and re-evaluating their future career pathways. Yet these strategies are not always fully successful. Our findings point towards the need for improved provision for adult refugees and a concerted effort by educational institutions to tackle continuing systemic barriers to education.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Asylum, Migration and Integration Fund (UK2020PR0104).https://doi.org/10.1177/27526461241286896aheadofprintaheadofprin

Human Papillomavirus Typing in HIV-Positive Women

Objective: Human papillomavirus (HPV) is the major cause of cervical carcinoma and cervical intraepithelial neoplasia worldwide. Certain HPV types have a strong association with and probably a causative role in the pathogenesis of premalignant cervical lesions. Epidemiologic studies in women infected by the human immunodeficiency virus (HIV) have shown an increased incidence of squamous intraepithelial lesions (SILs), whichwere predominantly high-grade. Six to 30 per cent of women diagnosed with atypical squamous cells of undetermined significance (ASCUS) on a Papanicolaou (Pap) smear harbor SIL in normal screening populations. This study was undertaken to determine the presence of low- and high-risk HPV types in women infected by HIV and to correlate the results to those of the Pap smear. Study design: HPV DNA typing (low- and high-risk) by Digene™ (Digene Corporation, Gathesburg, MD) hybrid capture methodology was performed on cervical swabs from 209 HIV-positive women. The results of HPV typing were correlated with those of the Pap smear in a retrospective analysis. Results: One hundred and one women (48%) tested positive for HPV subtypes by DNA typing by the hybrid capture method. Of these, 64 patients (63%) had Pap smears whichwere read as being normal, having benign cellular changes, or having ASCUS (favor reactive process). Of these, 19 patients tested positive for both high-risk and low-risk subtypes, 32 patients tested positive only for high-risk subtypes, and 13 patients tested positive only for low-risk subtypes. Conclusion: HPV subtyping identifies a significant group of HIV-positive women who are at risk for developing cervical intraepithelial neoplasia, although they may not show significant abnormalities on their Pap smears

Abundance and Spatial Distribution of Brown Crab (Cancer pagurus) from Fishery-Independent Dredge and Trawl surveys in the North Sea

Acknowledgements We would like to thank the MSS staff who participated in the east coast dredge surveys and IBTS quarter 3 surveys for the data sampling work that has been used in this study. Thanks to Andrzej Jaworski for providing advice on the use of geostatistical methods. Finally, would also like to thank the editor and two anonymous reviewers for their helpful comments. Funding This study was funded by the Marine Collaboration Research Forum (MarCRF), with Marine Scotland Science and the University of Aberdeen.Peer reviewedPostprin

MONITORAMENTO, POR MEIO DE GEOTECNOLOGIAS, DOS PROCESSOS DE INUNDAÇÃO E ALAGAMENTO NA BACIA HIDROGRÁFICA DO RIO DO BACURI, IMPERATRIZ-MA.

Os problemas ambientais têm-se tornado cada vez mais frequentes nos grandes centros urbanos, potencializados em grande parte pela ação antrópica. Atualmente, o monitoramento por meio das geotecnologias tornou-se uma ferramenta de grande utilidade no combate e prevenção das ocorrências dos problemas ambientais, uma vez que, torna-se possível, identificar, coletar, processar dados ou escalas espaciais dos objetos presentes na superfície terrestre. O trabalho tem por objetivo compreender as áreas atingidas pelos processos de inundação e alagamento, na área da Bacia Hidrográfica do Rio Bacuri, localizada no município de Imperatriz - MA, por meio do uso de geotecnologias. Para alcançar esse objetivo foi utilizado o modelo digital de elevação (MDE) Copernicus Dem, com resolução espacial de 30 metros, projetados no software (Qgis 3.22), em seguida, os dados foram projetados no modelo Hand Model onde foi gerado o mapa de áreas suscetíveis à inundação. Posteriormente, foram utilizados dados da Superintendência Municipal de Proteção e Defesa Civil (SUMPDEC) para o mapeamento dos principais pontos atingidos pela vazão do rio Bacuri. Os resultados obtidos constataram que a bacia hidrográfica do rio bacuri sofre demasiadamente com os processos de inundação e alagamento, geram transtornos em escalas sociais e econômicas para os habitantes que vivem em suas proximidades. Conclui-se que o trabalho foi de suma importância para identificar as áreas suscetíveis aos processos de inundação e alagamento, uma vez que, o município de Imperatriz sofre anualmente por tais eventos.Environmental problems have become increasingly frequent in large urban centers, greatly enhanced by human action. Currently, monitoring through geotechnology has become a very useful tool in combating and preventing the occurrence of environmental problems, since it becomes possible to identify, collect, process data or spatial scales of objects present on the Earth's surface. The aim of the work is to understand the areas affected by flooding processes, in the area of the Bacuri River Basin, located in the municipality of Imperatriz - MA, through the use of geotechnologies. To achieve this objective, the Copernicus Dem digital elevation model (DEM) was used, with a spatial resolution of 30 meters, projected in the software (Qgis 3.22), then the data was projected into the Hand Model where the area map was generated. susceptible to flooding. Subsequently, data from the Municipal Superintendence of Civil Protection and Defense (SUMPDEC) were used to map the main points affected by the flow of the Bacuri River. The results obtained found that the Bacuri river basin suffers greatly from flooding and flooding processes, generating disruptions on a social and economic scale for the inhabitants living in its vicinity. It is concluded that the work was extremely important to identify areas susceptible to flooding and flooding processes, since the municipality of Imperatriz suffers annually from such events

Effectiveness of appropriately trained nurses in preoperative assessment: randomised controlled equivalence/non-inferiority trial

Objective To determine whether preoperative assessments carried out by appropriately trained nurses are inferior in quality to those carried out by preregistration house officers. Design Randomised controlled equivalence/non-inferiority trial. Setting Four NHS hospitals in three trusts. Three of the four were teaching hospitals. Participants All patients attending for assessment before general anaesthesia for general, vascular, urological, or breast surgery between April 1998 and March 1999. Intervention Assessment by one of three appropriately trained nurses or by one of several preregistration house officers. Main outcome measures History taken, physical examination, and investigations ordered. Measures evaluated by a specialist registrar in anaesthetics and placed in four categories: correct, overassessment, underassessment not affecting management, and underassessment possibly affecting management (primary outcome). Results 1907 patients were randomised, and 1874 completed the study; 926 were assessed by house officers and 948 by nurses. Overall 121/948 (13%) assessments carried out by nurses were judged to have possibly affected management compared with 138/926 (15%) of those performed by house officers. Nurses were judged to be non-inferior to house officers in assessment, although there was variation among them in terms of the quality of history taking. The house officers ordered considerably more unnecessary tests than the nurses (218/926 (24%) v 129/948 (14%). Conclusions There is no reason to inhibit the development of nurse led preoperative assessment provided that the nurses involved receive adequate training. However, house officers will continue to require experience in preoperative assessment

Pulmonary capacity of patients with total traumatic injury of the brachial plexus submitted to neurotization with the phrenic nerve: a case series.

Total traumatic injury often requires surgical intervention such as neurotization using the phrenic nerve with the aim to recover the elbow function. However, its repercussions on the respiratory kinematics are unknown. Objective: To  valuate the ribcage volume in tricompartments division, kinematics of Duty Cycle, and shortening velocity of the respiratory muscles after nerve phrenic transfer. Methods: Five participants (4 male), aged 18 to 40 years old (32±2), diagnosed with total brachial plexus injury and with nerve phrenic transfer. The optoelectronic plethysmography (OEP) was the instrument to evaluate volume in quiet breathing (QB), inspiratory capacity (IC) and vital capacity (VC) of the rib cage in its tricompartments division (pulmonary rib cage, abdominal rib cage and abdomen rib cage) and in each hemithorax, as well as the shortening velocity of the respiratory muscles, and respiratory rate. Assessments occurred 30 days prior and 30 days after surgery. Results: There was a decrease in the total compartmental distribution in QB with statistical difference only in the abdominal compartment (p 0.05). Four patients showed a reduction in the shortening speed of the left diaphragm muscle. It was not possible to perform a group analysis of respiratory kinematics and volumes in CV, IC due to the variation found in each patient analyzed. Conclusion: There was a reduction in volume in the rib cage as well as a change in the speed of shortening of the respiratory muscles after the transfer of the phrenic nerve one month after surgery

A bibliometric analysis of systematic reviews on vaccines and immunisation.

INTRODUCTION: SYSVAC is an online bibliographic database of systematic reviews and systematic review protocols on vaccines and immunisation compiled by the London School of Hygiene & Tropical Medicine and hosted by the World Health Organization (WHO) through their National Immunization Technical Advisory Groups (NITAG) resource centre (www.nitag-resource.org). Here the development of the database and a bibliometric review of its content is presented, describing trends in the publication of policy-relevant systematic reviews on vaccines and immunisation from 2008 to 2016. MATERIALS AND METHODS: Searches were conducted in seven scientific databases according to a standardized search protocol, initially in 2014 with the most recent update in January 2017. Abstracts and titles were screened according to specific inclusion criteria. All included publications were coded into relevant categories based on a standardized protocol and subsequently analysed to look at trends in time, topic, area of focus, population and geographic location. RESULTS: After screening for inclusion criteria, 1285 systematic reviews were included in the database. While in 2008 there were only 34 systematic reviews on a vaccine-related topic, this increased to 322 in 2016. The most frequent pathogens/diseases studied were influenza, human papillomavirus and pneumococcus. There were several areas of duplication and overlap. DISCUSSION: As more systematic reviews are published it becomes increasingly time-consuming for decision-makers to identify relevant information among the ever-increasing volume available. The risk of duplication also increases, particularly given the current lack of coordination of systematic reviews on vaccine-related questions, both in terms of their commissioning and their execution. The SYSVAC database offers an accessible catalogue of vaccine-relevant systematic reviews with, where possible access or a link to the full-text. CONCLUSIONS: SYSVAC provides a freely searchable platform to identify existing vaccine-policy-relevant systematic reviews. Systematic reviews will need to be assessed adequately for each specific question and quality

Targeting SLMAP-ALK—a novel gene fusion in lung adenocarcinoma

Assessment of ALK gene rearrangements is strongly recommended by the Molecular Testing Guideline for Selection of Lung Cancer Patients proposed by IASLC, AMP, and CAP at the time of diagnosis for patients with advanced stage disease. Non- small-cell lung cancer (NSCLC) with ALK gene rearrangements or the resulting fusion pro- teins have been, for the most part, successfully targeted with ALK tyrosine kinase inhibitors (TKIs). The most frequent rearrangement, the EML4-ALK oncogenic fusion, has more than 10 distinct variants, each with a discrete breakpoint in EML4. Recent studies have suggested that EML4-ALK variants may have differential responses to TKIs. Additionally, non-EML4- ALK fusions that result from ALK rearrangements with diverse 5′ partners could possibly have varied biologic and clinical implications in their therapeutic responses and outcomes of patients with NSCLC. Existing literature documents at least 20 non-EML4 fusion partners for ALK, and the clinical responsiveness to crizotinib ranges from increased sensitivity to re- sistance. This underscores the importance of identifying the precise 5′ fusion partner to ALK before initiation of therapy. Herein we report the identification of a novel SLMAP-ALK fusion in a patient with NSCLC

Interpersonal relationships in work of multiprofessional team of family health unit

Objective: To learn the interpersonal relationships established by the multidisciplinary team in a Family Health Unit. Method: It is a qualitative, descriptive and exploratory study in a basic health unit located in a large city in southern Rio Grande do Sul. Participants were seven professionals of the staff, whose data were collected through semi-structured interviews and then treated by thematic analysis. Results: Three themes emerged in which it was revealed the fragility of interpersonal relationships in the study unit. Thus, some strategic aspects were listed for the consolidation of healthy interpersonal relationships as the proposal of a dialogical work environment and availability of spaces for discussions and team meetings, reflecting the improvement of health care to the described population. Conclusion: This study evidences the relevance of giving emphasis on interpersonal relationships and subjectivities of professionals in the labor process