Transnational conceptions: displacement, maternity, and onward migration among Somalis in Nairobi, Kenya

This thesis provides an anthropological account of the relationship between experiences of migration and reproduction among Somalis living in Nairobi, Kenya, specifically the complex relationship between motherhood and migration, and the intricacies of balancing the significance and consequences of both. Due to their legally ambiguous and often volatile status, many Somalis did not perceive Kenya as a `durable solution' for settlement, instead locating themselves within an ongoing process of migration, and as part of a fluid yet highly connected transnational diaspora. This thesis draws on twenty months of ethnographic fieldwork in Eastleigh, the `Little Mogadishu' area of Nairobi, with Somali women and their families, as well as medical practitioners, NGOs, UN agencies, and governmental bodies, during which I followed how reproductive decisions were made and medical facilities were navigated within a context of displacement.In this thesis I unpack what it means to exist as a `refugee', `a migrant', and `a Somali' within Kenya, as well as the significance of living within a global diaspora community. I analyse (re)creations of `home' through the temporal appropriation of space, as well as the reproduction of the nation within a context of displacement. I argue that in order to understand how women experience migration, it is essential to understand how they identify themselves within their own transnational family and clan networks as women, wives, and mothers. By illuminating how women protect and act upon their own social positions, this thesis will analyse interwoven concepts of beauty, morality, and motherhood, with a particular focus on how these were entwined with perceptions of both Islam and the Somali nation. Finally, a detailed ethnographic exploration of how women and their families navigated fertility, pregnancy, and childbirth, while simultaneously accounting for possibilities of onward migration, will shed light on the body as a site at which matters of kinship, migration and the future were negotiated. Drawing these issues together, and situating them within medical and political anthropology, this thesis argues that maternity and motherhood are points at which concepts of kinship, religion, citizenship, and gender are intricately interwoven and crucially tethered to strategies for onward migration

Associations between fibrin D-dimer, markers of inflammation, incident self-reported mobility limitation, and all-cause mortality in older men

Objectives<p></p> To examine the independent relationships between fibrin D-dimer, interleukin 6 (IL-6), C-reactive protein (CRP), and fibrinogen and incident mobility limitation and mortality.<p></p> Design<p></p> Prospective.<p></p> Setting<p></p> General practice in 24 British towns.<p></p> Participants<p></p> Men aged 60 to 79 without prevalent heart failure followed up for an average of 11.5 years (N = 3,925).<p></p> Measurements<p></p> All-cause mortality (n = 1,286) and self-reported mobility disability obtained at examination in 1998 to 2000 and in a postal questionnaire 3 to 5 years later in 2003.<p></p> Results<p></p> High D-dimer (top vs lowest tertile: adjusted odds ratio (aOR) = 1.46, 95% confidence interval = 1.02–2.05) and IL-6 (aOR = 1.43, 95% CI = 1.01–2.02) levels (but not CRP or fibrinogen) were associated with greater incident mobility limitation after adjustment for confounders and prevalent disease status. IL-6, CRP, fibrinogen, and D-dimer were significantly associated with total mortality after adjustment for confounders. Only D-dimer and IL-6 predicted total mortality independent of each other and the other biomarkers. The adjusted hazard ratio (aHR) was 1.16 (95% CI = 1.10–1.22) for a standard deviation increase in log D-dimer and 1.10 (95% CI = 1.04–1.18) for a standard deviation increase in log IL-6. D-dimer was independently related to vascular and nonvascular mortality, and IL-6 was independently related to vascular mortality. Risks of mobility limitation and mortality were greatest in those with a combination of high D-dimer and IL-6 levels.<p></p> Conclusion<p></p> D-dimer and IL-6 are associated with risk of mobility limitation and mortality in older men without heart failure. The findings suggest that coagulation leads to functional decline and mortality s that inflammation does not explain

Does being an athlete help a woman? Examining how subtle bias in perceptions of leadership potential differentially impact male and female athletes

El presente trabajo estudia las percepciones con relación al potencial de liderazgo de atletas hombres y mujeres, evaluando particularmente como aquellos que sostienen un sesgo sutil hacia las mujeres influencian estas percepciones. Se evaluaron doscientos treinta y un participantes (n = 231), atletas hombres o mujeres (en un deporte de género neutro o género especifico) u hombres o mujeres no atletas, con relación a su  potencial de liderazgo en un contexto simulado de empleo. Adicionalmente, se midió el nivel de sexismo entre los participantes. Se analizaron los resultados para evaluar la interacción entre participación en deportes, sexo del postulante y nivel de sexismo del participante. Por sí misma, la participación en deportes no afectó el puntaje de potencial de liderazgo de las mujeres  postulantes a un trabajo, sin embargo, los hallazgos apoyaron la presencia de un sutil sesgo hacia las atletas y no atletas mujeres, entre cierto tipo de evaluadores. Específicamente, los evaluadores que calificaron más alto en sexismo, tendieron a evaluar a las mujeres atletas tan alto en potencial de liderazgo como a las mujeres no atletas. Estos hallazgos se discuten en el contexto de la teoría de congruencia de rol

Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

Background: Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners' (GPs') use of delayed prescribing and to gain pharmacists' and the public's views about delayed prescribing in Australia. Methods: This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia. Forty-three semi-structured, face-to-face interviews with general practitioners, pharmacists and patients were conducted. Responses were coded into domains of the Theoretical Domains Framework, and specific criteria from the Behaviour Change Wheel were used to identify which domains were relevant to increasing the use of delayed prescribing by GPs. Results: The interviews revealed nine key domains that influence GPs' use of delayed prescribing: knowledge; cognitive and interpersonal skills; memory, attention and decision-making processes; optimism; beliefs about consequences; intentions; goals; emotion; and social influences: GPs knew about delayed prescribing; however, they did not use it consistently, preferring to bring patients back for review and only using it with patients in a highly selective way. Pharmacists would support GPs and the public in delayed prescribing but would fill the prescription if people insisted. The public said they would delay taking their antibiotics if asked by their GP and given the right information on managing symptoms and when to take antibiotics. Conclusions: Using a theory-driven approach, we identified nine key domains that influence GPs' willingness to provide a delayed prescription to patients with an acute respiratory infection presenting to general practice. These data can be used to develop a structured intervention to change this behaviour and thus reduce antibiotic use for acute respiratory infections in general practice

Haematological variables and risk of future venous thromboembolism in the British Regional Heart Study on men. Combined D-dimer and APTT as a predictive test for thromboembolism?

We examined the associations between haematological and inflammatory variables with future venous thromboembolism (VTE), in 3494 men aged 60–79 years, with no previous history of VTE or myocardial infarction, who were not receiving oral anticoagulants. After a mean follow-up period of 18 years, there were 149 confirmed cases of fatal or non-fatal VTE (deep vein thrombosis and/or pulmonary embolism). Among classical cardiovascular risk factors, only obesity and cigarette smoking were associated with VTE risk. After adjustment for age, obesity and smoking, VTE risk was associated with coagulation factor VIII, factor IX, von Willebrand factor (VWF), activated partial thromboplastin time (APTT), and fibrin D-dimer. Hazard ratios (95% CI) for top to bottom quarters (bottom to top for APTT), were respectively 2.17 (1.37, 3.44), 2.15 (1.30, 3.53), 2.02 (1.27, 3.22), 2.43 (1.47, 4.02) and 3.62 (2.18, 6.08). The 11% of men with both the shortest APTT and highest D-dimer combined had a 5.02 (2.37, 10.62) higher risk of VTE. VTE risk was not associated with fibrinogen, factor VII or activated protein C resistance; full blood count variables or with inflammatory markers, plasma viscosity, C-reactive protein or interleukin-6. The combination of D-dimer and APTT merits evaluation as an adjunct to VTE risk prediction scores

Rethinking (local) integration:Domains of integration and their durability in Kismayo and Garowe, Somalia

Amidst the ever-expanding debates in various academic and policy fields around migrant and refugee integration and local integration, we bring these two concepts in conversation with one another. Until very recently, theories of integration have had a state-centric focus in the Global North. This article expands and complicates this literature to focus on displaced Somalis within Somalia and its borderlands living in the cities of Kismayo and Garowe using mixed qualitative and quantitative methods in five displacement settlements. Toward this end, we use the often- engaged term “domains of integration” to frame integration. In our conceptualization, however, we incorporate the concept of “local integration” as a durable solution. In brief, we see the domains of integration as a productive concept in the Somali context. However, in Somalia, where clans are interwoven into the state, which lacks resources and power, clan affiliation represents social connections domains, yet also influences the state's role in the foundational domain of rights and citizenship and makers and means (employment, housing, education, health). International donors and NGOs, as well as international capitalist urban expansion also have a large role in these processes. As such, we argue that the ten domains of integration (discussed in detail below) intersect and blur to an even greater extent than in European and North American contexts, particularly around crucial issues such as housing, land, and property; a key factor in people's decisions to remain or leave.</p