193 research outputs found

    Los menores separados de sus familias y no acompañados en la UE

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    Cada vez hay más leyes, políticas y medidas prácticas europeas que abordan la situación de los menores no acompañados y separados de sus familias que llegan a la UE. Sin embargo, en medio del delicado clima político actual hay peligro de que se desvíen la atención y los recursos de aquello en lo que ya se está trabajando

    Diagnosing Cysts With Correlation Coefficient Images From 2‐Dimensional Freehand Elastography

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    Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135592/1/jum20072691201.pd

    Evaluation of P-glycoprotein expression in pain relevant tissues: understanding translation of efflux from preclinical species to human

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    Various efflux transporters, such as P-glycoprotein (P-gp) are now widely accepted to have profound influence on the disposition of substrates. Nevertheless, there is paucity of information about their expression and functionality in the pain relevant tissues (such as brain, spinal cord and dorsal root ganglia (DRG)) across various species. Therefore, our attempts were directed at evaluating P-gp expression in these tissues to understand its effect on the central nervous system (CNS) disposition. As a means of characterizing the normal tissue distribution of P-gp, immunohistochemistry was performed with two antibodies (C219 and H241) directed against different epitopes of MDR1 gene. Notable expression of P-gp was detected in the DRG of Sprague Dawley rat, Beagle Dog, Cynomolgous monkey as well as human. The expression of P-gp was observed in the CNS tissues with evident species differences, the expression of P-gp in human brain and spinal cord was lower than in rats and dogs but relatively comparable to that in monkeys. However, no species related differences were seen in the expression at the DRG level. Double-labelling using an antibody against a marker of endothelial cells confirmed that P-gp was exclusively localized in capillary endothelial cells. This study highlights the cross species similarities and differences in the expression of P-gp and thus serves as a vital step in understanding the translation of exposure of P-gp substrates to human

    Retention in statutory social work from fast-track child and family programs

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    Summary: Two fast-track child and family social work training programs have been established in England — Step Up to Social Work and Frontline. Trainees’ financial support is far higher than for mainstream social work degrees. One of the reasons claimed for setting up these programs is addressing retention, although critics (of Frontline) predicted graduates would not stay in social work. A 4-year study assessed retention and reasons for leaving social work. Attrition rates from statutory social work were calculated from responses (n = 2543) to annual surveys, plus looking up non-respondents in the professional register. Interviews were conducted with fast-track graduates (n = 80) and employers (n = 29). Findings: The overall rate of social work graduates not in statutory social work at 18 months post-qualification was 12% for fast-track programs, and Higher Education Statistics Agency survey data show attrition at 15 months post-qualification as 18% for all social work routes. Frontline's original national recruitment approach was less successful for retention than Step Up to Social Work's regional approach. Perceived local authority support and intrinsic job satisfaction were associated with attrition in longitudinal bivariate analysis. Fast-track graduates leaving statutory social work typically moved to work in social care (including policy roles), health, or education. Applications: Early-career attrition appears to be somewhat lower from fast-track programs than from all social work graduates. Longer-term comparison is not yet possible. In promoting retention, employers should be aware of the importance of staff perceptions of the local authority as supportive, and of their intrinsic job satisfaction

    Partners in the Parks: Field Guide to an Experiential Program in the National Parks (1st edition)

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    When Joan Digby first proposed taking collegiate honors students into our national parks, I jumped at the chance. Within minutes of reading her email, I not only responded with an enthusiastic “Yes!” but went so far as to volunteer the resources of the Southern Utah University Honors Program to get things started. Nestled among 5 national parks in southwestern Utah, I felt our campus would be a natural focal point for the kind of program Joan envisioned. Within weeks we had laid the groundwork for a proof-of-concept pilot project at nearby Bryce Canyon National Park. Little did I know at the time, but I was taking the first steps on a nationwide journey that would introduce me to 11 amazing national parks, some 47 park rangers, and over 100 outstanding college students—with the prospect of these numbers growing annually. The aim of Partners in the Parks (PITP) from its inception has been to introduce, or reintroduce, collegiate honors students to this country: not the transformed environment that we have constructed on its surface but the bedrock world upon which it rests. Like de Toqueville, Jefferson, Thoreau, Emerson, and so many others, we recognized that the unique place that is America cannot be separated from the land upon which it was built. One valuable way to study and understand it, then, is to visit places where the bones of America lie exposed, often without the veneer of civilization, cultivation, or modernization: places protected by the people to preserve for this and future generations, original American landscapes, and important historical landmarks that illustrate and define what America was, is, and can be. PITP takes students deep into America’s national parks. PITP is a see-America-first program. While we recognize the importance of a global perspective in an overall honors education, our goal is to help students see and understand America before or in addition to going abroad. Indeed, for students without the desire or resources to leave the country, PITP offers many of the same kinds of personal development that make study abroad so valuable. In the Field Notes to Chapter 2, “Growing from Within,” Bill Atwill and Kathleen King, share their experience in Acadia National Park, observing how their students demonstrated valuable growth in the same four key areas that researchers of study abroad programs have identified in their alumni: personal discovery, academic commitment, cultural development, and career development. The student writings in this volume, such as Andy Grube’s “soul expanding” talk with Juste Gatari on the rocky coast of Mount Desert Island, aptly illustrate this important facet of the PITP experience. (See the Field Notes to Chapter 5, “Sitting There in Silence.”

    Endotoxin tolerance in abdominal aortic aneurysm macrophages, in vitro: a case–control study

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    Macrophages are implicated in the pathogenesis of abdominal aortic aneurysm (AAA). This study examined the environmentally conditioned responses of AAA macrophages to inflammatory stimuli. Plasma- and blood-derived monocytes were separated from the whole blood of patients with AAA (30-45 mm diameter; = 33) and sex-matched control participants ( = 44). Increased concentrations of pro-inflammatory and pro-oxidant biomarkers were detected in the plasma of AAA patients, consistent with systemic inflammation and oxidative stress. However, in monocyte-derived macrophages, a suppressed cytokine response was observed in AAA compared to the control following stimulation with lipopolysaccharide (LPS) (tumor necrosis factor alpha (TNF-α) 26.9 ± 3.3 vs. 15.5 ± 3.2 ng/mL, < 0.05; IL-6 3.2 ± 0.6 vs. 1.4 ± 0.3 ng/mL, < 0.01). LPS-stimulated production of 8-isoprostane, a biomarker of oxidative stress, was also markedly lower in AAA compared to control participants. These findings are consistent with developed tolerance in human AAA macrophages. As Toll-like receptor 4 (TLR4) has been implicated in tolerance, macrophages were examined for changes in TLR4 expression and distribution. Although TLR4 mRNA and protein expression were unaltered in AAA, cytosolic internalization of receptors and lipid rafts was found. These findings suggest the inflamed, pro-oxidant AAA microenvironment favors macrophages with an endotoxin-tolerant-like phenotype characterized by a diminished capacity to produce pro-inflammatory mediators that enhance the immune response

    Malignant neuroendocrine tumour of the appendix in childhood with loco-regional lymph node invasion

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    The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1006600359152743 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13000-015-0287-z) contains supplementary material, which is available to authorized users

    An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda

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    This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Methods: Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. Results: The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher program with other services is likely to address some of the barriers. The public sector facilities were also seen as being well positioned to provide voucher services because of their countrywide reach, enhanced infrastructure, and referral networks. The voucher program also has the potential to address public sector constraints such as understaffing and supply shortages.Conclusions: Accrediting public facilities has the potential to increase voucher program coverage by reaching a wider pool of poor mothers, shortening distance to service, strengthening linkages between public and private sectors through public-private partnerships and referral systems as well as ensuring the awareness and buy-in of policy makers, which is crucial for mobilization of resources to support the sustainability of the programs. Specifically, identifying policy champions and consulting with key policy sectors is key to the successful inclusion of the public sector into the voucher program

    Neuro4Neuro: A neural network approach for neural tract segmentation using large-scale population-based diffusion imaging

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    Subtle changes in white matter (WM) microstructure have been associated with normal aging and neurodegeneration. To study these associations in more detail, it is highly important that the WM tracts can be accurately and reproducibly characterized from brain diffusion MRI. In addition, to enable analysis of WM tracts in large datasets and in clinical practice it is essential to have methodology that is fast and easy to apply. This work therefore presents a new approach for WM tract segmentation: Neuro4Neuro, that is capable of direct extraction of WM tracts from diffusion tensor images using convolutional neural network (CNN). This 3D end-to-end method is trained to segment 25 WM tracts in aging individuals from a large population-based study (N=9752, 1.5T MRI). The proposed method showed good segmentation performance and high reproducibility, i.e., a high spatial agreement (Cohen's kappa, k = 0.72 ~ 0.83) and a low scan-rescan error in tract-specific diffusion measures (e.g., fractional anisotropy: error = 1% ~ 5%). The reproducibility of the proposed method was higher than that of a tractography-based segmentation algorithm, while being orders of magnitude faster (0.5s to segment one tract). In addition, we showed that the method successfully generalizes to diffusion scans from an external dementia dataset (N=58, 3T MRI). In two proof-of-principle experiments, we associated WM microstructure obtained using the proposed method with age in a normal elderly population, and with disease subtypes in a dementia cohort. In concordance with the literature, results showed a widespread reduction of microstructural organization with aging and substantial group-wise microstructure differences between dementia subtypes. In conclusion, we presented a highly reproducible and fast method for WM tract segmentation that has the potential of being used in large-scale studies and clinical practice.Comment: Preprint to be published in NeuroImag

    Fetal programming of neuropsychiatric disorders by maternal pregnancy depression: a systematic mini review

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    BACKGROUND: Maternal depression complicates a large proportion of pregnancies. Current evidence shows numerous harmful effects on the offspring. Reviews, which include depression, concluded that stress has harmful effects on the offspring's outcomes neuro-cognitive development, temperament traits, and mental disorders. OBJECTIVE: This mini review of recent studies, sought to narrow the scope of exposure and identify studies specifically assessing prenatal depression and offspring neuropsychiatric outcomes. STUDY ELIGIBILITY CRITERIA: The review included longitudinal, cohort, cross-sectional, clinical, quasi-experimental, epidemiological, or intervention study designs published in English from 2014 to 2018. PARTICIPANTS: Study populations included mother-child dyads, mother-father-child triads, mother-alternative caregiver-child triads, and family studies utilizing sibling comparisons. METHODS: We searched PubMED and Web of Science. Study inclusion and data extraction were based on standardized templates. The quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Thirteen studies examining neuropsychiatric outcomes were included. We judged the evidence to be moderate to high quality. CONCLUSIONS: Our review supports that maternal prenatal depression is associated with neuropsychiatric adversities in children.Peer reviewe
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