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In the United States, as in many countries, convenience sample serosurveillance studies (e.g., in blood donors) have demonstrated that most of the population has SARS-CoV-2 antibodies from vaccination, infection, or [...]

Nella Larsen's Passing has been commonly read through a queer lens that presents Clare and Irene's relationship with each other as erotic yet repressed. Irene's repression of her desire and the subsequent narrative can be read as stemming from compulsory heterosexuality. This causes Irene to uphold the institution of marriage at any cost to prevent the sexual freedom that could lead to open queerness on not only her part, but also Brian's and Clare's. All three characters interact with their queerness in conjunction with their race, attempting to use or suppress it for different societal ends. As such, the queer dimension to Passing can be understood as standing in direct opposition to the inevitability of heterosexual union, as Irene alone attempts to preserve heterosexuality, even to the death. Keywords: Nella Larsen / Passing / queer theory / compulsory heterosexuality / marriage, Nella Larsen's 1929 novel Passing provides, in extremely limited space, a complex perspective on the life of two Black women who can 'pass' for white. Clare Kendry and Irene Redfield's [...]

BACKGROUND: Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance. OBJECTIVES: This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort. METHODS: Participants were recruited into CARES when they were 7-9 y old, and reenrolled at 13-18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height--weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine. RESULTS: CARES participants who completed the adolescent postural balance assessment (n=123) were 98% White and 54% female and had a mean age of 16 y (range: 13-18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males. DISCUSSION: This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. https://doi.org/10.1289/EHP13381, Introduction Manganese (Mn) is an element that exists ubiquitously in the environment, often in combination with other elements. (1) Mn plays a significant role in both human health and global [...]

Context.--The year 2023 marks the centenary of the Nobel Prize honoring the discovery of insulin. Little-known experimental pathologists Lydia DeWitt, MD, at the University of Michigan and Mary Kirkbride, DSc [Hon], at Columbia University, both just beginning their academic careers, made independent contributions to the discovery that have never been critically examined. This happened at a time when it was exceedingly rare for women to work in pathology. Objective.--To explore the facilitative roles of DeWitt and Kirkbride in the discovery of insulin and to examine their trail-breaking careers in academic pathology. Design.--Available primary and secondary historical resources were reviewed. Results.--DeWitt made and tested pancreatic extracts from duct-ligated atrophic pancreas (ie, Frederick Banting's great idea to prevent digestion of its hypothetical internal secretion) 15 years before Banting; Banting was unaware of her work. His idea came from reading a paper by pathologist Moses Barron. Prior duct-ligation studies had sometimes been viewed with skepticism because histologic identification of islets in atrophic duct-ligated pancreata was imperfect; Kirkbride addressed this with histochemical staining, convincing Barron and, therefore, indirectly influencing and motivating Banting. The lives and convoluted careers of these 2 early-20th-century women are explored and compared with those of other contemporary women in pathology. A unifying pattern becomes clear: careers in experimental pathology and bacteriology were accepted but performing clinical work in anatomic pathology was not. Conclusions.--Both DeWitt and Kirkbride are prototypical early-20th-century women in academic pathology whose careers were constrained by gender. However, Kirkbride made a unique and unrecognized contribution to the discovery of insulin. doi: 10.5858/arpa.2023-0060-HP, Lydia M. DeWitt, MD, and Mary B. Kirkbride, DSc, each published a sole-authored paper in the Journal of Experimental Medicine, one (1) in 1906 and the other (2) in 1912, [...]

I. Introduction Medicine in the United States is big business. (1) In 2022, spending on healthcare services totaled an estimated $4.5 trillion dollars--over 17% of the U.S. economy and growing. [...]

Rocking in the Free World: Popular Music and the Politics of Freedom in Postwar America. By Nicholas Tochka. New York: Oxford University Press, 2023. [xiv, 228 p. ISBN 9780197566510 (hardcover), [...]

I. INTRODUCTION 390 II. OVERVIEW OF TITLE IX 391 A. RECENT HISTORY OF TITLE IX 391 B. NON-ATHLETIC APPLICATIONS OF TITLE IX 393 1. Sexual Harassment 394 2. Employment Practices [...]

I. INTRODUCTION 830 II. DEVELOPMENTS IN PUBLIC SCHOOL 832 INTEGRATION: THE ROAD FROM MANDATORY TO VOLUNTARY A. THE PROMISE OF BROWN V. BOARD OF EDUCATION 832 B. BROWN'S PROGENY: EFFORTS [...]

Introduction: Pennsylvania opened its first medical marijuana (MMJ) dispensary in 2018. Qualifying conditions include six conditions determined to have no or insufficient evidence to support or refute MMJ effectiveness. We conducted a study to describe MMJ dispensary access in Pennsylvania and to determine whether dispensary proximity was associated with MMJ certifications and community demographics. Methods: Using data from the Pennsylvania Department of Health, we geocoded MMJ dispensary locations and linked them to US Census Bureau data. We created dispensary access measures from the population-weighted centroid of Zip Code Tabulation Areas (ZCTAs): distance to nearest dispensary and density of dispensaries within a 15-min drive. We evaluated associations between dispensary access and the proportion of adults who received MMJ certification and the proportion of certifications for low evidence conditions (amyotrophic lateral sclerosis, epilepsy, glaucoma, Huntington's disease, opioid use disorder, and Parkinson's disease) using negative binomial modeling, adjusting for community features. To evaluate associations racial and ethnic composition of communities and distance to nearest dispensary, we used logistic regression to estimate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for median income. Results: Distance and density of MMJ dispensaries were associated with the proportion of the ZCTA population certified and the proportion of certifications for insufficient evidence conditions. Compared to ZCTAs with no dispensary within 15 min, the proportion of adults certified increased by up to 31% and the proportion of certifications for insufficient evidence decreased by up to 22% for ZCTAs with two dispensaries. From 2018 to 2021, the odds of being within five miles of a dispensary was up to 20 times higher in ZCTAs with the highest proportions of individuals who were not White (2019: OR: 20.14, CI: 10.7-37.8) and more than double in ZCTAs with the highest proportion of Hispanic individuals (2018: OR: 2.81, CI: 1.51-5.24), compared to ZCTAs with the lowest proportions. Conclusions: Greater dispensary access was associated with the proportions of certified residents and certifications for low evidence conditions. Whether these patterns are due to differences in accessibility or demand is unknown. Associations between community demographics and dispensary proximity may indicate MMJ access differences. Keywords: Medical cannabis, Geospatial, Evidence-based medicine, Marijuana, Dispensary, Author(s): Annemarie G. Hirsch; Eric A. Wright; Cara M. Nordberg; Joseph DeWalle; Elena L. Stains; Amy L. Kennalley; Joy Zhang; Lorraine D. Tusing; Brian J. Piper Introduction The legalization of [...]

Introduction On 17 May 2021, the Quadripartite collaboration on One Health (OH) (2) convened an interdisciplinary One Health high-level expert panel (OHHLEP) (3) to provide evidence-based scientific and policy advice [...]

Background WHO established the One Health Initiative (OHI) (2) in July 2021 to support One Health (OH) activities and to coordinate interagency engagement and partnerships to ensure a collaborative, harmonized, [...]

2SLGBTQI youth are at disproportionately high risk of experiencing gender-based violence compared to their cis-heterosexual peers, although there is a gap in research explaining why as well as what this violence looks like. Part of the explanation relates to ongoing homophobia and transphobia; however, more research is needed to understand 2SLGBTQI youths' feelings of safety within their communities, their experiences of violence with partners, and their help- seeking behaviours. Given the limited Canadian research, the Speak Out project was undertaken. The Speak Out project is a multi-phase project with Phase 1 encompassing a survey of youth across Canada about their experiences of gender-based violence. From across Canada, 292 youths were recruited and asked to complete a survey on gender-based violence. The survey covered four domains related to violence (physical violence, emotional abuse/control, sexual violence, virtual violence) participants experienced, experiences with help-seeking, and connections to the 2SLGBTQI community. Most youths had connections to the broader 2SLGBTQI community and were open about their identities, but many reported being discriminated against based on their gender expression (50%) and sexual orientation (43%). Of the participants who answered questions related to physical, emotional, and sexual abuse, very few reported any incidents. More youths reported virtual violence via text messages (34%), making them afraid to ignore phone calls or other contact (18%), and surveillance of their social media (18%). These results contribute valuable knowledge on the experiences of Canadian 2SLGBTQI youths and have important implications for both education and frontline service provision. KEYWORDS: 2SLGBTQI youth, dating violence, gender-based violence, sexual violence, youth violence, Under the umbrella term, gender-based violence consists of experiences of sexual harassment, dating violence, and other forms of discrimination related to gender and sexuality. From the available Canadian research, it [...]

Martin Biddle, Jane Renfrew & Patrick Ottaway (ed.). 2018. Environment and agriculture of early Winchester. Oxford: Archaeopress; 978-180-32-7066-1 hardback 75 [pounds sterling]. Winchester is one of the most comprehensively excavated [...]

Background Antenatal care (ANC) is an essential platform to improve maternal and newborn health (MNH). While several articles have described the content of ANC in low- and middle-income countries (LMICs), few have investigated the quality of detection and management of pregnancy risk factors during ANC. It remains unclear whether women with pregnancy risk factors receive targeted management and additional ANC. Methods and findings This observational study uses baseline data from the MNH eCohort study conducted in 8 sites in Ethiopia, India, Kenya, and South Africa from April 2023 to January 2024. A total of 4,068 pregnant women seeking ANC for the first time in their pregnancy were surveyed. We built country-specific ANC completeness indices that measured provision of 16 to 22 recommended clinical actions in 5 domains: physical examinations, diagnostic tests, history taking and screening, counselling, and treatment and prevention. We investigated whether women with pregnancy risks tended to receive higher quality care and we assessed the quality of detection and management of 7 concurrent illnesses and pregnancy risk factors (anemia, undernutrition, obesity, chronic illnesses, depression, prior obstetric complications, and danger signs). ANC completeness ranged from 43% in Ethiopia, 66% in Kenya, 73% in India, and 76% in South Africa, with large gaps in history taking, screening, and counselling. Most women in Ethiopia, Kenya, and South Africa initiated ANC in second or third trimesters. We used country-specific multivariable mixed-effects linear regression models to investigate factors associated with ANC completeness. Models included individual demographics, health status, presence of risk factors, health facility characteristics, and fixed effects for the study site. We found that some facility characteristics (staffing, patient volume, structural readiness) were associated with variation in ANC completeness. In contrast, pregnancy risk factors were only associated with a 1.7 percentage points increase in ANC completeness (95% confidence interval 0.3, 3.0, p-value 0.014) in Kenya only. Poor self-reported health was associated with higher ANC completeness in India and South Africa and with lower ANC completeness in Ethiopia. Some concurrent illnesses and risk factors were overlooked during the ANC visit. Between 0% and 6% of undernourished women were prescribed food supplementation and only 1% to 3% of women with depression were referred to a mental health provider or prescribed antidepressants. Only 36% to 73% of women who had previously experienced an obstetric complication (a miscarriage, preterm birth, stillbirth, or newborn death) discussed their obstetric history with the provider during the first ANC visit. Although we aimed to validate self-reported information on health status and content of care with data from health cards, our findings may be affected by recall or other information biases. Conclusions In this study, we observed gaps in adherence to ANC standards, particularly for women in need of specialized management. Strategies to maximize the potential health benefits of ANC should target women at risk of poor pregnancy outcomes and improve early initiation of ANC in the first trimester., Author(s): Catherine Arsenault 1,*, Nompumelelo Gloria Mfeka-Nkabinde 2, Monica Chaudhry 3, Prashant Jarhyan 3, Tefera Taddele 4, Irene Mugenya 5, Shalom Sabwa 6, Katherine Wright 6, Beatrice Amboko 5, Laura [...]

This hermeneutic phenomenological study illustrates the value of key aspects of interpretative hermeneutics for illuminating the time shared between patients and students in forensic unit for men carrying a personality disorder diagnosis through interviews. The participants were being-with in their own time and space, sharing ordinary activities and common interests, and having a laugh, ultimately making enduring connections. This was despite experiences of thrownness into the world, ward landscapes, or the bearing of diagnostic labels. Students experienced a balance between therapeuticness (leaping-ahead) and professionalism (leaping-in). They were immune to the relational vacuum of the ward office and were viewed as 'sponges', reflecting their availability to patients, as opposed to other staff occupying more distant, identity defining set roles. On transition to fully fledged staff roles, students can become holders of keys, but can weather the ride by treasuring the everyday mundane, being-with and connecting with patients. This temporality of student-patient's relationships encompasses mutual recognition of shared humanness. This hermeneutic phenomenological study uniquely explores the time shared between patients and students in forensic settings. Learnings from their experiences as illuminated using philosophical notions aid our understanding of this time to ensure focus on human connection., Author(s): Emma S. Jones (corresponding author) [1]; Karen M. Wright [1]; Mick McKeown [1] 1. Background Across the globe, individuals studying to become registered mental health nurses across a variety [...]

While dysfunction and death of light-detecting photoreceptor cells underlie most inherited retinal dystrophies, knowledge of the species-specific details of human rod and cone photoreceptor cell development remains limited. Here, we generated retinal organoids carrying retinal disease-causing variants in NR2E3, as well as isogenic and unrelated controls. Organoids were sampled using single-cell RNA sequencing (scRNA-Seq) across the developmental window encompassing photoreceptor specification, emergence, and maturation. Using scRNA-Seq data, we reconstruct the rod photoreceptor developmental lineage and identify a branch point unique to the disease state. We show that the rod- specific transcription factor NR2E3 is required for the proper expression of genes involved in phototransduction, including rhodopsin, which is absent in divergent rods. NR2E3-null rods additionally misexpress several cone-specific phototransduction genes. Using joint multimodal single-cell sequencing, we further identify putative regulatory sites where rod-specific factors act to steer photoreceptor cell development. Finally, we show that rod-committed photoreceptor cells form and persist throughout life in a patient with NR2E3-associated disease. Importantly, these findings are strikingly different from those observed in Nr2e3 rodent models. Together, these data provide a road map of human photoreceptor development and leverage patient induced pluripotent stem cells to define the specific roles of rod transcription factors in photoreceptor cell emergence and maturation in health and disease., Introduction The human retina is a transparent multilayered neural tissue lining the posterior two-thirds of the eye that is responsible for detecting visual information and sending it to the brain [...]

The World Health Organization has developed target product profiles containing minimum and optimum targets for key characteristics for tests for tuberculosis treatment monitoring and optimization. Tuberculosis treatment optimization refers to initiating or switching to an effective tuberculosis treatment regimen that results in a high likelihood of a good treatment outcome. The target product profiles also cover tests of cure conducted at the end of treatment. The development of the target product profiles was informed by a stakeholder survey, a cost-effectiveness analysis and a patient-care pathway analysis. Additional feedback from stakeholders was obtained by means of a Delphi-like process, a technical consultation and a call for public comment on a draft document. A scientific development group agreed on the final targets in a consensus meeting. For characteristics rated of highest importance, the document lists: (i) high diagnostic accuracy (sensitivity and specificity); (ii) time to result of optimally [less than or equal to] 2 hours and no more than 1 day; (iii) required sample type to be minimally invasive, easily obtainable, such as urine, breath, or capillary blood, or a respiratory sample that goes beyond sputum; (iv) ideally the test could be placed at a peripheral-level health facility without a laboratory; and (v) the test should be affordable to low- and middle-income countries, and allow wide and equitable access and scale-up. Use of these target product profiles should facilitate the development of new tuberculosis treatment monitoring and optimization tests that are accurate and accessible for all people being treated for tuberculosis. L'Organisation mondiale de la sante a elabore des profils de produits cibles contenant des cibles minimales et optimales pour les caracteristiques principales des essais destines au suivi et a l'optimisation du traitement de la tuberculose. L'optimisation du traitement de la tuberculose fait reference a l'instauration d'un regime de traitement efficace de la tuberculose ou a l'adoption d'un tel regime, avec une probabilite elevee d'obtenir de bons resultats therapeutiques. Les profils de produits cibles couvrent egalement les essais de guerison effectues a l'issue du traitement. Les profils de produits cibles ont ete elabores sur la base d'un sondage aupres des parties prenantes, d'une analyse cout-efficacite et d'une analyse du parcours de soins du patient. Des retours supplementaires des parties prenantes ont ete obtenus au moyen d'un processus cree selon la methode Delphi, d'une consultation technique et d'un appel a commentaires publics sur un projet de document. Un groupe d'elaboration scientifique s'est mis d'accord sur les objectifs finaux lors d'une reunion de concertation. En ce qui concerne les caracteristiques jugees les plus importantes, le document enumere ce qui suit: (i) une grande precision diagnostique (sensibilite et specificite); (ii) un delai ideal d'obtention des resultats [less than or equal to] 2 heures et au maximum de 1 jour; (iii) le type d'echantillon requis doit etre peu invasif et facile a obtenir, comme l'urine, l'haleine ou le sang capillaire, ou bien un echantillon respiratoire au-dela des expectorations; (iv) idealement, l'essai pourrait avoir lieu dans un etablissement de sante peripherique sans laboratoire ; et (v) l'essai devrait etre abordable pour les pays a revenu faible et intermediaire et permettre un acces large et equitable ainsi qu'une mise a l'echelle. L'utilisation de ces profils de produits cibles devrait faciliter la mise au point de nouveaux essais de surveillance et d'optimisation du traitement de la tuberculose qui soient precis et accessibles a toutes les personnes suivant un traitement pour la tuberculose. La Organizacion Mundial de la Salud ha elaborado perfiles de productos objetivo que contienen objetivos minimos y optimos para las caracteristicas principales de las pruebas de seguimiento y optimizacion del tratamiento de la tuberculosis. La optimizacion del tratamiento de la tuberculosis consiste en iniciar o cambiar a un regimen eficaz de tratamiento de la tuberculosis que ofrezca una alta probabilidad de un buen resultado terapeutico. Los perfiles de productos objetivo tambien abarcan las pruebas de curacion realizadas al final del tratamiento. La elaboracion de los perfiles de los productos objetivo se baso en una encuesta a las partes interesadas, un analisis de rentabilidad y un analisis de la via de atencion al paciente. Se obtuvo informacion adicional de las partes interesadas mediante un proceso tipo Delphi, una consulta tecnica y una convocatoria de comentarios publicos sobre un borrador del documento. Un grupo de desarrollo cientifico acordo los objetivos finales en una reunion de consenso. Para las caracteristicas clasificadas de mayor importancia, el documento enumera: (i) alta precision diagnostica (sensibilidad y especificidad); (ii) tiempo hasta el resultado de optimamente [less than or equal to] 2 horas y no mas de 1 dia; (iii) el tipo de muestra requerida debe ser minimamente invasiva, facil de obtener, como orina, aliento o sangre capilar, o una muestra respiratoria que vaya mas alla del esputo; (iv) idealmente la prueba podria realizarse en un centro sanitario periferico sin laboratorio; y (v) la prueba debe ser asequible para los paises de ingresos bajos y medios y permitir un acceso amplio y equitativo y su expansion. El uso de estos perfiles de producto objetivo deberia facilitar el desarrollo de pruebas nuevas de seguimiento y optimizacion del tratamiento de la tuberculosis que sean precisas y accesibles para todas las personas que reciben tratamiento antituberculoso. [phrase omitted], Introduction Tuberculosis continues to be a major cause of morbidity and mortality globally, despite being curable and preventable. In 2021, an estimated 10.6 million people had tuberculosis disease and 1.6 [...]

Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women's representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women's perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women's feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth. L'acces aux soins obstetriques d'urgence, y compris l'accouchement vaginal assiste et la cesarienne, est essentiel pour ameliorer les effets de la maternite et de l'accouchement. Toutefois, bien que la proportion de cesariennes ait augmente ces dernieres decennies, le recours a l'accouchement vaginal assiste a diminue. C'est particulierement le cas dans les pays a revenu faible ou intermediaire, bien que l'accouchement vaginal assiste soit souvent moins risque qu'une cesarienne. Nous avons donc mene un processus en trois etapes afin d'imaginer un programme de recherche qui permettrait d'augmenter le recours a l'accouchement vaginal assiste ou de le reintroduire. Apres avoir realise une synthese des donnees probantes, qui a servi de base a une consultation avec des experts techniques qui ont propose un programme de recherche initial, nous avons sollicite et incorpore les avis des representantes des femmes pour ce programme. Ce processus nous a permis d'imaginer un programme de recherche complet, avec des sujets classes comme suit: (i) la necessite de comprendre la perception qu'ont les femmes de l'accouchement vaginal assiste et de fournir des informations appropriees et fiables; (ii) l'importance de la formation des prestataires de soins de sante en matiere de competences cliniques, mais aussi de respect dans les soins de sante, de communication efficace, de prise de decision partagee et de consentement eclaire; ou (iii) les obstacles a la mise en reuvre et a la durabilite et les facteurs qui les facilitent. Les reactions de femmes nous ont appris qu'il etait urgent de reconnaitre que l'accouchement, la naissance et le post-partum sont des processus humains intrinsequement physiologiques et dignes au cours desquels les interventions ne devraient etre mises en reuvre qu'en cas de necessite. La promotion et/ou la reintroduction de l'accouchement vaginal assiste dans les regions a faibles ressources necessitent que les pouvoirs publics, les decideurs politiques et les administrations d'hopitaux soutiennent les prestataires de soins de sante qualifies, qui pourront a leur tour soutenir respectueusement les femmes pendant l'accouchement. El acceso a la atencion obstetrica de emergencia, incluido el parto vaginal asistido y el parto por cesarea, es crucial para mejorar los resultados de la maternidad y el parto. No obstante, aunque el porcentaje de partos por cesarea ha aumentado en las ultimas decadas, el uso del parto vaginal asistido ha disminuido. Esto ocurre especialmente en los paises de ingresos bajos y medios, a pesar de que un parto vaginal asistido suele ser menos arriesgado que un parto por cesarea. Por lo tanto, llevamos a cabo un proceso de tres pasos para identificar un programa de investigacion necesario para aumentar el uso del parto vaginal asistido o volver a incorporarlo: tras realizar una sintesis de la evidencia, que sirvio de base para una consulta con expertos tecnicos que propusieron un programa de investigacion inicial, buscamos e integramos las opiniones de las representantes de las mujeres sobre este programa. Este proceso nos ha permitido identificar un programa de investigacion exhaustivo, con temas categorizados como: (i) la necesidad de comprender las percepciones de las mujeres sobre el parto vaginal asistido, y proporcionar informacion adecuada y fiable; (ii) la importancia de formar a los profesionales sanitarios en habilidades clinicas, pero tambien en atencion respetuosa, comunicacion efectiva, toma de decisiones compartida y consentimiento informado; o (iii) las barreras y los facilitadores de la implementacion y la sostenibilidad. A partir de las opiniones de las mujeres, nos enteramos de la urgente necesidad de reconocer las experiencias del parto, el alumbramiento y el posparto como procesos humanos inherentemente fisiologicos y dignos, en los que las intervenciones solo deben aplicarse si son necesarias. La promocion o la reincoporacion del parto vaginal asistido en regiones de escasos recursos exige que los gobiernos, los responsables de formular politicas y los administradores de hospitales apoyen a los profesionales sanitarios capacitados que, a su vez, pueden ayudar a las mujeres en el trabajo de parto y el alumbramiento de manera respetuosa. [phrase omitted], Introduction Assisted vaginal birth, also known as instrumental or operative vaginal birth, refers to a vaginal birth conducted with the help of an instrument such as forceps or a vacuum [...]

Enterovirus D68 (EV-D68) was recognized as a respiratory virus in 1962 (1). In 2014, unprecedented large outbreaks of EV-D68 infections associated with severe respiratory illnesses occurred in children in the [...]

Marburg virus (MARV) and Ravn virus (RAVV) (family Filoviridae, genus and species Orthomarburgvirus marburgense) are the causative agents of Marburg virus disease (MVD). The prototypical filovirus and close relative of [...]

Thirdhand exposure to methamphetamine occurs through contact with environments that have become contaminated during the manufacture or use of the substance. This exposure is a serious emerging public health concern. Exposure can cause adverse health effects in unwitting residents, particularly children. As an increasing number of reports appear in the scientific literature, we propose 'thirdhand exposure to methamphetamine syndrome' as a collective term to describe the various nonspecific symptoms that are related to methamphetamine exposure. This proposed term could provide a searchable keyword to facilitate the coordination of research to better understand the health-related consequences of exposure to methamphetamine that result from its manufacture and use., Introduction Methamphetamine usage has been described as a global epidemic (Chomchai & Chomchai, 2015; European Monitoring Centre for Drugs and Drug Addiction & Europol, 2022; Hansell, 2006; Jones & Comparin, [...]

Where previous scholars have read Hemingway's 'Soldier's Home' as a story about post-World War I disillusionment and the concomitant crisis in masculinity this article examines Hemingway's use of raced masculinity. By pointing to Oklahoma, a location of racial violence; Kansas, a location of extended Klan influence; and the National Baseball League, a site of exclusively White corruption, Hemingway builds a submerged text focused on the dangers of White Supremacy and White Privilege. Hemingway then engages the trope of White Womanhood as a tool of raced masculinity. 'Soldier's Home' shows how a spectral presence of anti-Black violence shapes one white soldier's reintegration. KEYWORDS: Raced Masculinity, White Supremacy, White Privilege, Anti-black Violence, Racial Violence, Scholars addressing Hemingway's 'Soldier's Home' have generally agreed the story is about post-World War I disillusionment. Milton Cohen claims Krebs was a good soldier who found fulfillment in soldiering and [...]

IAN: Peggy, you and I have been working on this project, along with Suzanne, off and on for close to two years. In that time, we've had many conversations, read [...]

Fish stocking occurs in aquatic systems for conservation purposes, to create or enhance recreational fisheries and to enhance wild-catch commercial fisheries. Identifying and quantifying the contribution of stocking efforts to wild populations is crucial to informing these management objectives. Provenance determination methods trade off accuracy, replicability, and costeffectiveness at fishery-relevant scales. We present and assess multiple methods for provenance determination using a case study of barramundi (Lates calcarifer) in the Dry Tropics region of northern Australia. A novel application of near-infrared spectroscopy (NIRS) is compared to two established methods for fish provenance, otolith microchemistry and genetic parentage analysis using microsatellites. The otolith microchemistry method was able to provide extremely high provenance resolution (>99% accuracy). The microsatellite parentage analysis method had a slightly lower overall accuracy (95%), likely as a result of genetic introgression in this region. Provenance determination using otolith NIRS had the lowest overall accuracy (76%). Once limitations regarding spectral noise, image resolution, and sample size are addressed, NIRS may have potential for costeffectively determining provenance in fish. Key words: barramundi, Lates calcarifer, provenance, natal origin, fish stocking, stock enhancement, otolith microchemistry, NIRS, microsatellite parentage analysis, Introduction Fish stocking occurs in aquatic systems around the world for conservation purposes, to create or enhance recreational fisheries and to enhance wild-catch commercial fisheries (Warren-Myers et al. 2018). Identifying [...]

Clinical workflows that prioritize repetitive patient intake screening to meet performance metrics may have unintended consequences. This retrospective analysis of electronic health record data from 24 Federally Qualified Health Centers assessed effectiveness and accuracy of the 2-item Patient Health Questionnaire (PHQ-2) for depression screening and Generalized Anxiety Disorder 2 (GAD-2) for anxiety screening from 2019 to 2021. Scores of over 91% of PHQ-2 and GAD-2 tests indicated low likelihood of depression or anxiety, which diverged markedly from published literature on screening outcomes. Visit-based screenings linked to performance metrics may not be delivering the intended value in a real-world setting and risk distracting clinical effort from other high value activities. Key words: performance measures; health care quality; administrative burden; practice-based research; PHQ-9; quality improvement; physician burnout, INTRODUCTION Primary care visits often start with a myriad of standardized intake screening questions that are tied to performance metrics and incorporated into electronic health records (EHRs). Prioritizing repetition of [...]

Not much is known about how bystanders' emotional reactions after not intervening in cyberbullying might impact their health issues. Narrowing this gap in the literature, the present study focused on examining the moderating effects of emotional reactions (i.e., guilt, sadness, anger) after not intervening in cyberbullying on the longitudinal relationship between cyberbullying bystanding and health issues (i.e., subjective health complaints, suicidal ideation, non-suicidal self-harm). Participants were 1,067 adolescents between 12 and 15 years old included in this study (M.sub.age = 13.67; 51% girls). The findings showed a positive association between Time 1 cyberbullying bystanding and Time 2 health issues. Guilt moderated the positive relationships among Time 1 cyberbullying bystanding, Time 2 subjective health complaints, suicidal ideation, and non-suicidal self-harm. Time 1 sadness also moderated the relationship between Time 1 cyberbullying bystanding and Time 2 suicidal ideation and non-suicidal self-harm. However, anger did not moderate any of the associations., Author(s): Michelle F. Wright [sup.1] [sup.2] , Sebastian Wachs [sup.3] [sup.4] Author Affiliations: (1) grid.29857.31, 0000 0001 2097 4281, Penn State University and DePaul University, , State College, United States [...]

The purpose of this pilot study was to examine Home Safety Hero an innovative serious game simulation designed to train parents on home safety risks and how to resolve those risks. The aim of this research was to compare whether the reaction times for multiple plays of Home Safety Hero would improve identification, with or without distraction, and resolution of hazards would improve when compared to single play. Participants were 19 parenting teens (M.sub.age = 17.66 years, SD.sub.age = 0.80 years; 100% female) who completed questionnaires on their demographics, frequency of game use, and their engagement with the game simulation and content. Teens were divided into two groups, one (n = 8) that played the game once and the second (n = 11) that played the game four times over a one-week period. Engagement data indicated no differences between the group of teens, suggesting that they found the game engaging even if they played it multiple times. Teens were faster at spotting risks in the home and were quicker at acting when encountering risks after playing the game four times when compared to teens in the single play group. Home Safety Hero shows promise for promoting home safety knowledge and resolution., Author(s): Michelle F. Wright [sup.1] [sup.2] , Sandra T. Azar [sup.1] , Elisabeth M. Whyte [sup.1] , Christian Lopez [sup.3] Author Affiliations: (1) grid.29857.31, 0000 0001 2097 4281, Department of [...]

The powerful El Nino of 1982-1983 precipitated a severe drought in the Hawai'i Islands and was followed by an unusually dry La Nina year. Our 1983/1984 study of the early successional demography of five shrub and one tree species on volcanic cinder, Big Island of Hawai'i, inadvertently coincided with the end of the ENSO drought. Life stage structure analyses showed a short-term dieback in the populations but then rapid population recovery. A new demographic tool, population flow diagram analysis, was developed as an aid to interpret the temporal dynamics of life stage structure. Crown size demographic depletion models were also used to describe the species' vital statistics. The apparent dieback was shown to be a temporary dormancyresponse to the El Nino/La Nina-induced drought rather than a true case of dieback related to cohort senescence. As precipitation levels returned to normal the populations were rejuvenated by the revival of senescent and dormant individuals. The species showed robust demographic resilience to an unusually powerful drought. The populations of the Devastation Area appear to be members of a non-equilibrium community but there was evidence of a shift towards equilibrium. Climate change may intensify ENSO droughts in Hawai'i and could cause longer-term diebacks of these populations and possibly their extirpation, affecting the rate and nature of primary succession on volcanic cinder ecosystems. Population viability modelling could determine if the species are likely to face extirpation from climate-change-driven alterations in the historic pattern of El Nino/La Nina events. Keywords: life stage dynamics, shrub population structure, dieback and rejuvenation, El Nino and La Nina droughts, Hawai'i, volcanic cinder, resilience, demography, ONE OF THE ENDURING THEMES of plant ecology has been the investigation of the pattern and process of succession. Dieter Mueller-Dombois (1983a) and Mueller-Dombois et al. (1983) have carried out [...]

Author(s): Martina Benvenuti [sup.1] , Michelle Wright [sup.2] , John Naslund [sup.3] , Anne C. Miers [sup.4] Author Affiliations: (1) grid.6292.f, 0000 0004 1757 1758, Department of Psychology, University of [...]

Background Fluid overload leads to poor neonatal outcomes. Diuretics may lower the rates of mechanical ventilation (MV) and mortality in neonates with fluid overload. Methods This is a retrospective study of preterm neonates [less than or equal to] 36 weeks of gestational age (GA) in the first 14 postnatal days in a level IV NICU in 2014-2020. We evaluated the epidemiology of fluid balance in the first 14 postnatal days and its association with MV and mortality and studied the association of diuretics with fluid balance, MV, and mortality. Results In 1383 included neonates, the overall median lowest and peak fluid balances were - 7.8% (IQR: - 11.7, - 4.6) and 8% (3, 16) on days 3 (2, 5) and 13 (5, 14), respectively. Fluid balance distribution varied significantly by GA. Peak fluid balance of [greater than or equal to] 10% was associated with increased odds of MV on days 7 and 14 with highest odds ratios (OR) of MV in neonates with fluid balance [greater than or equal to] 15%. Peak fluid balance of [greater than or equal to] 15% was associated with the greatest odds of mortality. Diuretics were used more frequently in neonates with younger GA, smaller birthweight, positive fluid balance, and those on MV. Conclusions Positive fluid balance negatively impacts pulmonary status. The odds of MV and death increase significantly as peak fluid balance percentage increases in all GA groups. The impact of diuretics on MV and death in preterm neonates needs further evaluation. Graphical abstract, Author(s): Mariah L. Wright [sup.1] , Brett G. Klamer [sup.2] [sup.3] [sup.4] , Elizabeth Bonachea [sup.1] , John D. Spencer [sup.1] [sup.2] [sup.3] , Jonathan L. Slaughter [sup.1] [sup.5] [sup.6] [...]

Opium's Long Shadow: From Asian Revolt to Global Drug Control. By steffen rimner. Cambridge, Massachusetts: Harvard University Press, 2018. x + 373 pp. ISBN 978-0-674-97630-6. $39.95 (hardcover). Opium's Long Shadow: [...]