Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important ...determinants of Indigenous peoples’ health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006–2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.
•Most research addresses colonialism; more nuanced approaches are recommended.•Overemphasis of substance use problems and suicide can have negative implications.•Mental health services developed by Indigenous communities are most effective.•Inuit are overrepresented in research; Métis are drastically underrepresented.•Urban and off-reserve Indigenous populations are dramatically underrepresented.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Reversible cerebral vasoconstriction syndrome (RCVS) refers to segmental, multifocal constriction of intracranial arteries along with acute headache and resolves within weeks. It occurs more commonly ...in women, and 1 well-known manifestation of RCVS is postpartum angiopathy. Furthermore, the female sex is included in scoring systems designed to assist with diagnosing RCVS. Nonetheless, the literature is mixed regarding the true role of female and pregnancy-related factors in the pathophysiology of RCVS, and it is similarly unclear whether management of this disorder differs by sex. Given the association of RCVS with female sex and the importance of highlighting, recognizing, and managing stroke etiologies in women, herein, the author reviews what is currently known and unknown about the topic of RCVS in women.
Almost 1.7 million people in the settler colonial nation of Canada identify as Indigenous. Approximately 52 per cent of Indigenous peoples in Canada live in urban areas. In spite of high rates of ...urbanization, urban Indigenous peoples are overlooked in health care policy and services. Because of this, although health care services are more plentiful in cities as compared to rural areas, Indigenous people still report significant barriers to health care access in urban settings. This qualitative study, undertaken in Prince George, Canada, examines perceived barriers to health care access for urban Indigenous people in light of how colonialism impacts Indigenous peoples in their everyday lives. The three most frequently reported barriers to health care access on the part of the 65 participating health care providers and Indigenous clients of health care services are: substandard quality of care; long wait times; and experiences of racism and discrimination. These barriers, some of which are common complaints among the general population in Canada, are interpreted by Indigenous clients in unique ways rooted in experiences of discrimination and exclusion that stem from the settler colonial context of the nation. Through the lenses of cultural safety and ethical space – frameworks developed by international Indigenous scholars in efforts to better understand and operationalize relationships between Indigenous and non-Indigenous individuals and societies in the context of settler colonialism – this study offers an understanding of these barriers in light of the specific ways that colonialism intrudes into Indigenous clients’ access to care on an everyday basis.
•Urban Indigenous peoples are overlooked in health care policy and practice.•Participants include 15 health care providers and 50 Indigenous clients.•Prince George provides a unique, small, northern urban setting for this study.•Perceived racism and discrimination are major barriers to health care access.•Cultural safety and ethical space help to understand how colonialism impacts access.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Hundreds of years ago, physicians had no professional or ethical obligation to take care of sick patients during disease outbreaks, some purposely fleeing from plague-ridden areas 1. Based on these ...principles, 6 recommendations have been made for the current outbreak: maximizing benefits including using scarce resources responsibly and saving more lives/years of life, prioritizing COVID-19 resources (i.e., PPE, vaccines) to healthcare workers, invoking equality using random allocation or lottery to distribute resources to those with similar prognoses, thoughtful consideration of resource allocation (e.g., prioritizing older patients, among the most affected by SARS-CoV-2, to receive a vaccine), prioritizing those who have participated in COVID-19-related research, and providing equal resources to those with COVID-19 and those with other medical conditions 9. Unfortunately, by increasing the number of people in a hospital at one time, hospital visitors can potentially hamper social distancing and contribute to increased spread of SARS-CoV-2. ...many hospitals have closed their doors to visitors except under special circumstances.
A traveling salesman with little formal education, Max Hunter gravitated to song catching and ballad hunting while on business trips in the Ozarks. Hunter recorded nearly 1600 traditional songs by ...more than 200 singers from the mid-1950s through the mid-1970s, all the while focused on preserving the music in its unaltered form.
Sarah Jane Nelson chronicles Hunter’s song collecting adventures alongside portraits of the singers and mentors he met along the way. The guitar-strumming Hunter picked up the recording habit to expand his repertoire but almost immediately embraced the role of song preservationist. Being a local allowed Hunter to merge his native Ozark earthiness with sharp observational skills to connect--often more than once--with his singers. Hunter’s own ability to be present added to that sense of connection. Despite his painstaking approach, ballad collecting was also a source of pleasure for Hunter. Ultimately, his dedication to capturing Ozarks song culture in its natural state brought Hunter into contact with people like Vance Randolph, Mary Parler, and non-academic folklorists who shared his values.
The antimicrobial peptide GL13K encompasses 13 amino acid residues and has been designed and optimized from the salivary protein BPIFA2 to exhibit potent bacteriocidal and anti-biofilm activity ...against Gram-negative and Gram-positive bacteria as well as anti-lipopolysaccharide activity in vitro and in vivo. Here, the peptide was analyzed in a variety of membrane environments by circular dichroism spectroscopy and by high-resolution multidimensional solution nuclear magnetic resonance (NMR) spectroscopy. Whereas in the absence of membranes a random coil conformation predominates, the peptide adopts a helical structure from residue 5 to 11 in the presence of dodecylphosphocholine micelles. In contrast, a predominantly β-sheet structure was observed in the presence of lipid bilayers carrying negatively charged phospholipids. Whereas 15N solid-state NMR spectra are indicative of a partial alignment of the peptide 15N–1H vector along the membrane surface, 2H and 31P solid-state NMR spectra indicate that in this configuration the peptide exhibits pronounced disordering activities on the phospholipid membrane, which is possibly related to antimicrobial action. GL13K, thus, undergoes a number of conformational transitions, including a random coil state in solution, a helical structure upon dilution at the surface of zwitterionic membranes, and β-sheet conformations at high peptide:lipid ratios.
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IJS, KILJ, NUK, PNG, UL, UM
Objective
There is ongoing discussion about whether sports participation is a risk or protective factor for eating disorders (EDs). Research is mixed, with some studies suggesting that athletes have ...higher mean levels of ED psychopathology compared to nonathletes, while other studies suggest the opposite effect or no differences. The purpose of the current meta‐analysis was to identify whether female athletes reported higher mean levels of ED psychopathology compared to nonathletes.
Method
Following PRISMA guidelines, we identified 56 studies that reported ED psychopathology for female athletes and nonathletes. A three‐level random‐effects model of between‐ and within‐study variance was completed for the following outcome variables: overall ED psychopathology, body dissatisfaction, drive for thinness, restricting, and loss‐of‐control eating.
Results
Athletes reported lower levels of body dissatisfaction compared to nonathletes (g = −.21, p < .0001). Athletes and nonathletes reported similar levels of overall ED psychopathology, drive for thinness, restricting, and loss‐of‐control eating on average. Sport type significantly moderated standardized mean difference effect sizes of ED psychopathology in athletes versus nonathletes. Effect sizes comparing levels of drive for thinness, restricting, and loss‐of‐control eating in athletes versus nonathletes were larger for studies with athletes participating in aesthetic/lean sports compared to nonaesthetic/nonlean sports.
Discussion
Findings from this meta‐analysis could inform future ED prevention and treatment in female athletes by providing further evidence that athletes in aesthetic/lean sports may report higher levels of ED psychopathology. Participating in nonaesthetic/nonlean sports may be a protective factor for experiencing less body dissatisfaction.
Public Significance Statement
The current meta‐analysis summarized findings from 56 studies that assessed levels of disordered eating, body dissatisfaction, dietary restricting, and loss‐of‐control eating in female athletes and nonathletes. Athletes reported lower levels of body dissatisfaction compared to nonathletes, highlighting that participation in sport could have some protective factors.
Athletes participating in sports that require weight categories (e.g., judo) and sports that emphasize thinness/leanness (e.g., gymnastics and distance running) had higher levels of disordered eating relative to athletes participating in other types of sports that do not emphasize thinness/leanness (e.g., volleyball and basketball).
Resumen
Objetivo
Existe un debate abierto sobre si la participación en los deportes es un factor de riesgo o protector para los trastornos de la conducta alimentaria (TCA). La investigación es mixta, con algunos estudios que sugieren que los atletas tienen niveles medios más altos de psicopatología de TCA en comparación con los no atletas, mientras que otros estudios sugieren el efecto opuesto o ninguna diferencia. El propósito del presente metanálisis fue identificar si las atletas femeninas reportaron niveles medios más altos de psicopatología de TCA en comparación con las no atletas.
Método
Siguiendo las guías PRISMA, se identificaron 56 estudios que informaron psicopatología de TCA para atletas femeninas y no atletas. Se completó un modelo de efectos aleatorios de tres niveles de varianza entre y dentro del estudio para las siguientes variables de resultado: psicopatología general de TCA, insatisfacción corporal, impulso por la delgadez, restricción y pérdida de control de la alimentación.
Resultados
Las atletas reportaron niveles más bajos de insatisfacción corporal en comparación con las no atletas (g = ‐.21, p <.0001). Las atletas y las no atletas reportaron niveles similares de psicopatología general de TCA, impulso por la delgadez, restricción y pérdida de control de la alimentación en promedio. El tipo de deporte moderó significativamente los tamaños del efecto de la diferencia de medias estandarizada de la psicopatología de TCA en atletas versus no atletas. Los tamaños del efecto que compararon los niveles de impulso por la delgadez, la restricción y la pérdida de control de la alimentación en atletas versus no atletas fueron mayores para los estudios con atletas que participaron en deportes que valoran lo estético/cuerpo magro, esbelto, en comparación con deportes que no valoran lo estético/cuerpo magro, esbelto.
Discusión
Los hallazgos de este metanálisis podrían informar la prevención y el tratamiento futuros de los TCA en atletas femeninas al proporcionar más evidencia de que las atletas en deportes que dan un gran valor a lo estético o al cuerpo magro, esbelto, pueden reportar niveles más altos de psicopatología de TCA. Participar en deportes que no dan valor a lo estético o al cuerpo magro, puede ser un factor protector para experimentar menos insatisfacción corporal.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
The use of quantitative, qualitative, and mixed methods approaches has been foundational to research on emerging adulthood, yet there remain many unresolved methodological issues pertaining to how to ...handle qualitative data. The purpose of this article is to review best practices for coding and establishing reliability when working with narrative data. In doing so, we highlight how establishing reliability must be seen as an evolving process, rather than simply a focus on the end product. The review is divided into three broad sections. In the first section, we discuss relatively more quantitatively focused methods of coding and establishing reliability, whereas in the second section we discuss relatively more qualitatively focused methods. In the final section, we provide recommendations for researchers interested in coding narrative and other types of open-ended data. This article is intended to serve as an essential resource for researchers working on a variety of topics related to emerging adulthood and beyond.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) are quality metrics for many ICUs, and financial ramifications can be applied to ...hospitals and providers who perform poorly on these measures. Despite some perceived benefits to tracking these metrics, there are a range of issues associated with this practice: lack of a solid evidence base that documenting them has led to decreased infection rates, moral distress associated with identifying these infections, problems with their definitions, and others. We discuss each of these concerns while also including international perspectives then recommend practical steps to attempt to remediate use of the CLABSI and CAUTI metrics. Specifically, we suggest forming a task force consisting of key stakeholders (e.g., providers, Centers for Medicare & Medicaid Services (CMS), patients/families) to review CLABSI and CAUTI-related issues and then to create a summary statement containing recommendations to improve the use of these metrics.
•CLABSIs and CAUTIs are quality metrics for many ICUs.•Ramifications (e.g., financial) occur due to poor performance on these measures.•However, several issues are associated with use of CLABSIs and CAUTIs.•We discuss each concern then recommend practical steps to remediate these metrics.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Delivering net zero by 2050 will require governments to utilise all available abatement opportunities, yet current policy largely ignores socially-driven mitigation in favour of technological ...innovation in the energy sector. Past energy transitions have typically taken several decades, but policymakers remain confident that low carbon technology can be deployed in time for a 2050 mitigation target. We consider the potential for social transitions to deliver emissions reductions within this time frame. Based on detailed analysis of 12 past transitions, we develop frameworks for technological and social transitions which draw out the relationships between progress, policy and diffusion. Using our generalised frameworks we compare the duration of transitions, finding that the technological transitions in our study take on average four decades longer than the social transitions to go from initial conception to market or behaviour saturation. Our evidence suggests that policymakers who continue to rely on technology transitions to reduce emissions will be unable to deliver climate targets by 2050. By engaging with the public to stimulate social transitions governments could have more impact, more swiftly. Only by utilising both technological and social transitions can policymakers hope to achieve net zero emissions by 2050.
•Data-based review of diffusion of past technological and social transitions.•Social transitions take on average four decades less than technological transitions.•Maximum technology deployment rate constrained by construction requirements.•Policymakers should utilise social transitions to deliver net zero by 2050.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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