'Asian whiz kids' perfect test scores.' 'Selective schools and tiger parents.' These types of headlines highlight the increased visibility of academically successful students from Asian migrant ...backgrounds, in Australia and other Western countries. They also point to anxiety about the perceived aggressive 'tiger' parenting often associated with Asian academic success. This paper focuses on the forms of everyday multiculturalism found in and around high-performing selective schools and classes in Sydney, Australia, almost all of which are dominated by Asian-Australian students. Drawing on interviews with parents and students from Anglo- and Asian-Australian backgrounds, it documents the different positionalities adopted by participants within these culturally diverse settings, including anger, aspiration and cosmopolitanism. This potentially volatile combination of approaches to diversity reveals some of the social consequences of neoliberal migration and education policies.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This paper critically engages with the concept of 'everyday multiculturalism', which advocates argue is a more productive way of understanding the reality of multiculturalism in contemporary ...Australia, as opposed to moral panics about 'home-grown terrorism', ghettoes and ethnic crime. Everyday multiculturalism, it is argued, can be found in 'micropublics' of cross-cultural encounter, in many of the social settings of everyday life, including schools, workplaces and neighbourhoods. This paper focuses on schools in particular, to show that everyday multiculturalism is highly uneven in its distribution, and that significant cultural polarisation is occurring within Sydney's secondary schools. However, it reiterates the importance of schools as potential micropublics, as they are ideal sites for fostering a respect for the presence of Others, which can coexist with tension and conflict.
Like many Western governments, the Australian government increasingly views migration through the lens of economic efficiency, arguing that skilled professionals achieve the best employment outcomes ...and therefore constitute the ideal migrant. This paper challenges these claims, showing that skilled migrants do not always successfully transfer their skills to new labour markets. It argues that the government's 'success story' narrative disguises a much more complex reality, in which migrants' employment outcomes are shaped by broader social and cultural factors, as well as just economic ones. In particular, it shows that men and women typically experience migration differently, and the challenges of re-negotiating work and care in a new setting often lead to a 'feminisation' of women's roles, as they find themselves taking up more traditional gender roles as wives and mothers. Using in-depth interviews with Chinese women and survey data from the Australian government, I show that, in Australia, migrant women often experience downward occupational mobility and a re-orientation away from paid work and towards the domestic sphere.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
To identify factors associated with overtreatment of presumed urinary tract infection (UTI) among children with spina bifida using such criteria.
A retrospective review of children with spina bifida ...(age <21 years) evaluated in the Emergency Department (ED) at a single institution was performed. Patients with a urinalysis (UA) performed who were reliant on assisted bladder emptying were included. The primary outcome was overtreatment, defined as receiving antibiotics for presumed UTI but ultimately not meeting spina bifida UTI criteria (≥2 urologic symptoms plus pyuria and urine culture growing >100k CFU/mL). The primary exposure was whether the components of the criteria available at the time of the ED visit (≥2 urologic symptoms plus pyuria) were met when antibiotics were initiated.
Among 236 ED encounters, overtreatment occurred in 80% of cases in which antibiotics were initiated (47% of the entire cohort). Pyuria with <2 urologic symptoms was the most important factor associated with overtreatment (OR 9.6). Non-Hispanic White race was associated with decreased odds of overtreatment (OR 0.3).
Overtreatment of presumed UTI among patients with spina bifida was common. Pyuria, which is not specific to UTI in this population, was the main driver of overtreatment. Symptoms are a cornerstone of UTI diagnosis among children with spina bifida, should be collected in a standardized manner, and considered in a decision to treat.
To present a unique series of children with previously repaired anorectal malformations (ARM) with subsequent urethral pathology repaired via a posterior sagittal exposure and highlight the ...associated technical advantages.
Using a retrospective review of all procedures performed in our pediatric colorectal and pelvic reconstruction program from January 2020 through December 2022, we compiled a case series of patients with a history of ARM and prior posterior sagittal anorectoplasty (PSARP) who had urethral pathology and concurrent indication for redo-PSARP. Clinical features, operative details, and postoperative outcomes were collected.
Six male patients presented at a median age of 4.3 years, all born with an ARM of recto-urinary fistula type, of which 3 were recto-prostatic, 1 recto-bladder-neck, and 2 unknown type. In addition to redo-PSARP, 2 underwent remnant of the original fistula excision and 4 had urethral stricture repair. One required post-operative Heineke-Mikulicz anoplasty. Patients underwent cystoscopy 4-6 weeks post-reconstruction, and none showed urethral stricture requiring treatment. Post-procedurally, 5 patients were able to void urethrally and 1 required additional bladder augmentation/Mitrofanoff.
Redo-PSARP completely mobilizes the rectum, thereby providing excellent exposure to the posterior urethra for repair. This approach also allows the option of a rectal flap for augmented urethroplasty as well as harvest of an ischiorectal fat pad for interposition.
Interleukin-4 (IL-4) is crucial in many helminth infections, but its role in urogenital schistosomiasis, infection with
worms, remains poorly understood due to a historical lack of animal models. The ...bladder pathology of urogenital schistosomiasis is caused by immune responses to eggs deposited in the bladder wall. A range of pathology occurs, including urothelial hyperplasia and cancer, but associated mechanisms and links to IL-4 are largely unknown. We modeled urogenital schistosomiasis by injecting the bladder walls of IL-4 receptor-alpha knockout (
) and wild-type mice with
eggs. Readouts included bladder histology and
assessments of urothelial proliferation, cell cycle, and ploidy status. We also quantified the effects of exogenous IL-4 on urothelial cell proliferation
, including cell cycle status and phosphorylation patterns of major downstream regulators in the IL-4 signaling pathway. There was a significant decrease in the intensity of granulomatous responses to bladder-wall-injected
eggs in
versus wild-type mice.
egg injection triggered significant urothelial proliferation, including evidence of urothelial hyper-diploidy and cell cycle skewing in wild-type but not
mice. Urothelial exposure to IL-4
led to cell cycle polarization and increased phosphorylation of AKT. Our results show that IL-4 signaling is required for key pathogenic features of urogenital schistosomiasis and that particular aspects of this signaling pathway may exert these effects directly on the urothelium. These findings point to potential mechanisms by which urogenital schistosomiasis promotes bladder carcinogenesis.
Background
To investigate a novel velopharyngeal squeeze maneuver (VPSM) and novel endoscopic pharyngeal contraction grade (EPCG) scale for the evaluation of pharyngeal motor function.
Methods
During ...endoscopic examination of 77 post‐irradiated nasopharyngeal carcinoma patients and control subjects, VPSM was rated and lateral pharyngeal wall movement graded with EPCG scale during swallowing. Pharyngeal constriction ratio (PCR) measured by videofluoroscopy was used for correlation.
Results
VPSM and EPCG scale showed almost perfect intra‐rater and inter‐rater reliability (Kappa: >0.90). VPSM was present in 61% of patients suggesting good pharyngeal motor function. VPSM was predictive of EPCG scale (Wald statistic = 29.99, p < 0.001). EPCG scale also correlated strongly with PCR (r: 0.812) and was predictive for aspiration (odds ratio: 22.14 95% CI 5.01–97.89, p < 0.001).
Conclusions
VPSM and EPCG scale are two novel tools to assess pharyngeal motor function, and both correlate well with pharyngeal contractility and aspiration.
“The assumption that rights are in this sense natural is simply one assumption to be made and examined for its power to unite and explain our political convictions, one basic programmatic decision to ...submit to this test of coherence and experience.”1
Although the combination of bladder dysfunction and upper tract anomalies puts patient with cloaca at risk for renal disease, the rarity of this condition makes it difficult to study empirically. As ...a high-volume center, we uniquely capture bladder function outcomes following our growing number of cloacal repairs.
1) Describe the rates of incomplete bladder emptying following primary cloacal repair (at 2–3 months after repair and last follow up), and 2) identify clinical factors associated with assisted bladder emptying.
We performed a prospective cohort study of patients undergoing primary cloaca repair by our Children's National Colorectal Center team between 2020 and 2021. The primary outcome was assisted bladder emptying at 2–3 months postoperatively and last visit. Covariables included preoperative characteristics (cloacagram measurements), ARM complexity (moderate = common channel CC <3-cm, severe = CC ≥ 3-cm), vesicoureteral reflux (VUR) status, sacral ratio (good ≥0.7, intermediate 0.7–0.4, poor ≤0.4), spinal cord status, means of preoperative bladder emptying, and operative details (age at repair, repair type, & concomitant laparotomy).
Eighteen participants were eligible. A majority had moderate cloaca (78%), VUR (67%), spinal cord abnormalities (89%), and good sacral ratios (56%). Preoperatively, 10 patients were diapered for urine and 8 had assisted bladder emptying. Surgical repairs were performed at a median age of 8 months (range 4–46). Nine (50%) patients underwent urogenital separation (UGS), eight (44%) total urogenital mobilization, and 1 (6%) perineal sparing posterior sagittal anorectoplasty with introitoplasty. Exploratory laparotomy was performed in 7 (39%) patients. At 2–3 months, 7 patients were voiding and 11 required assisted bladder emptying. Median length of long-term follow up was 12 months (range 5–25), and 8 patients were voiding and 10 required assisted bladder emptying. Postoperative need for assisted bladder emptying was significantly associated with assisted bladder emptying preoperatively, a shorter urethra and increasing common channel length, UGS and exploratory laparotomy. Spinal cord imaging findings were not associated.
Bladder emptying following cloaca repair is likely a result of congenital function and surgical effects. Indeed, increasingly cloaca complexity requiring UGS and laparotomy was associated with both pre- and post-operative assisted bladder emptying. The lack of association with spinal cord imaging may reflect a divergence between anatomy and function.
Approximately half of patients required assisted bladder emptying in this study. Associated factors included urethral and common channel length, the need for assisted bladder emptying preoperatively, the type of surgical approach and additional laparotomy. Being diapered with seemingly normal voiding prior to surgery did not guarantee normal bladder function postoperatively. Display omitted
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