scholarly journals Navigating healthcare systems before and after resettlement: Exploring experiences and recommendations for improvement from the perspectives of a Bhutanese refugee community

2021 ◽  
pp. 100049
Author(s):  
Manisha Salinas ◽  
David Matarrita-Cascante ◽  
Juan L. Salinas ◽  
James N. Burdine
2019 ◽  
Vol 26 (6) ◽  
pp. 547-552 ◽  
Author(s):  
William J Gordon ◽  
Adam Wright ◽  
Robert J Glynn ◽  
Jigar Kadakia ◽  
Christina Mazzone ◽  
...  

Abstract Objective The study sought to understand the impact of a phishing training program on phishing click rates for employees at a single, anonymous US healthcare institution. Materials and Methods We stratified our population into 2 groups: offenders and nonoffenders. Offenders were defined as those that had clicked on at least 5 simulated phishing emails and nonoffenders were those that had not. We calculated click rates for offenders and nonoffenders, before and after a mandatory training program for offenders was implemented. Results A total of 5416 unique employees received all 20 campaigns during the intervention period; 772 clicked on at least 5 emails and were labeled offenders. Only 975 (17.9%) of our set clicked on 0 phishing emails over the course of the 20 campaigns; 3565 (65.3%) clicked on at least 2 emails. There was a decrease in click rates for each group over the 20 campaigns. The mandatory training program, initiated after campaign 15, did not have a substantial impact on click rates, and the offenders remained more likely to click on a phishing simulation. Discussion Phishing is a common threat vector against hospital employees and an important cybersecurity risk to healthcare systems. Our work suggests that, under simulation, employee click rates decrease with repeated simulation, but a mandatory training program targeted at high-risk employees did not meaningfully decrease the click rates of this population. Conclusions Employee phishing click rates decrease over time, but a mandatory training program for the highest-risk employees did not decrease click rates when compared with lower-risk employees.


Author(s):  
Parangkush Subedi ◽  
Changwei Li ◽  
Ashok Gurung ◽  
Destani Bizune ◽  
M Christina Dogbey ◽  
...  

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A47.2-A47
Author(s):  
Esther Ngadaya ◽  
Godfather Kimaro ◽  
Ramadhani Shemtandulo ◽  
Erica Sandi ◽  
Sunday Simsokwe ◽  
...  

BackgroundWhile user fees in healthcare systems have been associated with quality improvement, a substantial increase may have a detrimental effect. This paper reports on the effects of increasing user fees on utilisation of TB diagnostic services in Tanzania.MethodsWe retrospectively analysed data on TB diagnostic services utilisation between July 2013 and June 2015 in Mnazi Mmoja Zanzibar (MMZ), Musoma and Sumbawanga hospitals. In July 2014, user fees in Musoma were increased substantially from 2 to 5 US dollar; Sumbawanga increased the fees stepwise, from 1 to 2 US dollar in July 2014, and from2 to 3 US dollar in January 2015 MMZ did not raise the fees. We compared TB services utilisation before and after introduction of user fees.ResultsOut of 7483 presumptive TB patients registered in all sites, 50.2% were males. Over half (3969) were registered before the user fee was increased. Among 3969, 1579 (39.8%) were from Musoma, 922 (23.2%) from Sumbawanga and 1468 (37.0%) from MMZ. Of the 3514 patients registered after the introduction of user fees, 983 (28%), 952 (27.1%) and 1579 (44.9%) patients were from Musoma, Sumbawanga and MMZ, respectively. The number of presumptive TB patients seeking TB diagnostic services at Musoma decreased significantly by 38% from 1579 to 983 after the increase of user fees (p=0.001). More females (817; 51.8% vs 458, 35.9%) attended Musoma before user fees were increased as compared to males whose attendance did not differ much (761; 48.2% vs 525; 53.4%); (p=0.01). There was no significant decrease of patients at Sumbawanga and MMZ.ConclusionThere was a significant decrease in the number of presumptive TB patients who accessed new TB diagnostic services in Musoma after a substantial increase of user fees, the effect was stronger among women. Although user fees are beneficial, they should be increased stepwise so as not to affect service utilisation.


2018 ◽  
Vol 62 (4) ◽  
pp. 1213-1229 ◽  
Author(s):  
Diane Griffiths ◽  
Christopher Loy

This study explores primary integration outcomes among 270 Bhutanese refugees, including education, employment, income, and health variables. Findings confirm that Bhutanese refugees are at a distinct disadvantage due to lower education and employment levels compared with other refugee groups. Almost a third fewer refugees have a high school degree compared with a national study of Bhutanese refugees. Women are employed at a rate 40 percent lower than the US population, and poverty levels are dramatically higher. The findings point to a need to adopt a more nuanced approach to studying integration outcomes and move away from a one-size-fits-all model of resettling refugees.


Author(s):  
Sarah E. Hickman ◽  
Gabrielle C. Baxter ◽  
Fiona J. Gilbert

AbstractRetrospective studies have shown artificial intelligence (AI) algorithms can match as well as enhance radiologist’s performance in breast screening. These tools can facilitate tasks not feasible by humans such as the automatic triage of patients and prediction of treatment outcomes. Breast imaging faces growing pressure with the exponential growth in imaging requests and a predicted reduced workforce to provide reports. Solutions to alleviate these pressures are being sought with an increasing interest in the adoption of AI to improve workflow efficiency as well as patient outcomes. Vast quantities of data are needed to test and monitor AI algorithms before and after their incorporation into healthcare systems. Availability of data is currently limited, although strategies are being devised to harness the data that already exists within healthcare institutions. Challenges that underpin the realisation of AI into everyday breast imaging cannot be underestimated and the provision of guidance from national agencies to tackle these challenges, taking into account views from a societal, industrial and healthcare prospective is essential. This review provides background on the evaluation and use of AI in breast imaging in addition to exploring key ethical, technical, legal and regulatory challenges that have been identified so far.


Author(s):  
J. Temple Black

Tool materials used in ultramicrotomy are glass, developed by Latta and Hartmann (1) and diamond, introduced by Fernandez-Moran (2). While diamonds produce more good sections per knife edge than glass, they are expensive; require careful mounting and handling; and are time consuming to clean before and after usage, purchase from vendors (3-6 months waiting time), and regrind. Glass offers an easily accessible, inexpensive material ($0.04 per knife) with very high compressive strength (3) that can be employed in microtomy of metals (4) as well as biological materials. When the orthogonal machining process is being studied, glass offers additional advantages. Sections of metal or plastic can be dried down on the rake face, coated with Au-Pd, and examined directly in the SEM with no additional handling (5). Figure 1 shows aluminum chips microtomed with a 75° glass knife at a cutting speed of 1 mm/sec with a depth of cut of 1000 Å lying on the rake face of the knife.


Author(s):  
R. F. Bils ◽  
W. F. Diller ◽  
F. Huth

Phosgene still plays an important role as a toxic substance in the chemical industry. Thiess (1968) recently reported observations on numerous cases of phosgene poisoning. A serious difficulty in the clinical handling of phosgene poisoning cases is a relatively long latent period, up to 12 hours, with no obvious signs of severity. At about 12 hours heavy lung edema appears suddenly, however changes can be seen in routine X-rays taken after only a few hours' exposure (Diller et al., 1969). This study was undertaken to correlate these early changes seen by the roengenologist with morphological alterations in the lungs seen in the'light and electron microscopes.Forty-two adult male and female Beagle dogs were selected for these exposure experiments. Treated animals were exposed to 94.5-107-5 ppm phosgene for 10 min. in a 15 m3 chamber. Roentgenograms were made of the thorax of each animal before and after exposure, up to 24 hrs.


Author(s):  
M. H. Wheeler ◽  
W. J. Tolmsoff ◽  
A. A. Bell

(+)-Scytalone [3,4-dihydro-3,6,8-trihydroxy-l-(2Hj-naphthalenone] and 1,8-di- hydroxynaphthalene (DHN) have been proposed as intermediates of melanin synthesis in the fungi Verticillium dahliae (1, 2, 3, 4) and Thielaviopsis basicola (4, 5). Scytalone is enzymatically dehydrated by V. dahliae to 1,3,8-trihydroxynaphthalene which is then reduced to (-)-vermelone [(-)-3,4- dihydro-3,8-dihydroxy-1(2H)-naphthalenone]. Vermelone is subsequently dehydrated to DHN which is enzymatically polymerized to melanin.Melanin formation in Curvularia sp., Alternaria sp., and Drechslera soro- kiniana was examined by light and electron-transmission microscopy. Wild-type isolates of each fungus were compared with albino mutants before and after treatment with 1 mM scytalone or 0.1 mM DHN in 50 mM potassium phosphate buffer, pH 7.0. Both chemicals were converted to dark pigments in the walls of hyphae and conidia of the albino mutants. The darkened cells were similar in appearance to corresponding cells of the wild types under the light microscope.


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