Labor Migration and Climate Change Adaptation

Social scientific evidence suggests that labor migration can increase resilience to climate change. For that reason, some have recently advocated using labor migration policy as a tool for climate adaptation. This paper engages with the normative question of whether, and under what conditions, states may permissibly use labor migration policy as a tool for climate adaptation. I argue that states may use labor migration policy as a tool for climate adaptation and may even have a duty to do so, subject to two moral constraints. First, states must also provide acceptable alternative options for adaptation so that the vulnerable are not forced to sacrifice their morally important interests in being able to remain where they are. Second, states may not impose restrictive terms on labor migrants to make accepting greater numbers less costly for themselves because doing so unfairly shifts the costs of adaptation onto the most vulnerable.

Timing of Initiation of Calcineurin Inhibitors in Pediatric Haploidentical Transplantation with Post-Transplantation Cyclophosphamide: Effects on Survival, Relapse, and Cytokine Release Syndrome

Background: The use of unmanipulated haploidentical stem cell transplantations (haplo-HSCT) with post-transplant cyclophosphamide (PTCY) in children has emerged as an acceptable alternative to the patients without a matched donor. However, the timing of calcineurin inhibitors (CNI) used in combination with PTCY is increasingly becoming a topic of controversy. Method: We evaluated 49 children with acute leukemia who underwent unmanipulated haplo-HSCT with PTCY according to the initiation day of CNIs (pre- or post-CY). Results: There were no significant differences in the overall survival analysis between the two groups. The cumulative incidence of relapse at 2 years was 21.2% in the pre-CY group and 38.9% in the post-CY group (p=0.33). Cytokine release syndrome (CRS) was observed more frequently in the post-CY group (p=0.04). The OS and EFS at 2 years in patients with and without CRS in the pre-Cy group were 42.9% vs 87.5% (p=0.04) and 38.1% vs 87.5% (p=0.04), respectively. Conclusion: Our study shows that the argument for starting CNI administration after CY is tenuous, and the rationale for not starting CNI before CY needs to be reconsidered.

Aquamation: legal nail in burial and cremation's coffin?

Respect for the dead defines a community. Burial of a corpse has for many years been the only way of disposing of a dead body. Land available for burial sites is limited. In the 1960s cremation became an acceptable alternative to burial. Recently a more environmentally friendly way of disposing of a corpse was introduced to South Africa. Alkaline Hydrolysis or aquamation is a chemical process dissolving a dead body. The wastewater can be disposed of in a sewage system. Legislation has not kept up with this new technology. A new set of regulations to the National Health Act 61 of 2003 is proposed.

995 Bedside Teaching from A Distance; Surgical Education in The COVID Era

Introduction The COVID pandemic resulted in a shutdown of facilities and resources globally. With drastic changes in the provision of services available in the health sector, so too were medical students’ provision of learning. With the onslaught of COVID and the need for ongoing learning resources for students, novel methods to maintain adequate surgical patient exposure and student interaction on a platform amenable to the interactive format required was devised using a virtual platform to compliment current pedagogical approaches. Method This was a randomised control trial to evaluate the perceived use of remote learning in place of surgical bedside teaching in the COVID-19 era. Medical students in a regional hospital were recruited and randomised to undergo the bedside teaching in person or receive the teaching virtually through a Xpert eye, smart glasses to facilitate connections remotely. Feedback questionnaires and exit interviews carried out following each session. Content analysis of transcripts was performed to evaluate the presence and quality of perceived learning, benefits, and limitations. Results Feedback demonstrated greater engagement, satisfaction, involvement, and learning (p < 0.01) in the bedside teaching group. Content analysis yielded three main themes: Interpersonal content, technological features, and provision of content. Students reported the virtual teaching was an acceptable alternative in the current climate of social distancing and reduced patient access. Conclusions The current pandemic poses a risk to adequate patient exposure to patient centred learning. Teaching sessions received remotely are an acceptable alternative in the current climate of reduced clinical access, however bedside teaching remains the preferred method of learning.

How Adults With Stroke Conceptualize Physical Activity: An Exploratory Qualitative Study

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. In this qualitative, phenomenological study, 15 stroke survivors indicated that performing moderate to vigorous physical activity (PA), performing activities of daily living (ADLs), and avoiding sedentary behavior were important types of PA. For adults with stroke for whom moderate PA is challenging, performing ADLs may be an acceptable alternative. OT practitioners can assist clients to decrease sedentary behavior and increase PA through the performance of meaningful activities and occupations. Primary Author and Speaker: Ryan Bailey Contributing Authors: Jennifer Stevenson

Diagnostic Accuracy of Dried Blood Spots Collected on HemaSpot HF Devices Compared to Venous Blood Specimens To Estimate Measles and Rubella Seroprevalence

Dried blood spot (DBS) collection provides an easy, practical, and acceptable alternative to venous blood collection, especially for community-based studies, provided that results from DBS are accurate. We demonstrated high sensitivity and specificity for measles- and rubella-specific immunoglobulin G (IgG) with DBS collected via HemaSpot HF devices compared to serum samples.

Concurrent validity and reliability of a functional electromechanical dynamometer to assess isometric mid-thigh pull performance

The aim of this study was to examine the concurrent validity and reliability of a functional electromechanical dynamometer (FEMD) to assess the isometric mid-thigh pull (IMTP) kinetic variables: peak force (PF), rate of force development (RFD), and time-specific force values (50-, 100-, 150-, and 200-ms). Twenty-seven male collegiate athletes (age: 22.9 ± 1.9 years; stature: 184.8 ± 10.4 cm; body mass: 84.2 ± 11.8 kg) performed four IMTP trials simultaneously on a force platform and the FEMD. The PF variables calculated from performance of the IMTP on both devices were reliable (CV < 3%; ICC > 0.90) and valid (bias < 13.9 N; random error < 52.1 N; r = 1.00), but they showed heteroscedasticity of the errors ( R2 > 0.23). The RFD (CV > 10.88%; ICC < 0.76) and initial force (CV > 8.81%; ICC < 0.76) variables did not reach an acceptable reliability for any device, but they showed strong associations between them ( r range = 0.53–0.69). These results indicate that the FEMD is an acceptable alternative to assess athlete’s maximal force production (i.e. PF), but the data collected with FEMD and force plates should not be used interchangeably.

To Medicalise or Not to Medicalise: Is that the Question?

Today, female genital cutting (fgc) is more often performed by health professionals. In this dissertation we aim to answer the question of why mothers opt to medicalise their daughters’ cut, and how this decision relates to their social position within their community. We focus on Egypt and Kenya. The first important conclusion of our research is that increasing medicalisation and decreasing fgc prevalence can coexist. Moreover, we identify three major drivers behind mothers’ choice to medicalise their daughters’ cut. Firstly, mothers argue that they opt for a medicalised cut to reduce the health risks related to the cut. They seek a less harmful but still culturally acceptable alternative. Secondly, the medicalisation of fgc is socially stratified. Thirdly, medicalisation may act as a social norm in itself. In conclusion, we state that the debate about medicalisation should be more nuanced and that the general discourse on medicalisation should be challenged and empirically grounded.

European experience application in replacing hydrofluorocarbons in air conditioning units in domestic railway transport

Adoption by Russia of the Kigali Amendment to the Montreal Protocol on substances that deplete the ozone layer posed a very difficult task for consumers of artificial cold, including rail transport, to find an acceptable alternative to the R134a freon and mixtures based on it, which is being phased out. Considering that there are no equivalent alternatives to these substances on the market, it was proposed to consider the use of widely known and previously used working fluids in climate technology, based on the positive experience of the European Union (EU) countries. The article analyzes the reasons for the bans on the use of hydrofluorocarbons, presents the mechanism for the legal use of refrigerants that are safe for humans and nature in the EU and a version of the roadmap for converting the climatic units of the Russian Railways holding to R22 freon and other types of fluorocarbons within the framework of the Kigali Amendment.

Timing of Initiation of Calcineurin Inhibitors in Pediatric Haploidentical Transplantation with Post-Transplantation Cyclophosphamide: Effects on Survival, Relapse, and Cytokine Release Syndrome

The use of unmanipulated haploidentical stem cell transplantations (haplo-HSCT) with post-transplant cyclophosphamide (PTCY) in children has emerged as an acceptable alternative to the patients without a matched donor. However, the timing of calcineurin inhibitors (CNI) used in combination with PTCY is increasingly becoming a topic of controversy. We evaluated 49 children with acute leukemia who underwent unmanipulated haplo-HSCT with PTCY according to the initiation day of CNIs (pre- or post-CY). There were no significant differences in the overall survival analysis between the two groups. The cumulative incidence of relapse at 2 years was 21.2% in the pre-CY group and 38.9% in the post-CY group (p = 0.33). Cytokine release syndrome (CRS) was observed more frequently in the post-CY group. Our study shows that the argument for starting CNI administration after CY is tenuous, and the rationale for not starting CNI before CY needs to be reconsidered.