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OBJECTIVES/SPECIFIC AIMS: This study aims to identify genetic biomarkers of GDM and facilitate the understanding of its molecular underpinnings. METHODS/STUDY POPULATION: We identified a cohort of mothers diagnosed with GDM in our longitudinal birth study by mining Electronic Health Records of participants utilizing PheCode map with ICD-9 and ICD-10 codes. We verified each case using ACOG’s GDM diagnosis criteria. RESULTS/ANTICIPATED RESULTS: Whole genome sequencing (WGS) data were available for 111 confirmed cases (out of 205) and 706 controls (out of 1,429) from different ancestries (412 EUR, 256 AMR, 56 EAS, 26 SAS and 18 AFR; 49 OTHER). SAS had the highest incidence of GDM at 38.46% and EUR had the lowest at 6.55%. We performed logistic regression using computed ancestry, age and BMI as covariates to determine if any variants are associated with GDM. The top variant (rs139014401) was found in an intron of DFFB gene, which is p53-bound and regulates DNA fragmentation during apoptosis. We will investigate the robustness of 49 identified variants and will separate the cohort by ancestry to detect population-specific differences in the top loci. DISCUSSION/SIGNIFICANCE OF IMPACT: Identification of molecular biomarkers in GDM across different ancestral backgrounds will address a gap in current GDM research. Findings may enhance screening and enable clinicians to identify those at risk for developing GDM earlier in the pregnancy. Early management of mothers at risk may lead to better health outcomes for mother and baby.
Hip fracture rehabilitation has two streams: high tolerance short duration (HTSD) and low tolerance long duration (LTLD). This study examined patient characteristics and outcomes in HTSD and LTLD associated with length of stay (LOS) and discharge destination. We retrospectively examined patients’ medical charts following hip fracture surgery and collected demographic, functional, and health characteristics. A statistical analysis was done to describe the differences between HTSD (n = 73) and LTLD (n = 57) patient characteristics and their relationship with LOS and discharge destination. Those in LTLD were significantly older, less independent with prefracture bathing and instrumental activities of daily living, had lower Functional Independence Measure (FIM) admission scores, and more co-morbidities. Higher FIM motor score on admission in HTSD and greater change in FIM total score in LTLD was significantly correlated with discharge home. Diabetes in LTLD and lower total admission FIM in HTSD was significantly associated with increased LOS.
Immigration poses numerous challenges for health professionals and public health lawyers. This article reviews these challenges. We begin by offering some background on immigration and health and then explain some of the reasons why immigrants are less likely than natives to have health insurance. Next we turn to a discussion of some of the particular challenges relating to the health care of refugees. We conclude by analyzing and rejecting some of the arguments that are made for discriminating against immigrants with respect to the provision of public health benefits and services.
We previously reported an association between 5HTTLPR genotype and
outcome following cognitive–behavioural therapy (CBT) in child anxiety
(Cohort 1). Children homozygous for the low-expression short-allele
showed more positive outcomes. Other similar studies have produced mixed
results, with most reporting no association between genotype and CBT
To replicate the association between 5HTTLPR and CBT outcome in child
anxiety from the Genes for Treatment study (GxT Cohort 2,
n = 829).
Logistic and linear mixed effects models were used to examine the
relationship between 5HTTLPR and CBT outcomes. Mega-analyses using both
cohorts were performed.
There was no significant effect of 5HTTLPR on CBT outcomes in Cohort 2.
Mega-analyses identified a significant association between 5HTTLPR and
remission from all anxiety disorders at follow-up (odds ratio 0.45,
P = 0.014), but not primary anxiety disorder
The association between 5HTTLPR genotype and CBT outcome did not
replicate. Short-allele homozygotes showed more positive treatment
outcomes, but with small, non-significant effects. Future studies would
benefit from utilising whole genome approaches and large, homogenous
In recent years, WikiLeaks and Anonymous have made headlines distributing confidential information, defacing websites, and generating protest around political issues. Although many have dismissed these actors as terrorists, criminals, and troublemakers, we argue that such actors are emblematic of a new kind of political actor: extraordinary bandits (e-bandits) that engage in the politics of no one via anonymizing Internet technologies. Building on Hobsbawm's idea of the social bandit, we show how these actors fundamentally change the terms of global activism. First, as political actors, e-bandits are akin to Robin Hood, resisting the powers that be who threaten the desire to keep the Internet free, not through lobbying legislators, but by “taking” what has been deemed off limits. Second, e-banditry forces us to think about how technology changes “ordinary” transnational activism. Iconic images of street protests and massive marches often underlie the way we as scholars think about social movements and citizen action; they are ordinary ways we expect non-state actors to behave when they demand political change. E-bandits force us to understand political protest as virtual missives and actions, activity that leaves no physical traces but that has real-world consequences, as when home phone numbers and addresses of public officials are released. Finally, e-banditry is relatively open in terms of who participates, which contributes to the growing sense that activism has outgrown organizations as the way by which individuals connect. We illustrate our theory with the actions of two e-bandits, Anonymous and WikiLeaks.
Does naming and shaming states affect respect for human rights in those states? This article argues that incentives to change repressive behaviour when facing international condemnation vary across regime types. In democracies and hybrid regimes – which combine democratic and authoritarian elements – opposition parties and relatively free presses paradoxically make rulers less likely to change behaviour when facing international criticism. In contrast, autocracies, which lack these domestic sources of information on abuses, are more sensitive to international shaming. Using data on naming and shaming taken from Western press reports and Amnesty International, the authors demonstrate that naming and shaming is associated with improved human rights outcomes in autocracies, but with either no effect or a worsening of outcomes in democracies and hybrid regimes.
Why should we believe the word of non-governmental organizations (NGOs) working on human rights? They are, after all, actors with interests and values, pursuing political agendas. Contrary to what some have argued, their positions are not apolitical (Wilson 1997; Winston 2001); they do not adopt views in an idealistic vacuum. While human rights NGOs can be considered virtuous because the nature of their work is characterized as “good” by most, like other NGOs and other political actors, NGOs also have distinct agendas. They make tradeoffs on the issues and cases they choose to advocate. Knowing this, under what conditions should we believe human rights NGOs? Should we always find them credible because they do good work protecting people from oppressive regimes, exposing violations of international law? Should we accept their monitoring as credible because they tend to be accurate? As it will become clear below, the “we” (i.e. the audience) that evaluates NGOs actually matters quite a bit. Knowing that credibility is in the eye of the beholder, human rights NGOs also attempt to position themselves such that they are more credible to certain audiences. The credibility of two of the most important human rights NGOs, Amnesty International and Human Rights Watch (HRW), is achieved through different organizational structure choices, which I argue is one critical method by which audiences can evaluate NGO credibility.
Human rights NGOs often stress the accuracy of their reporting to demonstrate their trustworthiness as a strategy to establish or augment their credibility. First, human rights NGOs fundamentally have to be accurate – their accounts that states are abusing human rights need to be true, or else it undermines their ability to engage in transnational politics: information, symbolic, leverage, accountability (Keck and Sikkink 1998). However, accuracy of information is a function of the perception of NGOs as trustworthy organizations themselves. NGOs are taken seriously when their reports turn out to be true; they become credible as political actors and informants as they establish their reputations for accurately revealing abuses on individuals. Accuracy leads to credibility. However, the credibility of an actor can also lead to the perception of that actor’s words as accurate. In other words, at some point, the assumption that an actor is credible leads to the perception (real or not) that the information she shares is accurate. Accuracy can therefore be seen as part of a definition of credibility, but not its entirety.
Audit has been defined as “a quality improvement process that seeks to improve patient care and outcome, through systematic review of care and comparison with explicit criteria, followed by the implementation of change”. As of May 2011, under the Medical Practitioners Act 2007, doctors are legally obliged to join in professional competence schemes, following requirements set by the Medical Council. These include the obligation for doctors to conduct one clinical audit per year. In Ireland and elsewhere, audit provides an opportunity for services to create an “environment in which clinical care will flourish”.