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Current evidence underscores a need to transform how we do clinical research, shifting from academic-driven priorities to co-led community partnership focused programs, accessible and relevant career pathway programs that expand opportunities for career development, and design of trainings and practices to develop cultural competence among research teams. Failures of equitable research translation contribute to health disparities. Drivers of this failed translation include lack of diversity in both researchers and participants, lack of alignment between research institutions and the communities they serve, and lack of attention to structural sources of inequity and drivers of mistrust for science and research. The Duke University Research Equity and Diversity Initiative (READI) is a program designed to better align clinical research programs with community health priorities through community engagement. Organized around three specific aims, READI-supported programs targeting increased workforce diversity, workforce training in community engagement and cultural competence, inclusive research engagement principles, and development of trustworthy partnerships.
Law and society scholars have long studied rights mobilization and gender inequality from the vantage point of complainants in private workplaces. This article pursues a new direction in this line of inquiry to explore, for the first time, mobilization from the vantage points of complainants and those accused of violating the rights of others in public-school workplaces in the United States. We conceptualize rights mobilization as legal, quasilegal, and/or extralegal processes. Based on a national random survey of teachers and administrators, and in-depth interviews with educators in California, New York, and North Carolina, we find an integral relationship between gender inequality and experiencing rights violations, choices about rights mobilization, and obstacles to formal mobilization. Compared to complainants, those accused of rights violations – especially male administrators – are more likely to use quasilegal and legal mobilization to defend themselves or to engage in anticipatory mobilization. Actors in less powerful status positions (teachers) most often pursue extralegal mobilization to complain about rights violations during which they engage in rights muting as a means of self-protection; when in more powerful status positions, actors use rights muting as a means of self-protection and to suppress the rights claims of others. This paper concludes with implications for future research on rights mobilization in school workplaces amidst changing political and demographic conditions.
Despite their use in clinical practice, there is little evidence to support the use of therapist written goodbye letters as therapeutic tools. However, preliminary evidence suggests that goodbye letters may have benefits in the treatment of anorexia nervosa (AN).
Aims:
This study aimed to examine whether therapist written goodbye letters were associated with improvements in body mass index (BMI) and eating disorder symptomology in patients with AN after treatment.
Method:
Participants were adults with AN (n = 41) who received The Maudsley Model of Anorexia Treatment for Adults (MANTRA) in a clinical trial evaluating two AN out-patient treatments. As part of MANTRA, therapists wrote goodbye letters to patients. A rating scheme was developed to rate letters for structure and quality. Linear regression analyses were used to examine associations between goodbye letter scores and outcomes after treatment.
Results:
Higher quality letters and letters that adopted a more affirming stance were associated with greater improvements in BMI at 12 months. Neither the overall quality nor the style of goodbye letters were associated with improvements in BMI at 24 months or reductions in eating disorder symptomology at either 12 or 24 months.
Conclusions:
The results highlight the potential importance of paying attention to the overall quality of therapist written goodbye letters in the treatment of AN, and adopting an affirming stance.
The Mascarene Islands of Mauritius and Réunion have long languished on the periphery of African studies. Surveys of African history pay little or no attention to the islands or the Mauritian dependencies of Rodrigues and, until they became a separate British Crown colony in 1903, the Seychelles. This indifference stems partly from the islands’ geographical isolation hundreds of miles east of the African mainland and Madagascar. The islands’ shallow historiographical footprint also reflects the fact that Mauritius and Réunion were not occupied permanently by humans until 1638 and 1663, respectively, while Rodrigues remained uninhabited until 1756 and the Seychelles were not colonized until 1770. The continuing reluctance of many Africanists to look beyond the beaches at Mogadishu, Mombasa, and Mozambique as they reconstruct eastern and southern Africa's history has likewise helped to ensure that the islands continue to be ignored. So has the fact that coming to terms with Mascarene history entails exploring complex patterns of social, economic, cultural, and political interaction between Indians, Southeast Asians, and Chinese as well as Africans, Malagasies, and Europeans. The failure of Mauritian, Réunionnais, and Seychellois historians to situate local developments in regional, global, or comparative contexts further reinforces the perception that the islands played little or no role in African history during the eighteenth and nineteenth centuries.
Similar attitudes plague studies of labor migration in the European colonial world. The pervasive Atlantic-centrism in modern slavery studies continues to hobble our understanding of European slave trading and often obscures the fact that millions of enslaved Africans reached parts of the world other than the Americas between the sixteenth and midnineteenth centuries. Studies of transoceanic slave trading in the Indian Ocean are, in turn, afflicted by a high degree of Africa-centrism and a tendency to focus on the northwestern Indian Ocean to the exclusion of other parts of this oceanic world. This practice of privileging certain geographic regions over others is matched by a propensity to draw a sharp dividing line between the pre- and postemancipation eras in the colonial world and an attendant proclivity to view the free and forced migrant labor trades that flourished before and after the abolition of slavery in the British Empire in 1834 as separate and distinct phenomena unto themselves. Studies of the slaves, convicts, and indentured laborers who reached the Mascarenes between the late seventeenth and early twentieth centuries attest as much.
Placebo-controlled clinical trials have led to concern over possible increased risk of suicide-related events in some populations exposed to antidepressants.
Aims
To evaluate the risk of suicide attempts by antidepressant drug class and the presence or absence of depression.
Method
A retrospective propensity-matched new-user cohort study was used to compare participants with incident depression classified by antidepressant treatment with each other and with the general population.
Results
Among the treated group, the suicide attempt rate peaked in the month prior to diagnosis then decreased steadily over the next 6 months. Among the pharmacologically untreated group, the highest rate was seen in the second month after diagnosis. Cohorts with depression had significantly higher suicide attempt risk than the general population, but the treated group did not differ significantly from the untreated group.
Conclusions
Patients on antidepressants did not have significantly higher risk compared with untreated patients. No significant differences were observed for patients treated with individual serotonin–noradrenaline reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) or by class (SSRI v. SNRI cohorts).