A Comparative Case Study of American and Ugandan Refugee Policies

This research was conducted in order to expand upon current understandings of the policies affecting refugees in Uganda and the United States (U.S.). Appreciating both policies and implementation strategies for each country is critical in providing the ability to fully grasp the reality of the refugee crisis faced by countries all over the world. This study employed field-based research, including observations, focus groups, and interviews with refugees and those who implement refugee policies. Non-governmental organizations (NGOs) and implementing partners of the United Nations High Commissioner for Refugees (UNHCR) in Uganda were interviewed, along with officers and commandants in the Office of the Prime Minister. Research was conducted within Kampala, Nakivale Refugee Settlement, and Bidi Bidi, the largest refugee camp in the world. Virtual interviews assisted in collecting information concerning U.S. policy. Additionally, a thorough exploration of the legal frameworks through which refugees exist, both in the U.S. and Uganda, was conducted through documentary research. Preliminary research found that America and Uganda maintain distinctly different refugee policies. America’s Refugee Act of 1980 focuses exclusively on resettlement. This contrasts with Uganda’s Refugee Act of 2006, which emphasizes local integration and repatriation strategies. The research revealed that financial and infrastructure resource constraints, compounded by developmental obstructions, are among the most important implementation issues affecting refugees, especially in Uganda. These challenges highlight the complex nature of implementing refugee policy, as well as the intricate relationship that refugees have with national development

Red Fruit: 1933

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Novel internally-staged ultrafiltration for protein purification

A new ultrafiltration technique based on a multimembrane stack has been developed to fractionate proteins closer in molecular weight than conventionally possible. The technique is illustrated here by obtaining a pure protein product from a binary protein mixture. By employing membranes in series using the same membrane without any gaskets or spacers in-between, ultrafiltration is carried out to separate two proteins relatively close in molecular weight. Flat membranes, of the same molecular weight cutoff (MWCO) 30,000 or 100,000, are stacked together in the desired number, and ultrafiltration takes place. The membrane rejection of a protein is amplified with each additional membrane, ultimately resulting in a completely rejected species. Complete purification of the more permeable protein may be achieved by operating under a physicochemical condition that is optimal for selective separation by a single membrane. Three systems; myoglobin and f3-lactoglobulin (molecular weight ratio 2.05), myoglobin, and β-lactalbumin (molecular weight ratio 1.22), and hemoglobin and bovine serum albumin (molecular weight ratio 1.03) were studied under various operating conditions. Complete rejection was achieved using three membranes one on top of the other for all three systems. To achieve complete rejection in a multimembrane stack, the single membrane rejection must be considerable. Cleaning in situ was achieved with reproducible experimental results before and after on-line cleaning. Flux decreased by a factor equal to the number of membranes when a multimembrane composite was used. However, the lost flux may be recovered by increasing the pressure by the same factor. The results clearly demonstrate that multimembrane stacks can be used for effective fractionation of proteins that are quite close in molecular weight. Internally-staged ultrafiltration (ISUF) with one flat membrane on top of the other may therefore overcome some of the limitations of conventional ultrafiltration (UF). Two types of models have been explored, one based on a lumped model, the other based on a convection-diffusion model with concentration polarization to explain the potential amplification of retention with each added membrane

Neighborhood Effects on the Long-Term Well-Being of Low-Income Adults

Nearly 9 million Americans live in extreme-poverty neighborhoods, places that also tend to be racially segregated and dangerous. Yet, the effects on the well-being of residents of moving out of such communities into less distressed areas remain uncertain. Using data from Moving to Opportunity, a unique randomized housing mobility experiment, we found that moving from a high-poverty to lower-poverty neighborhood leads to long-term (10- to 15-year) improvements in adult physical and mental health and subjective well-being, despite not affecting economic self-sufficiency. A 1–standard deviation decline in neighborhood poverty (13 percentage points) increases subjective well-being by an amount equal to the gap in subjective well-being between people whose annual incomes differ by $13,000—a large amount given that the average control group income is$20,000. Subjective well-being is more strongly affected by changes in neighborhood economic disadvantage than racial segregation, which is important because racial segregation has been declining since 1970, but income segregation has been increasing

Experience With the Cardiac Surgery Simulation Curriculum: Results of the Resident and Faculty Survey

BACKGROUND: The Cardiac Surgery Simulation Curriculum was developed at 8 institutions from 2010 to 2013. A total of 27 residents were trained by 18 faculty members. A survey was conducted to gain insight into the initial experience. METHODS: Residents and faculty were sent a 72- and 68-question survey, respectively. In addition to demographic information, participants reported their view of the overall impact of the curriculum. Focused investigation into each of the 6 modules was obtained. Participants evaluated the value of the specific simulators used. Institutional biases regarding implementation of the curriculum were evaluated. RESULTS: Twenty (74%) residents and 14 (78%) faculty responded. The majority (70%) of residents completed this training in their first and second year of traditional-track programs. The modules were well regarded with no respondents having an unfavorable view. Both residents and faculty found low, moderate, and high fidelity simulators to be extremely useful, with particular emphasis on utility of high fidelity components. The vast majority of residents (85%) and faculty (100%) felt more comfortable in the resident skill set and performance in the operating room. Simulation of rare adverse events allowed for development of multidisciplinary teams to address them. At most institutions, the conduct of this curriculum took precedence over clinical obligations (64%). CONCLUSIONS: The Cardiac Surgery Simulation Curriculum was implemented with robust adoption among the investigating centers. Both residents and faculty viewed the modules favorably. Using this curriculum, participants indicated an improvement in resident technical skills and were enthusiastic about training in adverse events and crisis management

Toxicity Profile and Pharmacokinetic Study of A Phase I Low-Dose Schedule–Dependent Radiosensitizing Paclitaxel Chemoradiation Regimen for Inoperable Non–Small-Cell Lung Cancer

We report the toxicity profile and pharmacokinetic data of a schedule-dependent chemoradiation regimen using pulsed low-dose paclitaxel for radiosensitization in a phase I study for inoperable non-small cell lung cancer (NSCLC)

Training less-experienced faculty improves reliability of skills assessment in cardiac surgery

OBJECTIVE: Previous work has demonstrated high inter-rater reliability in the objective assessment of simulated anastomoses among experienced educators. We evaluated the inter-rater reliability of less-experienced educators and the impact of focused training with a video-embedded coronary anastomosis assessment tool. METHODS: Nine less-experienced cardiothoracic surgery faculty members from different institutions evaluated 2 videos of simulated coronary anastomoses (1 by a medical student and 1 by a resident) at the Thoracic Surgery Directors Association Boot Camp. They then underwent a 30-minute training session using an assessment tool with embedded videos to anchor rating scores for 10 components of coronary artery anastomosis. Afterward, they evaluated 2 videos of a different student and resident performing the task. Components were scored on a 1 to 5 Likert scale, yielding an average composite score. Inter-rater reliabilities of component and composite scores were assessed using intraclass correlation coefficients (ICCs) and overall pass/fail ratings with kappa. RESULTS: All components of the assessment tool exhibited improvement in reliability, with 4 (bite, needle holder use, needle angles, and hand mechanics) improving the most from poor (ICC range, 0.09-0.48) to strong (ICC range, 0.80-0.90) agreement. After training, inter-rater reliabilities for composite scores improved from moderate (ICC, 0.76) to strong (ICC, 0.90) agreement, and for overall pass/fail ratings, from poor (kappa = 0.20) to moderate (kappa = 0.78) agreement. CONCLUSIONS: Focused, video-based anchor training facilitates greater inter-rater reliability in the objective assessment of simulated coronary anastomoses. Among raters with less teaching experience, such training may be needed before objective evaluation of technical skills