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Spiraling Violence and Drought Drive Refugee Crisis in South Sudan

Nearly 4 million South Sudanese have been driven from their homes by violence or food insecurity since late 2013, roughly half seeking refuge in neighboring countries. Drought and conflict have converged in the young country to fuel one of the world's most severe humanitarian emergencies. This article examines refugee flows from South Sudan, underlying drivers, and regional and international responses to the crisis.




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No Retreat: Climate Change and Voluntary Immobility in the Pacific Islands

While media and academic discussions of "climate refugees" paint a picture of mass displacement of millions, in reality many communities vulnerable to climate change may choose to stay as a result of strong cultural, historical, and spiritual attachments to place. This article explores this "voluntary immobility" and its implications in the Pacific Islands.




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Indonesia: A Country Grappling with Migrant Protection at Home and Abroad

Indonesia, which has a long history as a major origin for migrant labor in the Asia-Pacific and beyond, more recently has reluctantly found itself a transit and destination country, including for asylum seekers. Still, policymakers remain focused on protection of its nationals abroad rather than on assuring the status of Chinese and other foreigners in the country. This country profile explores Indonesia's rich migration history. 

 




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How One Woman Fled Domestic Violence During COVID-19 Pandemic

Source:

When the coronavirus initially hit Colorado in early March, many flocked to grocery stores and cleared shelves, preparing to hunker down in their homes. But for Jeara and her four young children, those first days of the pandemic were different: They were settling into a domestic violence shelter after an incident involving her husband days earlier.






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Human Needs Drive Rise in Gardening, and How to Start One

Source:

In the myriad of hobbies people have taken up to fill the time during the pandemic, one of the latest is gardening. Here's how you can use it to fulfill strong psychological needs, and how to start a vegetable garden in a few easy steps.






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Signs Your COVID-19 Anxiety Has Become Unhealthy, and What to Do

Source:

As the coronavirus pandemic drags on, experts fear that some of us may begin to lose our ability to cope with the anxiety and stress. Here are five signs that coronavirus anxiety is becoming unhealthy, and tips on how to reduce it.






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Climate Change and COVID-19: Five Charts That Explain the Impacts

Source:

We're living through the biggest carbon crash ever recorded. No war, no recession, no previous pandemic has had such a dramatic impact on emissions of carbon dioxide over the past century as COVID-19 has in a few short months. What does this unrivaled drop in carbon dioxide mean for climate change?






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Ahmaud Arbery and the Racist History of U.S. Loitering Laws

Source:

Ahmaud Arbery went for a jog in a neighborhood of Brunswick, Georgia, a coastal town south of Savannah, in late February. He paused to look around a construction site of a new house. Then, in the middle of his run, a newly public video reveals, he was confronted by Gregory and Travis McMichael, a father-son duo. The father, Gregory, was a retired police officer who'd seen Arbery and decided he looked like a local burglary suspect.






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Navajo Nation Reels Under Weight of Coronavirus and History of Neglect

Source:

The Navajo Nation now has the highest per-capita coronavirus infection rate after New York and New Jersey, but it has a fraction of the resources to treat and prevent the pandemic. "This has got to end," said president Jonathan Nez after federal relief funds arrived six weeks after they were promised and a week after the U.S. government missed a congressional deadline for distribution.






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Reaching a “Fair Deal” on Talent: Emigration, Circulation, and Human Capital in Countries of Origin

While skilled migration brings widely acknowledged economic benefits for destination countries and migrants, its impact on countries of origin has been the subject of more debate. Despite a growing consensus that origin countries can benefit from emigration and the circulation of skills, enabling this potential to be fully exploited remains a challenge. This report examines initiatives that develop skills and human capital.




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Emigration Trends and Policies in China: Movement of the Wealthy and Highly Skilled

This report analyzes the evolution of Chinese emigration from the 1970s, when market-oriented reforms began reducing barriers to movement beyond the country's borders, to the present day. High-skilled and high-value emigration is rising fast. Despite liberalized exit controls, low-skilled labor migration is stagnant as a result of complicated and expensive recruitment procedures.




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Achieving Skill Mobility in the ASEAN Economic Community: Challenges, Opportunities, and Policy Implications

This report by MPI and the Asian Development Bank lays out a realistic roadmap toward freer movement among skilled professionals within the ASEAN Economic Community (AEC), encouraging cooperation among ASEAN Member States in recognizing foreign qualifications and making government investments in training and educations systems that prepare workers in accordance with common standards.




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Children on the Run: An Analysis of First-Hand Accounts from Children Fleeing Central America

This event with UN High Commissioner for Refugees António Guterres includes a discussion on the state of citizen security in Central America and the resulting humanitarian impact, featuring findings from Children on the Run, a UNHCR report based on interviews with more than 400 unaccompanied children from the region.




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Building Skills in North and Central America: Barriers and Policy Options toward Harmonizing Qualifications in Nursing

Amid aging populations and the growth of chronic diseases, the demand for skilled health-care professionals is on the rise in the United States, Canada, and Mexico. This report explores the policy implications, benefits, and challenges of harmonizing nursing qualifications in the region, suggesting that a more collaborative approach could result in greater supply and quality of nurses.




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What's New in Farm Labor? Immigration and the Agricultural Sector

An expert discussion on the findings of the National Agricultural Workers Survey (NAWS) related to immigrants, along with an overview of farm labor in 2015 and discussion on how current and possible future immigration policies might impact immigrant workers in the agricultural sector.




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Regional Enforcement: A Profile of Migrants Deported from the United States and Mexico to the Northern Triangle

Marking the release of an MPI report, speakers on this webinar present an overview of regional immigration enforcement trends, including U.S. and Mexican apprehensions and deportations of both children and adults, along with a demographic, socioeconomic, and criminal profile of child and adult deportees.




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Migrants Deported from the United States and Mexico to the Northern Triangle: A Statistical and Socioeconomic Profile

This report examines the rising numbers of apprehensions and deportations of Central American children and adults by the United States and Mexico, and provides a demographic, socioeconomic, and criminal profile of deportees to El Salvador, Guatemala, and Honduras. The report traces how rising Mexican enforcement is reshaping regional dynamics and perhaps ushering in changes to long-lasting trends in apprehensions.




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Regional Enforcement: A Profile of Migrants Deported from the United States and Mexico to the Northern Triangle

This webinar includes an overview of regional immigration enforcement trends, including U.S. and Mexican apprehensions and deportations of Central American migrants, along with a demographic, socioeconomic, and criminal profile of child and adult deportees.




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What's New in Farm Labor? Immigration and the Agricultural Sector

An expert discussion on the findings of the National Agricultural Workers Survey (NAWS) related to immigrants, along with an overview of farm labor in 2015 and discussion on how current and possible future immigration policies might impact immigrant workers in the agricultural sector.




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Reception and Reintegration Services in Central America: Ending the Deportee Revolving Door

A webinar releasing a report examining deportations to Central America and reception and reintegration services in El Salvador, Guatemala, and Honduras.




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Stopping the Revolving Door: Reception and Reintegration Services for Central American Deportees

For a growing population of migrants deported from Mexico and the United States to Central America, the conditions upon return typically are worse than when they left, setting up a revolving-door cycle of migration, deportation, and remigration. This report provides a detailed profile of reception and reintegration services offered in El Salvador, Guatemala, and Honduras to deported migrants, examining their challenges and opportunities for improvement. 




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Reception and Reintegration Services in Central America: Ending the Deportee Revolving Door

A webinar releasing a report examining deportations to Central America and reception and reintegration services in El Salvador, Guatemala, and Honduras.




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Temporary Protected Status at Risk: Implications for Central America and U.S. Policy

As the Trump administration weighs the future of Temporary Protected Status (TPS) for Salvadorans, this teleconference focuses on the legal framework for TPS (particularly for Hondurans and Salvadorans) and profile of current TPS holders; the capacity of El Salvador and Honduras to receive and meaningfully reintegrate returnees; and the implications of TPS termination for broader U.S. policy goals in Central America.




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Vanishing Frontiers: The Forces Driving Mexico and the United States Together

Marking the release of MPI President Andrew Selee's book, this discussion explores the emerging trends in migration, economic interdependence, technology innovation, and cultural exchange that are transforming the relationship between the United States and Mexico.




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Promising Strategies for Reintegration of Migrants Returning to Mexico and Central America

Authors of a year-long study of reception and reintegration services in Mexico and the Northern Triangle discuss the findings of their fieldwork, including the differing reintegration needs of individual migrant groups, promising reception and reintegration programs, ongoing challenges for origin communities, and policy recommendations to improve reintegration strategies. 




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Despite Trump Invitation to Stop Taking Refugees, Red and Blue States Alike Endorse Resettlement

Forty-two governors, Republican and Democrat alike, have affirmed their consent for continued refugee resettlement, bypassing an invitation from the Trump administration to stop accepting refugees. These actions, which reportedly surprised the White House, suggest there may be limits to the Trump immigration agenda when it comes to refugees, as this Policy Beat explores.




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Suicide Risk Assessment in Youth and Young Adults With Type 1 Diabetes

OBJECTIVE

To describe sociodemographic and clinical characteristics of youth and young adults with type 1 diabetes who endorsed suicidal ideations as part of routine depression screening and the results of their suicide risk assessments.

RESEARCH DESIGN AND METHODS

The Patient Health Questionnaire–9 was used to assess depressive symptoms and suicide/death ideation in 550 youth and young adults with type 1 diabetes ages 10–24 years. Only individuals who endorsed suicidal/death ideations (n = 49) completed a standardized suicide risk assessment protocol and safety planning.

RESULTS

Nine percent of individuals endorsed suicidal/death ideation and of those, 83.4% reported clinically elevated depressive symptoms; 16% made a previous suicide attempt. No youth (n = 39) or young adults (n = 11) disclosed current plans or preparations for suicide, but five who expressed suicidal ideation acknowledged the lethality of insulin for an attempt. Three previously used insulin to attempt suicide. The overwhelming majority of individuals were classified as being low risk for future suicide attempt/completion. None were hospitalized as a part of the suicide risk assessment, and no suicide completions have occurred.

CONCLUSIONS

The findings of this study provide initial insight into the behaviors and cognitions of youth and young adults with type 1 diabetes who experience suicidal and death ideations. Comprehensive suicide risk assessment and safety planning are feasible during routine type 1 diabetes clinic appointments.




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Randomized Study to Evaluate the Impact of Telemedicine Care in Patients With Type 1 Diabetes With Multiple Doses of Insulin and Suboptimal HbA1c in Andalusia (Spain): PLATEDIAN Study

OBJECTIVE

To assess the impact of a telemedicine visit using the platform Diabetic compared with a face-to-face visit on clinical outcomes, patients’ health-related quality of life (HRQoL), and physicians’ satisfaction in patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS

PLATEDIAN (Telemedicine on Metabolic Control in Type 1 Diabetes Mellitus Andalusian Patients) (NCT03332472) was a multicenter, randomized, 6-month follow-up, open-label, parallel-group controlled study performed in patients with type 1 diabetes with suboptimal metabolic control (HbA1c <8% [<64 mmol/mol]), treated with multiple daily injections. A total of 388 patients were assessed for eligibility; 379 of them were randomized 1:1 to three face-to-face visits (control cohort [CC]) (n = 167) or the replacement of an intermediate face-to-face visit by a telemedicine visit using Diabetic (intervention cohort [IC]) (n = 163). The primary efficacy end point was the mean change of HbA1c levels from baseline to month 6. Other efficacy and safety end points were mean blood glucose, glucose variability, episodes of hypoglycemia and hyperglycemia, patient-reported outcomes, and physicians’ satisfaction.

RESULTS

At month 6, the mean change in HbA1c levels was –0.04 ± 0.5% (–0.5 ± 5.8 mmol/mol) in the CC and 0.01 ± 0.6% (0.1 ± 6.0 mmol/mol) in the IC (P = 0.4941). The number of patients who achieved HbA1c <7% (<53 mmol/mol) was 73 and 78 in the CC and IC, respectively. Significant differences were not found regarding safety end points at 6 months. Changes in HRQoL between the first visit and final visit did not differ between cohorts, and, regarding fear of hypoglycemia (FH-15 score ≥28), statistically significant differences observed at baseline remained unchanged at 6 months (P < 0.05).

CONCLUSIONS

The use of telemedicine in patients with type 1 diabetes with HbA1c <8% (<64 mmol/mol) provides similar efficacy and safety outcomes as face-to-face visits.




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Diabetes INSIDE: Improving Population HbA1c Testing and Targets in Primary Care With a Quality Initiative

OBJECTIVE

To improve outcomes of patients with adult type 2 diabetes by decreasing HbA1c undertesting, reducing the proportion of patients with poor glycemic control, and lowering mean HbA1c levels using a quality improvement (QI) program.

RESEARCH DESIGN AND METHODS

Six years of outpatient electronic health record (EHR) data were analyzed for care gaps before and 2 years after implementing a QI initiative in an urban academic medical center. QI strategies included 1) individual provider and departmental outcome reports, 2) patient outreach programs to address timely follow-up care, 3) a patient awareness campaign to improve understanding of achieving clinical goals, 4) improving EHR data capture to improve population monitoring, and 5) professional education.

RESULTS

Analysis (January 2010 to May 2018) of 7,798 patients from Tulane Medical Center (mean age 61 years, 57% female, 62% black, 97% insured) with 136,004 visits showed target improvements. A Cox proportional hazards model controlling for age, sex, race, and HbA1c level showed a statistically significant reduction in HbA1c undertesting >6 months (hazard ratio 1.20 ± 0.07). Statistical process control charts showed 15.5% relative improvement in the patient proportion with HbA1c >9% (75 mmol/mol) from 13% to 11% (P < 10–6) following QI interventions and a 2.1% improvement of population mean HbA1c from 7.4% (57 mmol/mol) to 7.2% (55 mmol/mol) (P < 10–6).

CONCLUSIONS

Multidisciplinary QI teams using EHR data to design interventions for providers and patients produced statistically significant improvements in both care process and clinical outcome goals.




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Sex Difference in Effects of Low-Dose Aspirin on Prevention of Dementia in Patients With Type 2 Diabetes: A Long-term Follow-up Study of a Randomized Clinical Trial

OBJECTIVE

To evaluate and compare the efficacy of long-term use of low-dose aspirin for the prevention of dementia in men and women.

RESEARCH DESIGN AND METHODS

This study is a follow-up cohort study of the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial, which was a randomized, open-label, standard care–controlled trial examining the effects of low-dose aspirin on cardiovascular events. We followed up 2,536 Japanese patients with type 2 diabetes (T2D) enrolled in the JPAD trial from 2002 to 2017. The primary outcome of this post hoc analysis was the incidence of dementia, which was defined by the prescription of antidementia drugs or admission due to dementia.

RESULTS

Among the originally enrolled patients, 2,121 (84%) retained their original allocation. During a median follow-up of 11.4 years, 128 patients developed dementia. The overall effect of low-dose aspirin on the prevention of dementia adjusted for age, sex, and other established risk factors was not significant (hazard ratio [HR] 0.82, 95% CI 0.58–1.16). However, a significant reduction was seen in the risk of dementia in women (HR 0.58, 95% CI 0.36–0.95), but not in men (HR 1.27, 95% CI 0.75–2.13) (Pinteraction = 0.03).

CONCLUSIONS

Long-term use of low-dose aspirin may reduce the risk for dementia in women with T2D.




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Screening for Glucose Perturbations and Risk Factor Management in Dysglycemic Patients With Coronary Artery Disease--A Persistent Challenge in Need of Substantial Improvement: A Report From ESC EORP EUROASPIRE V

OBJECTIVE

Dysglycemia, in this survey defined as impaired glucose tolerance (IGT) or type 2 diabetes, is common in patients with coronary artery disease (CAD) and associated with an unfavorable prognosis. This European survey investigated dysglycemia screening and risk factor management of patients with CAD in relation to standards of European guidelines for cardiovascular subjects.

RESEARCH DESIGN AND METHODS

The European Society of Cardiology’s European Observational Research Programme (ESC EORP) European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V (2016–2017) included 8,261 CAD patients, aged 18–80 years, from 27 countries. If the glycemic state was unknown, patients underwent an oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin A1c. Lifestyle, risk factors, and pharmacological management were investigated.

RESULTS

A total of 2,452 patients (29.7%) had known diabetes. OGTT was performed in 4,440 patients with unknown glycemic state, of whom 41.1% were dysglycemic. Without the OGTT, 30% of patients with type 2 diabetes and 70% of those with IGT would not have been detected. The presence of dysglycemia almost doubled from that self-reported to the true proportion after screening. Only approximately one-third of all coronary patients had completely normal glucose metabolism. Of patients with known diabetes, 31% had been advised to attend a diabetes clinic, and only 24% attended. Only 58% of dysglycemic patients were prescribed all cardioprotective drugs, and use of sodium–glucose cotransporter 2 inhibitors (3%) or glucagon-like peptide 1 receptor agonists (1%) was small.

CONCLUSIONS

Urgent action is required for both screening and management of patients with CAD and dysglycemia, in the expectation of a substantial reduction in risk of further cardiovascular events and in complications of diabetes, as well as longer life expectancy.




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Glucosamine Use, Inflammation, and Genetic Susceptibility, and Incidence of Type 2 Diabetes: A Prospective Study in UK Biobank

OBJECTIVE

Glucosamine is a widely used supplement typically taken for osteoarthritis and joint pain. Emerging evidence suggests potential links of glucosamine with glucose metabolism, inflammation, and cardiometabolic risk. We prospectively analyzed the association of habitual glucosamine use with risk of type 2 diabetes (T2D) and assessed whether genetic susceptibility and inflammation status might modify the association.

RESEARCH DESIGN AND METHODS

This study analyzed 404,508 participants from the UK Biobank who were free of diabetes, cancer, or cardiovascular disease at baseline and completed the questionnaire on supplement use. Cox proportional hazards models were used to evaluate the association between habitual use of glucosamine and risk of incident T2D.

RESULTS

During a median of 8.1 years of follow-up, 7,228 incident cases of T2D were documented. Glucosamine use was associated with a significantly lower risk of T2D (hazard ratio 0.83, 95% CI 0.78–0.89) after adjustment for age, sex, BMI, race, center, Townsend deprivation index, lifestyle factors, history of disease, and other supplement use. This inverse association was more pronounced in participants with a higher blood level of baseline C-reactive protein than in those with a lower level of this inflammation marker (P-interaction = 0.02). A genetic risk score for T2D did not modify this association (P-interaction = 0.99).

CONCLUSIONS

Our findings indicate that glucosamine use is associated with a lower risk of incident T2D.




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Targeting CXCR1/2 Does Not Improve Insulin Secretion After Pancreatic Islet Transplantation: A Phase 3, Double-Blind, Randomized, Placebo-Controlled Trial in Type 1 Diabetes

OBJECTIVE

Reparixin is an inhibitor of CXCR1/2 chemokine receptor shown to be an effective anti-inflammatory adjuvant in a pilot clinical trial in allotransplant recipients.

RESEARCH DESIGN AND METHODS

A phase 3, multicenter, randomized, double-blind, parallel-assignment study (NCT01817959) was conducted in recipients of islet allotransplants randomized (2:1) to reparixin or placebo in addition to immunosuppression. Primary outcome was the area under the curve (AUC) for C-peptide during the mixed-meal tolerance test at day 75 ± 5 after the first and day 365 ± 14 after the last transplant. Secondary end points included insulin independence and standard measures of glycemic control.

RESULTS

The intention-to-treat analysis did not show a significant difference in C-peptide AUC at both day 75 (27 on reparixin vs. 18 on placebo, P = 0.99) and day 365 (24 on reparixin vs. 15 on placebo, P = 0.71). There was no statistically significant difference between treatment groups at any time point for any secondary variable. Analysis of patient subsets showed a trend for a higher percentage of subjects retaining insulin independence for 1 year after a single islet infusion in patients receiving reparixin as compared with patients receiving placebo (26.7% vs. 0%, P = 0.09) when antithymocyte globulin was used as induction immunosuppression.

CONCLUSIONS

In this first double-blind randomized trial, islet transplantation data obtained with reparixin do not support a role of CXCR1/2 inhibition in preventing islet inflammation-mediated damage.




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What math professors and k-12 teachers think of each other

By Michael Pershan, St. Ann’s School I. What do primary/secondary math educators think of the teaching that happens in colleges? And — the other way around — what do mathematics professors think of primary and secondary math teaching? I’m nearing … Continue reading




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Help! I need to teach my course online and I’ve never done this before

By: Yvonne Lai, University of Nebraska-Lincoln Ray Levy, Mathematical Association of America This is cross-posted in MathValues and Abbe Herzig has written a companion post. Additional resources and future meetings are also available here: https://tinyurl.com/OnlineTalkshop. In times of crisis we … Continue reading




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Online learning in the time of Coronavirus: Tips for students and the instructors who support them

Abbe Herzig, AMS Director of Education In the midst of the upheaval due to the Coronavirus, students and faculty are transitioning to new virtual classrooms. Many of us haven’t chosen to learn or teach, but here we are, making the … Continue reading




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Cleveland Cavaliers planning to reopen training facility Friday

The Cleveland Cavaliers are planning to reopen their training facility for limited individual workouts amid the coronavirus pandemic.




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Taiwan baseball league to allow fans back in ballparks amid pandemic

A limited number of fans will be allowed to enter ballparks for games in Taiwan for the first time this season as stay-at-home orders continue to loosen amid the coronavirus pandemic.




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New Cowboys QB Andy Dalton believes he's 'a starter'

Dalton signed with the Cowboys on Monday after he was released May 30. Dak Prescott has started every game for the Cowboys since 2016.




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Kentucky Wildcats land star Wake Forest transfer Olivier Sarr

The University of Kentucky has landed a commitment from former Wake Forest big man Olivier Sarr, one of the top transfers ahead of the 2020 season.




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Smartphone-Based Glucose Monitors and Applications in the Management of Diabetes: An Overview of 10 Salient "Apps" and a Novel Smartphone-Connected Blood Glucose Monitor

Joseph Tran
Oct 1, 2012; 30:173-178
Practical Pointers




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Case Study: Seizures and Hypoglycemia

Michael R. Brennan
Jan 1, 2012; 30:23-24
Case Studies




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Case Study: Type 1 and Type 2, Too?

Heidi L. Gassner
Jul 1, 2003; 21:
Case Studies




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Opportunities and Challenges for Biosimilars: What's on the Horizon in the Global Insulin Market?

Lisa S. Rotenstein
Oct 1, 2012; 30:138-150
Features




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Case Study: A 43-Year-Old Man With Perineal Pain and Swelling

David J. Meier
Oct 1, 2001; 19:
Case Studies




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Glucose, Advanced Glycation End Products, and Diabetes Complications: What Is New and What Works

Melpomeni Peppa
Oct 1, 2003; 21:
Council's Voice




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Injecting Insulin: Taking shots safely, correctly, and with little or no pain


Jan 1, 2013; 31:46-46
Patient Information




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Type 2 Diabetes in Children and Young Adults: A "New Epidemic"

Francine Ratner Kaufman
Oct 1, 2002; 20:
President's Pen




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Empowerment and Self-Management of Diabetes

Martha M. Funnell
Jul 1, 2004; 22:123-127
Feature Articles




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Food, Culture, and Diabetes in the United States

Karmeen D. Kulkarni
Oct 1, 2004; 22:190-192
Practical Pointers