Experiences of immigrant women who self-petition under the Violence Against Women Act.

Undocumented immigrant women who are abused and living in the United States are isolated in a foreign country, in constant fear of deportation, and feel at the mercy of their spouse to gain legal status. To ensure that immigration law does not trap women in abusive relationships, the Violence Against Women Act (VAWA, 1994) enabled immigrant women to self-petition for legal status. Qualitative research methods were used in this participatory action research to investigate the experiences of Mexican immigrant women filing VAWA self-petitions. Emotional, financial, and logistic barriers in applying are identified, and recommendations for practice research and policy are provided.

Long-term divergent tidal flat benthic community recovery following hypoxia-induced mortality.

Macrobenthos recovery after hypoxia-induced mass mortality was assessed in an estuarine tidal mudflat during 3 years. During the first 2 years, a Pearson-Rosenberg type of community recovery took place along with the improving bottom water oxygen conditions. After 3 months, spionid polychaetes became superabundant (i.e. opportunistic peak), followed rapidly by a steep decline (i.e. ecotone point). Subsequently, a moderate increase in species richness and a steep increase in biomass, related to the growth of long-lived species occurred (i.e. transition region). Afterwards, however, the recovering community diverged again from the ambient, undisturbed, sediments due to enhanced recruitment success of long-lived species presumably resulting from the lowered interference from bioturbation during early recovery stages in the disturbed plots. Hence, despite early community recovery may be more or less deterministic, lagged divergent community reassembling may occur at the longer-term, thereby contributing to benthos patchiness in areas which are frequently subjected to disturbances.

Cuándo aflojar el manguito neumático de isquemia: su influencia sobre las pérdidas hemáticas y posibles complicaciones en la prótesis total de rodilla. Estudio prospectivo multicéntrico / The timing of tourniquet release: its influence on blood loss and possible complications after total knee arthroplasty. A prospective multicenter study

Objetivo. Realizar un estudio prospectivo multicéntrico de selección alternante para valorar las pérdidas hemáticas postoperatorias de la prótesis total de rodilla en relación con el momento de soltar la isquemia, realizando o no hemostasia, y las posibles complicaciones locales y generales.Material y método. Se analizan 194 pacientes (194 rodillas) distribuidos en dos grupos homogéneos:1. Grupo I hemostasia (H): se libera el torniquete de isquemia después de la colocación de los implantes metálicos, realizando la hemostasia previa al cierre de la herida quirúrgica.2. Grupo II no hemostasia (NH): se coloca la prótesis, se realiza el cierre de la herida quirúrgica, se coloca vendaje compresivo y en este momento se afloja el manguito neumático.Resultados. El sangrado promedio total del grupo I (H) fue de 721cc. (30-2210) y el del grupo II (NH) fue de 625cc. (60-1540), no existiendo diferencias significativas entre ambos grupos (p = 0,3). No se encuentran tampoco diferencias significativas entre ambos grupos con respecto a las complicacioneslocales o generales.Conclusión. Las pérdidas hemáticas postoperatorias no serelacionan directamente con el momento de soltar la isquemia durante las prótesis totales de rodilla

Purpose. We conducted a prospective multicenter study with alternate selection methodology in order to evaluate postoperative blood loss further to primary knee replacement at the time of tourniquet release, with or without hemostasis, as well as possible local and systemic complications.Materials and methods. We studied 194 patients (194 knees) divided into two similar groups. Group I (Hemostasis - H) - the tourniquet was deflated intraoperatively after implantation of the metal components and hemostasis was achieved prior to wound closure. Group II (No Hemostasis - NH) - the tourniquet was released after the wound was closed and a compressive bandage applied.Results. Mean bleeding was 721ml (30-1540) for group I and 625 ml (60-1540) for group II. No statistically significant differences were found (p = 0.3). No significant differences were found between the groups as regards general or local complications.Conclusions. Postoperative blood loss is not related directly with the time of tourniquet release further to TKR. Our findings cast certain doubts on the efficacy of tourniquet release, which means that intraoperative hemostasis may not be necessary (AU)

Human trampling as short-term disturbance on intertidal mudflats: effects on macrofauna biodiversity and population dynamics of bivalves.

The effect of physical disturbance in the form of trampling on the benthic environment of an intertidal mudflat was investigated. Intense trampling was created as unintended side-effect by benthic ecologists during field experiments in spring and summer 2005, when a mid-shore area of 25 × 25 m was visited twice per month by on average five researchers for a period of 8 months. At the putatively-impacted location (I) (25 × 25 m) and two nearby control locations (Cs) (25 × 25 m each), three sites (4 × 4 m) were randomly selected and at each site, three plots (50 × 50 cm) were sampled after 18 and 40 days from the end of the disturbance. Multivariate and univariate asymmetrical analyses tested for changes in the macrofaunal assemblage, biomass of microphytobenthos and various sediment properties (grain-size, water content, NH4 and NO3 concentrations in the pore water) between the two control locations (Cs) and the putatively-impacted location (I). There were no detectable changes in the sediment properties and microphytobenthos biomass, but variability at small scale was observed. Microphytobenthos and NH4 were correlated at I to the number of footprints, as estimated by the percentage cover of physical depressions. This indicated that trampling could have an impact at small scales, but more investigation is needed. Trampling, instead, clearly modified the abundance and population dynamics of the clam Macoma balthica (L.) and the cockle Cerastoderma edule (L.). There was a negative impact on adults of both species, probably because footsteps directly killed or buried the animals, provoking asphyxia. Conversely, trampling indirectly enhanced recruitment rate of M. balthica, while small-sized C. edule did not react to the trampling. It was likely that small animals could recover more quickly because trampling occurred during the growing season and there was a continuous supply of larvae and juveniles. In addition, trampling might have weakened negative adult-juvenile interactions between adult cockles and juvenile M. balthica, thus facilitating the recruitment. Our findings indicated that human trampling is a relevant source of disturbance for the conservation and management of mudflats. During the growing season recovery can be fast, but in the long-term it might lead towards the dominance of M. balthica to the cost of C. edule, thereby affecting ecosystem functioning.

Estudio multicéntrico sobre la repercusión de las lesiones meniscales y de ligamento cruzado anterior previas a la cirugía protésica en pacientes intervenidos de prótesis de rodilla / Multi-center study on the repercussion of meniscal and ACL injuries prior to prosthetic replacement in patients undergoing TKR

Objetivo. Evaluar la incidencia y repercusión de las lesiones e intervenciones previas en la articulación de la rodilla en pacientes operados de prótesis de rodilla. Material y método. Se registraron 474 pacientes diagnosticados de gonartrosis intervenidos con una prótesis total de rodilla (PTR) primaria en 5 centros españoles, durante 12 meses, analizando sus características morfológicas y las lesiones e intervenciones previas sufridas en la articulación de la rodilla comparado con una población aleatoria de 129 pacientes intervenidos, en los mismos centros y en el mismo período de tiempo, de prótesis total de cadera (PTC) primaria. En cada paciente analizamos la edad, el sexo, el lado intervenido, el peso, la talla y el índice de masa corporal (IMC: kg/m2), las prótesis previas en la articulación contralateral o en otras articulaciones y el año de su colocación. Los parámetros evaluados fueron la alineación de la rodilla, la actividad laboral desempeñada previamente y en el momento de la intervención, la actividad física, las enfermedades e intervenciones generales previas a la intervención, los traumatismos padecidos, las intervenciones en la articulación de la rodilla y el estado óseo. Resultados. No hemos encontrado diferencias estadísticamente significativas entre el grupo PTR y PTC comparando los traumatismos previos, la actividad laboral, las intervenciones del sistema musculoesquelético previas ni tampoco la alineación de la rodilla. En el grupo de las PTR no encontramos diferencias estadísticamente significativas entre las lesiones de rodilla previas con la edad, el peso, la talla o el IMC ni entre la técnica quirúrgica previa de la articulación de la rodilla con la edad, el peso, la talla o el IMC. Sin embargo, en el grupo PTR hubo un mayor número de lesiones meniscales y un mayor IMC que entre los operados de PTC. Además, en las PTR las mujeres presentaron un IMC mayor (p < 0,006). Las amas de casa tenían el IMC más elevado (p < 0,02) entre todos los grupos laborales. Conclusiones. Se constató una correlación significativa entre artrosis de rodilla y obesidad, y también una correlación baja entre meniscectomía previa y artrosis de rodilla. Por ello, el tratamiento de la obesidad debe ser una medida preventiva de la artrosis de rodilla, y por tanto de los PTR. Los pacientes operados de meniscectomía o rotura de ligamento cruzado anterior deben ser estudiados con mayor detenimiento (AU)

Purpose. To assess the incidence and repercussion of previous lesions to and procedures in the knee joint in patients undergoing TKR. Materials and methods. 474 subjects were included, who had undergone primary TKR with a diagnosis of gonarthrosis in 5 Spanish hospitals. The patients were followed up over a period of 12 months, during which their morphological characteristics as well as the earlier lesions and procedures they had had in the knee joint were analyzed. A comparison was made with a random control population of 129 patients who underwent a primary THR. For each patient we analyzed the following factors: age, gender, the operated side, weight, height and body mass index (BMI: kg/m2), any prior prostheses in the contralateral ¬ or any other - joint and the year it/they had been implanted. Other parameters assessed were: knee alignment, occupational profile of the patient at and prior to the time of operation, their degree of physical activity, any diseases or general operations suffered prior to the procedure, any trauma experienced, any surgery to the knee joint as well as the overall bone stock condition. Results. We did not find statistically significant differences between the TKR and the THR groups as regards previous trauma, occupational profile, previous surgery to the musculoskeletal system or knee alignment. In the TKR group, we did not find statistically significant differences between the previously sustained knee injuries and the patients' age, weight, height or BMI; or between the surgical technique used in any previous surgery to the knee joint and the patients' age, weight, height or BMI. Nonetheless, there was a larger number of meniscal lesions as well as a higher BMI in the TKR group than in the THR patients. Furthermore, in TKRs female patients showed a higher BMI (p<0,006), given that housewives had a higher BMI (p<0,02) then any of the other occupational groups. Conclusions. A significant correlation was found between knee osteoarthritis and obesity as well as a low correlation between previous meniscectomy and knee osteoarthritis. For that reason, obesity treatment should be a preventive measure against knee osteoarthritis and therefore it should be employed prior to a TKR. Patients undergoing a meniscectomy or ACL repair surgery should be considered more carefully (AU)