Voices of the community: Exploring the experiences of resettled refugee interpreters at a refugee clinic in a large multicultural city in Texas, United States of America

Worldwide refugees numbered nearly 25.9 million in 2018 and, according to the United Nations High Commissioner for Refugees, the crisis grows each year. Research reports that refugees have a high prevalence of mental health conditions and are at increased risk for emotional and mental distress during resettlement. Furthermore, interpreters have been shown to be at increased risk for secondary re-traumatisation, a condition similar to Post Traumatic Stress Disorder, where client trauma shares commonalities with trauma experienced by the interpreter. The purpose of this study was to explore the experiences of resettled refugee interpreters. Based on previous data from this community, the research team determined that a qualitative methodology was best practice to explore the experiences of resettled refugee interpreters. In May of 2019, seven participants were recruited from a pool of resettled refugee interpreters who worked at a refugee health clinic in a large multicultural city in Texas. One-on-one interviews were conducted, and the data were analysed using content analysis. Five themes emerged that represented the experiences of these participants: speaking for others, developing interpretation strategies, advocating for the community, receiving social support and overcoming challenges specific to the healthcare setting. The findings from this study add to the current body of literature that addresses the experiences of resettled refugee interpreters. Furthermore, these data may be used to create additional resources for refugee interpreters who work at health clinics, such as training on medical terminology, access to mental health services and site-specific incentives.

The use of portable XRF as a forensic geoscience non-destructive trace evidence tool for environmental and criminal investigations

Hand-held, portable X-Ray fluorescence instruments (pXRF) provide a means of rapid, in-situ chemical characterisation that has considerable application as a rapid trace evidence characterisation tool in forensic geoscience. This study presents both a control test study which demonstrates optimisation of the data collection process, alongside a range of individual forensic case studies, including heavy metal contamination, conflict archaeology, forensic soil characterisation, and verification of human remains, which together validate the technique and provide some comparison between field-based and laboratory-based pXRF applications. Results highlight the time-efficiency and cost-effectiveness of in-situ, field-based pXRF analyses for material characterisation when compared with other trace evidence methods. Analytical precision of various analytes during in-situ analysis was sufficient to demonstrate considerable application of field-based pXRF as a tool for rapid identification of specific areas of interest to be further investigated. Laboratory-based pXRF analyses yielded greater accuracy which could provide an efficient compromise between field-based pXRF and traditional laboratory-based analytical techniques (e.g. WD-XRF, ICP-MS). Further studies should collect more advanced datasets in more diverse locations to further validate the techniques capability to rapidly conduct geochemical surveys in a range of environments.

Chronic in vivo or acute in vitro resveratrol attenuates endothelium-dependent cyclooxygenase-mediated contractile signaling in hypertensive rat carotid artery

Exaggerated cyclooxygenase (COX) and thromboxane-prostanoid (TP) receptor-mediated endothelium-dependent contraction can contribute to endothelial dysfunction. This study examined the effect of resveratrol (RSV) on endothelium-dependent contraction and cell signaling in the common carotid artery (CCA) from spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). Acetylcholine (Ach)-stimulated endothelium-dependent nitric oxide synthase (NOS)-mediated relaxation in precontracted SHR CCA was impaired (maximum 73 ± 6% vs. 87 ± 5% in WKY) (P < 0.05) by competitive COX-mediated contraction. Chronic (28-day) treatment in vivo (drinking water) with a ∼0.075 mg·kg(-1)·day(-1) RSV dose affected neither endothelium-dependent relaxation nor endothelium-dependent contraction and associated prostaglandin (PG) production evaluated in non-precontracted NOS-blocked CCA. In contrast, a chronic ∼7.5 mg·kg(-1)·day(-1) RSV dose improved endothelium-dependent relaxation (94 ± 6%) and attenuated endothelium-dependent contraction (58 ± 4% vs. 73 ± 5% in No-RSV) and PG production (183 ± 43 vs. 519 ± 93 pg/ml) in SHR CCA, while U46619-stimulated TP receptor-mediated contraction was unaffected. In separate acute in vitro experiments, 20-μM RSV preincubation attenuated endothelium-dependent contraction (6 ± 4% vs. 62 ± 2% in No Drug) and PG production (121 ± 15 vs. 491 ± 93 pg/ml) and attenuated U46619-stimulated contraction (134 ± 5% vs. 171 ± 4%) in non-precontracted NOS-blocked SHR CCA. Compound C, a known AMP-activated protein kinase (AMPK) inhibitor, did not prevent the RSV attenuating effect on Ach- and U46619-stimulated contraction but did prevent the RSV attenuating effect on PG production (414 ± 58 pg/ml). These data demonstrate that RSV can attenuate endothelium-dependent contraction both by suppressing arterial wall PG production, which may be partially mediated by AMPK, and by TP receptor hyporesponsiveness, which does not appear to be mediated by AMPK.

Body piercing with fatal consequences

Body modifications such as piercings, tattoos and surgery have increased in popularity in recent times and have become more socially acceptable. The common complications of piercing different parts of the human anatomy are well-documented, including sepsis, allergic reactions and, more rarely, endocarditis and ischaemia. Deaths related to piercing complications are primarily septic in origin. In this case, a man in his 50s died due to complications of his multiple umbilical piercings. The cause of death was unusually linked to body modification; the umbilical piercings had ultimately led to a mesenteric infarction. Cases such as these are forensically important due to potential manslaughter charges that could be brought against a piercing establishment. More importantly, this case highlights another extreme complication of body modification. Fashion statements are always changing and impact upon many lives. It is important to highlight to people the potentially life-threatening complications of common piercing practices.

RhoA-Rho kinase signaling mediates endothelium- and endoperoxide-dependent contractile activities characteristic of hypertensive vascular dysfunction

Hypertensive vasomotor dysfunction is defined by endothelium-dependent contractions involving prostaglandins and ROS. Since both thromboxane-prostanoid receptor (TPr) signaling and ROS activate RhoA-Rho kinase (ROCK) in vascular smooth muscle (VSM) preparations, we hypothesized that enhanced endothelium-dependent contraction in the common carotid artery (CCA) of spontaneously hypertensive rats (SHRs) is ROCK mediated. ACh-stimulated contractions were approximately twofold greater in SHRs versus normotensive Wistar-Kyoto (WKY) rats, abolished by endothelial denudation or cyclooxygenase (COX)-1 inhibition, and nearly eliminated by TPr blockade. RhoA but not ROCK-II protein expression was increased ( approximately 50%) in the SHR CCA. Inhibition of ROCK, but not protein kinase C, caused a dose-dependent reduction in endothelium-dependent contractions to ACh across strains, with the highest dose mirroring the effect of high-dose TPr antagonism. Conversely, ROCK inhibition caused dose-dependent and endothelium- and nitric oxide-independent relaxation in CCAs precontracted with the TPr agonist U-46619. Prostacyclin was the predominant prostaglandin produced by ACh-stimulated CCAs, with greater than twofold more prostacyclin released from SHR versus WKY rats, and its production was unaffected by ROCK inhibition. RhoA activation was approximately twofold higher in quiescent SHR CCAs compared with those from WKY rats and was significantly increased by ACh stimulation. Augmentation of chemical superoxide quenching with tiron or inhibition of the NADPH oxidase-derived superoxide-producing pathway with apocynin reduced ACh-stimulated contractile activity in SHR more than in WKY rats, whereas the SOD mimetic tempol amplified the response. Exposure of CCAs to exogenous H(2)O(2) caused contractions, similar to ACh stimulation, that were greater in SHR than in WKY rats, abolished by COX-1 inhibition, and highly attenuated by TPr blockade or ROCK inhibition. These results indicate that RhoA-ROCK may act as a molecular switch, transducing signals from endothelium-derived prostaglandin(s) and ROS, which are overproduced in SHR CCAs, to "turn on" VSM contractile pathways, thus mediating the enhanced endothelium- and endoperoxide-dependent vascular contractions characteristic of hypertension, among other cardiovascular disease states, such as diabetes and aging.

Methadone toxicity in infants: a report of two fatalities

Fatalities in infants resulting from methadone toxicity are rare within the United Kingdom. We report two cases of fatality attributed to methadone toxicity in infants aged 3(1/2) and 15 months of age, respectively. One of the two cases was also associated with diazepam ingestion. We discuss the difficulties with the interpretation of paediatric forensic toxicology and review the current literature related to methadone and diazepam toxicity in infants and older children.

Computed tomography of projectile injuries

Computed tomography (CT) is a gold standard in clinical imaging but forensic professions have been slow to embrace radiological advances. Forensic applications of CT are now exponentially expanding, replacing other imaging methods. As post-mortem cross-sectional imaging increases, radiologists will fall under increasing pressure to interpret complex forensic cases involving both living and deceased patients. This review presents a wide variety of weapon and projectile types aiding interpretation of projectile injuries both in forensic and clinical practice.

The role of computed tomography in terminal ballistic analysis

Terminal ballistics concerns the science of projectile behaviour within a target and includes wound ballistics that considers what happens when a projectile strikes a living being. A number of soft tissue ballistic simulants have been used to assess the damage to tissue caused by projectiles. Standard assessment of these materials, such as ballistic soap or ordnance gelatine, requires the block to be opened or that a mould to be made to visualize the wound track. This is time consuming and may affect the accuracy of the findings especially if the block dries and alters shape during the process. Therefore, accurate numerical analysis of the permanent or temporary cavity is limited. Computed tomography (CT) potentially offers a quicker non-invasive analysis tool for this task. Four commercially purchased ballistic glycerine soap blocks were used. Each had a single firearm discharged into it from a distance of approximately 15 cm using both gunshot and shotgun projectiles. After discharge, each block was imaged by a modern 16 slice multi-detector CT scanner and analysed using 3-D reconstruction software. Using the anterior-posterior and lateral scout views and the multi-plane reconstructed images, it was possible to visualize the temporary cavity, as well as the fragmentation and dispersal pattern of the projectiles, the distance travelled and angle of dispersal within the block of each projectile or fragment. A virtual cast of the temporary cavity can be also be made. Multi-detector CT with 3-D analysis software is shown to create a reliable permanent record of the projectile path allowing rapid analysis of different firearms and projectiles.

HIV/AIDS treatment moves to the small city

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