Search results for: colonial trauma and treatment

Authors: Rebecca S. Hock, Cyralene P. Bryce, Kevin Williams, Arielle G. Rabinowitz, Janina R. Galler

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Background: Findings have been mixed regarding whether offspring of parents who were abused or neglected as children have a greater risk of experiencing abuse or neglect themselves. In addition, many studies on this topic are restricted to physical abuse and take place in a limited number of countries, representing a small segment of the world's population. Methods: We examined relationships between childhood maltreatment history assessed in a subset (N=68) of the original longitudinal birth cohort (G1) of the Barbados Nutrition Study and their now-adult offspring (G2) (N=111) using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We used Pearson correlations to assess relationships between parent and offspring CTQ-SF total and subscale scores (physical, emotional, and sexual abuse; physical and emotional neglect). Next, we ran multiple regression analyses, using the parental CTQ-SF total score and the parental Sexual Abuse score as primary predictors separately in our models of G2 CTQ-SF (total and subscale scores). Results: G1 total CTQ-SF scores were correlated with G2 offspring Emotional Neglect and total scores. G1 Sexual Abuse history was significantly correlated with G2 Emotional Abuse, Sexual Abuse, Emotional Neglect, and Total Score. In fully-adjusted regression models, parental (G1) total CTQ-SF scores remained significantly associated with G2 offspring reports of Emotional Neglect, and parental (G1) Sexual Abuse was associated with offspring (G2) reports of Emotional Abuse, Physical Abuse, Emotional Neglect, and overall CTQ-SF scores. Conclusions: Our findings support a link between parental exposure to childhood maltreatment and their offspring's self-reported exposure to childhood maltreatment. Of note, there was not an exact correspondence between the subcategory of maltreatment experienced from one generation to the next. Compared with other subcategories, G1 Sexual Abuse history was the most likely to predict G2 offspring maltreatment. Further studies are needed to delineate underlying mechanisms and to develop intervention strategies aimed at preventing intergenerational transmission.

Keywords: trauma, family, adolescents, intergenerational trauma, child abuse, child neglect, global mental health, North America

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Authors: Andriana Purnama, Reno Rudiman, Kezia Christy

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Anal stenosis which develops due to anoderm scarring usually caused by secondary to surgical trauma, has become common, causing significant decrease patient’s quality of life. Even though mild anal stenosis was treated with non-surgical treatment, but surgical reconstruction in unavoidable for moderate to severe anal stenosis that cause distressing, severe anal pain and inability to defecate. In our study, we intend to share our result with the use of diamond flap in treatment of anal stenosis. This case report illustrates a 57-year-old male patient who presented with difficulty and discomfort in defecation caused by anal stenosis after 2 years of open hemorrhoidectomy surgery. At physical examination, there was requirement of forceful dilatation when the index finger was inserted or precisely 6mm as measured by hegar dilator (moderate anal stenosis). Blood test result was within normal limits. The patient underwent anal repair and diamond flap where the scar tissue at 6 and 9 o’clock directions was excised and diamond graft was incised carefully while paying attention to the vascular supply. Finally, the graft was fixated without any tension to the anal canal, resulting in diameter of 2 cm after operation. After 2 days post operation, the patient was in stable condition, without any complication, and discharged. There was no abnormality concerning the stool. Ten days after the operation, diamond flap was in normal condition and without any complication. He was scheduled for futher follow up at the Digestive Surgery Department. Anal stenosis due to overzealous hemorrhoidectomy is a complication that is preventable when performed in experienced hands. Diamond flap was one of the options for the anal stenosis treatment with less complication.

Keywords: anal stenosis, diamond flap, post hemorrhoidectomy, anal repair

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Authors: G. L. Devnani, Shishir Sinha

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Natural fiber reinforced polymer composite is a very attractive area among the scientific community because of their low cost, eco-friendly and sustainable in nature. Among all advantages there are few issues which need to be addressed, those issues are the poor adhesion and compatibility between two opposite nature materials that is fiber and matrix and their relatively high water absorption. Therefore, natural fiber modifications are necessary to improve their adhesion with different matrices. Excellent properties could be achieved with the surface treatment of these natural fibers ultimately leads to property up-gradation of their reinforced composites with different polymer matrices. Lot of work is going on to improve the adhesion between reinforced fiber phase and polymer matrix phase to improve the properties of composites. Researchers have suggested various methods for natural fiber treatment like silane treatment, treatment with alkali, acetylation, acrylation, maleate coupling, etc. In this study a review is done on the different methods used for the surface treatment of natural fibers and what are the advance treatment methodologies for natural fiber surface treatment for property improvement of natural fiber reinforced polymer composites.

Keywords: composites, acetylation, natural fiber, surface treatment

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Authors: Evelyn Smith, Susan Simpson

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Background: Eating disorder (ED) treatment is complicated by high rates of chronicity, comorbidity, complex personality traits and client dropout. Given these complexities, Schema Therapy (ST) has been identified as a suitable treatment option. The study primarily aims to evaluate the efficacy of group ST for the treatment of EDs. The study further evaluated the effectiveness of ST in reducing schemas and improving quality of life. Method: Participant suitability was ascertained using the Eating Disorder Examination. Following this, participants attended 90-minute weekly group sessions over 25 weeks. Groups consisted of six to eight participants and were facilitated by two psychologists, at least one of who is trained in ST. Measures were completed at pre, mid and post-treatment. Measures assessed ED symptoms, cognitive schemas, schema mode presentations, quality of life, self-compassion and psychological distress. Results: As predicted, measures of ED symptoms were significantly reduced following treatment. No significant changes were observed in early maladaptive schema severity; however, reductions in schema modes were observed. Participants did not report improvements in general quality of life measures following treatment, though improvement in psychological well-being was observed. Discussion: Overall, the findings from the current study support the use of group ST for the treatment of EDs. It is expected that lengthier treatment is needed for the reduction in schema severity. Given participant dropout was considerably low, this has important treatment implications for the suitability of ST for the treatment of EDs.

Keywords: eating disorders, schema therapy, treatment, quality of life

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Authors: Felipe H. Sanders, Bryan A. Edwards, Matthew Fusco, Rod J. Oskouian, R. Shane Tubbs

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Introduction: Sinus pericranii is a rare vascular malformation that connects the intracranial dural sinuses to the extracranial venous drainage system and is caused by either trauma or congenital defects. Although the majority of these vascular structures are due to trauma, some are congenital. Case report: Herein, we report a 5-month-old patient with a very large and fluctuating subcutaneous mass over the occiput and the diagnosis of Crouzon’s syndrome. The child presented with a large midline mass that on imaging, connected to the underlying torcular and was diagnosed as a sinus pericranii. At long-term follow up and without operative intervention, the sinus pericranii resolved. This uncommon relationship is reviewed. Conclusion: Premature closure of posterior fossa sutures as part of Crouzon syndrome can present with large sinus pericranii. Such subcutaneous swellings might resolve spontaneously.

Keywords: congenital, craniosynostosis, pediatric, vascular malformation

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Authors: Lydia Ouma Radoli

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The paradox of documenting history through visuals that objectify gruesome images to depict the prominence of stories intrigues media researchers. In East Africa, the topic has been captured in a variety of media frames, but scantly in scholarly work. This paper adopts Visual Rhetoric and Framing Theories to tease out the drivers behind the criteria for the selection of violent visuals. The paper projects that quantitative and qualitative literature regarding journalists’ personal and work-related exposure to PSTD will give insights into the concept of trauma journalism - reporting of horrific events, e.g., violent crime and terror. The data will be collected through methods such as document analysis (photographs and videos) and in-depth interviews to summarize the informational contents with respect to the research objectives and questions. The study is hinged on the background that the criterion for news production is constructed from the idea that ‘if there’s violence, conflict, and death involved, the story gets top priority.’ The anticipated outcome is to establish trauma experiences of visual rhetors, suggest mitigations, and address gaps in academic research. The findings of the study will sustain the critical role of visual rhetors. Further, media practitioners may find the study useful in assessing the effects and values of visual witnessing. Historically, the criterion for visual news production has been that if there’s violence, conflict, and death involved, the story gets top priority. To capture the goriness of the images, media theorists and sociologists have used the expression: “If it bleeds, it leads.” The statement assumes that audiences are attracted to pictures that show violent images. Further, research on visual aspects of Television news has shown its ability to hold viewers’ attention and cause aggression. This paper samples images and narratives from Journalists who have covered trauma-related events. The samples are indicative of the problem under study, which depicts journalists exposed to traumatic events as not receiving any Psycho-social support within newsrooms. It is hoped that the study could inform policy and practice within developing countries through the interpretations of theoretical and empirical explanations of existing trauma phenomena among journalists.

Keywords: visual-witnessing, media culture, visual rhetoric, imaging violence in East Africa

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Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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Authors: Mohammad Jamiu Abdullahi, Shykh Ahmed Abdussalam

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The emergence of Arabic on the shore of West Africa heralded the practise of Islam and advocation for a just and egalitarian society. Islam, it was argued, has been perverted and subverted by the Hausa leadership. This necessitated the call for reforming Islam. Al-Shaykh Usman Bin Fodio grabbed the opportunity and fought the perverts to restore the glory of Islam and establish shari'ah way of life. This was the practice, especially in the northern part of Nigeria until the incursion of colonialism. The conquest of the colonial master halted the rule of jihadi leaderships and subjected them to colonialism under which only some aspects of Islamic system considered potentially beneficial to the British interest were retained. The current socio-political and economic crises in Nigeria has necessitated the need to look inwardly to the bulk of works, in Arabic, left behind by the Muslim scholars to help to salvage the country from its present political crisis, economic paralysis and legal decadence. This paper, therefore, examines the relevance of Arabic literary works that housed political/legal theories to salvaging the country from its present political crises, economic paralysis and legal decadence.

Keywords: Arabic Fodio Nigeria security, advocacy governance scholar Usman, British colonial perspective shaykh, leadership Islam jihad politics

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Authors: Anas Ali

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The British administration at Malabar, the southern coastal commercial outpost in the Indian Subcontinent, faced with a series of perpetual revolts from the Mappila Muslim peasants during the last decades of the 19th and early decades of the 20th century. The control of Malabar region was a concern for the British administrators as the region was a prime centre of spice trade and plantation products. The Madras government set up a special police battalion called the Malabar Special Police in 1884 and summoned different army battalions to Malabar to crush the revolts. The setting up of army camps in the rural Malabar led to the diffusion of modern sports as the army men played different games in the garrisons and with the local people. For the imperial army men deployed in Malabar, sports acted as a viable medium to strengthen solidarity with other European settlers. They actively participated in the ‘Canterbury Week’, an annual sporting event organized by the European planters and organized tournaments among themselves. This paper would argue that, sports enabled the imperial army men, European planters and British administrators to build camaraderie that enabled them to manifest their imperial solidarity during the time of these constant revolts. Based on newspaper reports and colonial memoirs, this paper would look at how modern sports enabled the imperial army men to be ‘good in health’ and create a feeling of ‘being at home’ during this period.

Keywords: imperial army, Malabar, modern sports, mutiny

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Authors: Fernando G. Torres, Omar P. Troncoso

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A wide range of bacteria synthesizes and secretes polymeric substances composed of a mixture of high-molecular-mass heteropolysaccharides. Nostoc commune cyanobacteria grow in colonial spherules of 10-20 mm in diameter. These spherules are filled with an internal gel made from a variety of polysaccharides known as Nostoc commune exopolysaccharides (NCE). In this paper, we report the use of these exopolysaccharides as a raw material for the preparation of a solid polymer electrolyte. Ammonium iodide and 1-butyl-3-methylimidazolium chloride ([Bmim]Cl) salts were used to provide NCE films with ionic conductivity. In addition, a carboxymethylation treatment was used to further increase the conductivity of NCE films. The structural characterization of the NCE films was assessed by FTIR, XRD, and DSC tests. Broadband dielectric spectroscopy (BDS) and dielectric thermal analysis (DETA) were used to evaluate the ionic conductivity of the samples. The results showed that NCE can be used to prepare solid polymer electrolyte films and that carboxymethylation improves their ionic conductivity. These NCE films can be used in the development of novel energy storage devices such as flat batteries or supercapacitors.

Keywords: polymer electrolyte, Nostoc commune, cyanobacteria, exopolysaccharides

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Authors: Stephen Hamafyelto, Hussaini Garba, Mary Pindar Ndahi

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The study was carried out with the intent to mitigate the trauma experienced by victims of insurgent attacks by the so-called Boko Haram militants in Borno state of Nigeria. The area was ridden by the crisis over the past 9 years. As a result, many people were killed, maimed and raped. Some others suffered all manner of inhuman treatment at the hands of their captors. The extent to which this dehumanized treatment has gone and impacted on the people in this area has left most of them traumatised. Victims who survived the attacks have been resettled in camps provided by government where their needs have been cared for. This can never be the same with their natural habitats. Many interventions have also been done by government, non-governmental organisations and corporate and individual bodies. In this regard, social needs of the victims have been the immediate concerns of most organisations, where food, shelter, and clothing were provided. However, there is little that has been done to rehabilitate these victims psychosocially. In this regard, sports and games including the victims’ local games were used to provide psychosocial rehabilitation of victims. The intent was to bring them back to social reality, social inclusion, and stable emotions and peer integration. Descriptive statistics and Multivariate analysis were done. No statistically significant difference was found among male and female children and adults in terms of psychosocial rehabilitation using sports and games.

Keywords: social reality, social inclusion, emotional intellegence, peer model

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Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: traditional healing system, healers, pluralist healthcare system, post-colonial era

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Authors: Elena Roadhouse

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“When it take the kitchen middens from the latest canning session out to the compost before going to bed, the orchestra is in full chorus. Night vapors and scents from the earth mingle with the fragrance of honeysuckle nearby and basil grown in the compost. They merge into the rhythmic pulse of night”. William Longgood Carl Jung did not specifically recognize scent and olfactory function as a window into the psyche. He did recognize instinct and the natural history of mankind as key to understanding and reconnecting with the Psyche. The progressive path of modern humans has brought incredible scientific and industrial advancements that have changed the human relationship with Mother Earth, the primal wisdom of mankind, and led to the loss of instinct. The olfactory bulbs are an integral part of our ancient brain and has evolved in a way that is proportional to the human separation with the instinctual self. If olfaction is a gateway to our instinct, then it is also a portal to the soul. Natural aromatics are significant and powerful instruments for supporting the mind, our emotional selves, and our bodies. This paper aims to shed light on the important role of scent in the understanding of the existence of the psyche, generational trauma, and archetypal fragrance. Personalized Natural Perfume combined with mindfulness practices can be used as an effective behavioral conditioning tool to promote the healing of transgenerational and individual trauma, the fragmented self, and the physical body.

Keywords: scentscape of the soul, psyche, individuation, epigenetics, depth psychology, carl Jung, instinct, trauma, archetypal scent, personal myth, holistic wellness, natural perfumery

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Authors: Parthasarathi Pramanik

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Paediatric blunt abdominal trauma associated with superficial bruise, hematoma, or laceration and internal organ damage secondary to bicycle handlebar is widely documented in the literature. In this article, we have presented a case of bicycle handlebar inflicted fatal neck laceration in a road accident. The deceased sustained a horizontally placed laceration injury over the front and both sides of the middle third of neck (13 cm x 5-8 cm x 2-3.5 cm).The margins of the wound were irregular and focally abraded. The right corner of the injury was pointed whereas the left one was ended with a skin flap. Multiple graze abrasions, contusions and lacerations were found on different parts of body. Autopsy findings and other circumstantial evidences revealed that the victim died due to exsanguination because of severance of carotid artery and jugular vein of both sides. Analysis of the wound suggests the decease sustained the wound by the revolving bicycle handle bar while he had lost the balance.

Keywords: bicycle handle bar, neck injury, lacerated injury, road acident

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Authors: Rahul Ranjan

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Using gender as a category to cull out historical analysis, feminist scholars have produced plethora of literature on the sexual symbolics and carnal practices of modern European empires. At a symbolic level, the penetration and conquest of faraway lands was charged with sexual significance and intrigue. The white male’s domination and possession of dark and fertile lands in Africa, Asia and the Americas offered, in Anne McClintock’s words, ‘a fantastic magic lantern of the mind onto which Europe projected its forbidden sexual desires and fears’. The politics of rape were also symbolically a question significant to the politics of empire. To the colonized subject, rape was a fearsome factor, a language that spoke of violent and voracious nature of imperial exploitation. The colonized often looked at rape as an act which colonizers used as tool of oppression. The rape as act of violence got encoded into the legal structure under the helm of Lord Macaulay in the so called ‘Age of Reform’ in 1860 under IPC (Indian penal code). Initially Lord Macaulay formed Indian Law Commission in 1837 in which he drafted a bill and defined the ‘crime of rape as sexual intercourse by a man to a woman against her will and without her consent , except in cases involving girls under nine years of age where consent was immaterial’. The modern English law of rape formulated under the colonial era introduced twofold issues to the forefront. On the one hand it deployed ‘technical experts’ who wrote textbooks of medical jurisprudence that were used as credential citation to make case more ‘objective’, while on the other hand the presumptions about barbaric subjects, the colonized women’s body that was docile which is prone to adultery reflected in cases. The untrustworthiness of native witness also remained an imperative for British jurists to put extra emphasis making ‘objective’ and ‘presumptuous’. This sort of formulation put women down on the pedestrian of justice because it disadvantaged her doubly through British legality and their thinking about the rape. The Imperial morality that acted as vanguards of women’s chastity coincided language of science propagated in the post-enlightenment which not only annulled non-conformist ideas but also made itself a hegemonic language, was often used as a tool and language in encoding of law. The medico-legal understanding of rape in the colonial India has its clear imprints in the post-colonial legality. The onus on the part of rape’s victim was dictated for the longest time and still continues does by widely referred idea that ‘there should signs, marks of resistance on the body of the victim’ otherwise it is likely to be considered consensual. Having said so, this paper looks at the textual continuity that had prolonged the colonial construct of women’s body and the self.

Keywords: body, politics, textual construct, phallocentric

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Authors: Chigbo Ikechukwu Emmanuel

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Microalgae can be used for tertiary treatment of wastewater due to their capacity to assimilate nutrients. The pH increase which is mediated by the growing algae also induces phosphorus precipitation and ammonia stripping to the air, and may in addition act disinfecting on the wastewater. Domestic wastewater is ideal for algal growth since it contains high concentrations of all necessary nutrients. The growth limiting factor is rather light, especially at higher latitudes. The most important operational factors for successful wastewater treatment with microalgae are depth, turbulence and hydraulic retention time.

Keywords: microalgae, wastewater treatment, phosphorus, nitrogen, light, operation, ponds, growth

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Authors: Neringa Bagdonaite

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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.

Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis

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Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa

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Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.

Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay

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Authors: Rajendra Kumar Kanojia

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Background; Massive bone gaps are common following road side accidents and injury to the tibia, specially open grade three fractures. It has been seen that the diaphyseal fractures in the tibia are prone to non-union, there are certain reasons known very well, like less soft tissues around the lower third tibia, less vascularity, less options of fixation of the fractures after trauma and prolonged surgical time, operation theatre time and special surgical means. Aim of study; To know the suitability of the ilizarov ring fixators in staged treatment of the fracture of the both bones leg, including tibia, we wish to see the role of ilizarov in management of open grade three fractures which have been operated and debrided, for getting the length use of ilizaorv ring in a tertiary canter is the aim of the study.

Keywords: open fracture, staged management, ilizarov, bone grafting, lengthening

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Authors: Samuel Capintero, Ole H. Petersen

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This paper examines the utilization of public-private partnerships for the building and operation of wastewater treatment plants. Our research focuses on risk allocation in this kind of projects. Our analysis builds on more than hundred wastewater treatment plants built and operated through PPP projects in Aragon (Spain). The paper illustrates the consequences of an inadequate management of construction risk and an unsuitable transfer of demand risk in wastewater treatment plants. It also shows that the involvement of many public bodies at local, regional and national level further increases the complexity of this kind of projects and make time delays more likely.

Keywords: wastewater, treatment plants, PPP, construction

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: M. Ridwanul Hassan, Samuel George

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Aims: Steroid injections are commonly used as a diagnostic tool or an alternative to surgical management of carpal tunnel syndrome (CTS) and are generally safe. Ischaemia is a rare complication with very few cases reported in the literature. Methods: We report a case of a 50-year-old female that presented with a necrotic wound to her left palm one month after a steroid injection into the carpal tunnel. She had a 2-year history of CTS in her left hand that was treated with six previous steroid injections in primary care during this period. The wound evolved from a blister to a necrotic ulcer which led to a painful, hollow defect in the centre of her palm. She did not report any history of trauma, nor did she have any co-morbidities. Clinical photographs were taken. Results: On examination, she had a 0.5 cmx1 cm defect in the palm of her left hand down to aponeurosis. There was purulent discharge in the wound with surrounding erythema but no spreading cellulitis. She had full function of her fingers but was very tender on movements and at rest. She was admitted for intravenous antibiotics and underwent a debridement, washout, and carpal tunnel release the next day. The defect was packed to heal by secondary intention and has now fully healed one month following her operation. Conclusions: This is an extremely rare complication of steroid injections to the carpal tunnel and may have been avoided by earlier referral for surgery rather than treatment using multiple steroid injections.

Keywords: hand surgery, complication, rare, carpal tunnel syndrome

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Authors: Priscila M. Lima, Corine A. P. de Almeida, Muriele R. de Lima, Fernando J. C. Magalhães Filho

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This work characterized the preliminary treatment in WWTPs in the state of Mato Grosso Do Sul (Brazil) and analyzed aspects of operation and maintenance of solid waste retained, and was evaluated the interference of this step in treatment efficiency beyond the relationship between solid waste generation with rainfall and seasonality in the region of each WTPs. The results shown that the standard setting in the preliminary treatment consists of grid along with Sand Trap, followed by Parshall that is used in 94.12% of WWTPs analyzed, and in 5.88% of WWTPs it was added the air-lift to the Sand Trap. Was concluded that the influence of rainfall, flow and seasonality associated with the rate of waste generation in the preliminary treatment, had little relation to the operation and maintenance of the primary treatment. But in some cases, precipitation data showed increased rainfall converging with increased flow and solid waste generation.

Keywords: pretreatment, sewage, solid waste, wastewater

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Authors: C. Pearcy, C. Rees

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Cognitive behavioural therapy (CBT) and exposure and response prevention (ERP) are currently the most efficacious treatments for Obsessive-compulsive disorder (OCD). Many clients, however, remain symptomatic following treatment. As a result, refusal of treatment, withdrawal from treatment, and partial adherence to treatment are common amongst ERP. Such limitations have caused few professionals to actually engage in ERP therapy, which has warranted the exploration of alternative treatments. This study evaluated an online self-help treatment program for OCD (the OCD Doctor Online); a 4-week Metacognitive Therapy (MCT) program which has implemented strategies from Wells’ Metacognitive model of OCD. The aim of the present study was to investigate whether an online self-help treatment using MCT would reduce symptoms of OCD, reduce unhelpful metacognitions and improve quality of life. Treatment effectiveness was assessed using a case series methodology in 3 consecutively referred individuals. At post-treatment, all participants showed reductions in unhelpful metacognitive beliefs (MCQ-30) and improvements in quality of life (Q-LES-Q), which were maintained through to 4 week follow-up. Two of the three participants showed reductions in OCD symptomology (OCI-R), which were further reduced at 4-week follow-up. The present study suggests that internet-based self-help treatment may be an effective means of delivering MCT to adults with OCD.

Keywords: internet-based, metacognitive therapy, obsessive-compulsive disorder, self-help

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Authors: Ashley Sainvil

Abstract:

The present study explores the relationship and possible effects of religiosity on both adverse childhood experiences and childhood attachment. Furthermore, to explore the idea that adult religiousness may play as a protective role, specifically protecting adults with a past of adverse childhood experiences and an insecure childhood attachment from reporting depression. Analyses are based on 57 participants (N= 57, 32.1% of ages 18-22; 70.2% female, 28.1% male, 1.8% other). In the form of an online Qualtrics survey through questionnaires, childhood attachment, adverse childhood experiences, sense of religiosity, and depression were measured. While not significant at conventional levels, there was no direct relationship between adverse childhood experiences, insecure childhood attachment, and sense of religiosity, and when assessing age for the relationship in later adulthood, there was no significance. Positive childhood experiences of feeling protected, love, and special had a direct relationship with a positive image and sense of closeness to God. Results highlight the importance of positive childhood experiences, secure childhood attachment quality relationship, such as trust, communication for positive health outcomes, such as less depression.

Keywords: religiosity, childhood trauma, childhood attachment, depression

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Authors: Afees Adebayo Salam

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This paper attempts an in-depth analysis of the economic impact of Ogbomoso migrant community in the Jos metropolis. It discusses the factors that motivated a sizeable number of Ogbomoso people (from southwestern Nigeria) to leave their hometown for a new place/space in Jos (northern Nigeria). It examines the historical antecedent of Ogbomoso migrants in northern Nigeria with emphasis on Jos metropolis. The movement of Ogbomoso migrants to Jos was dictated by the economic and social challenges of colonial and post-colonial periods. The political crisis of the 1960s was a contributory factor to the process of Ogbomoso migration to other parts of Nigeria. In the aftermath, many people migrated from Ogbomoso to different parts of the country and beyond to seek for better economic opportunities. The establishment of Ogbomoso migrant community in Jos was dated back to the colonial era when taxation was introduced by the British. Many people could not pay these taxes from their peasant farming activities, while some embarked on migration to places such as Jos, Kaduna, Kano, Keffi and Bauchi due to the harsh economic situation at home. Their settlement in Jos brought about success in several spheres of human endeavours. Ogbomoso migrants dominated both paid jobs and private business sector such as textile merchants, food stuff sellers, herbalists, printers, transporters, and religious missionaries, as well as clerical officers in the government establishments. Their remittances were invested in different sectors of Ogbomoso economy. The migrants had in one way or the other contributed to the socio-economic development of their host community in Jos as entrepreneurs. Branches of such industries were located in their hometown of Ogbomoso as a clear demonstration of community development. The remittance pattern of the migrants has transformed Ogbomoso to enviable position. Moreover, the economic success of Ogbomoso migrants over the period under review indicates the process of nation building due to peaceful nature of inter-ethnic engagements between Ogbomoso migrants and their host community in Jos. Therefore, the paper makes use of oral, archival and secondary sources to analyse the processes of migration and its economic impact. Oral interviews were conducted in Ogbomoso town with veteran migrants and their family members. Interviews were also conducted in Jos with the indigenous host community as well as other urban residents. Archival materials were obtained from Arewa House Archives and the National Archives, Kaduna and the National Archives, Ibadan.

Keywords: Ogbomoso migrants, Jos metropolis, community development, economic impact

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Authors: M. Hadji, A. Haddad, Y. Hadji

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The effects of boronizing treatment on the friction coefficient and wear behavior of 0.35 Vf TiC- Ti3 SiC2 composite were investigated. In order to modity the surface properties of Ti3SiC2, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti3SiC2. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti3SiC2 from 6 GPa to 13 GPa. In the pin-on-disc test, i twas found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti3SiC2/Al2O3 tribocouple under 7N load for the non treated and the boronized samples, respectively. The wear resistance of Ti3SiC2 underAl2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti3SiC2.

Keywords: MAX phase, wearing, friction, boronizing

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Authors: Ju Hyun Won, Seok Hong Min, Tae Kwon Ha

Abstract:

Phase equilibria of AZ91D Mg alloys for nonflammable use, containing Ca and Y, were carried out by using FactSage® and FTLite database, which revealed that solid solution treatment, could be performed at temperatures from 400 to 450 °C. Solid solution treatment of AZ91D Mg alloy without Ca and Y was successfully conducted at 420 °C and supersaturated microstructure with all beta phase resolved into matrix was obtained. In the case of AZ91D Mg alloy with some Ca and Y, however, a little amount of intermetallic particles were observed after solid solution treatment. After solid solution treatment, each alloy was annealed at temperatures of 180 and 200 °C for time intervals from 1 min to 48 hrs and hardness of each condition was measured by micro-Vickers method. Peak aging conditions were deduced as at the temperature of 200 °C for 10 hrs.

Keywords: Mg alloy, AZ91D, nonflammable alloy, phase equilibrium, peak aging

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Authors: Nguyen Thi Thanh Truc, Chi-Hyeon Lee, Srinivasa Reddy Mallampati, Byeong-Kyu Lee

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This study evaluated to facilitate separation of ABS plastics from other waste plastics by froth flotation after surface hydrophilization of ABS with heat treatment. The mild heat treatment at 100oC for 60s could selectively increase the hydrophilicity of the ABS plastics surface (i.e., ABS contact angle decreased from 79o to 65.8o) among other plastics mixture. The SEM and XPS results of plastic samples sufficiently supported the increase in hydrophilic functional groups and decrease contact angle on ABS surface, after heat treatment. As a result of the froth flotation (at mixing speed 150 rpm and airflow rate 0.3 L/min) after heat treatment, about 85% of ABS was selectively separated from other heavy plastics with 100% of purity. The effect of optimum treatment condition and detailed mechanism onto separation efficiency in the froth floatation was also investigated. This research is successful in giving a simple, effective, and inexpensive method for ABS separation from waste plastics.

Keywords: ABS, hydrophilic, heat treatment, froth flotation, contact angle

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Authors: Isaias Teklia Berhe

Abstract:

A decision that deals with international disputes, be it arbitral or judicial, has to properly reflect objectivity and coherence with existing rules of international law. This paper shows the decision of the Ethio-Eritrea Claims Commission on the jus ad bellum case is bereft of objectivity and coherence, which contributed a disservice to international law on many aspects. The Commission’s decision that holds Eritrea in contravention to Art 2(4) of the UN Charter based on Ethiopia’s contention is flawed. It fails to consider: the illegitimacy of an actual authority established over contested territory through hostile acts, the proper determination of effectivites under international law, the sanctity of colonially determined boundaries, Ethiopia’s prior firm political recognition and undergirds to respect colonial boundary, and Ethio-Eritrea Border Commission’s decision. The paper will also argue that the Commission confused Eritrea’s right of self-defense with the rule against the non-use of force to settle territorial disputes; wherefore its decision sanitizes or sterilizes unlawful change of territory resulted through unlawful use of force to the effect of advantaging aggressions. The paper likewise argues that the decision is so sacrilegious that it disregards the ossified legal finality of colonial boundaries. Moreover, its approach toward armed attack does not reflect the peculiarity of the jus ad bellum case rather it brings about definitional uncertainties and sustains the perception that the law on self-defense is unsettled.

Keywords: armed attack, Eritrea, Ethiopia, self-defense, territorial integrity, use of force

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