Search results for: children with a disability

Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: Chairun Wiedyaningsih, Sri Suryawati, Yati Soenarto, Muhammad Hakimi

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Background: Many drugs used in paediatrics are not commercially available in suitable dosage forms. Therefore, the drugs often prescribed in extemporaneous compounding dosage form. Compounding can pose health risks include poor quality and unsafe products. Studies of compounding dosage form have primarily focused on prescription profiles, reasons of prescribing never be explored. Objectives: The study was conducted to identify factors influencing physicians’ decision to prescribe extemporaneous compounding dosage form for paediatric outpatients. Setting: Daerah Istimewa Yogyakarta (DIY) province, Indonesia. Method: Qualitative semi-structured interviews were conducted with 15 general physicians and 7 paediatricians to identify the reason of prescribing extemporaneous compounding dosage form. The interviews were transcribed and analysed using thematic analysis. Results: Factors underlying prescribing of compounding could be categorized to therapy, healthcare system, patient and past experience. The primary reasons of therapy factors were limited availability of drug compositions, dosages or formulas specific for children. Beliefs in efficacy of the compounding forms were higher when the drugs used primarily to overcome complex cases. Physicians did not concern about compounding form containing several active substances because manufactured syrups may also contain several active substances. Although medicines were available in manufactured syrups, limited institutional budget was healthcare system factor of compounding prescribing. The prescribing factors related to patients include easy to use, efficient and lower price. The prescribing factors related to past experience were physicians’ beliefs to the progress of patient's health status. Conclusions: Compounding was prescribed based on therapy-related factors, healthcare system factors, patient factors and past experience.

Keywords: compounding dosage form, interview, physician, prescription

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Authors: Zahra R. Almansoor

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Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

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Authors: Suhera M. Aburawi, Habiba A. El Jaafari, Soad A. Treesh, Abdulssalam M. Abu-Aisha, Faisal S. Alwaer, Reda A. Eltubuly, Medeha Elghedamsi

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Introduction: Infertility is a source of psychological, and sometimes social, stress on parents who desire to have children. Formaldehyde is used chiefly as disinfectant, preservative and in the chemical synthesis. The medical uses of formaldehyde are limited, but focused especially on laboratory use. Selenium is an essential trace mineral element for human; it is essential for sperm function and male fertility. Selenium deficiency has been linked to reproductive problems in animals. Objectives: To investigate the prophylactic and curative effect of selenium on male infertility induced by formaldehyde using male albino mice. Method: Forty male albino mice were used, weight 25-30 gm. Five groups of male mice (n=8) were used. Group 1 was daily administered water for injection (5ml/kg) for five days, group 2 was daily administered selenium (100 μg/kg) for five days, group 3 was daily administered formaldehyde (30mg/kg) for five days, group 4 (prophylaxis) was daily administered a combination of formaldehyde and selenium for five days, while group 5 (curative) was daily administered formaldehyde for five days followed by daily administration of selenium for the next five days. Intraperitoneal administration was adopted. At the end of the administration, seminal fluid was collected from vas deferens. Sperm count, morphology and motility were scored; histopathological screening of genital system was carried out. SPSS was applied for comparing groups. Results and conclusion: It was found that formaldehyde toxicity did not change the sperm count and percentage of motile sperm; unhealthy sperm was increased, while healthy sperm was decreased. Formaldehyde produces degeneration/damage to the male mice genital system. Selenium alone produce an increase in sperm count, volume of seminal fluid and the percentage of motile sperm. Selenium has prophylactic and curative effects against formaldehyde-induce genital system toxicity. Future work is recommended to find out if selenium protective effect is through antioxidant or other mechanisms.

Keywords: infertility, formaldehyde, selenium, male mice

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Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Adèle Hotte-Meunier, Lisa Sarraf, Alan Bougeard, Félicia Bernier, Chloé Voyer, Jiaxuan Deng, Stéphanie El Asmar, Alina Stamate, Marc Corbière, Patrizia Villotti, Geneviève Sauvé

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Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with psychosocial, educational and occupational functioning. Although often conceptualized as a developmental disorder of childhood, 65% of children with ADHD continue to meet full or partial diagnostic criteria for ADHD in adulthood and an estimated 4% of the workforce has a diagnosis of ADHD. Methods: A systematic review was conducted to understand the experiences of people living with ADHD in the workplace. Articles reporting employment outcomes for people living with were identified by a search in eight databases on four separate occasions from June 27, 2022, to June 21, 2023. A risk of bias assessment for each study was performed using the Mixed Methods Appraisal Tool (MMAT). Results: A total of 79 studies were included in this systematic review (nADHD: 68, 216). Results were synthesized into three broad overarching categories: challenges, strengths and adaptations at work. Further, nine themes were included: ADHD symptoms at work, workplace performance, job satisfaction, interpersonal relationships at work, maladaptive work thoughts and behaviors, personal strengths, embracing ADHD, person-environment fit and accommodations and support. Sex differences were highlighted as a tenth subtheme. ADHD confers both strengths and limitations related to employment. Discussion: Workers with ADHD can not only adapt but thrive in employment with the right person-environment fit, accommodations and support. Many challenges related to ADHD can be managed or remodeled as assets in a workplace environment that fosters acceptance, flexible working practices and openness to neurodiversity.

Keywords: neurodivergence, occupation, workplace, person-environment fit

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Authors: Liang-Jen Wang, Sung-Chou Li, Yuan-Ming Yeh, Sheng-Yu Lee, Ho-Chang Kuo, Chia-Yu Yang

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Background: Dysbiosis in the gut microbial community might be involved in the pathophysiology of attention deficit/hyperactivity disorder (ADHD). The fungal component of the gut microbiome, namely the mycobiota, is a hyperdiverse group of multicellular eukaryotes that can influence host intestinal permeability. This study therefore aimed to investigate the impact of fungal mycobiome dysbiosis and intestinal permeability on ADHD. Methods: Faecal samples were collected from 35 children with ADHD and from 35 healthy controls. Total DNA was extracted from the faecal samples, and the internal transcribed spacer (ITS) regions were sequenced using high-throughput next-generation sequencing (NGS). The fungal taxonomic classification was analysed using bioinformatics tools, and the differentially expressed fungal species between the ADHD and healthy control groups were identified. An in vitro permeability assay (Caco-2 cell layer) was used to evaluate the biological effects of fungal dysbiosis on intestinal epithelial barrier function. Results: The β-diversity (the species diversity between two communities), but not α-diversity (the species diversity within a community), reflected the differences in fungal community composition between ADHD and control groups. At the phylum level, the ADHD group displayed a significantly higher abundance of Ascomycota and significantly lower abundance of Basidiomycota than the healthy control group. At the genus level, the abundance of Candida (especially Candida albicans) was significantly increased in ADHD patients compared to the healthy controls. In addition, the in vitro cell assay revealed that C. albicans secretions significantly enhanced the permeability of Caco-2 cells. Conclusions: The current study is the first to explore altered gut mycobiome dysbiosis using the NGS platform in ADHD. The findings from this study indicated that dysbiosis of the fungal mycobiome and intestinal permeability might be associated with susceptibility to ADHD.

Keywords: ADHD, fungus, gut–brain axis, biomarker, child psychiatry

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Authors: Aniekan James Akpan, Inemesit Akpan Umoren, Uduak Iwok

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From prehistoric and primitive cultures, education was seen as a process of culture transmission by way of guiding children into becoming good members of their local communities. Even in modern cultures, education is seen as a systematic discipline aimed at cultivating genuine values to improve oneself and society. Without education, the chances of realizing the desired vision are marred as it is believed that nations that invest much in education are able to reap the desired benefits technologically, economically, socially, politically, and otherwise. In this sense, the moulding of character is considered the primary purpose of education, and until the audience of mass media through its various vehicles is seen as tools for improving the overall development of society. It is believed that a media-friendly person is likely to perform better than someone who is less friendly. This work, therefore, examines the role media play in educational development. As highlighted by the study, a summary of the functions of media shows that they widen horizon by acting as a liberating force, breaking distance, bonds, and transforming a traditional society into a modern one. With the use of technological development theory, agenda-setting theory as well as uses and gratification theory and multiple intelligence theory, the work identifies different ways in which mass media help in educational development and draws attention to the audience’s perception of media functions in terms of educational development. With a survey method and a population of 6,903,321 people, the work sampled 220 respondents using purposive technique drawn from rural communities in the South-South region of Nigeria. The work concludes that mass media are potent vehicles for teaching and learning and therefore recommends that government should provide basic infrastructures to the rural communities to aid full utilization of media potentials in educational development and equally urge media owners and practitioners to as a matter of urgency increase coverage time on issues bordering on education as it is done for political and other issues.

Keywords: educational, development, media usage, perception

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Authors: Sadiah Baharom, Che Nidzam Che Ahmad, Saipol Barin Ramli, Asmayati Yahaya, Sopia Md Yassin

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The early childhood care and education (ECCE) in Malaysia aspire to develop children who are intellectually, emotionally, physically and spiritually balanced. This aspiration can only materialise if the early childhood program developed comprehensive and is of high quality comparable to international standards. As such, there is a pressing need to assess the quality of the program in an all-encompassing manner. The overall research project aims at developing a comprehensive and integrated model of high-quality Malaysian ECCE. One of the major objectives of this project is to assess and evaluate the scope and quality of the existing ECCE programs in Malaysia. To this end, a specific aspect of this objective is to develop and validate an instrument to assess and evaluate the ECCE curriculum of the country. Thus this paper describes the development and validation of an instrument to explore the quality of early childhood care and education curriculum currently implemented in the country’s ECCE centres. The generation of the constructs and items were based on a set of criteria mapped against existing ECCE practice, document analyses, expert interviews and panel discussions. The items went through expert validation and were field tested on 597 ECCE teachers. The data obtained went through an exploratory factor analysis to validate the constructs of the instrument followed by reliability studies on internal consistency based on the Cronbach Alpha values. The final set of items for the ECCE curriculum instrument, earmarked for the main study, consists of four constructs namely philosophy and core values, curriculum content, curriculum review and unique features. Each construct consists of between 21 to 3 items with a total of 36 items in all. The reliability coefficients for each construct range from 0.65 to 0.961. These values are within the acceptable limits for a reliable instrument to be used in the main study.

Keywords: early childhood and care education, instrument development, reliability studies, validity studies

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Authors: Beatrice Adeoye

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Background: One of the health challenges developing countries face is air pollution from indoor and outdoor activities. Smoke as a result of cooking, burning wastes and power generators litter the air space on a continual basis due to poverty and governance challenges. The short and long term implications of these actions are enormous and studies have attributed smoke as one of the leading preventable risk factors contributing to global burden of respiratory infections. Design/Methods: The issue at hand therefore includes an exploration of the existing policy frameworks regarding smoke, adherence to international conventions and practices, and more importantly the activities of the government in addressing these issues. Aside this, an understanding of the implications of smoke on peoples’ health and well-being also become crucial. Consequently, this article seeks to interrogate the effect of smoke on the health and well-being of Nigerians and the activities of the policy makers in addressing these challenges. Results (Main Argument): This study reviewed both primary and secondary data on poverty, smoke emission and attendant health risks coupled with existing policies on smoke and air pollution in the country. For instance, over 69% of Nigerians are poor, ranking third in the world; 2.9 billion people live in homes using wood, coal or dung as their primary cooking fuel; equally, 50.6% of Nigerians has no access to regular electricity supply. Further, sustainable policy regarding smoke emission is lacking in the country. This work further submitted that continued low standard of living as a result of governance challenges coupled with a lack of sustainable policy have aggravated the health risks related to smoke in the country. Conclusions: The implication on the health of the children, mothers and vulnerable groups for the future of the country is enormous and may continue if not addressed. Urgent attention therefore needs to be focused on this area considering what this portends for the nation now and in the future.

Keywords: air pollution, indoor, outdoor, respiratory infections

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Authors: Piyanee Khumpao

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Under the Thai Penal Code and Customs Act, sex toys are criminalized and completely prohibited through the legal interpretation as obscene objects by law enforcement, despite there is no explicit legal sanction against them. The purpose of preventing people from accessing sex toys is to preserve public morals. However, sex toys are still available, exposed, and sold publicly in main cities throughout Thailand. They are easily observed by people of any age. This paper argues that sexuality is human nature and human right. Human deserves sexual pleasure as long as getting sexual pleasure does not inflict any harm on others. Using sex toys in private (individually and/or as a couple with mutual consent) does not constitute any harm nor degrade public moral. Therefore, the complete ban of sex toys shall be lifted and decriminalized. Nevertheless, the economic analysis illustrates that criminalization and prohibition of sex toys would lead to its black market – higher price and lower quantity. Although it is socially desirable to have fewer sex toys in the market, there will usually be high demand for them because sexual pleasure is natural and, hence, people have a lower price elasticity of demand for such things, including pornography. Thus, its deterrent effect is not very effective. Moreover, sex toys vendors still always exist because higher price incentivizes them to act illegally and may gain benefits from selling low-quality sex toys. Consequently, consumers do not have a choice to select high-quality sex toys at a reasonable price. Then, they are forced to purchase low quality sex toys at a higher price. They also may suffer from health issues as well as other harms from its dangerous/toxic substances since lower quality products are manufactured poorly to save costs. A law and economics approach supports the decriminalization of sex toys in Thailand. Other measures to control its availability shall be adopted to protect the vulnerable, such as children. Options are i) zoning or regulation on-premises selling sex toys as in Singapore, Japan, and China, ii) regulations of sex toys as medical apparatus like in the state of Alabama, and iii) the prevention of sex toys exposure in the real (physical) appearance (i.e., allowing virtual exposure of sex toys) like in India.

Keywords: human nature, law and economics approach, sex toys, sexual pleasure

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Authors: Husain Rajib, T. H. Sheikh, D. G. Jewel

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Background: Amblyopia is a frequent cause of monocular blindness in children. It can be unilateral or bilateral reduction of best corrected visual acuity associated with decrement in visual processing, accomodation, motility, spatial perception or spatial projection. Anisometropia is an important risk factor for amblyopia that develops when unequal refractive error causes the image to be blurred in the critical developmental period and central inhibition of the visual signal originating from the affected eye associated with significant visual problems including anisokonia, strabismus, and reduced stereopsis. Methods: It is a prospective hospital based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 50 anisometropic amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 3 to 13 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over month, then occlusion treatment was started. Occlusion was done daily for 6-8 hours (full time) together with vision therapy. The occlusion was carried out for 3 months. Results: In this study about 8% subjects had anisometropia from myopia, 18% from hyperopia, 74% from astigmatism. The initial mean visual acuity was 0.74 ± 0.39 Log MAR and after intervention of amblyopia therapy with active vision therapy mean visual acuity was 0.34 ± 0.26 Log MAR. About 94% of subjects were improving at least two lines. The depth of amblyopia associated with type of anisometropic refractive error and magnitude of Anisometropia (p<0.005). By doing this study 10% mild amblyopia, 64% moderate and 26% severe amblyopia were found. Binocular function also decreases with magnitude of Anisometropia. Conclusion: Anisometropic amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Occlusion therapy with at least one instructed hour of active visual activity practiced out of school hours was effective in anisometropic amblyopes who were diagnosed at the age of 8 years and older, and the patients complied well with the treatment.

Keywords: refractive error, anisometropia, amblyopia, strabismic amblyopia

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Authors: Alyona Cerfontyne, Levita D'Souza, Lefteris Patlamazoglou

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Unlike adoption and donor-assisted reproduction, misattributed paternity occurring within the context of spontaneous conception and outside of formally recognised practices of having a child remains largely an understudied phenomenon. In adulthood, to discover misattributed paternity, i.e., that the man you call your father is not related to you genetically, can have profound implications for everyone affected. Until the advent of direct-to-consumer DNA testing 20 years ago, such discoveries were relatively rare. Despite the growing number of individuals uncovering their biogenetic paternity through genetic testing, there is very limited research on misattributed paternity from the perspective of adult children affected by it. No research exists on how to support these individuals through counselling post-discovery. Framed as insider action research, this study aimed to explore the perceived psychosocial consequences of misattributed paternity discoveries and coping strategies used by individuals who discover their misattributed paternity status in adulthood. In total, 12 individuals with misattributed paternity participated in semi-structured interviews in July-August 2022. The collected data was analysed using reflexive thematic analysis. The study’s results indicate that discovering misattributed paternity in adulthood can be likened to a watershed moment forever changing the trajectory of one’s life. Psychological experiences consistent with trauma, as well as grief and loss, re-evaluation of close family relationships, reestablishment of one’s identity, as well as experiencing a profound need to belong are the key themes emerging from the analysis of psychosocial experiences. Post-discovery, individuals with misattributed paternity employ a wide range of emotional and problem-focused coping strategies, amongst which seeking connection with those who understand, searching for information on the new biogenetic family and finding new meanings to life are most prominent. The study contributes both to the academic and practical knowledge of experiences of misattributed paternity and highlights the importance of further research on the topic.

Keywords: discovery of misattributed paternity, misattributed paternity, paternal discrepancy, psychosocial consequences, coping

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Authors: Vandana Dave, Neelam Kumari

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India, a fast growing global power, is climbing the ladder of success very swiftly and has been attracting the world’s attention in recent decades. But unfortunately in the modern society, women who constitute half the population of our country have been the victims of violence in different fields of life both physically, socially, mentally and economically. Women face a lot of societal pressure, gender based violence – including rape, domestic violence, dowry death, murder and sexual abuse. But none the less, it is not considered as a problem of serious concern. Among the issues related to women, domestic violence is one of the major issue in our society which is occurring within the safe confines of home at the hands of close family members and cuts across line of race, nationality, language, culture, economics, sexual orientation, physical ability and religion to affect women from all walks of life. It is not to be perceived as a law and order problem alone but it is a socio- cultural problem and it is directly affecting the family life, health of women and life of children. Structural imbalance of power, systematic gender based discrimination; inequality between women and men and other kind of subordination are the context and cause of violence against women. Understanding it as a major problem of our society, the present study was conducted to assess the status of women of Rohtak, district of Haryana. The present study is based on primary and secondary data, adopting feminist research methodology. Case study method was incorporated during the research. It was observed that violence varied according to different age groups of women, marital status, education status, economic status and sociodemography factors. The case studies depicted the inadequate justice system for the victims of domestic violence. The study also revealed that the victims failed to understand the judiciary system and considered themselves helpless and hopeless. The study indicates the need of women friendly justice system for the upliftment of the society.

Keywords: domestic violence, women, victim, justice

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Authors: Rasha Ahmadi

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In December 2019, a coronavirus, currently identified as SARS-CoV-2, produced a series of acute atypical respiratory illnesses in Wuhan, Hubei Province, China. The sickness induced by this virus was named COVID-19. The virus is transmittable between humans and has caused pandemics worldwide. The number of death tolls continues to climb and a huge number of countries have been obliged to perform social isolation and lockdown. Lack of focused therapy continues to be a problem. Epidemiological research showed that senior patients were more susceptible to severe diseases, whereas children tend to have milder symptoms. In this study, we focus on other possible side effects of COVID-19 and more detailed treatment strategies. Using bioinformatics analysis, we first isolated the gene expression profile of patients with severe COVID-19 from the GEO database. Patients' blood samples were used in the GSE183071 dataset. We then categorized the genes with high and low expression. In the next step, we uploaded the genes separately to the Enrichr database and evaluated our data for signs and symptoms as well as related medication regimens. The results showed that 138 genes with high expression and 108 genes with low expression were observed differentially in the severe COVID-19 VS control group. Symptoms and diseases such as embolism and thrombosis of the abdominal aorta, ankylosing spondylitis, suicidal ideation or attempt, regional enteritis were observed in genes with high expression and in genes with low expression of acute and subacute forms of ischemic heart, CNS infection and poliomyelitis, synovitis and tenosynovitis. Following the detection of diseases and possible signs and symptoms, Carmustine, Bithionol, Leflunomide were evaluated more significantly for high-expression genes and Chlorambucil, Ifosfamide, Hydroxyurea, Bisphenol for low-expression genes. In general, examining the different and invisible aspects of COVID-19 and identifying possible treatments can help us significantly in the emergency and hospitalization of patients.

Keywords: phenotypes, drug regimens, gene expression profiles, bioinformatics analysis, severe COVID-19

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Authors: Péricles Maia Andrade, Temístocles Damasceno Silva, Hector Luiz Rodrigues Munaro

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The school physical education is going through several changes over the years, and diversification of its content from specific interests is one of the reasons for these changes, soon, the formality in education do not have to stay out, but needs to open up the possibilities offered by the world, so the Mountain Bike, an adventure sport, offers several opportunities for intervention Its application in the school allows diverse interventions in front of the psychomotor development, besides opening possibilities for other contents, respecting the previous experiences of the students in their common environment. The choice of theme was due to affinity with the practice and experience of the Mountain Bike at different levels. Both competitive as recreational, professional standard and amateur, focus as principle the bases of the Cycling, coupled with the inclusion in the Centre for Studies in Management of Sport and Leisure and of the Southwest Bahia State University and the preview of the modality's potential to help the children’s psychomotor development. The goal of this research was to demonstrate like a pilot project the effects of the Mountain Bike as psychomotor instrument in physical education at one of the psychomotor valences, Balance, evaluating Immobility, Static Balance and Dynamic Balance. The methodology used Fonseca’s Psychomotor Battery in 10 students (n=10) of a brazilian public primary’s school, with ages between 9 and 11 years old to use the Mountain Biking contents. The balance’s skills dichotomized in Regular and Good. Regarding the variable Immobility, in the initial test, regardless of gender, 70% (n = 7) were considered Regular. After four months of activity, the Good profile, which had only 30% (n = 3) of the sample, evolved to 60% (n = 6). As in Static and Dynamic Balance there was an increase of 30% (n = 3) and 50% (n = 5) respectively for Good. Between genders, female evolution was better for Good in Immobility and in Static Equilibrium. Already the male evolution was better observed in the Dynamic Equilibrium, with 66.7% (n = 4) for Good. Respecting the particularities of the motor development, an indication of the positive effects of the MTB for the evolution in the balance perceived, necessitating studies with greater sampling.

Keywords: psychomotricity, balance, mountain biking, education

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Authors: Km Tanu

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It has been widely accepted that the learning style of adults and children is different, the learning motivation among adults vary, and even their learning preferences cannot be predetermined. In India, where the population is widely diverse and socio-economic and cultural disparities are there, the learning strategies should also be according to their needs and preferences. The present study explores the concept of adult learners in India in order to understand their needs and styles better. The adult learning principles of Malcolm Knowles have been analyzed, and its presence in the different policies and programs has been traced. To what extent these principles and other such concepts would be beneficial for the Indian population and for effective learning strategies, and what contextual understanding is needed, has been argued in the study. Descriptive research methodology, along with content and thematic analyses, has been used for the paper. It has been argued that there are four areas that play crucial roles in making learning effective. These are the learner, the facilitator, the resources and the policy. The prior experiences of the learners, their motivation, the group to which they belong (i.e., the learning styles and the strategies can be varied for the group of farmers and migrant laborers), and their expected outcome play an important role in making any adult education program successful but along with this, the role of facilitator or the educator is also very important as it is not easy to deal with the adult learners, the understanding that the task is not to teach the adult learners but to make them learn and to use their prior knowledge is a task in itself, proper training is needed for that matter. Many times, it has been seen that adult education programs are poorly funded, or even if they are funded, the fund is not utilized well; the unavailability of the resources is one of the reasons for the failure of adult education programs, and if we see these four points as a triangle, at the bottom, there is a policy document. A well-stated and described doable policy document is also equally important.

Keywords: adult education, Indian adult learner, effective learning styles, Malcolm Knowles learning principles, adult education policies and program

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Authors: Denise Schrama, Claudia Raposo, Pedro Rodrigues

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Background: Food allergies are conducted by a hypersensitive response of the immune system. These allergies are a global concern for the public health. Consumption of fish is increasing worldwide as it is a healthy meat with high nutritional value. Unfortunately, fish can cause adverse immune-mediate reactions, affecting part of the population with higher incidence in children. β-parvalbumin, a small, highly conserved stable, calcium or magnesium binding muscle protein is the main fish allergen. In fish-allergic patients, cross-reactivity between different fish species exist due to recognition of highly identical protein regions. Enolases, aldolases, or fish gelatin are other identified fish allergens in some fish species. With no available cure for fish allergies, clinical management is only based on an avoidance diet aiming at the total exclusion of offending food. Methods: Mediterranean fish (S. aurata and D. labrax) were fed specifically designed diets, enriched in components that target the expression or inactivation of parvalbumin (creatine and EDTA, respectively). After 90 days fish were sampled and biological tissues were excised. Proteomics was used to access fish allergens characterization and expression in muscle while IgE assays to confirm the lower allergenic potential are conducted in patients with history of fish allergies. Fish welfare and quality of flesh were established with biochemical, texture and sensorial analysis. Results: Fish welfare shows no major impact between diets. In case of creatine supplementation in D. labrax proteomic analysis show a slight decrease in parvalbumin expression. No accumulation of this compound was found in muscle. For EDTA supplementation in S. aurata IgE assay show a slight decrease in allergenicity when using sera of fish allergic patients. Conclusion: Supplementation with these two compounds seems to change slightly the allergenicity of the two mean Mediterranean species.

Keywords: fish allergies, fish nutrition, proteomics, aquaculture

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Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

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The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

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Authors: Vaibhav Singh Parihar

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Incidents of serious offenses being committed by children are increasing day by day thereby becoming a matter of great concern. The involvement of a 17-year-old boy in the incident that took place on 16th December 2012 (most commonly known as ‘Nirbhaya Case’)wherein a 23-year-old girl was brutally gang-raped and thrown out of the moving bus, took the entire nation by shock. Previously, the legislation dealing with juvenile delinquency in India considered a child to be juvenile if he/she was below the age of 18 years. As a consequence, the accused who was just six months short of attaining the age of 18 years was convicted for only three years. The primary objective of the study is to understand the gravity as to why the need for distinguishing a child and juvenile arose in this time and to what extent legislations are successful in this regard. It initially explains the history and evolution of juvenile legislation in India and the provisions contained in the Indian Constitution. It then goes on to explain the causes of juvenile delinquency in India. Further, the study focuses on the latest trends that have developed in juvenile delinquency, explaining how the Nirbhaya Case led to the amendments made to the Juvenile Justice Act, 2010. Also, it focuses on the Child Rights and Child Protection and the stand taken by the National Human Rights Commission and the international community. An attempt has been made to settle the debate as to whether the juvenile justice system in India is reformative or punitive. The need for amendment in the Juvenile Justice Act is also highlighted. The outcome of the study suggests that the legislation relating to juvenile delinquency have not been able to achieve the desired results. The age determination method in our system has been given paramount importance. The maximum punishment prescribed, even for heinous crimes, is only three years. Also, the reformative style of punishment is not adequate and more emphasis should be laid on penalization. Finally, the author concludes that the legislation has failed at creating a deterrent effect. It is suggested to strengthen the role of government authorities and to sensitize people in this regard to increase community participation. A non-doctrinal and analytical approach has been adopted and secondary sources of data have been relied upon by the author for conducting the research for the study.

Keywords: child, delinquency, juvenile, Nirbhaya case

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Authors: Prathama Guha Chaudhuri, Arunima Datta, Ashis Mukhopadhyay

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Background: Visualization (guided imagery) is a set of techniques which induce relaxation and help people create positive mental images in order to reduce stress.It is relatively inexpensive and can even be practised by bed bound people. Studies have shown visualization to be an effective tool to improve cancer patients’ anxiety, depression and quality of life. The common images used with cancer patients in the developed world are those involving the individual’s body and its strengths. Since breast cancer patients in India are more family oriented and often their main concerns are the stigma of having cancer and subsequent isolation of their families, including their children, we figured that positive images involving acceptance and integration within family and society would be more effective for them. Method: Data was collected from 119 breast cancer patients on chemotherapy willing to undergo psychotherapy, with no history of past psychiatric illness. Their baseline stress, anxiety, depression and quality of life were assessed using validated tools. The participants were then randomly divided into three groups: a) those who received visualization therapy with standard imageries involving the body and its strengths (sVT), b) those who received visualization therapy using indigenous family oriented imageries (mVT) and c) a control group who received supportive therapy. There were six sessions spread over two months for each group. The psychological outcome variables were measured post intervention. Appropriate statistical analyses were done. Results:Both forms of visualization therapy were more effective than supportive therapy alone in reducing patients’ depression, anxiety and quality of life.Modified VT proved to be significantly more effective in improving patients’ anxiety and quality of life. Conclusion: Visualization is a valuable therapeutic option for reduction of psychological distress and improving quality of life of breast cancer patients.In order to be more effective, the images used need to be modified according to the sociocultural background and individual needs of the patients.

Keywords: breast cancer, visualization therapy, quality of life, anxiety, depression

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Authors: Rocio Murad, Marcela Sanchez, Mariana Calderon Jaramillo, Danny Rivera, Angela Cifuentes, Daniela Roldán, Juan Carlos Rivillas

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Women and girls have specific health needs, but during health pandemics such as COVID19 they are less likely to have access to quality essential health information, commodities and services, or insurance coverage for routine and catastrophic health expenses, especially in rural and marginalized communities. This is compounded by multiple or intersecting inequalities, such as ethnicity, socioeconomic status, disability, age, geographic location, and sexual orientation, among others. Despite concerted collective action, there is a lack of information on the situation of women, adolescents and youth, including gender inequalities exacerbated by the pandemic. Much more needs to be done to amplify the lived realities of women and adolescents in global and national advocacy and policy responses. The COVID 19 pandemic reflects the need for systematic advocacy policies based on the lived experiences of women and adolescents, underpinned by human rights. This research is part of the initiative of Profamilia Association (Solidarity Study), and its objective is twofold: i) to analyze the behavioral changes and immediate expectations of Colombians during the stage of relaxation of the confinement measures decreed by the national government; and ii) to identify the needs, experiences and resilient practices of adolescents and young women during the COVID-19 crisis in Colombia. Descriptive analysis of data collected by Profamilia through the Solidaridad study, an exploratory cross-sectional descriptive study that used subnational level data from a nonprobabilistic sample survey conducted to 1735 adults, between September 01 and 11, 2020. Interviews were conducted with key stakeholders about their experiences during COVID19, under three key axes: i) main challenges for adolescents and young women; ii) examples of what has worked well in responding to the challenge; and iii) how/what services are/should be provided during COVID-19 (and beyond) to address the challenge. Interviewees were selected based on prior mapping of social groups of interest. In total, 23 adolescents and young women participated in the interviews. The results show that people adopted behavioral changes such as wearing masks, avoiding people with symptoms, and reducing mobility, but there was also a doubling of concerns for many reasons, from effects on mental health, sexual health, and unattended reproductive health to the burden of care and working at home. The favorable perception that people had at the beginning of the quarantine about the response and actions of the national and local government to control Covid-19 decreased over the course of the quarantine. The challenges and needs of adolescents and young women were highlighted during the most restrictive measures to contain the COVID-19 pandemic, which resulted in disruptions to daily activities, education and work, as well as restrictions to mobility and social interaction. Concerns raised by participants included: impact on mental health and wellbeing due to disruption of daily life; limitations in access to formal and informal education; food insecurity; migration; loss of livelihoods; lack of access to health information and services; limitations to sexual and reproductive health and rights; insecurity problems; and problems in communication and treatment among household members.

Keywords: COVID-19, changes in behavior, adolescents, women

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Authors: Jane N. O'Sullivan

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In most studies relating change in fertility to potentially causal factors (such as girls’ educational attainment, infant mortality or urbanization), the presence or nature of family planning efforts are not examined, potentially misattributing their contributions. Modest impacts of voluntary family planning programs on fertility change have been claimed, citing the near-term effects of historical quasi-experimental projects – notably in Bangladesh and in Ghana – where recipients and non-recipients could be contrasted. By their nature, such experiments lacked the wider cultural impacts of national programs. Concurrently, analyses relating population growth with economic advancement have been equivocal, discrediting previous widespread concern which prevailed before the 1980s. This neutral view has been revised more recently with demographic dividend theory crediting higher working-age proportion with some economic stimulus if supported by sufficient institutional and human capacity. In this study of country-level data, cross-country comparisons spanning six decades relate fertility decline with family planning effort, GDP per capita and female education, finding that the timing of rapid fertility decline aligns with commencement of voluntary family planning programs, while economic betterment came after substantial fertility fall. The relationship between fertility and primary education completion was inconsistent, with potential channels of causation operating in both directions. GDP per capita was unrelated to rate of fertility decline, but total fertility rates above three children per woman strongly impeded enrichment. By synchronizing countries with respect to their fertility transition, strong relationships are revealed which suggest lower fertility enables economic betterment, rather than the other way around. These results argue in favour of elevating voluntary family planning as a development priority.

Keywords: economic advance, family planning effort, fertility decline, population growth rate

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Authors: Waqas Ashraf, Yasir Nawab, Haritham Khan, Habib Awais, Shahbaz Ahmad

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Seersucker is a popular lightweight fabric widely used in men’s and women’s suiting, casual wear, children’s clothing, house robes, bed spreads and for spring and summer wear. The puckered effect generates air spaces between body and the fabric, keeping the wearer cool in hot conditions. The aim of this work was to develop knitted seersucker fabric on single cylinder weft knitting machine using plain jersey structure. Core spun cotton yarn and cotton spun yarn of same linear density were used. Core spun cotton yarn, contains cotton fiber in the sheath and elastase filament in the core. The both yarn were fed at regular interval to feeders on the machine. The loop length and yarn tension were kept constant at each feeder. The samples were then scoured and bleached. After wet processing, the fabric samples were washed and tumble dried. Parameters like loop length, stitch density and areal density were measured after conditioning these samples for 24 hours in Standard atmospheric condition. Produced sample has a regular puckering stripe along the width of the fabric with same height. The stitch density of both the flat and puckered area of relaxed fabric was found to be different .Air permeability and moisture management tests were performed. The results indicated that the knitted seersucker fabric has better wicking and moisture management properties as the flat area contact, whereas puckered area held away from the skin. Seersucker effect in knitted fabric was achieved by the difference of contraction of both sets of courses produced from different types of yarns. The seer sucker fabric produce by knitting technique is less expensive as compared to woven seer sucker fabric as there is no need of yarn preparation. The knitted seersucker fabric is more practicable for summer dresses, skirts, blouses, shirts, trousers and shorts.

Keywords: air permeability, knitted structure, moisture management, seersucker

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Authors: Neuma Chaveiro, Juliana Guimarães Faria

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Introduction: The thematic that guides this study is teacher training for the teaching of sign language in a perspective of bilingual education – specifically aimed at Brazilian public schools that offer inclusive education, and that have, among its students, deaf children who use Brazilian Sign Language as a means of communication and expression. In the Teacher Training Course for Letters/Libras at the Universidade Federal de Goiás/UFG, we developed a bilingual education project for the deaf, linked to PIBID (Institutional Scholarship for Teaching Initiation Program), funded by the Brazilian Federal Government through CAPES (Coordination for the Improvement of Higher Education Personnel). Goals: to provide the education of higher education teachers to work in public schools in basic education and to insert students from the UFG’s Letters/Libras course in the school’s daily life, giving them the opportunity for the creation and participation in methodological experiences and of teaching practices in order to overcome the problems identified in the teaching-learning process of deaf students, in a bilingual perspective, associating Libras (Brazilian Sign Language) and Portuguese. Methodology: qualitative approach and research-action, prioritizing action – reflection – action of the people involved. The Letters-Libras PIBID of the College of Letters/UFG, in this qualitative context, is guided by the assumptions of investigation-action to contribute to the education of the Libras teacher. Results: production of studies and researches in the area of education, professionalization and teaching practice for the degree holder in Letters: Libras; b) studies, research and training in bilingual education; c) clarification and discussion of the myths that permeate the reality of users of sign languages; d) involving students in the development of didactic materials for bilingual education. Conclusion: the PIBID Project Letters/Libras allows, both to the basic education school and to the teachers in training for the teaching of Libras, an integrated and collective work partnership, with discussions and changes in relation to bilingual education for the deaf and the teaching of Libras.

Keywords: deaf, sign language, teacher training, educacion

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Authors: Ali Al Orf, Khawaja Bilal Waheed

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Background and objective: Joubert syndrome (JS) is a rare, autosomal-recessive condition. Early recognition is important for management and counseling. Magnetic resonance imaging (MRI) can help in diagnosis. Therefore, we sought to evaluate clinical presentation and MRI findings in Joubert syndrome and related disorders. Method: A retrospective review of genetically proven cases of Joubert syndromes and related disorders was reviewed for their clinical presentation, demographic information, and magnetic resonance imaging findings in a period of the last 10 years. Two radiologists documented magnetic resonance imaging (MRI) findings. The presence of hypoplasia of the cerebellar vermis with hypoplasia of the superior cerebellar peduncle resembling the “Molar Tooth Sign” in the mid-brain was documented. Genetic testing results were collected to label genes linked to the diagnoses. Results: Out of 12 genetically proven JS cases, most were females (9/12), and nearly all presented with hypotonia, ataxia, developmental delay, intellectual impairment, and speech disorders. 5/12 children presented at age of 1 or below. The molar tooth sign was seen in 10/12 cases. Two cases were associated with other brain findings. Most of the cases were found associated with consanguineous marriage Conclusion and discussion: The molar tooth sign is a frequent and reliable sign of JS and related disorders. Genes related to defective cilia result in malfunctioning in the retina, renal tubule, and neural cell migration, thus producing heterogeneous syndrome complexes known as “ciliopathies.” Other ciliopathies like Senior-Loken syndrome, Bardet Biedl syndrome, and isolated nephronophthisis must be considered as the differential diagnosis of JS. The main imaging findings are the partial or complete absence of the cerebellar vermis, hypoplastic cerebellar peduncles (giving MTS), and (bat-wing appearance) fourth ventricular deformity. LimitationsSingle-center, small sample size, and retrospective nature of the study were a few of the study limitations.

Keywords: Joubart syndrome, magnetic resonance imaging, molar tooth sign, hypotonia

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Authors: Karen Fang

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Investigative genetic genealogy has attracted much interest in both the field of ethics and the public eye due to its global application in criminal cases. Arguments have been made regarding privacy and informed consent, especially with law enforcement using consumer genetic testing results to convict individuals. In the case of public interest, DNA databases have the strong potential to significantly reduce crime, which in turn leads to safer communities and better futures. With the advancement of genetic technologies, the integration of a universal forensic DNA database in violent crimes, crimes against children, and missing person cases is expected to deter crime while protecting one’s privacy. Rather than collecting whole genomes from the whole population, STR profiles can be used to identify unrelated individuals without compromising personal information such as physical appearance, disease risk, and geographical origin, and additionally, reduce cost and storage space. STR DNA profiling is already used in the forensic science field and going a step further benefits several areas, including the reduction in recidivism, improved criminal court case turnaround time, and just punishment. Furthermore, adding individuals to the database as early as possible prevents young offenders and first-time offenders from participating in criminal activity. It is important to highlight that DNA databases should be inclusive and tightly governed, and the misconception on the use of DNA based on crime television series and other media sources should be addressed. Nonetheless, deterrent effects have been observed in countries like the US and Denmark with DNA databases that consist of serious violent offenders. Fewer crimes were reported, and fewer people were convicted of those crimes- a favorable outcome, not even the death penalty could provide. Currently, there is no better alternative than a universal forensic DNA database made up of STR profiles. It can open doors for investigative genetic genealogy and fostering better communities. Expanding the appropriate use of DNA databases is ethically acceptable and positively impacts the public.

Keywords: bioethics, deterrent effects, DNA database, investigative genetic genealogy, privacy, public interest

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Authors: Ritwik Saha, Anindita Chaudhuri

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The psychological dimension of work-based mobility of the contemporary time in the context of the ever-changing socio-economic process mounting the interest to address the consequential issues of quality of life and well-being of the migrant section of society. The negotiation with the fluidity of the job market and the changing psychosocial dimensions within and between psychosocial relations may disentangle the resilience as well as the mechanism of diligence toward migrant (marginal) life. The work-based mobility and its associated phenomena have highly impacted the migrant’s quality of life especially the marginalized (socioeconomically weak) ones along with their family members staying away from them. The subjective experiences of the journey of their migrant life and reconstruction of the psychosocial being in terms of existence and well-being at the host place are the minimal addressed issues in migrant literature. Hence this gap instigates to bring forth the issue with the present study exploring the phenomenal aspects of lived experiences, resilience, and sense-making of the well-being of migrant living by the marginalized migrant people engaging in unorganized space. In doing so qualitative research method was followed, and semi-structured interviews were used for data collection from the four selected migrant groups (Fuchkawala, Bhunjawala, Bhari - drinking water supplier, Construction worker) as they migrated to Kolkata and its metropolis area from different states of India, Five participants from each group (20 participants in total) age range between 20 to 45 were interviewed physically and participants’ observatory notes were taken to capture their lived experiences, audio recordings were transcribed and analyzed systematically following Charmaz’s three-layer coding of grounded theory. Being truthful to daily industry, the strong desire to build children’s future, the mastering mechanism to dual existence, use of traditional social network these four themes emerges after analysis of the data. However, incorporating fate as their usual way of life and making sense of well-being through their assertion is another evolving aspect of migrant life.

Keywords: lived experiences, marginal living, resilience, sense-making process, well-being

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Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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