Search results for: the double burden of malnutrition

Authors: Naqoosh Haidry

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Objective & Goal: Enucleation of the maxillomandibular cysts will lead to the creation of post-surgical bone defects which may take more than a year for complete bone healing. The use of bone grafts is common to aid bone regeneration in large defects. The study aimed to evaluate the healing and bone formation capabilities of polymer of injectable platelet fibrin (i-PRF) and hydroxyapatite (HA) as bone graft substitute in maxilla-mandibular postsurgical defects compared to hydroxyapatite alone. The primary objective was to find out the clinical and radiological assessment of healing postoperatively and compare the outcome of both groups. Material and Methods: After surgical enucleation of 19 maxillomandibular cysts/tumors, either HA or HA+ i-PRF graft was adapted to the defect. Clinical outcome variables such as pain (VAS score), edema, and mucosal color were evaluated on postoperative days 01, 03, and 07 while radiological outcome variables such as volume of defect (cc), density of new bone (HU) on computed tomography were evaluated at 2nd and 4th month. The results obtained were tabulated and compared with the inferential analysis. Results: Clinical parameters seem to be better in the HA + i-PRF group, but the result was non-significant. Radiologically, the mean healing ratios were significantly greater in the HA + i-PRF group (63.5 ± 2.34 at 2nd month, 90.3 ± 7.32 at 4th month) compared to the HA group (57.2 ± 5.21at 2nd month, 80.8 ± 5.33 at 4th month). When comparing the mean density of new bone, there was a statistically significant difference with a mean difference of 95.2 HU more in the HA + i-PRF (623 HU ± 42.9) compared to the HA group (528 HU ± 96.5) in 2nd month. Conclusion: The polymer of i-PRF and HA prepared as the sticky bone yields faster and better bone healing in post-enucleation maxillomandibular bony defects as compared to hydroxyapatite alone based on radiological findings till four months.

Keywords: bone defect, density of new bone, hydroxyapatite, injectable platelet rich fibrin, maxillomandibular cysts, surgical defect

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Janani Selvaraj, M. Prashanthi Devi, P. B. Harathi

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Epidemiologic studies conducted over several decades have provided evidence to suggest that long-term exposure to elevated ambient levels of particulate air pollution is associated with increased mortality. Air quality risk management is significant in developing countries and it highlights the need to understand the role of ecologic covariates in the association between air pollution and mortality. Several new methods show promise in exploring the geographical distribution of disease and the identification of high risk areas using epidemiological maps. However, the addition of the temporal attribute would further give us an in depth idea of the disease burden with respect to forecasting measures. In recent years, new methods developed in the reanalysis were useful for exploring the spatial structure of the data and the impact of spatial autocorrelation on estimates of risk associated with exposure to air pollution. Based on this, our present study aims to explore the spatial and temporal distribution of the lung cancer cases in the Coimbatore district of Tamil Nadu in relation to air pollution risk areas. A spatio temporal moving average method was computed using the CrimeStat software and visualized in ArcGIS 10.1 to document the spatio temporal movement of the disease in the study region. The random walk analysis performed showed the progress of the peak cancer incidences in the intersection regions of the Coimbatore North and South taluks that include major commercial and residential regions like Gandhipuram, Peelamedu, Ganapathy, etc. Our study shows evidence that daily exposure to high air pollutant concentration zones may lead to the risk of lung cancer. The observations from the present study will be useful in delineating high risk zones of environmental exposure that contribute to the increase of cancer among daily commuters. Through our study we suggest that spatially resolved exposure models in relevant time frames will produce higher risks zones rather than solely on statistical theory about the impact of measurement error and the empirical findings.

Keywords: air pollution, cancer, spatio-temporal analysis, India

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Authors: Byung Il You, Ryun Oh, Gyo Woo Lee

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Manhole refers to facilities that are accessible to the people cleaning and inspection of sewer, and its covering is called manhole lid. Manhole lid is typically made of a cast iron material. Due to the heavy weight of the cast iron manhole lids their installation and maintenance are not easy, and an electrical shock and corrosion aging of them can cause critical problems. The manhole body and the lid manufacturing using the fiber-reinforced composite material can reduce the weight considerably compared to the cast iron manhole. But only the fiber reinforcing is hard to maintain the heavy load, and the method of the iron frame with double injection molding of the composite material has been proposed widely. In this study reflecting the situation of this market, the structural design of the iron frame for the composite manhole lid was carried out. Structural analysis with the computer simulation for the effectively distributed load on the iron frame was conducted. In addition, we want to assess manufacturing costs through the comparing of weights and number of welding spots of the frames. Despite the cross-sectional area is up to 38% compared with the basic solid form the maximum von Mises stress is increased at least about 7 times locally near the rim and the maximum strain in the central part of the lid is about 5.5 times. The number of welding points related to the manufacturing cost was increased gradually with the more complicated shape. Also, the higher the height of the arch in the center of the lid the better result might be obtained. But considering the economic aspect of the composite fabrication we determined the same thickness as the frame for the height of the arch at the center of the lid. Additionally in consideration of the number of the welding points we selected the hexagonal as the optimal shape. Acknowledgment: These are results of a study on the 'Leaders Industry-university Cooperation' Project, supported by the Ministry of Education (MOE).

Keywords: manhole lid, iron frame, structural design, computer simulation

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Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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Authors: David Broussard

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This review article delves into the realm of marine conservation finance, addressing the inadequacies in current financial streams from the private sector and the underutilization of existing financing mechanisms. The study emphasizes the emerging field of “blue finance”, which contributes to economic growth, improved livelihoods, and marine ecosystem health. The financial burden of marine conservation projects typically falls on philanthropists and governments, contrary to the polluter-pays principle. However, the private sector’s increasing commitment to NetZero and growing environmental and social responsibility goals prompts the need for alternative funding sources for marine conservation initiatives like marine protected areas. The article explores the potential of utilizing several financing mechanisms like carbon credits and other forms of payment for ecosystem services in the marine context, providing a solution to the lack of private funding for marine conservation. The methodology employed involves a systematic and quantitative approach, combining traditional review methods and elements of meta-analysis. A comprehensive search of the years 2000 - 2023, using relevant keywords on the Scopus platform, resulted in a review of 252 articles. The temporal evolution of blue finance studies reveals a significant increase in annual articles from 2010 to 2022, with notable peaks in 2011 and 2022. Marine Policy, Ecosystem Services, and Frontiers in Marine Science are prominent journals in this field. While the majority of articles focus on payment for ecosystem services, there is a growing awareness of the need for holistic approaches in conservation finance. Utilizing bibliometric techniques, the article showcases the dominant share of payment for ecosystem services in the literature with a focus on blue carbon. The classification of articles based on various criteria, including financing mechanisms and conservation types, aids in categorizing and understanding the diversity of research objectives and perspectives in this complex field of marine conservation finance.

Keywords: biodiversity offsets, carbon credits, ecosystem services, impact investment, payment for ecosystem services

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Authors: Maznieda Mahjom, Rohaida Ismail, Masita Arip, Mohd Shaiful Azlan, Nor’Ashikin Othman, Hafizah Abdullah, nor Zahrin Hasran, Joshita Jothimanickam, Syaqilah Shawaluddin, Nadia Mohamad, Raheel Nazakat, Tuan Mohd Amin, Mizanurfakhri Ghazali, Rosmanajihah Mat Lazim

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COVID-19 outbreak is particularly detrimental to the mental health of everyone as well as leaving a long devastating crisis in the healthcare sector. Daily increment of COVID-19 cases and close contact, necessitating the testing of a large number of samples, thus increasing the workload and burden to laboratory personnel. This study aims to determine the prevalence of personal-, work- and client-related burnout as well as to measure the concentration of salivary cortisol among laboratory personnel in the main laboratories in Klang Valley, Malaysia. This cross-sectional study was conducted in late 2021 and recruited a total of 404 respondents from three laboratories in Klang Valley, Malaysia. The level of burnout was assessed using Copenhagen Burnout Inventory (CBI) comprising three sub-dimensions of personal-, work- and client-related burnout. The cut-off score of 50% and above indicated possible burnout. Meanwhile, salivary cortisol was measured using a competitive enzyme immunoassay kit (Salimetrics, State College, PA, USA). Normal levels of salivary cortisol concentration in adults are within 0.094 to 1.551 μg/dl (morning) and can be none detected to 0.359 μg/dl (evening). The prevalence of personal-, work- and client-related burnout among laboratory personnel were 36.1%, 17.8% and 7.2% respectively. Meanwhile, the abnormal morning and evening cortisol concentration recorded were 29.5% and 21.8% excluding 6.9%-7.4% missing data. While the IgA level is normal for most of the respondents, which recorded at 95.53%. Laboratory personnel were at risk of suffering burnout during the COVID-19 pandemic. Thus, mental health programs need to be addressed at the department and hospital level by regularly screening healthcare workers and designing an intervention program. It is also vital to improve the coping skills of laboratory personnel by increasing the awareness of good coping skill techniques. The training must be in an innovative way to ensure that the lab personnel can internalise the technique and practise it in real life.

Keywords: burnout, COVID-19, laborotary personnel, salivary cortisol

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Authors: Christina Tafadzwa

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Global HIV and AIDS trends show that Sub-Saharan Africa is the hardest-hit region, and women are disproportionately affected and infected by HIV. The trend is conspicuous in South Africa, where adolescent girls and young women (AGYW), female university students included, bear the burden of HIV infection. Although the female condom (FC) is the only female-oriented HIV and AIDS technology that provides dual protection against unwanted pregnancy and HIV, its uptake and use remain erratic, especially among the youth and young women in institutions of higher learning. This paper explores empirical evidence from the University of Venda (UniVen), which is in the rural areas of Limpopo Province in South Africa, and also among higher learning institutions experiencing low uptake and use of the FC. A phenomenological approach consisting of in-depth interviews was utilized to collect data from a total of 20 female university students at UniVen who were purposively sampled based on their participation in HIV and AIDS dialogues and campaigns conducted on campus. The findings that were analysed thematically revealed that notions of rurality and sociocultural beliefs surrounding women's sexual and reproductive health are key structural factors that influence the low use and uptake of the FC at the rural university. The evidence thus far revealed that female students are discouraged from collecting or initiating FC because of cultural dictates or prescripts which place the responsibility to collect and initiate condom use on men. Hence the inference that UniVen female students' realities are compounded by notions of rurality and society's patriarchal nature that intersect and limit women's autonomy in matters of sex. Guided by the women empowerment theory, this paper argues that such practices take away UniVen female students' agency to decide on their sexual and reproductive health. The normalisation of socio-cultural and harmful gender practices is also a retrogression in the women's health agenda. The paper recommends a holistic approach that engages traditional and community leaders, particularly men, to unlearn and uproot harmful gender norms and patriarchal elements that hinder the promotion and use of the FC.

Keywords: female condom, UniVen, socio-cultural factors, female students, HIV and AIDS

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Authors: Cornelius Michael Ekenta, Aderonke Bashirat Mohammed, Sefi Ahmed

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The research examined the impact of flooding on food calorie intake and health challenges among smallholder farm households in Koton Karfe Local Government Area of Kogi State, Nigeria. Purposive and random sampling techniques were used to select 130 farm households in selected villages in the area. Primary data were generated through the administration of a well-structured questionnaire. Data were analyzed with descriptive statistics, Double Difference Estimator (DDE), Calorie Intake Estimation Function, t-test, and multiple regressions. The result shows that farm households lost an average of 132, 950kg of selected crops amounting to about N20m ($56, 542) loose in income. Food daily calorie intake indicates a loss of an average of 715.18Kcal, showing a significant difference in calorie intake before and after flooding (t = 2.0629) at 5% probability. Furthermore, the health challenges most prevalent during flooding were malaria fever, typhoid fever, cholera, and dysentery. The determinants of daily calorie intake were age, household size, level of income, flooding, health challenges, and food price. The study concluded that flooding had negative impacts on crop output and income, daily food calorie intact, and health challenges of a farm household in the study area. It was recommended that the State Government should make adequate and proper arrangements to relocate residents of the area at the warning of possible flooding by the National Metrological Centre and should, through the State Emergency Management Agency (SEMA), provide relieve items to the residents to cushion the effects of the flooding.

Keywords: calorie, cholera, flooding, health challenges, impact

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Authors: Paolo Di Pietro, Matteo Lelli, Kinjal Parmar

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Water hazards are consistently identified as among the highest global risks in terms of impact. Riverbank protection plays a key role in flood risk management. For erosion control and scour protection, flexible solutions like gabions & mattresses are being used since quite some time now. The efficacy of erosion control systems depends both on the ability to prevent soil loss underneath, as well as to maintain their integrity under the effects of the water flow. The paper presents the results of a research carried out at the Colorado State University on the performance of double twisted wire mesh products, known as Reno Mattresses, used as soil erosion control system. Mattresses were subjected to various flow conditions on a 10m long flume where they were placed on a 0.30 m thick soil layer. The performance against erosion was evaluated by assessing the effect of the stone motion inside the mattress combined with the condition of incipient soil erosion underneath, in relationship to the mattress thickness, the filling stone properties and under variable hydraulic flow regimes. While confirming the stability obtained using a conventional design approach (commonly referred to tractive force theories), the results of the research allowed to introduce a new performance limit based on incipient soil erosion underneath the revetment. Based on the research results, the authors propose to express the shear resistance of mattresses used as soil erosion control system as a function of the size of the filling stones, their uniformity, their unit weight, the thickness of the mattress, and the presence of vertical connecting elements between the mattress lid and bottom.

Keywords: Reno Mattress, riverbank protection, hydraulics, full scale tests

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Authors: Tamaz Mdzinarashvili, Mariam Khvedelidze, Eka Shekiladze, Salome Chinchaladze, Mariam Mdzinarashvili

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The work is about the preparation of calcium-containing 1,2-Dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and 1,2-Dipalmitoyl-sn-glycero-3-phosphatidic acid (DPPA) and their calorimetric study. In order to prepare these complex liposomes, for the first stage it is necessary for ligands and lipids to directly interact, followed by the addition of pH-buffered water or solvent at temperatures slightly above the liposome phase transition temperature. The resulting mixture is briefly but vigorously shaken and then transformed into liposomes of the desired size using an extruder. Particle sizing and calorimetry were used to evaluate liposome formation. We determined the possible structure of calcium-containing liposomes made by our new technology and determined their thermostability. The paper provides calculations showing how many phospholipid molecules are required to make a 200 nm diameter liposome. Calculations showed that 33x10³ lipid molecules are needed to prepare one DPPA and DPPC liposome. Based on the calorimetric experiments, we determined that the structure of uncomplexed DPPA liposomes is unilaminar (one double layer), while DPPC liposome is a nanoparticle with a multilaminar (multilayer) structure. This was determined by the cooperativity of the heat absorption peak. Calorimetric studies of calcium liposomes made by our technology showed that calcium ions are placed in the multilaminar structure of the DPPC liposome. Calcium ions also formed a complex in the DPPA liposome structure, moreover, calcium made the DPPA liposome multilaminar, since the cooperative narrow heat absorption peak was transformed into a three-peak heat absorption peak. Since both types of liposomes in complex with calcium ions present a multilaminar structure, where the number of lipid heads in one particle is large, the number of calcium ions in one particle will also be increased. That makes it possible to use these nanoparticles as transporters of a large amount of calcium ions in a living organism.

Keywords: calcium, liposomes, thermodynamic parameters, calorimetry

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Authors: Tomohiko Utsuki

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Currently, brain resuscitation becomes increasingly important due to revising various clinical guidelines pertinent to emergency care. In brain resuscitation, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) is required for stabilizing physiological state of brain, and is described as the essential treatment points in many guidelines of disorder and/or disease such as brain injury, stroke, and encephalopathy. Thus, an integrated control system of BT, ICP, and CBF will greatly contribute to alleviating the burden on medical staff and improving treatment effect in brain resuscitation. In order to develop such a control system, models related to BT, ICP, and CBF are required for control simulation, because trial and error experiments using patients are not ethically allowed. A static model of cerebral blood circulation from intracranial arteries and vertebral artery to jugular veins has already constructed and verified. However, it is impossible to represent the pooling of blood in blood vessels, which is one cause of cerebral hypertension in this model. And, it is also impossible to represent the pulsing motion of blood vessels caused by blood pressure change which can have an affect on the change of cerebral tissue pressure. Thus, a dynamic model of cerebral blood circulation is constructed in consideration of the elasticity of the blood vessel and the inertia of the blood vessel wall. The constructed dynamic model was numerically analyzed using the normal data, in which each arterial blood flow in cerebral blood circulation, the distribution of blood pressure in the Circle of Willis, and the change of blood pressure along blood flow were calculated for verifying against physiological knowledge. As the result, because each calculated numerical value falling within the generally known normal range, this model has no problem in representing at least the normal physiological state of the brain. It is the next task to verify the accuracy of the present model in the case of disease or disorder. Currently, the construction of a migration model of extracellular fluid and a model of heat transfer in cerebral tissue are in progress for making them parts of an integrated model of brain physiological state, which is necessary for developing an future integrated control system of BT, ICP and CBF. The present model is applicable to constructing the integrated model representing at least the normal condition of brain physiological state by uniting with such models.

Keywords: dynamic model, cerebral blood circulation, brain resuscitation, automatic control

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Authors: Ira Joseph

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The LNG paradox addresses the issue of how the most expensive form of gas supply, which is LNG, will grow in an end user market where demand is most competitive, which is power generation. In this case, LNG demand growth is under siege from two entirely different directions. At one end is price; it will be extremely difficult for gas to replace coal in Asia due to the low price of coal and the age of the generation plants. Asia's coal fleet, on average, is less than two decades old and will need significant financial incentives to retire before its state lifespan. While gas would cut emissions in half relative to coal, it would also more than double the price of the fuel source for power generation, which puts it in a precarious position. In most countries in Asia other than China, this cost increase, particularly from imports, is simply not realistic when it is also necessary to focus on economic growth and social welfare. On the other end, renewables are growing at an exponential rate for three reasons. One is that prices are dropping. Two is that policy incentives are driving deployment, and three is that China is forcing renewables infrastructure into the market to take a political seat at the global energy table with Saudi Arabia, the US, and Russia. Plus, more renewables will lower import growth of oil and gas in China, if not end it altogether. Renewables are the predator at the gate of gas demand in power generation and in every year that passes, renewables cut into demand growth projections for gas; in particular, the type of gas that is most expensive, which is LNG. Gas does have a role in the future, particularly within a domestic market. Once it crosses borders in the form of LNG or even pipeline gas, it quickly becomes a premium fuel and must be marketed and used this way. Our research shows that gas will be able to compete with batteries as an intermittency and storage tool and does offer a method to harmonize with renewables as part of the energy transition. As a baseload fuel, however, the role of gas, particularly, will be limited by cost once it needs to cross a border. Gas converted into blue or green hydrogen or ammonia is also an option for storage depending on the location. While this role is much reduced from the primary baseload role that gas once aspired to land, it still offers a credible option for decades to come.

Keywords: natural gas, LNG, demand, price, intermittency, storage, renewables

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Authors: Muhammad Asim, Mehvish Amjad

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Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, modern contraceptive use, South Asia, socio economic status

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Authors: Gebeyaw Molla Wondim, Damen Haile Mariam, Wubegzier Mekonnen, Catherine Arsenault

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Introduction: Maternal depression is a common psychological disorder that mostly occurs during pregnancy and after childbirth. It affects approximately one in four women worldwide. There is inconsistent evidence regarding the association between anemia and maternal depression. The objective of this systematic review was to examine the association between anemia and depression during pregnancy. Method: A comprehensive search of articles published before March 8, 2024, was conducted in seven databases such as PubMed, Scopus, Web of Science, PsycINFO, CINAHL, Cochrane Library, and Google Scholar. The Boolean operators “AND” or “OR” and “NOT” were used to connect the MeSH terms and keywords. Rayyan software was used to screen articles for final retrieval, and the PRISMA diagram was used to show the article selection process. Data extraction and risk bias assessment were done by two reviewers independently. JBI critical appraisal tool was used to assess the methodological quality of the retrieved articles. Heterogenicity was assessed through visual inspection of the extracted result, and narrative analysis was used to synthesize the result. Result: A total of 2,413 articles were obtained from seven electronic databases. Among these articles, a total of 2,398 were removed due to duplication (702 articles), by title and abstract selection criteria (1,678 articles), and by full-text review (18 articles). Finally, in this systematic review, 15 articles with a total of 628,781 pregnant women were included: seven articles were cohort studies, two were case-control, and six studies were cross-sectional. All included studies were published between 2013 and 2022. Studies conducted in the United States, South Korea, Finland, and one in South India found no significant association between anemia and maternal depression during pregnancy. On the other hand, studies conducted in Australia, Canada, Finland, Israel, Turkey, Vietnam, Ethiopia, and South India showed a significant association between anemia and depression during pregnancy. Conclusion: The overall finding of the systematic review shows the burden of anemia and antenatal depression is much higher among pregnant women in developing countries. Around three-fourths of the studies show that anemia is positively associated with antenatal depression. Almost all studies conducted in LMICs show anemia positively associated with antenatal depression.

Keywords: pregnant, women, anemia, depression

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Authors: Zahra Fotovatnia, Jeffery A. Jones, Alexandra Gottardo

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Speech communication often occurs in environments where noise conceals part of a message. Listeners should compensate for the lack of auditory information by picking up distinct acoustic cues and using semantic and sentential context to recreate the speaker’s intended message. This situation seems to be more challenging in a nonnative than native language. On the other hand, early bilinguals are expected to show an advantage over the late bilingual and monolingual speakers of a language due to their better executive functioning components. In this study, English monolingual speakers were compared with early and late nonnative speakers of English to understand speech in noise processing (SIN) and the underlying neurobiological features of this phenomenon. Auditory mismatch negativities (MMNs) were recorded using a double-oddball paradigm in response to a minimal pair that differed in their middle vowel (beat/bit) at Wilfrid Laurier University in Ontario, Canada. The results did not show any significant structural and electroneural differences across groups. However, vocabulary knowledge correlated positively with performance on tests that measured SIN processing in participants who learned English after age 6. Moreover, their performance on the test negatively correlated with the integral area amplitudes in the left superior temporal gyrus (STG). In addition, the STG was engaged before the inferior frontal gyrus (IFG) in noise-free and low-noise test conditions in all groups. We infer that the pre-attentive processing of words engages temporal lobes earlier than the fronto-central areas and that vocabulary knowledge helps the nonnative perception of degraded speech.

Keywords: degraded speech perception, event-related brain potentials, mismatch negativities, brain regions

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Authors: Charles Iledun Oyewole

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The daunting challenge that the ‘man with the hoe’ is going to face in the coming decades will be complex and interwoven. With global population already above 7 billion people, it has been estimated that food (crop) production must more than double by 2050 to meet up with the world’s food requirements. Nigeria population is also expected to reach over 240 million people by 2050, at the current annual population growth of 2.61 per cent. The country’s farming population is estimated at over 65 per cent, but the country still depends on food importation to complement production. The small scale farmer, who depends on simple hand tools: hoes and cutlasses, remains the centre of agricultural production, accounting for 90 per cent of the total agricultural output and 80 per cent of the market flow. While the hoe may have been a tool for sustainable development at a time in human history, this role has been smothered by population growth, which has brought too many mouths to be fed (over 170 million), as well as many industries to fuel with raw materials. It may then be argued that the hoe is unfortunately not a tool for the coming challenges and that agricultural mechanization should be the focus. However, agriculture as an enterprise is a ‘complete wheel’ which does not work when broken, particularly, in respect to mechanization. Generally, mechanization will prompt increase production, where land is readily available; increase production, will require post-harvest handling mechanisms, crop processing and subsequent storage. An important aspect of this is readily available and favourable markets for such produce; fuel by good agricultural policies. A break in this wheel will lead to the process of mechanization crashing back to subsistence production, and probably reversal to the hoe. The focus of any agricultural policy should be to chart a course for sustainable mechanization that is environmentally friendly, that may ameliorate Nigeria’s food and raw material gaps. This is the focal point of this article.

Keywords: Crop production, Farmer, Hoes, Mechanization, Policy framework, Population, Growth, Rural areas

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Authors: Dmitry Nosik, Nickolay Nosik, Elli Kaplina, Olga Lobach, Marina Chataeva, Lev Rasnetsov

Abstract:

Background and aims: Human Immunodeficiency Virus (HIV) infection is very often associated with Herpes Simplex Virus (HSV) infection but HIV patients are treated with a cocktail of antiretroviral drugs which are toxic. The use of an antiviral drug which will be active against both viruses like ferrovir found in our previous studies is rather actual. Earlier we had shown that Fullerene poly-amino capronic acid (FPACA) was active in case of monoinfection of HIV-1 or HSV-1. The aim of the study was to analyze the efficiency of FPACA against mixed infection of HIV and HSV. Methods: The peripheral blood lymphocytes, CEM, MT-4 cells were simultaneously infected with HIV-1 and HSV-1. FPACA was added 1 hour before infection. Cells viability was detected by MTT assay, virus antigens detected by ELISA, syncytium formation detected by microscopy. The different multiplicity of HIV-1/HSV-1 ratio was used. Results: The double viral HIV-1/HSV-1 infection was more cytopathic comparing with monoinfections. In mixed infection by the HIV-1/HSV-1 concentration of HIV-1 antigens and syncytium formations increased by 1,7 to 2,3 times in different cells in comparison with the culture infected with HIV-1 alone. The concentration of HSV-1 increased by 1,5-1,7 times, respectively. Administration of FPACA (1 microg/ml) protected cells: HIV-1/HSV-1 (1:1) – 80,1%; HIV-1/HSV-1 (1:4) – 57,2%; HIV-1/HSV-1 (1:8) – 46,3 %; HIV-1/HSV-1 (1:16) – 17,0%. Virus’s antigen levels were also reduced. Syncytium formation was totally inhibited in all cases of mixed infection. Conclusion: FPACA showed antiviral activity in case of mixed viral infection induced by Human Immunodeficiency Virus and Herpes Simplex Virus. The effect of viral inhibition increased with the multiplicity of HIV-1 in the inoculum. The mechanism of FPACA action is connected with the blocking of the virus particles adsorption to the cells and it could be suggested that it can have an antiviral activity against some other viruses too. Now FPACA could be considered as a potential drug for treatment of HIV disease complicated with opportunistic herpes viral infection.

Keywords: antiviral drug, human immunodeficiency virus (hiv), herpes simplex virus (hsv), mixed viral infection

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Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

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Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

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Authors: Wai Sang Wu, Florence Pik Sze Mok

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Introduction: Ageing population is one of the hot topics nowadays in the world and this phenomenon is believed to exacerbate continuously in the future. According to the latest information from World Health Organization (WHO) in 2016, the proportion of people aged more than 60 years is projected to be doubled from 12% in 2015 to 22% in 2050 of the world's population. Similarly, according to figures released by the Census and Statistic Department of Hong Kong in 2015, the contribution of elderly aged more than 65 years olds is projected to increase from 15% in 2014 to 34% in 2064 in local community. On the other hand, falls in elderly is a common problem, and it can bring along many negative consequences among elders, such as reducing their mobility level as well as their quality of life. In addition, it can also increase the caring stress of their family caregivers and as well increase the reliance and burden on the medical care system of Hong Kong. Therefore, appropriate measures should be implemented in order to minimize the risk of fall among elders. The objective of this study is to evaluate the effectiveness of the chair-based exercise programme in affecting the balance of the elderly in Hong Kong. Methods: Thirteen healthy subjects (males = 2; females = 11; mean age: 76.2 ± 7.8 years old) were recruited from an elderly social centre in the community to participate in a structural chair-based exercise programme for 6 weeks (1 session per week; 60-minutes per session). Subjects were being assessed on their balance ability using three commonly used clinical assessments, namely, 1) single leg stance (SLS) test, 2) functional reach test, and 3) 360-degree turn test, before and after their participation in the chair-based exercise programme. Pre and post within-subject comparison was adopted to assess the effectiveness of the programme. Results: There was significant improvement (p < 0.05) in all balance parameters of the subjects after their participation in the exercise programme. Elderly demonstrated significant improvement in SLS (p < 0.012), functional reach (p < 0.030) and 360 degree turn (p < 0.043). Conclusions: This study showed that a community chair-based exercise programme is effective in improving the balance ability of the elders. It seems to be another exercise regime that should be promoted among the elders in order to minimize their risk of falls and its negative consequence.

Keywords: balance, chair-based exercise programme, community, elderly

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Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

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Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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Authors: B. Yermekbayeva, A. Gulyayaev, T. Nurgozhin, C. Bektur

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Cytisine aminophosphonate under the name "Cytafat" was approved for clinical trials in Republic of Kazakhstan as a putative liver protecting drug for the treatment of acute toxic hepatitis. A method of conducting the clinical trial is a double blind study. Total number of patients -71, aged from 16 to 56 years. Research on healthy volunteers determined the maximal tolerable doze of "Cytafat" as 200 mg/kg. Side effects when administered at high dozes (100-200 mg/kg) are tachycardia and increase of arterial blood pressure. The drug is tested in the treatment of 28 patients with a syndrome of hepatocellular failure (a poisoning with substitutes of alcohol, rat poison, or medical products). "Cytafat" was intravenously administered at a dose of 10 mg/kg in 200 ml of 5 % glucose solution once daily. The number of administrations: 1-3. In the comparison group, 23 patients were treated intravenously once a day with “Essenciale H” at a dose of 10 ml. 20 patients received a placebo (10 ml of glucose intravenously). In all cases of toxic hepatopathology the significant positive clinical effect of the testing drug distinguishable from placebo and surpassing the alternative was observed. Within a day after administration a sharp reduction of cytolitic syndrome parameters (ALT, AST, alkaline phosphatase, thymol turbidity test, GGT) was registered, a reduction of the severity of cholestatic syndrome (bilirubin decreased) was recorded, significantly decreased indices of lipid peroxidation. The following day, in all cases the positive dynamics was determined with ultrasound study (reduction of diffuse changes and events of reactive pancreatitis), hepatomegaly disappeared. Normalization of all parameters occurred in 2-3 times faster, than when using the drug "Essenciale H" and placebo. Average term of elimination of toxic hepatopathy when using the drug "Cytafat" -2,8 days, "Essenciale H" -7,2 days, and placebo -10,6 days. The new drug "Cytafat" has expressed cytoprotective properties.

Keywords: cytisine, cytoprotection, hepatopathy, hepatoprotection

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Authors: Catarina Isabel Ramos Pereira, Jorge Machado, Begona Alonso Criado, Maria João Santos

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Introduction: Gait disorders are one of the symptoms that have severe implications on the quality of life in Parkinson's disease (PD). Currently, there is no therapy to reverse or treat this condition. None of the drugs used in conventional medical treatment is entirely efficient, and all have a high incidence of side effects. Acupuncture treatment is believed to improve motor ability, but there is still little scientific evidence in individuals with PD. Aim: The aim of the study is to investigate the acute effect of acupuncture on gait parameters in Parkinson's disease. Methods: This is a randomized and controlled crossover study. The same individual patient was part of both the experimental (real acupuncture) and control group (false acupuncture/sham), and the sequence was randomized. Gait parameters were measured at two different moments, before and after treatment, using four force platforms as well as the collection of 3D markers positions taken by 11 cameras. Images were quantitatively analyzed using Qualisys Track Manager software that let us extract data related to the quality of gait and balance. Seven patients with the diagnosis of Parkinson's disease were included in the study. Results: Statistically significant differences were found in gait speed (p = 0.016), gait cadence (p = 0.006), support base width (p = 0.0001), medio-lateral oscillation (p = 0.017), left-right step length (p = 0.0002), and stride length: right-right (p = 0.0000) and left-left (p = 0.0018), time of left support phase (p = 0.029), right support phase (p = 0.025) and double support phase (p = 0.015), between the initial and final moments for the experimental group. Differences in right-left stride length were found for both groups. Conclusion: Our results show that acupuncture could enhance gait in Parkinson's disease patients. Deep research involving a larger number of volunteers should be accomplished to validate these encouraging findings.

Keywords: acupuncture, traditional Chinese medicine, Parkinson's disease, gait

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Liliana Rytel, Jarosław Całka

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One of the diseases that are very common health problem of modern man is the stomach hyperacidity. It is well known that this pathological state, during which gastric glands secrete too much of hydrochloric acid can be caused due to various factors such as stress, eating habits, alcohol, smoking and some, especially anti-inflammatory drugs. Moreover, hyperacidity is recognized as one of factors leading to development of peptic ulcer disease. Therefore, we analyzed expression of substance P (SP) and neuronal isoform of nitric oxide synthase (nNOS) in the porcine nodose ganglion sensory neurons innervating prepyloric stomach region in physiological state and following intragastric infusion of hydrochloric acid. The study was performed on 8 immature gilts of the Large White Polish breed. All animals were injected retrograde marker Fast Blue (FB) into the anterior prepyloric stomach wall. After injections of FB, pigs were divided into two groups: control (group C; n = 4) and experimental (HCL group, n = 4) and after convalescence period of 23 days, animals of HCL group were subjected to renewed anaesthesia. Then, 0.25 M aqueous solution of hydrochloric acid with a dose of 5 ml/kg body weight was administered intragastrically with use of a stomach tube. On 28th day, all control and HCL pigs were euthanized and bilateral reght (rNG) and left (lNG) were collected. Cryostat sections were processed for double immunofluorescence using anibodies against SP and NOS. Immunofluorescence staining in the even-numbered ganglia nodes showed the presence of FB-positive cells expressing SP (45,9 ± 3,38% in rNG and 60,4 ± 1,71% in lNG), and nNOS (34,9 ± 6,83% in rNG and 49,9 ± 9,32% in lNG). In HCL group increased expression of both SP (54,8 ± 5,34% in rNG and 56,9 ± 3,28 % in lNG) as well as nNOS (54,9 ± 4,45% in rNG and 52,5 ± 2,17 % in lNG) in FB+ perikaria was found. The acquired results suggest that SP and nNOS are neurotransmitters and/ or neuromodulators participating in the sensory regulation of the prepyloric region of porcine stomach function as well as their potential role in development of the stomach inflamatory state.

Keywords: nNOS, nodose ganglion, pig, SP

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Katharina Kargel, Frederic Vobbe

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Sexualized violence against children and adolescents using digital media poses particular challenges for practitioners with a focus on crisis intervention (social work, psychotherapy, law enforcement). The technical delimitation of violence increases the burden on those affected and increases the complexity of interdisciplinary cooperation. Urgently needed recommendations for practical action do not yet exist in Germany. Funded by the Federal Ministry of Education and Research, these recommendations for action are being developed in the HUMAN project together with science and practice. The presentation introduces the participatory approach of the HUMAN project. We discuss the application-oriented, casuistic approach of the project and present its results using the example of concrete case-based recommendations for Action. The participants will be presented with concrete prototypical case studies from the project, which will be used to illustrate quality criteria for crisis intervention in cases of sexualized violence using digital media. On the basis of case analyses, focus group interviews and interviews with victims of violence, we present the six central challenges of sexualized violence with the use of digital media, namely: • Diffusion (Ambiguities regarding the extent and significance of violence) , • Transcendence (Space and time independence of the dynamics of violence, omnipresence), • omnipresent anxiety (considering diffusion and transcendence), • being haunted (repeated confrontation with digital memories of violence or the perpetrator), • disparity (conflicts of interpretative power between those affected and the social environment) • simultaneity (of all other factors). We point out generalizable principles with which these challenges can be dealt with professionally. Dealing professionally with sexualized violence using digital media requires a stronger networking of professional actors. A clear distinction must be made between their own mission and the mission of the network partners. Those affected by violence must be shown options for crisis intervention in the context of the aid networks. The different competencies and the professional mission of the offers of help are to be made transparent. The necessity of technical possibilities for deleting abuse images beyond criminal prosecution will be discussed. Those affected are stabilized by multimodal strategies such as a combination of rational emotive therapy, legal support and technical assistance.

Keywords: sexualized violence, intervention, digital media, children and youth

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Authors: Hong Li, Haiyang Yu, Shiqing Cheng, Nai Cao, Zhiliang Shi

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Unconventional resources have gradually become the main direction for oil and gas exploration and development. However, the productivity of gas wells, the level of water production, and the seepage law in tight fractured gas reservoirs are very different. These are the reasons why production prediction is so difficult. Firstly, a three-dimensional multi-scale fracture and multiphase mathematical model based on an embedded discrete fracture model (EDFM) is established. And the material balance method is used to calculate the water body multiple according to the production performance characteristics of water-producing gas well. This will help construct a 'virtual water body'. Based on these, this paper presents a numerical simulation process that can adapt to different production modes of gas wells. The research results show that fractures have a double-sided effect. The positive side is that it can increase the initial production capacity, but the negative side is that it can connect to the water body, which will lead to the gas production drop and the water production rise both rapidly, showing a 'scissor-like' characteristic. It is worth noting that fractures with different angles have different abilities to connect with the water body. The higher the angle of gas well development, the earlier the water maybe break through. When the reservoir is a single layer, there may be a stable production period without water before the fractures connect with the water body. Once connected, a 'scissors shape' will appear. If the reservoir has multiple layers, the gas and water will produce at the same time. The above gas-water relationship can be matched with the gas well production date of the Xujiahe gas reservoir in the Sichuan Basin. This method is used to predict the productivity of a well with hydraulic fractures in this gas reservoir, and the prediction results are in agreement with on-site production data by more than 90%. It shows that this research idea has great potential in the productivity prediction of water-producing gas wells. Early prediction results are of great significance to guide the design of development plans.

Keywords: EDFM, multiphase, multilayer, water body

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