Search results for: afghan women

Authors: Clarisse Umutoni, Augustine Ayantunde, Matthew Turner, Germain J. Sawadogo

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Decentralized governance of natural resources is considered one of the key strategies for promoting sustainable management of natural resources at local level. The rationale behind decentralization of natural resources is that local populations are both better situated and more highly motivated than outside agencies to manage the resources in an ecologically and economically sustainable manner. Effective decentralized natural resource management requires strong local natural resource institutions. Therefore, strengthening local institutions governing natural resource management is essential to promoting strong participation of local communities in managing their resources. This paper investigated the existing local institutions (rules, norms and or local conventions) governing the management of natural resources and forms of community participation in the development of these natural resource institutions. Group discussions and individual interviews were conducted to collect data. Our findings showed significant variation within the study sites regarding the level of knowledge of existing local rules and norms governing the management of natural resources by the respondents. The results also show that participation was dominated by a small group of individuals, often community leaders and elites. The results suggest that women are marginalized. In general, factors which influence the level of participation include; age, year of residence in the community, gender and education level. This study also highlights the strengths of local natural resource institutions especially if enforced. Presently, the big challenge that faces the institutions governing natural resource use in the study area is the system of representativeness in the community in the development of local rules and norms as community leaders and household heads often dominate, which does not encourage active participation of community members. Therefore, for effective implementation of local natural resource institutions, the interest of key natural resource users should be taken into account. It is also important to promote rules and norms that attempt to protect or strengthen women’s access to natural resources in the community.

Keywords: decentralization, land use plan, local institutions, Mali

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Authors: Mohammad Zakir, Saamia Shams

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Background: Provision of quality family planning services remarkably contribute towards increased uptake of modern contraceptive methods and have important implications on reducing fertility rates. The quality of care in family planning has beneficial impact on reproductive health of women, yet little empirical evidence is present to show the relationship between the impact of adequate training of Community Mid Wives (CMW) and quality family planning services. Aim: This study aimed to enhance the knowledge and counseling skills of CMWs in improving the access to quality client-centered family planning services in Pakistan. Methodology: A quasi-experimental longitudinal study using Initial Quality Assurance Scores-Training-Post Training Quality Assurance Scores design with a non- equivalent control group was adopted to compare a set of experimental CMWs that received four days training package including Family Planning Methods, Counselling, Communication skills and Practical training on IUCD insertion with a set of comparison CMWs that did not receive any intervention. A sample size of 100 CMW from Suraj Social Franchise (SSF) private providers was recruited from both urban and rural Pakistan. Results: Significant improvement in the family planning knowledge and counseling skills (p< 0.001) of the CMWs was evident in the experimental group as compared to comparison group with p > 0.05. Non- significant association between pre-test level family planning knowledge and counseling skills was observed in both the groups (p>0.05). Conclusion: The findings demonstrate that adequate training is an important determinant of quality of family planning services received by clients. Provider level training increases the likelihood of contraceptives uptake and decreases the likelihood of both unintended and unwanted pregnancies. Enhancing quality of family planning services may significantly help reduce the fertility and improve the reproductive health indicators of women in Pakistan.

Keywords: community mid wives, family planning services, quality of care, training

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Authors: Sabika Khalid, Endale Fantahun Tadesse

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Unlike other professional sectors, a great deal of studies has addressed the overwhelming gender disparity phenomena in the early childhood education (ECE) workforce, which is acknowledged for the dominance of women over men teachers. The irony of ECE being a gendered working environment is not only observed in societies that are ruled by gender roles but also in Western countries that claim to margin the gender gap in several professions. The participation of male teachers in ECE across most countries ranged from 1% to 3% of the total preschool or kindergarten teachers. When it comes to a dynamic Chinese society tempered with a deep-rooted tradition and cultural ideology, the ECE has no less place for males, and males have a low place for ECE. According to the Ministry of Education of China (2020), there are over 5 million kindergarten teachers and staff members, while only 2.3% are accounted for male teachers. The traditional gender-based discourse asserts that giving care and guidance for young children related to nurturing ‘mothering’ labels the profession in ECE as women’s work derived from originated from their ‘naturality.’ Although a large volume of evidence sheds light on the cause for low male teachers, the perception of parents, female teachers working with male teachers, and the experience of male teachers working in ECE, less is known and understood before being a teacher. Hence, this study argues that the promotion of the involvement of male teachers in light of their masculinity identity asset in the children's learning environment is comprehended to understand the construction of male student teachers' (preservice) professional identity during early childhood teacher training that allows obtaining substantial evidence that provides a feasible and robust implication in the preparation of competent and professional male preschool teachers that understand, cherish, and bring harmony in Chinese ECE through professionalism socialization with the stakeholders. This study intended to reveal male ECE preservice teachers’ knowledge of their professional identity, i.e., how they perceive themselves as a teacher and what factors agents these perceptions towards their professional identity.

Keywords: male teachers, Early Childhood Education (ECE), self-identity, perception of stakeholders

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Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett

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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.

Keywords: appalachia, CBT, opiods, pregnancy

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Authors: F. Berahmandpour, K. Bagheri

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Introduction: Spirulina is nutritious blue - green algae which are used as supplement or a preservative in many foods. The studies about the algae argue that the Spirulina can improve immune system, increase fat utilization, reduce oxidative stress and promote endurance at high-intensity exercise. The purpose of study is to assess the effects of Spirulina supplement on healthy weight control. Method: the study is a cross-sectional study which had 30 participants. The participants were men and women who referred to the nutrition and diet therapy clinic (in west of Tehran / Iran) for control weight. The sampling was a purposeful sampling. The participants were divided into three groups, and they were surveyed for 4 weeks. In the first group, 10 participants were used Spirulia supplement (dose: 500mg of Spiruvit Supplement as tablet / 3 times per day) without any special diet. The second group was 10 participants who received Spirulia supplement (dose 500mg of Spiruvit Supplement as tablet / 3 times per day) with a weight loss exercise program and without any special diet. The third group was 10 participants who used Spirulia supplement (dose 500mg of Spiruvit Supplement as tablet / 3 times per day) with an optimum weight loss diet. Results and Discussion: The results show that there were not any significant loss weights in first group. In while, the participants of second group argued that the Spirulina supplement had positive effects on their mud and physical body; however the clinical results showed that the loss weight had fixed tilt in this group. The significant results of study were related to the third group, because the participations could continuous loss weight during 4 weeks. However, the optimum weight loss diets were effective effects on weight loss in this group, but the researchers found that Spirulina supplement could improve loss weight with set of hormonal system (especially in women with menopause). Conclusion: The study is concluded that the Spirulina as a supplement (Spiruvit Supplement) can be an effective effect on healthy weight control, if it is used with a nutritious healthy weight loss diet. In fact, the effect of Spirulina can be related to powerful antioxidant effects and improvable hormonal system in the body.

Keywords: diet, healthy weight control, spirulina, spiruvit supplement

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Authors: Munaza Mubeen

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The colonial Urdu literature has played a significant role in uplifting the overall status of the Indians. Taking example of the Bhopal State, the contribution of the Royal ladies holds no match in the contemporary age. Similarly, the efforts of the Begamat-e-Bhopal in the field of education had been acknowledged across the Sub-continent. It had been noticed that with the downfall of the Mughal Empire at the hands of the British Raj, the local culture in the Indian sub-continent in general and in Bhopal State in proper got deteriorated. This led to uncertainty, chaos and an anti-British sentiment which created hatred against them in the entire sub-continent. Likely, in Bhopal State, the role of women in field of education also vanished. However, this change was felt by the ladies in the Royal Household where they struggled for restoration of the status quo with their personal efforts. The prominent contributors from the Royal household included Qudseya Begum, Nawab Sikander Begum, Nawab Shah Jahan Begum and Nawab Sultan Johan-they are known as Begamat-i-Bhopal. They established schools, colleges and universities to impart formal and non-formal education respectively. Their systematic approach and continued efforts constituted a dynamic aspect of women’ empowerment. Focused on the female education, however, one of the by-products of their efforts was an introduction of socio-cultural and politico-religious awareness among the middle class womenfolk. Unfortunately, the role of these Bagamat-i-Bhopal has been left untouched or ignored by the academic scholars. This study critically analyzed the role of Beghamat-i-Bhopal regarding female education in Hindustan in general and in Bhopal in particular. Similarly, the contribution of the contemporary writers in development of female education in Bhopal has also been discussed in this paper. This paper is based on the 'historico-textual' approach following structural reason which has established a justifiable argument. The researcher, therefore, has taken into consideration all the chronological nuances in order to accord greater visibility to the contents. The data has been described, analyzed and interpreted inclusively and in generalized manner.

Keywords: colonialism, Begamaat e Bhopal, female education, State of Bhopal

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Authors: Dragan Zivotic, Mirjana Ilic, Aleksandra Perovic, Predrag Gavrilovic

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As with the provision of other services, the service quality perception is one of the key factors that the modern manager must pay attention to. Countries in which the state regulation is in transition also have specific features in providing fitness services. Identification of the dimensions in which the most significant different service quality perception between different types of fitness centers, enables managers to profile the offer according to the wishes and expectations of users. The aim of the paper was the comparison of the quality of services perception in the field of fitness in Serbia between three categories of fitness centers: the privately owned centers, the publicly owned centers, and the Public-private partnership centers. For this research 350 respondents of both genders (174 men and 176 women) were interviewed, aged between 18 and 68 years, being beneficiaries of fitness services for at least 1 year. Administered questionnaire with 100 items provided information about the 15 basic areas in which they expressed the service quality perception in the gym. The core sample was composed of 212 service users in private fitness centers, 69 service users in public fitness centers and 69 service users in the public-private partnership. Sub-samples were equal in representation of women and men, as well as by age and length of use of fitness services. The obtained results were subject of univariate analysis with the Kruskal-Wallis non-parametric analysis of variance. Significant differences between the analyzed sub-samples were not found solely in the areas of rapid response and quality outcomes. In the multivariate model, the results were processed by backward stepwise discriminant analysis that extracted 3 areas that maximize the differences between sub-samples: material and technical basis, secondary facilities and coaches. By applying the classification function 93.87% of private centers services users, 62.32% of public centers services users and 85.51% of the public-private partnership centers users of services were correctly classified (total 86.00%). These results allow optimizing the allocation of the necessary resources in profiling offers of a fitness center in order to optimally adjust it to the user’s needs and expectations.

Keywords: fitness, quality perception, management, public ownership, private ownership, public-private partnership, discriminative analysis

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Authors: Jaqueline Bohn Donada

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The significance of Euripides’ Medea for contemporary literature is noticeable. Even if the bulk of Classical Reception studies does not tend to look carefully and consistently to the literature produced outside the Anglophone world, Brazilian literature offers abundant materials for such studies. Indeed, a certain Classical background can be observed in Brazilian literature at least since 1975 when Gota d’Água [The Final Straw, in English], a play that recreates the story of Medea and sets it in a favela in Rio de Janeiro. Also worthy of notice is Ivo Bender’s Trilogia Perversa [Perverse Trilogy, in English], a series of three historical plays set in Southern Brazil and based on Aeschylus’ Oresteia and on Euripides’ Iphigenia in Aulis published in the 1980s. Since then, a number of works directly inspired by the plays of Aeschylus, Sophocles and Euripides have been published, not to mention several adaptations of Homer’s two epic poems. This paper proposes a comparative analysis of two such works: Grace Passô’s 2017 play Mata teu Pai [Kill your father, in English] and Marcia Lima’s 2019 play Medeia Negra [Black Medea, in English] from the perspective of Classical Reception Studies in an intersection with feminist literary criticism. The paper intends to look at the endurance of Euripides’ character in contemporary Brazilian literature with a focus on how the character seems to have acquired special relevance to the treatment of pressing issues of the twenty-first century. Whereas Grace Passô’s play sets Medea at the center of a group of immigrant women, Marcia Limma has the character enact the dilemmas of incarcerated women in Brazil. The hypothesis that this research aims at testing is that both artists preserve the pathos of Euripides’s original character at the same time that they recreate his Medea in concrete circumstances of Brazilian contemporary social reality. At the end, the research aims at stating the significance of the Medea theme to contemporary Brazilian literature.

Keywords: Euripides, Medea, Grace Passô, Marcia Limma, Brazilian literature

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Authors: Doua AlSaad, Ahmed Awaisu, Samah Elsalem, Palli Valapila Abdulrouf, Binny Thomas, Moza AlHail

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Background: It has been suggested that pyridoxine has an anti-lactogenic effect. Studies of the efficacy of pyridoxine in suppressing lactation have reported conflicting results. The aim of this review is to evaluate the effectiveness and safety of high-dose pyridoxine in postpartum lactation inhibition. Methods: This systematic review included published trials that compared the efficacy and/or safety of pyridoxine to placebo or to other pharmacological agents for the inhibition of postpartum lactation. We searched PubMed, Embase, ScienceDirect, CINAHL, AMED, the Cochrane library, and the clinical trials registry to identify relevant literature. No limit was imposed on the year of publication of the studies, and the review included studies published until 15 January 2016. Two reviewers independently extracted data and assessed the risk of bias. Results: Seven studies were included, with a total of 1155 women, of which 471 women received pyridoxine. Three studies were randomized controlled trials, while the remaining four studies were non-randomized controlled trials. All of the included studies were relatively small (n = 18 – 482). The studies compared pyridoxine with placebo, bromocriptine, and/or stilboestrol. Pyridoxine was given orally, with a total daily dose of 450 – 600 mg for 5 to 7 days. Two trials (n = 349 participants) indicated that pyridoxine was effective in inhibiting lactation in approximately 95% of the enrolled patients. All other studies failed to demonstrate pyridoxine efficacy through either clinical assessment or prolactin level measurements. Pyridoxine safety was assessed by two trials in which no serious untoward side-effects were reported. Overall, the risk of bias for most of the studies was low to moderate. Conclusion: Current evidence supporting the effectiveness of high dose pyridoxine in the inhibition of postpartum lactation is inconsistent and insufficient. Larger randomized trials are needed to confirm the efficacy of pyridoxine in postpartum lactation inhibition. Acknowledgment: This review received a grant from the Medical Research Center of Hamad Medical Corporation in Qatar (grant number: 15100/15).

Keywords: pyridoxine, safety, effectiveness, lactation inhibition

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Authors: Afolabi Comfort Yemisi

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Gender-based violence remains a serious threat to the growth, health, and safety of women and girls globally, including Nigeria. The rising violence of various shades of violence, especially against women and girls in the guise of cultural preservation, raised serious concerns. The challenge of this harmful gender narrative is more critical in attaining the Sustainable Development Goals and Goal 4 (Quality Education) in Nigeria. The study investigated the perception and effects of gender-based violence on sustainable development and education of the girl-child in Southwestern Nigeria. Primary and Secondary data were used for the study. Primary data were obtained using a structured questionnaire administered to young females in tertiary institutions, secondary schools, non-governmental organizations, and government institutions dealing with gender-based violence in the study area, while the secondary data were sourced from journals, books and dailies. A multistage random sampling technique was employed to select a sample of 360 respondents who completed the questionnaire for the study. Descriptive statistics and regression analysis were applied to the data collected. The result revealed a high prevalence of gender-based violence, and it was perceived to be culturally motivated. Sexual violence, sexual harassment and psychological violence were the significant forms of gender-based violence that adversely affected the Sustainable Development Goal 4. The result further revealed that loss of concentration, shame and depression, school drop-out, poor academic performance and inferiority complex were the major effects of gender-based violence on the education of girl-child in the study area. The study recommended that to avert catastrophic damages and adverse effects of gender-based violence on the girl-child, there is a need for thorough awareness and sensitization programmes to build their resilience. Also, enforcement of established laws against gender-based violence by both government and non-governmental institutions is sacrosanct.

Keywords: perception, effects, gender-based violence, sustainable development, education, girl-child, sensitisation

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Authors: Fatima Meirkhankyzy Shaizadina, Alua Oralovna Omarova, Praskovya Mikhailovna Britskaya, Nessipkul Oryntayevna Alysheva

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In recent years in the Republic of Kazakhstan there have been registered outbreaks of measles among the population. The objective of work was the analysis of outbreak of measles in 2014 among the population of North-Kazakhstan region of the Republic of Kazakhstan. For the analysis of the measles outbreak descriptive and analytical research, techniques were used and threshold levels of morbidity were calculated. The increase of incidence was noted from March to July. The peak was registered in May and made 9.0 per 100000 population. High rates were registered in April – 5.7 per 100000 population, and in June and July they made 5.7 and 3.1 respectively. Duration of the period of increase made 5 months. The analysis of monthly incidence of measles revealed spring and summer seasonality. Across the territory it was established that 69.2% of cases were registered in the city, 29.1% in rural areas and 1.7% of cases were brought in from other regions of Kazakhstan. The registered cases and threshold values of measles during the outbreak revealed that from 12 to 24 week, and also during the 40th week the cases exceeding the threshold levels are registered. Thus, for example, for the analyzed 1 week the number of the revealed patients made 4, which exceeds the calculated threshold value (3) by 33.3%. The data exceeding the threshold values confirm the emergence of a disease outbreak or the beginning of epidemic rise in morbidity. Epidemic rise in incidence of the population of North-Kazakhstan region was observed throughout 2014. The risk group includes 0-4 year-old children, who made 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The analysis of measles cases registration by gender revealed that women are registered 1.1 times more often than men. The ratio of women to men made 1:0.87. In social and professional groups often ill are unorganized children – 23.3% and students – 19.8%. Studying clinical manifestations of measles in the hospitalized patients, the typical beginning of a disease with expressed intoxication symptoms – weakness, sickliness was established. In individual cases expressed intoxication symptoms, hemorrhagic and dyspeptic syndromes, complications in the form of overlay of a secondary bacterial infection, which defined high severity of the illness, were registered both in adults and in children. The average duration of stay of patients in the hospital made 6.9 days. The average duration of time between date of getting the disease and date of delivery of health care made 3.6 days. Thus, the analysis of monthly incidence of measles revealed spring and summer seasonality, the peak of which was registered in May. Urban dwellers are ill more often (69.2%), while in rural areas people are ill more rarely (29.1%). Throughout 2014 an epidemic rise in incidence of the population of North-Kazakhstan region was observed. Risk group includes: children under 4 – 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The ratio of women and men made 1:0.87. The typical beginning of a disease in all hospitalized with the expressed intoxication symptoms – weakness, sickliness was established.

Keywords: epidemiological analysis, measles, morbidity, outbreak

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Authors: F. Saleh, F. Lyall, A. Abdulsid, L. Marks

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Background: Labour in human is a complex biological process that involves interactions of neurological, hormonal and inflammatory pathways, with the placenta being a key regulator of these pathways. It is known that uterine contractions and labour pain cause physiological changes in gene expression in maternal and fetal blood, and in placenta during labour. Oxidative and inflammatory stress pathways are implicated in labour and they may cause alteration of placental gene expression. Additionally, in placental tissues, labour increases the expression of genes involved in placental oxidative stress, inflammatory cytokines, angiogenic regulators and apoptosis. Recently, Hydrogen Sulphide (H2S) has been considered as an endogenous gaseous mediator which promotes vasodilation and exhibits cytoprotective anti-inflammatory properties. The endogenous H2S is synthesised predominantly by two enzymes: cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE). As the H2S pathway has anti-oxidative and anti-inflammatory characteristics thus, we hypothesised that the expression of CBS and CSE in placental tissues would alter during labour. Methods: CBS and CSE expressions were examined in placentas using western blotting and RT-PCR in inner, middle and outer placental zones in placentas obtained from healthy non labouring women who delivered by caesarian section. These were compared with the equivalent zone of placentas obtained from women who had uncomplicated labour and delivered vaginally. Results: No differences in CBS and CSE mRNA or protein levels were found between the different sites within placentas in either the labour or non-labour group. There were no significant differences in either CBS or CSE expression between the two groups at the inner site and middle site. However, at the outer site there was a highly significant decrease in CBS protein expression in the labour group when compared to the non-labour group (p = 0.002). Conclusion: To the best of author’s knowledge, this is the first report to suggest that, CBS is expressed in a spatial manner within the human placenta. Further work is needed to clarify the precise function and mechanism of this spatial regulation although it is likely that inflammatory pathways regulation is a complex process in which this plays a role.

Keywords: anti-inflammatory, hydrogen sulphide, labour, oxidative stress

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Authors: R. Simões, M. Silveirinha

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Driven by the need to understand the results of previous research that clearly shows deep unbalances of the media discourses about women and men in spite of the growing numbers of female journalists, our paper aims to progress from the 'what' to the 'why' of these unbalanced representations. Furthermore, it does so at a time when journalism is undergoing a dramatic change in terms of professional practices and in how media organizations are organized and run, affecting women in particular. While some feminist research points to the fact that female and male journalists evaluate the role of the news and production methods in similar ways feminist theorizing also suggests that thought and knowledge are highly influenced by social identity, which is also inherently affected by the experiences of gender. This is particularly important at a time of deep societal and professional changes. While there are persuasive discussions of gender identities at work in newsrooms in various countries studies on the issue will benefit from cases that focus on the particularities of local contexts. In our paper, we present one such case: the case of Portugal, a country hit hard by austerity measures that have affected all cultural industries including journalism organizations, already feeling the broader impacts of the larger societal changes of the media landscape. Can we gender these changes? How are they felt and understood by female and male journalists? And how are these discourses framed by androcentric, feminist and post-feminist sensibilities? Foregrounding questions of gender, our paper seeks to explore some of the interactions of societal and professional forces, identifying their gendered character and outlining how they shape journalism work in general and the production of unbalanced gender representations in particular. We do so grounded in feminist studies of journalism as well as feminist organizational and work studies, looking at a corpus of 20 in-depth interviews of female and male Portuguese journalists. The research findings illustrate how gender in journalism practices interacts with broader experiences of the cultural and economic contexts and show the ambivalences of these interactions in news organizations.

Keywords: gender, journalism, newsroom culture, Portuguese journalists

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Authors: Aysen Muderrisoglu Esiner

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As an intellectual, scholar, bureaucrat, and statesman, Ahmed Cevdet Pasha (1822-1895) was the prominent figure of “Tanzimat” (reorganization) reforms of the Ottoman State while his daughter Fatma Aliye (1862-1936) was a novelist, columnist, essayist, and women’s rights activist. His father had numerous books on law, grammar, linguistics, logic, and astronomy, moreover, Aliye accepted as the first female novelist in the Turkish literature and the Islamic world. Even if she was better known as a novelist, she also published some works on philosophy, Islam, poetry. In addition, Aliye who was one of the pioneers of the Ottoman women’s movement, also wrote historical works. Her historical works which titled as Tarih-i Osmaninin Bir Devre-i Mühimmesi Kosova Zaferi-Ankara Hezimeti (An Important Era of the Ottoman History: Kosova Victory-Ankara Defeat), and Ahmed Cevdet Paşa ve Zamanı (Ahmed Cevdet Pasha and His Time) have been generally ignored in the literature. However, Aliye’s works in history field are worth being studied in terms of her methodological approach to the Ottoman historiography. On the other hand, written by Ahmed Cevdet Pasha, such as Tarih-i Cevdet (History of Cevdet), Tezâkir (Memoir), Mâruzat (Reports, the events that took place between 1839-1876, 1890), Kısas-ı Enbiya ve Tevârîh-i Hulefa (Retaliation of the Prophets and the History of Calips), Kırım ve Kafkas Tarihçesi (Crimean and Caucasian History) are the most important works in terms of historiography in the 19th century. In contrast to the traditional methodology, Cevdet Pasha brought a new understanding to the Ottoman historiography by making a synthesis between the traditional and modern methods. In this research, the historical works of these two prominent figures of the Ottoman State will be analyzed in terms of their approaches to the Ottoman historiography while evaluating the following questions: to what extent that their use of local and foreign historical sources and their handling of the historical events differ, or if it is possible to talk about a methodological similarities in terms of historiography.

Keywords: Ahmed Cevdet Pasha, Fatma Aliye, historiography, methodology

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Authors: Roxane A. Legaie, Kjiana E. Schwab, Caroline E. Gargett

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Studies looking at the changes in gene expression from RNAseq data often make use of linear models. It is also common practice to focus on a subset of data for a comparison of interest, leaving aside the samples not involved in this particular comparison. This work shows the importance of including all observations in the modeling process to better estimate variance parameters, even when the samples included are not directly used in the comparison under test. The human endometrium is a dynamic tissue, which undergoes cycles of growth and regression with each menstrual cycle. The mesenchymal stem cells (MSCs) present in the endometrium are likely responsible for this remarkable regenerative capacity. However recent studies suggest that MSCs also plays a role in the pathogenesis of endometriosis, one of the most common medical conditions affecting the lower abdomen in women in which the endometrial tissue grows outside the womb. In this study we compared gene expression profiles between MSCs and non-stem cell counterparts (‘non-MSC’) obtained from women with (‘E’) or without (‘noE’) endometriosis from RNAseq. Raw read counts were used for differential expression analysis using a linear model with the limma-voom R package, including either all samples in the study or only the samples belonging to the subset of interest (e.g. for the comparison ‘E vs noE in MSC cells’, including only MSC samples from E and noE patients but not the non-MSC ones). Using the full dataset we identified about 100 differentially expressed (DE) genes between E and noE samples in MSC samples (adj.p-val < 0.05 and |logFC|>1) while only 9 DE genes were identified when using only the subset of data (MSC samples only). Important genes known to be involved in endometriosis such as KLF9 and RND3 were missed in the latter case. When looking at the MSC vs non-MSC cells comparison, the linear model including all samples identified 260 genes for noE samples (including the stem cell marker SUSD2) while the subset analysis did not identify any DE genes. When looking at E samples, 12 genes were identified with the first approach and only 1 with the subset approach. Although the stem cell marker RGS5 was found in both cases, the subset test missed important genes involved in stem cell differentiation such as NOTCH3 and other potentially related genes to be used for further investigation and pathway analysis.

Keywords: differential expression, endometriosis, linear model, RNAseq

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Authors: Mohammad-Javad Eslami, Mahtab Zargham, Farshad Gholipour, Mohammadreza Hajian, Katayoun Bakhtiari, Sakineh Hajebrahimi, Melina Eghbal, Ziba Farajzadegan

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Introduction: To study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT). Methods: Between 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively. Results: One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%). Conclusion: Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up.

Keywords: stress urinary incontinence (SU, incontinence questionnaire-vaginal symptoms (ICIQ-VS), polyvinylidene fluoride (PVDF) mes, double trans-obturator technique (TOT)

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Authors: Steven D. Capener

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The 1997 Asian financial crisis was a watershed event in Korea as it necessitated changes that begin an unravelling of many of the norms and traditions that had served to underpin society. Divorce skyrocketed; the era of lifetime employment was over; women came out the home to become, in many cases, the main breadwinners; competitive forces were exacerbated; and traditional sources of authority began to crumble. All of these changes weekend the power to structure human relations of the Confucian Three Bonds and Five Relationships (삼강오륜). Since then, this “de-confucianization” has only become more pronounced with women increasingly refusing to marry, partly in protest to what they perceive as entrenched gender inequality, married couples eschewing childbirth resulting in the lowest birthrate in the world, and diminishing inheritances eroding the traditionally strong sense of filial piety (효) of children toward parents. The result of all this can be seen in the continued weakening or outright crumbling of the hierarchies codified in the Three Bonds and Five Relationship, which have served as a social template in Korea for centuries. In his 2004 work “Oppa Came Back,” writer Kim Yong Ha depicts what he apparently sees as the “post-Confucian” family in a wickedly funny portrayal of what Korean society could look like if traditional bulwarks of prescriptive values suddenly collapse and are not replaced with tenable alternatives. In the short story, Kim subverts all the traditional hierarchies while leaving the desire to dominate these hierarchies intact. This produces the picture of a Korean family governed by the new values of money and physical power. After lying out what can be identified as major cultural changes in what could be called “traditional” society,” the article uses a close reading of Kim’s story for its implications regarding a possible new, dysfunctional version of Korean society. It seems apparent that Kim’s story is a cautionary tale of the pitfalls that lie athwart the late-modern Korean landscape. These changes have important implications in the areas of education and socio-political philosophy. The conclusion focuses on possible alternatives to this post-Confucian conundrum.

Keywords: post-confucian, three bonds and five relationships, traditional society, hierarchies

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Authors: Adamnesh A. Bogale, Dorte Thorsen

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This paper aims to learn how children/siblings left behind due to parental migration experience care and the effects of the separation. It also aims to unpack the experiences of youth migrants in rural Ethiopia. It focuses specifically on how children and youth are affected in order to highlight in which areas intervention can enhance or inadvertently undermine the development impact of migration on young people. Based on a qualitative study in South Wollo, Ethiopia, which was undertaken in three stages in 2017-19 and involved 34 households and a number of key informants, the analysis offers insights into how migration contributes to household sustainability and, in the process, alters intergenerational relationships and dynamics. Contemporary migration in Ethiopia is complex and highly gendered. For young women, the migration corridor from Ethiopia to the Middle East is the most important, whereas young men mostly engage in local migration or travel to South Africa or Sudan. Arguing that children and youths’ experience of migration must be understood in the context of the moral, affective, and material economies, the paper distinguishes between young people’s experiences of migration as children of migrants, as siblings of a migrant, and as migrants. The material shows that children and youths demonstrate different experiences in parental migration depending on age, care arrangement, and the ability to communicate with an absent mother. Migration has a different implication for younger siblings depending on their gender. The division of work and future responsibilities post marriage combine to disadvantage female siblings while male siblings are either unaffected or reaped the benefits of investments made with remittances. Finally, migration is a mechanism to change generational power relationships. As remitters, young migrants yield better recognition in the family, though not always to the degree that they can control the use of remittances. The power to make decisions is not tied only to material resources and the household; migration facilitates social change that opens space for young women to have more influence over their own lives.

Keywords: migration, youth, Ethiopia, generations

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Authors: Leena Korpinen, Rauno Pääkkönen, Fabriziomaria Gobba

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This paper is based on a large questionnaire study. The paper presents how all participants and subgroups (upper- and lower-level white-collar workers) answered the question, “Have you had an ache, pain, or numbness, which you associate with desktop computer use, in the different body parts during the last 12 months?’ 14.6% of participants (19.4% of women and 8.2% of men) reported that they had often or very often physical symptoms in the neck. Even if our results cannot prove a causal relation of symptoms with computer use, show that workers believe that computer use can influence their wellbeing: This is important when devising treatment modalities to decrease these physical symptoms.

Keywords: ergonomics, work, computer, symptoms

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Authors: Irena Kostovska, Katerina Tosheska Trajkovska, Svetlana Cekovska, Julijana Brezovska Kavrakova, Hristina Ampova, Sonja Topuzovska, Ognen Kostovski, Goce Spasovski, Danica Labudovic

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Background: Proteinuria is an important feature of secondary nephropathies. The quantitative and qualitative analysis of proteinuria plays an important role in determining the types of proteinuria (glomerular, tubular and mixed), in the diagnosis and prognosis of secondary nephropathies. The damage of the glomerular basement membrane is responsible for a proteinuria characterized by the presence of large amounts of protein with high molecular weights such as albumin (69 kilo Daltons-kD), transferrin (78 kD) and immunoglobulin G (150 kD). An insufficiency of proximal tubular function is the cause of a proteinuria characterized by the presence of proteins with low molecular weight (LMW), such as retinol binding protein (21 kD) and α1-microglobulin (31 kD). In some renal diseases, a mixed glomerular and tubular proteinuria is frequently seen. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) is the most widely used method of analyzing urine proteins for clinical purposes. The main aim of the study is to determine the type of proteinuria in the most common secondary nephropathies such as diabetic, hypertensive nephropathy and preeclampsia. Material and methods: In this study were included 90 subjects: subjects with diabetic nephropathy (n=30), subjects with hypertensive nephropahty (n=30) and pregnant women with preeclampsia (n=30). We divided all subjects according to UM/CR into three subgroups: macroalbuminuric (UM/CR >300 mg/g), microalbuminuric (UM/CR 30-300 mg/g) and normolabuminuric (UM/CR<30 mg/g). In all subjects, we measured microalbumin and creatinine in urine with standard biochemical methods. Separation of urinary proteins was performed by SDS-PAGE, in several stages: linear gel preparation (4-22%), treatment of urinary samples before their application on the gel, electrophoresis, gel fixation, coloring with Coomassie blue, and identification of the separated protein fractions based on standards with exactly known molecular weight. Results: According to urinary microalbumin/creatinin ratio in group of subject with diabetic nephropathy, nine patients were macroalbuminuric, while 21 subject were microalbuminuric. In group of subjects with hypertensive nephropathy, we found macroalbuminuria (n=4), microalbuminuria (n=20) and normoalbuminuria (n=6). All pregnant women with preeclampsia were macroalbuminuric. Electrophoretic separation of urinary proteins showed that in macroalbuminric patients with diabetic nephropathy 56% have mixed proteinuria, 22% have glomerular proteinuria and 22% have tubular proteinuria. In subgroup of subjects with diabetic nephropathy and microalbuminuria, 52% have glomerular proteinuria, 8% have tubular proteinuria, and 40% of subjects have normal electrophoretic findings. All patients with maroalbuminuria and hypertensive nephropathy have mixed proteinuria. In subgroup of patients with microalbuminuria and hypertensive nephropathy, we found: 32% with mixed proteinuria, 27% with normal findings, 23% with tubular, and 18% with glomerular proteinuria. In all normoalbuminruic patiens with hypertensive nephropathy, we detected normal electrophoretic findings. In group of subjects pregnant women with preeclampsia, we found: 81% with mixed proteinuria, 13% with glomerular, and 8% with tubular proteinuria. Conclusion: By SDS PAGE method, we detected that in patients with secondary nephropathies the most common type of proteinuria is mixed proteinuria, indicating both loss of glomerular permeability and tubular function. We can conclude that SDS PAGE is high sensitive method for detection of renal impairment in patients with secondary nephropathies.

Keywords: diabetic nephropathy, preeclampsia, hypertensive nephropathy, SDS PAGE

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Authors: Pramoda Karunarathna, Hemamalie Gunatilaka

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This study is based on experiences of Sri Lankan lesbian and gay workers’ career in the corporate sector, which include both manufacturing and service sectors. The study has started with the intention of shedding light on a grey area to observe the negative effects on lesbian and gay workers and their experiences while they are employed in the Sri Lankan corporate sector. In order to understand the experiences of lesbian and gay workers while they are at work within the corporate sector, the study seeks to address four questions. First research question is about the challenges faced by lesbian and gay workers while they are at work, and the second research question looks at their career patterns. Third research question seeks to address the behavior at work, and the fourth research question looks at the influence of class, religion, and cultural aspects on the career of lesbian and gay workers. Methodologically, the research was based on semi-structured interviews with nine participants (five gay men and four lesbian women) having work experience in the corporate sector and residing in Colombo, the capital city of Sri Lanka. The research found that the participants have gone through the process of developing sexual identity; gay men possess more feminine characteristics, while lesbian women possess more masculine characteristics. Further, their identity gets revealed in different ways, such as through the curriculum vitae, at the interviews, through the attire and behavior, and with the use of social media. The study also found that lesbian and gay workers experience discrimination due to violation of hierarchical power difference by other employees and marginalization, verbal and nonverbal abuse by other men at work are common experiences. Another finding is that lesbian and gay workers adopt strategies for survival at work, and they prefer the NGO sector to the corporate sector. In contrast, even within the corporate sector, advertising is preferred by lesbian and gay workers. Some of the Sri Lankan corporate sector organizations, especially multinational organizations, have initiated diversity training, and it might lead to making these organisations lesbian and gay-friendly workplaces in the future. It is also found that nearly 44 percent of the participants do not have a religion, and it is due to the rejection of deviant behaviours by most of the religions. In conclusion, lesbian and gay workers experience discrimination at work in the Sri Lankan corporate sector with an exception to the companies relating to advertising and non-governmental organisations is the sector that these workers prefer the most.

Keywords: lesbian workers, gay workers, Sri Lankan corporate sector, discrimination

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Authors: Sheila M. Wicks, Gail Mahady, Udesh Patel, Joanna Michel, Armando Caceres

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Introduction: The genus piperaceae contains approximately 1000 species of herbs scrubs small trees and hanging vines distributed in both hemispheres. During our ethno medical work in Guatemala of the 27 plant families documented for us e by the Qeqchi Maya for reproductive disorders the most prominent were the Piperaceae (15%) and Menispermiaceae. Our Previous work showed that extracts from form Piper and Cissampelos species bound to both and progesterone and the estrogen receptors. In this work active extracts from Piper aeruginosibaccum Trelease, P auritum, P tuerckheimii and Cissampels tropaeolifolia were tested in functionalized cell based assays including a SEAP reporter gene and by qPCR of ER-responsive gene expression in MCF-7cells. In the reporter gene assay P aeruginosibaccum was estrogenic and enhanced E2 EFFECTS IN MCF-7 CELLS. P. tuerckheimi was not estrogenic alone but significantly enhanced the effects of E2 on SEAP reporter gene expression. Both altered mRNA expression of E2 responsive genes in MCF-7. Methods: this is collaborative project between University of Illinois at Chicago and University of San Carlos Guatemala City. 144 spices of plants were collected in Guatemala of which 57 used to treat a variety of women's reproductive health. The Genus Piperaraceae contains approximately 1000 species of herbs scrubs and small trees. Active extracts of the plants were tested in functionalized in cell-based bioassays including SEAP reporter genes. Results demonstrated altered mRNA expression of E2 responsive genes in MC-7 cells plants were collected in Guatemala of which 57 used. Conclusion of the 5 plants tested all were shown to contain components of binding to estrogenic receptor to a greater or lesser degree. These effects support the use of QEqchi Maya women in Guatemala for reproductive.

Keywords: reporter genes, MC7, guatemala piperaceae, reproductive health

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Authors: Sengly Sroy, Elodie Arnaud, Adrien Servent, Sokneang In, Sylvie Avallone

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In Cambodia, fish plays an important role for local community in term of food habits, preference and contribution to several nutritional intakes. Consumed on a daily basis, fishes and their derivatives products are good sources of proteins, essential fatty acids and fat-soluble vitamins. They mainly obtain from the Tonle Sap Lake but, during the last decade, the fish population decreased drastically due to climate change and human activities as well. Contamination by agricultural residues and heavy metals were identified. However, fishes are currently used in several nutrition programs for children and pregnant women to improve their nutritional status. The aim of our work was to characterize the nutritional profile and contamination of 10 fish species consumed near the Tonle Sap Lake with a special attention to fatty acid and fat-soluble vitamin profiles. Fish samples were analyzed for their nutritional profiles (AOAC methods for macronutrients and micronutrients), their lipid content (Folch modified method), their Fatty acid (FAME method), their vitamin A (HPLC) and their heavy metals (ICP-MS). The total lipid contents ranged from 1.43 to 10.00% according to fish species. Lipid profile was mainly dominated by saturated fat (from 47.95 to 57.32%) but some fish species were particularly rich in ω-3 and ω-6 especially eicosapentaenoic acid EPA (3.05%) and docosahexaenoic acid DHA (2.82%). The more the fishes were fats, the more they contained vitamin A, DHA and EPA. Vitamin A is particularly abundant in small fishes (250.10 μg RE/100 g) compare to big ones (13.77 μg RE/100 g) because they are consumed as a whole with their organs (liver) and head. However, the contents of heavy metal in some species are higher than the maximum permitted level (MPL) from codex alimentarius, especially Mn. The results obtained provided important information on the most interesting fish in term of human nutrition and the potential risk of contaminants. The fatty acids are important for child development and pregnant women. These data are useful for supply chain stakeholders and the people in charge of nutrition program.

Keywords: fat-soluble vitamin, fatty acid, freshwater fish, lipid content, Tonle Sap Lake

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Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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Authors: Leyla Sattarzadeh, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6) and adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of resistance exercise training on these inflammatory markers, the present study aimed to examine the effect of eight week different patterns of resistance exercise training on CRP, IL-6 and ICAM-1 levels in healthy untrained women. 40 volunteered and healthy untrained female university students (aged: 21+ 3 yr., Body Mass Index: 21.5+ 3.5 kg/m2) were selected purposefully and divided into three groups. At the end of training protocol and after subjects drop during the protocol in upper body exercise training (n=11), lower body (n=12) completed the eight week of training period although the control group (n=7) did anything. Blood samples gathered pre and post experimental period and CRP, IL-6 and ICAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one way Analysis of Variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP and ICAM-1 showed no significant changes due to the exercise training. But there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper and lower body exercise training by involving the different amount of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP and ICAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: C-reactive protein, interleukin-6, intracellular adhesion molecule-1, resistance training

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Authors: Iris W. A. Boot, Anke Wesselius, Maurice P. Zeegers

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Diet may play an essential role in the aetiology of bladder cancer (BC). Vitamin D is involved in various biological functions which have the potential to prevent BC development. Besides, vitamin D also influences the uptake of calcium and phosphorus , thereby possibly indirectly influencing the risk of BC. The aim of the present study was to investigate the relation between vitamin D intake and BC risk. Individual dietary data were pooled from three cohort studies. Food item intake was converted to daily intakes of vitamin D, calcium and phosphorus. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs) were obtained using Cox-regression models. Analyses were adjusted for gender, age and smoking status (Model 1), and additionally for the food groups fruit, vegetables and meat (Model 2). Dose–response relationships (Model 1) were examined using a nonparametric test for trend. In total, 2,871 cases and 522,364 non-cases were included in the analyses. The present study showed an overall increased BC risk for high dietary vitamin D intake (HR: 1.14, 95% CI: 1.03-1.26). A similar increase BC risk with high vitamin D intake was observed among women and for the non-muscle invasive BC subtype, (HR: 1.41, 95% CI: 1.15-1.72, HR: 1.13, 95% CI: 1.01-1.27, respectively). High calcium intake decreased the BC risk among women (HR: 0.81, 95% CI: 0.67-0.97). A combined inverse effect on BC risk was observed for low vitamin D intake and high calcium intake (HR: 0.67, 95% CI: 0.48-0.93), while a positive effect was observed for high vitamin D intake in combination with low, moderate and high phosphorus (HR: 1.31, 95% CI: 1.09-1.59, HR: 1.17, 95% CI: 1.01-1.36, HR: 1.16, 95% CI: 1.03-1.31, respectively). Combining all nutrients showed a decreased BC risk for low vitamin D intake, high calcium and moderate phosphor intake (HR: 0.37, 95% CI: 0.18-0.75), and an increased BC risk for moderate intake of all the nutrients (HR: 1.18, 95% CI: 1.02-1.38), for high vitamin D and low calcium and phosphor intake (HR: 1.28, 95% CI: 1.01-1.62), and for moderate vitamin D and calcium and high phosphorus intake (HR: 1.27, 95% CI: 1.01-1.59). No significant dose-response analyses were observed. The findings of this study show an increased BC risk for high dietary vitamin D intake and a decreased risk for high calcium intake. Besides, the study highlights the importance of examining the effect of a nutrient in combination with complementary nutrients for risk assessment. Future research should focus on nutrients in a wider context and in nutritional patterns.

Keywords: bladder cancer, nutritional oncology, pooled cohort analysis, vitamin D

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Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni

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Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.

Keywords: prep, uptake, continuation, AGYW

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Authors: Mustafa Mutahari, Nao Sugiki, Kojiro Matsuo

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The four decades of war, lack of job opportunities, poverty, lack of services, and natural disasters in different provinces of Afghanistan have contributed to a rapid increase in the population of Kabul, the capital city of Afghanistan. Population census has not been conducted since 1979, the first and last population census in Afghanistan. However, according to population estimations by Afghan authorities, the population of Kabul has been estimated at more than 4 million people, whereas the city was designed for two million people. Although the major transport mode of Kabul residents is public transport, responsible authorities within the country failed to supply the required means of transportation systems for the city. Besides, informal resettlement, lack of intersection control devices, presence of illegal vendors on streets, presence of illegal and unstandardized on-street parking and bus stops, driver`s unprofessional behavior, weak traffic law enforcement, and blocked roads and sidewalks have contributed to the extreme traffic congestion of Kabul. In 2018, the government of Afghanistan approved the Kabul city Urban Design Framework (KUDF), a vision towards the future of Kabul, which provides strategies and design guidance at different scales to direct urban development. Considering traffic congestion of the city and its budget limitations, the KUDF proposes a BRT route network with seven lines to reduce the traffic congestion, and it is said to facilitate more than 50% of Kabul population to benefit from this service. Based on the KUDF, it is planned to increase the BRT mode share from 0% to 17% and later to 30% in medium and long-term planning scenarios, respectively. Therefore, a detailed research study is needed to evaluate the proposed system before the implementation stage starts. The integrated land-use transport model is an effective tool to evaluate the Kabul BRT because of its future assessment capabilities that take into account the interaction between land use and transportation. This research aims to analyze and evaluate the proposed BRT route network with the application of an integrated land-use and transportation model. The research estimates the population distribution and travel behavior of Kabul within small boundary scales. The actual road network and land-use detailed data of the city are used to perform the analysis. The BRT corridors are evaluated not only considering its impacts on the spatial interactions in the city`s transportation system but also on the spatial developments. Therefore, the BRT are evaluated with the scenarios of improving the Kabul transportation system based on the distribution of land-use or spatial developments, planned development typology and population distribution of the city. The impacts of the new improved transport system on the BRT network are analyzed and the BRT network is evaluated accordingly. In addition, the research also focuses on the spatial accessibility of BRT stops, corridors, and BRT line beneficiaries, and each BRT stop and corridor are evaluated in terms of both access and geographic coverage, as well.

Keywords: accessibility, BRT, integrated land-use and transport model, travel behavior, spatial development

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Authors: Joelle Fong

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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

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Authors: Shahriyar Keshtgar, Mahmoud Reza Heyhat, Sasan Bagheri, Ebrahim Gholami, Seyed Naser Raiisosadat

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The eastern Iranian range is a Z-shaped sigmoidal outcrop appearing with a NS-trending general strike on the satellite images, has already been known as the Sistan suture zone, recently identified as the product of an orogenic event introduced either by the Paleogene or Sistan orogen names. The flysch sedimentary basin of eastern Iran was filled by a huge volume of fine-grained Eocene turbiditic sediments, smaller amounts of pelagic deposits and Cretaceous ophiolitic slices, which are entirely remnants of older accretionary prisms appeared in a fold-thrust belt developed onto a subduction zone under the Lut/Afghan block, portions of the Cimmerian superterrane. In these ranges, there are Triassic sedimentary and carbonate sequences (equivalent to Nayband and Shotori Formations) along with scattered outcrops of Permian limestones (equivalent to Jamal limestone) and greenschist-facies metamorphic rocks, probably belonging to the basement of the Lut block, which have tectonic contacts with younger rocks. Moreover, the younger Eocene detrital-volcanic rocks were also thrusted onto the Cretaceous or younger turbiditic deposits. The first generation folds (parallel folds) and thrusts with slaty cleavage appeared parallel to the NE edge of the Lut block. Structural analysis shows that the most vergence of thrusts is toward the southeast so that the Permo-Triassic units in Lut have been thrusted on the younger rocks, including older (probably Jurassic) granites. Additional structural studies show that the regional transport direction in this deformation event is from northwest to the southeast where, from the outside to the inside of the orogen in the Sechengi area. Younger thrusts of the second deformation event were either directly formed as a result of the second deformation event, or they were older thrusts that reactivated and folded so that often, two sets or more slickenlines can be recognized on the thrust planes. The recent thrusts have been redistributed in directions nearly perpendicular to the edge of the Lut block and parallel to the axial surfaces of the northwest second generation large-scale folds (radial folds). Some of these younger thrusts follow the out-of-the-syncline thrust system. The both axial planes of these folds and associated penetrative shear cleavage extended towards northwest appeared with both northeast and southwest dips parallel to the younger thrusts. The large-scale buckling with the layer-parallel stress field has created this deformation event. Such consecutive deformation events perpendicular to each other cannot be basically explained by the simple linear orogen models presented for eastern Iran so far and are more consistent with the oroclinal buckling model.

Keywords: thrust, tectonic vergence, orocline buckling, sechangi, eastern iranian ranges

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