Search results for: rabies survivors

Authors: Murphy P. Mohammed, Rita E. Pulmano

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This study determined the cases of violence against women in selected barangays of Tarlac City. In this research, the following questions were answered: what is the description of the cases on violence against women?; what are the causes of violence against women?; what support/assistance is provided by the LGUs?; and what plan of action can be proposed to improve the VAW services of the barangays? The methodologies used in the present study are qualitative and descriptive researches. The researchers used documentary analysis and interview to gather data. The subjects of the study are violence against women survivors from the selected ten (10) populous barangays of Tarlac City. Physical abuse, mental abuse, threatening, abandonment of children, child support issues, child custody, psychological abuse, economic abuse, and rape are the other recorded cases among the evaluated barangays. Based on the information, the researchers found out that a VAW desk was established in every respondent barangay. This in compliance with Section 12 D, Rule IV of the Rules and Regulations Implementing the Magna Carta of Women, which provides for the establishment of a VAW desk in every barangay to ensure that violence against women cases are fully addressed in a gender-responsive manner.

Keywords: Barangay VAW desk, cases of violence against women, violence against women, women's studies

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Authors: Samantha Ramachandra, Avanthi Rupasinghe

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Demographic transition from lower to higher percentage of elderly population eventually coupled with epidemiological transition from communicable to non-communicable diseases (NCD). Higher percentage of NCD overload the health system as NCD survivors claims continuous health care. The demands are challenging to a resource constrained setting but reorganizing the system may find solutions. The study focused on the facilities available and their utilization at outpatient department (OPD) setting of the public hospitals of Sri Lanka for continuous medical care. This will help in identifying steps of reorganizing the system to provide better care with the maximum utilization of available facilities. The study was conducted as a situation analysis with secondary data at hospital planning units. Variable were identified according to the world health organization (WHO) recommendation on continuous health care for elders in “age-friendly primary health care toolkit”. Data were collected from secondary and tertiary care hospitals of Sri Lanka where most of the continuous care services are available. Out of 58 secondary and tertiary care hospitals, 16 were included in the study to represent each hospital categories. Average number of patient attending for episodic treatment at OPD and Clinical follow-up of chronic conditions shows vast disparity according to the category of the hospital ranging from 3750 – 800 per day at OPD and 1250 – 200 per clinic session. Average time spent per person at OPD session is low, range from 1.54 - 2.28 minutes, the time was increasing as the hospital category goes down. 93.7% hospitals had special arrangements for providing acute care on chronic conditions such as catheter, feeding tube and wound care. 25% hospitals had special clinics for elders, 81.2% hospitals had healthy lifestyle clinics (HLC), 75% hospitals had physical rehabilitation facilities and 68.8% hospitals had facilities for counselling. Elderly clinics and HLC were mostly available at lower grade hospitals where as rehabilitation and counselling facilities were mostly available at bigger hospitals. HLC are providing health education for both patients and their family members, refer patients for screening of complication but not provide medical examinations, investigations or treatments even though they operate in the hospital setting. Physical rehabilitation is basically offered for patients with rheumatological conditions but utilization of centers for injury rehabilitation and rehabilitation of survivors following major illness such as myocardial infarctions, stroke, cancer is not satisfactory (12.5%). Human Resource distribution within hospital shows vast disparity and there are 103 physiotherapists in the biggest hospital where only 36 physiotherapists available at the next level hospital. Counselling facilities also provided mainly for the patient with psychological conditions (100%) but they were not providing counselling for newly diagnosed patients with major illnesses (0%). According to results, most of the public-sector hospitals in Sri Lanka have basic facilities required in providing continuous care but the utilization of services need more focus. Hospital administration or the government need to have initial steps in proper utilization of them in improving continuous health care incorporating team approach of rehabilitation. The author wishes to acknowledge that this paper was made possible by the support and guidance given by the “Australia Awards Fellowships Program for Sri Lanka – 2017,” which was funded by the Department of Foreign Affairs and Trade, Australia, and co-hosted by Monash University, Australia and the Sri Lanka Institute of Development Administration.

Keywords: continuous care, outpatient department, non communicable diseases, rehabilitation

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Authors: Imas Istiani

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The concept of home is usually closely related to the place of safety and security. For people who have travelled far and long, they long to be united with home to feel safe, secure and comfortable. However, for some people, especially for veterans, home cannot offer them those feelings, on the contrary, it can give them the sense of insecurity as well as guilty. Thus, its juxtaposed concept can also put home as an uncanny place that represses and haunt its occupant. As for veterans, 'survivor guilt' overpowers them in the way that it will be hard for them to embrace the comfort that home offers. In Home, Toni Morrison poignantly depicts Frank’s life upon returning from the war. Burdened with his traumatic experiences, Frank finds home full with terror, guilt, fear, grief, and loss. Using Dominick laCapra’s 'Trauma Theory,' the study finds that Frank works through his trauma by being able to distinguish between past and present so that he can overcome those repressed feelings. Aside from his inner healing power, Frank digests the process of working through with the help of home and community, as proposed by Evelyn Jaffe Schreiber claiming that community can help survivors to heal from traumatic experiences. Thus, Home has two juxtaposed functions; both as traumatizing and healing place.

Keywords: trauma, healing, home, trauma theory

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Authors: June Keeling, Christina Athanasiades, Vaiva Hendrixson, Delyth Wyndham

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Recognition and education in violence, abuse, and neglect for medical and healthcare practitioners (REVAMP) is a trans-European project aiming to introduce a training programme that has been specifically developed by partners across seven European countries to meet the needs of medical and healthcare practitioners. Amalgamating the knowledge and experience of clinicians, researchers, and educators from interdisciplinary and multi-professional backgrounds, REVAMP has tackled the under-resourced and underdeveloped area of domestic violence and abuse. The team designed an online training programme to support medical and healthcare practitioners to recognise and respond appropriately to survivors of domestic violence and abuse at their point of contact with a health provider. The REVAMP partner countries include Europe: France, Lithuania, Germany, Greece, Iceland, Norway, and the UK. The training is delivered through a series of interactive online modules, adapting evidence-based pedagogical approaches to learning. Capturing and addressing the complexities of the project impacted the methodological decisions and approaches to evaluation. The challenge was to find an evaluation methodology that captured valid data across all partner languages to demonstrate the extent of the change in knowledge and understanding. Co-development by all team members was a lengthy iterative process, challenged by a lack of consistency in terminology. A mixed methods approach enabled both qualitative and quantitative data to be collected, at the start, during, and at the conclusion of the training for the purposes of evaluation. The module content and evaluation instrument were accessible in each partner country's language. Collecting both types of data provided a high-level snapshot of attainment via the quantitative dataset and an in-depth understanding of the impact of the training from the qualitative dataset. The analysis was mixed methods, with integration at multiple interfaces. The primary focus of the analysis was to support the overall project evaluation for the funding agency. A key project outcome was identifying that the trans-European approach posed several challenges. Firstly, the project partners did not share a first language or a legal or professional approach to domestic abuse and neglect. This was negotiated through complex, systematic, and iterative interaction between team members so that consensus could be achieved. Secondly, the context of the data collection in several different cultural, educational, and healthcare systems across Europe challenged the development of a robust evaluation. The participants in the pilot evaluation shared that the training was contemporary, well-designed, and of great relevance to inform practice. Initial results from the evaluation indicated that the participants were drawn from more than eight partner countries due to the online nature of the training. The primary results indicated a high level of engagement with the content and achievement through the online assessment. The main finding was that the participants perceived the impact of domestic abuse and neglect in very different ways in their individual professional contexts. Most significantly, the participants recognised the need for the training and the gap that existed previously. It is notable that a mixed-methods evaluation of a trans-European project is unusual at this scale.

Keywords: domestic violence, e-learning, health professionals, trans-European

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Authors: Justina I. R. Udotong, Ofonime U. M. John

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Toxicity of copper (Cu), lead (Pb) and iron (Fe) to Tilapia guinensis was carried out for 4 days with a view to determining their effects on the liver and muscle tissues. Tilapia guinensis samples of about 10 - 14cm length and 0.2 – 0.4kg weight each were obtained from University of Calabar fish ponds and acclimated for three (3) days before the experimental set up. Survivors after the 96-hr LC50 test period were selected from test solutions of the heavy metals for the histopathological studies. Histological preparations of liver and muscle tissues were randomly examined for histopathological lesions. Results of the histological examinations showed gross abnormalities in the liver tissues due to pathological and degenerative changes compared to liver and muscle tissues from control samples (tilapia fishes from aquaria without heavy metals). Extensive hepatocyte necrosis with chronic inflammatory changes was observed in the liver of fishes exposed to Cu solution. Similar but less damaging effects were observed in the liver of fishes exposed to Pb and Fe. The extent of lesion observed was therefore heavy metal-related. However, no pathologic changes occurred in the muscle tissues.

Keywords: degenerative changes, heavy metal, hepatocyte necrosis, histopathology, toxicity

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Authors: Paul M. H. J. Roekaerts

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In recent years, it became clear that much intensive care (ICU) survivors develop a post-intensive care syndrome (PICS) consisting of psychiatric, cognitive and physical problems for a prolonged period after their ICU stay. Physical inactivity and delirium during the ICU stay are the main determinants of the post-ICU PICS. This presentation will focus on delirium, its epidemiology, prevalence, effect on outcome, risk factors and the current standard of care for managing delirium. Because ICU delirium is a predictor of prolonged length-of-stay in the ICU and of death, the use of a delirium prevention bundle (DPB) becomes mandatory in every ICU. In this presentation, a DPB bundle will be discussed consisting of six components: pain, sedation, sleep, sensory and intellectual stimulation, early mobilization, and hydration. For every of the six components, what to do and what not to do will be discussed. The author will present his own institutional policy on pharmacological and non-pharmacological interventions in the management of delirium. The component ‘early mobilization’ will be discussed more in detail, as this component is extremely important in the prevention of delirium as well as in the prevention of the PICS. The author will conclude his presentation with the remaining areas of uncertainties/work and research to be done.

Keywords: delirium, delirium prevention bundle, early mobilisation in intensive care (ICU), post-intensive care syndrome (PICS)

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Authors: Agbor Ekama Prisca Anne

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Current data on the prevalence and psychosocial correlates of sexual violence in the Cameroon is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of University students have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. A nationally representative sample of University students (N = 1,020) completed self-report measures of history of sexual violence and mental health. Approximately one-in-three (34.4%) students experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Female students were significantly more likely than men to have experienced all forms of sexual violence (ps < .001), with the exception of sexual assault by teachers or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a teacher associated with several other psychosocial outcomes in life, including education achievement, and behavior disorder. Sexual violence is a common experience in the general population and female students are disproportionately affected (1-in-2 girls versus 1-in-5 boys). Additional resources to increase mental health care among survivors of sexual violence is urgently needed.

Keywords: psychosocial, effects sexual, violence, females, students

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Authors: Babak Masoomian, Masoud Khorrami Nejad, Hamid Riazi Esfahani

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Purpose: To report the result of strabismus surgery in eye-salvaged retinoblastoma (Rb) patients. Methods: A retrospective case series including 18 patients with Rb and strabismus who underwent strabismus surgery after completing tumor treatment by a single pediatric ophthalmologist. Results: A total of 18 patients (10 females and 8 males) were included with a mean age of 13.3 ± 3.0 (range, 2-39) months at the time tumor presentation and 6.0 ± 1.5 (range, 4-9) years at the time of strabismus surgery. Ten (56%) patients had unilateral, and 8(44%) had bilateral involvement, and the most common worse eye tumor’s group was D (n=11), C (n=4), B (n=2) and E (n=1). Macula was involved by the tumors in 12 (67%) patients. The tumors were managed by intravenous chemotherapy (n=8, 47%), intra-arterial chemotherapy (n=7, 41%) and both (n=3, 17%). After complete treatment, the average time to strabismus surgery was 29.9 ± 20.5 (range, 12-84) months. Except for one, visual acuity was equal or less than 1.0 logMAR (≤ 20/200) in the affected eye. Seven (39%) patients had exotropia, 11(61%) had esotropia (P=0.346) and vertical deviation was found in 8 (48%) cases. The angle of deviation was 42.0 ± 10.4 (range, 30-60) prism diopter (PD) for esotropic and 35.7± 7.9 (range, 25-50) PD for exotropic patients (P=0.32) that after surgery significantly decreased to 8.5 ± 5.3 PD in esotropic cases and 5.9±6.7 PD in exotropic cases (P<0.001). The mean follow-up after surgery was 15.2 ± 2.0 (range, 10-24) months, in which 3 (17%) patients needed a second surgery. Conclusion: Strabismus surgery in treated Rb is safe, and results of the surgeries are acceptable and close to the general population. There was not associated with tumor recurrence or metastasis.

Keywords: retinoblastoma, strabismus, chemotherapy, surgery

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Authors: Pugazhenthan Thangaraju

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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

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Authors: Joseph Osafo, Winifred Asare-Doku, Charity Akotia

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Decriminalizing suicide is one of the major goals of suicide prevention worldwide. In Ghana, suicide is legally prescribed and there is a wide-spread societal condemnation of the act, the survivor and families share the stigma. Evidence and advocacy continue to mount towards pressuring the government, the legal fraternity and lawmakers to consider decriminalizing the act. However, within this discourse, the views of families of attempt survivors are absent. The purpose of this study was to explore from relatives of suicide attempters their reactions towards the criminality of suicide attempt in the country. A total of 10 relatives of suicide attempters were interviewed using a semi-structured interview guide. Thematic analysis was used to analyze the data. We found that there were divergent views from families on decriminalizing suicide. We generated two major themes; Out-group bias versus In-group bias. Half of the participants opined that suicide attempt should not be decriminalized and others advocated for help and mental health care for victims of the suicide attempt. It was generally observed that although all 10 participants were cognizant that suicide attempt is a crime in Ghana, they preferred their relatives were spared from prosecution. The findings indicate incongruity, especially when participants want their relatives to avoid jail term but want the law that criminalizes suicide to remain. Findings are explained using the Fundamental Attribution Error and the concept of Kin selection. Implications for public education on decriminalization and advocacy are addressed.

Keywords: decriminalization, families, Ghana suicide, suicide attempt

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Authors: Elias Kodjo Kekesi

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This study seeks to investigate a critical but neglected area in disaster and emergency management in Ghana. It explores aspects of work within one of the safety-critical work environments that expose workers to psychological, social and physical harm. With much attention to crises’ survivors, deceased and their families, this research attempts to answer a key question: ‘What happens to the rescuer’? Emergency response is associated with immense and unprecedented pressure that puts responders’ physical, mental and social well-being at risk. Despite the negative psychological outcomes, scholars argue that being in a traumatic situation may trigger positive outcomes for some people. Thus, the study also focuses on the positive impact of working in a risky crisis environment. Additionally, people’s interpretation of negative experiences or exposure to adverse conditions differ owing to their personal resources which explains why some people may be negatively affected whiles others are positively impacted. To examine these complex nuances, an exploratory sequential mixed method design is adopted. This paper will highlight the findings of study one, which explores the underlying themes emerging from the Ghanaian disaster and emergency response environment regarding psychosocial hazard exposures and the corresponding outcomes.

Keywords: psychosocial hazards, organisational outcomes, qualitative research, Ghana

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Authors: Christine Marie Cocchiola

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This study assesses the relationship between coercive control and subjugation. Coercive control is the foundation of most domestic violence and a serious public health problem, having significant legal and social justice ramifications. Beyond the physical, it oftentimes is preceded by or motivated by a need for control. Subjugation, as a personality trait and a maladaptive schema, leads individuals to minimize their own needs or wants and, thereby, often to a loss of autonomy, a dismissal of what one might know to be true. This includes a dismissal of the trademarks of an abusive relationship. Subjugation may contribute to a person engaging in or remaining in a coercively controlling relationship. One hundred fifty-four female survivors of domestic violence participated in this study, assessing their own level of subjugation. Participants were limited to individuals who experienced non-physical abuse in their relationships. Subjugation was attributed as a “concern” or greater in 137 of the 154 participants. 11 participants were interviewed to determine their personal experiences in this abusive relationship. Common themes emerged from interviews, including that the participants worked diligently to fix these abusive relationships by regulating their own behaviors and attempting to please the offender. The results indicate a continued need for advocacy and support of this vulnerable population. Further education is indicated for mental health professionals and for individuals in or having left an abusive relationship on how to identify signs of subjugation, thereby empowering individuals to avoid future experiences of abuse.

Keywords: coercive control, intimate partner violence, subjugation, schemas, gender oppression, autonomy, gaslighting

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Authors: Natalie Thorburn

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New Zealand legalised and regulated prostitution 13 years ago with the hope of eradicating unsafe or exploitative practices in the sex trade, but the extent to which this has been successful has been hotly contested, with the New Zealand Government denying any existence of sex trafficking and evidence generally indicating the success of the 2004 reform. The aim of the research was therefore to establish the circumstances in which sex trafficking may be occurring without using any previously instrumental gatekeepers of the New Zealand sex industry. 14 survivors of gang, family, or intimate partner trafficking (all of whom had first been trafficked prior to the age of 16) were interviewed, as well as several key informants. It was found that there was a perceived lack of commitment by Police to investigate instances of trafficking, and this was considered to be linked to the legal status of prostitution. The lack of recognition at both community and political levels of the existence and prevalence of trafficking also meant that medical and social service practitioners were unaware trafficking was occurring, and would not know who to refer to if it was disclosed. Participants commonly normalised coercion into sex, seeing this as a continuation of prior sexually abusive experiences that were prevalent in their childhood and early adolescent environments. Their experiences with the helping services were typically either negative or non-existent, and they expressed frustration regarding the absence of justice, the lack of awareness, and health and outcomes they suffered in relation to their experiences of having been trafficked. Barriers to engagement and strategies to facilitate meaningful and sustainable engagement with this population group are therefore presented.

Keywords: legalisation, regulation, service access, socio-political context

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Authors: Kimberly McCabe

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The trafficking of women and children for abuse and exploitation is not a new problem under the umbrella of human trafficking; however, over the last decade, the problem has attracted increased attention from international governments and non-profits attempting to reduce victimization and provide services for survivors. Research on human trafficking suggests that the trafficking of human beings is, largely, a symptom of poverty. As the trafficking of human beings may be viewed as a response to the demand for people for various forms of exploitation, a product of poverty, and a consequence of the subordinate positions of women and children in society, it reaches beyond randomized victimization. Hence, human trafficking, and especially the trafficking of women and children, goes beyond the realm of poorness. Therefore, to begin to understand the reasons for the existence of human trafficking, one must identify and consider not only the immediate causes but also those underlying structural determinants that facilitate this form of victimization. Specifically, one must acknowledge the economic, social, and cultural factors that support human trafficking. This research attempts to study human trafficking at the country level by focusing on economic, social, and cultural characteristics. This study focuses on inequality and, in particular, gender inequality as related to legislative attempts to address human trafficking. Within the design of this project is the use of the US State Department’s tier classification system for Trafficking in Persons (TIP) and the USA CIA Fact Sheet of country characteristics for over 150 countries in an attempt to model legal outcomes as related to human trafficking. Results of this research demonstrate the significance of characteristics beyond poverty as related to country-level responses to human trafficking.

Keywords: child trafficking, gender inequality, human trafficking, inequality

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Authors: Brahmi Brahim, Mohammad Habibur Rahman, Maarouf Saad, Cristóbal Ochoa Luna

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A repetitive training movement is an efficient method to improve the ability and movement performance of stroke survivors and help them to recover their lost motor function and acquire new skills. The ETS-MARSE is seven degrees of freedom (DOF) exoskeleton robot developed to be worn on the lateral side of the right upper-extremity to assist and rehabilitate the patients with upper-extremity dysfunction resulting from stroke. Practically, rehabilitation activities are repetitive tasks, which make the assistive/robotic systems to suffer from repetitive/periodic uncertainties and external perturbations induced by the high-order dynamic model (seven DOF) and interaction with human muscle which impact on the tracking performance and even on the stability of the exoskeleton. To ensure the robustness and the stability of the robot, a new nonlinear backstepping control was implemented with designed tests performed by healthy subjects. In order to limit and to reject the periodic/repetitive disturbances, an iterative estimator was integrated into the control of the system. The estimator does not need the precise dynamic model of the exoskeleton. Experimental results confirm the robustness and accuracy of the controller performance to deal with the external perturbation, and the effectiveness of the iterative estimator to reject the repetitive/periodic disturbances.

Keywords: backstepping control, iterative control, Rehabilitation, ETS-MARSE

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Authors: Jesus Kombaya, Nadia Hamani, Lyes Kermad

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The preservation of a company’s place on the market in such aggressive competition is becoming a survival challenge for manufacturers. In this context, survivors are only those who succeed to satisfy their customers’ needs as quickly as possible. The production system should be endowed with a certain level of flexibility to eliminate or reduce the rigidity of the production systems in order to facilitate the conversion and/or the change of system’s features to produce different products. Therefore, it is essential to guarantee the quality, the speed and the flexibility to survive in this competition. According to literature, this adaptability is referred to as the notion of "change". Indeed, companies are trying to establish a more flexible and agile manufacturing system through several reconfiguration actions. Reconfiguration contributes to the extension of the manufacturing system life cycle by modifying its physical, organizational and computer characteristics according to the changing market conditions. Reconfigurability is characterized by six key elements that are: modularity, integrability, diagnosability, convertibility, scalability and customization. In order to control the production systems, it is essential for manufacturers to make good use of this capability in order to be sure that the system has an optimal and adapted level of reconfigurability that allows it to produce in accordance with the set requirements. This document develops a measure of customization of reconfigurable production systems. These measures do not only impact the production system but also impact the product design and the process design, which can therefore serve as a guide for the customization of manufactured product. A case study is presented to show the use of the proposed approach.

Keywords: reconfigurable manufacturing systems, customization, measure, flexibility

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Authors: Radah Yousuf, Ashraf Shebl

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Suicide is a tragic event with strong emotional repercussions for its survivors and for families of its victims. There were thousands of cases all over the world. There are many risk factors include mental disorders such as depression, and substance abuse, including alcoholism and use of benzodiazepines. Other suicides are impulsive acts due to stress such as from financial difficulties, troubles with relationships, or from bullying. The aim of work in this study is making a survey from archives of the suicidal cases, which had a medicolegal examination, in forensic medicine center in Al Madinah Almunawarah-KSA, for ten years in the period between 1428-1438h. In each case, some data are collected such as age, sex, time and place of an act, method of suicide, the presence of the witness, medical history. This study demonstrates that suicide is more common in male than female, and the 4th decade was the most period of age. The most common method of suicide was hanging followed by falling from the height. These results indicated that cultural and religious beliefs that discourage suicide and support self-preservation instinct, and suicide education programs provide information to students in high school, builds awareness, one of the most important issues in solving that problem. From the forensic view, circumstantial evidence of every forensic case must take and record, full history about the social, medical and psychological problems, attend the scene of death is a very important, complete medicolegal investigation for every case, and full autopsy with very skilled techniques and facilities can help in diagnosing what type of crimes.

Keywords: suicide, age, sex, hanging

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Authors: Neimenuo Kengurusie

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Human trafficking is considered a form of slavery in modern day era and a gross violation of human rights and one of the most organized crimes of the day transcending cultures, geography and time. Human trafficking is a highly complex phenomenon involving many actors like victims, survivors, their families, communities and third parties that recruit, transport and exploit the trafficked victims. It takes different forms such as child trafficking, trafficking for labour, trafficking for sexual exploitation, trafficking for organ transplantation etc. and affects virtually every corner of the world. This research draws on a variety of sources, including books, articles, journals, newspaper reports, human rights reports, online materials and interviews. In India, particularly the North East region, the issue of human trafficking has become a concern regionally, nationally and internationally. The focus of this paper is on the North Eastern part of India as it is a socially and economically backward region of the country which makes women and children susceptible to trafficking. Women and children from these regions are trafficked within and outside the state. Therefore, the paper seeks to explore the issue of human trafficking, especially trafficking of women and children in North East India, which receives insufficient attention in literature. The paper seeks to analyze and understand the trend and patterns of trafficking and the mechanisms that reinforces the process and perpetuates the phenomenon of trafficking considering the nature and scope of the problem. The paper also analyzes the anti-trafficking laws initiated by India and the North East states in particular for combating human trafficking in North East India.

Keywords: children, human trafficking, North East India, women

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Authors: Li-Ting Chen, Chih-Tao Cheng, I-Ping Huang, Jen-Ho Chang, Nien-Tzu Chang, Fei-Hsiu Hsiao

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Background: Insecurity adult attachment style may be triggered by cancer threat, which in turn influences depression symptoms. Dispositional mindfulness may have benefits of insecure attachment on depression for colorectal patient transfer to survivor. Objective: This study examined the mediating and moderating effects of quality of life (QOL) and dispositional mindfulness on the relationship between insecure attachment style and depression symptoms. Methods: A cross-sectional study design was used. Data were collected using the QOL functional and symptoms (EORTC-C30 and EORTC CR29), dispositional mindfulness (FFMQ), Short form of Experience in Close Relationships Revised Questionnaire (SF-ECRRQ), and depressive symptoms (BDI-II scale). Results: Of the 90 CRC survivors who participated, the indirect effect of both ECR anxiety (β=0.23, CI=0.05-0.44) and ECR avoidance (β=0.12, CI=0.02-0.24) on depression were significantly mediated through EORTC-C29 colorectal symptoms. Three components of dispositional mindfulness (i.e., acting of awareness, non-judging, non-reactivity) as the moderator in the relationship between ECR anxiety and depressive symptoms. Acting of awareness was a moderator in the relationship between ECR avoidance and depressive symptoms. Conclusions: There are two pathways from insecure attachment to depression: through the mediator of colorectal symptoms and the moderator of dispositional mindfulness. Cancer symptom management and mindfulness practices could improve the impact of insecure attachment on depression among CRC patients in a post-treatment transition period.

Keywords: acting of awareness, attachment style, colorectal cancer, disposisitonal mindfulness, depression

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Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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Authors: Jiang Yuqi

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Aims: The aim is to analyze the facilitators and barriers of family resilience in cancer patients based on the theoretical domain framework, provide a basis for intervention in the family resilience of cancer patients, and identify the progress and enlightenment of existing intervention projects. Methods: NVivo software was used to code the influencing factors using the framework of 14 theoretical domains as primary nodes; secondary nodes were then refined using thematic analysis, and specific influencing factors were aggregated and analyzed for evaluator reliability. Data sources: PubMed, Embase, CINAHL, Web of Science, Cochrane Library, MEDLINE, CNKI, and Wanfang (search dates: from construction to November 2023). Results: A total of 35 papers were included, with 142 coding points across 14 theoretical domains and 38 secondary nodes. The three most relevant theoretical domains are social influences (norms), the environment and resources, and emotions (mood). The factors with the greatest impact were family support, mood, confidence and beliefs, external support, quality of life, economic circumstances, family adaptation, coping styles with illness, and management. Conclusion: The factors influencing family resilience in cancer patients cover most of the theoretical domains in the Theoretical Domains Framework and are cross-cutting, multi-sourced, and complex. Further in-depth exploration of the key factors influencing family resilience is necessary to provide a basis for intervention research.

Keywords: cancer, survivors, family resilience, theoretical domains framework, literature review

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Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan

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Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.

Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan

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Authors: Szu Mei Hsiao

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This study explores the spiritual needs of inpatients with advanced cancer and their family caregivers in one southern regional teaching hospital in Taiwan and elucidates the differences and similarities of spiritual needs between them. Little research reports the different phases of spiritual needs and the potential impact of Chinese cultural values on the spiritual needs. Qualitative inquiry was used. Twenty-one patients with advanced cancer and twenty-two family caregivers were recruited. During hospitalization, all participants identified spiritual needs both the palliative phase and the dying phase: (a) the need to foster faith/confidence and hope for medicine and/or God; (b) to understand the meaning and values of life; (c) to experience more reciprocal human love and forgiveness; and (d) to obey God’s/Heaven will. Furthermore, the differences of spiritual needs between patients with advanced cancer and their family caregivers are as follows: (a) family caregivers emphasized the need to inform relatives and say goodbye in order to die peacefully; (b) patients highlighted a need to maintain a certain physical appearance in order to preserve their dignity; nurture one’s willpower; learn about the experiences of cancer survivors; and identify one’s own life experience for understanding the meaning and values of life. Moreover, the dissimilarity of spiritual needs is that the patients pointed out the need to understand God’s will during the palliative treatment phase. However, the family caregivers identified the need to forgive each other, and inform relatives and say goodbye to patients in the dying phase. This research has shown that the needs of meaning/values of life and facing death peacefully are different between two groups. Health professionals will be encouraged to detect and to develop individualized care strategies to meet spiritual needs.

Keywords: advanced cancer, Chinese culture, family caregivers, qualitative research, spiritual needs

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Authors: Jelena Riznić

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Sexual violence is a social fact that is both ubiquitous and invisible. From the myth of Medusa and Lucretia, through legends about sexual violence in war conflicts, to Hollywood films and other productions — sexual violence exists as a motive, implicitly or explicitly. Many Hollywood films contain a scene of rape, and the media is increasingly reporting on cases of sexual violence, often not following the guidelines for sensitized and ethical reporting. On the other hand, sexual violence remains an invisible phenomenon if we are talking from the perspective of the survivors. Only the wave of women's testimonies that flooded social networks after the #MeToo campaign in 2017 pointed to the prevalence and to the existing ideas about sexual violence that persist at the level of myths in society, but also through formal norms in the hearing of justice systems. The problem is also in the way rape is defined in the criminal codes of different countries, and all of this affects the reproduction of sexual violence. Precisely because it is a deeply intimate experience of violence, but also a structural problem; on the other hand, understanding sexual violence requires sociological imagination. Accordingly, the subject of this paper is the presentation and analysis of various discourses on sexual violence throughout history — pre/anti-feminist, feminist and criminal law, with particular reference to the situation in Serbia. The paper uses a critical review and comparative analysis of various sources on sexual violence, as well as an analysis of the impact of these sources on the modern legal framework that regulates sexual violence. Research has shown that despite feminist contributions, myths about sexual violence persist and influence the treatment of women who have survived violence in criminal systems and society in general.

Keywords: sexual violence, gender-based violence, MeToo campaign, feminism, Serbia

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Authors: Erin Brands-Saliba

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In this evaluation study, we explore the efficacy and implementation of the five guiding principles of Bekaadendang “Being Peaceful,” a suite of services facilitated by our Anti-Human Trafficking Team, and a pivotal component of the Holistic Prevention Services department at NCFST. The guiding principles—trauma-informed care, cultural safety, 4-quadrant medicine wheel approach, harm reduction, and after-care peer support—are the foundation of Bekaadendang's mission to support at-risk individuals and survivors of human trafficking. This evaluation is of paramount importance given the profound impact of human trafficking on these communities and aims to ensure that Bekaadendang's principles are not only understood by staff but experienced by community members in a purposeful and meaningful manner. The issues at the heart of this evaluation are deeply entrenched in the historical and contemporary challenges faced by Indigenous communities, with a particular emphasis on Indigenous women and 2SLGBTQQIA+ individuals. Well-documented reports like the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) have cast a glaring light on the disproportionately high rates of violence, exploitation, and trafficking experienced by these communities. The MMIWG report underlines the pressing need for holistic, culturally informed interventions like Bekaadendang. Furthermore, the research efforts of scholars, both Indigenous and non-Indigenous, shed light on the persistent systemic issues that make Indigenous individuals more vulnerable to trafficking and exploitation. Recognizing this broader context is crucial to truly grasp the importance of evaluating the guiding principles that underpin Bekaadendang's service model.

Keywords: human trafficking, indigenous healing, MMIWG, program evaluation

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Authors: Ishaq Alhassan Meriga

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This study examined the phenomenon of mob violence and its implication for peace in Ghana. The study used the archival study of media reports and content analysis of other secondary data as well as eyewitness accounts. The study examined trends and patterns of vigilante violence within the Ghanaian context. Results showed a considerable increase in the occurrence of mob violence within the last 10 years. Theft and robbery emerged as the most frequently suspected crimes for which victims were attacked, while the LGBT community is not left out. Cases of mob violence were most frequently reported in urban areas. This study has shown that the patterns, scope, nature, and implication of mob justice in Ghana are fairly and comparatively similar to those found in other parts of Africa and the globe. Mob violence is identified as undermining the rule of law and thereby infringing on the fundamental human rights of the victims. It is confirmed to have a cycle of effects that is an impediment to the peace of the country. The study underscores the implications of mob violence in terms of disdaining human life and dignity, revisiting our justice systems and punishment procedures, resourcing, and empowering law enforcers to fight the menace of vigilantism. First, the archival study had a limitation regarding missing data. The majority of the cases used for the study lack information mostly on perpetrators and the steps taken by public authorities and security agencies after reports of a mob attack have been lodged with them. The study recommends for further research to be undertaken on the perpetrators and survivors of mob actions in order to get a holistic understanding of the phenomenon. This will give a more comprehensive view of the issue of mob violence in Ghana. From the findings, it can be concluded that mob justice is a social canker in Ghanaian communities, which has a great impact on the peace of the country.

Keywords: LGBT, mob justice, peace, vigilantism

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Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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Authors: Bonnie Pollak

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As the world continues to suffer grievous injuries, future generations will suffer from trauma that was inflicted on innocent victims. Trauma can result from refugees fleeing their homes, exposure to warfare, loss of loved ones, and lack of shelter and basic necessities. The Holocaust continues to cause pain even though WWII ended nearly 80 years ago. One cannot forget the inhumane treatment and murder of relatives. The pain and trauma may continue for generations. The purpose of the Final Solution was to eliminate Jews in totality. Though Hitler’s plan was not successful, he managed to cause trauma that will continue with no end date in sight. “The Effects of Trauma and Secondary Trauma,” Trauma can cause life-long challenges, eating disorders, cardiovascular disease, cancer, sleeping difficulties, fear of going outside, guilt, separation problems, and epigenetic changes. Secondary Trauma, witnessing a loved one in danger or hearing about the danger, can cause similar symptoms as seen in primary trauma. The transmission of trauma was demonstrated in children of Holocaust survivors and in communities where oppression was commonplace. We are witnessing a repeat of widescale death and horrific injuries today in Ukraine and in other parts of the world, where concern for pain and trauma is not acknowledged by perpetrators. Lessons from the Holocaust can be applied to help others who have been traumatized by widescale terrorism resulting in death of loved ones, loss of home and shelter, food and other life-sustaining measures. The world must help victims by providing basic necessities but also by using trauma-informed care, focusing on strength and resilience, and helping individuals to feel pride in their identity.

Keywords: transmission of intergenerational trauma, impact on religious beliefs and practices, 2nd generation, identity

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Authors: Medagedara Kaushalya Sewwandi Supun Gunarathne

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This research explores the underlying motivations and consequences of individuals changing their sexual orientation as a response to sexual violence. The primary objective of the study is to unravel the psychological, emotional, and social factors that drive individuals, akin to Celie in Alice Walker’s ‘The Color Purple’, to contemplate and undergo changes in their sexual orientation following the trauma of sexual violence. Through an analytical and qualitative approach, the study employs in-depth textual and thematic analyses to scrutinize the complex interplay between sexual orientation and violence within the selected text. Through a close examination of Celie’s journey and experiences, the study reveals that her decision to switch sexual orientation arises from a desire for a more favorable and benevolent relationship driven by the absence of safety and refuge in her previous relationships. By establishing this bond between sexual orientation and violence, the research underscores how sexual violence can lead individuals to opt for a change in their sexual orientation. The findings highlight Celie’s transformation as a means to seek solace and security, thus concluding that sexual violence can prompt individuals to alter their sexual orientation. The ensuing discussion explores the implications of these findings, encompassing psychological, emotional, and social consequences, as well as the societal and cultural factors influencing the perception of sexual orientation. Additionally, it sheds light on the challenges and stigma faced by those who undergo such transformations. By comprehending the complex relationship between sexual violence and the decision to change sexual orientation, as exemplified by Celie in ‘The Color Purple’, a deeper understanding of the experiences of survivors who seek a safe haven through altering their sexual orientation can be attained.

Keywords: sexual violence, sexual orientation, refuge, transition

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Authors: Joanna Maj

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Body machine interfaces (BMIs) afford users a non-invasive way coordinate movement. Vibrotactile stimulation has been incorporated into BMIs to allow feedback in real-time and guide movement control to benefit patients with cognitive deficits, such as stroke survivors. To advance research in this area, we examined vibrational discrimination thresholds at four body locations to determine suitable application sites for future multi-channel BMIs using vibration cues to guide movement planning and control. Twelve healthy adults had a pair of small vibrators (tactors) affixed to the skin at each location: forearm, shoulders, torso, and knee. A "standard" stimulus (186 Hz; 750 ms) and "probe" stimuli (11 levels ranging from 100 Hz to 235 Hz; 750 ms) were delivered. Probe and test stimulus pairs could occur sequentially or simultaneously (timing). Participants verbally indicated which stimulus felt more intense. Stimulus order was counterbalanced across tactors and body locations. Probabilities that probe stimuli felt more intense than the standard stimulus were computed and fit with a cumulative Gaussian function; the discrimination threshold was defined as one standard deviation of the underlying distribution. Threshold magnitudes depended on stimulus timing and location. Discrimination thresholds were better for stimuli applied sequentially vs. simultaneously at the torso as well as the knee. Thresholds were small (better) and relatively insensitive to timing differences for vibrations applied at the shoulder. BMI applications requiring multiple channels of simultaneous vibrotactile stimulation should therefore consider the shoulder as a deployment site for a vibrotactile BMI interface.

Keywords: electromyography, electromyogram, neuromuscular disorders, biomedical instrumentation, controls engineering

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