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Increasing numbers of Rohingya refugees have been found to be infected with HIV since they arrived in Bangladesh after being ousted from Myanmar in 2017. This study aimed to examine the knowledge about HIV transmission among Rohingya refugee women and to identify factors that are associated with that knowledge.
A cross-sectional survey was conducted using a structured questionnaire that was based on the standard questionnaire of the Demographic and Health Survey programme.
Rohingya settlements in the Kutupalong refugee camp at Ukhiya, Cox's Bazar, Bangladesh.
Interviews were conducted with 508 women who had married or given birth in the 2 years before the survey was done.
The participants were asked to answer a set of questions to assess their knowledge about HIV transmission.
Around 70% of the women could not accurately answer four of the eight questions, and there were substantial misconceptions about the modes of HIV transmission. Knowledge regarding HIV transmission among participants increases in conjunction with the age at which they were first married. Women who were involved in work outside their households or those whose husbands were employed were more likely than others to demonstrate relatively good knowledge of transmission. Women who had received some formal education were 2.37 times likely to show relatively good knowledge of HIV transmission than those who had not received any education. Availability of healthcare facilities in the blocks where women resided is also associated with better knowledge. However, knowledge of HIV transmission among Rohingya women was significantly lower than among women in Bangladesh and Myanmar.
Most Rohingya women have inadequate knowledge of HIV transmission. Targeted interventions are needed to provide HIV education and to assist with prevention and behavioural changes.
Most Rohingya women have inadequate knowledge of HIV transmission. Targeted interventions are needed to provide HIV education and to assist with prevention and behavioural changes.
Process evaluations accompanying complex interventions examine the implementation process of the underlying intervention, identify mechanisms of impact and assess contextual factors. This paper presents the protocol for a process evaluation conducted alongside the randomised controlled trial POWER@MS2. The trial comprises the evaluation of a web-based complex intervention on relapse management in 188 people with multiple sclerosis conducted in 20 centres. The web-based intervention programme focuses on relapse treatment decision making and includes a decision aid, a nurse-led webinar and an online chat. With the process evaluation presented here, we aim to assess participants' responses to and interactions with the intervention to understand how and why the intervention produces change.
A mixed methods design is used to explore the acceptance of the intervention as well as its use and impact on participants. Participants are people with multiple sclerosis, neurologists, nurses and stakeholders. Quantitative semistandardised evaluation forms will be collected throughout the study. Qualitative semistructured telephone interviews will be conducted at the end of the study with selected participants, especially people with multiple sclerosis and neurologists. Quantitative data will be collected and analysed descriptively. Based on the results, the qualitative interviews will be conducted and analysed thematically, and the results will be merged in a joint display table.
The process evaluation has received ethical approval from the Ethical Committee of the University of Lübeck (reference 19-024). Findings will be disseminated in peer-reviewed journals, at conferences, meetings and on relevant patient websites.
NCT04233970.
NCT04233970.
To investigate if there are differences between acupuncture and transcutaneous electrical nerve stimulation (TENS) as treatment for pelvic girdle pain (PGP) in pregnancy in order to manage pain and thus maintain health and functioning in daily activities and physical activity (PA).
Randomised controlled trial.
Pregnant women (n=113) with clinically verified PGP in gestational weeks 12-28, recruited from maternity healthcare centres, randomised (11) into two groups.
any obstetrical complication, systemic disease or previous disorder that could contradict tests or treatment.
The intervention consisted of either 10 acupuncture sessions (two sessions per week) provided by a physiotherapist or daily home-based TENS during 5 weeks.
Disability (Oswestry Disability Index), functioning (Patient Specific Functional Scale), work ability (Work Ability Index) and PA-level according to general recommendations.
Functioning related to PGP (Pelvic Girdle Questionnaire), evening pain intensity (Numeric Rating Sca
12726. https//www.researchweb.org/is/sverige/project/127261.
12726. https//www.researchweb.org/is/sverige/project/127261.
As early prediction of severe illness and death for patients with coronavirus disease 2019 (COVID-19) is important, we aim to explore the clinical value of laboratory indicators in evaluating the progression and prognosis of patients with COVID-19.
Retrospective cohort study.
Hospital-based study in China.
Adult patients with COVID-19 from December 15, 2019 to March 15, 2020.
Disease severity and mortality.
Clinical data of 638 patients with COVID-19 were collected and compared between severe and non-severe groups. The predictive ability of laboratory indicators in disease progression and prognosis of COVID-19 was analysed using the receiver operating characteristic curve. The survival differences of COVID-19 patients with different levels of laboratory indicators were analysed utilising Kaplan-Meier analysis.
29.8% (190/638) of patients with COVID-19 progressed to severe. Compared with patients with no adverse events, C reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and D-dimer wery response and multiple adverse events in patients with severe COVID-19.
The combination of CRP, NLR and D-dimer could be an effective predictor for the aggravation and death in patients with COVID-19. The abnormal expression of these indicators might suggest a strong inflammatory response and multiple adverse events in patients with severe COVID-19.
Human white adipose tissue (AT) is a metabolically active organ with distinct depot-specific functions. Despite their locations close to the gastrointestinal tract, mesenteric AT and epiploic AT (epiAT) have only scarcely been investigated. Here, we aim to characterise these ATs in-depth and estimate their contribution to alterations in whole-body metabolism.
Mesenteric, epiploic, omental and abdominal subcutaneous ATs were collected from 70 patients with obesity undergoing Roux-en-Y gastric bypass surgery. The metabolically well-characterised cohort included nine subjects with insulin sensitive (IS) obesity, whose AT samples were analysed in a multiomics approach, including methylome, transcriptome and proteome along with samples from subjects with insulin resistance (IR) matched for age, sex and body mass index (n=9). Findings implying differences between AT depots in these subgroups were validated in the entire cohort (n=70) by quantitative real-time PCR.
While mesenteric AT exhibited signatures simiy, impaired insulin sensitivity and related diseases.
Hundreds of thousands of people have been killed during the Syrian civil war and millions more displaced along with an unconscionable amount of destroyed civilian infrastructure.
We aggregate attack data from Airwars, Physicians for Human Rights and the Safeguarding Health in Conflict Coalition/Insecurity Insight to provide a summary of attacks against civilian infrastructure during the years 2012-2018. Specifically, we explore relationships between date of attack, governorate, perpetrator and weapon for 2689 attacks against five civilian infrastructure classes healthcare, private, public, school and unknown. Multiple correspondence analysis (MCA) via squared cosine distance, k-means clustering of the MCA row coordinates, binomial lasso classification and Cramer's V coefficients are used to produce and investigate these correlations.
Frequencies and proportions of attacks against the civilian infrastructure classes by year, governorate, perpetrator and weapon are presented. MCA results identify variationd the Syrian conflict.A 62-year-old man presents with breathlessness 6 months following right pneumonectomy for lung adenocarcinoma. Previous investigations had not yielded a diagnosis and his symptoms were progressing. The patient described worsened symptoms when stood up (platypnoea), with profound hypoxia until laid supine (orthodeoxia). Platypnoea-orthodeoxia syndrome due to a right-to-left interatrial shunt was diagnosed on contrast-enhanced transoesophageal echocardiography with the patient undergoing successful percutaneous patent foramen ovale closure. Patent foramen ovale is often asymptomatic with a population prevalence of around 20%-30%. Anatomical shifts postpneumonectomy can open, or worsen a previously closed interatrial communication leading to right-to-left shunting of blood. Platypnoea-orthodeoxia is under-recognised, impairing quality of life and patient outcome. Investigations can be falsely reassuring, or poorly sensitive for the causative pathology. Percutaneous closure is safe with high success rates and this case highlights the need for a high index of suspicion for shunts, particularly in postpneumonectomy patients.The posterior interosseous nerve is the terminal motor branch of the radial nerve that innervates the extensor carpi ulnaris and the extensors of the thumb and fingers. T0901317 We describe a case of a posterior interosseous neuropathy presenting with the typical 'finger drop' and partial 'wrist drop'. We focus on the clinical signs that distinguish it from a more proximal radial neuropathy, clarified by nerve conduction studies and needle electromyography. Multimodal imaging of the forearm did not identify a compressive lesion. Persistent symptoms prompted surgical exploration 5 years after initial onset. It identified compression of the posterior interosseous nerve in the region of the arcade of Frohse and leash of Henry. The sites were decompressed and concurrent salvage secondary reconstructive tendon transfers were required in view of the severe axonal loss with minimal chance of functional reinnervation.Placenta accreta spectrum disorder varies from minimally adherent placenta to deeply invasive placenta. Placenta percreta is a rare cause for uterine rupture and the incidence of morbidly adherent placenta is on the rise due to increase in the rates of caesarean section. We report a case of a 32-year-old, G2P1L1 who presented to us at 27 weeks in a state of haemodynamic shock with intrauterine fetal death. She had a history of prior caesarean section complicated by postpartum haemorrhage requiring B-Lynch suturing. With an initial diagnosis of caesarean scar rupture, she underwent an emergency laparotomy. Intraoperatively, the caesarean scar was found to be intact and uterine fundal rupture with placental protrusion identified. She underwent caesarean hysterectomy and was discharged in a stable condition. The histopathology report confirmed the diagnosis of placenta percreta.
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