The exploration of Dom Moraes’s life and work gives us a vivid picture of the reconfiguration of Asia and Europe after the Second World War and the wave of independences and of the transformation of the relationship between the UK, India, and Hong Kong during the Cold War period. Through his poetry, his autobiographic and journalistic writings, he develops a unique and personal sense of cultural location across societies and continents while being a keen observer and promoter of cultural transfers between those localities.Moraes was born in 1938 in Bombay among the Indian political and cultural anglophone-educated elite. His childhood was marked by the fight for Indian independence, the fall of the British Empire and the fragmentation of South Asia that ensued. Then, at the age of 16, he was sent to England to study at Jesus College in Oxford. He chose to mingle with the Soho bohemian artistic elite and after a meteoric rise to success, he became at 18 the youngest recipient of the Hawthornden Prize (1958) and was identified as a rising star of English literature. Thus, tensions between his Britishness and Indianness and the outsider/insider conflict inevitably emerged.He then turned to journalism to explore the UK and the Indian subcontinent. He was also witness to the Eichmann trial in Israel. He left his European-centered scope for Hong Kong and later for the United Nations, collecting and recording the world’s transformations in Asia and Africa. His autobiographical writings allowed him to question his cosmopolitan nomadic life and his positioning as an artist and intellectual in this reconfigured world—as the titles of his two autobiographies, Gone Away and Never at Home, point to.
Musthamin Balumbi, Stang Stang, Suriah Suriah
et al.
Reproductive health education at the primary school level is a controversial topic. Although some recognize its importance in providing accurate information about the body and development, others raise concerns about cultural sensitivities and age-appropriateness. This review intends to explore various aspects related to the importance of reproductive health education among primary school children, as well as the challenges and benefits associated. This article presents a literature review of previous studies on the implementation of health and reproductive education in elementary school children. An extensive search was conducted to identify relevant papers using relevant databases like ScienceDirect, PubMed, and Google Scholar. The articles included were selected if published between 2013 and 2023, in the English language, and have undergone a rigorous peer-review process. Our review identified substantial benefits of reproductive health education in primary schools. Studies showed a positive impact on reducing misconceptions about reproduction, promoting healthy attitudes towards the body, and potentially lowering risks of teenage pregnancy and sexually transmitted diseases. However, the review also revealed significant challenges. Cultural and religious sensitivities often lead to resistance from some communities. Additionally, ensuring age-appropriate language, content, and delivery methods remains a concern. The findings highlight the need for a balanced approach to reproductive health education in primary schools. While acknowledging cultural sensitivities, strategies like involving communities and using inclusive language can promote inclusivity. Open communication within families and well-trained teachers are crucial for effective reproductive health implementation. By addressing these challenges through inclusive and age-appropriate methods, reproductive health education programs can equip children with the knowledge and skills necessary for a healthy future.
Special aspects of education, Public aspects of medicine
Background and aimFecal incontinence (FI) is defined as the unintended loss of solid or liquid stool. FI adversely affects the patient’s quality of life. However, due to stigma, lack of awareness, and underdiagnosis, there is a notable gap in the knowledge regarding its prevalence. This study aimed to conduct a systematic review and meta-analysis of published literature reporting on FI prevalence and estimate the number of people afflicted by FI.MethodsA systematic review was conducted following the PRISMA 2020 guidelines, using the Embase, MEDLINE, CINHAL, and PubMed databases to identify relevant publications in the English language. Two reviewers independently screened the articles and extracted data. The reference sections and content of the review papers were also evaluated. Thirty-two articles were selected and included. A meta-analysis of proportions was performed using RStudio software. A sub-analysis was conducted to account for the variation between sample population age groups to minimize heterogeneity. The pooled prevalence was extrapolated to the Canadian population and a sample of ten densely populated countries to estimate the number of people affected by FI.ResultsThe Mean pooled FI prevalence in men and women was 7% (95% CI: 6-9%) and 10% (95% CI: 8-12%), respectively. The sub-analysis mean pooled prevalence of FI in men and women was 8% (95% CI: 6-10%) and 10% (95% CI: 8-12%), respectively. The authors estimate that between 1 and 1.5 million Canadians and 320 to 500 million people in the ten most populous countries suffer from FI.ConclusionFecal incontinence is a prevalent underdiagnosed condition requiring appropriate and timely treatment to improve a patient’s quality of life.
Diseases of the digestive system. Gastroenterology
Yi-Qiang Guo, Yuling Chen, Annette DeVito Dabbs
et al.
BackgroundSmoking is a leading cause of premature death globally. Quitting smoking reduces the risk of all-cause mortality by 11%-34%. Smartphone app–based smoking cessation (SASC) interventions have been developed and are widely used. However, the evidence for the effectiveness of smartphone-based interventions for smoking cessation is currently equivocal.
ObjectiveThe purpose of this study was to synthesize the evidence for the effectiveness of smartphone app–based interventions for smoking cessation.
MethodsWe conducted a systematic review and meta-analysis of the effectiveness of smartphone interventions for smoking cessation based on the Cochrane methodology. An electronic literature search was performed using the Cochrane Library, Web of Science, PubMed, Embase, PsycINFO, China National Knowledge Infrastructure, and Wanfang databases to identify published papers in English or Chinese (there was no time limit regarding the publication date). The outcome was the smoking abstinence rate, which was either a 7-day point prevalence abstinence rate or a continuous abstinence rate.
ResultsA total of 9 randomized controlled trials involving 12,967 adults were selected for the final analysis. The selected studies from 6 countries (the United States, Spain, France, Switzerland, Canada, and Japan) were included in the meta-analysis between 2018 and 2022. Pooled effect sizes (across all follow-up time points) revealed no difference between the smartphone app group and the comparators (standard care, SMS text messaging intervention, web-based intervention, smoking cessation counseling, or apps as placebos without real function; odds ratio [OR] 1.25, 95% CI 0.99-1.56, P=.06, I2=73.6%). Based on the subanalyses, 6 trials comparing smartphone app interventions to comparator interventions reported no significant differences in effectiveness (OR 1.03, 95% CI 0.85-1.26, P=.74, I2=57.1%). However, the 3 trials that evaluated the combination of smartphone interventions combined with pharmacotherapy compared to pharmacotherapy alone found higher smoking abstinence rates in the combined intervention (OR 1.79, 95% CI 1.38-2.33, P=.74, I2=7.4%). All SASC interventions with higher levels of adherence were significantly more effective (OR 1.48, 95% CI 1.20-1.84, P<.001, I2=24.5%).
ConclusionsThis systematic review and meta-analysis did not support the effectiveness of delivering smartphone-based interventions alone to achieve higher smoking abstinence rates. However, the efficacy of smartphone-based interventions increased when combined with pharmacotherapy-based smoking cessation approaches.
Trial RegistrationPROSPERO CRD42021267615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=267615
Computer applications to medicine. Medical informatics, Public aspects of medicine
Fei-Yi Zhao,1– 3,* Wen-Jing Zhang,3,* Gerard A Kennedy,1,4,5 Russell Conduit,1 Zhen Zheng,1 Qiang-Qiang Fu6 1School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, 3083, Australia; 2Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, 201209, People’s Republic of China; 3Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China; 4School of Science, Psychology and Sport, Federation University, Mount Helen, Victoria, Australia; 5Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, 3084, Australia; 6Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhen ZhengSchool of Health and Biomedical Sciences, RMIT University, PO Box 71, Bundoora, Victoria, 3083, AustraliaTel +61 3 9925 7167Fax +61 3 9925 7178Email zhen.zheng@rmit.edu.auQiang-Qiang FuDepartment of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People’s Republic of ChinaTel +86 21-6569 0520Fax +86 21-6569 0520-813Email 286852271@qq.comObjective: To summarize and critically assess the reliability of the methodological quality and outcome measures from systematic reviews (SRs)/meta-analyses (MAs) and provide an overall verdict about the therapeutic value of acupuncture for perimenopausal insomnia (PMI).Methods: We conducted a comprehensive literature search for SRs/MAs of seven major databases (English and Chinese). For each included review, the methodological quality was appraised according to the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the evidence quality was classified on the basis of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE), and reporting quality was evaluated complying with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 (PRISMA-2009). Veritas plots were used to quantify the quality of included SRs/MAs.Results: Nine SRs/MAs were deemed eligible for the present overview. Considering the assessment of results from the AMSTAR-2 checklist, the methodological quality of one SR/MA was considered low, and the remaining eight were critically low. Major methodological deficiencies were concentrated on item 2 (the lack of protocol and/or registration information), item 7 (the lack of a list of excluded studies), and item 10 (the lack of reports on funding sources for individual studies included in the SRs/MAs). For the GRADE system, of the 25 outcomes, only three (12%) were rated as moderate-quality, while the remaining 22 were rated between low- and very low-quality. The PRISMA-2009 statement indicated three major reporting quality limitations in most SRs/MAs, namely: 1) only search terms without specific retrieval strategy; 2) incomplete descriptions for study characteristics, particularly the specific dosage and frequency of interventions in treatment/control groups; and 3) inadequate investigation and explanation of the source of high heterogeneity among original randomized control trials included. According to Veritas plots, quality rank scores of included SRs/MAs ranged from 3.3 to 8.3, with an average score of 6.4 ± 1.7.Conclusion: Acupuncture appears to be beneficial for PMI management, but the quality of evidence is weakened by the unsatisfactory quality of both SRs/MAs and original trials included.Keywords: acupuncture, perimenopausal insomnia, systematic review, meta-analysis, methodological quality, quality of evidence
Neurosciences. Biological psychiatry. Neuropsychiatry, Neurology. Diseases of the nervous system
Amir Hossein Firoozkohi, Musa Nushi (0000-0003-1917-5372)
The present study examines Iranian EFL instructors’ conceptualizations of task-based language teaching (TBLT) to identify whether teaching experience plays a significant role in their familiarity with the theoretical underpinnings of TBLT. One hundred sixty-two EFL instructors, reportedly practicing CLT, took part in the study; they were grouped into two categories of novice (N=74) and experienced (N=88). They were asked to fill out a five-point Likert-scale questionnaire designed by the researchers. The responses from the participants were then measured against Ellis’s (2012) criteria of task. The analyses indicated that both novice and experienced language instructors lacked a clear understanding of the ins and outs of TBLT. The findings suggest that without having been fully introduced to this approach, one cannot expect teachers to perform well in a task-based classroom. Hence, not only should stakeholders, administrators, and teacher educators consider offering teaching practicum opportunities, but they also should include introductory courses and workshops at theoretical levels for all teachers, irrespective of their teaching experience.
Andreea Giorgiana Mantescu, Diana-Antonia Iordachescu, Elena-Otilia Vladislav
et al.
Pregnancy and birth in adolescence involve certain risks for both mother and fetus. Psychologically, adolescent mothers have a higher risk of developing emotional disorders. This paper is a review based on information from the literature. The analysis was limited to articles in English published between January 1, 2000 and September 1, 2021 on PubMed, ScienceDirect and Google Scholar using the following keywords: pregnancy, adolescents, adolescence, risk factors, support factors, psychological interventions. In the context of pregnancy in this challenging stage of adolescence girls should be referred to pre- and postnatal counseling programs or support groups so that they develop healthy relationships and support networks.
To improve health outcomes in people living with HIV, adoption of evidence-based interventions (EBIs) using effective and transferable implementation strategies to optimise the delivery of healthcare is needed. ViiV Healthcare's Positive Pathways initiative was established to support the UNAIDS 90-90-90 goals. A compendium of EBIs was developed to address gaps within the HIV care continuum, yet it was unknown whether efforts existed to adapt and implement these EBIs across diverse clinical contexts. Therefore, this review sought to report on the use of implementation science in adapting HIV continuum of care EBIs. A systematic literature review was undertaken to summarise the evaluation of implementation and effectiveness outcomes, and report on the use of implementation science in HIV care. Ten databases were reviewed to identify studies (time-period: 2013-2018; geographic scope: United States, United Kingdom, France, Germany, Italy, Spain, Canada, Australia and Europe; English only publications). Studies were included if they reported on people living with HIV or those at risk of acquiring HIV and used interventions consistent with the EBIs. A broad range of study designs and methods were searched, including hybrid designs. Overall, 118 publications covering 225 interventions consistent with the EBIs were identified. These interventions were evaluated on implementation (N = 183), effectiveness (N = 81), or both outcomes (N = 39). High variability in the methodological approaches was observed. Implementation outcomes were frequently evaluated but use of theoretical frameworks was limited (N = 13). Evaluations undertaken to assess effectiveness were inconsistent, resulting in a range of measures. This review revealed extensive reporting on implementation science as defined using evaluation outcomes. However, high variability was observed in how implementation outcomes and effectiveness were defined, quantified, and reported. A more specific and consistent approach to conducting and reporting on implementation science in HIV could facilitate achievement of UNAIDS 90-90-90 targets.
This paper presents an overview of reviews of the literature on the opportunities and constraints of social media use for professional development. The objective is to map the studies in the field to identify possible research gaps and, in tandem, to indicate future directions for effective and safe use of social platforms for lifelong learning. The study is based on Ebsco, WoS, Scopus and Google Scholar search, and on the adoption of explicit criteria for the selection of relevant studies, i.e. literature reviews published in English in peer-reviewed journals from 2009 to 2019 with a specific focus on social media for professional development. Thirteen pertinent studies were identified that were analysed with respect to the theme and nature of the reviews. The results of the selected studies were also coded in terms of benefits and constraints.
Lo sviluppo professionale nell’era digitale. Vantaggi e criticità dei social media per l’apprendimento permanente
Il contributo presenta una rassegna delle revisioni della letteratura sulle opportunità e le criticità legate all’uso dei social media per lo sviluppo professionale. L’obiettivo è di mappare gli studi nel settore per individuare aree di ricerca ancora inesplorate e, parallelamente, indicare direzioni di sviluppo per l’uso efficace e sicuro delle piattaforme social per il lifelong learning. Lo studio si basa sull’interrogazione di Ebsco, WoS, Scopus e Google Scholar e sull’applicazione di criteri espliciti di selezione degli studi rilevanti, vale a dire revisioni della letteratura pubblicate in inglese su riviste referate nel periodo 2009-2019 con un focus specifico sui social media per lo sviluppo professionale. Sono stati individuati 13 studi significativi che sono stati analizzati rispetto al tema e alla natura delle rassegne. I risultati di tali studi sono stati poi codificati in termini di opportunità e criticità.
Milly Buwenge,1 Gabriella Macchia,2 Alessandra Arcelli,1 Rezarta Frakulli,3 Lorenzo Fuccio,4 Sara Guerri,1 Elisa Grassi,1 Silvia Cammelli,1 Francesco Cellini,5 Alessio G Morganti1 1Department of Experimental, Diagnostic and Specialty Medicine – DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; 2Radiation Oncology Unit, Research and Care Foundation “Giovanni Paolo II”, Catholic University of Sacred Heart, Campobasso, Italy; 3Radiation Oncology Unit, Bellaria Hospital, Bologna, Italy; 4Department of Medical and Surgical Sciences – DIMEC, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; 5Department of Radiotherapy, “A. Gemelli” Hospital, Catholic University, Rome, Italy Abstract: Locally advanced pancreatic carcinoma (LAPC) has a poor prognosis and the purpose of treatment is survival prolongation and symptom palliation. Radiotherapy has been reported to reduce pain in LAPC. Stereotactic RT (SBRT) is considered as an emerging radiotherapy technique able to achieve high local control rates with acceptable toxicity. However, its role in pain palliation is not clear. To review the impact on pain relief with SBRT in LAPC patients, a literature search was performed on PubMed, Scopus, and Embase (January 2000–December 2017) for prospective and retrospective articles published in English. Fourteen studies (479 patients) reporting the effect of SBRT on pain relief were finally included in this analysis. SBRT was delivered with both standard and/or robotic linear accelerators. The median prescribed SBRT doses ranged from 16.5 to 45 Gy (median: 27.8 Gy), and the number of fractions ranged from 1 to 6 (median: 3.5). Twelve of the 14 studies reported the percentage of pain relief (in patients with pain at presentation) with a global overall response rate (complete and partial response) of 84.9% (95% CI, 75.8%–91.5%), with high heterogeneity (Q2 test: P<0.001; I2=83.63%). All studies reported toxicity data. Acute and late toxicity (grade ≥3) rates were 3.3%–18.0% and 6.0%–8.2%, respectively. Reported gastrointestinal side effects were duodenal obstruction/ulcer, small bowel obstruction, duodenal bleeding, hemorrhage, and gastric perforation. SBRT achieves pain relief in most patients with pancreatic cancer with an acceptable gastrointestinal toxicity rate. Further prospective studies are needed to define optimal dose/fractionation and the best systemic therapies modality integration to reduce toxicity and improve the palliative outcome. Finally, the quality of life and, particularly, pain control should be considered as an endpoint in all future trials on this emerging treatment technique. Keywords: radiotherapy, pancreatic neoplasms, systematic review, palliative, pain
Antonyms have always been considered the starting point for language learners; therefore, they are familiar cross-linguistically. In this research, we try to provide a semantic description of antonymy in Neo-Aramaic (a member of the Semitic family) as it has not been put under scrutiny in the literature. Second, we analyze the semantic features of Neo-Aramaic antonyms according to two criteria, viz., markedness and committedness. We try to answer questions such as which member neutralizes the opposition in questions and whether nominalizations of these adjectives follow the same pattern as to markedness and committedness. The study sheds some light on the universality of these criteria and how they correlate in some cases but dissociate in others. Our analysis is, in most part, context-bound and shows that adjectives tend to change their semantic features due to the influence of the quantified noun. The analysis has revealed some striking differences between Neo-Aramaic and English, for example hot and cold are not prototypical equipollents in Neo-Aramaic. Nominalizations of the adjectives are morphologically derived; suppletive nominalizations do not exist in the grammar of this language. A preference for using yes/no questions has been noticed as a manoeuvring technique with some uncalibrated attributes.
If voting for the Conservative party had become somewhat of a rarity in Scotland since the Thatcher era, the May 2016 Scottish Parliament election ushered in a new era, as it saw the resurgence of the Scottish Conservatives after they obtained a total of 31 seats. A comparative perspective on Labour and Conservative Party attitudes to devolution and post-devolution Scottish politics will shed light on the electoral demise of the former and the rising fortunes of the latter. This article seeks to examine the main unionist parties’ differences in terms of structural and ideological adaptation to devolution within the broad centre-left consensus that characterizes the current Scottish political landscape.
OBJECTIVE: To review the literature on the importance of antioxidant vitamins, analyzed in the context of dietary intake, its plasma levels, and its current use as a supplementation treatment in obese children and adolescents with nonalcoholic fatty liver disease. DATA SOURCES: The articles were identified in Lilacs, Ibecs, SciELO, PubMed/Medline, and Scopus databases. To conduct the survey, the "fatty liver" descriptor was associated to the following words: "children", "antioxidants" and "vitamins". The search was limited to articles written in Portuguese, Spanish and English, with publication date until December, 2012. DATA SYNTHESIS: Six studies were selected. The survey revealed a low dietary intake and low antioxidant vitamins serum levels in this population. The changes in lifestyle, with adequate dietary intake of vitamins, and the increase in physical activity were associated with a significant improvement in liver histology and in laboratory tests. Vitamin supplementation also improved the disease progression markers, as the alanine aminotransferase serum levels and the histological characteristics of lobular inflammation and hepatocellular damage. However, these improvements were not statistically significant in all studies. CONCLUSIONS: There is insufficient evidence to recommend or to refute antioxidant supplementation in patients with simple steatosis or steatohepatitis. The changes in lifestyle seem to be, at the present time, the more advisable therapy.
Alison K Cohen, Paul J Christine, Abdulrahman M El-Sayed
Introduction: In high-income countries around the world, there appears to be an inverse association between educational attainment and obesity. However, the literature about this association in Spain remains disorganized and disparate.
Material and Methods: We systematically reviewed peer-reviewed English- or Spanish language studies of this association in Spain from 10 databases from all periods of time available.
Results: Our search identified twenty-four studies. In both nationally representative and subnational studies, women with less education had higher odds of obesity than their more educated counterparts. Men, despite exhibiting greater variability in the education-body weight relationship, also demonstrated a similar social patterning of body weight in many studies, with those at lower levels of educational attainment having higher odds of obesity relative to their more-educated counterparts. These associations in men and women were fairly consistent across time and place, though some regional variations did exist.
Discussion and conclusions: We encourage future researchers to move towards more meaningful, unbiased estimates of the association between educational attainment and obesity by measuring height and weight with physical exams, controlling for a more robust set of possible confounders, and exploring potential modifying factors of the association. Additionally, when possible, we encourage researchers to employ prospective study designs that facilitate causal inference with respect to this association.
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases
Objective: Treating menorrhagia in women of reproductive age by endometrial ablation (EA) decreases menstrual flow and increases quality of life. However, unexpected pregnancy and associated complications are challenges following EA.
Materials and Methods: From January 2000 to March 2008, a total of 356 women aged 26-45 years with persistent menorrhagia underwent total hysteroresectoscopic EA with follow-up at our hospital and were retrospectively evaluated. We also performed a literature search for articles reporting pregnancy after EA published between January 1983 and June 2008.
Results: Overall, 123 pregnancies after EA have been reported in the English literature, including five pregnancies among 356 women who underwent EA at our hospital. Fifty-nine (48%) of 123 pregnancies were terminated at the mother's request. The remaining 64 pregnancies were associated with spontaneous abortion (28%, 17/64), premature rupture of membranes (16%, 10/64), prematurity (31%, 19/64), cesarean section (44%, 27/64), and placental adherence complications (25%, 17/64) which necessitating hysterectomy in 10 women. Four tubal ectopic, two cornual and two cervical ectopic pregnancies were reported. The ectopic pregnancy rate was 6.5% (8/123). There were nine perinatal deaths, corresponding to a perinatal mortality rate of 14% (9/64). Five babies had congenital anomalies, including craniosynostosis (1 case), a set of twins with Down syndrome (1 case), agenesis of the corpus callosum (1 case), bilateral talipes (1 case), and one case of fetal malformation caused by intrauterine synechiae. The only maternal death was a 29-year-old woman with spontaneous rupture of her unscarred uterus and massive intraabdominal hemorrhage at 24 weeks of gestation.
Conclusion: Clinicians must recognize the potential complications associated with pregnancy after EA. Appropriate postoperative contraception and follow-up of menstrual patterns are strongly recommended.
Minhas estratégias de analise textual se tornarão mais ou menos evidentes na leitura que se segue. Sua proveniência deveriam tornar-se & cia. 0 ensaio foi inicialmente pensado come parte do livro The Linguistic Moment (Princeton: Princeton University Press, 1985). Aqui, como no livro, minha preocupação maior e com aqueles momentos em poemas em que a poesia como meio de comunicação constitui problema. Interessa-me particularmente a forma pela qual as fronteiras entre a linguagem conceitual e a figurative se tornam pouco visiveis no poema "A Primitive like an Orb", da última fase da poesia de Wallace Stevens.