Economic Strain Research Articles

Beta amyloid PET scans for dementia diagnoses: Practice and research implications from CARE-IDEAS.

Beta amyloid PET scans are a minimally invasive biomarker that may inform Alzheimer's disease (AD) diagnosis. The Caregiver's Reactions and Experience (CARE) study, an IDEAS supplement, aimed to understand experiences of PET scan recipients and their care partners regarding motivations for scans, reporting and interpreting results, and impact of results. Patients with mild cognitive impairment or dementia who agreed to join the CARE-IDEAS study and their care partners participated in a baseline survey and follow-up survey approximately 18 months later, supplemented by in-depth qualitative interviews with subsets of participants. Patients who received scans and volunteered for follow-up research were more likely to be male, better educated, and have higher income than the general population. Survey information was merged with Medicare data. This article integrates findings from several CARE-IDEAS publications and provides implications for practice and research. Although most participants accurately reported scan results, they were often confused about their meaning for prognosis. Some participants reported distress with results, but there were no significant changes in measured depression, burden, or economic strain over time. Many respondents desired more information about prognosis and supportive resources. Scan results were not differentially associated with changes in service use over time. Findings suggest a need for carefully designed and tested tools for clinicians to discuss risks and benefits of scans and their results, and resources to support patients and care partners in subsequent planning. Learning of scan results provides a point-of-contact that should be leveraged to facilitate shared decision-making and person-centered longitudinal AD care.

Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis.

This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.

Making money moves: rural women, returnees, and renegotiations of sex work through the street in Addis Ababa, Ethiopia

ABSTRACT Feminist research has highlighted both the emancipatory components of sex work on women’s lives, as well as the problematic nature of an overly romanticised reading of women’s sexual labour. In Ethiopian cities, including the capital, Addis Ababa, rural migrant women and returnee women from the Gulf States are confronted with layered forms of structural disadvantage that narrow the scope of their prospects for economic empowerment and deepen their vulnerability. Consequently, women relate to the street as a connector to capital, despite clashing claims for access and proximity that govern the street economy. This paper explores the everyday lived experiences of rural migrant women and returnee women streetworkers in Addis Ababa. Drawing on qualitative data collected in 2022 and 2023, the findings of this study show that women resort to sex work under conditions of protracted economic strain and an absence of viable alternatives for self-employment. Due to the marginalisation they face as part of the informal labour market, women exercise sex work both in the form of streetwalking and through routine engagements in transactional sexual relationships; both activities representing a central component of women’s ability to get by in the city. This paper argues that despite being the site of consequential transformation, women’s economic empowerment through sex work takes place within an entrenched patriarchal order that reproduces disenfranchising power inequalities through the practice of sex work itself, while reasserting the way women’s bodily integrity, safety, aspirations, and social standing are governed on – and by – the street.

Hospitalization Events Among Adolescents and Adults With Sickle Cell Disease in a Tertiary Care Center in Central India.

Sickle cell disease (SCD) is an inherited red blood cell disorder, wherein mutation causes the substitution of glutamic acid to valine at the sixth position of the β-globin chain. These include sickle cell anemia (homozygous sickle mutation), sickle-beta thalassemia, and hemoglobin SCD. The clinical manifestations of SCD are protean. Individuals with SCD suffer from both acute and chronic complications, which include recurring episodes of pain commonly called vaso-occlusive crisis (VOC) - acute chest syndrome (ACS); aseptic necrosis of the bone; micro-infarction of the spleen, brain, and kidney; infections; stroke; and organ damage affecting every part of the body. SCD necessitates frequent hospitalizations because of severe complications, which pose a significant burden on caregivers and economic strain on healthcare systems. The pattern of hospital admission with SCD varies in different parts of the world. This study aimed to determine the causes of hospitalization among adolescent and adult patients with SCD and to determine factors associated with their hospital stay. The study was a hospital-based prospective observational study comprising adolescent and adult patients diagnosed with SCD, aged 15-45 years, who were hospitalized in the Department of General Medicine at All India Institute of Medical Sciences in Raipur from August 2021 to August 2022. According to our study, the primary reason for hospitalization was a painful crisis, accounting for 63% of cases, followed by infection (17%), ACS (11%), and acute hemolytic crisis (9%). Notably, we did not observe any significant differences between genders and causes of admission (p > 0.05). Joint pain (p = 0.005), back pain (p = 0.001), and chest pain (p = 0.001) were more frequently reported by adults over the age of 19. In addition, our analysis of the duration of hospital stays and various factors revealed that patients admitted for infections had a significantly longer mean hospital stay duration (p = 0.040). Acute painful crises were the primary cause of hospital admission among individuals with SCD; many patients also encountered infections and ACS. Furthermore, patients who experienced infections and VOC had a lengthier duration of hospital stay. Therefore, it is essential to provide them with comprehensive instructions on various preventive measures against infections and the factors that trigger painful crises.

Health Seeking Patterns among Tribal Women in Lahaul Spiti and Kinnaur Districts of Himachal Pradesh: Addressing Healthcare Challenges

The present study investigates the health seeking behaviour of tribal women in the remote regions of Lahaul Spiti and Kinnaur. It emphasizes the role of supply side factors as key determinants in healthcare access. Despite governmental efforts to enhance healthcare reach, our study uncovers significant shortcomings that adversely affect service quality. Through primary survey and focus group discussions, the study explores the challenges faced by tribal women. These challenges include a constantly changing roster of medical professionals, limited access to experienced doctors, and a notable lack of specialized care, especially in gynaecology. The frequent dysfunction of vital diagnostic tools forces local residents to undertake long, costly journeys for medical care, leading to potential delays in receiving treatment. The study also observes the prevalent use of traditional medicine, deeply ingrained in local traditions, serving as both a supplement and an alternative to the mainstream healthcare system. This research sheds light on how these deficiencies in supply side healthcare, compounded by environmental and infrastructural barriers, influence the health related decisions of women, often pushing them towards alternative treatments and increasing their socio economic strain. The findings emphasize the urgent need for an integrated approach to bridge the healthcare gap and ensure the provision of quality medical services to these isolated and vulnerable communities.

Gender-based violence perpetrated against migrant women during lockdowns: A pastoral care challenge

Background: The article unpacks the complexities of gender-based violence (GBV) against illegal migrant women during lockdowns and contributes to the broader discourse on gender equality, human rights and social justice within the Pentecostal or Charismatic pastoral praxis. The geographical demography was a semi-formal area located between South Africa’s Gauteng and Northwest provinces. The period for the inquiry was South Africa’s coronavirus disease 2019 (COVID-19) induced lockdowns that began on 27 March 2020 until 05 April 2022.Objectives: The study aimed to shed light on the unique challenges faced by this vulnerable population, exploring the intersectionality of their undocumented status, gender and the socio-economic impacts of restrictive measures and the challenges to pastorally care for them.Method: The qualitative approach and case study were used to select two sets of participants; 13 illegal Zimbabwean Migrant Women (ZMW) and 3 Pentecostal or Charismatic clergy.Results: There was a disturbing prevalence of GBV incidents, ranging from physical, sexual to psychological abuse. The illegal status of migrant women exacerbated their vulnerability and reluctance to seek help due to fear of deportation and societal stigmatisation. The lockdown-induced economic strain further compounded their susceptibility to GBV.Conclusion: There was nonexistent pastoral care policy or praxis within the Pentecostal or Charismatic church for illegal ZMW who were victims of GBV during the lockdowns. These themes emerged: (1) high incidents of GBV perpetrated against illegal ZMW during lockdowns; (2) barriers to seeking pastoral care were lack of trust, migration status, fear of deportation, fear of infection and (3) no physical virtual pastoral care.Contribution: This article is embedded in the Pentecostal or Charismatic practice of care; postmodern, using the interpretive narrative framework to highlight the narratives of illegal Zimbabwean Migrant Women (ZMW) who were victims of gender-based violence (GBV) during South Africa’s COVID-19 lockdowns and the challenges of pastorally caring for them.

0123 Family Economic Strain Is Associated with Parent-Child Sleep Interactions

0123 Family Economic Strain Is Associated with Parent-Child Sleep Interactions

Epistemic stance and public discourse on irregular migration in one of Europe’s outermost regions

Abstract This article falls within the conceptual framework of critical discourse studies and cognitive linguistics whose attention has focused on the discourse found in the public sphere on the topic of migration. I will demonstrate the results of my analysis of a corpus composed of 74 opinion articles that were published in a Spanish regional newspaper between August 2020 and February 2021. All of them focus on the same issue: the mass arrival of irregular migrants at one of Europe’s outermost borders, the Canary Islands, and the social, political and economic strain that this is generating. The results of this analysis indicate that the periphrastic auxiliary verb poder (can/could/might) constitutes an essential resource for the way in which knowledge is managed by the authors whose intention is to fuel the debate by guiding the conceptualisation of reality of readers who do not have perceptual access to the events described.

Design of a Remote Multiparametric Tool to Assess Mental Well-Being and Distress in Young People (mHealth Methods in Mental Health Research Project): Protocol for an Observational Study.

Mental health conditions have become a substantial cause of disability worldwide, resulting in economic burden and strain on the public health system. Incorporating cognitive and physiological biomarkers using noninvasive sensors combined with self-reported questionnaires can provide a more accurate characterization of the individual's well-being. Biomarkers such as heart rate variability or those extracted from the electrodermal activity signal are commonly considered as indices of autonomic nervous system functioning, providing objective indicators of stress response. A model combining a set of these biomarkers can constitute a comprehensive tool to remotely assess mental well-being and distress. This study aims to design and validate a remote multiparametric tool, including physiological and cognitive variables, to objectively assess mental well-being and distress. This ongoing observational study pursues to enroll 60 young participants (aged 18-34 years) in 3 groups, including participants with high mental well-being, participants with mild to moderate psychological distress, and participants diagnosed with depression or anxiety disorder. The inclusion and exclusion criteria are being evaluated through a web-based questionnaire, and for those with a mental health condition, the criteria are identified by psychologists. The assessment consists of collecting mental health self-reported measures and physiological data during a baseline state, the Stroop Color and Word Test as a stress-inducing stage, and a final recovery period. Several variables related to heart rate variability, pulse arrival time, breathing, electrodermal activity, and peripheral temperature are collected using medical and wearable devices. A second assessment is carried out after 1 month. The assessment tool will be developed using self-reported questionnaires assessing well-being (short version of Warwick-Edinburgh Mental Well-being Scale), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) as the reference. We will perform correlation and principal component analysis to reduce the number of variables, followed by the calculation of multiple regression models. Test-retest reliability, known-group validity, and predictive validity will be assessed. Participant recruitment is being carried out on a university campus and in mental health services. Recruitment commenced in October 2022 and is expected to be completed by June 2024. As of July 2023, we have recruited 41 participants. Most participants correspond to the group with mild to moderate psychological distress (n=20, 49%), followed by the high mental well-being group (n=13, 32%) and those diagnosed with a mental health condition (n=8, 20%). Data preprocessing is currently ongoing, and publication of the first results is expected by September 2024. This study will establish an initial framework for a comprehensive mental health assessment tool, taking measurements from sophisticated devices, with the goal of progressing toward a remotely accessible and objectively measured approach that maintains an acceptable level of accuracy in clinical practice and epidemiological studies. OSF Registries N3GCH; https://doi.org/10.17605/OSF.IO/N3GCH. DERR1-10.2196/51298.

Perceived Economic Strain, Subjective Social Status, and Colorectal Cancer Screening Utilization in U.S. Men—A Cross-Sectional Analysis

Although socioeconomic status (SES) is fundamentally related to underutilization of colorectal cancer (CRC) screening, the role of perceived economic strain and subjective social status with CRC screening is understudied. The aim of this study was to investigate whether greater perceived economic strain or lower subjective social status would decrease the odds of CRC screening uptake and being up-to-date with guideline-recommended CRC screening. We also explored interactions with household income and educational attainment. Cross-sectional survey-based data from men aged 45–75 years living in the United States (N = 499) were collected in February 2022. Study outcomes were ever completing a stool- or exam-based CRC screening test and being up-to-date with CRC screening. Perceived economic strain and subjective social status were the predictors. We conducted logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI). Greater perceptions of economic strain decreased odds of being up-to-date with CRC screening. Household income modified the association between perceived economic strain and completing a stool-based test; the association was stronger for men from lower-income households. In unadjusted models, higher subjective social status increased odds of completing an exam-based test and being up-to-date with CRC screening. Our findings suggest that experiencing economic strain may interfere with men’s CRC screening decisions and may capture additional information about barriers to CRC screening utilization beyond those captured by income or education.

Building a maternal and child cohort amidst Lebanon’s socioeconomic collapse: preliminary results and navigating research challenges

The impact of conflict and crisis on maternal and child health underscores the need for reliable research in vulnerable populations. Lebanon, amidst ongoing economic collapse, political instability, and healthcare system strain, offers a case study for exploring these impacts, particularly on preterm babies and their development. This study aims to assess the feasibility of establishing a prospective cohort of mothers and their full-term and preterm babies in Lebanon, examining the association between social determinants, preterm birth, and developmental outcomes amidst the nation's multifaceted crises. The planned cohort involves 50 full-term and 50 preterm mother-baby pairs recruited at birth and followed up to 9–12 months post-birth. Data collection spans social determinants, perceived stress, social support, quality of life, and developmental assessments. Challenges in recruitment, follow-up, and data collection in the context of Lebanon's socio-political and economic turmoil are evaluated, alongside ethical considerations for research in vulnerable populations. Preliminary findings highlight substantial recruitment and follow-up challenges, notably due to population mobility, economic instability, and healthcare access issues. Despite these obstacles, 113 mother-baby pairs have been recruited. Early analysis reveals significant stress and reduced quality of life among mothers, particularly those with preterm infants, against a backdrop of declining birth rates and healthcare worker exodus. Conducting research in crisis settings like Lebanon presents unique methodological and ethical challenges but remains crucial for understanding and improving health outcomes in vulnerable populations. The study underscores the importance of adaptable research designs and ethical diligence in crisis research, highlighting the need for interventions tailored to these contexts. Establishing a mother and child cohort in Lebanon's crisis-ridden setting is faced with many challenges but is essential for guiding future interventions. Research in such contexts is needed to address health disparities and supporting vulnerable populations, emphasizing the need for dedicated funding and innovative research approaches in times of crisis.

Comprehensive Study of Ehretia laevis in Treatment of Diabetes and Related Complications

Diabetes mellitus appears to be a significant health issue globally, impacting millions of individuals and imposing an economic strain on healthcare systems all over the world. The pursuit of effective and safe alternative therapies has led researchers to investigate therapeutic plants with probable antidiabetic activity. This article highlights a comprehensive study investigating the therapeutic potential of Ehretia laevis in controlling of diabetes and associated complications in rats. The phytochemical investigation of E. laevis extracts observed phytoconstituents like flavonoids, phenolics, and triterpenoids. These phytoconstituents are known to possess antidiabetic properties. By injecting 60 mg/kg of STZ intraperitoneally once, rats were induced to develop diabetes. According to the experimental study, blood glucose levels were significantly reduced from 270 to 118 mg/dl after administering 200 and 400 mg/kg of aqueous and methanolic E. laevis extracts. Further evaluations on serum glutamic oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) revealed a significant reduction in their values, highlighting the control of liver complications. A lowering of serum urea and creatinine levels served to assess kidney-related complications. This comprehensive study sheds light on the potential of E. laevis in the treatment of diabetes and paves a path for the development of formulations, however, further mechanistic evaluation could be explored.

Exploring the therapeutic potential of cinnamon and clove essential oils for mitigating foodborne diseases: bioactivity and molecular interactions

Foodborne diseases remain a global concern due to their widespread impact on public health. Contaminated food can lead to outbreaks of illness that affect millions of people each year, leading to significant economic burdens and strain on healthcare systems. This study delves into the potential of cinnamon and clove essential oils to combat foodborne diseases. Essential oils extracted via the Soxhlet method using ethanol as solvent, these oils exhibit potent antibacterial, anti-inflammatory, antioxidant and anticancer properties. Gas chromatography-mass spectrometry analysis was performed to analyze the chemical constituents in both essential oils. Employing the Lipinski rule, bioactive compounds are screened and docked against a viral replication responsible protein of norovirus and the neurotoxin (botulinum toxin) of Clostridium botulinum both responsible for severe foodborne illnesses. Acetyleugenol demonstrates strong binding affinity, while the pyrimidine derivative from cinnamon sourced from Mbeya, Tanzania forms pi-sulfur interactions with both target molecules. This research emphasizes how essential oils confront foodborne diseases, granting valuable perspectives on potential compounds for extended examination and therapeutic interventions.

Reevaluating the Concern of Climate Change

Climate change is inevitably a defining characteristic of this century, which is inattentively attributed to anthropogenic factors far beyond its actualities. The paper challenges the prevailing narrative, proposing that global warming and climate shifts are inherent to Earth's history rather than primarily driven by human activities. It argues that climate change policies impose unwarranted economic strains on nations and impede technological advancement. Scientific assertions of human-induced climate change are scrutinized, with a focus on manipulated data and selective presentation to reinforce the narrative of impending global catastrophe. The exclusive emphasis on curbing greenhouse gas emissions is critiqued for fostering costly and ineffective measures, ultimately stalling economic growth and job creation. The study challenges the prevailing discourse on climate change and socio-economic challenges posed by climate migrations, advocating for a nuanced understanding that considers historical climatic shifts and questions the validity of current research methodologies, encouraging a more comprehensive examination of its multifaceted dynamics and potential societal impacts.

The clinical and economic burden of illness in the first two years after ostomy creation: a nationwide Danish cohort study

ABSTRACT Background Living with an ostomy is often associated with costly complications. This study examined the burden of illness the first two years after ostomy creation. Methods Data from Danish national registries included all adult Danes with an ostomy created between 2002 and 2014. Results Four cohorts consisted, respectively, of 11,385 subjects with a colostomy and 4,574 with an ileostomy, of which 1,663 subjects had inflammatory bowel disease (IBD) and 1,270 colorectal cancer as cause of their ileostomy. The healthcare cost was significantly higher for cases versus matched controls for all cohorts. In the first year, the total healthcare cost per person-year was €27,962 versus €4,200 for subjects with colostomy, €29,392 versus €3,308 for subjects with ileostomy, €15,947 versus €2,216 when IBD was the underlying cause, and €32,438 versus €4,196 when it was colorectal cancer. Healthcare costs decreased in the second year but remained significantly higher than controls. Hospitalization and outpatient services were primary cost drivers, with ostomy-related complications comprising 8–16% of hospitalization expenses. Conclusion Compared to controls, subjects with an ostomy bear a significant health and financial burden attributable to ostomy-related complications, in addition to the underlying disease, emphasizing the importance of better ostomy care to enhance well-being and reduce economic strain.

At the Intersection of Critical Care and Infectious Diseases: The Year in Review.

Severe infection represents a leading reason for admission to the intensive care unit (ICU) while nosocomial infection can arise as a complication of care in the ICU. The mortality and morbidity of such infections are substantial. These processes also put economic strain on the healthcare system. Additionally, the continued spread of antimicrobial resistance has made it more challenging both to prevent and treat severe infection. Until recently, there were few well-done trials addressing infection among the critically ill. However, over the last year, six important randomized studies have dealt with a range of topics at the intersection of infectious diseases and critical care. Our goal is to review these reports in order to clarify their major findings, significance, strengths, weaknesses, and clinical applications. Specifically, we explore and discuss six trials conducted in the areas of (1) prevention, (2) the present use of standard antimicrobials, and (3) novel adjunctive and antibiotic treatments. Through highlighting these trials, we hope to help clinicians apply their important findings in an evidence-based fashion at the bedside. It is through the application of key evidence that both infectious disease practitioners and intensivists can improve patient outcomes.

Dehydroevodiamine Ameliorates Neurological Dysfunction After Traumatic Brain Injury in Mice via Regulating the SIRT1/FOXO3a/Bim Pathway

BackgroundTraumatic Brain Injury (TBI) poses a considerable public health challenge, resulting in mortality, disability, and economic strain. Dehydroevodiamine (DEDM) is a natural compound derived from a traditional Chinese herbal medicine. Prior studies have substantiated the neuroprotective attributes of this compound in the context of TBI. Nevertheless, a comprehensive comprehension of the exact mechanisms responsible for its neuroprotective effects remains elusive. It is imperative to elucidate the precise intrinsic mechanisms underlying the neuroprotective actions of DEDM. PurposeThe aim of this investigation was to elucidate the mechanism underlying DEDM treatment in TBI utilizing both in vivo and in vitro models. Specifically, our focus was on comprehending the impact of DEDM on the Sirtuin1 (SIRT1) / Forkhead box O3 (FOXO3a) / Bcl-2-like protein 11 (Bim) pathway, a pivotal player in TBI-induced cell death attributed to oxidative stress. Study design and methodsWe established a TBI mouse model via the weight drop method. Following continuous intraperitoneal administration, we assessed the neurological dysfunction using the Modified Neurological Severity Score (mNSS) and behavioral assay, followed by sample collection. Secondary brain damage in mice was evaluated through Nissl staining, brain water content measurement, Evans blue detection, and Western blot assays. We scrutinized the expression levels of oxidative stress-related indicators and key proteins for apoptosis. The intricate mechanism of DEDM in TBI was further explored through immunofluorescence, Co-immunoprecipitation (Co-IP) assays, real-time quantitative PCR (RT-qPCR), dual-luciferase assays and western blotting. Additionally, we further investigated the specific therapeutic mechanism of DEDM in an oxidative stress cell model. ResultsThe results indicated that DEDM effectively ameliorated oxidative stress and apoptosis post-TBI, mitigating neurological dysfunction and brain injury in mice. DEDM facilitated the deacetylation of FOXO3a by up-regulating the expression of the deacetylase SIRT1, consequently suppressing Bim expression. This mechanism contributed to the alleviation of neurological injury and symptom improvement in TBI-afflicted mice. Remarkably, SIRT1 emerged as a central mediator in the overall treatment mechanism. ConclusionsDEDM exerted significant neuroprotective effects on TBI mice by modulating the SIRT1/FOXO3a/Bim pathway. Our innovative research provides a basis for further exploration of the clinical therapeutic potential of DEDM in the context of TBI.

Benefits of Some Phytochemical Compounds in Experimental Sepsis Models: A Therapeutic Perspective.

Sepsis represents a major contributor to mortality among critically ill patients, imposing a substantial economic strain on health-care systems. The uncontrolled inflammatory response during sepsis development, often leading to multiorgan failure and death, remains a challenge despite advances in antibiotics and supportive care. Factors such as antibiotic resistance, noninfectious causes, and delays in treatment initiation contribute to the complexity of managing sepsis. This review explores alternative treatment strategies focusing on the ameliorative efects of widely consumed phytochemicals and their cellular and molecular mechanisms in various in vitro and in vivo sepsis models. Preemptive administration of phytochemicals before sepsis onset appears efective, emphasizing their potential as adjunct or complementary therapeutic agents for critically ill sepsis patients. As a consequence, phytochemicals can be included in treatment regimens to enhance overall efectiveness and expedite the healing process.

Faecal incontinence with concurrent disorders of gut-brain interaction: A worse outcome.

Faecal incontinence is a common debilitating condition associated with poor quality of life that generates substantial economic strain on healthcare systems. We aimed to evaluate, in a tertiary referral population presenting with faecal incontinence, the impact of suffering additional disorders of gut-brain interaction (DGBI) on symptom severity, anxiety, depression and quality of life. Design: Retrospective cohort study. Tertiary referral Neurogastroenterology centre. All patients presenting with faecal incontinence from 2007 to 2020 were included. The results from structured medical and surgical questionnaires including Rome III Integrative Questionnaire, Faecal Incontinence Severity Index, Hospital Anxiety and Depression Scale, SF-36, and anorectal physiology were analysed using Stata version 17. Patients were categorised into 3 groups: 0-1 additional DGBI, 2 DGBIs, and 3+ DGBI. Statistical significance was defined as p<0.05 (two-tailed). Faecal incontinence patients (n=249; mean age 63.4±12.6years; 93.6% female, 48.1% urge subtype) met diagnostic criteria for mean 2.2 additional DGBI each, mostly affecting bowel (n=231, 42.4%) and anorectal (n=150, 27.5%) regions. A greater number of DGBIs was associated with higher faecal incontinence symptom severity (p<0.001), higher anxiety (p=0.002) and depression (p=0.003), and worse quality of life in areas of mental health (p=0.037) and social effect (p<0.001). Patients with a greater number of concurrent DGBI demonstrated a greater family history of gastrointestinal problems (p=0.004). There were no associations found between a greater amount of DGBIs and anorectal physiology. A greater number of additional DGBIs in faecal incontinence patients was associated with worse faecal incontinence symptoms, higher anxiety and depression scores, and worse quality of life but was unrelated to physiology. This highlights the need to proactively search for comorbid DGBI in patients presenting with faecal incontinence.

GROUNDWATER DEPLETION IN AGRICULTURAL REGIONS: CAUSES, CONSEQUENCES, AND SUSTAINABLE MANAGEMENT: A CASE STUDY OF BASALTIC TERRAIN OF SOLAPUR DISTRICT

This research paper investigates the intricate dynamics of groundwater depletion in the agricultural region of Solapur, characterized by a basaltic terrain. The study unveils the multifaceted causes, consequences, and sustainable management strategies tailored to the unique geological and socio-economic conditions of Solapur. Over-extraction for irrigation, geological factors related to the low permeability of basaltic rocks, and specific agricultural practices have collectively contributed to a discernible decline in water table levels. The agricultural impacts are profound, with reduced crop yields and economic strains on farmers. Socioeconomic consequences extend to local communities, necessitating a holistic approach to address the challenges. The research proposes sustainable management strategies, including water conservation practices, localized policy interventions, community engagement, and technological innovations, designed to mitigate the adverse effects of groundwater depletion. These strategies, tailored to Solapurs conditions, showcase a pathway towards long-term resilience and sustainability. The case study of Solapur holds broader significance, serving as a microcosm for understanding and addressing groundwater depletion in agricultural regions globally. The complex interplay between geological, climatic, and anthropogenic factors underscores the importance of context-specific solutions and collaborative efforts to ensure the sustainable use of groundwater resources. The findings contribute valuable insights for policymakers, researchers, and communities striving to achieve water security and resilience in agricultural regions worldwide. KEYWORDS: Agricultural Regions, Basaltic Terrain, Groundwater Depletion, Solapur Case Study, Sustainable Management.