Half Years Research Articles

Индивидуализация подходов к реабилитации детей с хроническим аденоидитом с учетом их конституциональных различий

The purpose — to reveal the features of the development, course and character of clinical manifestations of chronic adenoiditis in 4–7 y. o. children of various constitutional types. Material and methods. Children aged 4–7 years with a verified diagnosis of chronic adenoiditis were examined; they were divided into groups by constitutional types using the scale of mental activity orientation. The children with the expert assessment of mental activity orientation in the 1–3 interval were referred to the subgroup of «introverts», with 4–6 points — to the subgroup of «centroverts», and with 7–9 — to the subgroup of «extroverts». The sample of children was as follows: extroverts made up 35.9% of the total number of children, introverts — 34.1%, centroverts — 30%. The nature of clinical manifestations, development and course of chronic adenoiditis were assessed with the data from the child’s developmental history, additional parental questionnaire, and examination. Results. In introverts, the debut of chronic adenoiditis was at the age of 3–4 years, the disease duration by this age was about one and a half years, the diagnosis was made earlier than in extroverts, but with a later development of exudative otitis. In introverted children, complaints related to snoring and obstructive sleep apnea syndrome, as well as sound pronunciation disorders, came to the forefront. In extroverted children, chronic adenoiditis debuted at the age of 4–5 years, with the disease duration of about six months, with later diagnosis, but with early formation of exudative otitis. Clinical manifestations in extroverted children were associated with postnasal syndrome combined with nocturnal cough, formation of exudative otitis, frequent purulent otitis media and sharp hearing loss. Conclusion. Differences in the clinical and functional course of chronic adenoiditis in preschool children of various constitutional types should be taken into account in the organization of rehabilitation. This will improve the quality of life of these children, increase the bodily reactive capabilities and the levels of success and social adaptation in educational institutions.

MDA5 Juvenile Dermatomyositis Misdiagnosed as Childhood Psoriasis: A Case Report

Juvenile Dermatomyositis (JDM) is a rare autoimmune disorder which mainly affects the skin and skeletal muscles. Characteristic features of this rare disorder include Gottron papules, heliotrope rashes and proximal muscle weakness. MDA5 positive JDM is usually associated with interstitial lung disease in later part of life. The authors report a case of an 11-year-old male child who presented to the Paediatric Department with complaints of rashes over extensor surfaces, Gottron papules and pain and weakness in all limbs. The child was on treatment from the Dermatology Department as a case of psoriasis for last six months. During hospital stay after detailed work-up, the child was diagnosed to have JDM. Anti-melanoma Differentiation-Associated gene 5 (Anti-MDA5) antibodies were positive in the present case. The child was treated with immunosuppressive drugs with supportive care and is currently on treatment for the last one and a half years and is largely asymptomatic. JDM requires meticulous clinical examination and specific investigations so that timely diagnosis can be made to ensure appropriate treatment. In the present index case, the authors describe the typical clinical presentation, newer investigative modalities like myositis specific antibody and treatment outcomes of this rare condition.

Successful Surgical Resection of an Ependymal Cyst in the Fourth Ventricle of a Dog.

Ependymal cysts represent congenital brain malformations rarely described in human medicine, where surgical resection is the treatment of choice. In veterinary medicine, only three cases have been previously reported, with one partially resected with surgery. A 6 yr old entire male American Staffordshire terrier was referred with a 4 mo history of incoordination and collapsing episodes with extensor rigidity. Neurological examination localized the lesion to the left central vestibular system and cerebellum. A brain computed tomography scan showed a hypoattenuating lesion with peripheral contrast enhancement in the fourth ventricle consistent with a cyst and secondary hydrocephalus. Treatment with prednisone was initiated, but despite an initial improvement, neurologic signs recurred and a suboccipital craniectomy to remove the cyst was performed. The cyst was first drained, and the capsule was carefully resected. The histopathological evaluation revealed a simple cubic to cylindrical epithelium with apical cilia and loose surrounding fibrillar tissue consistent with an intraventricular ependymal cyst. Four and a half years after surgery, the dog only shows short episodes of balance loss when turning abruptly but is otherwise neurologically normal. To the authors' knowledge, this is the first reported ependymal cyst in the fourth ventricle of a dog with successful surgical resection.

Pubertal Development in Girls with Beta Thalassaemia and Assessment of the Adequacy of Chelation Therapy: A Quasi-experimental Study

Introduction: Beta thalassaemia is the most prevalent hereditary autosomal disorder, significantly impacting endocrine function during pubertal development. The pathology is rooted in the excessive deposition of iron in vital organs. If left untreated, this condition leads to serious morbidity and mortality. Hypogonadism stands as the most common endocrine complication. Aim: To observe pubertal development in girls with thalassaemia and evaluate the adequacy of chelation therapy in such patients by measuring levels of Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), oestrogen, and serum ferritin. Materials and Methods: A quasi-experimental study was conducted at the Thalassaemia Clinic at the Department of Obstetrics and Gynaecology, Burdwan Medical College, Purba Bardhaman, West Bengal, India involving 300 diagnosed Beta Thalassaemia Major (BTM) (case) patients aged 13 to 17 years over a period of one and a half years (January 2020 to June 2021). The girls in the study groups were sequentially enrolled from the Outpatient Department of the Thalassaemia Clinic after meeting inclusion and exclusion criteria. Demographic data, anthropometric measurements, and Sexual Maturity Rating (SMR) were recorded. Hormonal assays of serum FSH, LH, oestrogen, and serum ferritin levels were conducted. Thalassaemic girls with serum ferritin levels exceeding 500 ng/mL received chelation therapy. Serum ferritin levels were measured at two-month intervals for up to six months, with reassessment of serum FSH, LH, oestrogen, and ferritin levels at the end of the six-month period. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 27.0, Microsoft excel spreadsheet, and Epi Info 7. Results: A total of 190 (63.3%) of the thalassaemic girls were aged 13 to 15 years, with a mean Body Mass Index (BMI) of 22.5000±2.6100 kg/m2 , and 74 of them (38.94%) experienced menarche in this age group. Out of 300 cases, 269 thalassaemic girls (89.6%) received chelation therapy, and 89 cases (33.09%) reached menarche after chelation therapy. A significant (p<0.0001) increase in mean LH and FSH levels was observed after chelation therapy. The mean ferritin level decreased from 3168.85 ng/mL to 2227.24 ng/mL following chelation therapy. Conclusion: Pubertal development failure is common in beta thalassaemic girls. Intervention in the form of adequate chelation therapy in girls with high serum ferritin levels yielded favourable outcomes, as evident from serum gonadotropin and oestrogen levels.

Frequency and prescription patterns of laboratory investigations in evaluating physical morbidity among psychiatric inpatients – A cross-sectional study

Abstract Background: Comorbid physical illnesses worsen the morbidity and mortality in patients with mental illness. There is inadequate consensus regarding the optimal level of laboratory investigations and there is a need to know regarding the assessment of physical morbidity. Our study was conducted to study the frequency of prescription of laboratory investigation in evaluating psychiatric inpatients in a tertiary care center. Materials and Methods: An observational cross-sectional study was conducted in the inpatient psychiatry unit of a tertiary care hospital for one and a half years. Patients diagnosed with any mental illness and required hospitalization were included in the study. Sociodemographic data, illness details, and data regarding frequency and indications of laboratory investigations were recorded using a semistructured pro forma. For inferential analysis, P ≤ 0.05 was considered statistically significant. Results: One hundred and sixty-two participants were included in the study. “Endocrine, nutritional, or metabolic diseases” were the most common preexisting and newly diagnosed group of physical illness. A total of 705 additional tests were ordered for the study sample. Blood biochemistry was the most frequently ordered investigation. The most frequent blood biochemistry test, hematological test, and imaging were the estimation of glycemic indices, complete blood count, and ultrasound abdomen, respectively. One in two additional laboratory tests had abnormal or out-of-reference range (ORR) values in the results. Hematological tests were the most common, with abnormal or ORR values, followed by imaging and blood biochemistry. Clinician judgment was the most frequent reason for ordering an additional investigation. Conclusion: The study revealed that age, gender, the type of psychiatric illness, and the illness course-related characteristics significantly influenced the prescribing frequency of additional investigations and the proportion of abnormal/outside reference range results.

Johnson Matthey: Half year results for the six months ended 30 Sep 2023

Johnson Matthey: Half year results for the six months ended 30 Sep 2023

Forty years of a Postgraduate Program in Cardiology at a Brazilian public university: indicators of its graduates.

To evaluate the profile of graduates of the Postgraduate Program (PGP) in Cardiology of a public federal university, according to sociodemographic factors and professional trajectory. The variables were collected from databases from the observed institution and digital platforms. The analysis of differences between the various levels of degrees was carried out in three cohorts: the entire historical series (graduates from 1978-2021), the first 20 years (1978-1997) and the second 20 years (1998-2018). The results demonstrated that most students from the PGP completed a PhD and are men over 30 years old, they came from public universities and the Southeast region. In the first 20 years, significant differences were observed in the distribution of masters and doctors working professionally at the institution analyzed, as well as in the age of the students. In the 20 years of the second half, there were differences between masters and PhD working professionally in the institution itself, as they came from private universities, they are women and PhD. The changes in the profile of masters and PhD that graduated from this PGP in cardiology reflect transformations that occurred in the job market and academy over the decades.

Body mass index levels in students living in areas of military conflict

Background and Study Aim. At present, human health and related elements face ongoing risks from environmental conditions. Thus, regular tracking of health metrics gains significant importance. The research objective is to assess the BMI level of students residing in areas affected by the extended military conflict in Ukraine. Material and Methods. The study involved students from three universities in Ukraine (96 men and 160 women). Prior to the experiment, these students had been living a sedentary life due to the worldwide COVID-19 pandemic (beginning in 2020) and the ongoing war in Ukraine (starting February 24, 2022). They spent a cumulative total of three and a half years in this challenging setting. Data gathering was carried out through a Google Form, which comprised details such as the student's name or alias, gender, height, weight, academic year, field of study, and university association. The PyCharm CE platform and a range of Python programming libraries were employed for the statistical analysis of the data. Results. The study revealed that the mean Body Mass Index (BMI) values are 22.73 kg/m2 in males and 21.20 kg/m2 in females. Among women, the BMI breakdown is: 73.75% normal weight, 17.5% underweight, 7.5% overweight, and 1.25% obese. For men, the figures are: 69.79% normal weight, 20.83% overweight, 5.21% underweight, and 4.17% obese. Conclusions. The outcomes stress the necessity of a tailored approach to body mass control, considering gender-specific, educational, and societal-cultural factors.

Pengujian dan Pemilihan Model Neraca Pembayaran Indonesia Dengan Uji Non-Nested

This research has the purpose of analyzing the Indonesian Balance of Payments by tracing international reserves based on Keynesian and Monetary theory. This research uses using ECM data analysis technique to see short run and long-run relation of macroeconomic variables to international reserve changes and a nested test to see the causality inter variables. The result of data analysis using the ECM technique on Keynesian and Monetary models shows a significant ECT value. This value means that according to the Keynesian model, it will take around a quarter for the adjusting process to attain a new equilibrium on the international reserve, while according to the Monetary model, it will take around six quarters or one and a half years. Based on the non-nested test, it is found that the Monetary model is fitter than the Keynesian model in analyzing Indonesian Balance of Payments behavior

A COMPARATIVE ANALYTICAL STUDY OF MATERNAL MORBIDITY AND MORTALITY INDICATORS BETWEEN PLACENTA ACCRETA SPECTRUM (PAS) AND NORMAL PLACENTATION DURING CAESAREAN SECTION

Introduction: The Placenta Accreta Spectrum (PAS) has emerged as a complex and increasingly prevalent condition, presenting formidable challenges in the field of obstetrics. PAS refers to a range of pathological conditions characterized by abnormal placental attachment to the uterine wall, leading to potentially life-threatening complications during pregnancy and childbirth. This condition has garnered significant attention from researchers, clinicians, and healthcare providers due to its rising incidence and the critical management decisions it demands. Methods: This was a Case-Control study which was conducted at the department of Obstetrics and Gynecology in a tertiary care referral center in Akola, India between January 2020, and June 2021, over a period of 18 months (about 1 and a half years). Sample size calculation were considered based on the incidence of Placenta Accreta Spectrum as outlined by the study done by Wu S et al [4]. Result: As noted by earlier studies, our study also found an increase in the overall morbidity of the patients of Placenta Accreta Spectrum disorders over patients with normal placentation, during and after caesarean section. Conclusion: Placenta Accreta Spectrum leads to significant maternal morbidity and mortality compared to normal placentation at caesarean section, as established by and increased rate of Obstetric Hysterectomies, longer operating times, increased need for blood and blood products, longer ICU stay, and increased rates of postpartum fever.

Screening of New-Born through Otoacoustic Emission Device in a Rural Setting for Early Detection of Hearing Impairment - An Observational Study

BACKGROUND
 Hearing is a special sense needed for proper speech, language, mental development and academic performance. The objectives of our study were to screen neonates at rural area with otoacoustic emission device for detecting hearing impairment and develop a comprehensive rehabilitation model for hearing impaired children in rural areas. Hearing loss initial signs are subtle and therefore for early detection routine neonatal hearing screening is the most effective tool. At first otoacoustic emissions are done, failing which neonates undergo BERA as final screening method to identify hearing impairment as a confirmatory test. In a country like India where neonatal hearing tests are not a part of the routine screening program, the chances of missing early detection and possible rehabilitation are large. In this context, the current project envisages to develop a practical and pragmatic screening model for detecting early neonatal hearing impairment using otoacoustic emission technique in a rural sector reaching every door step possible.
 METHODS
 From the government health records collected for a duration of one and half years, all babies delivered in PHC were included for the screening. The babies were screened every Thursday (Immunisation day) with OAE devices by an audiologist at the PHC. The total number of infants screened were 1737. The first screening test done was otoacoustic emission, failing which patient was referred for BERA as a confirmatory test.
 RESULTS
 The total number of babies screened by OAE in our study was 1737. Out of the total infants screened, 1st OAE referrals were 327 babies. All the 327 infants were screened by OAE for the 2nd time, out of which 10 infants were referred for the 2nd consecutive time. 317 infants were passed on 2nd OAE screening. All the 10 infants who were referred for the 2nd time were subjected to BERA at Ramaiah medical Hospital. Out of these 10 infants, BERA showed severe to profound bilateral hearing loss in 7 infants (Confirmed Hearing loss). Other 3 infants had normal BERA reading hence normal hearing. The statistics showed that the overall rate of hearing loss prevalence was 4.03 per thousand.
 CONCLUSIONS
 In order to diagnose hearing loss in neonates, it is critical to identify hearing loss at birth and provide a screening test for it. OAE screening of neonates should be done at the earliest to detect hearing impairment so that hearing and speech rehabilitation can be started at the earliest. It should be done at each & every health care centre on a large-scale basis to cover all the babies.

Critical analysis of fire incidents and self-assessment of fire safety program in a tertiary care hospital of India: an observational study

Background: Self-assessment of fire safety provides valuable insights for framing a robust fire safety program for hospitals by identifying gaps and taking corrective measures. The study was performed to (i) critically analyse fire incidents which occurred in the hospital and (ii) assess fire safety program of the hospital. Methods: A critical analysis of 3 fire incidents which occurred in hospital was performed. Further review of records regarding all fire incident reports was performed for last 4.5 years and analysed for cause, site, timing, triggering factor and firefighting. For the second objective, fire safety mechanisms in hospital were compared with national accreditation board of hospital checklist and national building code 2016 part 4 “fire and life safety” guideline. Results: It was found that a total of 44 incidents of fire occurred over a period of four and a half years from January 2019 to July 2023, of which 42 were minor, confined fires while two were major and non confined fires. Electrical cause was found in 48.84% of fire incidents, 37% occurred in external areas, 41% in the morning shift hours and in 51.16% incidents clean agent was used for extinguishing the fire. In 93.18% incidents, trained hospital security extinguished the fire. Average reporting time was 1.23 minutes and mean time taken to act and extinguish the fire completely was 10 minutes. Conclusions: Critical analysis of fire safety using records of fire incidents and comparison with guidelines helps hospitals in self assessment of their fire safety plans and guides in filling lacunae.

Mikroagresyon ve Japon Müslüman Kadınlar

Microaggressions are subtle, mostly unintentional and not ill-intended but discriminatory or biased behaviours, actions or conversations that have negative impacts towards minorities, disadvantaged or marginalised groups. Even though they are not intentional or not ill-intended, due to their cumulative nature, they still can have harmful effects on those who experience them. These effects include emotional ones such as anger, stress, frustration, anxiety, self-doubt and depression as well as stress-related physiological diseases: hypertension and heart diseases. Therefore, they significantly impact the life of those who are exposed to them. Microaggressions can take three forms: microassaults, microinsults and microinvalidations. They are several types of microaggressions: racial, sexist, albeit or ageist, or religious. 
 Japan has approximately 150.000 Muslims. A majority of them are immigrant Muslims, and only %10 of them are estimated to be native Japanese Muslims. This makes Japanese Muslims a minority among a minority. Although both immigrant and Japanese Muslims are quite contented with their lives in Japanese society, Japanese Muslim women are easily identified as Muslims in the society due to their hijab, and come across microaggressions from time to time. This work is an ethnographic study focusing on religious microaggressions that Japanese Muslim women encounter during their daily lives in Japan. The data is obtained during the researcher’s almost two and half years of studies in Japan, Tokyo. The participant observation, semi-structured interviews and field notes data are analysed thematically to discover the religious microaggression types of Japanese women experience and their responses towards them. It is also aimed to see to what extent religious microaggressions have an influence on their lives.
 It is discovered that Japanese Muslim women encounter three types of microaggressions: being mistaken as a foreigner, underestimation of personal agency and offensive jokes. Due to a lack of familiarity with Japanese society about hijab-wearing Japanese Muslim women, they are frequently assumed to be foreigners and approached in English, and this is the first microaggression, being mistaken as a foreigner. The second one is when society assumes it is their Muslim husbands or boyfriends who convinced them for religious conversion and for hijab as well, thus, underestimating Japanese Muslim women’s personal agency. The last one is offensive jokes: jokes on stereotypes such as terrorism and jokes on their mental health. These three microaggressions affect Japanese Muslim women’s lives in four ways: frustration, efforts to prove themselves, leading double lives, and last but not least, detachment from the society. The first step is getting frustrated. Dealing with daily assumptions on them frustrates them. Next comes more serious steps. Some get into an effort of proving their decision to be correct: showing the society the rightness and/or the beauty of Islam. Some, rather than dealing with the society, prefer to hide their religious identity and continue their daily lives as secret Muslims. They do not wear hijab in front of their non-Muslim friends, family and acquaintances, but wear it while attending to Islamic events. They do not pray openly and they find excuses for not eating non-halal. They lead double lives. Lastly, some, perhaps the most serious impact of microaggressions, distance themselves from Japanese society. They leave their jobs. They do not socialise with non-Muslim friends. Due to microaggressions they experience, they detach themselves from the society.
 Microaggression is still a new discussion topic among social scientists and the public. Due to the suspicions of its nature or harmful results, awareness-raising activities are not widespread enough. Therefore, in order to understand migroagression and its harmful results better, and to create more equal and inclusive societies, it is necessary to increase the microaggression studies.

Experiences of University College Hospital, Ibadan surgical residents in audit and research

An online monthly seminar was started in April 2021 for surgical residents at the College of Medicine University of Ibadan by a faculty of alumni based in the United Kingdom. The surgical residents felt the seminars will make them better clinicians, fill gaps in their training and find out about Gold Standards of care. Moodle learning management system was used to manage course materials, communication, feedback, online surveys, and interaction with trainees. Seventy-two residents registered, but only about 30 were core attendees. All recorded lectures were placed on You Tube https://www.youtube.com/playlist?list=PLXzLiMlwy2sjLAacZLav58h7aj7qXZaWZ. Topics were multispecialty and determined by the residents. At the same time, an audit-and-research group (ARG) was formed, with eight residents joining. This number has risen to 14. The ARG was a response to a survey assessing residents’ experiences in research and audit. Thirty-seven surgical residents, with an average age of 34.3 years, completed the questionnaire. Forty-three per cent were senior residents and 84% were males. Forty-three percent were general surgery residents, 16% orthopaedics and 11% in urology, 8% in neurosurgery and 8% in paediatric surgery, The rest were from plastic, ENT and cardiothoracic surgery. The median number of years from graduation was 9 years with an inter-quartile range of 7–11 years. Sixty-five per cent of residents had not done any audit since graduation, and only 24% had completed an audit cycle. All residents agreed that surgeons should do audits, and all agreed that it was good for clinical practice. Ninety-five per cent agreed that surgeons should do a least an audit annually, however, only 68% of residents indicated that they would like to do an audit. Eighty-one per cent of residents had never presented an audit or research work, oral or poster, at a national or international meeting, and 65% have never been an author in a peer-reviewed article. Ninety-seven per cent indicated that they would like to take part in a study. The six top reasons given for poor audit and research outputs by the residents were (multiple answers allowed): Not knowing where to start by 60% of surgical residents No support for it by 46% No source of funding by 38% Audit and research is not a culture in their environment by 38% No opportunities by 24%. No suitable role models by 16% After completion of training, 76% of residents indicated that they wanted to work in a teaching hospital. In two and half years since its formation, the ARG has completed a qualitative study on clinical learning environments (OP05) and an audit on the use of WHO surgical safety checklists in theatre (OP06). These were supervised by both a local faculty and a UK-based alumnus. These have generated two oral and one poster presentations at international conferences.

Tuberculous trochanteric bursitis in an immunocompetent patient

Musculoskeletal Tuberculosis occurs in 1%–3% of patients with tuberculosis, and Tuberculous trochanteric bursitis (TTB) is responsible for 1%, assuming it as a rare clinical condition, especially if it occurs in immunocompetent patients. This is a case report about a 51 years old man, with pain in right trochanteric area, without swelling or inflammatory signs, 1 year of evolution. About 20 years ago, he suffered an infected traumatic local hematoma. Ultrasound revealed trochanteric bursitis. He was then submitted to a bursectomy. Histological study revealed chronic necrotizing granulomatous bursitis, with negative Acid-Fast Bacillus (AFB) Tests. After 6 mouths the patient suffer relapse of his complains. The MRI revealed intraosseous edema of the great right trochanter, inflammation of adjacent soft tissues and small infratrochanteric collection. Analytically, CRP of 1.24 mg/dl and positive interferon Gamma. A new bursectomy and curettage were performed with sequestrectomy. Lowestein culture was positive for AFB, it was identified protein MPT64, and a positive DNA Mycobacterium tuberculosis complex research. It was associated medical treatment with antibiotics (12 months). Currently with clinical and imaging improvement, without relapse, after 1 and a half years of follow-up. Usually, TTB arises from the reactivation of an unknown primary infection, whose clinical presentation is often vague, characterized by chronic symptoms. This condition should be considered in the diagnostic discussion whenever a case of recurrent bursitis arises despite the treatment instituted. With the decline in the incidence of tuberculosis, the number of clinical cases of TTB described in the recent literature has decreased considerably, with special attention being given to the reporting and sharing of these cases, with the goal of keeping this diagnosis in perspective in the discussion and orientation of cases of trochanteric bursitis.

Relationship between emotional intelligence and non verbal behaviour in enhancing workplace relationship

The recent Covid 19 pandemic has disrupted the operations of many organisations around the world. Many employees had to change their work arrangements, by working at home. This was the work arrangement for about 1 and half years from 2020 until 2021. Towards the end of 2021 and beginning of 2022, many employees are happy to be able to resume their almost normal work arrangements. After working from remote places, the transition to return to normal would need some changes in habits and behaviour. The purpose of this paper is to examine the contribution of emotional intelligence and non verbal behaviour in enhancing the workplace relationship. A successful organisation has been chosen for this study. All of their executives took part in this analysis. The Genos emotional intelligence questionnaire has been used to collect the data from the respondents. From the analysis, it was found that both emotional intelligence and non verbal behaviour enhances the workplace relationship.

An in-depth study of the biology, trophic ecology and catchability of the invasive pufferfish Lagocephalus sceleratus from southern Turkey, eastern Mediterranean Sea

The silver-cheeked toadfish (Lagocephalus sceleratus) is an invasive species of highest concern. Its population must be controlled to mitigate its negative impacts on marine ecosystems, fishers, fisheries and human health. This study thoroughly investigates the biology, diet and catchability of the L. sceleratus stock from Finike, Turkey from March 2017 to February 2018 in order to better manage its invasion. A total of 751 specimens were sampled for this study with a M/F ratio of 1.25/1. The species becomes sexually mature at three and a half years of age, and Lm50 was 41.39 cm for males and 42.08 cm for females. Its spawning season in this region was from June to August, peaking in July. Its diet was mostly crustaceans in spring, fish in summer and both fish and crustaceans in winter. This species consumed a large amount of other pufferfish species, resulting in over a quarter of its fish diet. The trophic level of L. sceleratus was 4.41, demonstrating that it is indeed a top predator carnivore in the eastern Mediterranean Sea. Ingested fishing gear parts such as net pieces and hooks were found in about 10% of the fish. A slight modification of longlines using steel branch lines and a swivel hook resulted in double the catch per unit effort than standard longlines, so this technique can be used to target and control more of this invasive species, which is a national priority.

Adolescent fertility and its impact on educational attainment in Nigeria: A propensity score matching approach

ABSTRACT Teenage childbearing remains a persistent challenge in Nigeria, characterized by a high rate of early adolescent births. This study examines the impact of teenage fertility on educational attainment of young mothers in Nigeria. Utilizing data from the 2018 Nigerian Demographic and Health Survey, we applied propensity score matching techniques to construct a matched sample of non-fertile teenagers aged 15 to19 years that closely corresponds to a sample of fertile teenagers. The results of our analysis reveal that the average treatment effect of teenage fertility is a reduction in education attainment by nearly two and half years. Furthermore, being fertile during the teenage years is associated with a 25 percent decrease in the probability of completing secondary school. This underscores the significant educational challenges faced by young mothers in Nigeria due to early childbirth. Addressing the challenge of early childbearing among adolescent girls in Nigeria is critical not only for the well-being of these girls but also for the country's overall development and future prospects.

Role of Gardening in Mental Health, Food Security, and Economic Well-Being in Resettled Refugees: A Mixed Methods Study

Executive Summary Home and community gardening is emerging as a beneficial intervention for resettled refugee populations. Using an interdisciplinary lens, we examined whether gardening influences mental health, food security, and economic well-being. A mixed methods study ( n = 29) was conducted with quantitative surveys to assess indicators of mental health, food security, and economic well-being. Qualitative, semi-structured interviews explored gardener participants’ experience of gardening benefits ( n = 10). Participants had on average been in the United States for seven and a half years, with most having lived in refugee camps prior to arrival. Findings showed gardeners reporting fewer symptoms of anxiety, depression, and trauma, and lesser food insecurity than non-gardeners, and similar indicators of economic well-being. Non-parametric regression analysis showed that being a gardener significantly predicted less psychological distress. Qualitative data substantiated these findings with gardeners reporting improved mental health, closer family, social relationships and connections with culture, and more access to fresh and organic food. The multiple, simultaneous benefits of gardening reported here provide strong support for building community-based health promotion programs to assist refugee integration, including long after arrival. The study further highlights the importance of examining these interrelated factors of mental health, food security, and economic well-being simultaneously and reevaluating the established goals of refugee resettlement, particularly in the United States. We offer the following recommendations: • Policymakers and refugee resettlement practitioners should integrate culturally appropriate community-based health promotion efforts in refugee programs long after the initial resettlement period. • Researchers on refugee integration outcomes should include interdisciplinary perspectives that offer comprehensive understanding of processes related to health outcomes. • Policymakers on refugee resettlement and integration should consider the linkages between mental health, food security, and economic well-being.

Gross motor development in children with epidermolysis bullosa.

Epidermolysis bullosa (EB) is a group of rare, congenital skin disorders, characterized by skin fragility and formation of blisters. The gross motor outcomes of children with EB are not known. The primary objective of the study was to measure the proportion of gross motor delay in children with EB. The secondary objectives were to measure the difference in gross motor outcomes between EB sub-types and change in gross motor outcomes over time. Children with EB, aged between one month and five and a half years of age, attending the Sydney Children's Hospital, Epidermolysis Bullosa Clinic, were eligible. Carers completed Ages and Stages Questionnaires, Third Edition, on behalf of their children. Questionnaires were scored, and outcomes were compared to age-expected norms. There were 24 participants to complete a questionnaire. Eleven participants completed additional questionnaires over the 24 month study duration. The proportion of children with EB with gross motor delay was greater than age-expected norms (29.17% vs. 2.5%). The delay occurred in children with recessive dystrophic (80%) and epidermolysis bullosa simplex (33.33%) sub-types, but not dominant dystrophic (0%). No children with Junctional EB or Kindler EB joined this study. This study demonstrates a difference in gross motor outcomes in children with EB. Children with recessive dystrophic and epidermolysis bullosa simplex should be prioritized for monitoring of, and intervention for, gross motor outcomes through multidisciplinary care. Further research investigating long-term outcomes for children with EB and the effectiveness of interventions would be beneficial.