Long-standing Effects Research Articles

Meloxicam-amino acids salts/ion pair complexes with advanced solubility, dissolution, and gastric safety

Amino acids have attracted attention as a potential functional excipient for optimizing biopharmaceutics characteristics of poorly soluble drugs. The amino acids are a diverse class with many functional groups, natural compounds, biocompatible and low molecular weight substances. Two amino acids serine and arginine were investigated with meloxicam. Meloxicam has extremely low solubility; being NSAIDs, gastric upset and ulcer are common side effects. Solid dispersions were produced by precipitation and physical mixing techniques. The produced combinations underwent in vitro dissolution, docking, DSC, FTIR, XRD, solubility and gastric ulcer formation studies. Docking indicated formation of ion pair/salt between the basic amino acid arginine and meloxicam. Both solubility and dissolution rates were increased by up to 3000- and 12-fold, respectively. DSC, FTIR an XRD supported these findings. Rats treated with meloxicam showed loss of surface gastric epithelium integrity and ulceration. The animal group received meloxicam: arginine showed intact gastric mucosa with the surface epithelium and gastric glands well organized and nearly similar to the untreated control. Arginine with the guanidine group that was capable of preserving gastric mucosa after repeated administration for 10 days. This study highlighted the role of arginine as a functional excipient that did not only improve solubility and dissolution rates but ameliorated the long-standing gastric side effects attributed to meloxicam.

Provider Perspectives: Feasibility, Acceptability, and Appropriateness of Online Parent Training With Therapist Coaching in a Community Practice Setting

A considerable body of evidence documents the detrimental impact of disruptive behavior disorders (DBDs) in childhood and their longstanding effects across development and into adulthood. While research has yielded evidence-based interventions for DBDs, such as parent management training, disparities in access to care persist. The growing ubiquity of consumer technologies underscores the potential to provide evidence-based treatments through online programs; however, structural barriers continue to impede dissemination in community settings. This paper examines clinic staff’s perspectives on the implementation of an online parent management program in a community mental health center (CMHC) to integrate novel programming with existing therapeutic care to maximize resource efficiency in treatment delivery and increase family adherence and engagement. Quantitative and qualitative data were collected from 16 staff members who were trained to deliver the intervention at a CMHC. Quantitative data indicated positive perceptions across various domains, while qualitative findings highlighted feasibility, acceptability, and appropriateness. Facilitators to feasibility included program ease, integration into sessions, and flexible access. Time constraints and technology access were barriers. Acceptability was high, with videos reinforcing therapy and promoting family connection. The program’s structure and psychoeducation were appreciated, while quiz format and time constraints were concerns. Appropriateness was positive, with broad relevance, insight-building impact, comprehensive coverage, evidence-based strategies, and support. Barriers existed for specific patient characteristics. Implications for implementation in practice and future directions of research are discussed.

Efficacy of pegylated Graphene oxide quantum dots as a nanoconjugate sustained release metformin delivery system in in vitro insulin resistance model.

Metformin, the primary therapy for type 2 diabetes mellitus (T2DM), showed limitations such as varying absorption, rapid system clearance, required large amount, resistance, longstanding side effects. Use of Nano formulations for pharmaceuticals is emerging as a viable technique to reduce negative consequences of drug, while simultaneously attaining precise release and targeted distribution. This study developed a Polyethylene Glycol conjugated Graphene Oxide Quantum dots (GOQD-PEG) nanocomposite for the sustained release of metformin. Herein, we evaluated the effectiveness of metformin-loaded nanoconjugate in in vitro insulin resistance model. Results demonstrated drug loaded nanoconjugate successfully restored glucose uptake and reversed insulin resistance in in vitro conditions at reduced dosage compared to free metformin.

Should Pregnant Women Consume Probiotics to Combat Endocrine-Disrupting Chemical-Induced Health Risks to Their Unborn Offspring?

Endocrine-disrupting chemicals (EDCs) have become so pervasive in our environment and daily lives that it is impossible to avoid contact with such compounds, including pregnant women seeking to minimize exposures to themselves and their unborn children. Developmental exposure of humans and rodent models to bisphenol A (BPA) and other EDCs is linked to increased anxiogenic behaviors, learning and memory deficits, and decreased socio-sexual behaviors. Prenatal exposure to BPA and other EDCs leads to longstanding and harmful effects on gut microbiota with reductions in beneficial bacteria, i.e., gut dysbiosis, and such microbial changes are linked to host changes in fecal metabolites, including those involved in carbohydrate metabolism and synthesis, and neurobehavioral alterations in adulthood, in particular, social and cognitive deficits. Gut dysbiosis is increasingly being recognized as a key driver of a myriad of diseases, ranging from metabolic, cardiovascular, reproductive, and neurobehavioral disorders via the gut-microbiome-brain axis. Thus, EDCs might induce indirect effects on physical and mental health by acting as microbiome-disrupting chemicals. Findings raise the important question as to whether pregnant women should consume a probiotic supplement to mitigate pernicious effects of EDCs, especially BPA, on themselves and their unborn offspring. Current studies investigating the effects of maternal probiotic supplementation on pregnant women's health and that of their unborn offspring will be reviewed. Data will inform on the potential application of probiotic supplementation to reverse harmful effects of EDCs, especially BPA, in pregnant women unwittingly exposed to these compounds and striving to give their offspring the best start in life.

Evaluating the long-term effects of income assistance for material hardship among families with children

BackgroundAs a key aspect of poverty, material hardship describes day-to-day struggles in affording necessities. In explorations of policy initiatives that mitigate material hardship, evidence suggests direct income support can be effective in alleviating hardship. However, research investigating the long-term effects of income supports is limited, and it remains uncertain as to how benefit receipt may mitigate material hardship for families with children across time. MethodsTo explore the associations between income assistance and material hardship longitudinally, we utilised data from four waves of the Growing Up in New Zealand birth-cohort study (n = 5964), where family experiences were tracked between birth and adolescence. The variables of interest included mother-reported receipt of income benefits and material hardship from when the children were aged 9-months, 54-months, 8-years, and 12-years. Multilevel logistic regression analysis was employed to examine the associations between benefit receipt and material hardship in the short- and long-term. Interaction terms between benefit receipt and time were incorporated in the modelling to determine whether receiving benefits corresponded with significant changes in the likelihood of experiencing material hardship at specific time points. ResultsThe key results suggest that benefit receipt in early childhood reduced the likelihood of experiencing material hardship at subsequent time points at least until adolescence, when controlling for key sociodemographic characteristics. ConclusionThese findings provide insight into the associations between early childhood income supports and reductions in the likelihood of experiencing material hardship in the long-term, to emphasise the potential for such interventions to have longstanding effects. By elucidating the associations between benefit receipt and subsequent material hardship, this research gives direction for policy interventions and timely support for families.

Comparison of Continuous Intracortical and Scalp Electroencephalography in Comatose Patients with Acute Brain Injury.

Depth electroencephalography (dEEG) is a recent invasive monitoring technique used in patients with acute brain injury. This study aimed to describe in detail the clinical manifestations of nonconvulsive seizures (NCSzs) with and without a surface EEG correlate, analyze their long-standing effects, and provide data that contribute to understanding the significance of certain scalp EEG patterns observed in critically ill patients. We prospectively enrolled a cohort of 33 adults with severe acute brain injury admitted to the neurological intensive care unit. All of them underwent multimodal invasive monitoring, including dEEG. All patients were scanned on a 3T magnetic resonance imaging scanner at 6months after hospital discharge, and mesial temporal atrophy (MTA) was calculated using a visual scale. In 21 (65.6%) of 32 study participants, highly epileptiform intracortical patterns were observed. A total of 11 (34.3%) patients had electrographic or electroclinical seizures in the dEEG, of whom 8 had both spontaneous and stimulus-induced (SI) seizures, and 3 patients had only spontaneous intracortical seizures. An unequivocal ictal scalp correlate was observed in only 3 (27.2%) of the 11 study participants. SI-NCSzs occurred during nursing care, medical procedures, and family visits. Subtle clinical manifestations, such as restlessness, purposeless stereotyped movements of the upper limbs, ventilation disturbances, jerks, head movements, hyperextension posturing, chewing, and oroalimentary automatisms, occurred during intracortical electroclinical seizures. MTA was detected in 18 (81.8%) of the 22 patients. There were no statistically significant differences between patients with MTA with and without seizures or status epilepticus. Most NCSzs in critically ill comatose patients remain undetectable on scalp EEG. SI-NCSzs frequently occur during nursing care, medical procedures, and family visits. Semiology of NCSzs included ictal minor signs and subtle symptoms, such as breathing pattern changes manifested as patient-ventilator dyssynchrony.

Parenting practices and interventions during the COVID-19 pandemic lockdown: an exploratory cross-sectional study of caregivers in Brazil, Mexico, and the United States.

The COVID-19 pandemic led countries' governments to rapidly establish lockdowns and social distancing, which altered family routines and the quality of family relationships worldwide. This exploratory cross-sectional study aimed to identify the impacts of the social distancing and lockdown in parenting practices of caregivers from Brazil, Mexico, and the USA, and to analyze the continuity of parenting intervention support for children and their families at the beginning of the pandemic in these countries. The sample consisted of 704 caregivers of children (286 from Brazil, 225 from Mexico, and 193 from the USA) who answered an online survey about parenting practices before/after quarantine, caregiver/child routines, feelings related to quarantine, changes in everyday life since the beginning of the COVID-19 pandemic, contact with health professionals, and sources of parenting information. Data indicate that caregivers from the three countries experienced similar parenting practices during this time, and did not report significant changes before and after the lockdown. They sought information about parenting predominantly via social media. Those receiving previous mental health care perceived the transition from in-person to telehealth services during the pandemic as feasible and acceptable. This study will be helpful for clinicians and parents to contextualize their practices amid long-standing effects that the COVID-19 pandemic can have on children and their families during and post-pandemic from multiple cultural backgrounds.

Programmatic considerations and evidence gaps for chikungunya vaccine introduction in countries at risk of chikungunya outbreaks: Stakeholder analysis.

Chikungunya can have longstanding effects on health and quality of life. Alongside the recent approval of the world's first chikungunya vaccine by the US Food and Drug Administration in November 2023 and with new chikungunya vaccines in the pipeline, it is important to understand the perspectives of stakeholders before vaccine rollout. Our study aim is to identify key programmatic considerations and gaps in Evidence-to-Recommendation criteria for chikungunya vaccine introduction. We used purposive and snowball sampling to identify global, national, and subnational stakeholders from outbreak prone areas, including Latin America, Asia, and Africa. Semi-structured in-depth interviews were conducted and analysed using qualitative descriptive methods. We found that perspectives varied between tiers of stakeholders and geographies. Unknown disease burden, diagnostics, non-specific disease surveillance, undefined target populations for vaccination, and low disease prioritisation were critical challenges identified by stakeholders that need to be addressed to facilitate rolling out a chikungunya vaccine. Future investments should address these challenges to generate useful evidence for decision-making on new chikungunya vaccine introduction.

Nanostrategy of Targeting at Embryonic Trophoblast Cells Using CuO Nanoparticles for Female Contraception.

Effective contraceptives have been comprehensively adopted by women to prevent the negative consequences of unintended pregnancy for women, families, and societies. With great contributions of traditional hormonal drugs and intrauterine devices (IUDs) to effective female contraception by inhibiting ovulation and deactivating sperm, their long-standing side effects on hormonal homeostasis and reproductive organs for females remain concerns. Herein, we proposed a nanostrategy for female contraceptives, inducing embryonic trophoblast cell death using nanoparticles to prevent embryo implantation. Cupric oxide nanoparticles (CuO NPs) were adopted in this work to verify the feasibility of the nanostrategy and its contraceptive efficacy. We carried out the in vitro assessment on the interaction of CuO NPs with trophoblast cells using the HTR8/SVneo cell line. The results showed that the CuO NPs were able to be preferably uptaken into cells and induced cell damage via a variety of pathways including oxidative stress, mitochondrial damage, DNA damage, and cell cycle arrest to induce cell death of apoptosis, ferroptosis, and cuproptosis. Moreover, the key regulatory processes and the key genes for cell damage and cell death caused by CuO NPs were revealed by RNA-Seq. We also conducted in vivo experiments using a rat model to examine the contraceptive efficacy of both the bare CuO NPs and the CuO/thermosensitive hydrogel nanocomposite. The results demonstrated that the CuO NPs were highly effective for contraception. There was no sign of disrupting the homeostasis of copper and hormone, or causing inflammation and organ damage in vivo. In all, this nanostrategy exhibited huge potential for contraceptive development with high biosafety, efficacy, clinical translation, nonhormonal style, and on-demand for women.

Suicide by firearm: One family's lived experience

In this paper, my nephews and I will share our individual perspectives of their father's completed suicide 30 years ago. Our intention is that the importance of recovery, hope, and support will be illuminated by telling our unique stories to describe the lived experience of a tragedy by gun violence and its longstanding effects.

Effect of successful bariatric surgery on maternal cardiovascular outcomes

Abstract Background Obesity is a common comorbidity and is prevalent in at least 20% of pregnant women. Its prevalence is increasing at an alarming rate and is associated with worse pregnancy outcomes. With increasing obesity, more females are considering bariatric surgery (BS) as a form of weight-loss. Purpose The purpose of the study is to evaluate the effect of successful bariatric surgery (sBS) on maternal cardiovascular outcomes. Methods Pregnant females were sampled from the National Inpatient Sample Database (2016-2018). Demographics and comorbidities were collected using ICD-10 and DRG codes. Pregnant patients were stratified into three groups – morbidly obese, overweight/obese, and sBS. Individuals with a history of BS and not currently morbidly obese or overweight/obese were included in the sBS group. The primary outcome was a composite and was defined as major adverse cardiovascular events (MACE; Table 1). Secondary outcomes included pre-eclampsia (preE), gestational diabetes (GDM), and length of hospital stay (LOS). Patients with concurrent history of BS and overweight/obese/morbidly obese were excluded. To address confounding factors, sBS patients were matched 1:1 with morbidly obese and overweight/obese patients by 15 variables (Table 1). Binary logistic regression analyses were performed to assess for association between sBS and cardiac outcomes. Results Out of 207,511 patients included, 5,517 were sBS, 132,483 were overweight/obese, and 69,511 were morbidly obese. Compared to the sBS group (0.1%), MACE was higher in morbidly obese (0.7%) and overweight/obese patients (0.3%). Additionally, morbidly obese patients had higher acute heart failure, peripartum cardiomyopathy, acute pulmonary edema, preE, GDM, and longer LOS than sBS patients. Overweight/obese had more preE and GDM than the sBS cohort (Table 1). After 1:1 matching, MACE was more prevalent in morbidly obese patients (OR:6.69 [1.99-22.52]; p=0.002) and overweight/obese patients (OR:6.5 [1.5-28.9; p=0.01) when compared to sBS group. Both morbidly obese and overweight/obese groups were associated with increased preE (OR:3.0 and 2.1 respectively), GDM (OR:3.2 and 2.3 respectively), LOS (Coefficient:3.4 and 3.3 respectively; Figure 1). Conclusion Despite longstanding effects of obesity, sBS patients had better cardiovascular outcomes, even after matching for pre-existing cardiac conditions. A reduction in weight leads to decreased circulatory volume and improved cardiac output, resulting in lower risk of acute pulmonary edema, peripartum cardiomyopathy, and acute heart failure. The decrease in systemic inflammation and endothelial dysfunction likely led to a reduction in preE. Although pregnancy after bariatric surgery requires multidisciplinary management due to specific nutritional needs, the significant reduction in MACE highlights the importance of considering it as an option if conventional weight loss measures fail.Table 1Figure 1

Eugenia supra-axillaris Essential Oil and Its Nanoemulsion: Chemical Characterization, In Vivo Anti-Inflammatory, Analgesic, and Antipyretic Activities

The use of standard synthetic medications to treat inflammatory illnesses is associated with several negative effects. It has been shown that medicinal plants and their by-products are useful for safely treating inflammation. Herein, the essential oil of Eugenia supra-axillaris (family: Myrtaceae, ESA-EO) was isolated and further chemically characterized by GC-MS, and then, its nanoemulsion (ESA-EO-NE) was prepared. In addition, the anti-inflammation against the carrageenan-induced rats, the analgesic, and antipyretic activities of ESA-EO and ESA-EO-NE were evaluated in rats. Forty-three compounds were identified via GC-MS and categorized as mono- (61.38%) and sesquiterpenes (34.86%). d-limonene (32.82%), α-pinene (24.33%), germacrene-D (4.88%), α-humulene (4.73%), α-cadinol (3.39%), and trans-caryophyllene (3.15%) represented the main components. The administration of ES-EO and ES-EO-NE (50 and 100 mg/kg) demonstrated strong, dose-dependent inflammation inhibition capabilities in the model of rat paw edema, in comparison with both the reference drug and control. Reduced levels of malondialdehyde (MDA), increased levels of glutathione (GSH), and decreased levels of the proinflammatory cytokines (TNF-α), nitrosative (NO), and prostaglandin E2 (PGE2) in paw tissues all contributed to these substantial reductions in inflammation. Moreover, the oral administration of ESA-EO and ESA-EO-NE (50 and 100 mg/kg) exhibited potent analgesic and antipyretic activities in rats. Although the higher dose of ESA-EO and ESA-EO-NE (100 mg/kg) displayed delayed anti-inflammatory activity, they have long-lasting inflammation inhibition with fast onset and long-standing analgesic effects better than reference drugs. Furthermore, the most effective antipyretic efficacy was provided by ESA-EO-NE (100 mg/kg). These results provide insight into the possible therapeutic application of ESA-EO and its nanoemulsion against various inflammatory and painful illnesses as well as hyperthermia ailments.

Missing and murdered Indigenous women, girls, and Two Spirit people: a paediatric health crisis.

Indigenous children and adolescents across the USA and Canada experience increased emotional, physical, and sexual violence resulting from the longstanding effects of colonialism and historical trauma. There is a substantial lack of research exploring these issues and scarce efforts outside of Indigenous communities to support victims. However, the association between exposure to violence and abuse and adverse health outcomes among Indigenous children and adolescents is clear. In this Viewpoint, we explore this association, discuss historical context, highlight important work by governments and community organisations, and suggest actions for paediatricians and paediatric health-care providers.

A multivariable model of barriers to COVID-19 vaccination: Using cross sectional data from a nationally distributed survey in the United States

ObjectiveDiscrimination has had longstanding effects on mental and physiological health, which became more evident and synergized during the COVID-19 pandemic. The role of discrimination on vaccination for COVID-19 during the pandemic, however, is not well understood. As such, we examined the relationship of everyday discrimination on COVID-19 vaccination. MethodsUsing a multivariate logistic regression on data collected from a nationally distributed survey in the United States (US), we examined the relationship of discrimination measured by the Everyday Discrimination Scale on self-reported COVID-19 vaccination while adjusting for US nativity, as well as sociodemographic (i.e., age; gender; sexual orientation; race, and ethnicity) and socioeconomic (i.e., educational attainment; employment status; household income) factors. ResultsWe found that participants reporting monthly to weekly discrimination and multiple times a week to daily discrimination had decreased odds of reporting COVID-19 vaccination (adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI]:0.68–0.90; and AOR = 0.75, 95% CI = 0.62–0.91, respectively) compared to those that reported no discrimination experienced. Educational attainment of high school equivalent or above, employment as an essential worker, and household-annual income of $50,000 or greater were significant socioeconomic factors. Age, sexual orientation, and race/ethnicity had mixed associations with COVID-19 vaccination. ConclusionsDiscrimination overall remained a significant barrier to vaccination, while nativity was not significant when accounting for socioeconomic and sociodemographic factors. Discrimination must become a public health priority in addressing disparities in health and access and barriers that may affect preventive behaviors.

Impaired erythropoietin-producing hepatocellular B receptors signaling in the prefrontal cortex and hippocampus following maternal immune activation in male rats.

An environmental risk factor for schizophrenia (SZ) is maternal infection, which exerts longstanding effects on the neurodevelopment of offspring. Accumulating evidence suggests that synaptic disturbances may contribute to the pathology of the disease, but the underlying molecular mechanisms remain poorly understood. Erythropoietin-producing hepatocellular B (EphB) receptor signaling plays an important role in synaptic plasticity by regulating the formation and maturation of dendritic spines and regulating excitatory neurotransmission. We examined whether EphB receptors and downstream associated proteins are susceptible to environmental risk factors implicated in the etiology of synaptic disturbances in SZ. Using an established rodent model, which closely imitates the characteristics of SZ, we observed the behavioral performance and synaptic structure of male offspring in adolescence and early adulthood. We then analyzed the expression of EphB receptors and associated proteins in the prefrontal cortex and hippocampus. Maternal immune activation offspring showed significantly progressive cognitive impairment and pre-pulse inhibition deficits together with an increase in the expression of EphB2 receptors and NMDA receptor subunits. We also found changes in EphB receptor downstream signaling, in particular, a decrease in phospho-cofilin levels which may explain the reduced dendritic spine density. Besides, we found that the AMPA glutamate, another glutamate ionic receptor associated with cofilin, decreased significantly in maternal immune activation offspring. Thus, alterations in EphB signaling induced by immune activation during pregnancy may underlie disruptions in synaptic plasticity and function in the prefrontal cortex and hippocampus associated with behavioral and cognitive impairment. These findings may provide insight into the mechanisms underlying SZ.

Longstanding effects of continuous theta burst stimulation in adult amblyopes

ABSTRACT Clinical Relevance Continuous theta burst stimulation may be an important tool in the therapeutic management of amblyopia, when trying to correct the established neuronal imbalance. It is important to understand whether two sessions of continuous theta burst stimulation produce greater and longstanding changes in visual acuity and suppressive imbalance than one session of continuous theta burst stimulation Background We hypothesise that through the usage of continuous theta burst stimulation (cTBS) it is possible to change cortical excitability in a situation where visual impairment is present. Methods We selected 22 adult amblyopes, 18 females and 4 males, with an age range of 20–59 years. They were randomised into two groups: group A with 10 amblyopes was submitted to one session of cTBS and group B with 12 amblyopes submitted to two sessions of cTBS. Visual acuity (VA) and suppressive imbalance (SI) were evaluated immediately before and after stimulation in both groups A and B. A follow-up was done in both groups. Results For both group A and B, the VA improvements were significant after cTBS (p = 0.005 and p = 0.003, respectively). Regarding SI, both group A and B had significant improvements after cTBS (p = 0.03 and p = 0.005, respectively). Comparing groups, A and B no significant differences were found with regard to the results obtained both for VA (p = 0.72) and SI (p = 0.24). However, significant differences were found between group A and B with regard to the duration of stimulation effect for VA (p = 0.049) and SI (p = 0.03). Conclusion We conclude that two sessions of cTBS do not produce better results than one session of stimulation. However, it seems that two sessions of cTBS produce longstanding effects in VA and SI.

A multiple mediation analysis to untangle the impacts of COVID-19 on nationwide bus ridership in the United States.

The COVID-19 pandemic has resulted in major consequences for many aspects of human life and the broader economy. Many transportation modes were severely impacted, including public transportation. During the early months of the pandemic in 2020, transit ridership dropped to unprecedented levels. Even by the end of 2022, bus ridership in the United States had not recovered to pre-pandemic levels. Despite the longstanding effects on public transportation, the direct and indirect impacts of the COVID-19 pandemic on bus ridership are largely unknown. In the context of this study, the direct impact refers to a change in travel behavior (i.e., due to the increased spread of COVID-19), while the indirect impact refers to reduced ridership due to factors such as lower employment or increased teleworking. This study proposes a framework to explore the drivers of transit ridership declines during COVID-19. The method is a multiple mediation analysis to estimate the monthly direct and indirect impacts of COVID-19 on bus ridership from March 2020 to December 2021. The results of this study revealed that three mediators (employment, telework, and people relocating) mediated about 13% to 38% of the total decline in bus ridership during the analysis period. The multiple mediation approach used in this study could be applied in many other transportation applications.

Impacts of Coronavirus Disease 2019 Pandemic on Sleep Pattern

The ongoing coronavirus disease 2019 (COVID-19) pandemic is the third global crisis after two epidemics of severe acute respiratory syndromes. It has affected general public besides health care systems and governments. Confinements and lock downs have changed waking up time and going to bed time, ultimately affecting circadian clocks that can disturb sleep quality which can lead to anxiety, stress, and depression. This puts the most susceptible group -young adults and females- at risk of psychological disorders and even inflammatory events. Several kinds of sleep disorders due to COVID-19 including insomnia, sleep apnea, sleepiness during daytime, post-traumatic-like sleep dysfunction, abnormal dreams, and restless legs syndrome have been reported. As sleep deprivation can alter circadian clock and weaken immunity which makes human more susceptible to pulmonary inflammatory process of COVID-19 and even enhance its manifestations, it should be considered as an urgent complication that needs to be treated. Furthermore, longstanding effects of sleep disturbances during COVID-19 pandemic need to be elucidated.

Recovering the Lost Soul: Older Women's Reflections on Past Intrafamilial Child Sexual Abuse.

Intrafamilial child sexual abuse (IFCSA) is a social problem with longstanding effects on victims' lives. While scholarly literature has focused on the adverse aftermath of sexual abuse, only a few studies have acknowledged older women's perspectives on their experience of IFCSA and their journey of healing and recovery. The aim of the present study was to explore how older survivors of IFCSA construct and shape their experience of healing in later life and the meaning they assign to this process. Narrative inquiry was selected to explore the narratives of 11 older women survivors of IFCSA. Participants were interviewed using a biographical narrative interviewing method. The narratives were then transcribed and analyzed using thematic, structural, and performance analyses. Four major themes emerged from the participants' narratives: Achieving closure; Spiritual framing of IFCSA as a platform for self-growth; Becoming whole in old age; and Looking to the future after IFCSA. During the aging years, IFCSA survivors may redefine their identity and their place in the world. Using life review processes, older women in this study were striving to heal and reconcile with their past.

Academic freedom and the decolonisation of knowledge: curriculum transformation in South Africa from a UNESCO perspective

ABSTRACT Decolonisation aims at exposing the ills of colonialism in an attempt to undo their long-standing effects. Important criticism of curriculum decolonisation has focused on potential conflicts with academic freedom. However, this criticism has to some extent suffered from a perceived lack of agreement on the concept and status of academic freedom itself. The present study views decolonisation in South Africa from the perspective of the international standard afforded by the UNESCO recommendation concerning the status of higher-education teaching personnel (1997). It is argued that, whereas some conceptions of decolonisation are intrinsically in conflict with the recommendation, compliance depends in other cases on implementational details. Moreover, regarding several conceptions, furthering decolonisation and implementing the UNESCO recommendation go hand in hand. In a case study, the Nelson Mandela University Transformation Plan 2018–2020 is critically examined. Finally, it is suggested that there may be considerable benefits associated with using the UNESCO recommendation as a guide in and throughout curriculum transformation.