Open Invitation Research Articles

Hijras, Lovers, Brothers: Surviving Sex and Poverty in Rural India by Vaibhav Saria

Reviewed by: Hijras, Lovers, Brothers: Surviving Sex and Poverty in Rural India by Vaibhav Saria Nikhil Pandhi Vaibhav Saria. Hijras, Lovers, Brothers: Surviving Sex and Poverty in Rural India. New York: Fordham University Press, 2021. 268 pp. In an early, instructive ethnographic vignette, anthropologist Vaibhav Saria, who is living with a community of hijras (commonly referred to as a "third gender" in India), describes a conversation with an interlocutor who has just returned from conducting sex work along a local highway in eastern India. Nandita, a poor hijra, ecstatically shows off a used condom and proclaims she "finally ate Saajan" (8). Amid peals of laughter and jubilation, Nandita empties the contents of the condom into her mouth, momentarily consuming her lover's semen before spitting it back into the condom. The hijra swallows and spits her lover's semen repeatedly, declaring, "I want his smell in my mouth, so that I can smell him every time I breathe. It's like perfume…" (8). Attuned to such intimate, intricate scenes of pleasure and desire, alongside the wider sensorium of affective labors and longings, Saria's ethnography skillfully traces the textures and tapestries that make "the fullness of hijra lives in India" (1). Drawing on 24 months of living and traveling with hijras between 2008 and 2019—including 16 continuous months of fieldwork in Bhadrak and Kalahandi, two of eastern India's poorest districts—Saria traces fraught webs of kinship, sexual fields of fantasy and fucking, libidinal attachments and gendered labors, as well as everyday struggles and quotidian pleasures. The author grounds his vital analysis in a decolonial critique of global public health, which both singles out hijras as biopolitical mascots for spreading information about safe sex and casts hijras' own quests for survival and sexual desire as stigma-ridden, dangerous, and incommensurable with the normative goals of global health practice. [End Page 697] Replete with ethnographic rigor as well as creative engagements with South Asian social and literary theory, Saria's analysis disrupts Euro-American theories of kinship, queerness, and the psyche by foregrounding hijra's stories and bodies, which deepen decolonial understandings of "living and dying in the contemporary world" (3). Chapter 1 explores how hijras' affective labors of laughing, flirting, and fucking are crucial means to sustain shifting moral modes of normative kinship. Hijras' open invitations to men to fornicate in fields and marketplaces dramatize the everyday anxieties of heteropatriarchy and poverty, allowing for masculinities and domesticities to be (re)inscribed as well as (re)imagined through wild sex. Hijras provide their lovers with sex to "enjoy the pleasures of betrayal afforded by the temporary suspension of the moral" (27), relieving them from "the deceptively comforting shelter of domesticity" (61). The hijra engages in the "drama of seduction" (30), wilfully knowing that by "opting out" (21) of a reproductive future, she can never really set up a house with a man. Hijras are haunted by fantasies of unborn children, yet sex becomes an "instance of sexual pedagogy between a hijra and lover" (30). The hijra teaches her man sexually to calibrate his relationships precisely so that he can return "more fortified to meet the demands of domesticity" (61). In Saria's sensitive analysis, this "care afforded by the erotic relationships of hijras" (55) makes life more "bearable in the world" (56). Chapter 2 analyzes how hijras move through webs of domestic relations burdened by the normative demands of fertility and futurity. Far from being socially abandoned, hijras remain tied to their families in ways that sustain fraternal intimacy yet allow for the contradictions of internecine disputes and familial disruptions—e.g., feuds over property among sons and brothers—to be absorbed without annihilating the scaffolding of kinship. Saria intriguingly notes that for families, "the presence of a hijra sibling was not seen as a breach of nature so much as a breach of structure" (64). Hijra lives and the brokerage they provide to sustain "everyday domestic existence" (84) become central to the kinship calibrations that brothers, daughters, sisters, and mothers must make as they negotiate patriarchal futures for the family. Beyond the familial, the love and lust that hijras receive from their sexual pleasures "dilates" (88) the violent hold...

E-1500: Survey on feeding practices in the first 1,500 days of life, recommended by healthcare professionals in Latin America

IntroductionHealth-disease processes are established and programmed in the first 1500 days of life, a period in which nutrition and the microbiota play a fundamental role. Feeding practices vary, according to regional sociocultural characteristics. The Early Nutrition Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) established the goal of identifying the main feeding practices in the first 1500 days that were recommended by health professionals in Latin America. Materials and methodsA survey was conducted on the aspects of maternal-infant and young child nutrition during the first 1500 days of life. An open invitation was extended to Latin American healthcare professionals to anonymously answer the online survey. ResultsA total of 1284 surveys from participants in 18 Latin American countries were analyzed. The mean age of the participants was 37.14 ± 11.1 years, 75.7% were women, 64.7% were physicians, and the rest were nutritionists/nutriologists. A total of 71.4% were familiar with the concept of the first 1000 days of life, 95% answered that exclusive breastfeeding should be carried out up to 6 months of age, and 34.3% responded that complementary feeding should be begun between 4 and 6 months of age. There was scant knowledge regarding nutrition in the pregnant woman. Adherence to traditional complementary feeding practices was evident. ConclusionsIn a group of Latin American healthcare professionals, knowledge about nutrition in the first 1000–1500 days of life of an individual is still incomplete and insufficient, showing the need for continued training of healthcare professionals, with respect to those themes.

Sensory Trial of Quintuple Fortified Salt—Salt Fortified With Iodine, Iron, Folic Acid, Vitamin B12, and Zinc—Among Consumers in New Delhi, India

Background:Micronutrient deficiencies are a cause of significant public health burden and loss of gross domestic product, especially in developing countries. Multiple fortified salt can potentially address this challenge at scale and in a cost-effective manner.Objective:This laboratory-based sensory trial evaluated the acceptability of quintuple fortified salt (Q5FS), that is, iodized salt (IS) fortified with additional 4 micronutrients: iron, folic acid, vitamin B12, and zinc. Iodized salt and double fortified salt (DFS), that is, IS fortified with iron, are used for comparison.Methods:Forty-five respondents were recruited by open invitations to the university staff and their families. Each study participant rated 10 food items each in a set of 3 identical preparations differing only in the salt used. A 5-point hedonic scale was used to rate each dish on 6 sensory attributes: appearance, color, aroma, taste, texture, and aftertaste. Finally, the dish was rated on the attribute of overall acceptability—a subjective combined score based on all sensory attributes considered together.Results:Among the 3 salt types, there was no difference in scores for the sensory attributes of appearance, aroma, taste, texture, and aftertaste, and the attribute of overall acceptability. Color in IS scored significantly higher than in Q5FS and DFS, but there was no difference between the scores of DFS and Q5FS.Conclusions:The 3 salts IS, DFS, and Q5FS are comparable to each other in all sensory properties, except for color. This study concludes that Q5FS is organoleptically acceptable under ideal conditions.

Is the Language you Teach Racist?

In this manuscript, I weave personal and professional stories with available literature to advocate for the necessity of decolonizing language education, taking a primary interest in the English and Spanish languages and in the Indigenous Peoples of the Americas and the Caribbean islands. Thus, I first set the stage by providing a brief historical overview of the effects caused by colonialism on the Indigenous Peoples, languages, and cultures of the Americas and the Caribbean islands. Then, I introduce my journey toward personal and professional decolonization and share practical examples of how I decolonize my teaching with the vision that this information will be helpful to readers. I end this article with final thoughts and an open invitation for further dialogue. My hope is that language (teacher) educators will use this essay as a critical reading for their language teacher pre- and in-service preparation programs and in other academic spaces.

Patient experiences with depression care in general practice: a qualitative questionnaire study

Objective To investigate patient experiences and preferences regarding depression care in general practice. Design and setting A qualitative study based on free-text responses in a web-based survey in 2017. Participants were recruited by open invitation on the web page of a Norwegian patient organization for mental health. The survey consisted of four open-ended questions concerning depression care provided by general practitioners (GPs), including positive and negative experiences, and suggestions for improvement. The responses were analysed by Template Analysis. Subjects 250 persons completed the web-based survey, 86% were women. Results The analysis revealed five themes: The informants appreciated help from their GP; they wanted to be met by the GP with a listening, accepting, understanding and respectful attitude; they wanted to be involved in decisions regarding their treatment, including antidepressants which they thought should not be prescribed without follow-up; when referred to secondary mental care they found it wrong to have to find and contact a caregiver themselves; and they thought sickness certification should be individualised to be helpful. Conclusions Patients in Norway appreciate the depression care they receive from their GP. It is important for patients to be involved in decision-making regarding their treatment. KEY POINTS Depression is common, and GPs are often patients’ first point of contact when they seek help. • Patients who feel depressed appreciate help from their GP. • Patients prefer an empathetic GP who listens attentively and acknowledges their problems. • Individualised follow-up is essential when prescribing antidepressants, making a referral, or issuing a sickness absence certificate.

Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development. We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)-a composite of life expectancy, education, and income measures-into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation. Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24-51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34-69) and the youngest in the low HDI tier (median 28 years, IQR 20-38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6-32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55-5·2) and high HDI tier (2·26, 1·23-4·15), but not the low HDI tier (1·66, 0·61-4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17-2·49). Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices. National Institute for Health Research Global Health Research Group.

E-1500: encuesta sobre prácticas de alimentación en los primeros 1500 días recomendadas por profesionales de la salud en Latinoamérica

IntroductionHealth-disease processes are established and programmed in the first 1,500 days of life, a period in which nutrition and the microbiota play a fundamental role. Feeding practices vary, according to regional sociocultural characteristics. The Early Nutrition Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) established the goal of identifying the main feeding practices in the first 1,500 days that were recommended by health professionals in Latin America. Materials and methodsA survey was conducted on the aspects of maternal-infant and young child nutrition during the first 1,500 days of life. An open invitation was extended to Latin American healthcare professionals to anonymously answer the online survey. ResultsA total of 1,284 surveys from participants in 18 Latin American countries were analyzed. The mean age of the participants was 37.14±11.1 years, 75.7% were women, 64.7% were physicians, and the rest were nutritionists/nutriologists. A total of 71.4% were familiar with the concept of the first 1,000 days of life, 95% answered that exclusive breastfeeding should be carried out up to 6 months of age, and 34.3% responded that complementary feeding should be begun between 4 and 6 months of age. There was scant knowledge regarding nutrition in the pregnant woman. Adherence to traditional complementary feeding practices was evident. ConclusionsIn a group of Latin American healthcare professionals, knowledge about nutrition in the first 1,000-1,500 days of life of an individual is still incomplete and insufficient, showing the need for continued training of healthcare professionals, with respect to those themes.

Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis

Adequate maternal thyroid function is important for an uncomplicated pregnancy. Although multiple observational studies have evaluated the association between thyroid dysfunction and hypertensive disorders of pregnancy, the methods and definitions of abnormalities in thyroid function tests were heterogeneous, and the results were conflicting. We aimed to examine the association between abnormalities in thyroid function tests and risk of gestational hypertension and pre-eclampsia. In this systematic review and meta-analysis of individual-participant data, we searched MEDLINE (Ovid), Embase, Scopus, and the Cochrane Database of Systematic Reviews from date of inception to Dec 27, 2019, for prospective cohort studies with data on maternal concentrations of thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase (TPO) antibodies, individually or in combination, as well as on gestational hypertension, pre-eclampsia, or both. We issued open invitations to study authors to participate in the Consortium on Thyroid and Pregnancy and to share the individual-participant data. We excluded participants who had pre-existing thyroid disease or multifetal pregnancy, or were taking medications that affect thyroid function. The primary outcomes were documented gestational hypertension and pre-eclampsia. Individual-participant data were analysed using logistic mixed-effects regression models adjusting for maternal age, BMI, smoking, parity, ethnicity, and gestational age at blood sampling. The study protocol was registered with PROSPERO, CRD42019128585. We identified 1539 published studies, of which 33 cohorts met the inclusion criteria and 19 cohorts were included after the authors agreed to participate. Our study population comprised 46 528 pregnant women, of whom 39 826 (85·6%) women had sufficient data (TSH and FT4 concentrations and TPO antibody status) to be classified according to their thyroid function status. Of these women, 1275 (3·2%) had subclinical hypothyroidism, 933 (2·3%) had isolated hypothyroxinaemia, 619 (1·6%) had subclinical hyperthyroidism, and 337 (0·8%) had overt hyperthyroidism. Compared with euthyroidism, subclinical hypothyroidism was associated with a higher risk of pre-eclampsia (2·1% vs 3·6%; OR 1·53 [95% CI 1·09-2·15]). Subclinical hyperthyroidism, isolated hypothyroxinaemia, or TPO antibody positivity were not associated with gestational hypertension or pre-eclampsia. In continuous analyses, both a higher and a lower TSH concentration were associated with a higher risk of pre-eclampsia (p=0·0001). FT4 concentrations were not associated with the outcomes measured. Compared with euthyroidism, subclinical hypothyroidism during pregnancy was associated with a higher risk of pre-eclampsia. There was a U-shaped association of TSH with pre-eclampsia. These results quantify the risks of gestational hypertension or pre-eclampsia in women with thyroid function test abnormalities, adding to the total body of evidence on the risk of adverse maternal and fetal outcomes of thyroid dysfunction during pregnancy. These findings have potential implications for defining the optimal treatment target in women treated with levothyroxine during pregnancy, which needs to be assessed in future interventional studies. Arkansas Biosciences Institute and Netherlands Organization for Scientific Research.

You Have One (1) Pending Invitation! The Early Career Committee Invites You to Join Their Discussion Forums!

Early Career Committee members Colin Trumbull and Kevin Jewett use the Early Career Group Discussion Forum as an example of a way that you can join any of the ISMTE Discussion Forums, and include an open invitation for anyone who is interested to join the Early Career forum.

Clinical lipidomics – A community-driven roadmap to translate research into clinical applications

Lipid metabolites, beyond triglycerides and cholesterol, have been shown to have vast potential for applications in clinical applications, with substantial societal and economical value. To successfully evolve from the current research-grade methods to assays suitable for routine clinical applications, a harmonization – if not standardization – of these mass spectrometry-based workflows is necessary. Input on clinical needs and technological capabilities must be obtained from all relevant stakeholders, including wet lab scientists, informaticians and data scientists, manufacturers, and medical professionals. In order to build bridges between this diverse group of professionals, the International Lipidomics Society and its Clinical Lipidomics Interest Group were created. This opinion article is intended to provide an overview of international efforts to tackle the issues of workflow harmonization, and to serve as an open invitation for others to join this growing community.

Postpartum blood pressure self-management following hypertensive pregnancy: protocol of the Physician Optimised Post-partum Hypertension Treatment (POP-HT) trial

IntroductionNew-onset hypertension affects approximately 10% of pregnancies and is associated with a significant increase in risk of cardiovascular disease in later life, with blood pressure measured 6 weeks postpartum predictive...

Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course.

The Latin American Society of Nephrology and Hypertension conducted a prospective cohort, multinational registry of Latin American patients with kidney impairment associated to COVID-19 infection with the objective to describe the characteristics of acute kidney disease under these circumstances. The study was carried out through open invitation in order to describe the characteristics of the disease in the region. Eight-hundred and seventy patients from 12 countries were included. Median age was 63 years (54–74), most of patients were male (68.4%) and with diverse comorbidities (87.2%). Acute kidney injury (AKI) was hospital-acquired in 64.7% and non-oliguric in 59.9%. Multiorgan dysfunction syndrome (MODS) due to COVID-19 and volume depletion were the main factors contributing to AKI (59.2% and 35.7% respectively). Kidney replacement therapy was started in 46.2%. Non-recovery of renal function was observed in 65.3%. 71.5% of patients were admitted to ICU and 72.2% underwent mechanical ventilation. Proteinuria at admission was present in 62.4% of patients and proteinuria during hospital-stay occurred in 37.5%. Those patients with proteinuria at admission had higher burden of comorbidities, higher baseline sCr, and MODS was severe. On the other hand, patients with de novo proteinuria had lower incidence of comorbidities and near normal sCr at admission, but showed adverse course of disease. COVID-19 MODS was the main cause of AKI in both groups. All-cause mortality of the general population was 57.4%, and it was associated to age, sepsis as cause of AKI, severity of condition at admission, oliguria, mechanical ventilation, non-recovery of renal function, in-hospital complications and hospital stay. In conclusion, our study contributes to a better knowledge of this condition and highlights the relevance of the detection of proteinuria throughout the clinical course.

THE WESLEYAN SYNTHESIS RECONSIDERED

This article purpose finds what is “the Wesleyan synthesis,” and will also briefly revisit the much-discussed Wesleyan Quadrilateral. Wesley effectively combined in thought and practice these five elements, namely: (1) Divine sovereignty and human freedom, (2) Doctrine and experience, (3) Experience and structure, (4) Charismatic and institutional elements, and (5) Present and future salvation. This article argues that this synthesis is powerful, but also that it is biblical. In fact, the reason this synthesis is powerful is that it faithfully embodies the revealed truth of Scripture. The results of the Wesleyan synthesis are drawing three general conclusions. First, Wesley's theology was broader and more profound than has often been realized. Second, Wesley's theology can help us develop a biblical understanding of culture and culture change. Third, Wesley's theology is thus an open invitation to continue to develop a theology of church, mission, and culture that is profoundly biblical and sharply relevant to the present age.

PAEAN: Pain in Aging, Educational Assessment of Need - An Interprofessional Collaboration

Pain is prevalent in older adults limiting independence directly and through comorbidity-related effects on functional domains such as mobility, well-being, sleep, productivity, and oligo-pharmacy. Improved outcomes for older adults with pain depends on provider knowledge and competence; concomitantly, Veterans, women, and others at socioeconomic disadvantage may face increased pain, comorbidities, and complications of treatments. Previous guidance for educational programs, from pre-licensure to post-graduate training, in geriatrics and pain have focused on expert opinion, whereas an evidence-based approach is preferred. Our working group is conducting a structured needs assessment regarding comorbidities of common pain-associated conditions in older adults. Methods: To capture expertise in medicine, nursing, pharmacy, clinical psychology, and physical therapy, we extended an open invitation to members of the VA Geriatric Research, Education, Clinical Centers Associate Director-Education network and selected, nationally-recognized clinical education experts outside VA. Results: An eight-member working group, interprofessional in composition, through multiple remote meetings has defined goals of the program, evaluated preliminary evidence addressing the clinical needs of older adults with pain, and posed ‘curious questions’ about the available large-scale data. The overarching goal is evidence-based needs assessment of gaps in education about pain in older adults, with purposeful attention to risks of healthcare inequities for older adult women, Veterans, persons of color, those at socioeconomic disadvantage, and caregivers. Conclusions: Interprofessional collaboration is effective in framing a broad needs assessment regarding pain and common comorbidities in older adults with the intent of meeting the educational needs of clinical trainees. More study is needed.

The thermodynamic theory of action potential propagation: a sound basis for unification of the physics of nerve impulses.

The thermodynamic theory of action potential propagation challenges the conventional understanding of the nerve signal as an exclusively electrical phenomenon. Often misunderstood as to its basic tenets and predictions, the thermodynamic theory is virtually ignored in mainstream neuroscience. Addressing a broad audience of neuroscientists, we here attempt to stimulate interest in the theory. We do this by providing a concise overview of its background, discussion of its intimate connection to Albert Einstein's treatment of the thermodynamics of interfaces and outlining its potential contribution to the building of a physical brain theory firmly grounded in first principles and the biophysical reality of individual nerve cells. As such, the paper does not attempt to advocate the superiority of the thermodynamic theory over any other approach to model the nerve impulse, but is meant as an open invitation totheneuroscience community to experimentally test the assumptions and predictions of the theory on their validity.

The Language Ecology of Graduate Students: An Exploration through Vocabulary Contribution

This study explores the language ecology of graduate students through vocabulary contribution. Understanding students’ learning ecology may be done through the identification of pertinent sociomaterial networks with which students engage to initiate or complement learning. This study was set in an academic writing module taught by the researcher. An open invitation was extended to his students to contribute any vocabulary they encountered outside of his classroom. Along with the vocabulary contribution, students also had to provide the excerpt where the word occurred and the source-type. Contributions were made on an online Excel file. There was a total of 277 contributions made, of which 259 were unique (229 words and 30 unique strings of words). Students’ contributions of strings of words were not anticipated. A majority of these contributions came from academic sources, such as research articles or book chapters, which may be a pertinent aspect of the graduate students’ language ecology. Through the findings, it is recommended that English for academic purposes (EAP) or English for specific purposes (ESP) instructors identify language ecologies found in the broader university setting to glean relevant pedagogical materials that can support students’ language development.

An Open Invitation—Depicting Immigration: What Can Words, Images, and Notes Do?

An Open Invitation—Depicting Immigration: What Can Words, Images, and Notes Do?

The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey

IntroductionTo assess the impact of the COVID-19 pandemic impact on hemodialysis (HD) centers, The Dialysis Outcomes and Practice Patterns Study and ISN collaborated on a web-survey of centers.MethodsA combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centers in 78 countries and all 10 ISN regions.ResultsIn 8 regions, rates of SARS-CoV-2 infection were <20% in most centers, but in North East Asia (NE Asia) and Newly Independent States and Russia (NIS & Russia), rates were ≥20% and ≥30%, respectively. Mortality was ≥10% in most centers in 8 regions, although lower in North America and Caribbean (N America & Caribbean) and NE Asia. Diagnostic testing was not available in 33%, 37%, and 61% of centers in Latin America, Africa, and East and Central Europe, respectively. Surgical masks were widely available, but severe shortages of particulate-air filter masks were reported in Latin America (18%) and Africa (30%). Rates of infection in staff ranged from 0% in 90% of centers in NE Asia to ≥50% in 63% of centers in the Middle East and 68% of centers in NIS & Russia. In most centers, <10% of staff died, but in Africa and South Asia (S Asia), 2% and 6% of centers reported ≥50% mortality, respectively.ConclusionThere has been wide global variation in SARS-CoV-2 infection rates among HD patients and staff, personal protective equipment (PPE) availability, and testing, and the ways in which services have been redesigned in response to the pandemic.

Relational long-term breastfeeding

ABSTRACT This article uses a relationality-sensitive perspective to analyse long-term breastfeeding. The data was gathered through open invitations to write, and the article is based on the written reflections of 39 long-term breastfeeding Finnish mothers. In Finland, the breastfeeding of babies is strongly supported, but long-term breastfeeding (over 12 months) is a more conflicted issue, and the cultural norm of one year of breastfeeding is strong. Through qualitative content analysis, the article shows how mothers reflect on long-term breastfeeding’s effects on their relations with their breastfed children, partners (if any), relatives and healthcare professionals. The findings show that long-term breastfeeding is often a rewarding experience, but that it takes place in a network of relations and has effects on those relations. With a relationality-sensitive approach to breastfeeding, we can better understand how mothering is done in and through relations with others, and how mothers express the need for a change in attitudes towards long-term breastfeeding. This article gives a voice to mothers who are often silent in our society, and therefore participates in the feminist empowerment of women and especially mothers.

Anti-oxidant Features of Amla –A Review

The role of reactive oxygen species and oxidative stress in bringing about a negative impact on health and providing an open invitation to a plethora of diseases is a well-known fact. This has led to the search of antioxidants. The number of conventional available antioxidants have certain limitations and researchers are constantly in search of herbs and medicinal plants. Amla possesses a wide range of medicinal values used ardently by our seers for the treatment of the diseased and to maintain the health of the healthy people as well. Researches have thrown light upon the fact that Amla possess anti-oxidative features and has a wide range of therapeutic utilities. The antioxidant property of Amla has been even experimented to offer a readily available alternative in certain cases as well. The scattered information pertaining to the antioxidant potential of Amla is reported. Present review embraces the general introduction, morphology, phytochemical and pharmacological attributes and an in-depth information of reported antioxidant properties of Amla in terms of available experimental and clinical studies.