Poor Socioeconomic Situation Research Articles

Seeds of Modern Education: American Influence in Turkey

American private foundations invested huge financial resources in institutions and individuals in the Republic of Turkey in the process of westernization of the country. This study seeks to present a detailed historical perspective of the activities of American philanthropic foundations and their influence on the development and the process of modernization of Turkey. Due to the war-torn state and poor socio-economic situation, the modernization process in Turkey implied comprehensive help from the Western countries, which Ataturk took as a model. Based on charity and humanitarian work, first American organizations arrived in Turkey at the beginning of 19th century. Popularly known as ‘‘missionary organizations’’ or simply ‘‘missionaries’’, they devoted their work to religious conversion of dominantly Christian minorities in the Ottoman Empire, charity activities and education. From the period of the first arrivals until 1920s, missionary organizations established number of hospitals and schools that proved beneficial to people and students across Turkey. At the beginning of 20th century, some of the American richest industrialists and businessmen in that period like Andrew Carnegie, John D. Rockefeller and Russell Sage have decided to establish private grant-providing foundations for the melioration of life standards of humankind all around the world – investing dominantly in education, infrastructure and public health. In terms of time scale, growth of the foundation imbricates with the establishment of modern Turkey in 1923. Led by Mustafa Kemal Ataturk, the new government of Turkey was dedicated to the process of modernization of the country – a project that seriously needed support from the external powers. Therefore, this study aims to analyze the role of American private foundations in the process of development of education, health sector, and overall Turkey’s modernization. These findings suggest that American private organizations such as Rockefeller and Ford foundations had a strong hold in the development of institutions and education and training of individuals from Turkey in various fields.

Changes in the Croatian migration system: conceptualising the complexities of migrations, 1990-2023

ABSTRACT This article explores the recent history of labour migration in post-independence Croatia. The time period under investigation is 1990–2023, which encompasses three decades during which the country has experienced complex migrations, in particular of labour migrants and refugees. The article’s ambition is twofold. First, it identifies changing elements of the Croatian migration system, exploring how it is embedded in the wider regional and international migration systems. Second, it proposes a pioneering typology of Croatian migrations and discusses their drivers. The article argues that the Croatian migrations have been significantly affected by the country’s changing affiliations to neighbouring states and the European Union. Several historical, socioeconomic and political junctions have enabled, driven and hampered labour migrations and other migratory flows of the Croatian migration system. It is evident that the war of independence, the poor socioeconomic situation in the post-war period and increased opportunities to emigrate to more developed parts of Europe have all contributed to the depopulation of Croatia and to ongoing changes in its migration system. It is also asserted that understanding the Croatian migration system necessitates a long-term perspective on the interactions between immigrant and emigrant flows, and on how they overlap with return migrations.

Restrição de Crescimento Intrauterino e os fatores de risco associados no Brasil

Introduction: Intrauterine Growth Restriction is defined as the inability of the fetus to reach its growth potential and can be caused by maternal, placental and fetal factors. Objective: The study aims to make a major social contribution, in order to help the health sectors develop actions aimed at improving the quality of life of pregnant women, promoting changes in behaviors that are harmful to the fetus and thus contributing to reducing infant morbidity and mortality. Methodology: A bibliographic survey was carried out in the Scielo, PubMed and VHL databases, between 2010-2020, with the descriptors and their combinations in Portuguese and English, using the Boolean operators: "fetal growth retardation" OR "intrauterine growth retardation" OR "intrauterine growth restriction" AND "risk factors" AND "intrauterine growth restriction" AND "Brazil". After applying inclusion and exclusion criteria, 10 articles were selected. Results: Analysis of the articles showed that Intrauterine Growth Restriction is strictly related to five themes: evolution in prenatal treatment; socioeconomic factor; low birth weight; fetal mortality and serum leptin concentration, eclampsia and HIV. Conclusion: The analyses available on the main categories related to IUGR showed that lack of prenatal care, poor socioeconomic situation, low leptin concentration during pregnancy, pre-eclampsia and viral infections such as HIV are risk factors for IUGR in Brazil.

Ecosystem Services and Linkages of Naturally Managed Monotheca buxifolia (Falc.) A. DC. Forests with Local Communities across Contiguous Mountainous Ranges in Pakistan.

Simple SummaryMonotheca buxifolia is a wild fruit yielding tree species of the Sapotaceae family, frequently reported in northern and western parts of Pakistan. This species is highly involved in providing a number of services, including provisioning, regulation, maintenance and cultural indicating the close relations between society and the protection of mountain areas. Due to the poor socio-economic situation and natural hazards in this region, Monotheca phytocoenoses have been heavily exploited during the last few decades. Apart from the dominant species, we also report some other important tree species (Juglans regia, Pinus roxburghii, Ficus palmata, Punica granatum, Olea ferruginea, and Acacia modesta, etc.) that play a key role in improving the economic situation of the mountain inhabitants. These phytocoenoses should be properly managed on a priority basis to support long-term consumption.The local community of the Suleiman and Hindukush mountain systems in Pakistan has largely depended on the natural resources of the environment since ancient times. The ecosystem of these regions is under huge pressure due to a lack of awareness and the uncontrolled interference of communal, commercial, security, political, and ecological conditions. The present study was designed to illuminate the link between mountain society and the consumption of the benefits from Monotheca phytocoenoses using the ecosystem services concept from the sphere of the socio-ecological system to cultural relations. The use of this approach is very important due to the visible role and dominant status of Monotheca vegetation within the ecological system of the region. M. buxifolia is strongly connected with both local and cultural traditions and is counted as a key species, particularly for high-mountain inhabitants. We report that Monotheca phytocoenoses provide several services including shelter, food, fodder, medicines, and wood, etc., to the indigenous community and is highly valued in the local culture because of the poor economic condition of the society. The concept of this cultural keystone species is crucial for understanding ecosystem services and must be considered for the protection and conservation of these habitats. The results of field and social studies have shown that the stable maintenance of Monotheca phytocoenosis forests ensures the existence of key species as the most important providers of ecosystem services, e.g., provisioning, regulation, maintenance and cultural services, indicating the close relations between society and the protection of mountain areas. According to the results obtained, the mountains community of the studied area believes that tree species like M. buxifolia, F. palmata, O. ferruginea, P. granatum, A. modesta, J. regia, etc., are the key components contributing to the function of both the mountain ecosystem and communities’ well-being. This approach will be extremely useful for ensuring an inclusive management of the socio-ecological system of the Hindukush and Suleiman Mountain ranges of Pakistan.

Prevalence and factors associated with the awareness of obstetric fistula among women of reproductive age in The Gambia: a multilevel fixed effects analysis

BackgroundAn obstetric fistula is an inappropriate connection between the vagina, rectum, or bladder that results in faecal or urine incontinence. Young women from rural areas with poor socioeconomic situations and education are the majority of victims, which restricts their access to high-quality healthcare. Obstetric fistulas can have devastating effects on the physical health of affected women if they are not promptly treated. Inadequate awareness of the symptoms delays recognition of the problem, prompt reporting, and treatment. Women with poor awareness of the disorder are also more likely to develop complications, including mental health issues. Using data from a nationally representative survey, this study investigated the prevalence and factors associated with the awareness of obstetric fistula among women of reproductive age in The Gambia.MethodsThis study used population-based cross-sectional data from the 2019–2020 Gambia Demographic and Health survey. A total of 11823 reproductive-aged women were sampled for this study. Stata software version 16.0 was used for all statistical analyses. Obstetric fistula awareness was the outcome variable. Multilevel logistic regression models were fitted, and the results were presented as adjusted odds ratios (aOR) with statistical significance set at p < 0.05.ResultsThe prevalence of obstetric fistula awareness was 12.81% (95%CI: 11.69, 14.12). Women aged 45–49 years (aOR = 2.17, 95%CI [1.54, 3.06]), married women (aOR = 1.39, 95%CI [1.04, 1.87]), those with higher education (aOR = 2.80, 95%CI [2.08, 3.79]), and women who worked as professionals or occupied managerial positions (aOR = 2.32, 95%CI [1.74, 3.10]) had higher odds of obstetric fistula awareness. Women who had ever terminated pregnancy (aOR = 1.224, 95%CI [1.06, 1.42]), those who listened to radio at least once a week (aOR = 1.20, 95%CI [1.02, 1.41]), ownership of a mobile phone (aOR = 1.20, 95%CI [1.01, 1.42]) and those who were within the richest wealth index (aOR = 1.39, 95%CI [1.03, 1.86]) had higher odds of obstetric fistula awareness.ConclusionOur findings have revealed inadequate awareness of obstetric fistula among women of reproductive-age in The Gambia. Obstetric fistulas can be mitigated by implementing well-planned public awareness initiatives at the institutional and community levels. We, therefore, recommend reproductive health education on obstetric fistula beyond the hospital setting to raise reproductive-age women's awareness.

Risk factors for the double burden of malnutrition in children younger than 5 years in the Gaza Strip: a systematic review

BackgroundMalnutrition, the coexistence of both undernutrition and obesity, poses a considerable public health and economic burden worldwide. Globally, undernutrition is the largest cause of death in children younger than 5 years, being responsible for 3·1 million, or approximately 45%, of deaths in this population. Conversely, WHO estimated that, in 2016, 41 million children younger than 5 years were overweight or obese. The global problem of malnutrition can be ascribed to changing dietary and lifestyle habits and to the epidemiological transition of most countries. Developing communities, such as in the Gaza Strip, are thus subject to a double burden of preexisting widespread undernutrition and emerging obesity and chronic diseases. MethodsA systematic search and literature review was done in PubMed, Embase, and the Cochrane Library for articles discussing risk factors for obesity and undernutrition among Palestinians. Additionally, we reviewed UN Relief and Works Agency and Ministry of Health of the occupied Palestinian territory health annual reports. We included all original, population-based studies, irrespective of their design or publication status, language, or age of participants. We independently screened titles, abstracts, and full texts for eligibility, then extracted relevant data and assessed the risk of bias. We pooled the most common reported risk factors for the double burden of malnutrition in the occupied Palestinian territories (Gaza Strip and West Bank) for the period of June, 2017, to June, 2018. FindingsOf 432 publications retrieved, we included 23 eligible articles. The pooled risk factors for undernutrition and obesity in the Gaza Strip were poverty and poor socioeconomic situations (63%), poor awareness of healthy diets and lifestyle among communities (26%), developmental transition and urbanisation (6%), and others (5%). The political situation and the blockade in the Gaza Strip contributed to different weights of the risk factors above mentioned. All studies had a moderate to high risk of bias, especially selection bias. Annual health reports of UN Relief and Works Agency and Ministry of Health of the occupied Palestinian territory showed that overweight was in high prevalence in children younger than 5 years (6·5%), as were other problems of undernutrition, such as stunting (7·1%). InterpretationThe poor political and socioeconomic situation in Gaza compound the risk factors contributing to the high prevalence of malnutrition in the area. In addition, awareness about healthy lifestyles is scarce, which increases the prevalence of overweight and obesity in children. Urbanisation and developmental factors such as globalisation and technological developments added a small risk of overweight and obesity. FundingNone.

BRAGGING КАК ОДИН ИЗ ОПОРНЫХ КОНЦЕПТОВ ХИП-ХОП-ДИСКУРСА

Statement of the problem. The subculture of hip-hop was formed among the African-American population of the United States during a period of poor socio-economic situation. These conditions for the development of hip-hop build a system of values and knowledge, which acts as the foundation of the discursive space of hip-hop. Hip-hop discourse unfolds around the basic concepts of racism, violence and bragging. The concept of bragging is based on the consequences of living conditions in the segregated society of the United States, when African Americans did not have the opportunity to possess certain goods which are available to the white population. After the restrictions having been lifted, high-priced goods have become an element of hip-hop discourse participants’ system of values. The purpose of the article is to identify and systematize the linguistic means of representing the concept of bragging as one of the basic concepts of hip-hop discourse. The methodology of the research is the analysis and summary of works about the basic concepts on the basis of which the discourse is built. Research results. In the article the most common linguistic means of implementing the concept of bragging are identified. The analysis of the song texts of the hip-hop discourse shows that the studied concept is represented mainly through lexical means. Conclusions. The most common ways of representing the concept of bragging are the lexemes of the semantic fields “jewelry” and “financial well-being”. In addition, precedent names are important for the nomination of companies that produce high-value goods, which represent the attributes of success for the participants of the hip-hop discourse. The concept of bragging acts as a basic concept of hip-hop discourse and reflects the specifics of hip-hop discourse. It also determines the perception of the surrounding world by subculture participants.

Influencing Factors of Depression among Adolescent Asians in North America: A Systematic Review.

Background: Asian American adolescents experience rates of depression comparable to or greater than those of other ethnic minorities. The purpose of this systematic review is to summarize psychosocial factors related to depressive symptoms of Asian American adolescents between the ages of 10 to 19. Methods: Various electronic databases were systematically searched to identify research articles published from 2000 to 2021, and the psychosocial factors influencing depression among Asian adolescents in North America were examined. Results: A total of 81 studies were included in this systematic review. Consistent findings on relationships between depressive symptoms and influencing factors included (a) acculturative stress, (b) religious or spiritual significance for females, (c) parent–child cohesion, (d) harsh parenting style, (e) responsive parenting style, (f) racial or ethnic discrimination, (g) being bullied, (h) positive mentor presence, and (i) exposure to community violence. Collectively, the majority of included studies suggest that depressive symptoms were more likely found among Asian American adolescents who (a) are older, (b) are female, (c) have immigrant status, (d) exhibit coping behaviours, (e) face academic challenges, (f) face a poor socioeconomic situation, (g) perceive parent–child conflict, (h) perceive maternal disconnectedness, and (i) perceive negative peer relations. A number of conflictive findings also existed. Discussion/Conclusions: This systematic review provides a summary of the various psychosocial factors on individual, familial, and social levels, which influenced the depressive symptoms of Asian American adolescents. Such findings offer a starting point to examine what factors should be necessarily included in related depression-preventive intervention design and evaluation. Culturally sensitive care, strengthened family–school–community collaboration, and targeted research efforts are needed to meet the needs of Asian adolescents experiencing a range of depressive symptoms.

Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke.

PurposeDetails on adequate care and prevalence of depression in long-term stroke aftercare are limited. We aimed to determine long-term depression rates after stroke and to test for an association between depression and inadequate screening, socio-economic complications and lack of sub-optimal care.Patients and MethodsIn this cross-sectional study, 57 patients were re-invited into the clinic 2–3 years after stroke. Patients were interviewed about recalled screening concerning depression and unmet needs. Depression, the patient’s social situation, and confounders were assessed by standardized scores.ResultsIn our study, 20% (n = 11) of patients were classified as depressed by the HDRS-17 score result. However, only 36% of all patients recalled to have been previously screened for depression and only 43% of those patients also recalled out-patient screening. Patients classified as depressed reported significantly lower recalled screening rates (9% vs 43%; p = 0.036) and higher rates of self-reported unmet need with emotional problems (72% vs 18%; p < 0.001). Depression in our study was further associated with a worse socio-economic situation, fewer social contacts, unmet needs with regard to emotional problems and higher rates of recommendations to apply for additional social support.ConclusionOur data suggest that systematic out-patient screening for depression is lacking in stroke aftercare. Furthermore, the high rate of unmet emotional needs, the poor socio-economic situation and the higher rates of recommendations for social counselling and application for benefits suggest an undersupply of care in the out-patient setting that is more prominent in patients with depression and warrants further studies to investigate the underlying causes.

Evaluation of DMFT in paediatric patients with social vulnerability conditions.

The aim of this study was to analyse the dmft/DMFT index in paediatric patients belonging to families with low income, in conditions of social vulnerability and absolute poverty and to compare it with a control group with a good socioeconomic status. The study analysed a total sample of 160 patients with average age of 8.6±2.5. The sample was divided into two groups based on the Equivalent Economic Situation Indicator (ISEE). Group 1 consists of 80 patients with an ISEE value less than €6.000 and was examined at the "Solidarietà Vincenziana" Dental Centre - Rome (Italy), which is a centre dedicated to people with minimum income, destitute, elderly without resources, immigrant children; Group 2 consists of 80 patients with an ISEE value of more than €20.000 and was examined at the Pediatric Dentistry Unit, University of Rome Tor Vergata. Statistical analysis was performed using SPSS for Windows version 21 (IBM SPSS Inc., Chicago, IL, USA). The statistical analysis included a descriptive evaluation of the results in a bivariate analysis. The association between the presence of caries and the background variables was evaluated with the chi-squared association or Fisher test. The minimum level of significance was fixed at P-value?0.05. Analysing the number of caries-free subjects and subjects with caries in reference to the age group between 5 and 12 years and the ISEE value, without distinction of sex, there is a statistically significant difference between Group 1 and Group 2, both in relation to the dmft (p=0.038, Chi-squared Test=4.28) and to the DMFT (p=0.001, Chi-squared Test=19.23). Subjects aged between 5 and 12 years had an average DMFT of 1.88 ± 0.83 (Group 1) and 0.95 ±0.54 (Group 2). The study highlights a positive relationship between ISEE value, of poor socio-economic situations (condition of absolute poverty, low economic income) and increase in the DMFT index. The oral health status is an indicator of poverty. For this reason it would be advisable to plan early preventive interventions, providing the possibility of appropriate and effective access for children in economic and social needs, whose quality of life can be further negatively affected by oral diseases.

Factors influencing the migration intention of dental and medical graduates in developing countries

Abstract Background Migration of skilled health workers could result in shortage of human resources and rising inequalities in service provision in source countries. To date, most of relevant papers are focused on rate and reasons of migration while the need for conducting studies on modelling of factors is more vividly felt. The aim of this review was to determine the factors influencing the migration decisions of medical and dental graduates migrating from developing countries and to introduce a practical conceptual framework for health worker migration. Methods Electronic databases PubMed, Google Scholar and relevant Journals were systematically searched for English language publications from January 2009 to April 2019. The inclusion criteria were: 1) article stated factors affecting migration decisions of medical doctors and/or dentists, 2) the source country in the study was a developing country, 3) participants’ primary qualification country was in a developing country,4) the study used primary data both qualitative or quantitative. Results The search identified 814 articles from which we included 23 full-text studies after applying eligibility checklist. Push and pull theory was the most popular model to describe the migration driving factors. Poor socio-economic situation, political instability, lack of professional and educational opportunities together with family concerns found as strong common push factors that perpetuate migration. The most influencing pull factors were desire for better quality of life, career and training opportunities and financial gain. Conclusions Despite the fact that health workers migrate for different reasons, they follow a same route for decision to stay or leave their own countries. Un-fulfillment of expectations in mother land in addition to media reconstructed reality of life in foreign land can develop a positive attitude for migration Which should be considered before weighing up the push and pull factors of both sides. Key messages A better understanding of the migration motives of health professionals will help health authorities to improve their workforce recruitment and retention strategies and health service planning. Our simple yet comprehensive framework can mainly identify the development of migration desire through combining different models and concepts of migration, behavioral change, values, needs and so on.

Prevalence of and Factors Associated with Metabolic Syndrome in Afro-Descendant Communities in a Situation of Vulnerability in Northern Brazil: A Cross-Sectional Study.

Background: Quilombos are Brazilian communities developed by survivor groups following fight against slavery. They are found in the whole of the Brazilian territory, far from urban centers, living in vulnerable and poor socioeconomic situations and continuously suffering from influence of occidentalization. Based on the hypothesis that the way Quilombolas live may be associated with metabolic syndrome (MS), the objective of this study was to estimate the prevalence of MS and to analyze the associated factors in adult residents of Quilombola communities in the northern region of Brazil. Methods: A cross-sectional study was conducted according to the guidelines of the STROBE Statement in five communities of Tocantins. Results: The study investigated 193 individuals who lived for at least 1 year in the communities. The prevalence of MS in this population was 32.12%. There was a higher prevalence of MS or metabolic disorders in women, as well as metabolic profiles related to low high-density lipoprotein and obesity among participants with MS. Conclusion: The prevalence of MS is higher compared with other Quilombola and African communities, indicating an opportunity to improve or develop new programs to reduce MS and metabolic disorders, by making changes in some habits, such as physical activities, because there were differences in metabolic disorders related to the presence of MS.

Assessment of Health-Related Problems in Dizaj-e Siavosh Community of Urmia, Iran, Based on the North Carolina Model

Introduction: To determine the health-related strengths, resources, and needs of a given community, it is necessary to obtain complete and correct information about its healthcare system and the people’s health problems. In this study, we identified and prioritized the health-related problems of the highly disadvantaged Dizaj-e Siavosh community of Urmia, Iran.Materials and Methods: This study was based on the so-called North Carolina Model. In this eight-step model, a community’s health-related problems are identified in the first seven stages. In the eighth stage, an operational plan is developed with the goal of addressing, prioritizing, and solving the identified problems.Results: In this study, 10 different problems were identified, including improper removal of sewage and garbage; involuntary marriage of girls, especially at an early age; the large number of poor households; the lack of continuing education for girls after elementary school; keeping pets without observing principles of health; lack of respect for a 3-year child-bearing interval; a generally poor socioeconomic situation; unemployment; widespread substance abuse; and low level of education for men. These problems were prioritized respectively.Conclusion: Most problems identified in this study were associated with people’s lack of knowledge about health-related issues, which is rooted in low social, cultural, and economic status.

Intersekcionalita útlaku u matek bez domova z azylových domů

This paper deals with how the intersectionality of oppression manifests in narratives of single mothers with experience residing in a homeless shelter. Oppression is of a structural nature and single mothers from homeless shelters encounter it in various forms and on various levels. Using a qualitative research strategy, in particular a participatory approach, it has been found that oppression is ever-present in the narratives of homeless mothers, and that their living experience can only be understood through the intermingling and intersecting of different forms of oppression, such as gender, motherhood, lone- parent families, andthe interrelated poor socio-economic situations, ethnicity, and homelessness. This intersecting of different forms of oppression leads to disabled identities, that resulting in segregation, marginaliszation, or social exclusion.

Poor physical function, relationship problems and alcohol use are predictors of increased overall mortality in Swedish cancer patients: 27-years follow-up study in Stockholm County

BackgroundTo study the mortality rates among cancer patients and whether these differences are associated with history of poor physical health and socio-economic situation. MethodThe relation between overall mortality and 30 questions of life-style and health was investigated in all subjects (n = 3197) who received a diagnosis of cancer (ICD-7 140-209) between 1969 and 1996 from the Rebus-cohort created in 1969 (n = 32186). ResultsThe overall mortality was increased in both men and women who received a cancer diagnose if they had reported problems with physical function at the beginning of the study. Men who received a cancer diagnose also had higher mortality due to cancer if they had relationship problems (HR = 1.23, 1.02–1.48), and alcohol use problem (HR = 1.35, 1.04–1.74) at baseline. Women who received cancer also had higher risk to die in cardiovascular diseases if they had reported physical function problem (HR = 1.97, 1.25–3.12) at the beginning of the study. ConclusionsPoor physical function is a predictor of increased mortality among subjects with diagnosis of cancer.

Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea.

Aims/IntroductionFrequent emergency department (ED) visitors are medically vulnerable individuals. We identified the characteristics of “frequent ED users” among Korean patients with type 2 diabetes mellitus.Materials and methodsWe used the Health Insurance Review and Assessment Service National Patient Sample, which is a nationally representative sample. Patients (n = 109,412) with type 2 diabetes mellitus as a primary or secondary diagnosis at one of their visits were included. Individuals were classified into three groups according to the number of ED visits: frequent (≥4 visits), occasional (<4 visits) and non‐users of the ED. The characteristics of the patients that distinguished frequent users from the other groups were investigated.ResultsFrequent ED users were mainly men (P < 0.001), with longer treatment duration (P < 0.001), more frequent comorbidities (cardiovascular and chronic kidney disease) and primary diagnosis made by surgery (P = 0.0028). They had higher mortality (P = 0.0085), longer hospitalization duration (P < 0.001), higher costs per visit (P < 0.001) and more often required medical protection (P < 0.001). These patients were treated more frequently with sulfonylurea, insulin, meglitinide and alpha‐glucosidase inhibitors (P < 0.05).ConclusionsThe present findings suggest that frequent users of the ED with type 2 diabetes mellitus have serious health conditions, a poor socioeconomic situation and tend to take some medicines (sulfonylurea, etc.), which often are associated with hypoglycemia. Attention should be given to therapy, and to patients with renal and cardiovascular diseases to decrease the dependency of these patients on the ED.

Vulnerabilities to flood hazards among rural households in India

Flooding constitutes the most predominant natural disaster in India. The degree and causes of vulnerability to flood risk vary by society, geographical region and over time. The rural people of India are highly vulnerable to flood hazards due to high dependence on natural resources for livelihood and poor socio-economic situations. The information regarding the degree of vulnerability of these people is limited. In order to formulate improved adaption policies and effective programmes to reduce vulnerability, it is crucial to quantify the vulnerability of rural households affected by floods at a regional level. Our study provides insight into the vulnerability of rural households affected by floods in India. We use primary data of 220 flood-prone rural households of Odisha state in India for analysis. The vulnerability is analysed using the Livelihood Vulnerability Index and the Socio-economic Vulnerability Index. Our results show that these households are vulnerable to flood in more than one dimension. Sociodemographic characteristics such as a low literacy rate, a high dependency ratio and a weak housing structure increase these residents’ vulnerability. Access to social networks and social institutions plays a significant role in uplifting poor rural households. Our study concludes that the vulnerability of a household is governed by both non-climatic factors and the incidence of floods. The findings of our study may be considered in developing policies and programmes that will reduce the flood risk. The recommendations we suggested in this study can be applied in other south Asian counties with similar socio-economic profiles.

TUBERCULOSIS MENINGITIS IN CHILDREN: MODERN REQUIREMENTS TO DIAGNOSTICS

Тhe aim: to analyze reasons of late diagnostics and course specifics of tuberculosis meningitis (TBM) in children in Saint Petersburg, Russia. Materials and methods: Data was obtained from the Russian official statistics on the frequency of childhood tuberculosis meningitis in 2000-2016. We also analyzed the frequency, the course and the diagnostic specifics of tuberculosis meningitis in children in 2005–2016 in Saint Petersburg. Results and discussion: In the Russian Federation the number of children diagnosed with tuberculosis meningitis per year was reduced from 51 in 2000 to 13 in 2016. In Saint Petersburg over the period of 2005 to 2016 there were seven registered cases of childhood tuberculosis meningitis. Unfortunately only three children out of seven in Saint Petersburg tuberculosis meningitis cases survived. The main factors associated with tuberculosis meningitis in children were young age, children three years old and younger (5 out of 7 children), the presence of a TB patient in the family (6 out of 7 children), lack of BCG vaccination (5 out of 7 children), and poor socio-economic situation (5 out of 7 children). Three out of seven children developed tuberculosis meningitis after becoming HIV positive. The following methods of tuberculosis meningitis diagnostics exist in Russia: Diaskintest, PCR, and Bactec culture tests for Mycobacterium tuberculosis. QuantiFERON-TB Gold and T-SPOT.TB are available but too expensive for most patients. However, a low prevalence of tuberculosis meningitis cases resulted in insufficient attention to TBM, late diagnostics and fatal cases. Three clinical cases were analyzed. Conclusion: To improve tuberculosis meningitis treatment outcomes it is necessary to raise awareness of TB infection among treatment providers, especially when evaluating high risk children population. It is critical to determine presence of latent Mycobacterium tuberculosis, use all etiological diagnostic methods, including PCR and Bactec, when analyzing cerebrospinal fluid and other specimen, and initiate anti-TB treatment immediately when tuberculosis meningitis is suspected.

Calorific value and fuel wood consumption patterns of a forest plantation made by villagers at Kahinure (Distt Mau), Uttar Pradesh, India

In the present study, calorific value of different fuel wood biomass and its consumption patterns of the plantation forest in rural area of Kahinure (Distt Mau) Uttar Pradesh, India had been evaluated. A questionnaire survey of random sampling method was employed for 180 households to understand socio-economic conditions and energy use pattern for cooking purposes in the study area. The study reveals that fuel wood was largely utilised as noncommercial and cheap source of energy, followed by dung cake and agriculture residue. The highest calorific value was estimated by Prosopis juliflora (22.56 MJ/kg) followed in Terminalia arjuna (21.63 MJ/kg) and Pithecellobium dulce (20.67 MJ/kg), whereas the lowest value was found in Streblus asper (17.32 MJ/kg). About 65% of household energy consumption was in form of wood biomass fuel derived from the plantation forest. The cow dung was used by 22% households and agriculture residue by 12%. About 1.3% people used kerosene for cooking. Average cooking time was estimated at 4.46 h/day/family, and average value of fuel wood consumption was estimated at 4.5 t/family/year, whereas average market value of annual consumption of fuel wood had been calculated as Rs 8,700.00 per households. Due to poor socio-economic situations in the village, a significant amount of fixed carbon of plantation forest was used for cooking of food which could be saved by providing them renewable source of energy for cooking or cooking gas cylinders.

Trafficking of women for the purpose of sexual exploitation in Europe

Tens of thousands of women and girls are trafficked from mainly poorer to richer regions of Europe and forced into prostitution. Traffickers abuse the poor socio-economic situation of young women in these poorer regions to exploit them into prostitution. Sex trafficking poses a huge impact on society. Besides the economical side – sanctions for not complying with certain anti-trafficking efforts or health care costs for victims – the political- and social impact is drastic. Social impact for victims is huge: during their trafficking they face extreme violence, coercion, and rape, which leave both psychological as physical marks after their return. Additionally, drug use by victims will eventually place another burden on society. In order to stop sex trafficking the pre-departure state, transit stage, exploitation stage and demand side need to be targeted. The pre-departure state is most important for source countries. The exploitation- and demand stages are tightly intertwined with legislation on prostitution. When prostitution is legalized and demand is high, exploitation is a natural result. Sweden has shown that demand can be strongly decreased by criminalizing the purchase of sex. By not criminalizing sales of sex, victims of sexual exploitation cannot be prosecuted. The European Commission has recently adopted a law prohibiting the purchase of sex, therewith copying this system. Country-specific adaptations might be necessary, as European countries are very different and deal with trafficking in very dissimilar ways. Adopting demand-tackling legislation might not have the desired effect in Eastern European source countries. Additionally, European countries must continue to work together. Sex trafficking seemingly follows basic economics: when there’s no demand, there’s no market, and therefore supplies will drop. Having looked at the different efforts countries make, it can be concluded that – although all stages of sex trafficking need to be targeted – eliminating the demand for sex workers seems to work as a best method.