Form Of Relief Research Articles

Efficacy of omeprazole and domperidone fixed combination in the treatment of patients with functional dyspepsia: results from TANDEM study

Introduction. Functional dyspepsia (FD) is a multifactorial disease, and the combination of drugs with different mechanisms of action makes it possible to optimally influence various parts of the pathogenesis.Aim. Prospective observational study TANDEM evaluated the efficacy and tolerability of omeprazole and domperidone fixed combination therapy in the treatment of functional dyspepsia in patients with chronic Helicobacter pylori negative gastritis after 4 weeks course of treatment.Materials and methods. In accordance with the purpose of the study, a study cohort was formed of 50 patients with symptoms of functional dyspepsia (30 men, 20 women). The mean age was 29.06 (25.88–32.25). Efficacy and tolerability were assessed using the Visual Analog Scale and the Likert scale.Results. The study was completed by 47 patients. After 4 weeks of treatment, positive dynamics in the form of complete relief of symptoms was noted in all 47 patients; no clinically significant changes in the QT interval were detected.Conclusion. Evaluation of the efficacy of fixed combination omeprazole and domperidone in the treatment of functional dyspepsia in patients with chronic Hp-negative gastritis demonstrated 100% efficacy of the drug in relieving symptoms 4 weeks after the start of therapy. After 72 hours from the start of the treatment, the effect in the form of complete relief of symptoms was registered in 87.25% of patients. On the 14th day the symptoms were completely relieved in 95.74% of patients. Assessment of tolerability demonstrated a good safety profile of the drug, in particular, the absence of clinically significant changes in the QTс interval.

Unpleasant surprises? Debt relief and risk of sovereign default

PurposeThe Covid-19 pandemic has rekindled interest in sovereign debt crises amidst calls for debt relief for developing and emerging countries. But has debt relief lessened the debt burdens of emerging and developing economies? The purpose of this paper is to empirically address this question. In particular, the focus is on the implications of debt relief and institutional qualities for sovereign debt in emerging and developing economies.Design/methodology/approachThe model extends the framework on the probability of default by incorporating the receipt of debt relief by a debtor country. Doing so allows to better explain movements of sovereign defaults relating to debt relief. The model is estimated via the regular probit regression.FindingsThe analysis shows that the debt relief provided, thus, far, failed to ease the debt overhang problems of developing and emerging countries and reduced investment. The current debt relief schemes may underscore the prospects of self-enforcing and self-fulfilling sovereign debt crises rather than eliminating the dilemma completely. Regarding the forms of debt relief, the analysis shows that debt forgiveness offers favourable prospects in terms of debt sustainability and economic outcomes than debt rescheduling. Perhaps, the sovereign debt crises, particularly in low-income countries, hinge on insolvency problems rather than transitory illiquidity issues.Practical implicationsAny debt relief mechanism should consider seriously the potential incentive effect that reinforces expectations of future debt-relief initiatives. Importantly, solving the sovereign debt problem requires a programme for sustained investment and economic growth, while not discounting the critical role of prudent debt management policies and institutions.Originality/valueThis study contributes a different angle to the debate on sovereign debt distress. Aside from the structural and economic factors, this study investigates the role of debt management policy in the debtor nation and the implications of debt relief benefits for sovereign risk. The framework also focuses on whether the different forms of debt relief exert distinctive impacts.

‘[T]here are no winners here, only losers’+

ABSTRACT The Supreme Court recently handed down its decision in Guest v Guest [2022] UKSC 27. This was an appeal against an award in proprietary estoppel of around £1.3 million. A proprietary estoppel claim requires detrimental reliance on a promise to grant the claimant an interest in land. This generates an ‘equity’, which enables the court to fashion a remedy to cure this unconscionable situation: for example, an order to transfer the promised interest to the claimant, or an order to pay a monetary equivalent of what the claimant expected. The doctrine has been relied upon in media-friendly cases where claimants had worked on their family farms for low or no pay for many years on the expectation of an inheritance and ended up being cut out of that inheritance. Lord Briggs, for the majority, favoured enforcing the promise as a starting point while allowing for variation where ‘real-life problems’ warranted it. He held that the claimant should have what he expected but, in a novel approach, gave the defendants an entitlement to choose between two forms of relief. Lord Leggatt, dissenting, held that the remedial aim was to do only what was necessary to prevent detriment to the claimant. On his view, compensating the claimant’s reliance loss would be sufficient for this, and, in that regard, he did not factor in lost opportunities. This was a narrow scope to adopt, and the majority judgment is more likely to provide redress for the loss of important life opportunities.

ANALYSIS OF THE TOURISM SECTOR DEVELOPMENT STRATEGY DURING THE COVID 19 PANDEMIC IN THE CITY OF SABANG

Anticipating the spread of COVID-19, a number of tourist sites in various provinces in Indonesia are temporarily closed including in the province of Aceh. Aceh Province is a tourist destination that has cultural diversity and natural beauty to invite tourists to visit and witness it. The decline in the number of tourist visits in Indonesia certainly has a significant effect on the number of tourist visits in Aceh Province. The development of the tourism sector in the city of Sabang requires the right direction and strategy so that benefits for the regional economy remain profitable even in the midst of Covid 19. In the long term the sustainability of the tourism sector will depend on maintaining a balance between the interests of the economic aspect. This study aims to analyze the estimated value of the sector's economic losses. tourism, tourism sector development strategies and Sabang City government policies related to Tourism Areas during the COVID19 pandemic in Sabang City. This research is survey research with a qualitative approach, using SWOT. The sample in this study amounted to 62 respondents. The results of this study indicate that the value of the economic loss in the tourism sector in Sabang City is estimated at IDR 3,950,000,000 or only 41% of revenue before the COVID-19 pandemic. So the decline in tourism sector revenue due to COVID-19 was 59%. This loss is the value of lost revenue from tourism business actors including hotel managers and restaurant managers in the Sabang Island Tourism Area. The right strategy to be implemented in the development of the Sabang tourism sector is a diversification strategy (quadrant II). Alternative strategies that can be implemented are optimizing the use of social media as a means of promotion, collaborating with elements of the government, increasing access to financing for tourism business actors, increasing incentives for tourism business actors, airlines, travel agents, and promotions in the form of ticket discounts, providing incentives for group incentive trips/famtrips and promotions through influence Acceleration of infrastructure development in priority tourist destinations; Tourism promotions, exhibitions and events are gradually starting to be activated. One of the policies of the Sabang City Government regarding tourism sector policies is contained in Sabang Mayor Regulation Number 30 of 2020 concerning the application of discipline and health protocols as an effort to prevent and control the spread of the Covid virus which is quite effective in reducing the number of tourist visits to Sabang Island both at tourist attractions, hotels , and restaurants. Based on the results of this study, the authors suggest that the Sabang City Government can provide assistance to tourism business actors not only in the form of relief in paying taxes, but also in the form of direct financial assistance. The management of the tourism business is tightening and emphasizing the health protocol for visiting tourists in order to reduce the spread of the COVID-19 pandemic. Especially tourists coming from outside should be checked for the completeness of the letter not infected with the COVID-19 pandemic and the COVID-19 vaccine card. Requiring vaccinations for tourists so that tourism activities can continue during the COVID-19 pandemic with a lower possibility of COVID-19 infection.

Морфометрический анализ донного рельефа крупного долинного водохранилища в процессе его эволюции

Until now, the study of the morphology of the bottom of large reservoirs, subject to gradual siltation, received little attention. Morphometric descriptions of reservoirs are limited by the type, shape, altitude position, size of the bed, and the volume of water in them. The article presents the results of the analysis of the bottom relief of the Krasnodar Reservoir and the transformations of this relief for 2005–2021. The analysis was performed based on the materials of bathymetric surveys for the regulated volume of the reservoir on an area of 224 km2 with the construction of the corresponding digital relief models. The relief of the bottom of the reservoir is represented by flat areas of a flooded accumulative plain with prevailing slopes of about 0.2–0.4°, dissected by river channels of lower order tributaries. The transformation of the relief is caused by gradual siltation. The total volume of deposits for the specified area in 2005–2021 amounted to 127 million m3 with an average silt layer of 0.4 m. To describe the morphological properties of the bottom topography, we used geomorphometric techniques with the calculation of the BPI (Bathymetric Position Index) and the classification of mesoscale landforms based on it. For the bed, relief forms have been established related to three types of surfaces: flat (lower bank shelf), concave (depressions, deep depressions) and convex (reef crests, back reefs, mid-slope reefs). The constructed maps reflect the differentiated morphology of the bed surface, the evolution of landforms under conditions of continuous transformation of the basin, and also make it possible to judge the prevailing processes of morphogenesis. The coastal zone and the shallow part of the bed are the most complex in morphological terms. Here, along with reefs of different genesis, deep depressions and depressions in the form of underwater channels in advanced deltas can form on the accumulative shoal.

Using Remote Data and GIS in Research of Morphometric Characteristics of the Coastal Area in Bulgaria

Remote methods provide information on both the natural objects on the earth's surface, water bodies, water-land boundaries, and relief and relief forms. Satellite images were used to determine the characteristics of the coastline and Black Sea area (about 50 km distance) of the Republic of Bulgaria. Its fractal dimension and curvature are determined. A number of thematic maps have been generated through the digital relief model to assist in the interpretation and geomorphologic characteristics of the study area. A database was created as part of the project MARINEGEOHAZARD – “Set-up and implementation of key core components of a regional early-warning system for marine geohazards of risk to the Romanian-Bulgarian Black Sea coastal area” from CBC Romania-Bulgaria Programme.

Geography and Onomastics: Geographical Terminology in the Oronymy of the Balearic Islands

Toponymy and, more specifically, toponymic generics constitute an important source of geographical terminology, which is a valuable object of study in both linguistics and cultural geography. Based on this, the authors compiled, analysed and classified the oronymic generics of the Balearic Islands (Spain) from the largest toponymic collection of the archipelago, made up of some 50,000 place names gathered for the Balearic Topographical Map at a scale of 1:5,000. A considerable part of toponyms was obtained from field work, which consisted of hundreds of interviews with informants previously selected for their special knowledge of the territory they live in. Field work allowed to obtain popular (“folk,” “unofficial”) toponyms that contain specific generics used in the function of geographical terms, often based on metaphor or another type of semantic shift. This work made it possible to bring together the terms that, in the Catalan language of the Balearic Islands, identify the diverse inland orographic morphologies of each of the islands that form the archipelago (Mallorca, Menorca, Ibiza, and Formentera). The corpus of terminology relating to the names of the relief of the Balearic Islands is formed by 120 oronymic generics. All the terms are classified into three groups distinguishing between terms related to positive relief features (macro, meso- and micro-relief), negative relief features (elongated, rounded, and elevated depressions), and neutral relief that brings together and differentiates forms of vertical, horizontal, inclined and stepped relief. Quantitative observations made by the author show the relatively wider diversity of terminology used in the names of positive relief features, in which macro-relief features are predominant. In the negative relief group, the most varied subgroup of term relates to longitudinal depressions, while in the neutral relief the biggest part of terms specifically designates sloped landforms.

Экспедиции клуба Портулан в район г. Мунку-Сардык в 2021 году

The results of the summer expedition 2020 of the student teaching club "Portulan" together with the staff of the Institute of Geography of the Siberian Branch of the Russian Academy of Sciences to the Munku-Sardyk mountain area, where the field research of nival-glacial formations, river and slope aufeis, slope forms of relief and processes of their formation in the valleys of the Bely Irkut, Bugovek and Muguvek rivers were carried out, are summarized: regime surveys of high altitude aufeis, as well as traditional weather monitoring and study of the rock stream "Active".

Экспедиция клуба Портулан в район г. Мунку-Сардык в 2020 году

The results of the summer expedition 2020 of the student teaching club "Portulan" together with the staff of the Institute of Geography of the Siberian Branch of the Russian Academy of Sciences to the Munku-Sardyk mountain area, where the field research of nival-glacial formations, river and slope aufeis, slope forms of relief and processes of their formation in the valleys of the Bely Irkut, Bugovek and Muguvek rivers were carried out, are summarized: regime surveys of high altitude aufeis, as well as traditional weather monitoring and study of the rock stream "Active".

Гнездовые группировки орлов на ключевой орнитологической территории «Чинк Донызтау» в 2022 году

Гнездовые группировки орлов на ключевой орнитологической территории «Чинк Донызтау» в 2022 году

URDU-JURISPRUDENTIAL STATUS OF RULES OF LAW IN MITIGATION OF SHARIAH ORDERS

The welfare of human kind in individualand collective live is in believing and following Islamic way of life. Islamic code of life exalts the human kind to new dimentions. It has a code of life for all times and universal, not subservient to time and space. On the contemporary, Islamic code of life with all its manufestation is as much work-able and needed today as it was it was in the early glorious period of Islam. Allah, in all His mercy has made the "Islam" simple, workable with exceptions and relief where ever one feels difficulty, danger or deprivation. Based on the Quran, the Holy Prophet guided the followers on such matter where exceptions or relief was needed. After ther Holy Prophet, the reponsibility of guidance was taken out by his companions, after their period the Imams coded all the problems in "fiqah". Today the human kind, particulary Muslims face new chalangesregardingdifferent problems in the matter of practice. This study has established guidance and solutions in the form of exceptions and relief given in Sharia. The hall-mark of it is that Allah and his Prophet has provided relief where ever it is needed.

APPLICATION OF UNMANNED AERIAL VEHICLES FOR THE STUDY OF QUARRIES

The purpose of the study is to analyse the prospects of studying quarry landforms by modern innovative research methods, namely using an Unmanned Aerial Vehicle (UAV). The main tasks of this study are to research quarry landforms in the village of Korystova, create a geomorphological map and digital elevation model, and study modern anthropogenic and natural- past decade. The study results are the research of quarry landforms, their main elements mapping, the analysis of anthropogenic deformations and the load for the terrain, in particular, its anthropogenic processes using a UAV. The research source materials are detailed surveys of the quarry and its surroundings in 2015 and 2021 by UAV technologies and field research over the modification. The study also has applied value to the mining industry in the area of counting techniques of rock mining and the process of quarry reclamation. A 3D survey of the quarry as an anthropogenic form of relief was carried out in the village of Korystova in the Khmelnytskyi region using an Unmanned Aerial Vehicle (UAV). In order to study the morphometric characteristics of the forms and elements of the relief an orthophoto plan of the quarry was created, as well as a digital terrain model (DTM) and a digital elevation model (DEM). Changes in the anthropogenic load on the landforms as of July 2021 compared to 2015 were analysed, which were recorded on the corresponding orthophoto plan and digital elevation model. On their basis, geomorphological maps of the quarry territory were created, showing the major forms and elements of the relief. The main geomorphological processes (water erosion, landslides, etc.), the state of quarry land reclamation, and directions and prospects for further mineral extraction are characterized. It is demonstrated that modern means of scientific research, such as UAVs, are a promising source of geographic information that should be used for both fundamental and applied geomorphological research. With their use, it is possible to obtain much more detailed data for the study of specific natural and anthropogenic forms and elements of the relief, as well as to trace their dynamics in time and space with the necessary periodicity. Key words: quarry; reference section; unmanned aerial vehicle; digital terrain model; digital elevation model; morphometry of the relief; natural-anthropogenic processes.

“THE RELIEF OF EUROPE” AND THE PARADIGM OF GEOMORPHOLOGY OF THE FUTURE (CONCLUSIONS TO THE FIRST TRAINING MANUAL ON THE RELIEF OF CONTINENTS WRITTEN IN THE UKRAINIAN LANGUAGE)

The article emphasizes the need to prepare training manuals on the geomorphology of large land areas. The relief of continents (their parts) and parts of the world is an object of regional geomorphology. The author substantiates the structure and content of the textbook "The relief of Europe", the first written in Ukrainian on the geomorphology of the continents. The manual consists of an introduction, 2 chapters, conclusions and a list of references. The manual uses 6 schematic maps, 9 digital maps, 2 tables, and 28 color photos. The first section of the manual is devoted to issues of planetary geomorphology – the main regularities of Earth's relief forms. Geotexture, morphostructure and morphosculpture are the categories of their are considered as parts of their size-genetic classification and its critical assessment is given (1.1). In 1.2 the planetary features of the Earth's relief at the level of the largest geotextures – continental ridges and ocean depressions are considered (the time of formation and the main trends in the process of the Earth's evolution - the increase in the area of the oceans at the expense of the continents; the sequence of the appearance of the main types of the Earth's crust in the process of the geological evolution of the Earth; the scheme of the geological evolution of the Earth's lithosphere: oceanic-type crust > transition-type crust > continental crust). In 1.3 the considered geomorphological stage of the Earth's development (the beginning of the end of the Paleozoic – the beginning of the Mesozoic – the breakup of Pangea), during which the main features of the modern relief were formed. It is characterized by the following trends: oceanization (expansion and deepening of ocean depressions through the destruction of ancient platforms; increasing the area of continents due to the joining of young platforms (plates); tectonic activation of continents (epiplatform orogeny and the formation of reborn mountains). In 1.4 general regularities of the Earth's morphostructure are considered – 14 types of main morphostructures of plain-platform areas, mountain (orogenic) areas, high platforms and revived mountains, the age and history of the development of land morphostructures, the role of the neotectonic stage, the importance of studying alignment surfaces and hydrographic basins in the study of morphostructure. General regularities of the morphosculpture of the Earth – modern zonal and ancient and the influence of the latter on the development of modern, azonal types of morphosculpture are considered (1.5). The second section consists of general and regional parts. The main regularities of geotexture, morphostructure and morphosculpture of Europe are considered in the general part. In the regional part, modern and ancient geomorphological formations of the author's accepted taxonomic units of geomorphological zoning of Europe (4 zones and 13 countries) are considered. In the conclusions, the author, using data from geology, geomorphology, planetology, substantiates, in his opinion, the content of the future paradigm of geomorphology. Key words: relief of Europe, geotecture; morphostructure; morphosculpture; morphochronodynamic concept; thermodynamic evolution of the Earth.

Introduction: Charity, Relief and Humanitarianism as a Means of Maintaining Social and Political Stability in the Middle East. A Longue Durée Analysis of Actors, Categories and Practices

Abstract Different forms of charity, relief and humanitarian action can be jointly approached as a means of governance and social regulation. More precisely, in the Middle East the question of stability – social and political – can be considered as a central driver for local and international actors alike. This study adopts a broad historical framework, reaching from antiquity to the present day, with the aim of approaching the subject with an openness conducive to understanding the evolution of the actors, modes of action and representations underlying aid initiatives. The longue durée approach allows to show two main specificities of the modern and contemporary Middle East: firstly, the evolution of aid practices is directly linked to human mobility, since they are connected to religious practices, commerce or violence, which led to the need to take a census, to categorise and sometimes isolate populations in order to govern and control them. Secondly, in the absence of the welfare state as the most important provider of aid, the state has until today in the Middle East much less prominence among the multiplicity of aid providers, such as the family, non-governmental, religious and community organisations.

GEO-TOURIST SITES AND ROUTES IN THE TERRITORY OF SAMBIR-KHYRIV TERRACE FOOTHILLS

The geological and geomorphological objects of Sambir-Khyriv terrace foothills have been characterized as natural monuments and potentially popular geo-touristic sites. The foothills cover the pre-Carpathian sections of the Stryvihor and Dniester valleys, the entire Bolozivka valley and the uplands of the interfluves. The main geomorphological elements of the study area are river valleys with a complex of river terraces of different ages. Outside the valleys, in the uplands of the interfluves, the most ancient foothill terraces and different-aged denudation leveling surfaces are spread. Relief-forming deposits of the foothills are mainly represented by Neogene and Anthropogenic accumulations. The anthropogenic depositsoverlapping the older accumulations are extremely heterogeneous in terms of genesis, age, and lithological structure. Within the foothills, the most valuable natural monuments are the following objects: sections of anthropogenic accumulations Slokhyni, Torhanovychi 1 and 2 and Kruzhyky, as well as landforms, i.e. a fragment of Krasna surfacedeveloped on the eastern macro-slope of RadychMountain and the western part of the Bolozivka valley. We identify the listed objects as stratigraphic and geochronological (sections of Slokhyni, Torhanovychi 1 and 2 and Kruzhyky), paleontological (section of Kruzhyky), geomorphological (surface of Krasna, Bolozivka valley),and scenic natural monuments (surface of Krasna). Foothill natural monuments are important in terms of research and geo-educational functions, in particular to study and illustrate stratification of sedimentary accumulations of anthropogenic age; lithological and sedimentological features of continental deposits; variability of paleogeographic conditions of anthropogenic age; cyclicityof continental morpholithogenetic processes; formation of exogenic forms of relief due to denudation shearing of uneven surface of the Earth, erosion and accretion activity of fluvial flows; soil-forming processes; and geological age of human material culture. The described natural monuments are important for the organization of events intended to popularize geological and geographical science, as well as environmental education among people, and teach the skills of careful attitude to the environment. It would befeasible to integrate them into the existing network of tourist routes inLviv region. Key words: Sambir-Khyriv terrace foothills; natural monuments; sections of anthropogenic deposits; surface of Krasna; Bolozivka valley.

Anisotropy of elastic properties of SHS-synthesized porous titanium nickelide

Samples of porous NiTi were obtained by the method of self-propagating high-temperature synthesis. The mechanical characteristics of the porous ones were studied by quasi-static compression. When the samples of porous titanium nickelide were subject to quasi-static compression, the deformation was of an elastic-plastic nature. Three characteristic types of the fracture surface under quasi-static compression of the porous SHS – TiNi alloy were identified: 1) ductile fracture of the austenite phase in the form of a cup relief, 2) brittle fracture accompanied by the formation of cleavage steps, 3) large areas of plastic shear deformation, on which cups and cleavage facets were nucleated. To determine the anisotropy of the porous TiNi alloy properties, the volume of the porous sample was simulated, and estimated calculations were carried out. Based on the results of reconstructing 3D neutron high resolution tomography of the porous volume of titanium nickelide and the numerical parameters of the model porous medium, an algorithm was developed for obtaining a solid-state 3D model of the porous framework for using in finite element calculations. The studied porous titanium nickelide alloy, as well as spongy bone tissues, was shown to have orthotropic elastic properties conditioned by the geometric features of the porous framework. The effective moduli of elasticity and shear for the porous volume of the material were determined. The calculation results of the elastic moduli for the studied model of porous titanium nickelide numerically agree with the results obtained by compressing the samples of porous TiNi. The porous TiNi alloy under uniaxial compression was established to be destroyed under the action of tangential shear stresses at an angle of 45 degrees to the direction of uniaxial compression. The research was carried out with financial support of the Russian Science Foundation under the Grant No. 22-72-10037, https://rscf.ru/project/22-72-10037/.

Sliding tracheoplasty of complete tracheal cartilage rings in children

IntroductionComplete tracheal rings are a rare malformation that occurs in 1 out of 100,000 live births. It is rare, isolated tracheal or tracheobronchial anomaly developed due to abnormal cartilage growth with formation of complete ring and often resulting in airway stenosis. Slide tracheoplasty, as it was originally described by Tsang et al. and popularized by Grillo et al., overlaps stenotic segments of trachea, shortening trachea itself, thus, doubling the circumference and diameter of the stenotic area. Materials and methodsWe have performed slide tracheoplasty in 12 children during the period of 2019–2021 in thoracic surgery department of our center. Median age was 15 ± 21,1 months (2 months-6 years),median weight – 8,04 ± 4,75 kg (3–20,7 kg),tracheal lumen varied from 2.5 to 3.0 mm, stenosis length – from 40 to 70% of the trachea length. ResultsSlide tracheoplasty was performed using central veno-arterial extracorporeal membrane oxygenation in 7 cases and using cardiopulmonary bypass in 5 cases. Concomitant heart disease was revealed in 5 children (pulmonary artery sling in 3 cases, ventricular septal defects – 1, aberrant subclavian artery −1). 5 children underwent one-stage correction of VSD: plastic VSD –1; left pulmonary artery reimplantation – 3; subclavian artery reimplantation – 1. All patients were on mechanical ventilation for 4,3 ± 2,78 days at postoperative period. Patients were discharged 16,3 ± 5,14 days after surgery. Satisfactory result of treatment in the form of respiratory failure relief was achieved in 10 patients. It was possible to increase the trachea lumen from 1.5 to 2 times in all cases. There were 2 (16,6%) fatal cases due to sepsis and multi-organ failure development. ConclusionsChildren with complete tracheal rings are very complicated patients with various comorbidities. Despite the advances in medicine, sometimes it is impossible to save lives of these children. The use of extracorporeal circulation (ECMO and bypass) allows us to safely perform reconstructive surgery on the trachea and save the child from respiratory failure manifestations. If needed, simultaneous correction of heart and tracheal defects is possible. Slide tracheoplasty allows to increase trachea lumen at least in 1.5–2 times. Mechanical ventilation is an unfavorable predictive factor for the outcomes of congenital tracheal stenosis management. Level of evidenceIII.

The relationship between affiliate stigma, stress, and quality of life for parents of individuals with cerebral palsy in Malaysia

Objective To examine the relationship between affiliate stigma, stress, and perceived quality of life among parents of children with cerebral palsy (CP). Method Surveys (Study 1) and semi-structured interviews (Study 2) were used to collect data. Thirty-eight respondents completed the Affiliate Stigma Scale (ASS), Caregiver Burden Inventory (CBI), and Care-related Quality of Life (CarerQol) scales (GMFCS). Eleven respondents took part in semi-structured interviews, which were then thematically evaluated. Results Parents did not feel stigmatized because they had a child with CP. However, parents needed some form of short-term relief from caregiving. After controlling for demographics, high stress respondents experienced high affiliate stigma whereas low stress respondents had better quality of life. Although the respondents with less stigma had a better quality of life, this effect was moderate. Three major themes emerged from the interviews. Conclusion Counseling, support groups, and helper services should be offered to parents. Also, healthcare professionals participating in CP rehabilitation, community-based rehabilitation, and health institutions should be educated on how to better help parents of children with CP.

The Influence of Selected Soft-Tissue and Telerehabilitation Techniques on Headaches in Young Adults During the COVID-19 Pandemic

Introduction: Headaches are a very common pain syndrome. The International Headache Society distinguishes primary pains, which include, among others, migraines and tension headaches, and secondary pain. Manual techniques, including soft tissue methods, are mentioned in the literature as an effective form of pain relief, but it is ambiguous whether manual therapy is a more effective form of headache therapy than exercises improving the flexibility of soft tissues in the neck area and cervical mobility. Objective: The aim of the study was to investigate the influence of selected techniques regarding working with soft tissues on headache symptoms. Material and methods: The study included 29 people with headaches, who were randomly divided into 2 groups. The study group, subjected to soft tissue techniques, comprised 15 people (13 women and 2 men), average age was 27.73 ± 5.06 years, body height, on average, 1.70 ± 0.08 cm, body mass, on average, 64.80 ± 12.31 kg. The control group, subjected to telerehabilitation, included 14 individuals (12 women and 2 men), average age was 28.36 ± 4.88, body height, on average, 1.68 ± 0.09 m, body mass, on average, 64.93 ± 12.78 kg. Participants were enrolled in the study after completing the questionnaire in which they reported currently experiencing headaches. The HIT-6 (headache impact test) and HDI (head disability index) screening tests were used to assess pain, and the results before and after the 3-week therapy were compared. In the study group, soft tissue therapy was performed in 3 sessions, for 30 minutes, 1 week apart. The control group was assigned self-therapy through teleconsultation in the form of exercises, at least 4 times a week, once a day, for 30 minutes, aimed at improving mobility of the cervical spine and elasticity of soft tissues. Results: In the study group, on the HIT-6 scale, the effect of pain on functioning prior to therapy was, on average, 61.87 ± 5.64, while at the end of therapy, a statistically significant decrease was observed – to an average of 48.60 ± 5.22 (p<0.001). In the control group, on the HIT-6, the effect of pain on functioning was, on average, 59.00 ± 4.10, while at the end of the therapy, a significant decrease to the mean value was observed: 53.50 ± 6.04 (p<0.01). For HDI, disability in the study group was at an average of 43.20 ± 19.78 before the therapy and 25.33 ± 14.32 (p<0.01) following the therapy. In the control group, disability before and after the therapy was 31.43 ± 17.62 and 26.57 ± 13.73, respectively (p<0.01). There were no statistically significant differences in the HDI results – 25.33 ± 14.32 for the study group and 26.57 ± 13.73 for the control group (p>0.05) after treatment. Conclusions: Soft tissue therapy and telerehabilitation caused a significant reduction in the impact of headaches on daily functioning and disability. In the era of epidemics, telerehabilitation may be an effective treatment for headaches in young adults.

Intrapartum Epidural Anesthesia and Obstetric Outcome in Nulliparous Women with Term Labor: An analysis of 2 years’ Experience

Aim: to ascertain whether labour profiles and delivery outcomes of nulliparous women who received epidural analgesia were comparable to those of women whose labour was managed with alternative forms of pain relief. Patients and Methods: a prospective, randomised, controlled clinical study carried out in Saudi German and Elhussine University hospitals. Recruitment was open to 100 nulliparous women planning a vaginal delivery of a term singleton foetus. Results: 100 women, with gestational age of 37–41 completed weeks, were chosen at random to receive either continuous epidural analgesia (EPI) or alternative forms of pain relief (NEPI). Compared to the EPI group, the NEPI group's labour took less time to deliver (P<0.05). The first stage's mean duration was 3.7 ± 1.1 hours compared to 4.8 ± 3.1 hours (P < 0.05), while the second stage's mean duration was 102.4 ± 9.3 minutes compared to 132.1 ± 15.8 minutes (p < 0.05). The mean NEPI dose of oxytocin was 10.5 ± 2.3 units, while the mean EPI dose was 15.6 ± 2.5 units (p < 0.05). While NEPI groups had higher rates of spontaneous vaginal deliveries and caesarean sections than EPI groups, NEPI groups required fewer surgical deliveries overall (p < 0.05). VAS scores during labour were less significantly in EPI group (p < 0.05). Conclusion: Regardless of their intention to labour, nulliparous women use epidural analgesia frequently. Other pain management techniques are linked to a slight but statistically significant decrease in the average length of labour and the rate of surgical delivery in women who do not plan to use epidural analgesia as their primary analgesic modality.