Total Population Research Articles

Impression of excessive digital media utilization on psychological well-being: A case of Pakistan’s metropolitan cities

Digital media utilization assumes an imperative part in changing millennials’ way of life. The rapid growth in the usage of digital media may have an impact on the mental prosperity of users. The primary focus of this research is to examine how excessive usage of digital media affects its consumers' psychological well-being in Pakistan's major cities. In January this year, there were 72 million digital media users in Pakistan, equal to 32% of the total population, of which 28% of Pakistan is between the ages of 26-41 (Kemp, 2022). This is the most probable age group to be used and influenced by digital media. Based on prior works, it delivers a more inclusive study of the spectacle by the view of independent variables (social capital, social isolation, and smartphone addiction), dependent variable (psychological well-being), and one mediator (excessive digital media utilization). This study sheds light on the best ways to mitigate the negative effects of using digital media, which claims to have a clear adverse effect on mental health through social capital creation and management. Overall, this research provides important insights for academics, scholars, and society at large. This paper consists of a quantitative approach of 236 users from metropolitan cities in Pakistan with the help of structural equation modeling to test the projected propositions. The research study could be additionally upgraded if we center around more factors and other various areas of Pakistan for exploring the effect of excessive digital media utilization on mental prosperity.

The Formal Demography of Peak Population.

When will the human population peak? In this article, we build on classical results by Ansley Coale, who showed that when fertility declines steadily, births reach their maximum before fertility reaches replacement level, and the decline in total population size does not occur until several decades after fertility has reached that level. We extend Coale's results by modeling longevity increases, net immigration, and a slowdown in fertility decline that resembles current projections. With these extensions, our models predict a typical lag between replacement-level fertility and population decline of about 35 to 40 years, consistent with projections by the United Nations and about 15 years longer than the lag predicted by Coale. Our analysis helps reveal underlying factors in the timing of peak population.

Evolution of cosmic filaments in the MTNG simulation

We present a study of the evolution of cosmic filaments across redshift with an emphasis on some important properties: filament lengths, growth rates, and radial profiles of galaxy densities. Following an observation-driven approach, we built cosmic filament catalogues at z = 0, 1, 2, 3, and 4 from the galaxy distributions of the large hydro-dynamical run of the MilleniumTNG project. We employed the extensively used DisPerSE cosmic web finder code, for which we provide a user-friendly guide, including the details of a physics-driven calibration procedure, with the hope of helping future users. We performed the first statistical measurements of the evolution of connectivity in a large-scale simulation, finding that the connectivity of cosmic nodes (defined as the number of filaments attached) globally decreases from early to late times. The study of cosmic filaments in proper coordinates reveals that filaments grow in length and radial extent, as expected from large-scale structures in an expanding Universe. But the most interesting results arise once the Hubble flow is factored out. We find remarkably stable comoving filament length functions and over-density profiles, showing only little evolution of the total population of filaments in the past ∼12.25 Gyr. However, by tracking the spatial evolution of individual structures, we demonstrate that filaments of different lengths actually follow different evolutionary paths. While short filaments preferentially contract, long filaments expand along their longitudinal direction with growth rates that are the highest in the early, matter-dominated Universe. Filament diversity at a fixed redshift is also shown by the different (∼5σ) density values between the shortest and longest filaments. Our results hint that cosmic filaments can be used as additional probes for dark energy, but further theoretical work is still needed.

Abstract 755: Fecal microbial dysbiosis is associated with colorectal cancer risk

Abstract Although there is evidence of an association between the fecal microbiota and colorectal cancer (CRC) risk in epidemiologic studies, there is a lack of data from large-scale population-based studies. To address this gap, we assessed the dysbiosis of the fecal microbiome in a large-scale study in Korea. We recruited 287 CRC patients from the Center for Colorectal Cancer, National Cancer Center Hospital, Korea to perform 16S rRNA gene sequencing of fecal samples. A total of 287 age- and sex-matched healthy participants were selected from 890 cohort of healthy Koreans that are publicly available (PRJEB33905). The microbial dysbiosis index (MDI) was calculated based on the differentially abundant species. The association between MDI and CRC risk was observed using conditional logistic regression. Alpha-diversity indices were not significantly different between CRC cases and controls. The first three principal coordinates derived by a principal coordinate analysis (PCoA) based on weighted UniFrac distance explained 41.24% of the overall microbial diversity, with a significant divergence of the microbial composition between CRC patients and controls (PERMANOVA p=0.001). Three enterotypes were found based on CRC patients’ microbial composition. Those who were in the third tertile of the MDI showed a significantly increased risk of CRC in the total population (OR: 6.59, 95% CI: 3.83-11.33, p-trend<0.001) compared to those in the lowest tertile. Similar results were found for men (OR: 6.58, 95% CI: 3.17-13.63, p-trend<0.001) and women (OR: 6.69, 95% CI: 2.91-15.37, p-trend<0.001). Dysbiosis in the fecal microbiota may be associated with an increased risk of CRC. Due to the potentially modifiable nature of the gut microbiota, our findings may have implications for CRC prevention among Koreans. Key words: Fecal microbiome, 16S rRNA gene sequencing, Microbial dysbiosis, Colorectal cancer Citation Format: Jeongseon Kim, Madhawa Gunathilake, Hyun Yang Yeo, Jae Hwan Oh, Byung Chang Kim, Nayoung Han, Bun Kim, Hyojin Pyun, Mi Young Lim, Young-Do Nam, Hee Jin Chang. Fecal microbial dysbiosis is associated with colorectal cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 755.

Abstract 4824: Multi-level intervention to increase minority cancer patient enrollment to clinical treatment trials- Study design considerations and baseline characteristics from the ACTWONDER2S Study

Abstract Introduction: Black/African American (AA) and Hispanic cancer patients are underrepresented in cancer clinical trials (CCTs). Disparities stem from multiple factors, thus, comprehensive, multi-level interventions (MLI) are needed. Presented here is a conceptual framework for selecting the appropriate study design for MLIs using ACTWONDER2S, a multi-level intervention (MLI) aimed to increase Black/AA and Hispanic patient participation into CCTs, as an illustrative example. Baseline characteristics of the ACTWONDER2S target populations are also provided. Methods: ACTWONDER2S integrates community health educator and digital tools into an MLI targeting community residents and physicians in the Moffitt Cancer Center (MCC) catchment area, as well as MCC patients, physicians and CCT coordinators. A literature review of the relative strengths and weakness of 5 candidate designs for MLIs was conducted, and a cluster stratified randomized design was selected. Geospatial analytics were used to identify clusters of census tracts (“priority zones”) with high Black/AA and Hispanic populations for intervention deployment. Baseline characteristics of the priority zones were described using US Census data and other sources. Results: 14 priority zones were identified, which were matched on population characteristics and randomized into intervention (n=7) and control (n=7) zones. There were no statistically significant differences between the intervention and control priority zones in total population size (paired t-test p-value=0.63), proportions of Black/AA (p=0.133) and Hispanic populations p=0.17), and distance (in miles) from MCC (p=0.64). Approximately 35.8% and 16.5% of the intervention priority zones were Hispanic or Black/AA, respectively. Average distance to MCC, cancer cases, referral and CCT enrollment rates were also similar between groups. Conclusion: Decision frameworks for MLI study design selection are lacking. The framework provided here for ACTWONDER2S can be applied to other studies seeking to evaluate MLIs. Furthermore, the randomization of the priority zones produced optimal target populations for testing the efficacy of the MIL within ACTWONDER2S. Citation Format: Dana E. Rollison, Rossybelle P. Amorrortu, Lindsay N. Fuzzell, Melany A. Garcia, Elliott S. Tapia-Kwan, Yayi Zhao, Steven A. Eschrich, Bob R. Gore, Brian S. Mittman, Nathanael B. Stanley, Susan T. Vadaparampil. Multi-level intervention to increase minority cancer patient enrollment to clinical treatment trials- Study design considerations and baseline characteristics from the ACTWONDER2S Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4824.

Role of Vocational Education in Economic Empowerment of Adivasis of Jharkhand

The Adivasis are categorized as the Scheduled Tribes in the Constitution of India. Adivasis consist of 26% of the total population of State of Jharkhand. 78% of the total Adivasi population lives in the rural areas of the State. At least half of the rural population of the Adivasi lives below the poverty line. The Adivasis of Jharkhand are enslaved in the poverty trap. The per-capita income of the Adivasi community is very low. The majority of the Adivasi youth of the state are poorly equipped for employment in the labour market. Most of the Adivasi youth are neither adequately educated nor equipped with vocation skills. They are unable to succeed in finding productive employment which increases their per capita income and helps them to escape from the poverty trap. In this context the paper tries to study the roles of vocational education in the economic empowerment of the Adivasis of Jharkhand. Vocational education can equip the Adivasis with skills, especially the Adivasi youth, for self-employment and employment in labor market. It can trigger economic change and transformation in the Adivasi community in Jharkhand.

Income-related inequality in health outcomes among older individuals in China: A measurement and decomposition analysis

Population aging in China presents a significant challenge, with projections indicating that individuals aged 65 and above will exceed 30% of the total population by 2050, thereby increasing health-care and long-term care (LTC) demands. Therefore, this study aimed to examine income-related inequality in self-rated health (SRH) and functional ability among older individuals in China while also examining the contribution of socioeconomic factors to health inequality. Data were drawn from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey. Well-established tools, such as concentration curves, the Erreygers concentration index (EI), and decomposition analysis, were employed to elucidate income-related inequality in health within the sample. The results revealed that for SRH, both unstandardized and standardized concentration curves were observed below the 45° line, with unstandardized EI at 0.068 and standardized EI at 0.033. For functional ability, both unstandardized and standardized concentration curves were observed above the 45° line, with unstandardized EI at −0.016 and standardized EI at −0.003. These results suggest that, after controlling for demographic factors, the better-off group is more likely to report better SRH and less likely to experience functional limitations compared to the worse-off group. Furthermore, this inequality in health outcomes is predominantly driven by socioeconomic factors rather than demographic factors. For SRH, income emerges as the primary contributor to total inequality. Similarly, for functional ability, income emerges as the key factor driving inequality, disproportionately affecting the less affluent population. Consequently, it is crucial for the government to protect older individuals with lower socioeconomic status to mitigate income-related inequality in health by directly providing cash aids and formal LTC, which could contribute to promoting healthy aging in the context of global aging.

Identification of Inflammatory Mediators in Saliva Samples From Hospitalized Newborns: Potential Biomarkers?

To characterize the levels of 11 inflammatory mediators (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF) in saliva samples from NB on the first and second day of hospitalization in the Neonatal Intensive Care Unit (NICU). Exploratory study, descriptive, nested within a primary clinical, observational, and prospective study, conducted in the NICU of a public hospital in São Paulo, Brazil. Demographic data and vital signs were recorded in the clinical records of 90 NB, and five saliva samples from 5 NB were collected between the first and second day of life (D1-D2) at approximately 8-hr intervals (8-9 am, 4-5 pm, and 11-12 pm). Saliva samples were used for the measurement of 11 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF). Five NBs participated in this exploratory study, and the vital signs showed variability from the first (D1) to the second day (D2) of hospitalization, variability similar to that of the total population of the primary study. The presence and levels of the 11 cytokines were detected in the saliva samples, as well as a statistical correlation between 10 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL10, IL12, IL17, TNF, and VEGF) and vital signs. The novelty of measuring inflammatory mediators in saliva samples from hospitalized NBs in the NICU is highlighted, providing support and new perspectives for the development of clinical and experimental research and an opportunity for developing and implementing new salivary biomarkers in different population segments.

Measles vaccination coverage and immunization status of nurses: An interventional study in Türkiye

IntroductionHealthcare workers are more likely to contract measles than the general population. Our study aimed to assess measles vaccination and immunization levels among nurses, examine the influencing factors and implement an intervention program to increase immunization coverage. Materials and methodsOur study was conducted in a university hospital in Türkiye. The study included 1012 nurses. It was an intervention study, continued between 01/11/2021 and 30/10/2023. Measles IgG and vaccination status of the participants were evaluated. Participants with negative measles IgG results who had not been vaccinated against measles or received a single dose of the vaccine were invited to the outpatient clinic to receive two doses. Participants who had received two doses of the measles vaccine and had negative measles IgG results were invited to the outpatient clinic for one dose of the measles vaccine. Nine hundred seventy-eight people participated in our study. The access frequency was 96.6%. ResultsAmong the participants aged 21–30, 68.4 % were Measles IgG (+). Measles IgG (+) prevalence was higher in women than men (85.3 % vs. 61.0 %). The department with the lowest measles IgG positivity was intensive care (75.8 %). Measles IgG (+) prevalence became higher as the duration of employment increased. The measles seropositivity in total population rose from 83.1 % before the intervention to 94.3 % after, to 91.8 % in the 21–30 age group, and to 90.2 % in male. Sixteen people had never received measles vaccination. Of the 37 participants who had previously received two doses of measles vaccine, 22 received a single dose and after the intervention 16 (72.7 %) were positive. Only 1 person was found to have vaccine refusal during the intervention. ConclusionExpanding the immunization scope in hospitals by screening for measles antibodies among healthcare personnel and vaccinating those who are seronegative can be considered an effective public health strategy.

The challenge of diagnosing cultural syndromes: A narrative review.

In 2022 the total world migrant population was 281 million (an increase of approximately 62% compared to year 2000), of whom 169 million were migrant workers. The number of refugees, asylum seekers and others in need of international protection increased by 22% compared to 2021. Research has shown that the forcibly displaced have high rates of mental disorders (including depression, post-traumatic stress disorder (PTSD) and anxiety), with an estimated prevalence almost 6 to 7 times higher than the general population. Given the increase of the overall migration phenomenon and the challenge raised by the cultural features concerning mental health, we consider that this is an area that requires close attention to ensure that culturally sensitive health services be available to the migrant and displaced population. The aim of this narrative review is to provide a background to the issue and take stock of what is currently available in the literature regarding culture-bound illnesses and the relevant diagnostic tools. A comprehensive search was performed in PubMed, Psychinfo, Embase, Google Scholar, organized in stages to assure inclusion of all the relevant studies. Of the 703 papers initially identified, only 30 papers finally satisfied the inclusion criteria. Eleven diagnostic scales were found, only two of which are being used for displaced people. Further work is required in this field, including a debate as to whether scales are indeed an appropriate tool for use with this population.

Incidence and mortality of endometrial cancer in China, data from China Cancer Registry Annual Report, 2004-2017

Objective: To analysis the incidence rate and mortality rate of endometrial cancer in China from 2004 to 2017 according to the data from China Cancer Registry Annual Report. Methods: The incidence and mortality data of endometrial cancer were extracted from the China Cancer Registry Annual Report 2004 to 2017, and the incidence, mortality, number of new cases, number of deaths were extracted according to the region (national, urban, rural and eastern, middle and western areas) and the age composition of population to estimate the incidence and mortality of endometrial cancer nationwide. The age-standardized incidence rate and mortality rate were calculated based on the Chinese standard population in 2000 (ASIRC, ASIRW) and Segi's world population (ASMRC, ASMRW). Join Point regression was used to calculate the annual percentage change of morbidity rate, and Cochran-Armitage trend test was used to analyze the changing trend of morbidity and mortality. Results: From 2004 to 2017, the number of women covered by the China Cancer Registry Annual Report has increased from 35 571 657 to 215 201 995, and the total population of the covered areas has increased from 5.53% to 31.39%. The crude incidence rate of endometrial cancer increased from 6.20/100 000 to 10.06/100 000, and showed an upward trend over time (P<0.001). After adjusting for age, ASIRC increased from 5.75/100 000 in 2004 to 6.79/100 000 in 2017, and ASIRW increased from 5.60/100 000 in 2004 to 6.56/100 000 in 2017, both showing an upward trend over time (all P<0.001). The crude incidence rates in urban area and rural area were respectively 10.89/100 000 and 9.25/100 000 in 2017, and the ASIRC was higher in urban than rural areas (7.14/100 000 vs 6.43/100 000) after adjusting for age. The ASIRW was higher in eastern areas than middle areas and western areas (7.16/100 000 vs 6.44/100 000 vs 5.60/100 000). The incidence rate in rural areas showed more significant growth than urban areas [annual percent change (APC): 3.2% vs 0.7%, P<0.001]. The age-specific incidence rate increased with age and reached a peak in the age group of 50-54 years (25.70/100 000). Incidence rate in the under-40 age group increased more in rural areas than in urban areas (69.84% vs-7.09%). From 2004 to 2017, the age-standardized mortality rate shows a decreasing trend, with the ASMRC from 1.83/100 000 to 1.47/100 000, and the ASMRW from 1.81/100, 000 to 1.46/100, 000. There was no significant difference between urban and rural areas in mortality of endometrial cancer. Age-specific mortality rates increased with age, reaching a peak in the age group 85 years and older (13.16/100 000). Conclusions: Recent years, there was an increasing incidence rate of endometrial cancer in China. Especially in rural areas, the incidence rate of endometrial cancer is increasing rapidly in young women under 40 years of age. There were differences between urban and rural areas and regions in the incidence rate of endometrial cancer. The incidence rates of endometrial cancer in some high-income cities have occupied the first place of female reproductive system malignant cancers. The age-standardized mortality rate of endometrial cancer shows a decreasing trend.

Training and Development, Work Performance, and Social Capital Constructs of Library Personnel in the South Manila Educational Consortium

Libraries play a crucial role in promoting information access and intellectual growth. To ensure library personnel thrive and meet diverse client needs, it is essential to understand their professional development and performance. There is insufficient research in a library working environment that integrates training and development, work performance, and social capital among personnel into a unified paradigm. This study is being carried out in this context to assess all three variables from library personnel and the findings will serve as a basis for improving training and development programs, enhancing work performance, and fostering social capital among library personnel, thus leading to informed decision-making processes related to human resource development and organizational strategy for optimizing library personnel performance and promoting a conducive working environment. The study utilized descriptive quantitative methodology, collecting data through a structured survey questionnaire from the South Manila Educational Consortium Libraries. Sixty-one (61) questionnaires were completed and returned from the total population, and SPSS was used for analysis, interpretation, frequency distribution, percentages, and mean. The findings showed that seminars, conferences, and workshops were the most available and widely used interventions of the respondents. The study also found that inadequate funding hinders training and development, with library funding being a key strategy to enhance them. Furthermore, respondents demonstrated above-average task and contextual performance, excellent counterproductive work behavior, and high levels of structural, relational, and cognitive social capital. Based on the notable results, it becomes evident that the training and development interventions of respondents were not significantly available. Additionally, it was observed that most of the library personnel made full use of the available interventions. Also, the study discovered positive work performance and the presence of social capital in the examined population. Keywords: Academic Library, Training and Development, Work Performance, Social Capital, Library Personnel

Vietnamese farmers’ perception of climate change effects on water resources and determinants of climate change

ABSTRACT This study investigates crop farmers’ perception on climate change effects on water resources and factors that influence their perceptions of it in Vietnam. A sample of 253 was randomly selected from a total population of 685 crop farmers and a structured questionnaire was created to gather data. Descriptive and inferential statistics were used. The research results showed that climate change effects on water resources varied by landform. A majority of farmers perceived that: shifts in rainfall amount and variability affect the operation of runoff water and groundwater recharge; shifts in temperature level and variability considerably influence evapotranspiration; and changes in runoff amount and runoff variability greatly influence soil water storage and groundwater. Mixed cropping systems, use of soil conservation, extension contacts, farming practices, non-agricultural activities, credit programme participation, information and communication technology (ICT) owned, and education level are the important determinants of farmers’ perceptions on climate change.

Higher total energy costs strain the elderly, especially low-income, across 31 developed countries

Addressing the total energy cost burden of elderly people is essential for designing equitable and effective energy policies, especially in responding to energy crisis in an aging society. It is due to the double impact of energy price hikes on households-through direct impact on fuel bills and indirect impact on the prices of goods and services consumed. However, while examining the household energy cost burden of the elderly, their indirect energy consumption and associated cost burden remain poorly understood. This study quantifies and compares the direct and indirect energy footprints and associated total energy cost burdens for different age groups across 31 developed countries. It reveals that the elderly have larger per capita energy footprints, resulting from higher levels of both direct and indirect energy consumption compared with the younger age groups. More importantly, the elderly, especially the low-income elderly, have a higher total energy cost burden rate. As the share of elderly in the total population rapidly grows in these countries, the larger per capita energy footprint and associated cost burden rate of elderly people would make these aging countries more vulnerable in times of energy crises. It is therefore crucial to develop policies that aim to reduce energy consumption and costs, improve energy efficiency, and support low-income elderly populations. Such policies are necessary to reduce the vulnerability of these aging countries to the energy crisis.

Analisis Asuhan Keperawatan Pada Pasien Dengan Gangguan Sistem Pencernaan

According to data released by the Ministry of Health of the Republic of Indonesia regarding the incidence of appendicitis in Indonesia in 2016, the number of patients with appendicitis in Indonesia reached 591,819 people and increased in 2017 by 596,132 people (Soewito, 2017). The incidence of appendicitis in 2018 reached 7 of the world's population. In 2018 the incidence of appendicitis in most parts of Indonesia is still high. In Indonesia, the number of patients suffering from appendicitis is about 7% of the total population or about 179,000 people (Depkes, 2018). The author's goal is to be able to provide nursing care for post-operative appendectomy patients with acute pain nursing problems. Appendicitis is a painful swelling of the appendix with the management of appendectomy, namely surgery to remove the appendix, surgery is indicated when the diagnosis of appendicitis has been established. The research method used is a case study. Samples were taken according to the inclusion criteria of patients with post-appendectomy digestive system disorders with acute pain problems. The care was carried out for 3 days at the Bekasi District Hospital. Data was collected by: interviews, observations, physical examinations, and documentation studies. Data were analyzed narratively based on a comparison of two patients. Patient data 1 and 2 have been supportive to raise the problem of acute pain and its implementation has been implemented and there are no obstacles.

Assessing Carbon Emissions from Animal Husbandry in China: Trends, Regional Variations and Mitigation Strategies

The intensification of land use and the accelerated integration of three industries (agricultural production, agricultural product processing industry, and agricultural product market service industry) in China have resulted in the continuous expansion of animal husbandry and its industrial chain. This phenomenon has led to a rise in greenhouse gas (GHG) emissions from livestock farming, intensifying climate change and placing strain on worldwide environmental conservation efforts. Life cycle assessment (LCA) was utilized to evaluate carbon emissions from China’s animal husbandry sector from 2012 to 2021. Additionally, the logarithmic mean divisia index (LMDI) decomposition method was employed to examine and elucidate the influential impacts of five factors on carbon emissions. These factors included the efficiency of animal husbandry production, the structure of the agricultural industry, per capita agricultural production income, urbanization, and the total population. The results reveal the following: (1) From 2012 to 2021, China’s animal husbandry sector witnessed a marginal increase in cumulative carbon emissions from 287.74 million tons to 294.73 million tons, with an annual growth rate of 0.42%. (2) Emission contributions were categorized as follows: the production stage (149.61 million tons), the transportation stage (145.07 million tons), and the processing stage (0.05 million tons). (3) The primary factor contributing to the rise in carbon emissions from animal husbandry from 2012 to 2021 was the per capita agricultural production income factor (A3), alongside a notable impact from the total population factor (A5).

Socio-Cultural Potential for Low Delivery Assistance by Nakes in Working Area of the Bibida Health Center, Paniai Regency, Central Papua

One method that can reduce maternal and newborn mortality rates is delivery carried out by health workers. Most maternal and newborn complications and deaths occur during the labor period. This happens because the assistance is provided by health workers who do not have midwifery (professional) competence. This study aims to identify factors that contribute to the low level of delivery assistance by health workers in the Bibida Community Health Center working area. In 2021, 56.3 percent of births will be assisted by health workers, and 32% will be at the Bibida Community Health Center. Quantitative research was conducted using a cross-sectional analytical design. The research was conducted in the Bibida Community Health Center working area in Paniai Regency, Central Papua, from October 2023 to November 2023. This research involved all mothers who had just given birth who were in the Bibida Community Health Center working area during July, August and September. The total population technique was used to collect 35 samples. Use of computerization to process univariate and bivariate data. Research resultdelivery assistance by non-health workers 62.9% andculture does not support 51.4%. With p value=0.000, the results of statistical analysis show that there is a socio-cultural relationship. It is recommended that pregnant women give birth at health workers and in health facilities. In addition, it is important for midwives to work together with local community leaders and related sectors in encouraging people to give birth with health workers.

Democracy for the Democrats? Historical Origins of Soviet and Post-Soviet Intelligentsia

Tomila Lankina’s The Estate Origins of Democracy in Russia, published by Cambridge University Press in 2021, is a very powerful and thought-provoking book. It contains a bold argument, exhibiting the author’s erudition across several disciplines, as well as an unusual richness of empirical evidence and an exquisite prose style. The book delves into the intricacies of social resilience in the aftermath of the Russian Revolution. Contrary to the notion that the Bolshevik Revolution served as “the great leveler,” Lankina demonstrates the enduring presence of Tsarist-era estates within the social fabric throughout the Soviet era and even into the post-Soviet period. The estates encompassed a system of legal classifications that stratified Russian imperial society into distinct categories: aristocracy, clergy, merchants, and meshchane (petty bourgeoisie), as well as peasants. Lankina’s primary focus lies upon the meshchane, an estate that, by the twilight of the tsarist regime, accounted for approximately 10 percent of the empire’s total population.1 Within Lankina’s narrative, the meshchane emerged as an imperial middle class – comprising individuals such as small shopkeepers, rentiers, doctors, teachers, engineers – who mostly resided in urban centers and towns. Many among this group hailed from ethnic and religious minority backgrounds, including Jewish, Polish, German, Old Believers, and others.

Patient Characteristics and Adherence to Antidepressant Medication Treatment at PsychiatricOutpatient Department of Mardan Medical Complex, Pakistan

Background: Adherence to antidepressant treatment is an important factor in the treatment and effective management of depressed patients. Characteristics of patients can help in determining compliance to treatment protocols. In order to find link between compliance and demographic characteristics of patients, insight can be obtained through exploration of these variables.Objectives: To determine the association between patient characteristics and antidepressant medication adherence. To identify characteristics of patients that may improve or worsen compliance to antidepressant medication. Material and Methods: This study was a descriptive, cross-sectional study aiming to find the link between personal characteristics and adherence to anti-depressant medications. The study was conducted at Psychiatry outpatient department of a tertiary care hospital, Mardan Medical Complex, Mardan Pakistan, from 05th September 2018 to 08th February 2021. Data was collected from 660 patients who presented with depressive symptoms to Psychiatry OPD. The main objective was to identify characteristics of patients leading to poor compliance to antidepressant medication. Results: Total study population was 660. Majority of the study population 82.9 % (n-549) were female. Uneducated were, 56.6 % (375), 81.1 % (n-537) were unemployed, and 65.9 % (n-436) were married. Follow up interviews were conducted in 316 (47.7 %) patients at 3rd week, 186 (28.1 %) patients at 6th week, 130 (19.6 %) patients at 9th week, 96 (14.5 %) patients at 12th week, and 31 (4.7 %) patients at 6 months. There was no significant difference found on the basis of patient characteristics and adherence. However, compliance was better among patients who had longer duration of illness. Conclusion: Medication adherence is a common problem among depressed patients and leads to impaired daily life functioning. Our study could not found any significant difference regarding patient characteristics among compliant and non compliant patients. Educating patients regarding the use of antidepressant medication treatment should be added to routine practice. Keywords: Anti depressants, Depression, Non-adherence, Poor compliance.

Impact of total indoor smoking ban on cardiovascular disease hospitalizations and mortality: the case of Chile.

The harmful effects of first and secondhand smoking are well established. Smoke-free laws aim at protecting nonsmokers. This study aimed to assess the impact of the 2013 total ban on indoor smoking in Chile on hospitalizations and deaths of major cardiovascular events. The logarithm of the monthly hospitalization and death rates, standardized by age for every 100,000 inhabitants, were estimated for ischemic heart disease, acute myocardial infarction, strokes, and a composite outcome of ischemic heart diseases (which includes acute myocardial infarction) and strokes. In addition, interrupted time series with synthetic control groups were used to assess changes in levels and trends after the intervention. The total ban on indoor smoking caused significant reductions in death rates for the three diseases studied for age groups above 20 years old. In addition, there were substantial decreases in the postintervention hospitalization rates for ischemic heart disease: for the 20-44 age group, the decrease was 8.7% compared to the pre-intervention period (p<0.01). In comparison, such a reduction was 4% (p<0.01) for the ≥65 age group. For acute myocardial infarction, the decrease was 11.5% (p<0.01) for the 20-44 age group, while for stroke, it was a 1.2% (p<0.01) decrease for the total population. It is estimated that the smoking ban averted 15.6% of the deaths compared with the synthetic control groups. The implementation of total smoke-free environments in Chile contributed to the reduction of mortality for main cardiovascular diseases. This study provides additional evidence of causality linking the policy to health outcomes. The total indoor smoking ban significantly affected age-standardized hospitalization and deaths. The number of deaths averted by this policy is estimated at approximately 4,758 and 5,256 for IHD and stroke, respectively, during the 2013-2017 period (15.6% fewer deaths than predicted by the synthetic control groups). The study contributes to the body of evidence that supports total indoor smoking bans.