Multivariable regression analysis in Schistosoma mansoni-infected individuals in the Sudan reveals unique immunoepidemiological profiles in uninfected, egg+ and non-egg+ infected individuals

Background: In the Sudan, Schistosoma mansoni infections are a major cause of morbidity in schoolaged children and infection rates are associated with available clean water sources. During infection, immune responses pass through a Th1 followed by Th2 and Treg phases and patterns can relate to different stages of infection or immunity. Methodology: This retrospective study evaluated immunoepidemiological aspects in 234 individuals(range 4–85 years old) from Kassala and Khartoum states in 2011. Systemic immune profiles(cytokines and immunoglobulins) and epidemiological parameters were surveyed in n = 110 persons presenting patent S. mansoni infections (egg+), n = 63 individuals positive for S. mansoni via PCR in sera but egg negative (SmPCR+) and n = 61 people who were infection-free (Sm uninf). Immunoepidemiological findings were further investigated using two binary multivariable regression analysis. Principal Findings: Nearly all egg+ individuals had no access to latrines and over 90% obtained water via the canal stemming from the Atbara River. With regards to age, infection and an egg+ status was linked to young and adolescent groups. In terms of immunology, S. mansoni infection per se was strongly associated with increased SEA-specific IgG4 but not IgE levels. IL-6, IL-13 and IL-10 were significantly elevated in patently-infected individuals and positively correlated with egg load. In contrast, IL-2 and IL-1β were significantly lower in SmPCR+ individuals when compared to Sm uninf and egg+ groups which was further confirmed during multivariate regression analysis. Conclusions/Significance: Schistosomiasis remains an important public health problem in the Sudan with a high number of patent individuals. In addition, SmPCR diagnostics revealed another cohort of infected individuals with a unique immunological profile and provides an avenue for future studies on non-patent infection states. Future studies should investigate the downstream signalling pathways/mechanisms of IL-2 and IL-1β as potential diagnostic markers in order to distinguish patent from non-patent individuals

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Role of Government Policies in Combating Poverty Rates as One of the 2030 Sustainable Development Goals in Palestine

The study aimed to evaluate the role of government policies in reducing poverty in Palestine, testing their effectiveness and adequacy, and assessing the challenges associated with their implementation. The study also evaluated the satisfaction of poor families with government programs directed at them. To achieve the objectives of the study, the study followed the descriptive analytical approach, through the use of the quantitative approach, where a questionnaire was distributed to 447 poor families in the West Bank. The qualitative method was developed to study the content of all Palestinian government policies followed to reduce poverty. The results showed a decrease in the confidence of poor families in the adequacy and effectiveness of government policies used to combat poverty, in light of the rise in poverty rates (74.3% in 2024). Accordingly, the study recommends the need to enhance integration between social protection policies and economic development by adopting a comprehensive, innovative, and visionary approach that integrates the provision of resources and sustainable economic empowerment programs to achieve sustainable development goals better

Human trafficking policy implementation: A case study of Malaysia / Wan Nur Ibtisam Wan Ismail

Human trafficking is a complex global crime that exploits women, men and children. Due to the seriousness of the crime, Malaysia enacted the Anti-Trafficking in Persons and Anti-Smuggling of Migrants Act in 2007. Despite considering human trafficking to be a priority area for action through the enactment of the 2007 Act, Malaysia is still struggling in translating the intent of the policy into actual implementation. Hence, the study attempts to provide an understanding of human trafficking in Malaysia through the policy implementation lens. It analyses how human trafficking policy is being translated by bureaucratic implementers into action. The study adopts a combination of qualitative research methods – semi-structured individual and focus group interviews, field observations and written documents – to illustrate human trafficking policy implementation in Malaysia. The target population of the study is government bureaucrats who are involved in implementing human trafficking policy in Malaysia. For the study, 15 government bureaucrats were interviewed regarding their experience on human trafficking policy implementation. To provide multiple perspectives to the study, it also incorporates non-governmental organisations (NGOs) and trafficked victims as participants. Six NGO representatives and five male trafficked victims were interviewed. Three focus group interviews based on different categories of victims were also conducted, which consist of 49 female trafficked victims at selected shelter homes. There is a dearth of knowledge on human trafficking in Malaysia particularly on policy implementation. Hence, this study contributes to the body of knowledge on human trafficking and the body of work on implementation research. Using the policy implementation lens, the study explores human trafficking phenomenon in Malaysia through four theoretical underpinnings: theory of bureaucracy, implementation study, iv inter-organisational coordination and street-level bureaucracy. The 2007 Act becomes the country‟s primary policy that provides for the offence of trafficking in persons, the victims‟ protection and support, and the establishment of Council for Anti-Trafficking in Persons and Anti-Smuggling of Migrants (MAPO). To ensure effective implementation of the legal mechanisms outlined in the 2007 Act, the government formulated the National Action Plan against Trafficking in Persons (2010-2015) as a guideline to the national initiative in combating human trafficking. The empirical study identifies seven emerging themes that influence the implementation process of translating the policy intent into actual practice: incomprehensive coordination; incompatible resources; criminal approach; critical information flows; hierarchical control; low discretion; and paradigm shift imperative. These themes emerge through the analysis of research findings against the backdrop of the theoretical underpinnings and past studies. This study indicates the need to address these factors that critically influence human trafficking policy implementation in Malaysia. Understanding the complexity of human trafficking policy implementation entails the development of pragmatic recommendations towards abating the crime

Shaping the identity of the furniture designer through his influence on local cultural values and future visions of design

The designer lives in this life according to certain values that he applies or seeks to reach, as the values are considered a type of determinants or goals, and access to them is considered a type of success, and a sign that indicates the proper progress of work in its previous stages, or what is called reverse or feedback. .The technology helped to discover future visions of the designer and discover the extent of the impact of the ocean on the psychological and physiological health of the designer and the physical and intellectual energy. So that it opens up new horizons towards development in the field of furniture design, and in the formation of design thinking and a philosophy that is different from what it was in the past.The research problem is the scarcity of the identity of a local furniture designer with a vision that matches the value and cultural concept of society.The objectives of the research are:- Analyzing the designer's scientific and societal values and methods.- Linking societal and cultural values and the future visions of the designer.There is importance for research:To shed light on the extent of the furniture designer's impact on local cultural values through an introduction to the definition of values and their importance, and to identify the reciprocal relationship between cultural values and the future visions of the designer.Research hypotheses :- The influence of the designer with different values on society contributes to defining his identity through future visions of local furniture designsearch limits :1- The limits of the research potential are determined within the Arab Republic of Egypt, with reference to the most important local and international works that serve the subject of the research.2- Time limits: The study is limited to the contemporary period of research locally, while citing some historical developments that contributed to the formation of the idea of Egyptian furniture design. key words : Furniture designer - values - identity - the future - future visions

Human Trafficking in Malaysia: Bureaucratic Challenges in Policy Implementation

Recent studies have suggested that migrants are highly vulnerable to being trafficked. Malaysia, with its large number of migrants is vulnerable and is struggling to implement its Anti-Trafficking in Persons and Anti-Smuggling of Migrants Act 2007. There is also little information on implementation experience so far. Through in-depth interviews with government bureaucrats and other stakeholders, this study seeks to gain some insight into Malaysia’s policy implementation experience. It finds inadequate coordination, limited resources, poor information flow, enforcement approach, hierarchical control structure, and need for change as the major factors constraining effective policy implementation