Ending Neglect of older people in the response to Humanitarian Emergencies

Older people make up a significant and growing number of those affected by humanitarian crises, yet they are often not sought out or prioritised within the humanitarian response. Humanitarian agencies, donors, and international bodies neglect older people's health and nutrition. The gaps in knowledge and research about the needs of older people in emergencies are considerable. Older people are not monitored in emergencies and they are not prioritised despite evidence of disproportionate mortality and morbidity in this group. We call for policy changes by humanitarian agencies and donors to ensure that the needs of this vulnerable group are met

Developing procedures for assessment of ecological status of Indian River basins in the context of environmental water requirements

River basins / Ecology / Indicators / Environmental flows / Environmental management / Habitats / Biota / Fish / Ecosystems / India / Krishna River Basin / Chauvery River Basin / Narmada River Basin / Periyar River Basin / Ganga River Basin

Accuracy of five algorithms to diagnose gambiense human African trypanosomiasis.

Algorithms to diagnose gambiense human African trypanosomiasis (HAT, sleeping sickness) are often complex due to the unsatisfactory sensitivity and/or specificity of available tests, and typically include a screening (serological), confirmation (parasitological) and staging component. There is insufficient evidence on the relative accuracy of these algorithms. This paper presents estimates of the accuracy of five algorithms used by past Médecins Sans Frontières programmes in the Republic of Congo, Southern Sudan and Uganda

Randomized control trial of Teaching Recovery Techniques in rural occupied Palestine:Effect on adolescent dissociation

The current study assessed the effect of a cognitive behavioral group intervention, Teaching Recovery Techniques (TRT), for adolescents with high levels of posttraumatic stress (n = 154), from villages in occupied Palestine. A randomized control trial involved standardized measures to assess war stressors, posttraumatic stress, depression, and dissociation. Program fidelity was measured by presenter and observer ratings and program delivery cost was calculated per adolescent. High levels of traumatic exposure, dissociation, and posttraumatic stress were found. In comparison to a Wait List group (n = 75), TRT adolescents reported significantly fewer posttraumatic stress symptoms post-intervention. Depression and dissociation remained stable for TRT adolescents, but worsened for Wait List. Given the high returns and low costs, this costbenefit analysis makes a clear case for TRT to be delivered throughout the West Bank. Longitudinal evaluation is needed to assess adolescent traumatization and the impact of TRT within a context of ongoing violence.<br/

Are Ethnic and Gender Specific Equations Needed to Derive Fat Free Mass from Bioelectrical Impedance in Children of South Asian, Black African-Caribbean and White European Origin? Results of the Assessment of Body Composition in Children Study

Background Bioelectrical impedance analysis (BIA) is a potentially valuable method for assessing lean mass and body fat levels in children from different ethnic groups. We examined the need for ethnic- and gender-specific equations for estimating fat free mass (FFM) from BIA in children from different ethnic groups and examined their effects on the assessment of ethnic differences in body fat. Methods Cross-sectional study of children aged 8–10 years in London Primary schools including 325 South Asians, 250 black African-Caribbeans and 289 white Europeans with measurements of height, weight and arm-leg impedance (Z; Bodystat 1500). Total body water was estimated from deuterium dilution and converted to FFM. Multilevel models were used to derive three types of equation {A: FFM = linear combination(height+weight+Z); B: FFM = linear combination(height2/Z); C: FFM = linear combination(height2/Z+weight)}. Results Ethnicity and gender were important predictors of FFM and improved model fit in all equations. The models of best fit were ethnicity and gender specific versions of equation A, followed by equation C; these provided accurate assessments of ethnic differences in FFM and FM. In contrast, the use of generic equations led to underestimation of both the negative South Asian-white European FFM difference and the positive black African-Caribbean-white European FFM difference (by 0.53 kg and by 0.73 kg respectively for equation A). The use of generic equations underestimated the positive South Asian-white European difference in fat mass (FM) and overestimated the positive black African-Caribbean-white European difference in FM (by 4.7% and 10.1% respectively for equation A). Consistent results were observed when the equations were applied to a large external data set. Conclusions Ethnic- and gender-specific equations for predicting FFM from BIA provide better estimates of ethnic differences in FFM and FM in children, while generic equations can misrepresent these ethnic differences

DRUG UTILIZATION PATTERN IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE INPATIENTS AT A TERTIARY CARE HOSPITAL

Objective: Drug utilization studies provide useful insights into the current prescribing practices. In view of this, the present study was designed to establish the drug utilization pattern in hospitalized chronic obstructive pulmonary disease (COPD) patients.Methods: In this retrospective study, all patient data relevant to the study were obtained by examination of patient's medical records and hospital information system.Results: A total of 237 patients with acute exacerbation were evaluated. The population predominantly consisted of males (92.4%) and most of the patients were in the age group of 61 to 70 y (39.7%). Cough, sputum production and dyspnea were observed in 88.2%, 80.6% and 37.6% patients, respectively. Hypertension (49.4%) was the most common co-morbidity. Candida albicans (16%) and Pseudomonas aeruginosa (4.6%) were the most common microorganisms isolated from sputum samples. Majority of the patients were on multidrug therapy during both hospital stay (98.7%) and at the time of discharge (99.6%). During hospital stay, the most commonly prescribed drugs were ipratropium (91.6%) and levosalbutamol (88.2%); antibiotics and systemic corticosteroids were received by 96.2% and 83.1% patients, respectively. At discharge, antibiotics, inhaled corticosteroids, methyl xanthines, long acting beta-2 agonist and tiotropium were received by 94.1%, 93.7%, 92.4%, 86.1% and 56.5% patients, respectively.Conclusion: The prescribing trend observed at our hospital appears to be in concordance with the current guidelines for the management of COPD patients.Â

Chemical Properties of Water Hyancinth Plant Ash

In ponds, water hyacinth expands rapidly and doubles in size in just two weeks. The significance of integrated and adaptable management strategies that take into account the ecological, economic, and social aspects of water hyacinth reduction is emphasized in this abstract. To successfully handle the water hyacinth issue and encourage the sustainable use of this problematic plant, cooperation among governments, communities, researchers, and environmental groups is essential. We can improve the quality of life for individuals impacted by the existence of water hyacinth by putting these measures into practice and working to restore the health of aquatic ecosystems. The dense mats of water hyacinth on the water's surface can block sunlight, reduce oxygen levels, and obstruct natural water movement, which can have a negative impact on native aquatic species and ecological balance. Additionally, its presence in water bodies can hinder fishing, transportation, and irrigation, which can result in losses for people who depend on these resources economically

Patient’s Perception of Community Pharmacist in North Malabar region of Kerala, India: A questionnaire based study

Pharmacists as vital healthcare professionals play significant role in effective medication management and their use among the patients. However the perception of community pharmacist&nbsp; among the public needs to be assessed for effective role and further patient care. This questionnaire based study was aimed to identify the perception of patients towards the community pharmacist in north Malabar region of Kerala, India. The questionnaire consisted of 16 questions with sections evaluating the demographic details (age, sex, marital status, education level &amp; occupation) and the perception of patients towards the community pharmacist. The results were prepared based upon the responses obtained from 110 patients. The study respondents consisted of 51 (46.36%) adults (18-59 years) and 59 (53.63%) geriatrics (above 60 years). Based on their education level, 9 (8.18%), 35 (31.81%) and 66 (60%) participants were illiterate, secondary school and graduate holders respectively. The respondents of the study informed that the pharmacist enquired about their past medication history (58, 52.73%), any allergic reactions (21, 19.1%) and use of any herbal medication (31, 28.18%) prior to the dispensing process. The patients also responded that proper advice regarding dosage (90%), side effects (25%), storage (12%), healthy eating &amp; exercise (10%) were also provided by the concerned pharmacist. As a matter of fact, 91 out of 110 patients thought the pharmacist service were good, 17 thought they were fairly good and 2 were of the opinion that it was poor. The pharmacy rating was evaluated as good by 32 (29.09%), fairly good by 78 (70.90%) and no respondents were of opinion that the pharmacy was poor in its service. Through this study, we found that the overall perception of patients towards the pharmacist in concerned community pharmacy setting was good. To further improvise their role, continued pharmacy education programmes, better communication skills and good professional training must be imparted among the community pharmacists