The role of comprehensive sexuality education (CSE) in reimagining HIV/AIDS inequalities

Over 70 million people globally have been infected with HIV since the beginning of the epidemic. HIV infection has neither a cure nor a vaccine; hence, education and awareness have been adopted to prevent the spread of the virus. Despite the action to reduce the HIV prevalence with access to effective information, prevention, diagnosis, treatment, and care, it remains a major health concern and a chronic health condition that could only be managed by enabling people living with the condition a better, longer, and healthy life. However, comprehensive sexuality education (CSE), which is a right-based approach that provides and equips people with the right knowledge on sexual education and reproductive health, can be utilised in sexual health promotion. It comprises seven essential components that focus on several aspects of sexuality. Thus, this paper provides evidence for the importance of CSE in reducing HIV prevalence, especially amongst the vulnerable population. The incorporation of long-term sexuality education programs in the school-based curriculum will contribute to the massive reduction in teenage pregnancies and abortion, and the decline in rates of sexually transmitted infections and HIV. It will also increase the knowledge about sexual and reproductive issues normalization and self-efficacy. Hence, CSE health educators and school teachers should be adequately trained in comprehensive sexuality education to curb the spread of HIV infection

Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Background Musculoskeletal disorders include more than 150 different conditions affecting joints, muscles, bones, ligaments, tendons, and the spine. To capture all health loss from death and disability due to musculoskeletal disorders, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) includes a residual musculoskeletal category for conditions other than osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain. This category is called other musculoskeletal disorders and includes, for example, systemic lupus erythematosus and spondylopathies. We provide updated estimates of the prevalence, mortality, and disability attributable to other musculoskeletal disorders and forecasted prevalence to 2050. Methods Prevalence of other musculoskeletal disorders was estimated in 204 countries and territories from 1990 to 2020 using data from 68 sources across 23 countries from which subtraction of cases of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, and gout from the total number of cases of musculoskeletal disorders was possible. Data were analysed with Bayesian meta-regression models to estimate prevalence by year, age, sex, and location. Years lived with disability (YLDs) were estimated from prevalence and disability weights. Mortality attributed to other musculoskeletal disorders was estimated using vital registration data. Prevalence was forecast to 2050 by regressing prevalence estimates from 1990 to 2020 with Socio-demographic Index as a predictor, then multiplying by population forecasts. Findings Globally, 494 million (95% uncertainty interval 431–564) people had other musculoskeletal disorders in 2020, an increase of 123·4% (116·9–129·3) in total cases from 221 million (192–253) in 1990. Cases of other musculoskeletal disorders are projected to increase by 115% (107–124) from 2020 to 2050, to an estimated 1060 million (95% UI 964–1170) prevalent cases in 2050; most regions were projected to have at least a 50% increase in cases between 2020 and 2050. The global age-standardised prevalence of other musculoskeletal disorders was 47·4% (44·9–49·4) higher in females than in males and increased with age to a peak at 65–69 years in male and female sexes. In 2020, other musculoskeletal disorders was the sixth ranked cause of YLDs globally (42·7 million [29·4–60·0]) and was associated with 83 100 deaths (73 600–91 600). Interpretation Other musculoskeletal disorders were responsible for a large number of global YLDs in 2020. Until individual conditions and risk factors are more explicitly quantified, policy responses to this burden remain a challenge. Temporal trends and geographical differences in estimates of non-fatal disease burden should not be overinterpreted as they are based on sparse, low-quality data.publishedVersio

Global, regional, and national burden of rheumatoid arthritis, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Background Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with disability and premature death. Up-to-date estimates of the burden of rheumatoid arthritis are required for health-care planning, resource allocation, and prevention. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we provide updated estimates of the prevalence of rheumatoid arthritis and its associated deaths and disability-adjusted life-years (DALYs) by age, sex, year, and location, with forecasted prevalence to 2050. Methods Rheumatoid arthritis prevalence was estimated in 204 countries and territories from 1990 to 2020 using Bayesian meta-regression models and data from population-based studies and medical claims data (98 prevalence and 25 incidence studies). Mortality was estimated from vital registration data with the Cause of Death Ensemble model (CODEm). Years of life lost (YLL) were calculated with use of standard GBD lifetables, and years lived with disability (YLDs) were estimated from prevalence, a meta-analysed distribution of rheumatoid arthritis severity, and disability weights. DALYs were calculated by summing YLLs and YLDs. Smoking was the only risk factor analysed. Rheumatoid arthritis prevalence was forecast to 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates. Findings In 2020, an estimated 17·6 million (95% uncertainty interval 15·8–20·3) people had rheumatoid arthritis worldwide. The age-standardised global prevalence rate was 208·8 cases (186·8–241·1) per 100 000 population, representing a 14·1% (12·7–15·4) increase since 1990. Prevalence was higher in females (age-standardised female-to-male prevalence ratio 2·45 [2·40–2·47]). The age-standardised death rate was 0·47 (0·41–0·54) per 100 000 population (38 300 global deaths [33 500–44 000]), a 23·8% (17·5–29·3) decrease from 1990 to 2020. The 2020 DALY count was 3 060 000 (2 320 000–3 860 000), with an age-standardised DALY rate of 36·4 (27·6–45·9) per 100 000 population. YLDs accounted for 76·4% (68·3–81·0) of DALYs. Smoking risk attribution for rheumatoid arthritis DALYs was 7·1% (3·6–10·3). We forecast that 31·7 million (25·8–39·0) individuals will be living with rheumatoid arthritis worldwide by 2050. Interpretation Rheumatoid arthritis mortality has decreased globally over the past three decades. Global age-standardised prevalence rate and YLDs have increased over the same period, and the number of cases is projected to continue to increase to the year 2050. Improved access to early diagnosis and treatment of rheumatoid arthritis globally is required to reduce the future burden of the disease.publishedVersio

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Physical and Psychological Complications of Mastectomy: The Role of Physioterapy

Breast cancer affects a large number of women worldwide. Surgical management has evolved towards mastectomies and breast-conserving surgeries. The complications following a mastectomy can be physical and/or psychological. The physical complications include pain, scarring, lymphedema, limitation in range of motion at the shoulder, muscle weakness, change in body posture, etc. Some of the psychological complications are negative boy image, anxiety, depression and depressive disorders, negative body image. Appropriate management requires a multi-disciplinary team of which the physiotherapist is a part of. Literature has shown that there is a better improvement in physical function if physiotherapy is commenced early. Therefore, physiotherapy should be incorporated pre and post-mastectomy. Physiotherapy management should focus on lymphatic drainage, soft tissue mobilization, range of motion exercises, strengthening exercises and postural correction. Increased physical activity and recommendation of support groups can help to improve psychological outcomes. It is the role of the physical therapist to deal with the physical and psychological complications of a mastectomy to improve the quality of life of the patients

Virtual Reality: A Breakthrough in Pain Management?

Virtual reality is a computer-generated scenario in which the user can interact in 3 dimensions so that the user feels that he or she is part of the scene. Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is often undertreated and this comes along with several consequences such as anger, depression, anxiety, workplace absenteeism, underemployment, unemployment and fear, among others. In the past decade, there has been need to find a safer way of controlling chronic pain without the necessary complication of opioid misuse. Virtual reality has been proved to be a safer adjunct for this. Several studies have reported that virtual reality is quite effective for pain management, with participants reporting significant relief of symptoms. The discovery of the use of virtual reality in the management of pain may prove to be a breakthrough in pain medicine, saving people from the complications of prolonged opioid use and opioid misuse. However, more research still has to be done to fully establish the mechanism of action and use of virtual reality in pain management, especially in the management of chronic pain. This would be a true breakthrough, allowing the full safety and effectiveness of virtual reality to be harnessed

Physiotherapeutic Management of People Living with HIV/AIDS

The Human immunodeficiency virus (HIV) is a lentivirus that causes HIV infection, and over time, Acquired Immunodeficiency Syndrome (AIDS). HIV infection (simply called HIV at its early stage and AIDS at its later stage) is a very prevalent global disease condition affecting about 36.7 million people, both young and old. Sadly, HIV/AIDS affects almost all the systems in the body (particularly the neurological and musculoskeletal systems), which may result into physical disability. Physiotherapists are known to play important roles in the management of physical disability. In this paper, the authors provide information on the clinical and epidemiological features of HIV/AIDS, as well as the treatment modalities for the neurological and musculoskeletal problems experienced by people living with HIV/AIDS

Trichotillomania: Hair Pulling Disorder

Trichotillomania, also known as hair pulling disorder, is a chronic psychiatric condition common among women. It is a condition that causes impairment in social, occupational, or other important areas of functioning. The rate of presentation of such cases to medical practitioners is low, as affected individuals conceal it because of the shame associated with hair pulling behaviour. This makes the aetiology and management of the condition to be fairly understood; creating the need for extensive empirical research. This paper discusses the clinical and epidemiological features of trichotillomania and its management

Mechanical and optimization studies of polypropylene hybrid biocomposites

Towards developing a polymeric matrix characterized by high strength to cost ratio, polypropylene (PP) was hybridized with low-cost particulate snail shell (PSS) and kenaf fiber (KF) via compression moulding at 180 °C and 0.2 MPa. The developed composites were grouped into three and labeled as mix 2, 4, and 10. Each group entailed the blend of 5, 10, 20, and 30 wt% KF with 2, 4, 10 wt% PSS respectively. From the results, it is observed that the hardness value was enhanced by the blend of 5 to 30 wt% KF and 2, 4, and 10 wt% PSS. However, 2 wt% PSS mix with 5 to 30 wt% KF resulted in progressive improvement in impact, compressive, flexural, and tensile strengths values. The 4 wt% PSS yielded consecutive increase in impact, compressive and flexural strength when combined with 5 and 10 wt% KF. However, it was observed that subsequent addition of 20 and 30 wt% KF led to a marginal reduction in the strength values. The tensile strength attained optimum value when 4 wt% PSS was commixed with 30 wt% KF. Conversely, the combinations of 10 wt% PSS with 5, 10, 20, and 30 wt% KF had no significant improvement to the mechanical properties of PSS/KF-bio-PP composite (except for hardness) siring strength decrease. Taguchi optimization revealed that the collage of 4 wt% PSS and 10 wt% KF presented optimum mix for hybrid bio-PP composit

Effectiveness of electrical stimulation and low-intensity laser therapy on diabetic neuropathy: A systematic review

Diabetes mellitus (DM) is a group of metabolic diseases which typically presents with frequent urination, increased thirst and increased hunger. DM be classified into three main types: type I (insulin-dependent DM), type-II (non-insulin dependent DM) and type III (gestational DM). Diabetes is a group of diseases of global health significance as 382 million people worldwide had diabetes in the year 2013 and this was projected to increase to an estimated 415 million in 2015. Damage to the nerves of the body (diabetic neuropathy) is the most common complication of diabetes. The signs and symptoms of diabetic neuropathy include numbness, diminished sensation, pain etc. Various types of electrotherapy, such as transcutaneous electrical nerve stimulation (TENS), pulsed-dose electrical stimulation, frequency-modulated electromagnetic neural stimulation, have been reported effective in managing diabetic neuropathy. This study is a systematic review of the evidence to enable the determination of the effectiveness of electrical stimulation and low-intensity laser therapy (LILT), and also aid their recommendation if proven to be effective. The outcome of this study was that TENS and other forms of electrical stimulation reviewed in this study may be effective and safe non-pharmacological treatment modalities in relieving the symptoms associated with diabetic neuropathy. The effectiveness of LILT couldn’t be determined due to the different parameters used to evaluate patients’ outcome and limited number of studies. Authors recommend that further randomized controlled trials with similar methodological parameters and studies with higher quality of evidences are needed to establish the true effectiveness of these modalities in diabetic neuropathy