Listening, resistance and mobile phone playlists: musical listening practices of Syrian women living as refugees in northern Jordan

In 2011, when the Syrians poured into the streets in nationwide protest against the regime of Bashar Al-Assad, they did so in song. Public places became filled with the voices of men, women and children who gained courage and determination through an increasing repertoire of songs shared through social media and learned in the homes and on the streets. Later as the violence intensified in the street, the women returned to their homes, their voices no longer heard in the public protests, their songs playing now from behind closed doors. When their homes were destroyed, many took their children and walked to the safety of neighbouring Lebanon, Turkey, Iraq and Jordan, songs saved on SIM cards tucked into their bras. This paper looks at those living in the border towns of northern Jordan and at the role the revolutionary songs play in their lives. Through analysis of the songs on the mobile phones of 45 women and interviews with them and their families on the role these have in their day-to-day life, British ethnomusicologist Karen Boswall and Jordanian social anthropologist Dr Ruba Al Akash ask how the songs are contributing to the women’s sense of self and their connection with the country they left behind

A Randomized Controlled Trial of Sertraline in Young Children With Autism Spectrum Disorder.

Objective: Selective serotonin reuptake inhibitors like sertraline have been shown in observational studies and anecdotal reports to improve language development in young children with fragile X syndrome (FXS). A previous controlled trial of sertraline in young children with FXS found significant improvement in expressive language development as measured by the Mullen Scales of Early Learning (MSEL) among those with comorbid autism spectrum disorder (ASD) in post hoc analysis, prompting the authors to probe whether sertraline is also indicated in nonsyndromic ASD. Methods: The authors evaluated the efficacy of 6 months of treatment with low-dose sertraline in a randomized, double-blind, placebo-controlled trial in 58 children with ASD aged 24 to 72 months. Results: 179 subjects were screened for eligibility, and 58 were randomized to sertraline (32) or placebo (26). Eight subjects from the sertraline arm and five from the placebo arm discontinued. Intent-to-treat analysis showed no significant difference from placebo on the primary outcomes (MSEL expressive language raw score and age equivalent combined score) or secondary outcomes. Sertraline was well tolerated, with no difference in side effects between sertraline and placebo groups. No serious adverse events possibly related to study treatment occurred. Conclusion: This randomized controlled trial of sertraline treatment showed no benefit with respect to primary or secondary outcome measures. For the 6-month period, treatment in young children with ASD appears safe, although the long-term side effects of low-dose sertraline in early childhood are unknown. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02385799

Study of histopathological and Histochemical changes Caused by Toxoplasma gondii in Vision Systems of Mice congenitally infected and the synergistic effect of Malarone and Clindamycin

The present work was conducted aiming at isolating and diagnosing Toxoplasma gondii from the placentae of infected women and inducing infection in female Swiss albino mice, through intraperitoneal injection resulted in 100% infection rate. Evaluation of malarone and clindamycin, single and synergistic between them in infection of female mice on the tenth day of gestation and delivery and confirmation of congenital infection, treatment was started at the age of one month with the above mentioned drugs. The criteria considered were the number of dead mice, the percentage of survival, and the average number of brain tissue cysts. Treatment with the synergized malarone and clindamycin were used to treat congenitally infected mice, number of death was not reported and the survival rate was 100%. Average numbers of brain tissue cysts are reduced to 5.55 in adult infected mice and the cure rate was 100%. Histopathological effects that occurred in the congenitally affected females, they were the appearance of hyperplasia and introversion of the retina several folds and the presence of scars that connect the retina to the choroid, and the reduction of the visual papilla, and it was noted for the first time by using the Congo red stain, signs of amyloid deposits in the vitreous fluid and in the debris of the lens that appeared irregular and seemed filled with fluid. And fatty materials and debris residues of lentil fibers. It was observed for the first time that the optic nerve was doubled using Mallory's triple stain. As for the brains, the same changes were observed, and amyloidosis appeared using the toludine stain. When using the treatment malaron and clindamycin at a dose of 100 mg/kg synergistically, the effect of infection in the eyes was slight and a noticeable improvement appeared in the brains. As for the histochemistry of stains and their components, and brain, different response were noted between strong +ev control and –ev for those treated with the two drugs malarone and clindamycin at a dose of 200mg/kg with PAS stain and Alician blue stain pH 2.5%. For Von kossa stain and Pearl`s stain, different responses also appeared in the eyes and the brains.For Feulgen stain, used to detect apoptosis good results was obtained in eyes, brains

Management of Warfarin Anticoagulation in Patients with Fractured Neck of Femur

Background. Most orthopaedic units do not have a policy for reversal of anticoagulation in patients with hip fractures. The aim of this study was to examine the current practice in a district general hospital and determine difference in the time to surgery, if any, with cessation of warfarin versus cessation and treatment with vitamin K. Methods. A retrospective review of the case notes between January 2005 and December 2008 identified 1797 patients with fracture neck of femur. Fifty seven (3.2%) patients were on warfarin at the time of admission. Patients were divided into 2 groups (A and B). Group A patients (16/57; 28%) were treated with cessation of warfarin only and group B patients (41; 72%) received pharmacological therapy in addition to stopping warfarin. Time to surgery between the two groups was compared. Results. The mean INR on admission was 2.9 (range 1.7–6.5) and prior to surgery 1.4 (range 1.0–2.1). Thirty eight patients received vitamin K only and 3 patients received fresh frozen plasma and vitamin K. The average time to surgery was 4.4 days in group A and 2.4 days in group B. The difference was statistically significant (P < .01). Conclusion. Reversal of high INR is important to avoid significant delay in surgery. There is a need for a national policy for reversing warfarin anticoagulation in patients with hip fractures requiring surgery. Vitamin K is safe and effective for anticoagulation reversal in hip fracture patients

15-02 Estimating and Enhancing Public Transit Accessibility for People with Mobility Limitations

This two-part study employs fine-scale performance measures and analytical techniques designed to evaluate and improve transit services for people experiencing disability. Part one puts forth a series of time-sensitive, general transit feed system (GTFS)-enhanced employment accessibility models that account for multiple transportation modes, categories of functional limitation and design characteristics of existing public transit infrastructure. Model results shed light on the degree to which a medium-size city’s public transit system addresses the gap between a theoretical continuum of rider capacities and the physical demands required to achieve mobility and access to employment. Our research finds that an individual’s combined physical mobility constraints (e.g., walking speed and maximum walking distance) and public transit infrastructure requirements (e.g., presence/absence of wheelchair boarding platforms and connections to pedestrian access routes) may reduce employment accessibility outcomes by as much as 86 percent. Part two of the study utilizes performance measures developed in part one to model—via spatially explicit structural equations—the degree to which employment accessibility explains variations in public transit ridership and work commute transportation mode share. Here we find that commute share and ridership…(results). Developing a better understanding of relationships between accessibility and transit usage, we reason, will help shed light on how American Disabilities Act (ADA) compliant transit infrastructure affects mode choice decisions among people with considerable functional limitations and across the broader population

Economic evaluation of implementation science outcomes in low- and middle-income countries: A scoping review

BACKGROUND: Historically, the focus of cost-effectiveness analyses has been on the costs to operate and deliver interventions after their initial design and launch. The costs related to design and implementation of interventions have often been omitted. Ignoring these costs leads to an underestimation of the true price of interventions and biases economic analyses toward favoring new interventions. This is especially true in low- and middle-income countries (LMICs), where implementation may require substantial up-front investment. This scoping review was conducted to explore the topics, depth, and availability of scientific literature on integrating implementation science into economic evaluations of health interventions in LMICs. METHODS: We searched Web of Science and PubMed for papers published between January 1, 2010, and December 31, 2021, that included components of both implementation science and economic evaluation. Studies from LMICs were prioritized for review, but papers from high-income countries were included if their methodology/findings were relevant to LMIC settings. RESULTS: Six thousand nine hundred eighty-six studies were screened, of which 55 were included in full-text review and 23 selected for inclusion and data extraction. Most papers were theoretical, though some focused on a single disease or disease subset, including: mental health (n = 5), HIV (n = 3), tuberculosis (n = 3), and diabetes (n = 2). Manuscripts included a mix of methodology papers, empirical studies, and other (e.g., narrative) reviews. Authorship of the included literature was skewed toward high-income settings, with 22 of the 23 papers featuring first and senior authors from high-income countries. Of nine empirical studies included, no consistent implementation cost outcomes were measured, and only four could be mapped to an existing costing or implementation framework. There was also substantial heterogeneity across studies in how implementation costs were defined, and the methods used to collect them. CONCLUSION: A sparse but growing literature explores the intersection of implementation science and economic evaluation. Key needs include more research in LMICs, greater consensus on the definition of implementation costs, standardized methods to collect such costs, and identifying outcomes of greatest relevance. Addressing these gaps will result in stronger links between implementation science and economic evaluation and will create more robust and accurate estimates of intervention costs. TRIAL REGISTRATION: The protocol for this manuscript was published on the Open Science Framework. It is available at: https://osf.io/ms5fa/ (DOI: 10.17605/OSF.IO/32EPJ)

Early marriage and displacement – a conversation:How Syrian daughters, mothers and mothers-in-law in Jordan understand marital decision-making

Conflict and forced migration threaten to reverse the decline of early marriage in the Middle East. In some Syrian refugee communities, protracted displacement and precarious livelihoods, together with pre-war traditions of early marriage, push families to arrange matches for their adolescent daughters, and sometimes sons. Drawing on thirteen ethnographic interviews with young Syrian women, mothers, mothers-in-law and grandmothers in Jordan, we develop a multi-perspective approach to the study of early marriage. A feminist outlook has informed our fieldwork and the way its results are presented: around a conversation with Syrian women of different ages and from different generational groups. While humanitarian reports often use women’s voices in a tokenistic way, we stay attentive to the complex nature of their stories and ambitions, contrasting them with insights from interviews with Jordanian academics, aid workers and policymakers. Our study adds nuance to existing humanitarian narratives by drawing attention to the interplay of multigenerational household dynamics, legal and economic constraints in host countries, but also younger and older women’s aspirations, that shape marital decision-making within displaced families

Risk of early versus later rebleeding from dural arteriovenous fistulas with cortical venous drainage

BACKGROUND: Cranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage. METHODS: Patients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time from hemorrhage to first treatment, rebleed, or last follow-up. Rebleeding in the first 2 weeks and first year were compared using incidence rate ratio and difference. RESULTS: Of 1077 patients, 250 met the inclusion criteria and had 95 cumulative person-years natural history follow-up. The overall annualized rebleed rate was 7.3% (95% CI, 3.2-14.5). The incidence rate of rebleeding in the first 2 weeks was 0.0011 per person-day; an early rebleed risk of 1.6% in the first 14 days (95% CI, 0.3-5.1). For the remainder of the first year, the incidence rate was 0.00015 per person-day; a rebleed rate of 5.3% (CI, 1.7-12.4) over 1 year. The incidence rate ratio was 7.3 (95% CI, 1.4-37.7; CONCLUSIONS: The risk of rebleeding of a dural arteriovenous fistula with cortical venous drainage presenting with hemorrhage is increased in the first 2 weeks justifying early treatment. However, the magnitude of this increase may be considerably lower than previously thought. Treatment within 5 days was associated with a low rate of rebleeding and appears an appropriate timeframe