Idiopathic adult intussusception

Intussusception is an uncommon cause of abdominal pain in adults and poses diagnostic challenges for emergency physicians, due to its varied presenting symptoms and time course. Diagnosis is thus often delayed and results in surgical intervention due to the development of bowel ischaemia. We report on a young patient who presented with an ileo-ileal intussusception in whom there were no underlying lesions identified as a causal factor

Dynamics of Socioeconomic Risk Factors for Neglected Tropical Diseases and Malaria in an Armed Conflict

Armed conflict and war and infectious diseases are globally among the leading causes of human suffering and premature death. Moreover, they are closely interlinked, as an adverse public health situation may spur violent conflict, and violent conflict may favor the spread of infectious diseases. The consequences of this vicious cycle are increasingly borne by civilians, often as a hidden and hence neglected burden. We analyzed household data that were collected before and after an armed conflict in a rural part of western Côte d'Ivoire, and investigated the dynamics of socioeconomic risk factors for neglected tropical diseases (NTDs) and malaria. We identified a worsening of the sanitation infrastructure, decreasing use of protective measures against mosquito bites, and increasing difficulties to reach public health care infrastructure. In contrast, household crowding, the availability of soap, and the accessibility of comparatively simple means of health care provision (e.g., traditional healers and community health workers) seemed to be more stable. Knowledge about such dynamics may help to increase crisis-proofness of critical infrastructure and public health systems, and hence mitigate human suffering due to armed conflict and war

Empowerment of intergroup harmony and equity

The impact of empowerment interventions is often short-lived because they are not anchored in changes in the wider social and structural context. This chapter draws its inspiration from social representation theory and social identity theory. Several theoretical propositions are derived from these theories that bear on the effectiveness of empowerment interventions. Drawing on field experiences with Roma communities and young unemployed people in Hungary and Italy, we demonstrate how a focus on intergroup interactions, between minority and majority group members, is central to the empowerment process. In addition, we address the role of power and the means by which power can be dissembled and more equitably shared. Finally, we discuss the importance of placing contextual factors at the center of our analysis and enacting changes in context in order to arrive at empowerment interventions that produce sustainable changes in intergroup harmony and equity

Explicit Alignment of Requirements and Architecture in Agile Development

[Context & Motivation] Requirements and architectural components are designed concurrently, with the former guiding the latter, and the latter restricting the former. [Question/problem] Effective communication between requirements engineers and software architects is often experienced as problematic. [Principal ideas/results] We present the Requirements Engineering for Software Architecture (RE4SA) model with the intention to support the communication within the development team. In RE4SA, requirements are expressed as epic stories and user stories, which are linked to modules and features, respectively, as their architectural counterparts. Additionally, we provide metrics to measure the alignment between these concepts, and we also discuss how to use the model and the usefulness of the metrics by applying both to case studies. [Contribution] The RE4SA model employs widely adopted notations and allows for explicitly relating a system’s requirements and architectural components, while the metrics make it possible to measure the alignment between requirements and architecture

Jejunojejunal intussusception after Roux-en-Y gastric bypass: a review.

Small bowel intussusception is a rare long-term complication after Roux-en-Y gastric bypass, the etiology of which remains unclear. Except for one series reporting on 23 patients, case reports represent the vast majority of all cases reported so far. With this complete review of the world literature, based on a total of 63 patients including 2 of our own cases, we provide an extensive overview of the subject. The origin of intussusception after gastric bypass is different from that of intussusception of other causes, in that there is usually no lead point. It is likely related to motility disorders in the divided small bowel, especially in the Roux limb. This rare condition may cause obstruction and lead to bowel necrosis if not recognized and treated promptly. Clinical presentation is not specific. Computerized tomography scan represents the diagnostic test of choice, but surgery is sometimes the only way to establish the diagnosis. Treatment may be limited to reduction if the small bowel is viable, but resection of the affected segment is recommended on the basis of this review, since it seems to result in fewer recurrences. Knowledge of this entity and a high index of suspicion are required to make the correct diagnosis and offer appropriate treatment in a timely fashion