Investigating Fear, Shyness, And Discomfort Related To Menstrual Hygiene Management In Rural Cambodia

Over the last decade, increasing attention has been given to understanding girls\u27 menstrual hygiene management (MHM) experiences in school. However, little has been done to understand girls\u27 MHM experiences in other contexts, such as the home environment. The purpose of this study was to explore the knowledge, attitudes, and practices of MHM and menstrual related experiences among rural Cambodians, with an expanded scope to include both the home and school environments, and five participant perspectives. Our study was conducted in eight rural secondary schools and eight rural villages from two Cambodian provinces, Banteay Meanchey and Kratie. Our target participants included girls (14+ years, post-menarche; n=120), mothers (n=88), fathers (n=15), teachers (n=37; 54.1% female), and boys (14+ years; n=59), for a total of 346 participants. Qualitative and quantitative data were collected using structured interviews (n=165), structured focus groups (SFGs) (24 SFGs: n=180), and observational latrine surveys (n=8). Qualitative analysis employed inductive approaches derived from Grounded Theory. Based on our findings, although girls expressed feeling capable of managing their menses each month, fear, shyness, and discomfort (FSD) associated with their menstrual experience was a major theme. As such, emergent categories from girls’ responses and other participant groups revealed three primary determinants of FSD: (1) relational impacts on FSD, regarding girls’ social experiences during menstruation; (2) knowledge-related impacts on FSD, indicating areas of knowledge that influenced MHM and FSD; and (3) managerial impacts on FSD, dealing with the material and WASH resources that were most pragmatic for MHM and influential on FSD. A fourth theme considered the impact of FSD on girls’ behavior. Quantitative and qualitative analysis showed that FSD had a significant impact on girls’ confidence, relationships, and decision-making regarding MHM. Evidence and recommendations from this study support the tailoring of programs and interventions to target overt social, educational, and environmental challenges and underlying factors that contribute to girls’ FSD, in order to meet the traditionally unserved MHM needs of women and girls

Examining the group-level effects of corporate identity cues on organisational identification and role behaviours

Corporate identity cues – the information that amongst other things reflects the central, enduring and distinctive attributes of the organisation that comprise its corporate identity – help influence the psychological bond of identification that employees have with their organisations. Organisational identification in turn affects the job-specific in-role and additional voluntary extra-role behaviours that employees practice within and towards their organisations that can influence its success. Corporate identity research has mostly addressed corporate identity cues as manifestations of the communications, behaviour and symbolism of the organisation. Despite being part of the many pieces of information that employees store in memory about their organisations which provide insights into their interpretations of and responses to the corporate identity (i.e., their member organisational associations), considerably less attention has been directed towards examining these cues from this perspective. Consequently, it is unclear which of these manifestations, or types, of corporate identity cues affect organisational identification and its subsequent influence on role behaviours, or whether these effects are constant across the organisation and under different conditions. This study contributes to building understanding of the manifestations and effects of corporate identity cues on organisational identification and its influence on role behaviours, by examining empirically this relationship at the aggregate and subgroup level. Its underlying premise is that to evaluate sufficiently the effects of corporate identity cues, these cues must also be considered from the member organisational associations perspective. The findings of this mixed methods study show a significant relationship between corporate identity cues derived from member organisational associations, organisational identification and role behaviours, and that the cues that influence organisational identification vary according to organisational levels and conditions. This points to the strategic importance and value of examining periodically corporate identity cues drawn from member organisational associations

Agreeing is Not the Same as Accepting: Exploring Pre-Service Teachers’ Growth Mindsets

The popularity of mindset theory has resulted in a surge of mindset interventions in schools. However, with increased popularity, there is the potential for misunderstandings and hesitations about what a growth mindset fully entails. Therefore, we sought to disentangle which components of growth mindset messages pre-service teachers find hard to accept alongside their level of agreement with growth mindset questionnaire items. We used a descriptive design with both quantitative and qualitative data to explore 182 pre-service teachers’ responses to growth mindset messages. The results of this study suggest that pre-service teachers hold a growth mindset. However, despite strong quantitative endorsements, in the qualitative analyses we determined three ways in which participants found a growth mindset hard to accept: (1) the notion of mindset theory itself, (2) the level of growth, (3) and the necessary actions behind having a growth mindset. The findings of this study suggest we need to pay close attention to false growth mindsets in theory and practice

Multipotent adult hippocampal progenitor cells maintained as neurospheres favor differentiation toward glial lineages

Adult hippocampal progenitor cells (AHPCs) are generally maintained as a dispersed monolayer population of multipotent neural progenitors. To better understand cell-cell interactions among neural progenitors and their influences on cellular characteristics, we generated free-floating cellular aggregates, or neurospheres, from the adherent monolayer population of AHPCs. Results from in vitro analyses demonstrated that both populations of AHPCs were highly proliferative under maintenance conditions, but AHPCs formed in neurospheres favored differentiation along a glial lineage and displayed greater migrational activity, than the traditionally cultured AHPCs. To study the plasticity of AHPCs from both populations in vivo, we transplanted GFP-expressing AHPCs via intraocular injection into the developing rat eyes. Both AHPC populations were capable of surviving and integrating into the developing host central nervous system, but considerably more GFP-positive cells were observed in the retinas transplanted with neurosphere AHPCs, compared to adherent AHPCs. These results suggest that the culture configuration during maintenance for neural progenitor cells (NPCs) influences cell fate and motility in vitro as well as in vivo. Our findings have implication for understanding different cellular characteristics of NPCs according to distinct intercellular architectures and for developing cell-based therapeutic strategies using lineage-committed NPCs

Rheumatoid arthritis - clinical aspects: 134. Predictors of Joint Damage in South Africans with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) causes progressive joint damage and functional disability. Studies on factors affecting joint damage as clinical outcome are lacking in Africa. The aim of the present study was to identify predictors of joint damage in adult South Africans with established RA. Methods: A cross-sectional study of 100 black patients with RA of >5 years were assessed for joint damage using a validated clinical method, the RA articular damage (RAAD) score. Potential predictors of joint damage that were documented included socio-demographics, smoking, body mass index (BMI), disease duration, delay in disease modifying antirheumatic drug (DMARD) initiation, global disease activity as measured by the disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and autoantibody status. The predictive value of variables was assessed by univariate and stepwise multivariate regression analyses. A p value <0.05 was considered significant. Results: The mean (SD) age was 56 (9.8) years, disease duration 17.5 (8.5) years, educational level 7.5 (3.5) years and DMARD lag was 9 (8.8) years. Female to male ratio was 10:1. The mean (SD) DAS28 was 4.9 (1.5) and total RAAD score was 28.3 (12.8). The mean (SD) BMI was 27.2 kg/m2 (6.2) and 93% of patients were rheumatoid factor (RF) positive. More than 90% of patients received between 2 to 3 DMARDs. Significant univariate predictors of a poor RAAD score were increasing age (p = 0.001), lower education level (p = 0.019), longer disease duration (p < 0.001), longer DMARD lag (p = 0.014), lower BMI (p = 0.025), high RF titre (p < 0.001) and high ESR (p = 0.008). The multivariate regression analysis showed that the only independent significant predictors of a higher mean RAAD score were older age at disease onset (p = 0.04), disease duration (p < 0.001) and RF titre (p < 0.001). There was also a negative association between BMI and the mean total RAAD score (p = 0.049). Conclusions: Patients with longstanding established RA have more severe irreversible joint damage as measured by the clinical RAAD score, contrary to other studies in Africa. This is largely reflected by a delay in the initiation of early effective treatment. Independent of disease duration, older age at disease onset and a higher RF titre are strongly associated with more joint damage. The inverse association between BMI and articular damage in RA has been observed in several studies using radiographic damage scores. The mechanisms underlying this paradoxical association are still widely unknown but adipokines have recently been suggested to play a role. Disclosure statement: C.I. has received a research grant from the Connective Tissue Diseases Research Fund, University of the Witwatersrand. All other authors have declared no conflicts of interes

Construction and validation of indicators and respective definitions for the nursing outcome Swallowing Status

;;OBJETIVO:;; construir e validar por especialistas e clinicamente os indicadores para o resultado de enfermagem Estado da deglutição e suas definições conceituais e operacionais em pacientes após acidente vascular cerebral.;;;;MÉTODO:;; estudo metodológico, com análise de conceito e validações de conteúdo e clínica. Verificou-se o Índice de Validade de Conteúdo para as notas atribuídas por 11 especialistas aos indicadores revisados. Na validação clínica, examinaram-se 81 pacientes por duas duplas de enfermeiros, uma usando instrumento com as definições construídas e outra com instrumento sem definições. As avaliações foram comparadas pelo Coeficiente de Correlação Intraclasse, teste de Friedman e Diferença Mínima Significante.;;;;RESULTADOS:;; exceto o indicador Captura do alimento, todos apresentaram Índice de Validade de Conteúdo superior a 0,80. A dupla de enfermeiros com instrumento contendo as definições construídas apresentou Coeficiente de Correlação Intraclasse superior a 0,80 para todos os indicadores e pelo cálculo da Diferença Mínima Significante houve similaridade entre todas as avaliações. Na dupla que estava sem as definições elaboradas, o coeficiente foi baixo (ρ;;;;CONCLUSÃO:;; os dados evidenciaram aumento na uniformidade e acurácia entre as avaliações dos enfermeiros ao utilizar as definições conceituais e operacionais para os indicadores do resultado de enfermagem Estado da deglutição.;;;;OBJECTIVE:;; to develop indicators for the nursing outcome Swallowing Status and the respective conceptual and operational definitions validated by experts and in a clinical setting among patients after having experienced a stroke.;;;;METHOD:;; methodological study with concept analysis and content and clinical validations. The Content Validation Index was verified for the scores assigned by 11 experts to indicators. Two pairs of nurses assessed 81 patients during the clinical validation: one pair used an instrument with definitions and the other used an instrument without definitions. The resulting assessments were compared using Intraclass Correlation Coefficient, Friedman's test, and Minimal Important Difference calculation.;;;;RESULTS:;; All the indicators, with the exception of the indicator Ability to bring food to mouth, presented Content Validation Index above 0.80. The pair using the instrument with definitions presented an Intraclass Correlation Coefficient above 0.80 for all the indicators and similarity was found in all the assessments, according to the Minimal Important Difference calculation. The pair using the instrument without definitions presented a low coefficient (ρ;;OBJETIVO:;; construir y validar por especialistas y clínicamente los indicadores para el resultado de enfermería Estado de la deglución y sus definiciones conceptuales y operacionales en pacientes después de accidente vascular cerebral.;;;;MÉTODO:;; estudio metodológico, con análisis de concepto y validaciones de contenido y clínicas. Se verificó el Índice de Validez de Contenido para las notas atribuidas por 11 especialistas a los indicadores revisados. En la validación clínica, fueron examinados 81 pacientes por dos parejas de enfermeros, una usando instrumento con las definiciones construidas y la otra con instrumento sin definiciones. Las evaluaciones fueron comparadas por el Coeficiente de Correlación Intraclase, test de Friedman y Diferencia Mínima Significativa.;;;;RESULTADOS:;; exceptuando el indicador Captura del alimento, todos presentaron Índice de Validez de Contenido superior a 0,80. La pareja de enfermeros con instrumento conteniendo las definiciones construidas presentó Coeficiente de Correlación Intraclase superior a 0,80 para todos los indicadores y por el cálculo de la Diferencia Mínima Significativa hubo semejanza entre todas las evaluaciones. En la pareja que estaba sin las definiciones elaboradas, el coeficiente fue bajo (

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead