Indoor Radon Concentration Measurement in Selected Factories in Northern and Central Iraq

In this work, the outdoor radon concentration level and lung cancer risks have been measured in selected locations in northern and central Iraq during the summer season 2012 by using time integrated passive radon dosimeters containing LR-115 Type II plastic track detectors. These measurements were carried out in the factories for an exposure time of 60 day. The radon concentration in these factories ranges from (36.36 – 125.10) Bq.m-3 with an average of (59.93Bq.m-3), which within the acceptable radon levels (50-150) Bq.m-3 recommended by the International Commission on Radiological Protection (ICRP). The average absorption effective dose equivalent for a person living in factories for which the investigation were done was found to be (1.425mSv.y-1). It is observed that the average lung cancer per year per 106 person was found to be 25.654. Keyword: LR-115 Type II nuclear track detectors; Radon concentration; AEDE; PAEC

Diagnostic Findings of Sclerosing Mesenteritis and the Disease Correlations with Caecal Adenocarcinoma

Sclerosing mesenteritis (SM) is a rare disease with non-specific clinical manifestations and should be supported by radiological examination and confirmed by histopathological evaluation. Its relationship with cancer especially caecal adenocarcinoma is still unclear. This case report describes a young man who was diagnosed as having SM and poorly-differentiated caecal adenocarcinoma

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Laya Behbahani: Human Trafficking in the Gulf States

Human trafficking in the Gulf Co-operation Council (GCC) states of the Middle East is a growing concern. With over 90 per cent of the population constituting as migrant workers in parts of the Gulf, concerns around the gross human rights violations of migrants workers has attracted the much needed attention it deserves. In this discussion, Laya Behbahani, who recently completed her MA in Criminology at SFU, will provide media accounts of the experiences of migrant workers in the GCC against a backdrop of the hybrid legal system and varying innovative, and often evasive, state responses in the GCC. Despite the GCC\u27s claim to be operating according to a hybrid legal system whereby Shariah law, common law and civil law are applied to different realms of social transactions, Behbahani argues that the current treatment of migrant works and related policies and practices in the GCC, are not merely labour violations, but are tantamount to state-sponsored human trafficking. She will examine the gap between criminal laws, immigration policies and labour standards, and practices in the GCC that are incongruent with international norms and standards with respect to the treatment of migrant workers. Behbahani will examine how human trafficking in the GCC is strikingly similar to, or at minimum entails forms of modern day slavery. Understanding the proximity of slavery to human trafficking provides a basis for arguing that human trafficking and slavery are not distinct enough crimes so as to prevent human trafficking from being exclusively catalogued as a jus cogens norm in international law. Post-lecture dialogue moderated by SFU School of Communication\u27s Adel Iskandar. Speaker Bios: Laya Behbahani is a Business and Policy Analyst at Simon Fraser University. She is also a sessional lecturer in Labour Studies and an associate at the Police Studies Centre at the School of Criminology at SFU. She has previously worked at the Human Trafficking and Migrant Smuggling Section of the United Nations Office on Drugs and Crime in Vienna, Austria, the Just Governance for Human Security conference in Geneva, Switzerland and as a research associate at the Centre of Excellence in Responsible Business at York University’s Schulich School of Business. Behbahani completed her BA with Honours and Master’s at the School of Criminology at SFU before completing further course work at the University of Vienna, BCIT and Harvard University’s Kennedy School of Government. Her research focuses on international trade, labour and human trafficking in the global political economy. Adel Iskandar is an Assistant Professor of Global Communication at Simon Fraser University. He is the author, co-author, and editor of several works including Egypt In Flux: Essays on an Unfinished Revolution (AUCP/OUP); Al-Jazeera: The Story of the Network that is Rattling Governments and Redefining Modern Journalism (Basic Books); Edward Said: A Legacy of Emancipation and Representation (University of California Press); Mediating the Arab Uprisings (Tadween Publishing), and Media Evolution on the Eve of the Arab Spring (Palgrave Macmillan). Iskandar\u27s work deals with media, identity and politics; and he has lectured extensively on these topics at universities in more than thirty countries. His forthcoming works deal with propaganda and cultural dissidence online. Prior to his arrival at SFU, Iskandar taught for several years at the Center for Contemporary Arab Studies and the Communication, Culture, and Technology Program at Georgetown University, in Washington, DC. He is a co-editor of the online publication Jadaliyya

Social Media and Revolution — with Adel Iskandar

On this episode of Below the Radar, our host Am Johal is joined by Adel Iskandar, Middle East media scholar and Assistant Professor of Global Communication at Simon Fraser University’s School of Communication. He is the author and co-author of several works, including “Egypt In Flux: Essays on an Unfinished Revolution” (2013, AUCP/OUP), “Edward Said: A Legacy of Emancipation and Representation”, (2010, University of California Press) and “Al-Jazeera: The Story of the Network that is Rattling Governments and Redefining Modern Journalism" (2002, Basic Books). His research primarily involves media, identity and politics. Adel is also the co-editor of online publication “Jadaliyya,” and academic podcast “Status.

Pi Theatre: Auditing Terrorism

Join Pi Theatre for an exploration of the connections between the global financial system and terrorism. We’ll be looking at the belief in fundamental ideologies from capitalism to religion—what do they have in common and how far do people go to defend their convictions?&nbsp; Pi Theatre will be presenting The Invisible Hand by Pulitzer prize-winning playwright Ayad Akhtar at The Cultch in April. This high stakes thriller follows Nick Bright, an American capital funds manager for the Citi Bank Corporation in South Asia, into a terrifying world of kidnapping and unrest in a remote region of Pakistan. As Nick negotiates to save his own life he begins to see his captors in a new light. The Invisible Hand is a complex look at how far we’ll go to save ourselves and asks what is the ultimate cost of our actions? Samir Gandesha is an Associate Professor in the Department of the Humanities and the Director of the Institute for the Humanities at Simon Fraser University. He specializes in modern European thought and culture, with a particular emphasis on the 19th and 20th centuries. He is co-editor with Lars Rensmann of "Arendt and Adorno: Political and Philosophical Investigations" (Stanford, 2012). His book (coedited with Johan Hartle) "Reification and Spectacle: The Timeliness of Western Marxism" (University of Amsterdam Press) is forthcoming later this year and he has also recently completed (also with Johan Hartle) "Poetry of the Future: Marx and the Aesthetic." Adel Iskandar is an Assistant Professor of Global Communication at Simon Fraser University in Vancouver/Burnaby, Canada. He is the author, co-author, and editor of several works including "Egypt In Flux: Essays on an Unfinished Revolution" (AUCP/OUP); "Al-Jazeera: The Story of the Network that is Rattling Governments and Redefining Modern Journalism" (Basic Books); "Edward Said: A Legacy of Emancipation and Representation" (University of California Press); and "Mediating the Arab Uprisings" (Tadween Publishing). Iskandar\u27s work deals with media, identity and politics; and he has lectured extensively on these topics at universities worldwide. His forthcoming publication is the co-edited volume "Media Evolution on the Eve of the Arab Spring" (Palgrave Macmillan). Prior to his arrival at SFU, Iskandar taught for several years at the Center for Contemporary Arab Studies and the Communication, Culture, and Technology Program at Georgetown University, in Washington, DC. He is a co-editor of Jadaliyya