Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study

PURPOSE: To describe medium-term physical and mental health and social outcomes following adolescent sexual assault, and examine users’ perceived needs and experiences. METHOD: Longitudinal, mixed methods cohort study of adolescents aged 13–17 years recruited within 6 weeks of sexual assault (study entry) and followed to study end, 13–15 months post-assault. RESULTS: 75/141 participants were followed to study end (53% retention; 71 females) and 19 completed an in-depth qualitative interview. Despite many participants accessing support services, 54%, 59% and 72% remained at risk for depressive, anxiety and post-traumatic stress disorders 13–15 months post-assault. Physical symptoms were reported more frequently. Persistent (> 30 days) absence from school doubled between study entry and end, from 22 to 47%. Enduring mental ill-health and disengagement from education/employment were associated with psychosocial risk factors rather than assault characteristics. Qualitative data suggested inter-relationships between mental ill-health, physical health problems and disengagement from school, and poor understanding from schools regarding how to support young people post-assault. Baseline levels of smoking, alcohol and ever drug use were high and increased during the study period (only significantly for alcohol use). CONCLUSION: Adolescents presenting after sexual assault have high levels of vulnerability over a year post-assault. Many remain at risk for mental health disorders, highlighting the need for specialist intervention and ongoing support. A key concern for young people is disruption to their education. Multi-faceted support is needed to prevent social exclusion and further widening of health inequalities in this population, and to support young people in their immediate and long-term recovery

Investigating the relationship between substance use and sexual behaviour in young people in Britain: findings from a national probability survey.

BACKGROUND: Health risk behaviours are prominent in late adolescence and young adulthood, yet UK population-level research examining the relationship between drug or alcohol use and sexual health and behaviour among young people is scarce, despite public health calls for an integrated approach to health improvement. Our objective was to further our understanding of the scale of and nature of any such relationship, using contemporary data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). METHODS: Analyses of data from Natsal-3, a stratified probability survey of 15 162 men and women (3869 aged 16-24 years), undertaken in 2010-2012, using computer-assisted personal interviewing, were carried out. Logistic regression was used to explore associations between reporting (1) frequent binge drinking (≥weekly), (2) recent drug use (within past 4 weeks) or (3) multiple (both types of) substance use, and key sexual risk behaviours and adverse sexual health outcomes. We then examined the sociodemographic profile, health behaviours and attitudes reported by 'risky' young people, defined as those reporting ≥1 type of substance use plus non-condom use at first sex with ≥1 new partner(s), last year. RESULTS: Men and women reporting frequent binge drinking or recent drug use were more likely to report: unprotected first sex with ≥1 new partner(s), last year; first sex with their last partner after only recently meeting; emergency contraception use (last year) and sexually transmitted infection diagnosis/es (past 5 years). Associations with sexual risk were frequently stronger for those reporting multiple substance use, particularly among men. The profile of 'risky' young people differed from that of other 16-24 years old. CONCLUSIONS: In this nationally representative study, substance use was strongly associated with sexual risk and adverse sexual health outcomes among young people. Qualitative or event-level research is needed to examine the context and motivations behind these associations to inform joined-up interventions to address these inter-related behaviours

Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK

BACKGROUND: In adolescents with severe and persistent gender dysphoria (GD), gonadotropin releasing hormone analogues (GnRHa) are used from early/middle puberty with the aim of delaying irreversible and unwanted pubertal body changes. Evidence of outcomes of pubertal suppression in GD is limited. METHODS: We undertook an uncontrolled prospective observational study of GnRHa as monotherapy in 44 12-15 year olds with persistent and severe GD. Prespecified analyses were limited to key outcomes: bone mineral content (BMC) and bone mineral density (BMD); Child Behaviour CheckList (CBCL) total t-score; Youth Self-Report (YSR) total t-score; CBCL and YSR self-harm indices; at 12, 24 and 36 months. Semistructured interviews were conducted on GnRHa. RESULTS: 44 patients had data at 12 months follow-up, 24 at 24 months and 14 at 36 months. All had normal karyotype and endocrinology consistent with birth-registered sex. All achieved suppression of gonadotropins by 6 months. At the end of the study one ceased GnRHa and 43 (98%) elected to start cross-sex hormones. There was no change from baseline in spine BMD at 12 months nor in hip BMD at 24 and 36 months, but at 24 months lumbar spine BMC and BMD were higher than at baseline (BMC +6.0 (95% CI: 4.0, 7.9); BMD +0.05 (0.03, 0.07)). There were no changes from baseline to 12 or 24 months in CBCL or YSR total t-scores or for CBCL or YSR self-harm indices, nor for CBCL total t-score or self-harm index at 36 months. Most participants reported positive or a mixture of positive and negative life changes on GnRHa. Anticipated adverse events were common. CONCLUSIONS: Overall patient experience of changes on GnRHa treatment was positive. We identified no changes in psychological function. Changes in BMD were consistent with suppression of growth. Larger and longer-term prospective studies using a range of designs are needed to more fully quantify the benefits and harms of pubertal suppression in GD

First impressions and perceived roles: Palestinian perceptions on foreign aid

This paper summarizes some results of a wider research on foreign aid that was conducted in the West Bank and Gaza Strip in 2010. It seeks to describe the impressions and feelings of Palestinian aid beneficiaries as well as the roles and functions they attached to foreign aid. To capture and measure local perceptions on Western assistance a series of individual in depth interviews and few focus group interviews were conducted in the Palestinian territories. The interview transcripts were processed by content analysis. As research results show — from the perspective of aid beneficiaries — foreign aid is more related to human dignity than to any economic development. All this implies that frustration with the ongoing Israeli-Palestinian conflict inevitably embraces the donor policies and practices too

The evaluation of "Safe Motherhood" program on maternal care utilization in rural western China: a difference in difference approach

BACKGROUND: Maternal care is an important strategy for protection and promotion of maternal and children's health by reducing maternal mortality and improving the quality of birth. However, the status of maternal care is quite weak in the less developed rural areas in western China. It is found that the maternal mortality rates in some western areas of China were 5.8 times higher than those of their eastern costal counterparts. In order to reduce the maternal mortality rates and to improve maternal care in western rural areas of China, the Chinese Ministry of Health (MOH) and the United Nations Children's Fund (UNICEF) sponsored a program named "Safe Motherhood" in ten western provinces of China from 2001 through 2005. This study mainly aims to evaluate the effects of "Safe Motherhood" program on maternal care utilization. METHODS: 32 counties were included in both surveys conducted in 2001 and 2005, respectively. Ten counties of which implemented comprehensive community-based intervention were used as intervention groups, while 22 counties were used as control groups. Stratified 3-stage probability-proportion-to-size sampling method was used to select participating women. Two cross-sectional surveys were conducted with questionnaires about the prenatal care utilization in 2001 and 2005, respectively. Difference in difference estimation was used to assess the effect of intervention on the maternal care utilization while controlling for socio-economic characteristics of women. RESULTS: After the intervention, the proportion of pregnant women who had their first prenatal visit in the first trimester was increased from 38.9% to 76.1%. The proportion of prenatal visits increased from 82.6% to 98.3%. The proportion of women mobilized to deliver in hospitals increased from 62.7% to 94.5%. Hospital delivery was improved greatly from 31.1% to 87.3%. The maternal mortality rate was lowered by 34.9% from 91.76 to 59.74 per 100,000 live births. The community-based intervention had increased prenatal visits rate by 5.2%, first prenatal visit in first trimester rate by 12.0% and hospital delivery rate by 22.5%, respectively. No effect was found on rate of women being mobilized to hospital delivery compared with that of the control group. CONCLUSION: The intervention program seemed to have improved the prenatal care utilization in rural western China

Osmoregulators proline and glycine betaine counteract salinity stress in canola

Salt inundation leads to increased salinization of arable land in many arid and semi-arid regions. Until genetic solutions are found farmers and growers must either abandon salt-affected fields or use agronomic treatments that alleviate salt stress symptoms. Here, field experiments were carried out to study the effect of the osmoregulators proline at 200 mg L-1 and glycine betaine at 400 mg L-1 in counteracting the harmful effect of soil salinity stress on canola plants grown in Egypt. We assessed growth characteristics, yield and biochemical constituents. Results show first that all growth characters decreased with increasing salinity stress but applied osmoregulators alleviated these negative effects. Second, salinity stress decreased photosynthetic pigments, K and P contents, whilst increasing proline, soluble sugars, ascorbic acid, Na and Cl contents. Third, application of osmoregulators without salt stress increased photosynthetic pigments, proline, soluble sugars, N, K and P contents whilst decreasing Na and Cl contents. It is concluded that the exogenously applied osmoregulators glycine betaine and proline can fully or partially counteract the harmful effect of salinity stress on growth and yield of canola.© INRA and Springer-Verlag, France 2012

Evaluation and prediction of groundwater quality for irrigation using an integrated water quality indices, machine learning models and GIS approaches: a representative case study

Agriculture has significantly aided in meeting the food needs of growing population. In addition, it has boosted economic development in irrigated regions. In this study, an assessment of the groundwater (GW) quality for agricultural land was carried out in El Kharga Oasis, Western Desert of Egypt. Several irrigation water quality indices (IWQIs) and geographic information systems (GIS) were used for the modeling development. Two machine learning (ML) models (i.e., adaptive neuro-fuzzy inference system (ANFIS) and support vector machine (SVM)) were developed for the prediction of eight IWQIs, including the irrigation water quality index (IWQI), sodium adsorption ratio (SAR), soluble sodium percentage (SSP), potential salinity (PS), residual sodium carbonate index (RSC), and Kelley index (KI). The physicochemical parameters included T°, pH, EC, TDS, K+, Na+, Mg2+, Ca2+, Cl−, SO42−, HCO3−, CO32−, and NO3−, and they were measured in 140 GW wells. The hydrochemical facies of the GW resources were of Ca-Mg-SO4, mixed Ca-Mg-Cl-SO4, Na-Cl, Ca-Mg-HCO3, and mixed Na-Ca-HCO3 types, which revealed silicate weathering, dissolution of gypsum/calcite/dolomite/ halite, rock–water interactions, and reverse ion exchange processes. The IWQI, SAR, KI, and PS showed that the majority of the GW samples were categorized for irrigation purposes into no restriction (67.85%), excellent (100%), good (57.85%), and excellent to good (65.71%), respectively. Moreover, the majority of the selected samples were categorized as excellent to good and safe for irrigation according to the SSP and RSC. The performance of the simulation models was evaluated based on several prediction skills criteria, which revealed that the ANFIS model and SVM model were capable of simulating the IWQIs with reasonable accuracy for both training “determination coefficient (R2)” (R2 = 0.99 and 0.97) and testing (R2 = 0.97 and 0.76). The presented models’ promising accuracy illustrates their potential for use in IWQI prediction. The findings indicate the potential for ML methods of geographically dispersed hydrogeochemical data, such as ANFIS and SVM, to be used for assessing the GW quality for irrigation. The proposed methodological approach offers a useful tool for identifying the crucial hydrogeochemical components for GW evolution assessment and mitigation measures related to GW management in arid and semi-arid environments

Integrated methodological framework fos assesing the risk of failure in water supply incorporating drought forecast. Case study: Andean regulated river basin

[EN] Hydroclimatic drought conditions can affect the hydrological services offered by mountain river basins causing severe impacts on the population, becoming a challenge for water resource managers in Andean river basins. This study proposes an integrated methodological framework for assessing the risk of failure in water supply, incorporating probabilistic drought forecasts, which assists in making decisions regarding the satisfaction of consumptive, non-consumptive and environmental requirements under water scarcity conditions. Monte Carlo simulation was used to assess the risk of failure in multiple stochastic scenarios, which incorporate probabilistic forecasts of drought events based on a Markov chains (MC) model using a recently developed drought index (DI). This methodology was tested in the Machángara river basin located in the south of Ecuador. Results were grouped in integrated satisfaction indexes of the system (DSIG). They demonstrated that the incorporation of probabilistic drought forecasts could better target the projections of simulation scenarios, with a view of obtaining realistic situations instead of optimistic projections that would lead to riskier decisions. Moreover, they contribute to more effective results in order to propose multiple alternatives for prevention and/or mitigation under drought conditions.This study was part of the doctoral thesis of Aviles A. at the Technical University of Valencia. This research was funded by the University of Cuenca through its Research Department (DIUC) and the Municipal public enterprise of telecommunications, drinking water, sewage and sanitation of Cuenca (ETAPA) through the projects: BIdentificacion de los procesos hidrometeorologicos que desencadenan inundaciones en la ciudad de Cuenca usando un radar de precipitacion" and "Ciclos meteorologicos y evapotranspiracion a lo largo de una gradiente altitudinal del Parque Nacional Cajas". 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Screening alfalfa accessions for regeneration capacity

Nine cultivars of Medicago sativa and one accession of M. arborea were tested in six different media for their capacity to produce somatic embryos and plantlets from callus cultures. The effect of the interaction of genotype and culture medium on the initiation of callus from root, hypocotyl and cotyledon explants and the subsequent somatic embryogenesis was investigated. The results indicated that the number of embryos was significantly influenced by the variety and medium protocols and their interac-tion. The varieties responded differently to medium protocol with respect to number of plantlets