Human Rights and the Global Climate Change Regime

This article discusses human rights implications of the market-based mechanisms operationalized under the global climate change regime. It examines greenhouse gas emissions rights created by the Kyoto Protocol and continued by the Paris Agreement. This article discusses implications of these rights for the protection and realization of human rights in the wake of climate change and argues that greenhouse gas emissions rights, as currently constituted, are incompatible with human rights protections. While the Paris Agreement’s recognition of human rights is a significant development, the protection and realization of human rights by states under a free-market approach to climate change remains a challenge. This article calls for allocation of carbon investment rights for developing countries as a means of promoting the climate justice platform identified by human rights proponents, and reducing the economic gulf between developed and developing countries

Contraceptive Use in Cambodia: A Multi-Method Examination of Determinants and Barriers to Modern Contraception

In Cambodia, 79% of married women of reproductive age wish to limit or delay births, yet only 27% are using a modern method of contraception. The purpose of this mixed-method dissertation is to examine the determinants and barriers to contraceptive use in this population. The two specific aims are to 1) use quantitative data examine the associations between social support and contraceptive use among Cambodian women of low vs. high parity; and 2) use qualitative data to understand the different characteristics and barriers to method use of women who use contraceptives, women who have discontinued contraceptive use and women who have never used a modern method. The quantitative study (aim 1) surveyed a representative sample of married women ages 15-49 from two rural provinces in Cambodia (Kampong Thom and Kampot) and measured current contraceptive use, demographic characteristics and items related to contraceptive social support of husbands, peers and elders. Multivariate logistic regression methods were used to measure the association between contraceptive use and social support and models were stratified by low (=3 live births), The qualitative study (aim 2) used in-depth interviews and focus group discussions with different contraceptive user types to understand unique barriers and motivations of users, discontinuers and non-users of contraceptive methods. The quantitative paper shows significant associations between husband's support and contraceptive use. For all women, a husband's positive attitude towards methods and ease of communication with the husband are associated with higher contraceptive use; however, when the husband has full decision-making power, the likelihood of method use decreases among high-parity women. For low-parity woman, perceiving that peers use modern methods increases the likelihood of contraception. In both groups elders' negative opinions about contraceptive use decrease actual use. The qualitative findings show that rumors of myths and misconceptions about side effects are main barriers to the use and were wide-spread among all women. Differences between the three user types show that positive husband support, access to health providers and a high degree of self-efficacy for contraceptive use contribute to successful initiation and continuation of modern methods

Infant feeding experiences among teen mothers in North Carolina: Findings from a mixed-methods study

<p>Abstract</p> <p>Background</p> <p>Adolescent mothers in the U.S. are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations. The purpose of this mixed-methods study is to investigate breastfeeding practices, barriers and facilitators among adolescent mothers ages 17 and younger.</p> <p>Methods</p> <p>Quantitative descriptive analyses are conducted using data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The population-based sample comprises 389 teens ages 13-17 giving birth to a live born infant in North Carolina in 2000 - 2005 and in 2007. Qualitative analyses are based on in-depth interviews with 22 Black, White and Hispanic teen mothers residing in rural and urban areas of North Carolina conducted between November 2007 and February 2009.</p> <p>Results</p> <p>In quantitative analyses, 52% (196 of 389) of North Carolina teen mothers initiated breastfeeding, but half of those who initiated breastfeeding (92/196) stopped within the first month postpartum. Hispanic teens (44/52 or 89%) were much more likely than Black (61/159 or 41%) or White teens (87/164 or 52%) to initiate breastfeeding and to continue for a longer duration. Nearly sixty two percent (29/52) of Hispanic respondents breastfed for greater than four weeks as compared to 16% (29/159) of Black respondents and 26% (39/164) of White respondents. Common barriers to breastfeeding initiation and continuation included not liking breastfeeding, returning to school, nipple pain, and insufficient milk. Qualitative data provided context for the quantitative findings, elucidating the barriers and facilitators to breastfeeding from the teens' perspective and insight into the ways in which breastfeeding support to teens could be enhanced.</p> <p>Conclusions</p> <p>The large number of adolescents ceasing breastfeeding within the first month points to the need for more individualized follow-up after hospital discharge in the first few days postpartum, to address common technical challenges and to provide assistance managing the transition back to school. Provision of an extra home visit or outpatient visit for teens within the first few days following hospital discharge, and advocacy to make schools more compatible with breastfeeding, could potentially help teens who desire to breastfeed to successfully continue. These interventions warrant further research to test their effectiveness among adolescents.</p

Determination of anterior femoral bowing to length ratio in Iranian population

Due to the existence of different races and ethnicities and their different life styles, anatomical structure of people vary from one region of the world to another. The goal of this study is to determine the anterior femoral bowing to length ratio, which can be useful for planning major medical and therapeutic projects as well as designing medical equipment (including nails, orthoses and prosthetics). Lateral X-rays of femur bones of 250 patients who referred to Taleghani hospital in recent years (2011-2016) were retrieved from hospital archives and studied. 150 patients were females and 100 were males, ages ranging from 16 to 57 years old. All patients were Iranians with different ethnical backgrounds that referred to radiology centers of Tehran and Taleghani hospital and their records were saved in these centers archive. Based on femoral length, X-rays were categorized into eight groups; 300mm, 320mm, 340mm, 360mm, 380mm, 400mm, 420mm and 440mm, which are standards for manufacturing femoral nails in Iran as well as imported nails to Iran. Results showed significant difference compared to available femoral nails on the Iranian market, which indicates that these nails are not standard for Iranian population. Data analysis was based on anterior femoral bowing to length ratio alone. Gender and age were not considered for data analysis in this study and results were conclusive for all ages and genders

Comparing the Effectiveness of Acceptance and Commitment Therapy (ACT), Drug Therapy, and the Combination of These Two Methods in the Treatment of Major Depression

Introduction: A large number of people are afflicted with major depressive disorder, leading to high societal costs. In addition, the treatment remains one of the most challenging and controversial issues in mental health. The main purpose of this study is to compare the effectiveness of acceptance and commitment therapy (ACT), pharmacotherapy, and a blend of the two methods in treating major depressive disorder. Methods: A sample of 60 subjects was selected randomly from the middle-aged patients suffering from major depressive disorder (based on DSM-V criteria) with illness duration of one year that referred to all outpatient clinics of the Modares hospital in Isfahan. The patients were divided into four experimental groups including: acceptance and commitment therapy (ACT), Drug Therapy, blend of the two aforementioned methods and control group. Statistical analysis was conducted using analysis of covariance. Results: Findings showed a significant difference in terms of depression among the three treatment groups. While the mean scores of depression in the posttest were 44.60 for the control group, the results for pharmacotherapy, ACT and combination group were 17.66, 26.53 and 15.13 respectively (p˂0.05). Discussion: Although, Pharmacotherapy and combined treatment are more effective than ACT alone, the combination of ACT and pharmacotherapy is the most effective with longer-lasting results in the treatment of adults with major depressive disorder in middle-aged Iranian patients. Declaration of Interest: None

Implementation of legal abortion in Nepal: a model for rapid scale-up of high-quality care

Unsafe abortion's significant contribution to maternal mortality and morbidity was a critical factor leading to liberalization of Nepal's restrictive abortion law in 2002. Careful, comprehensive planning among a range of multisectoral stakeholders, led by Nepal's Ministry of Health and Population, enabled the country subsequently to introduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that contributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate attention to the key areas of policy, health system capacity, equipment and supplies, and information dissemination. Important elements of this successful model of scaling up safe legal abortion include: the pre-existence of postabortion care services, through which health-care providers were already familiar with the main clinical technique for safe abortion; government leadership in coordinating complementary contributions from a wide range of public- and private-sector actors; reliance on public-health evidence in formulating policies governing abortion provision, which led to the embrace of medical abortion and authorization of midlevel providers as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood and the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise their legal right to early pregnancy termination, the national safe abortion program has already yielded strong positive results. Nepal's experience making high-quality abortion care widely accessible in a short period of time offers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe abortion and to achieve Millennium Development Goals

Moving from legality to reality: how medical abortion methods were introduced with implementation science in Zambia

Although abortion is technically legal in Zambia, the reality is far more complicated. This study describes the process and results of galvanizing access to medical abortion where abortion has been legal for many years, but provision severely limited. It highlights the challenges and successes of scaling up abortion care using implementation science to document 2 years of implementation

Comparison of success rate and onset time of two different anesthesia techniques

Background: Using local anesthetic is common to control the pain through blocking the nerve reversibly in dental procedures. Gow-Gates (GG) technique has a high success rate but less common. This study aimed to compare the onset time and success rate in GG and standard technique of inferior alveolar nerve block (IANB). Material and Methods: This descriptive, single blind study was consisted of 136 patients (59 males and 77 females) who were randomly received GG or IANB for extraction of mandibular molar teeth. Comparisons between the successes of two anesthetic injection techniques were analyzed with Chi-square test. Incidence of pulpal anesthesia and soft tissue anesthesia were analyzed with Kaplan-Meier method. Mean onset times of pulpal anesthesia, soft tissue and lip numbness were analyzed with Log-Rank test. Comparisons were considered significant at P ≤0.05 by using SPSS software ver.15. Results: The incidence of pulpal anesthesia in the IANB group (canine 49.3%, premolar 60.3%) were not significantly different from the GG group (canine 41.3%, premolar 74.6%) ( P =0.200 and P =0.723). The success rate in the IANB group (80.82%) was not significantly different from the GG group (92.02%) ( P =0.123). Furthermore, onset time of lip and buccal soft tissue numbness in GG group (3.25, 4.96 minutes) was quite similar to IANB group (3.22, 4.89 minutes) (all P values >0.05). Conclusions: Although this study demonstrated higher clinical success rate for GG than IANB technique, no significant differences in success rates and onset time were observed between two techniques

Surface acoustic waves induced micropatterning of cells in gelatin methacryloyl (GelMA) hydrogels

Acoustic force patterning is an emerging technology that provides a platform to control the spatial location of cells in a rapid, accurate, yet contactless manner. However, very few studies have been reported on the usage of acoustic force patterning for the rapid arrangement of biological objects, such as cells, in a three-dimensional (3D) environment. In this study, we report on a bio-acoustic force patterning technique, which uses surface acoustic waves (SAWs) for the rapid arrangement of cells within an extracellular matrix-based hydrogel such as gelatin methacryloyl (GelMA). A proof-of-principle was achieved through both simulations and experiments based on the in-house fabricated piezoelectric SAW transducers, which enabled us to explore the effects of various parameters on the performance of the built construct. The SAWs were applied in a fashion that generated standing SAWs (SSAWs) on the substrate, the energy of which subsequently was transferred into the gel, creating a rapid, and contactless alignment of the cells (&lt;10 s, based on the experimental conditions). Following ultraviolet radiation induced photo-crosslinking of the cell encapsulated GelMA pre-polymer solution, the patterned cardiac cells readily spread after alignment in the GelMA hydrogel and demonstrated beating activity in 5–7 days. The described acoustic force assembly method can be utilized not only to control the spatial distribution of the cells inside a 3D construct, but can also preserve the viability and functionality of the patterned cells (e.g. beating rates of cardiac cells). This platform can be potentially employed in a diverse range of applications, whether it is for tissue engineering, in vitro cell studies, or creating 3D biomimetic tissue structures