Advancing Women, Changing Lives A Comprehensive Evaluation of the Gap Inc. P.A.C.E. Program

Globally the garment industry is one of the biggest employers of low-skilled women workers. Despite their large numbers in the workforce, relatively few female garment workers advance to higher-level positions as they have limited opportunities to acquire the skills that would enable their professional and personal growth. In response to this need, Gap Inc. initiated the P.A.C.E. (Personal Advancement & Career Enhancement) workplace education program to teach women the managerial, interpersonal, organizational and other practical skills needed to move forward in work and in life. This report summarizes findings from program evaluations conducted by ICRW from 2009 - 2013 at six factory sites where P.A.C.E. is implemented - two in India and one each in Cambodia, Vietnam, Bangladesh and China.Research findings from these robust, multi-country evaluations demonstrate that P.A.C.E. is an effective, sustainable and scalable model that yields high returns for women, their families and the businesses where they work

UNINTENTIONAL RAPID OPIOID DETOXIFICATION: CASE REPORT

Background: Naltrexone is a competitive opioid antagonist and is often used to maintain abstinence in detoxified opioid dependent patients. However, it can precipitate an accelerated withdrawal when ingested by an individual with concurrent opioid use. Methods: We report the case of a 28 year old male with opioid dependence syndrome presenting with chaotic symptoms following ingestion of naltrexone. Symptomatology, management is described and literature in this area is reviewed. Results: Accidental or surreptitious ingestion of naltrexone in a patient with concurrent opioid use can precipitate symptoms typical of opioid withdrawal in addition to other varying symptomatology. Most cases would require sedation and management of concurrent vomiting and diarrhoea. Conclusions: Clinicians, especially those providing substance abuse and emergency care, need to be aware of the possibility of an accelerated and possibly life threatening withdrawal associated with naltrexone ingestion in an incompletely detoxified patient with opioid dependence

A comprehensive review of new innovations in dental implant imaging techniques

Background: Over the past three decades, dentistry has undergone considerable development in all of its branches. The need for more accurate diagnostic methods have become inevitable with these progresses. Advanced imaging methods such as computed tomography, cone beam computed tomography, magnetic resonance imaging have also found space in modern dentistry from the traditional intra-oral periapical X-rays. Aim: This paper is intended to explore recent developments in imaging technology and its applications in various dental disciplines. Conclusion: The three - dimensional visualization has made the complex cranio-facial structures more available for analysis and early and precise diagnosis of deep rooted lesions. Clinical Significance: Moving from analog to digital radiography has not only made the process easier and quicker, but has also enabled image storage, manipulation (brightness/contrast, cropping of images, etc.) and recovery

Assessment of Soil Fertility Status in Rupani Rural Municipality, Saptari, Nepal

As soil fertility is one of the most important factors for soil productivity, soil fertility management is important for sustainable soil management. This study was conducted to determine the soil fertility status of Rupani Rural Municipality, Saptari, Nepal. A total of 60 soil samples were collected randomly from 0-30 cm depth. The exact location of the samples was recorded using a handheld GPS device. All collected samples were analyzed at a regional soil testing laboratory in Saptari to determine their pH, soil texture, nitrogen, phosphorus, potassium, and organic matter status. In addition, fertility status maps were prepared using ArcGIS 10.8 software. The study area consists mainly of 51.66% clay and 18.33% sandy loam soils. The soil pH ranged from highly acidic to slightly alkaline, with pH values ranging from 4.5 to 8.0. Soil organic matter (0.42-3.21%), nitrogen (0.02-0.16%), available phosphorus (40.1-282.35 kg P2O5/ha) and exchangeable potassium (64.8-729.6 kg K2O/ha) are present in the soil with the status of low to high in the study area. In order to improve crop potential and maintain soil nutrient status through the use of site-specific fertilizers, a reduction in the use of chemical fertilizers and various sustainable soil management practices were adopted. This research provides valuable information to policymakers, farmers, and agricultural stakeholders, facilitating evidence-based decision-making for agricultural development and food security in Rupani Rural Municipality, Saptari, Nepal

The melanocortin pathway and energy homeostasis: From discovery to obesity therapy.

BACKGROUND: Over the past 20 years, insights from human and mouse genetics have illuminated the central role of the brain leptin-melanocortin pathway in controlling mammalian food intake, with genetic disruption resulting in extreme obesity, and more subtle polymorphic variations influencing the population distribution of body weight. At the end of 2020, the U.S. Food and Drug Administration (FDA) approved setmelanotide, a melanocortin 4 receptor agonist, for use in individuals with severe obesity due to either pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency. SCOPE OF REVIEW: Herein, we chart the melanocortin pathway's history, explore its pharmacology, genetics, and physiology, and describe how a neuropeptidergic circuit became an important druggable obesity target. MAJOR CONCLUSIONS: Unravelling the genetics of the subset of severe obesity has revealed the importance of the melanocortin pathway in appetitive control; coupling this with studying the molecular pharmacology of compounds that bind melanocortin receptors has brought a new obesity drug to the market. This process provides a drug discovery template for complex disorders, which for setmelanotide took 25 years to transform from a single gene into an approved drug

The experience with repetitive transcranial magnetic stimulation as add-on treatment in the elderly with depression: A preliminary report

Background: Elderly depression is a fairly common and often difficult to treat condition. Elderly patients also often have comorbid medical conditions that preclude the use of other somatic treatment modalities. Repetitive transcranial magnetic stimulation (rTMS) is a treatment methodology that is approved to be used in depression and is supposed to have fewer side-effects. This paper describes the experience of a recently started rTMS service in a tertiary hospital in North India with referred elderly patients suffering from depression. Methods: Results of rTMS therapy administered to 7 elderly patients who were referred during this period are described. Results: Only one patient with bipolar depression perceived significant benefit from rTMS. Three patients complained of mild and transient side-effects, and one patient discontinued treatment due to his medical condition (unrelated to rTMS). Conclusions: rTMS seems to be safe and well-tolerated in this population. However, further experience is needed before commenting definitely on effectiveness of this treatment modality

Clinic-based group multi-professional education causes significant decline in psoriasis severity: A randomized open label pilot study

Background: The evidence for efficacy of psychoeducational interventions in psoriasis is not well researched. Objective: The objective of this study was to assess the benefits of a group, multi-professional, psychoeducational training in psoriasis. Materials and Methods: Adults with moderate-to-severe psoriasis were randomized into psychoeducational intervention plus treatment (intervention arm [IA]) and treatment as usual alone (control arm [CA]) groups using random number tables. The primary efficacy measures were mean changes in Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) at 6months from the end of intervention. The secondary efficacy measures were the mean changes in the WHO-5 well-being index (WHO-5) and the subsets of the patient health questionnaire (PHQ), namely, PHQ-9, generalized anxiety disorder (GAD)-7, andPHQ-15. Datawere analyzed by intention-to-treat analysis. Results: One-hundred and three participants were randomized into IA (n = 54) and CA (n = 49). The prevalence of psychiatric disorders in the entire population was 26.2% and was similar in both groups.Following intervention, there was statistically significant improvement in the mean scores in PASI, DLQI, and WHO-5 in the IA unlike that seen in the CA. There was statistically significant improvement in PHQ-9 scores in IA and CA. The scores on PHQ-15 and GAD-7 did not show any change. Intergroup comparisons showed that PASI was reduced significantly in IA as compared to CA. More participants in CA dropped out of the study than in the IA. Limitations: Modest sample size and lack of blinding of the participants and the administrators were the limitations of this study. Conclusion: Group psychoeducational intervention resulted in overall improvement in both clinical and psychological outcome measures in psoriasis patients

Immediate loading of bicortically engaged long implants in maxillary and mandibular esthetic region – A clinicoradiographic evaluation

Background: Bicortical engagement is the engagement of nasal cortical plate and basal cortical plate in maxillary and mandibular esthetic zone, respectively. These are longer implants which offer osseointegration along with high osseofixation. Increased length of implant provides increased bone–implant contact offering primary stability which permits immediate loading. Aim: The aim of the study was to clinicoradiographically evaluate immediate loading in bicortically engaged long implants in maxillary and mandibular esthetic region. Materials and Methods: Thirty patients with missing teeth in esthetic region were selected for the study. Implants were placed in both arches engaging nasal cortex and basal bone wherever required. One-time definitive abutment was placed and immediate loading was done. Results: No failure was observed in the study period of 9 months. The mean insertion and reverse torque was 66.67 ± 6.794 and 41.67 ± 3.101, respectively, indicating high primary stability. No pain, discomfort, infection, or implant mobility was observed. The mean crestal bone loss changes were statistically insignificant. Conclusion: Hundred percent implant survival was observed