Wellbeing, law, and marriage Recognition of Nikah in multicultural Britain and the Finnish welfare state

Peer reviewe

Efficacy of Decentralized CSS Clustering Model Over TWDP Fading Scenario

Cognitive Radio technology, which lowers spectrum scarcity, is a rapidly growing wireless communication technology. CR technology detects spectrum holes or unlicensed spectrums which primary users are not using and assigns it to secondary users. The dependability of the spectrum-sensing approach is significantly impacted from two of the most critical aspects, namely fading channels and neighboring wireless users. Users of non-cooperative spectrum sensing devices face numerous difficulties, including multipath fading, masked terminals, and shadowing. This problem can be solved using a cooperative- spectrum-sensing technique. For the user, CSS enables them to detect the spectrum by using a common receiver. It has also been divided into distributed CSS and centralized CSS. This article compares both ideas by using a set of rules to find out whether a licensed user exists or not. This thought was previously used to the conventional fading channels, such as the Rician, Rayleigh and the nakagami-m models. This work focused on D-CSS using clustering approach over TWDP fading channel using two-phase hard decision algorithms with the help of OR rule as well as AND rule. The evaluation of the proposed approaches clearly depicted that the sack of achieve a detection-probability of greater than 0.8; the values SNR varies between -14 dB to -8 dB. For all two-phase hard decision algorithms using proposed approach and CSS techniques, the detection probability is essentially identical while the value of signal to noise ratio is between -12 dB to -8dB. Throughout this work, we assess performance of cluster-based cooperative spectrum-sensing over TWDP channel with the previous findings of AWGN, Rayleigh, and wei-bull fading channels. The obtained simulation results show that OR-AND decision scheme enhanced the performance of the detector for the considered range of signal to noise ratios

Trying to get a piece of paper from City Hall? The availability, accessibility, and administration of the register office wedding

In principle, it is possible for a couple to get married in a register office in England or Wales for £127 (including the cost of giving notice and a certificate). In this article, we draw on empirical research to show how limited this option is in practice. Its availability is constrained by the scarcity of register offices limited slots for weddings, and the addition of other fees not provided for in the regulations. Its accessibility is often not obvious from local authorities’ websites, and the administration of such a wedding varies hugely, with some local authorities treating it as a no-frills legal procedure, and others regarding it as a significant ceremony that is incomplete without music or a reflective introductory speech by the superintendent registrar – even if the couple wanted neither. With significant numbers of couples having a register office wedding because the marriage ceremony they choose to have to reflect their beliefs is not legally binding, there is a need to address these issues of availability, accessibility and administration so that couples are not put off or discriminated against. Further research is also needed to explore how these issues impact those with limited means

Postpartum quality of life in Indian women after vaginal birth and cesarean section : a pilot study using the EQ-5D-5L descriptive system

Background: There has been little evaluation of the postpartum quality of life (QOL) of women in India and its association with the mode of birth. This study piloted the use of the generic EQ-5D-5L questionnaire to assess postpartum QOL experienced by rural Indian women. Methods: A convenience sample of rural women who gave birth in a health facility in Gujarat or Madhya Pradesh was recruited into this pilot study. QOL was measured during three interviews within 30days of birth using the EQ-5D-5L questionnaire. Patient-level quality-adjusted life days (QALDs) were estimated. Multivariate regression was used to adjust for selected baseline characteristics. Results: Forty-six women with cesarean section and 178 with vaginal birth from 17 public and private health facilities were studied. Postpartum QOL in both groups improved between interviews 1 and 3. Comparing between vaginal and cesarean births indicated that the vaginal birth group had a higher QOL (0-3 days postpartum: 0.28 vs. 0.57, 3-7 days postpartum: 0.59 vs. 0.81; P<0.001) and was more likely to report no or slight problems in 4 of 5 health dimensions (mobility, self-care, usual activities, painordiscomfort; P0.04) during interviews 1 and 2. Postpartum QOL converged, but still differed between groups by the time of interview 3 (21-30 days postpartum: 0.85 vs. 0.93; P<0.001). While most women reported no problems by the end of the first postpartum month, the difference in the ability to perform usual activities persisted (P=0.001). In result, fewer QALDs were attained by women in the cesarean section group between day 1 and day 21 postpartum (13.1 vs. 16.6 QALDs; P<0.001). Subgroup analysis showed that having had an episiotomy during vaginal birth was also associated with reduced QOL postpartum, but to a lesser extent than cesarean section. Similar results were obtained when adjusting for socioeconomic, pregnancy and birth characteristics, but postpartum QOL already ceased to be statistically different between groups before interview 3. Conclusions: Vaginal births, even with episiotomy, were associated with a higher postpartum QOL than cesarean births among the Indian women in our pilot study. Finding these expected results suggests that the EQ-5D-5L questionnaire is asuitable instrumentto assess postpartum QOL in Indian women

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic donor nephrectomy: A randomized controlled study

Background: Transversus abdominis plane (TAP) block is suitable for lower abdominal surgeries. Blind TAP block has many complications and uncertainty of its effects. Use of ultrasonography increases the safety and efficacy. This study was conducted to evaluate the analgesic efficacy of ultrasound (USG)-guided TAP block for retroperitoneoscopic donor nephrectomy (RDN). Methods: In a prospective randomized double-blind study, 60 patients undergoing laparoscopic donor nephrectomy were randomly divided into two groups by closed envelope method. At the end of surgery, USG-guided TAP block was given to the patients of both the groups. Study group (group S) received inj. Bupivacaine (0.375%), whereas control group (group C) received normal saline. Inj. Tramadol (1 mg/kg) was given as rescue analgesic at visual analog scale (VAS) more than 3 in any group at rest or on movement. The analgesic efficacy was judged by VAS both at rest and on movement, time to first dose of rescue analgesic, cumulative dose of tramadol, sedation score, and nausea score, which were also noted at 30 min, 2, 4, 6, 12, 18, and 24 h postoperatively. Total tramadol consumption at 24 h was also assessed. Results: Patients in group S had significantly lower VAS score, longer time to first dose of rescue analgesic (547.13±266.96 min vs. 49.17±24.95 min) and lower tramadol consumption (103.8±32.18 mg vs. 235.8±47.5 mg) in 24 h. Conclusion: The USG-guided TAP block is easy to perform and effective as a postoperative analgesic regimen in RDN, with opioids-sparing effect and without any complications

Does a dedicated Scoliosis Team and surgical standardization improve outcomes in adolescent idiopathic scoliosis surgery and is it reproducible?

PURPOSE: The objective of this study was to determine if standardization improves adolescent idiopathic scoliosis (AIS) surgery outcomes and whether it is transferrable between institutions. METHODS: A retrospective review was conducted of AIS patients operated between 2009 and 2021 at two institutions (IA and IB). Each institution consisted of a non-standardized (NST) and standardized group (ST). In 2015, surgeons changed institutions (IA- \u3e IB). Reproducibility was determined between institutions. Median and interquartile ranges (IQR), Kruskal-Wallis, and χ tests were used. RESULTS: 500 consecutive AIS patients were included. Age (p = 0.06), body mass index (p = 0.74), preoperative Cobb angle (p = 0.53), and levels fused (p = 0.94) were similar between institutions. IA-ST and IB-ST had lower blood loss (p \u3c 0.001) and shorter surgical time (p \u3c 0.001). IB-ST had significantly shorter hospital stay (p \u3c 0.001) and transfusion rate (p = 0.007) than IB-NST. Standardized protocols in IB-ST reduced costs by 18.7%, significantly lowering hospital costs from $74,794.05 in IB-NST to$60,778.60 for IB-ST (p \u3c 0.001). Annual analysis of surgical time revealed while implementation of standardized protocols decreased operative time within IA, when surgeons transitioned to IB, and upon standardization, IB operative time values decreased once again, and continued to decrease annually. Additions to standardized protocol in IB temporarily affected the operative time, before stabilizing. CONCLUSION: Surgeon-led standardized AIS approach and streamlined surgical steps improve outcomes and efficiency, is transferrable between institutions, and adjusts to additional protocol changes