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BACKGROUND: Sexual abuse is a global concern among children with intellectual disabilities. Sexual abuse is frequent and long-lasting when the victim is a child with an intellectual disability. Moreover, the rate of sexual abuse is two to eight times the rate in the general population. OBJECTIVE: This study aimed to investigate the knowledge of sexual abuse and resistance ability among children with intellectual disabilities. PARTICIPANTS AND SETTING: The study was conducted among 120 children with mild or moderate intellectual disabilities attending twelve schools for specific purposes. METHODS: We adopted a cross-sectional design to assess knowledge and resistance ability. Personal Safety Questionnaire and Modified What If Situation Test were administered verbally during individual interviews. Institutional Ethics Committee approved our study. RESULTS: Current study suggests that children with intellectual disabilities have average knowledge (M = 6.6, SD = 1.6) regarding sexual abuse. More than 90 % of children demonstrated poor reporting skills. Although children exhibited good knowledge in differentiating appropriate from inappropriate touch requests, most children reported they would not disclose this incident to anyone. CONCLUSIONS: This study strongly suggests the need for a structured training program for children with intellectual disabilities to prevent sexual abuse.
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Discapacidad Intelectual , Delitos Sexuales , Humanos , Niño , Estudios Transversales , Encuestas y CuestionariosRESUMEN
Zoonosis-based epidemics are inevitable unless we revisit our relationship with the natural world, protect habitats, and regulate wildlife trade, including live animals and non-sustenance products. To prevent future zoonoses, governments must establish effective legislation addressing wildlife trade, protection of habitats, and reduction of the wildlife-livestock-human interface.
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Animales Salvajes , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Animales , Betacoronavirus , COVID-19 , Humanos , SARS-CoV-2 , Zoonosis/epidemiologíaRESUMEN
Sequestration of plastics in sediments is considered the ultimate sink of marine plastic pollution that would justify unexpectedly low loads found in surface waters. Here, we demonstrate that mangroves, generally supporting high sediment accretion rates, efficiently sequester plastics in their sediments. To this end, we extracted microplastics from dated sediment cores of the Red Sea and Arabian Gulf mangrove (Avicennia marina) forests along the Saudi Arabian coast. We found that microplastics <0.5 mm dominated in mangrove sediments, helping explain their scarcity, in surface waters. We estimate that 50 ± 30 and 110 ± 80 metric tons of plastic may have been buried since the 1930s in mangrove sediments across the Red Sea and the Arabian Gulf, respectively. We observed an exponential increase in the plastic burial rate (8.5 ± 1.2% year-1) since the 1950s in line with the global plastic production increase, confirming mangrove sediments as long-term sinks for plastics.
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This study was conducted to analyse the clinical characteristics of measles in infants and to compare them with those in older children. Clinical and sociodemographic details of all hospitalised children with suspected measles were recorded and confirmed cases were analysed further. Twenty-four infants and 34 children aged >1 year were included. Most infants were boys and 15 (62.5%) of them were aged <9 months. Early onset of rash (within three days of fever in 62.5% of cases) occurred in infants. The complications of measles in infants included bronchopneumonia (n = 17, 71%), acute diarrhoea (n = 8, 33%), meningitis (n = 1, 4%) and staphylococcal sepsis (n = 2, 8%). The number of infants with complications was significantly high (88% and 65%; P = 0.05). Measles in infants can have atypical presentations, a greater risk for complications and may occur before they are due to receive the conventional first dose of measles vaccine.
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Sarampión/epidemiología , Bronconeumonía/etiología , Niño , Preescolar , Diarrea/etiología , Femenino , Fiebre/etiología , Humanos , India/epidemiología , Lactante , Masculino , Sarampión/complicaciones , Vacuna Antisarampión , Estudios RetrospectivosRESUMEN
BACKGROUND: Estimates of psychiatric morbidity in the community will help service development. Participation of trained nonspecialist health-care providers will facilitate scaling up of services in resource-limited settings. AIMS: This study aimed to estimate the prevalence of priority mental health problems in populations served by the District Mental Health Program (DMHP). SETTINGS AND DESIGN: This is a population-based cross-sectional survey. MATERIALS AND METHODS: We did stratified cluster sampling of households in five districts of Kerala. Trained Accredited Social Health Activists (ASHAs) identified people who had symptoms suggestive of schizophrenia or bipolar disorder. Clinicians evaluated the information collected by the ASHAs and designated individuals as probable cases of psychosis or noncases. Screening instruments such as General Health Questionnaire-12, CAGE questionnaire, and Everyday Abilities Scale for India were used for identifying common mental disorders (CMDs), clinically significant alcohol-related problems, and functional impairment. RESULTS: We found 12.43% of the adult population affected by mental health conditions. We found CMD as most common with a prevalence of 9%. The prevalence of psychosis was 0.71%, clinically significant alcohol-related problems was 1.46%, and dementia and other cognitive impairments was 1.26%. We found informant-based case finding to be useful in the identification of psychosis. CONCLUSIONS: Mental health problems are common. Nonspecialist health-care providers can be trained to identify psychiatric morbidity in the community. Their participation will help in narrowing the treatment gap. Embedding operational research to DMHP will make scaling up more efficient.
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The present study evaluated the perceptions and practice of 92 final year pediatric residents with regard to breaking bad news. Only 16% of residents had received any training in communication skills. Majority (65%) of the residents were not comfortable while breaking bad news.
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Actitud del Personal de Salud , Revelación , Pediatras/psicología , Pediatras/estadística & datos numéricos , Humanos , Relaciones Médico-Paciente , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To study the clinical characteristics and predictors of mortality from snake bite envenomation in children. DESIGN: Prospective observational study with a one-group cohort design. SETTING: Paediatric intensive care unit of a tertiary care hospital in South India. SUBJECTS: The study cohort consisted of 145 children (55 girls and 90 boys) <12â years of age with snake bite envenomation. METHODS: Demographic and clinical details were recorded in a semistructured pro forma. Children were treated with polyvalent antisnake venom (ASV) as per WHO protocol. Details of treatment, complications and outcomes were recorded. Univariate analysis was done to identify statistical significance, and those variables found to be significant were analysed using binary logistic regression. RESULTS: Russell's viper was the most common offending snake followed by hump-nosed pit viper. Features of haemotoxicity, neurotoxicity and combined haemotoxicity and neurotoxicity occurred in 68 (47%), 39 (26.9%) and 9 (6%) children, respectively. Acute kidney injury (AKI) occurred in 36 (25%) children. The mortality rate was 10.3%. On univariate analysis, nocturnal bites, severe leucocytosis on day 1, AKI, capillary leak syndrome and a need for more than 20 vials of ASV were significantly associated with mortality. On multivariate analysis, only severe leucocytosis on day 1 (OR 35.29; 95% CI 1.37 to 911.89) and AKI (OR 35.05 95% CI 1.74 to 706.93) were found to be independent predictors of mortality. CONCLUSIONS: This study has identified two hitherto unrecognised risk factors-severe leucocytosis on day 1 and capillary leak syndrome. These findings need to be taken into consideration when planning management strategies for snake bite envenomation in children.
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Antivenenos/administración & dosificación , Mordeduras de Serpientes/mortalidad , Lesión Renal Aguda/etiología , Lesión Renal Aguda/mortalidad , Animales , Antivenenos/uso terapéutico , Síndrome de Fuga Capilar/etiología , Síndrome de Fuga Capilar/mortalidad , Niño , Preescolar , Esquema de Medicación , Femenino , Humanos , India/epidemiología , Lactante , Unidades de Cuidado Intensivo Pediátrico , Leucocitosis/etiología , Leucocitosis/mortalidad , Masculino , Pronóstico , Daboia , Mordeduras de Serpientes/complicaciones , Mordeduras de Serpientes/terapia , ViperidaeRESUMEN
Potentially carcinogenic compounds may cause cancer through direct DNA damage or through indirect cellular or physiological effects. To study possible carcinogens, the fields of endocrinology, genetics, epigenetics, medicine, environmental health, toxicology, pharmacology and oncology must be considered. Disruptive chemicals may also contribute to multiple stages of tumor development through effects on the tumor microenvironment. In turn, the tumor microenvironment consists of a complex interaction among blood vessels that feed the tumor, the extracellular matrix that provides structural and biochemical support, signaling molecules that send messages and soluble factors such as cytokines. The tumor microenvironment also consists of many host cellular effectors including multipotent stromal cells/mesenchymal stem cells, fibroblasts, endothelial cell precursors, antigen-presenting cells, lymphocytes and innate immune cells. Carcinogens can influence the tumor microenvironment through effects on epithelial cells, the most common origin of cancer, as well as on stromal cells, extracellular matrix components and immune cells. Here, we review how environmental exposures can perturb the tumor microenvironment. We suggest a role for disrupting chemicals such as nickel chloride, Bisphenol A, butyltins, methylmercury and paraquat as well as more traditional carcinogens, such as radiation, and pharmaceuticals, such as diabetes medications, in the disruption of the tumor microenvironment. Further studies interrogating the role of chemicals and their mixtures in dose-dependent effects on the tumor microenvironment could have important general mechanistic implications for the etiology and prevention of tumorigenesis.
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Exposición a Riesgos Ambientales/efectos adversos , Sustancias Peligrosas/efectos adversos , Microambiente Tumoral/efectos de los fármacos , Animales , Carcinogénesis/inducido químicamente , Humanos , Neoplasias/inducido químicamenteRESUMEN
OBJECTIVE: To study the prevalence and spectrum of sexual abuse among adolescents in Kerala, South India. METHODS: A self- report survey was conducted among adolescents in the 15-19 y age group, studying in the plus one and plus two classes in selected schools. RESULTS: Of the 1614 respondents (688 boys and 926 girls), 36 % of boys and 35 % of girls had experienced sexual abuse at some point during their lifetime. Most instances were sexual advances while using public transport. Feelings of insecurity and isolation at home, of being disliked by parents and of being depressed were significantly more in adolescents who had experienced sexual abuse, compared to those who had not. CONCLUSIONS: Sexual abuse is widely prevalent and both boys and girls are equally susceptible. There is a need to evolve strategies to protect children from sexual abuse and the programmes should address both boys and girls.
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Delitos Sexuales/estadística & datos numéricos , Adolescente , Femenino , Humanos , India/epidemiología , Masculino , Prevalencia , Psicología del Adolescente , Adulto JovenRESUMEN
Studies of DNA translocation through graphene nanopores have revealed their potential for DNA sequencing. Here we report a study of protein translocation through chemically modified graphene nanopores. A transmission electron microscope (TEM) was used to cut nanopores with diameters between 5 and 20 nm in multilayer graphene prepared by chemical vapor deposition (CVD). After oxygen plasma treatment, the dependence of the measured ionic current on salt concentration and pH was consistent with a small surface charge induced by the formation of carboxyl groups. While translocation of gold nanoparticles (10 nm) was readily detected through such treated pores of a larger diameter, translocation of the protein ferritin was not observed either for oxygen plasma treated pores, or for pores modified with mercaptohexadecanoic acid. Ferritin translocation events were reliably observed after the pores were modified with the phospholipid-PEG (DPPE-PEG750) amphiphile. The ion current signature of translocation events was complex, suggesting that a series of interactions between the protein and pores occurs during the process.
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Grafito/química , Nanoporos , Transporte de Proteínas , Animales , Bovinos , Ferritinas/química , Oro/química , Caballos , Concentración de Iones de Hidrógeno , Nanopartículas del Metal/química , Microscopía Electrónica de Transmisión , Oxígeno/química , Fosfatidiletanolaminas/química , Fosfolípidos/química , Polietilenglicoles/química , Sales (Química)/química , Albúmina Sérica Bovina/química , Propiedades de SuperficieRESUMEN
AIM: To identify the risk factors for scholastic backwardness in children. PARTICIPANTS: Children in the 6-12 year age group attending regular schools and referred to the child guidance clinic for scholastic backwardness. SETTING: Tertiary care hospital in South India. METHODS: Participants were compared with an age-and sex- matched group of children with good academic performance, to ascertain risk factors for scholastic backwardness. RESULTS: There were 75 boys and 35 girls in the study group. Among them 30 (27%) children had mental retardation, 39 (36%) had borderline intelligence and 12 (11%) had microcephaly. Undernutrition was noted in 36 (33%) children and 31 (28%) had stunted growth. 28 (26%) children had a history of chronic medical problems like epilepsy, bronchial asthma and congenital heart diseases. Visual, hearing and speech defects were present in 6 (6%), 5 (5%) and 12 (11%) children, respectively. Statistically significant differences were noted in the educational level and employment status of parents of children with scholastic backwardness and those with good academic performance. CONCLUSIONS: Social and family factors have a significant influence on the academic functioning of children.
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Discapacidades para el Aprendizaje/etiología , Niño , Femenino , Humanos , Masculino , Estudios Prospectivos , Factores de Riesgo , Factores SocioeconómicosRESUMEN
We have fabricated porous membranes using a parylene encapsulated vertically aligned forest of multi-walled carbon nanotubes (MWCNTs, about 7 nm inner diameter). The transport of charged particles in electrolyte through these membranes was studied by applying electric field and pressure. Under an electric field in the range of 4.4 × 10(4) V m(-1), electrophoresis instead of electroomosis is found to be the main mechanism for ion transport. Small molecules and 5 nm gold nanoparticles can be driven through the membranes by an electric field. However, small biomolecules, like DNA oligomers, cannot. Due to the weak electric driving force, the interactions between charged particles and the hydrophobic CNT inner surface play important roles in the transport, leading to enhanced selectivity for small molecules. Simple chemical modification on the CNT ends also induces an obvious effect on the translocation of single strand DNA oligomers and gold nanoparticles under a modest pressure (<294 Pa).
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Iones/química , Nanotubos de Carbono/química , Polímeros/química , Xilenos/química , ADN/química , Electrólitos/química , Electroforesis/instrumentación , Diseño de Equipo , Oro/química , Nanopartículas/química , Nanotubos de Carbono/ultraestructura , Tamaño de la Partícula , Porosidad , PresiónRESUMEN
The 1991 Gulf oil spill heavily impacted the coastal areas of the Saudi waters of the Arabian Gulf and recent studies have indicated that even 15 years after the incident, macrobenthos had not completely recovered in the sheltered bays in the affected region such as, Manifa Bay. This study investigates the community conditions of macrobenthos in the open waters in one of the impacted areas, Al-Khafji waters, about 14 years after the spill. Diversity measures and community structure analyses indicate a healthy status of polychaete communities. The BOPA index reveals that oil sensitive amphipods were recolonized in the study area. This confirms that the benthic communities of the oil spill impacted area had taken only <14 years to recover in the open waters of the impacted areas. The study also reveals the existence of three distinct polychaete communities along the depth and sediment gradients.
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Ecosistema , Sedimentos Geológicos/análisis , Contaminación por Petróleo , Anfípodos/fisiología , Animales , Bahías/análisis , Biodiversidad , Poliquetos/fisiología , Arabia SauditaRESUMEN
A survey on the Partially Extracted Trace Metals (PETMs) concentration (Fe, Mn, Cr, Cu, Ni, Co, Pb, Zn, Cd) in beach sediments is reported for the first time from 57 different locations in Chennai Metropolitan City of Southeast coast of India. The concentration of PETMs suggests that they are mainly concentrated with organic matter in the crowded part of the industrial regions in the beaches from the northern part rather than the tourist beaches in the southern part of the city. The comparison on enrichment of trace metals indicates higher values of Pb, Ni in the beaches than lowest effect level (LEL) and effects range low (ERL) than the tourist beaches.
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Playas , Monitoreo del Ambiente/estadística & datos numéricos , Contaminantes Ambientales/análisis , Sedimentos Geológicos/análisis , Metales Pesados/análisis , Recolección de Datos , Monitoreo del Ambiente/métodos , IndiaRESUMEN
Shallow water bays located in the western Arabian Gulf experience harsh environmental conditions. Some of these bays, including Manifa-Tanajib Bay System (MTBS), were also exposed to the 1991 oil pollution event. This study investigates the status of the macrobenthos in MTBS during 2006. This bay system is characterized by very shallow inner bays with elevated salinity and temperature compared to the rest of the bay area. As a result mainly of the hyper salinity, the inner bay communities are distinct from the outer bay communities. Overall, fairly high species richness with several rare species was observed. High Shannon-Wiener diversity values and ABC plots indicated the healthy status of the polychaete communities, while BOPA index indicated slightly polluted status in 20% of the stations. The oil sensitive amphipods were not completely re-colonized in 20% of the stations, even after 15 years of recovery from the 1991 oil spill.
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Organismos Acuáticos/crecimiento & desarrollo , Biodiversidad , Monitoreo del Ambiente/métodos , Invertebrados/crecimiento & desarrollo , Animales , Organismos Acuáticos/clasificación , Sedimentos Geológicos/química , Invertebrados/clasificación , Océanos y Mares , Poliquetos/clasificación , Poliquetos/crecimiento & desarrollo , Arabia Saudita , Agua de Mar/química , Algas Marinas/clasificación , Algas Marinas/crecimiento & desarrollo , Contaminación Química del Agua/análisis , Contaminación Química del Agua/estadística & datos numéricosRESUMEN
OBJECTIVE: To assess the effectiveness of a structured communication skills training workshop on the perceptions and practice of pediatric residents. METHODS: The perceptions and practice of pediatric residents with regard to doctor- patient (parent) communication were evaluated before and 6 weeks after a communication skills training workshop, using a structured questionnaire. RESULTS: Twenty pediatric residents participated in the study. They included nine residents who had completed 1 year of pediatric training and 11 residents who had completed 2 years or more of pediatric training. 9 were female residents and 11 were males. Before the intervention, majority of the residents rated themselves poorly on assessment of their perceptions and practice of communication skills. After the workshop there was overall improvement in the communication skills of the residents. CONCLUSIONS: Communication skills of pediatric residents are generally inadequate. Structured training programs will help to improve their communication skills. There is a need to incorporate communication skills training in the pediatric postgraduate curriculum.