Suchergebnisse

This article examines Pakistan State's ruling practices in Lower Dir, a peripheral region. It argues that this peripheral region was ruled by a colonial logic of governmentality. Through a "thick" ethnography of Lower Dir, I documented the militarized and fragmented state practices that Tsing refers to as the "sticky materiality of practical encounters" of the local people with the state apparatuses. The study collected data through anthropological methods such as mobile ethnography at checkpoints, casual conversations with locals, and firsthand observations of state ruling practices in the region. This article concludes that it is the Pakistan state's strategic interest that keeps the region out of the mainstream, and its security status is now even more important for Pakistan state following the Taliban's takeover of Kabul in August 2021.

Introduction: Erythropoietin (EPO) has acute hemodynamic and anti-inflammatory effects in addition to its erythropoietic action. We tested the hypothesis that recombinant human EPO (rHuEPO) given at the time of resuscitation with normal saline (NS) or lactated Ringer's (LR) will improve capillary perfusion and tissue bioenergetics in a hemorrhagic shock and resuscitation (HS/R) rat model. Methods: Anesthetized rats' ileal muscular layer was prepared for intra-vital microscopy. The rats were hemorrhaged 30 millitres per kilogram over 10 minutes with uncontrolled mean arterial pressure for 50 minutes. They were then randomized to one of four groups (NS, NS + rHuEPO, LR, and LR + rHuEPO; n = 6/group) and underwent a 60-minute resuscitation period. Intravenous rHuEPO (1,000 U/kg) was given at the start of fluid resuscitation. Gut microcirculation and nicotinamide adenine dinucleotide dehydrogenase (NADH) fluorescence were recorded for off-line analysis at baseline, 50 minutes of shock, and 60 minutes of resuscitation. In a separate HS/R experiment ( n = 10/group), gut permeability to fluorescein isothiocyanate dextran and endotoxin levels, tissue damage, and portal vein blood levels of interleukin (IL)-6 and tumour necrosis factor (TNF) were examined. Results: LR alone demonstrated better gut microcirculation and decreased gut injury than NS alone. NS + rHuEPO, compared with NS alone, improved functional capillary density (22.9 ± 0.6 Cap/mm and 20.2 ± 1.0 Cap/mm, respectively; p < 0.01), red blood cell flow scores (2.1 ± 0.2 and 1.3 ± 0.2, respectively; p < 0.01), and tissue NADH fluorescence (54.5 ± 0.3% and 59.7 ± 0.8%, respectively; p < 0.01). Compared with LR, LR + rHuEPO did not result in significant improvement in microcirculation. Adding rHuEPO to NS improved gut permeability, inflammatory mediators (IL-6, TNF), and tissue injury, but adding it to LR did not. Discussion: LR improved tissue microcirculation, decreased permeability to macromolecules, and reduced mucosal injury in the ileum compared with NS alone. The beneficial effects of rHuEPO administration were mostly observed in the NS resuscitation group.

Abstract

Aim
To survey the use of alcohol, and its correlates by mental health professions in China, a nation where there is rapid increase in alcohol consumption and problems.


Methods
As a part of a large-scale, nation-wide online survey of healthcare professionals, we collected demographic variables and other health-related variables anonymously. The Alcohol Use Disorder Identification Test-Concise (AUDIT-C) was used to collect data on alcohol use.


Results
13,980 mental health professionals completed the survey (4382 doctors, 9339 nurses and 259 clinical psychologists), representing 64% of the total targeted. Respondents were predominantly female (75.1%). Alcohol consumption was reported by 41.8% of participants (by 53.9% of doctors, 36.2% of nurses and 40.5% of clinical psychologists). Based on the cut-off scores of the AUDIT-C (≥3 for women and ≥4 for men), 7.5% were classified as probable alcohol misusers in the past year, and the rates were 10.2% in doctors, 6.3% in nurses and 5.8% in clinical psychologists. Multiple logistic regression showed that male sex (OR = 3.772; CI = 3.206–4.439), being a doctor (OR = 1.259; CI = 1.052–1.506), being divorced or widowed (OR = 1.979; CI = 1.467–2.666), having an associate degree or less (OR = 1.809; CI = 1.040–3.147), working in Northeast China (OR = 1.538; CI = 1.281–1.848) and the habit of smoking (OR = 3.345; CI = 2.280–3.967) were significantly associated with alcohol misuse.


Conclusions
Alcohol use and misuse were relatively common among mental health professionals in China, and male sex, being a doctor, with lower education, working in Northeast China and cigarette smoking were significant associations. Awareness and interventions are recommended to promote healthier use of alcohol in this professional group, especially among risk subgroups.