"The colonizing wars against Native Americans created the template for anticommunist repression in the United States. Tariq D. Khan's analysis reveals bloodshed and class war as foundational aspects of capitalist domination and vital elements of the nation's long history of internal repression and social control. Khan shows how the state wielded the tactics, weapons, myths, and ideology refined in America's colonizing wars to repress anarchists, labor unions, and a host of others labeled as alien, multi-racial, multi-ethnic urban rabble. The ruling classes considered radicals of all stripes to be anticolonial insurgents. As Khan charts the decades of red scares that began in the 1840s, he reveals how capitalists and government used much-practiced counterinsurgency rhetoric and tactics against the movements they perceived and vilified as "anarchist." Original and boldly argued, The Republic Shall Be Kept Clean offers an enlightening new history with relevance for our own time"--
Motivated by the prospective uses of plastically compressible materials such as, metallic and polymeric foams, transformation toughened ceramics, toughened structural polymers etc., the present authors investigate the crack-tip radius effect on fatigue crack growth (FCG) of a mode I crack and near-tip stress-strain fields in such plastically compressible solids. These plastically compressible materials have been characterised by elastic-viscoplastic constitutive equations. Simulations are conducted for plane strain geometry with two different hardness functions: one is bilinear hardening and the other one is hardening-softening-hardening. It has been observed that plastic compressibility as well as strain softening lead to significant deviation in the amount of crack growth. It has further been revealed that the nature of FCG is appreciably affected by initial crack-tip radius. Even though it may look from outside that the increase in tip radius will lead to decrease in FCG, but the nature of FCG variation with respect to tip radius is found to be a combined effect of tip radius, plastic compressibility and work or strain softening etc.
BACKGROUND/AIMS—Landmines have long been used in conventional warfare. These are antipersonnel mines which continue to injure people long after a ceasefire without differentiating between friend or foe, soldier or civilian, women or children. This study focuses on Afghan non-combatants engaged in mine clearing operations in Afghanistan in the aftermath of the Russo-Afghan war. The patterns and types of injuries seen are described and experiences in their management, ways, and means to prevent them, and recommendations for the rehabilitation of the affected individuals are given. METHODS—It is a retrospective and analytical study of 84 patients aged 19-56 years who sustained mine blast injuries during mine clearing operations in Afghanistan from November 1992 to January 1996. The study was carried out at a military hospital with tertiary care facilities. The patients were divided into three groups on the basis of their injuries. Group 1 required only general surgical attention, group 2 sustained only ocular injuries, while group 3 had combined ocular and general injuries. Patients in groups 2 and 3 were treated in two phases. The first phase aimed at immediate restoration of the anatomy, while restoration of function wherever possible was done in subsequent surgical procedures in the second phase. RESULTS—It was observed that 51 out of 84 patients (60.7%) had sustained ocular trauma of a variable degree as a result of the blasts. The mean age of the victims was 29 years and they were all male. A total of 91 eyes of 51 patients (89.2%) had been damaged. Bilaterality of damage was seen in 40 (78.4%) patients. Most, 34 (37.3%), eyes became totally blind (NPL). Only a few escaped with injury mild enough not to impair vision. Foreign bodies, small and multiple, were found in the majority of eyes; most, however, were found in the anterior segment, and posterior segment injuries were proportionally less. CONCLUSIONS—The prevalence of blindness caused by mine blast injuries is quite high. The resulting psychosocial ...
Background. Integrated Child Development Services(ICDS) is an Indian community-centric government program organized under Anganwadi centres catering to supplementary nutrition, health andpreschooleducation, primary healthcare, growth monitoring and counselling the children under six years old along with their mothers. It is the world's largest outreach program in a developing country covering a population of 1.35 billion; the variations in service delivery were analysed involving cross-sectional rural and urban Anganwadi centers in New Delhi. Methods. Data were collected by assessment of children and mothers, interview of Anganwadi workers and observation of service delivery parameters and conduction of activities. Infrastructural, beneficiaries, services and content were evaluated by a suitable pre-tested questionnaire based on the National Institute of Public Cooperation and Child Development (NIPCCD) evaluation proforma. The data was analysed by a descriptive statistics. Results. Gaps were found in respect of infrastructure, resources, health and nutrition facilities especially at rural Anganwadi centre which was inadequate in terms of implementation of nutrition and health program, supplementary nutrition, preschool education and nutrition rehabilitation centre for existing beneficiaries. Both Anganwadi centres were not catering for new WHO growth standards and adolescent health. Conclusions. Gaps found in respect of infrastructure, resources, health and nutrition facilities can affect performance of ICDS program and the services delivered by Anganwadi centres, which need a boost. Both urban and rural centres have a direct opportunity towards delivering adolescent health program focusing on nutrition and education of girls prior to their pregnancy, and adoption of new WHO growth standards. ; Вступ. Об'єднані центри дитячого розвитку (ICDS) – це державна соціально-орієнтована програма у Індії під егідою Анганваді центрів, яка забезпечує додаткове харчування, санітарно-гігієнічну просвітницьку діяльність та дошкільну освіту, надання первинної медичної допомоги, моніторинг та консультування дітей віком до шести років разом з їхніми матерями. Це найбільша у світі за охопленням (коло 1,35 мільйонів населення) програма у країнах, які розвиваються. Мета роботи – проаналізувати діяльність Анганваді центрів у міській та сільській місцевостях Нью Делі. Методи. Дані збиралися шляхом опитування матерів та дітей і працівників Анганваді центрів, а також оцінки діяльності центрів. Опитувальники щодо інфраструктури, переваг та наданих центрами послуг базувалися на формі, запропонованій Національним інститутом громадського співробітництва та розвитку дітей. Дані аналізувалися за допомогою описової статистики. Результати. Були знайдені недосконалі моменти у роботі Анганваді центрів, особливо у сільській місцевості, а саме щодо термінів впровадження програм здорового харчування та дошкільної освіти та програм реабілітації. У обох центрах не було запроваджено нові стандарти ВООЗ. Висновки. Виявлені прогалини можуть вплинути на ефективність роботи об'єднаних центрів дитячого розвитку та якість послуг, які надаються у Анганваді центрах. Однак, як міські, так і сільські центри мають можливість здійснювати програми охорони здоров'я підлітків, зосереджуючись на харчуванні та вихованні дівчат до їх вагітності, а також прийняття нових стандартів ВООЗ.
Background. Integrated Child Development Services(ICDS) is an Indian community-centric government program organized under Anganwadi centres catering to supplementary nutrition, health andpreschooleducation, primary healthcare, growth monitoring and counselling the children under six years old along with their mothers. It is the world's largest outreach program in a developing country covering a population of 1.35 billion; the variations in service delivery were analysed involving cross-sectional rural and urban Anganwadi centers in New Delhi. Methods. Data were collected by assessment of children and mothers, interview of Anganwadi workers and observation of service delivery parameters and conduction of activities. Infrastructural, beneficiaries, services and content were evaluated by a suitable pre-tested questionnaire based on the National Institute of Public Cooperation and Child Development (NIPCCD) evaluation proforma. The data was analysed by a descriptive statistics. Results. Gaps were found in respect of infrastructure, resources, health and nutrition facilities especially at rural Anganwadi centre which was inadequate in terms of implementation of nutrition and health program, supplementary nutrition, preschool education and nutrition rehabilitation centre for existing beneficiaries. Both Anganwadi centres were not catering for new WHO growth standards and adolescent health. Conclusions. Gaps found in respect of infrastructure, resources, health and nutrition facilities can affect performance of ICDS program and the services delivered by Anganwadi centres, which need a boost. Both urban and rural centres have a direct opportunity towards delivering adolescent health program focusing on nutrition and education of girls prior to their pregnancy, and adoption of new WHO growth standards. ; Вступ. Об'єднані центри дитячого розвитку (ICDS) – це державна соціально-орієнтована програма у Індії під егідою Анганваді центрів, яка забезпечує додаткове харчування, санітарно-гігієнічну просвітницьку діяльність та дошкільну освіту, надання первинної медичної допомоги, моніторинг та консультування дітей віком до шести років разом з їхніми матерями. Це найбільша у світі за охопленням (коло 1,35 мільйонів населення) програма у країнах, які розвиваються. Мета роботи – проаналізувати діяльність Анганваді центрів у міській та сільській місцевостях Нью Делі. Методи. Дані збиралися шляхом опитування матерів та дітей і працівників Анганваді центрів, а також оцінки діяльності центрів. Опитувальники щодо інфраструктури, переваг та наданих центрами послуг базувалися на формі, запропонованій Національним інститутом громадського співробітництва та розвитку дітей. Дані аналізувалися за допомогою описової статистики. Результати. Були знайдені недосконалі моменти у роботі Анганваді центрів, особливо у сільській місцевості, а саме щодо термінів впровадження програм здорового харчування та дошкільної освіти та програм реабілітації. У обох центрах не було запроваджено нові стандарти ВООЗ. Висновки. Виявлені прогалини можуть вплинути на ефективність роботи об'єднаних центрів дитячого розвитку та якість послуг, які надаються у Анганваді центрах. Однак, як міські, так і сільські центри мають можливість здійснювати програми охорони здоров'я підлітків, зосереджуючись на харчуванні та вихованні дівчат до їх вагітності, а також прийняття нових стандартів ВООЗ.
Contemporary healthcare has progressed towards world health security through advancements in medication-based and surgical interventions, supported by the success of antimicrobial therapy. The emergence of panresistant infectious diseases is becoming a public health problem worldwide. Panresistance is attributable to a complex interplay of antimicrobial overuse in healthcare facilities due to lack of regulatory commitment in the backdrop of natural mutations in pathogens and rise in immunocompromised hosts. Developing countries are facing the brunt in epidemic proportions due to strained public health infrastructure and limited resource allocation to healthcare. Panresistance is a biological, behavioural, technical, economic, regulatory and educational problem of global concern and combating it will require concerted efforts to preserve the efficacy of the available antimicrobials. An intensified commitment needs to be taken up on a war footing to increase awareness in the society, increase laboratory capacity, facilitate antimicrobial research, foster emphasis on infection control and antimicrobial stewardship, and legislation on manufacturing, marketing and dispensing of antimicrobials.
Contemporary healthcare has progressed towards world health security through advancements in medication-based and surgical interventions, supported by the success of antimicrobial therapy. The emergence of panresistant infectious diseases is becoming a public health problem worldwide. Panresistance is attributable to a complex interplay of antimicrobial overuse in healthcare facilities due to lack of regulatory commitment in the backdrop of natural mutations in pathogens and rise in immunocompromised hosts. Developing countries are facing the brunt in epidemic proportions due to strained public health infrastructure and limited resource allocation to healthcare. Panresistance is a biological, behavioural, technical, economic, regulatory and educational problem of global concern and combating it will require concerted efforts to preserve the efficacy of the available antimicrobials. An intensified commitment needs to be taken up on a war footing to increase awareness in the society, increase laboratory capacity, facilitate antimicrobial research, foster emphasis on infection control and antimicrobial stewardship, and legislation on manufacturing, marketing and dispensing of antimicrobials.
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.