Domestic vioknce often presents in health care settings, yet health care professionals sometimes miss obvious signs or fail to ask about abuse. Lack of training, the belief that domestic abuse is none of their business, and lack of system support are all reasons why domestic violence is often not identified. Clinicians may also have personal reasons for their lack of intervention, including lack of comfort with the topic or negative beliefs about women who are domestically abused. This chapter describes these barriers and offers practical steps clinicians can take to overcome them.Mrs. WT, a 32-year-old woman, presents to Dr. JK's office five months after her preterm delivery for a postpartum checkup with complaints of not feeling well and wanting a prescription to increase her energy. She is also requesting sleeping medicine and a referral for tubal ligation. Mrs. WT describes to Dr. JK that lately she has been feeling very tired and not able to get enough sleep with three kids and her husband's odd work schedule. She says she has to pay lots of attention to her sick premature son, Joey.
The study has been carried out in the North Gujarat region of Gujarat state, Western India which represents unique habitats from arid regions to dry deciduous forests with annual rainfall ranging from 25-125 cms. Humanwildlife conflicts are intensifying owing to increase in human population and destruction of wildlife habitats. In the present study we characterized and classif ied the conflicts, identif ied zones with acute conflicts and evaluated the economic loss to the local villagers due to such humanwildlife conflicts. Sampling methods mainly included village surveys for interviewing locals who are affected by wildlife damage. The information was overlaid on the existing digital land use data to identify landscape characteristics associated with wildlife occupancy in the region. The result depicts that 80% of total damage in seasonal crop is caused by wild ungulates. Wild animals like Blue bull, Wild boar and Porcupine are reported as a chief crop raider. The Leopard is the only big cat occurring in the region reported to cause human injury and livestock predation. Sloth bear attacks on human are very common in some part of the study area. Conflicts are more severe around unprotected forests while high intensity of conflicts was recorded on the fringes of the forests. Less compensation and delayed process of compensation by the government makes the local community more hostile towards the presence of wildlife in the area. Human-Wildlife Conflicts in
Cervical cancer is one of the leading causes of morbidity and mortality. It can be preventable and diagnosed early with adequate and repetitive cytological screening by pap test. The conventional cervical cytological screening is the most common technique used throughout the world. Objective: To characterize the age and pattern of Pap smear abnormalities in a population of Gujarat, India. Materials and Methods: A retrospective study was conducted at tertiary care hospital of Gujarat India. All previously collected pap smear from 2011 -2014 was evaluated for cytological pattern and during this duration total 1100 pap smear was evaluated. Results: The mean age of patients with abnormal smears was 37.5 years. The mean parity was 4.34. There were 46 (4.18%) unsatisfactory smears and 1054(95.82%) adequate smears. Atypical squamous cell of undetermined significance(ASCUS), low grade squamous intraepithelial lesion (LSIL), and high grade squamous intraepithelial lesion (HSIL) were reported in 69 (6.54%), 111(10.53%), and 55 (5.21%) women respectively. Atypical glandular cell and squamous cell carcinoma were reported in 10 (0.94%) and 5 (0.47%) respectively Conclusion: This study emphasized the importance of Pap smears screening for early detection of premalignant and malignant lesions of cervix. Pap smear testing is a very useful, simple, economical and safe tool to detect preinvasive cervical epithelial lesions. Hence, on a routine basis, every woman above the age of 30 must be subjected to Pap smear and this must be continued even in post-menopausal period as most of patients with epithelial abnormalities in our study falls in this group.
ObjectiveOur main goals were to assess the incidence of sleep problems in our patients and to improve the awareness of sleep disorders amongst our neurology clinicians. We hoped that our patients with significant sleeprelated symptoms would be referred for further objective testing. MethodsWe designed a 5-question sleep quality survey to be filled out by each patient seen in our outpatient neurology clinics. The forms were collected for entry and analysis on an Excel spreadsheet program. A response of 2 or 3 (moderate or high chance of having a symptom) for each of the questions 1-4 and a "yes" for question 5 were considered significant symptomology. We compared the incidence of sleep problems between the general clinic and the multiple sclerosis (MS) clinic. ResultsSurveys from 1008 patients were analyzed. A large majority (78%) of the neurology patients seen in our clinics was found to have at least one significant sleep related symptom. Most of these patients were not referred for further diagnostic testing by polysomnography (PSG) or for formal evaluation by a sleep clinic. ConclusionsOur data support a well-known notion that neurological patients have a high prevalence of symptoms related to sleep disorders. As neurologists, we ought to include sleep as one of the functions of the brain, and we need to be more diligent in the diagnosis of sleep disorders in our patients. Our future goals include verification of our data with objective evidence from PSG results or formal sleep evaluations.
<p>Technology has changed the way that young adults begin their careers. Exploring potential work opportunities is easier to do now than 20 years ago with the rise of technology. However, with the rise of job accessibility a number of challenges for young adults looking to get ahead have arisen. Work experience is crucial in making the transition from simply getting a job, to starting a career that will have meaning and impact. In contrast, technology has affected the way that small businesses survive, and then grow. It can be challenging for small businesses to grow with limited resources, in a competitive commercial environment. Small business owners in the start-up and growth phases in particular struggle, to fill the gaps in their capabilities with little time, money or the necessary skills and expertise. This research, in partnership with Accenture, explores the commercial potential of an innovative connection service. The proposed service will provide work experience opportunities for young adults that will drive small business growth. Research involved the application of lean start-up methodology and service design thinking principles across three phases; Phase One Market Development and Validation, Phase Two Service Development and Validation, and Phase Three Business Case Development. Phase One involved interviewing 20 young adults and 10 small business owners to identify the specific market segments that the service could benefit. Phase Two involved matching two pairs of suitable young adults and small businesses from Phase One, to trial the prototyped service solution. Phase Three involved conducting a retrospective focus group with the trial participants to understand thoughts and feelings about the service as potential customers. Findings from each research phase indicate that young adults and small businesses are suitable markets for the service and that the service concept is feasible. A major finding from Phase One was that certain characteristics improved the potential of some market segments for the proposed service over others. For young adults this meant having the necessary knowledge, skills and confidence to solve a small business problem. For small businesses those with zero employees in particular had suitable gaps to fill and were open to young adults helping them. In Phase Two, critical success factors were identified for the service, most significantly a key indicator of success for the relationship was understanding a person’s work purpose, culture and values. Phase Three found that the success of the match reflected on perception of service quality. It highlighted that young adults and small businesses preferred short term, meaningful engagements. Research findings led to recommendations of suitable development strategies and a proposed business model for the service. A key recommendation is to incorporate both lean start-up methodology and service design thinking as the main development strategy, for fast iteration with the customer at the centre of decisions made. It was also recommended that the service adopt a freemium marketplace business model where users are able to view potential jobs, at no cost but engage in the customised matching service on a subscription basis. The implementation and success of this service could ultimately change how young adults seek work experience and differentiate themselves in competitive job markets. For small businesses, the service could offer an affordable tool in seeking talent to overcome business shortcomings and ultimately achieving growth.</p>
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