Awareness of the Termination of Pregnancy Act of the Laws of Zambia among Women of Reproductive Age at Kanyama First Level Hospital in Lusaka District Zambia

Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.

Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis: A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).

Occupational therapy's role in promoting the“Learn the Signs.Act Early.”developmental monitoring program to public health employees

Background:Occupational therapists can play a key role in early identifica-tion of delay at the population health level by providing education to public health employees on how to implement developmental monitoring with caregivers of children birth to age 5.Methods:A pretest posttest design was utilized to assess the online education and training that was provided to Department of Public Health employees(N=339),including Head Start,Special Supplemental Nutrition Program for Women,Infants and Children,Home Visiting,and Early Intervention.Results:Analysis of pretest‐posttest survey data showed significant results for all 12 key learning outcomes.Six out of 12 outcomes were found to have a large effect size(d>0.8),4 outcomes indicated a medium effect size(d>0.5),and 2 outcomes had a small effect size(d>0.2).Participants gained knowledge of the“Learn the Signs.Act Early.”(LTSAE)developmental monitoring program,the difference between developmental monitoring and screening,the state's referral system and age‐appropriate parental engagement activities through knowledge of child development.Conclusions:Occupational therapists are child development specialists who can provide education on developmental monitoring and activities for parental engagement.The online course proved to be an effective platform to promote LTSAE within state agencies.

Meaning and the Theory of Speech Acts

According to J.L.Austin and J.R.Searle Speech Act Theory,many actions can actually be performed with words that is to say an important part of the meaning of an utterance is what that utterance does.Language is not only used to inform or describe things,it is often used to "do things".The utterances are of three kinds of acts:Locutionary Act,Illocutionary Act,and Perlocutionary Act which are performed simultaneously.Through the study,we see that speech can be far beyond the level of language system.

Coherence inThe Star Child from Speech Act Metonymic Perspective

Based on Thornburg and Panther's theory of speech act metonymy,the paper analyzes the speech act in Wilde's fairy tale——"The Star Child".It proposes any component in the action scenario can stand for the whole scenario,and it helps save energy both for encoding and decoding during communication,and understand the coherence in a discourse.

心房颤动患者射频消融术中首剂肝素ACT预测模型构建

目的:建立并验证心房颤动患者射频消融术中给予首剂肝素30 min后测得活化凝血时间(activated clotting time,ACT)(30 min-ACT)的列线图预测模型。方法:选择2020年1月—2022年12月于南京医科大学第一附属医院心内科导管室行导管射频消融治疗、非瓣膜性心房颤动患者1 090例,以3∶1比例随机分为训练集和测试集,对两组各项指标进行Kruskal-Wallis检验、卡方检验比较其基线特征。通过LASSO回归及单因素、多因素线性回归分析影响30 min-ACT的因素,据此建立心房颤动患者射频消融术中30 min-ACT的预测模型并评估其预测效果。结果:多因素结果分析提示卒中史、华法林、血小板计数、凝血酶原时间、基础ACT、基础ACT^(2)、首剂肝素剂量是房颤患者射频消融术中首剂肝素ACT的独立预测因素,据此构建的列线图预测模型预测具有一定的准确度(训练集65.9%,测试集74.6%)和较高的灵敏度(训练集77.4%,测试集83.0%)。结论:根据卒中史、华法林、血小板计数、凝血酶原时间、基础ACT、基础ACT^(2)、首剂肝素剂量构建的30 min-ACT列线图模型可以预测心房颤动患者射频消融术中首剂肝素的抗凝效果,对临床工作具有一定指导作用。

A Review of Indirect Speech Acts in Speech Act Theory

The theory of indirect speech acts proposed by John Searle is a problematic issue in speech act theory. The theory is subject to various criticisms.This essay reviews various arguments and the significant problems with reference to the indirect speech acts. The review includes some important concepts of speech act theory which are related to indirect speech acts; inference theory and idiom theory which underline indirect speech acts and their major problems in accounting for indirect speech acts.

A Brief Account of Vague Language in Advertising Based on Speech Act Theory

In the modern world, advertising plays an important role in commercial field and permeates in all aspects of our daily life. While due to the utilitarian essen ce of advertising, audience may have resistance or This thesis objects at vague language examples in advertisements, use Austin and Searle ' s speech act theory as anal yzing tool to make classification, comparation and analysis of the materials.

Subtitle Translation of Puns in English Sitcoms from the Perspective of Speech Act Theory——A Case Study of Mind Your Language

Puns always play a vital role in sitcoms in order to create humor or ironies.Sometimes good translations of puns can decide whether target language audiences are able to obtain the equal understandings and reactions of the sitcoms as source language audiences get.Nevertheless,it is not easy for many translators to render faithfully and smoothly some English puns into Chinese.Therefore,this paper will analyze the subtitle translation of puns in the British sitcom Mind Your Language from the perspective of Speech Act Theory so as to find out some useful and helpful strategies for translation of puns in subtitling.

基于ACT反馈的延续性护理对老年间质性肺炎患者治疗依从性的影响评价

分析以ACT反馈为基础的延续性护理模式,对老年间质性肺炎患者的影响价值。方法 从2022年7月开始,截至2023年7月,本院总计选入老年间质性肺炎患者60例,经抽签法进行两组均分。30例对照组实施基础护理,30例研究组实施基于ACT反馈的延续性护理。比较两组护理后肺功能水平、临床恢复结果、生活质量以及总依从率。结果 研究组各肺功能结果、生活质量评分高于对照组;恢复时间短于对照组;总依从率高于对照组,差异有统计学意义(P<0.05)。结论 老年间质性肺炎患者,进行基于ACT反馈的延续性护理,可提升生活质量和依从性,稳定肺功能水平。

Predictive factors associated with hepatitis C antiviral therapy response

Hepatitis C virus(HCV) infection may lead to significant liver injury, and viral, environmental, host, immunologic and genetic factors may contribute to the differences in the disease expression and treatment response. In the early 2000 s, dual therapy using a combinationof pegylated interferon plus ribavirin(PR) became the standard of care for HCV treatment. In this PR era, predictive factors of therapy response related to virus and host have been identified. In 2010/2011, therapeutic regimens for HCV genotype 1 patients were modified, and the addition of NS3/4a protease inhibitors(boceprevir or telaprevir) to dual therapy increased the effectiveness and chances of sustained virologic response(SVR). Nevertheless, the first-generation triple therapy is associated with many adverse events, some of which are serious and associated with death, particularly in cirrhotic patients. This led to the need to identify viral and host predictive factors that might influence the SVR rate to triple therapy and avoid unnecessary exposure to these drugs. Over the past four years, hepatitis C treatment has been rapidly changing with the development of new therapies and other developments. Currently, with the more recent generations of pangenotipic antiviral therapies, there have been higher sustained virologic rates, and prognostic factors may not have the same importance and strength as before. Nonetheless, some variables may still be consistent with the low rates of non-response with regimens that include sofosbuvir, daclatasvir and ledipasvir. In this manuscript, we review the predictive factors of therapy response across the different treatment regimens over the last decade including the new antiviral drugs.

Future of liver disease in the era of direct acting antivirals for the treatment of hepatitis C

Hepatitis C virus(HCV) infection has been a global health problem for decades, due to the high number of infected people and to the lack of effective and welltolerated therapies. In the last 3 years, the approval of new direct acting antivirals characterized by high rates of virological clearance and excellent tolerability has dramatically improved HCV infection curability, especially for patients with advanced liver disease and for liver transplant recipients. Long-term data about the impact of the new direct acting antivirals on liver fibrosis and liver disease-related outcomes are not yet available, due to their recent introduction. However, previously published data deriving from the use of pegylatedinterferon and ribavirin lead to hypothesizing that we are going to observe, in the future, a reduction in mortality and in the incidence of hepatocellular carcinoma, as well as a regression of fibrosis for people previously affected by hepatitis C. In the liver transplant setting, clinical improvement has already been described after treatment with the new direct acting antivirals, which has often led to patients delisting. In the future, this may hopefully reduce the gap between liver organ request and availability, probably expanding liver transplant indications to other clinical conditions. Therefore, these new drugs are going to change the natural history of HCV-related liver disease and the epidemiology of HCV infection worldwide. However, the global consequences will depend on treatment accessibility and on the number of countries that could afford the use of the new direct acting antivirals.

Long acting octreotide in the treatment of advanced hepatocellular cancer and overexpression of somatostatin receptors: Randomized placebo-controlled trial

AIM: To estimate if and to what extent long acting octreotide (LAR) improves survival and quality of life in patients with advanced hepatocellular carcinoma (HCC). METHODS: A total of 127 cirrhotics, stages A-B, due to chronic viral infections and with advanced HCC, were enrolled in the study. Scintigraphy with 111Indium labeled octreotide was performed in all cases. The patients with increased accumulation of radionuclear compound were randomized to receive either oral placebo only or octreotide/octreotide LAR only as follows: octreotide 0.5mg s.c. every 8 h for 6 wk, at the end of wk 4-8 octreotide LAR 20 mg i.m. and at the end of wk 12 and every 4 wk octreotide LAR 30mg i.m.. Follow-up was worked out monthly as well as the estimation of quality of life (QLQ-C30 questionnaire). Patients with negative somatostatin receptors (SSTR) detection were followed up in the same manner. RESULTS: Scintigraphy demonstrated SSTR in 61 patients. Thirty were randomized to receive only placebo and 31 only octreotide. A significantly higher survival time was observed for the octreotide group (49 ± 6 wk) as compared to the control group (28 ± 1 wk) and to the SSTR negative group (28 ± 2 wk), LR = 20.39, df = 2, P < 0.01. The octreotide group presented 68.5% lower hazard ratio [95% CI (47.4%-81.2%)]. During the f irst year, a 22%, 39% and 43% decrease in the QLQ-C30 score was observed in each group respectively.CONCLUSION: The proposed therapeutic approach has shown to improve the survival and quality of life in SSTR positive patients with advanced HCC.

Direct acting antiviral therapy is curative for chronic hepatitis C/autoimmune hepatitis overlap syndrome

Autoimmune phenomena are common in patients with chronic hepatitis C. Management of chronic hepatitis C/autoimmune hepatitis syndrome has until recently been problematic due to the adverse effects of interferon on autoimmune processes and immunosuppression on viral replication. In this report we describe 3 patients with chronic hepatitis C/autoimmune hepatitis overlap syndrome who responded rapidly to direct acting antiviral therapy. The resolution of the autoimmune process supports a direct viral role in its pathophysiology.

The Shandong Shidao Bay 200 MW_e High-Temperature Gas-Cooled Reactor Pebble-Bed Module(HTR-PM) Demonstration Power Plant: An Engineering and Technological Innovation

In 2005, the US passed the Energy Policy Act of 2005 mandating the construction and operation of a high-temperature gas reactor （HTGR） by 2021. This law was passed after a multiyear study by national experts on what future nuclear technologies should be developed. As a result of the Act, the US Congress chose to develop the so-called Next-Generation Nuclear Plant, which was to be an HTGR designed to produce process heat for hydrogen production. Despite high hopes and expectations, the current status is that high temperature reactors have been relegated to completing research programs on advanced fuels, graphite and materials with no plans to build a demonstration plant as required by the US Con- gress in 2005. There are many reasons behind this diminution of HTGR development, including but not limited to insufficient government funding requirements for research, unrealistically high temperature requirements for the reactor, the delay in the need for a ＂hydrogen＂ economy, competition from light water small modular light water reactors, little utility interest in new technologies, very low natural gas prices in the US, and a challenging licensing process in the US for non-water reactors.

Era of direct acting anti-viral agents for the treatment of hepatitis C

Hepatitis C infection is universal and the most common indication of liver transplantation in the United States. The period of less effective interferon therapy with intolerable side effects has gone. Now we have stepped into the era of direct acting anti-viral agents(DAAs) against hepatitis C virus. Treatment of hepatitis C is now extremely effective, tolerable and requires a short duration of intake of oral agents. Less monitoring is required with the current therapy and drug-drug interactions are less than the previous regimen. The current treatment options of chronic hepatitis C with various DAAs are discussed in this article.

Natural Nanoskin ACT Management of the Rare Disease as Burnt Patient with Epidermolysis Bullosa and Stevens-Johnson

Epidermolysis Bullosa (EB) is a group of rare genetic skin conditions, which is characterised by extremely fragile skin and recurrent blister formation, resulting from minor mechanical friction or trauma. Sufferers of EB have compared the sores to third-degree burns. Stevens-Johnson syndrome is a rare but very serious skin problem, which causes the appearance of reddish lesions throughout the body and other changes, such as difficulty in breathing and fever, which can endanger the life of the affected person. The aim of this study was to show efficacy of a NANOSKIN ACT, AND NANOSKIN ACT SOFT wound dressing on the wound care management in patients with EB AND Stevens-Johnson syndrome (SJS).

Hepatocellular carcinoma after direct-acting antiviral hepatitis C virus therapy:A debate near the end

Direct acting antivirals(DAAs)have revolutionized the treatment of hepatitis C virus(HCV)infection,achieving high rates(≥95%)of sustained virological response,with a good safety profile and high compliance rates.Consequently,it had been expected that viral clearance will reduce morbidity and mortality rates,as well as the risk of hepatocellular carcinoma(HCC).However,since 2016,concerns have been raised over an unexpected high rate of HCC occurrence and recurrence after DAA therapy,which led to an avalanche of studies with contradictory results.We aimed to review the most recent and relevant articles regarding the risk of HCC after DAA treatment and identify the associated risk factors.

An Interpretation of“Is He Living or Is He Dead”——From the Perspective of the Speech Acts Theory of Pragmatics

Speech acts theory has been widely studied in linguistics, but applied into analyzing literature works has been very few. This paper interprets Mark Twain's short novel "Is He Living or Is He Dead" from the perspective of the speech acts theory of pragmatics.

An Analysis of Pride and Prejudice from Illocutionary Act Theory

It is rare to analyze Austen's Pride and Prejudice from the perspective of Speech Act Theory.The author will employ this theory to find out the real intentions of speakers in this novel.Through analyzing,readers can find more detailed meanings and intentions of the characters and the writer.