6 research outputs found
Sparks of Platonic Love in Pashto Poetry
No full textPlatonic love is a word used by psychologists to describe illusory love and connection. It is typically a one-sided love that revolves around the axis of imagination, with no objective and genuine interaction between the lover and the beloved. Many societies, people, and values, particularly psychologists, refer to this type of love as original and pure love. It is also known as divine love, while the opposite is earthly or bodily love. Plato, the Greek philosopher and thinker, preached a love that was solely spiritual and ideal, with no regard for the body, particularly sexual impulses. The lover and the adored have no relationship and do not make a connection. It is known as Platonic love since Plato cannot be held responsible for its defeat or failure. This love was not previously known as Platonic love, as it is today, but researchers of our time, who studied Plato's norms and values for love, attributed this view of love to him in Pashto poetry. There are several examples of such love, and the purpose of this article is to explore a few of them
The Effectiveness of Transcranial Direct Current Stimulation Treatment with Cognitive Rehabilitation on Reducing Craving and Improving Inhibitory Control in Tramadol-Dependent Adolescents
No full textAims: Abuse of substances leads to much damage in different fields. Therefore, necessary measures should be taken to prevent infection, withdrawal and prevent return. The present study was conducted to investigate the effectiveness of transcranial Direct Current Stimulation combined with cognitive rehabilitation in reducing cravings and improving inhibitory control in adolescents dependent on tramadol.
MATERIALS & METHODS: The current research is a semi-experimental type using a pre-test-post-test design and a 2-month follow-up with a control group. The statistical population of the present study is all the boys and girls (14 to 18 years old) dependent on tramadol in Shahrekord in Iran who contacted the researcher in 2022 through calls published in schools and social media. From this population, 30 people (12 girls and 18 boys) were selected from the people who met the criteria for entering the research. The subjects were randomly divided into two groups of 15 people, experimental and control, based on gender matching. The criteria for entering the study were the diagnosis of substance abuse disorder (tramadol), not suffering from other psychological disorders, age 14 to 18 years, not having a history of epilepsy and convulsions, not receiving any other psychological or drug treatment at the same time, no history of direct transcranial current stimulation treatment, no intracranial implants or any other metal object near the head that cannot be removed, having a high motivation to participate as determined through the initial interview and agreeing to participate in the research and signing a written consent form. And the exclusion criteria were the inability to perform cognitive rehabilitation tasks, not participating in more than 2 consecutive sessions in therapy sessions, and the participant's lack of motivation in therapy sessions. To collect data, the desire for drug questionnaire and go/ no go test were used.
The Desires for drug questionnaire (DDQ): this questionnaire was designed by Franken et al. in 2002 and it measures the desire to drug at the moment. This questionnaire consists of 14 questions, which are 3 factors of desire and intention towards drug use (questions 1, 2, 12 and 14), desire to use and negative reinforcement and pleasure (questions 4, 5, 7, 9 and 11) and severity of lack of control (questions 3, 6, 8, 10, and 13) on a 6-point Likert scale from zero (not at all true) to five (completely true). The maximum score of a person on this questionnaire is 70 and the minimum score is zero [26]. In Poursaeid et al.'s study, Cronbach's alpha for the entire scale was 0.96 for opium users, 0.95 for crack, 0.90 for methamphetamine and 0.94 for heroin [27]. In the present study, Cronbach's alpha coefficient for the whole scale was equal to 0.91.
Go/ No Go Test: This test was used in 1984 by Hoffman to measure response inhibition. In the go/no-go test, there are two situations, in the first situation (go) by presenting a stimulus, the person must provide a response that is compatible with the existing stimulus as quickly as possible and in the second situation (no go), after the presentation of the first stimulus, another stimulus is also presented, and the person must refrain from responding when the second stimulus appears. A person's ability to control his response in the second situation, i.e. the no-go level, is an indicator of his inhibitory control. This test has different versions. In the present study, the second version of PEBL software was used. In the go/ no go test of this software, there are two target stimuli, one of which appears on the screen each time. These two stimuli are P and R. The test consists of two levels. In the first stage, 128 P stimuli and 32 R stimuli appear. The subject must click on the screen when he sees the P, and if the R appears, he must refrain from answering. In the second level, 128 times the R stimulus and 32 times the P stimulus appears, where the person has to click on the screen when they see the R stimulus but refrain from responding when they see the P. The number of wrong responses to the no-go stimulus (R in the first stage and P in the second stage) or in other words, the commission error is considered the main indicator of measuring inhibitory control [28]. Since this test is non-verbal, it is not dependent on culture and foreign research can be used to cite validity and reliability. The reliability and retest coefficient of this test has been reported above 0.8 [29]. In the current study, Cronbach's alpha coefficient for this test (no-go error score) was 0.92.
To carry out the current research, calls were first published in the schools of Shahrekord city and on the channels and pages of social media to recruit subjects to carry out the research. After checking the conditions for entering the project, to conduct the current research, the subjects who were contacted to participate in the research were interviewed and received sufficient information about the conditions and duration of the intervention and its safety. Also, before participating in the research, all the subjects completed the informed personal consent form to participate in the research and they were assured of confidentiality and non-disclosure of information. Then the subjects or their parents were given explanations about the treatment methods used and also the research procedure. Before starting the interventions, the subjects were evaluated through the desired tools, i.e. the desires for drug questionnaire and the go/no-go test. Then the members of the experimental group were treated with transcranial direct current stimulation combined with cognitive rehabilitation, but the members of the control group did not receive any intervention and were placed in the waiting line. After completing the interventions, the subjects were re-evaluated. Also, after a period of intervention and a second evaluation, the third evaluation or two-month follow-up was done.
In the present study, transcranial direct current stimulation was used through the Neurostim 2 electric current generating device, manufactured by Medina Medicine Company, which continuously and mildly passes the electric current through the head. In this research, the subjects of the experimental group also performed cognitive rehabilitation tasks related to inhibitory control with Captain Log software while receiving transcranial direct current stimulation. Transcranial direct current stimulation was applied in 10 sessions of 20 minutes and 3 sessions every week. The intervention was such that the anode (excitatory) electrode in the posterior lateral region of the left prefrontal lip (left DLPFC) and the cathode (inhibitory) electrode on the posterior lateral region of the right prefrontal lip (right DLPFC), i.e. F3 and F4 regions, respectively, based on the system 10-20 international electroencephalography was placed. In this research, direct electric current was applied with an intensity of 1.5 milliamperes and a duration of 20 minutes. A summary of treatment sessions is given in Table 1.
Ethical Permissions: This research has been approved by the research ethics committee of the Shahid Chamran University of Ahvaz in Iran with ethics code 1401.2.24.183177/scu.ac.ir. The ethical principles of the current research were fully observed; Subjects could leave the research whenever they wanted and all their confidential information was protected and destroyed without exploitation.
Statistical analysis: To check the effectiveness of the intervention, the method of covariance analysis (MANCOVA) was used. Data were analyzed through SPSS 20 software.
FINDINGS: Out of the 30 statistical samples selected, 3 people (2 people from the control group and 1 person from the experimental group) were not able to continue cooperating with the researchers and were excluded from the study. The size of the control group was reduced to 13 people (4 girls and 9 boys) and the size of the experimental group was reduced to 14 people (4 girls and 10 boys). The demographic information of the statistical sample of the present study showed that the average age of the subjects in the study was 16.70±1.35 years. The average of the research variables in the pre-test, post-test and follow-up levels can be seen in Table 2.
The Kolmogorov-Smirnov one-sample test was used to check the default normality of the distribution of the variables, and the results showed that except for the inhibitory control in the control group of the follow-up level, the rest of the data had a normal distribution. Since the skewness and kurtosis of this case were in the range of -3.29 to +3.29 (in samples with small volumes), we were able to use parametric tests for analysis. Leven's test was used to check the default homogeneity of variances. The results obtained from Leven's test showed that the F value was not significant at the alpha level of 0.05 in both the post-test and follow-up levels, so the default of homogeneity of variances was maintained. Also, the default homogeneity of the regression slope was investigated. The results showed that the F value of the interaction between the independent variable and the covariance variable, both craving and inhibitory control variables was not significant at the alpha level of 0.05 in both the post-test and follow-up levels, so the default of homogeneity of the regression slopes was also maintained in both the post-test and follow-up levels. Also, based on the Box's M test, the equality of the covariance matrix of the dependent variables between the experimental and control groups in both the post-test and follow-up levels was not significant at the alpha level of 0.05.
Considering that the presuppositions of multivariate covariance analysis were established, this test was used to answer the research hypotheses. The results are given in Table 3. The results of Wilk's lambda test at the post-test level showed that there was a significant difference between the averages of the two experimental and control groups, controlling for the effect of the pre-test, at least in terms of one of the dependent variables. And this meant that transcranial direct electrical current stimulation was successful in influencing at least one of the dependent variables (p<0.05; F=21.053; Eta=0.65). Also, the results of Wilks's lambda test in the follow-up stage showed that there was a significant difference between the averages of the two experimental and control groups, by controlling the effect of the pre-test, at least in terms of one of the dependent variables, And this meant that transcranial direct current stimulation was successful in affecting at least one of the dependent variables (p<0.05; F=17.221; Eta=0.61).
To examine the difference patterns, univariate covariance analysis was used in the context of multivariate covariance analysis. The F statistic with a value of (39.396) was significant for craving at the post-test level (Table 4). This result showed that there was a significant difference between the research groups in the mean craving scores at the post-test level. Considering the lower average scores of the experimental group compared to the control group, it can be said that the intended treatment was significantly effective in reducing the cravings of tramadol-dependent teenagers at the post-test level. Also, the F statistic with a value of (24.404) was significant for cravings at the follow-up level (Table 4). This result showed that there was a significant difference between the study groups in craving for consumption at the follow-up level. Considering the lower average scores of the experimental group compared to the control group, it can be said that the intended treatment was significantly effective in reducing the cravings of adolescents dependent on tramadol at the follow-up level. Also, the F statistic with a value of (15.677) was significant for inhibitory control (number of no-go errors) at the post-test level. This result showed that there was a significant difference between the research groups in the mean scores of inhibitory control at the post-test level. Considering the lower average scores of the experimental group compared to the control group, it can be said that the intended treatment was significantly effective in improving the inhibitory control of adolescents dependent on tramadol at the post-test level. Also, the F statistic with a value of (13.840) was significant for inhibitory control in the follow-up level (Table 4). This result showed that there was a significant difference between the research groups in inhibitory control at the follow-up level. Considering the lower average scores of the experimental group compared to the control group, it can be said that the intended treatment was significantly effective in improving the inhibitory control of adolescents dependent on tramadol at the follow-up level.
Conclusion: Transcranial Direct Current Stimulation treatment combined with cognitive rehabilitation is effective in reducing cravings and improving inhibitory control in adolescents addicted to tramadol and can be used by relevant experts as an effective treatment in this field.
Clinical & Practical Tips in POLICE MEDICINE: According to the results of the current research on the effectiveness of direct transcranial current stimulation treatment combined with cognitive rehabilitation on reducing cravings and improving the inhibitory control of tramadol-dependent teenagers, such interventions can be implemented in counselling and treatment centers of police c, addiction treatment centers affiliated to this organization. Also, the police can provide free interventions for this purpose in educational environments in cooperation with education to prevent drug abuse among teenagers.
Acknowledgements: We thank all the participants who accompanied us in this research.
Conflict of interest: The authors of the article stated that there is no conflict of interest regarding the present study.
Authors' Contribution: First author, idea design, data collection; Second author, idea design; third author, data analysis; All the authors participated in the initial writing of the article and its revision, and all accept the responsibility for the accuracy and correctness of the contents of the present article by finalizing the present article.
Financial Sources: The present study had no financial support
Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
No full textMapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
No full textA double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1–70.8) million) to 6.4 (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8–38.5) million) in 2000 to 6.0 (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)
Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)
No full textAn amendment to this paper has been published and can be accessed via a link at the top of the paper
Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017
No full textBackground Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package-a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1.95 million deaths (95 uncertainty interval 1.87-2.04) and has since decreased to 0.95 million deaths (0.91-1.01) in 2017. New cases of HIV globally peaked in 1999 (3.16 million, 2.79-3.67) and since then have gradually decreased to 1.94 million (1.63-2.29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36.8 million (34.8-39.2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65.7 in Lesotho to 85.7 in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81 ART coverage by 2020 and 12 countries are on track to meet 90 ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd
