Juelhaney2829

South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints.

Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis.

Two prominent themes emerged the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an importantces.

While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.

The relationship between economic conditions and substance abuse is unclear, with few studies reporting drug-specific substance abuse. The present study examined the association between economic conditions and drug-specific substance abuse admissions.

State annual administrative data were drawn from the 1993-2016 Treatment Episode Data Set. The outcome variable was state-level aggregate number of treatment admissions for six categories of primary substance abuse (alcohol, marijuana/hashish,opiates, cocaine, stimulants, and other drugs). Additionally, we used a broader outcome for the number of treatment admissions, including primary, secondary, and tertiary diagnoses. We used a quasi-experimental approach -difference-in-difference model- to estimate the association between changes in economic conditions and substance abuse treatment admissions, adjusting for state characteristics. In addition, we performed two additional analyses to investigate (1) whether economic conditions have an asymmetric effect on ound that the association between state unemployment rates and annual substance abuse admissions has the same direction during economic downturns and upturns. During the economic recession, the negative association between unemployment rate and treatment admissions for stimulants was weakened.

These findings suggest that economic hardship may have increased substance abuse. Treatment for substance use of certain drugs and alcohol should remain a priority even during economic downturns.

These findings suggest that economic hardship may have increased substance abuse. Treatment for substance use of certain drugs and alcohol should remain a priority even during economic downturns.

Adiposity is a strong risk factor for cancer incidence and mortality. However, most of the evidence available has focused on body mass index (BMI) as a marker of adiposity. There is limited evidence on relationships of cancer with other adiposity markers, and if these associations are linear or not. The aim of this study was to investigate the associations of six adiposity markers with incidence and mortality from 24 cancers by accounting for potential non-linear associations.

A total of 437,393 participants (53.8% women; mean age 56.3 years) from the UK Biobank prospective cohort study were included in this study. The median follow-up was 8.8 years (interquartile range 7.9 to 9.6) for mortality and 9.3years (IQR 8.6 to 9.9) for cancer incidence. Adiposity-related exposures were BMI, body fatpercentage, waist-hip ratio, waist-height ratio, and waist and hip circumference. Incidence and mortality of 24 cancers sites were the outcomes. Cox proportional hazard models were used with each of the exposure varias of the marker used, was associated with an increased risk in 10 cancer sites.

Adiposity, regardless of the marker used, was associated with an increased risk in 10 cancer sites.

The rising burden of the ongoing COVID-19 epidemic in South Africa has motivated the application of modeling strategies to predict the COVID-19 cases and deaths. Reliable and accurate short and long-term forecasts of COVID-19 cases and deaths, both at the national and provincial level, are a key aspect of the strategy to handle the COVID-19 epidemic in the country.

In this paper we apply the previously validated approach of phenomenological models, fitting several non-linear growth curves (Richards, 3 and 4 parameter logistic, Weibull and Gompertz), to produce short term forecasts of COVID-19 cases and deaths at the national level as well as the provincial level. Using publicly available daily reported cumulative case and death data up until 22 June 2020, we report 5, 10, 15, 20, 25 and 30-day ahead forecasts of cumulative cases and deaths. All predictions are compared to the actual observed values in the forecasting period.

We observed that all models for cases provided accurate and similar short-term he predictions of deaths and cases to the observed data in the forecasting period, we found that this modeling approach provides reliable and accurate forecasts for a maximum period of 10 days ahead.

To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) on hepatic sinusoidal obstruction syndrome (HSOS) associated with consumption of Gynura segetum (GS).

We retrospectively reviewed 9 consecutive patients with GS-related HSOS who were refractory to supportive treatment and underwent TIPS at our institution between January 2014 and September 2019. The patients were evaluated for safety and efficacy, including TIPS complications and changes in portosystemic pressure gradient (PPG), ascites, total bilirubin, liver size and portal vein diameter.

TIPS procedures were performed successfully in the 9 patients, and no technically-related complications due to the TIPS procedure were recorded. The PPG was improved by TIPS in all patients (mean PPG before TIPS, 30.4 ± 5.2 vs. DBZ inhibitor concentration 13.0 ± 4.1mm Hg post-TIPS, P = 0.008). One patient who was lost to follow-up, whereas the remaining 8 patients survived with a median follow-up period of 12months (range 5-39months). Although the total bilirubin was significantly increased 5-7days after TIPS compared with that before the procedure (3.