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Parenting by lying is a practice in which parents lie to their children to influence their emotions or behavior. Recently, researchers have tried to document the nature of this phenomenon and to understand its causes and consequences. The present research provides an overview of the research in the emerging field, describes some key theoretical and methodological challenges in studying this topic, and proposes a theoretical framework for understanding parenting by lying and for guiding future research to advance our knowledge about this understudied parenting practice.

Abstract Background Namibia, a low malaria transmission country targeting elimination, has made substantial progress in reducing malaria burden through improved case management, widespread indoor residual spraying and distribution of insecticidal nets. The country's diverse landscape includes regions with varying population densities and geographical niches, with the north of the country prone to periodic outbreaks. As Namibia approaches elimination, malaria transmission has clustered into distinct foci, the identification of which is essential for deployment of targeted interventions to attain the southern Africa Elimination Eight Initiative targets by 2030. Geospatial modelling provides an effective mechanism to identify these foci, synthesizing aggregate routinely collected case counts with gridded environmental covariates to downscale case data into high-resolution risk maps. Methods This study introduces innovative infectious disease mapping techniques to generate high-resolution spatio-temporal risk maps for malaria in Namibia. A two-stage approach is employed to create maps using statistical Bayesian modelling to combine environmental covariates, population data, and clinical malaria case counts gathered from the routine surveillance system between 2018 and 2021. Results A fine-scale spatial endemicity surface was produced for annual average incidence, followed by a spatio-temporal modelling of seasonal fluctuations in weekly incidence and aggregated further to district level. A seasonal profile was inferred across most districts of the country, where cases rose from late December/early January to a peak around early April and then declined rapidly to a low level from July to December. There was a high degree of spatial heterogeneity in incidence, with much higher rates observed in the northern part and some local epidemic occurrence in specific districts sporadically. Conclusions While the study acknowledges certain limitations, such as population mobility and incomplete clinical case reporting, it underscores the importance of continuously refining geostatistical techniques to provide timely and accurate support for malaria elimination efforts. The high-resolution spatial risk maps presented in this study have been instrumental in guiding the Namibian Ministry of Health and Social Services in prioritizing and targeting malaria prevention efforts. This two-stage spatio-temporal approach offers a valuable tool for identifying hotspots and monitoring malaria risk patterns, ultimately contributing to the achievement of national and sub-national elimination goals.

Cosmeceutical products based on plant raw materials have a complex effect, are available, and low-toxic. The creation of new natural products for wound healing without tissue scarring is topical. For this, the secondary metabolites of the plant must demonstrate antibacterial, anti-inflammatory, and antioxidant effects, and have low cytotoxicity. Aim. To conduct an analysis of literary sources in electronic databases, regarding products on the market with a wound healing effect and plant raw materials that would have a therapeutic effect on wound healing without the formation of scars. Results. The characteristics of four types of scars are described. Plants and secondary metabolites are listed according to their action: antibacterial, antioxidant, anti-inflammatory, collagenstimulating, and anti-scarring. Lupeol, allicin, and cinnamaldehyde show antibacterial effect; quercetin, resveratrol, luteolin, naringenin, gallic acid, and curcumin show antioxidant effect; asiatic acid, pinocembrin, and myricetin show anti-inflammatory effect. Cryptotanshinone, bexarotene, taspine, sesamol, and astragaloside IV contribute to the deposition of fresh collagen in the wound. On the Ukrainian market, there are natural wound healing products in the form of a balm, cream, and gel. They include vegetable oils, essential oils, extracts of Thymus L., Arnica montana, Inula helenium, Aloe vera, Matricaria chamomilla, etc. Wound healing medicinal products of a chemical nature occupy a large part of the Ukrainian market, among them the products with dexapentanol predominate. The use of the cell culture method as an alternative source of plant raw materials for wound and scar treatment is perspective. The biotechnological method helps preserve biodiversity and obtain chemically pure plant raw materials regardless of environmental conditions. Conclusions. The study demonstrates the possibilities of using plant raw materials to create new cosmeceuticals with wound healing and anti-scaring effects for use in combined therapy.

Abstract Background Insecticide-treated nets (ITNs) are the backbone of anti-malarial vector control in Papua New Guinea (PNG). Over recent years the quality and performance of ITNs delivered to PNG decreased, which has likely contributed to the stagnation in the malaria control effort in the country. The present study reports results from the first 24 months of a durability study with the ITN product Yahe LN® in PNG. Methods The durability study was conducted in four villages on the northern coast of PNG, in an area with high malaria parasite transmission, following WHO-recommended methodology adapted to the local scenario. A cohort of n = 500 individually identifiable Yahe® ITNs was distributed by the PNG National Malaria Control Programme from October to December 2021. Insecticidal efficacy of the ITNs was tested using cone bioassays with fully pyrethroid susceptible Anopheles farauti colony mosquitoes at baseline and at 6 months intervals, alongside evaluation of physical integrity and the proportion of ITNs lost to follow-up. A questionnaire was used to collect information on ITN end user behaviour, such as the frequency of use and washing. The observations from the durability study were augmented with simulated laboratory wash assays. Results Gradual uptake and replacement of previous campaign nets by the communities was observed, such that at 6 months 45% of all newly distributed nets were in use in their designated households. Insecticidal efficacy of the Yahe® nets, expressed as the percent 24 h mortality in cone bioassays decreased from 91 to 45% within the first 6 months of distribution, even though > 90% of study nets had never been washed. Insecticidal efficacy decreased further to

Abstract Background Pyrethroid-based indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) have been employed as key vector control measures against malaria in Namibia. However, pyrethroid resistance in Anopheles mosquitoes may compromise the efficacy of these interventions. To address this challenge, the World Health Organization (WHO) recommends the use of piperonyl butoxide (PBO) LLINs in areas where pyrethroid resistance is confirmed to be mediated by mixed function oxidase (MFO). Methods This study assessed the susceptibility of Anopheles gambiae sensu lato (s.l.) mosquitoes to WHO tube bioassays with 4% DDT and 0.05% deltamethrin insecticides. Additionally, the study explored the effect of piperonyl butoxide (PBO) synergist by sequentially exposing mosquitoes to deltamethrin (0.05%) alone, PBO (4%) + deltamethrin (0.05%), and PBO alone. The Anopheles mosquitoes were further identified morphologically and molecularly. Results The findings revealed that An. gambiae sensu stricto (s.s.) (62%) was more prevalent than Anopheles arabiensis (38%). The WHO tube bioassays confirmed resistance to deltamethrin 0.05% in the Oshikoto, Kunene, and Kavango West regions, with mortality rates of 79, 86, and 67%, respectively. In contrast, An. arabiensis displayed resistance to deltamethrin 0.05% in Oshikoto (82% mortality) and reduced susceptibility in Kavango West (96% mortality). Notably, there was reduced susceptibility to DDT 4% in both An. gambiae s.s. and An. arabiensis from the Kavango West region. Subsequently, a subsample from PBO synergist assays in 2020 demonstrated a high proportion of An. arabiensis in Oshana (84.4%) and Oshikoto (73.6%), and 0.42% of Anopheles quadriannulatus in Oshana. Non-amplifiers were also present (15.2% in Oshana; 26.4% in Oshikoto). Deltamethrin resistance with less than 95% mortality, was consistently observed in An. gambiae s.l. populations across all sites in both 2020 and 2021. Following pre-exposure to the PBO synergist, susceptibility to deltamethrin was fully restored with 100.0% mortality at all sites in 2020 and 2021. Conclusions Pyrethroid resistance has been identified in An. gambiae s.s. and An. arabiensis in the Kavango West, Kunene, and Oshikoto regions, indicating potential challenges for pyrethroid-based IRS and LLINs. Consequently, the data highlights the promise of pyrethroid-PBO LLINs in addressing resistance issues in the region.

Abstract Background Over 3000 young people under the age of 18 are admitted to Tier 4 Child and Adolescent Mental Health Services (CAMHS) inpatient units across the UK each year. The average length of hospital stay for young people across all psychiatric units in the UK is 120 days. Research is needed to identify the most effective and efficient ways to care for young people (YP) with psychiatric emergencies. This study aims to evaluate the clinical effectiveness and cost-effectiveness of intensive community care service (ICCS) compared to treatment as usual (TAU) for young people with psychiatric emergencies. Methods This is a multicentre two-arm randomized controlled trial (RCT) with an internal pilot phase. Young people aged 12 to < 18 considered for admission at participating NHS organizations across the UK will be randomized 1:1 to either TAU or ICCS. The primary outcome is the time to return to or start education, employment, or training (EET) at 6 months post-randomization. Secondary outcomes will include evaluations of mental health and overall well-being and patient satisfaction. Service use and costs and cost-effectiveness will also be explored. Intention-to-treat analysis will be adopted. The trial is expected to be completed within 42 months, with an internal pilot phase in the first 12 months to assess the recruitment feasibility. A process evaluation using visual semi-structured interviews will be conducted with 42 young people and 42 healthcare workers. Discussion This trial is the first well-powered randomized controlled trial evaluating the clinical and cost-effectiveness of ICCS compared to TAU for young people with psychiatric emergencies in Great Britain. Trial registration ISRCTN ISRCTN42999542, Registration on April 29, 2020

Abstract The number of accident and emergency (A&E) hospital attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition more than tripled between 2010 and 2022. After discharge from the hospital, attendance at follow-up appointments in the community is critical to ensure the safety of young people and optimise the use of clinical resources. A retrospective cohort study was conducted to evaluate the association between follow-up attendance and the continuity of clinicians and clinical teams, using electronic clinical record data from East London NHS Foundation Trust (ELFT), between April 2019 and March 2022. Multi-level mixed effects logistic regression was performed to model the follow-up attendance odds based on whether the same or different clinician and clinical team offered the initial A&E and the community follow-up appointment or whether a crisis team was involved. 3134 A&E presentations by 2368 young people were identified within the study period. Following these presentations, 2091 follow-up appointments in the community were offered. The attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in A&E (odds ratio (OR) = 3.66; 95% CI 1.65–8.13). Whether the same clinical team provided the community follow-up appointment, or whether a crisis team was involved before discharge made no difference to the likelihood of follow-up attendance. The findings support the importance of the continuity of clinicians in the care of young people in crisis.

Amaranth is used as a medicinal plant with antioxidant, hemostatic, and wound-healing properties. The aim of the research is the quantitative determination of polyphenolic compounds and flavonoids in ethanolic extracts of amaranth seeds of the "Lera" and "Ultra" varieties and leaves Amaranthus retroflexus. Methods. Extracts were obtained by infusion for 7 days in 70% and 80% ethanol. Quantitative determination of secondary metabolites was conducted by spectrophotometric methods. Results. The largest amount of polyphenolic compounds was found in the ethanolic extract of Amaranthus retroflexus leaves - 0.228 mg/ml. More polyphenols were found in the ethanolic extract of amaranth seeds of the "Lera" variety than in the extract of amaranth seeds of the "Ultra" variety. In the extract of leaves of Amaranthus retroflexus, 2.1 x 10-4 mg/ml of flavonoids were found, in extracts of amaranth seeds were found from 0.7 x 10-5 mg/ml to 1.55 x 10-5 mg/ml of flavonoids. Conclusion. The ethanolic extract of the leaves of Amaranthus retroflexus contains a greater number of investigated secondary metabolites than the extracts of amaranth seeds of the "Lera" and "Ultra" varieties. The ethanol extract of amaranth seeds of the "Lera" variety contains more polyphenolic compounds and flavonoids than the ethanol extract of amaranth seeds of the "Ultra" variety.

Background. Floppy infants are correlated with the extensive differential diagnosis. It can make diagnostic approach become more challenging. Case report. We report a 10-months-old infant referred from Pediatrician to electromyography (EMG) laboratory presenting with floppy and developmental delays. The central and motor neuron manifestations also increased of CPK levels bring ambiguity for the diagnosis. EMG may distinguish the cause from myopathy, anterior horn cell, neuromuscular junction (NMJ) or central origin when genetic testing is not routinely done in developing country. Conclusion. EMG helps clinician to distinguish the diagnosis of floppy infant.

INTRODUCTION: Lichen planopilaris (LPP) is characterized by chronic scarring alopecia that is progressive and typically refractory to therapy. Current drug treatments are suboptimal and not applicable for long-term use because of the high potential for adverse effects, warranting safer and more effective treatment alternatives. METHODS: Based on our previous success in treating a patient with central centrifugal cicatricial alopecia using a topical botanical formulation (Gashee), we reviewed records of four patients with biopsy-proven LPP treated with the topical formulation alone or in combination with its oral preparation. Three patients had failed previous treatment with intralesional steroid injections, topical minoxidil, tacrolimus, and clobetasol. Physical examination and photographic documentation were also used as outcome measures. Treatment duration with the botanical formulations ranged from 6 weeks to 9.5 months. RESULTS: All patients showed overall improvement in surrogate indicators of LPP activity as evidenced by the disappearance of symptoms (pruritus, tenderness, scalp irritation, and hair shedding), improvement in hair growth, and reduction in redness. All reported a high satisfaction level and no adverse effects. CONCLUSIONS: Patients with treatment-refractory LPP responded to a novel botanical treatment. To the best of our knowledge, this is the first published report of LPP responding to a plant-based natural treatment. Further evaluation of this treatment in a controlled trial with a larger number of patients is warranted.

Theory of Mind (ToM) is an individual's ability to understand the cognitive states of others, including their desires, beliefs, and knowledge. ToM describes how children, by the age of four, understand how others may be thinking or feeling. It is the ability to understand the thinking or viewpoints of their peers. This paper will describe ToM levels with preschool-aged children (n = 5). The current research used a storybook task battery to measure children's ToM, as well as developed observational measures, focused on three domains from the task battery. Results of this exploratory study indicate that three of the children had a high level of ToM while the other two were low, as they were not of age. Results also indicate that ToM was observed but challenging to measure as it is primarily an internal process. Future studies can use these suggested tools in conjunction to get a better understanding of ToM with groups preschool-aged children.

This study explores the needs and preparedness of teachers of refugees and forced immigrant (RFI) students in the United States. Research examining the role and influence of teachers on RFIs in education systems is sparse. As a result, there is a critical shortage of an evidence base and subsequent resources, strategies, and policies on teacher training and professional development in the US to support the unique academic and non-academic needs of these students related to trauma, identity and language (TIDAL). Interviews were conducted with education professionals in the United States, specifically the states of Ohio and New Jersey, related to their expectations and needs for working with RFI youth. Results of this study show that educators lack training and support for working with the increasingly diverse population of RFI students. Utilising the capabilities approach, the analysis suggests that proactive change at the macro-level, which activates organisational support, and institutionalising policy related to TIDAL are needed at the meso and micro-levels. Not only does change at these levels provide legitimacy to the needs of RFI students, but it also acknowledges the needs of educators, the work they are actively doing, and the importance of providing quality education to all students.

This article explores Namibian students' perception of work-integrated learning (WIL) readiness skills developed from an offline and online business simulation course, pre and during the COVID-19 pandemic, as well as the use of simulations to prepare students for WIL placements. The findings indicate that both versions of the business simulation were able to inculcate WIL readiness skill in the students and that students perceive learning tools, such as the business simulation course, appropriate in developing the skills needed for WIL. Skills including communication, professionalism, leadership, teamwork, analytical, problem solving, critical thinking, assertiveness, time management, willingness to learn, attention to detail, diversity and accountability were more significantly developed in the offline business simulation than in the online version. It is thus highlighted in the study that pedagogical and content related strategies that can enhance online business simulations be considered.

BackgroundDue to challenges in measuring changes in malaria at low transmission, serology is increasingly being used to complement clinical and parasitological surveillance. Longitudinal studies have shown that serological markers, such as Etramp5.Ag1, can reflect spatio-temporal differences in malaria transmission. However, these markers have yet to be used as endpoints in intervention trials.MethodsBased on data from a 2017 cluster randomised trial conducted in Zambezi Region, Namibia, evaluating the effectiveness of reactive focal mass drug administration (rfMDA) and reactive vector control (RAVC), this study conducted a secondary analysis comparing antibody responses between intervention arms as trial endpoints. Antibody responses were measured on a multiplex immunoassay, using a panel of eight serological markers of Plasmodium falciparum infection - Etramp5.Ag1, GEXP18, HSP40.Ag1, Rh2.2030, EBA175, PfMSP119, PfAMA1, and PfGLURP.R2.FindingsReductions in sero-prevalence to antigens Etramp.Ag1, PfMSP119, Rh2.2030, and PfAMA1 were observed in study arms combining rfMDA and RAVC, but only effects for Etramp5.Ag1 were statistically significant. Etramp5.Ag1 sero-prevalence was significantly lower in all intervention arms. Compared to the reference arms, adjusted prevalence ratio (aPR) for Etramp5.Ag1 was 0.78 (95%CI 0.65 - 0.91, p = 0.0007) in the rfMDA arms and 0.79 (95%CI 0.67 - 0.92, p = 0.001) in the RAVC arms. For the combined rfMDA plus RAVC intervention, aPR was 0.59 (95%CI 0.46 - 0.76, p < 0.0001). Significant reductions were also observed based on continuous antibody responses. Sero-prevalence as an endpoint was found to achieve higher study power (99.9% power to detect a 50% reduction in prevalence) compared to quantitative polymerase chain reaction (qPCR) prevalence (72.9% power to detect a 50% reduction in prevalence).InterpretationWhile the observed relative reduction in qPCR prevalence in the study was greater than serology, the use of serological endpoints to evaluate trial outcomes measured effect size with improved precision and study power. Serology has clear application in cluster randomised trials, particularly in settings where measuring clinical incidence or infection is less reliable due to seasonal fluctuations, limitations in health care seeking, or incomplete testing and reporting.FundingThis study was supported by Novartis Foundation (A122666), the Bill & Melinda Gates Foundation (OPP1160129), and the Horchow Family Fund (5,300,375,400).

Background: Self-limited epilepsy with autonomic seizures (SeLEAS), formerly known as Panayiotopoulos syndrome (PS), is a common multifocal autonomic childhood epileptic syndrome. SeLEAS affects 6% of children in between the ages of 1 and 15 years who have had one or more afebrile seizures in their lifetime. Case: A 5-year-old girl was admitted to the paediatric emergency room (ER) of our hospital due to a reported episode of vomiting during her sleep, followed by central cyanosis perorally of sort duration (

PURPOSE: Central centrifugal cicatricial alopecia (CCCA) is the most common cause of scarring alopecia in women of African descent. However, current treatments for CCCA, such as immunosuppressants and immunomodulatory pharmaceutical agents, have suboptimal efficacy and undesirable side effects. This case series reports the therapeutic effect of a new botanical formulation (Dr. UGro Gashee) in four patients with histologically supported diagnoses of CCCA. The formulations contain at least three phytoactive ingredients that affect multiple targets in the cascade of pathophysiologic events contributing to CCCA. Possible mechanisms of action include anti-inflammatory effects, inhibiting proinflammatory cytokines, and the net antifibrotic effect of inhibiting transforming growth factor-beta while upregulating AMP-activated protein kinase and peroxisome proliferator-associated receptor-gamma activity. PATIENTS AND METHODS: Four African American women with treatment-refractory CCCA were treated with a new topical botanical formula (cosmeceutical) alone or in combination with its oral formulation (nutraceutical) for 8 weeks to 1 year. The cosmeceutical and nutraceutical treatments contain similar phytoactive ingredient profiles. Treatment outcomes were collected using documented patient reports and images and by direct observation. RESULTS: In all patients, scalp pruritus cessation occurred within 2 weeks of treatment, and significant hair regrowth was observed within 2 months. All patients reported a high satisfaction level without adverse effects. CONCLUSION: Patients with treatment-refractory CCCA responded to the novel botanical treatment reported in this study. Further evaluations in a controlled trial with more patients are warranted.

BackgroundIn Namibia, as in many malaria elimination settings, reactive case detection (RACD), or malaria testing and treatment around index cases, is a standard intervention. Reactive focal mass drug administration (rfMDA), or treatment without testing, and reactive focal vector control (RAVC) in the form of indoor residual spraying, are alternative or adjunctive interventions, but there are limited data regarding their community acceptability.MethodsA parent trial aimed to compare the effectiveness of rfMDA versus RACD, RAVC versus no RAVC, and rfMDA + RAVC versus RACD only. To assess acceptability of these interventions, a mixed-methods study was conducted using key informant interviews (KIIs) and focus group discussions (FGDs) in three rounds (pre-trial and in years 1 and 2 of the trial), and an endline survey.ResultsIn total, 17 KIIs, 49 FGDs were conducted with 449 people over three annual rounds of qualitative data collection. Pre-trial, community members more accurately predicted the level of community acceptability than key stakeholders. Throughout the trial, key participant motivators included: malaria risk perception, access to free community-based healthcare and IRS, and community education by respectful study teams. RACD or rfMDA were offered to 1372 and 8948 individuals in years 1 and 2, respectively, and refusal rates were low (