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Changes in hematological parameters due to diabetes are reflected in changes in whole blood viscosity (WBV). Understanding the impact of diabetes and its cardiovascular disease (CVD) complications can provide substantiation of how laboratory tests for WBV are useful to monitor the progression and treatment. The review examines research work done in the past 20 years to provide a framework for the present agenda. This was a narrative review that followed the standard Scale for the Assessment of Narrative Review Articles (SANRA) approach. It includes both conceptual and empirical reviews. WBV was appraised in the context of bibliographic research on diabetes and other related factors such as metabolic syndrome (MetS) and oxidative stress. The association of abnormal erythrocytes as well as the relationship between WBV and MetS is established. Changes in diabetes that contribute to the development of diabetic cardiovascular complications occur through the pathway of WBV physiology. However, longitudinal analysis is very limited. There is a dearth of longitudinal study data on WBV in diabetes management. This lack of data justifies a need for further studies, especially prospective and retrospective analysis, to investigate the prevalence of diabetes mellitus about the prevalence of cardiovascular complications indices, especially estimated WBV (eWBV) between periods and within cohorts.

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Purpose: This study aimed to examine the effect of video training and intraoperative progress report on the anxiety of family caregivers awaiting relatives undergoing surgery. Methods: A three-armed randomized controlled design was used. One hundred and two participants were enrolled and randomly assigned to three groups: the video training group (n = 34), the intraoperative progress report group (n = 34), and the control group (n = 34). Interventions were performed when the relatives of the participants were undergoing surgery. The participants in the video training group received video training containing images of the operating room environment and animations related to the patient's surgical procedure, postoperative care, and possible complications from the surgery. In the intraoperative progress report group, information regarding the patient's general condition, the percentage of surgical progress, and the approximate time of the patient's transfer from the operating room were provided. The control group received routine care. A demographic data questionnaire and the Spielberger State-Trait Anxiety Inventory (STAI) was used for data collection. Results: It was found a statistically significant decrease in the state anxiety in the video training (p < 0.001) and intraoperative progress report (p < 0.001) group after the intervention when compared to before the intervention. It was found no significant difference among the study groups in terms of the level of state and trait anxiety after the intervention (p > 0.05). Conclusions: This study found that both video training and intraoperative progress report are effective in reducing the state anxiety of family caregivers awaiting relatives undergoing surgery.

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The present editorial 2020 continues the series of status reports in Environmental Earth Sciences (EES) in previous years 2017 and 2019 (Kolditz et al. in Environ Earth Sci 77: 8, 2018, Kolditz et al. in Environ Earth Sci 79: 11, 2020). The year 2020 coming to an end was heavily influenced by the COVID-19 pandemic affecting all areas of life including research work and, therefore, scientific publishing as well ("Introduction"). One bright spot which shows longevity of journals that produce a quality product is that Environmental Earth Sciences (EES) is celebrating its 45th anniversary of publication. To this extent EES continues the tradition to honor the most cited papers contributing to the 2020 Impact Factor (IF) ("Highly and most cited topics") and provide information on the current status of EES as well as an outlook to 2021 ("Progress report").

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BACKGROUND AND OBJECTIVE: Descemet membrane endothelial keratoplasty (DMEK) has increased in popularity since its introduction over 10 years ago. This article presents a summary of the experiences of the past years collected at the Department of Ophthalmology at the University of Cologne. METHODS: A literature review of DMEK studies primarily from the Department of Ophthalmology at the University of Cologne, Germany was carried out. Own experiences in the fields of donor selection and graft preparation, DMEK surgery, complication management and postoperative treatment are summarized. RESULTS: Since the introduction of DMEK experience has been gained and ongoing improvements have occurred ranging from donor-recipient allocation to postoperative follow-up. These led to a better reproducibility of the intervention for the surgeon, to a better postoperative result and to a reduction of the complication rate. DISCUSSION: The DMEK represents a safe and individualized procedure for endothelial transplantation for corneal endothelial dysfunction. Continuing development of the method leads to optimization and safer results.

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Check-in/Check-out (CICO) is an intervention designed to improve behavioral outcomes for students identified as at-risk for school failure. Core principles of the intervention include clearly defined behavioral expectations and rules, precorrections for meeting behavioral expectations, high rates of feedback and reinforcement for demonstration of desired behavior, use of data to monitor outcomes, and a system for school-to- home communication. The purpose of this investigation was to use the 2014 Council for Exceptional Children's quality indicators and standards for establishing evidence-based practices in special education to review the existing research for CICO. Implications regarding the use of different sets of quality indicators to evaluate extant research are provided, and recommendations for future research are discussed.

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In 1988, The World Health Assembly committed WHO and its member states to the goal of poliomyelitis eradication by the year 2000. Global progress in implementation of strategies include routine and supplementary immunisation, AFP surveillance strategy and mopping up. Progress made in global polio eradication within 10 years has been dramatic. Challenges consist of tailoring and fine tuning strategies and sustaining adequate levels of findings. Although the intensified effort will increase needed resources in the short term, it will save costs in the long term.

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In Latin America, health sector reforms have gone hand in hand with social and economic trends during the latter half of the twentieth century and have reflected the particular concept of "development" that has been in vogue at different times. Economic stagnation and increased social spending, both hallmarks of the 1960s, led to the decline of the "import substitution" development model, which had prevailed since the beginning of the century, and slowly gave way in the 1980s to the "globalization" model. From the earlier model, a transition took place toward a restructuring of production and a series of economic adjustment policies that led, ironically, to an increase in poverty in Latin America. Implementation of the new model has occurred in two phases. The first, known as the "social reform" or "first generation" phase, sprang from the notion that poverty is the sum of a number of material shortages that can be corrected through an equitable redistribution of a fixed volume of goods belonging to society. This conceptual framework, which was completely devoid of all historical linkages and separated from economic policy, led to social policies whose entire purpose was to mitigate poverty through subsidies targeting the poorest persons in the society. In the second phase of the globalization model, which arose in the 1990s and became known as the "second generation" or "postadjustment" phase, new economic rules came into play that were based primarily on international competition, efficiency in production, and openness and fairness in the capital markets. And if during the initial stage the conceptual strategy behind all social policy was to fight poverty, in the second stage the strategy became one of achieving equity, which was no longer interpreted as the even distribution of a fixed volume of capital goods, but as the sustained provision of greater and better opportunities for all. Having grown accustomed to the protectionism inherent in the earlier development model, Latin American societies today feel threatened by a new model that offers them no social safety net. The feasibility of economic and social reform policies during the second phase, which reflect the demands of a "globalized" world, thus depends on the ability to overcome people's lack of trust and to garner the support of a political, social, and institutional majority.

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PIP: This paper discusses the benefits of training local people to become community health workers in south Sudan. Joyce Kiden relates her experiences as a health worker and gives a detailed account on the benefits of the work as well as the fulfillment of helping others. Despite some challenges and difficulties, the training that was organized by WHO has made considerable impact on the improvement of primary health care services at the community level. Many agencies realize importance of community health workers training. These training enhances the basic skills of people and hopefully encourage international donors to support not just the international organizations that are vital, but also the local people who will make improving health a sustainable possibility.^ieng

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PIP: Negotiating protection against poliomyelitis has been a very difficult issue in Somalia, particularly in the conflict zone of Mogadishu where most of the remaining reservoirs of wild polio are found. This article focuses on the polio eradication campaign conducted by the WHO in the danger zones of Somalia. The importance of such a campaign is accounted for in the fact that, since January, there have been 14 confirmed cases of wild polio, with 32 more cases under investigation. Hence, the international staff aimed to surpass challenges, which include noncooperation of rival clans, in order to carry out the campaign. Their success is attributable to reports that the first round of the campaign in Mogadishu achieved average coverage rates of 95% on the north side of the Green Line and 130% on the south side. If these results will continue for the rest of the scheduled national immunizations, WHO estimates that Somalia could be free of polio within 24 months.^ieng

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An HIV-1 vaccine offers the best long-term hope to control the AIDS pandemic, especially in less-developed countries. To ensure its future availability we need to increase our research efforts today, including clinical trials. Although small-scale clinical trials of HIV-1 vaccines have been underway since 1987, the first phase III efficacy trials started only recently in the USA and Thailand. Initial results from these trials will be available within the next 2-3 years, and we must start planning now how vaccines should be used if found to be effective. In the meantime, the continuing promotion of the parallel development and assessment of other candidate vaccines is important. Financial mechanisms should also be developed as an incentive to industry and to ensure equitable distribution of future vaccines in less-developed countries. Moreover, a concerted effort is needed to ensure the development and future availability of appropriate vaccines for Africa.

PIP: An HIV-1 vaccine offers the best long-term hope to control the AIDS pandemic, especially in less-developed countries. To ensure its future availability, an increase in immediate research efforts, including clinical trials is necessary. Although small-scale clinical trials of HIV-1 vaccines have been underway since 1987, the phase 3 efficacy trials started only recently in the US and Thailand. Initial results of these trials will be available within the next 2-3 years, and researchers must start planning how the vaccines should be used if found effective. In the meantime, the continuing promotion of the parallel development and assessment of other candidate vaccines is important. Financial mechanisms should also be developed as an incentive to industry and to ensure equitable distribution of future vaccines in less-developed countries. Moreover, a concerted effort is needed to ensure the development and future availability of appropriate vaccines for Africa.

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More than 250 million of the world's children suffer from vitamin A deficiency. Nepal is one of 60 countries in which this deficiency constitutes a significant public health problem. Each year in Nepal, vitamin A deficiency is responsible for the deaths of 9000 children and for 2500 children becoming permanently blind. The Nepal National Vitamin A Program (NVAP) was begun in 1993 in eight of the country's 75 districts. By the end of 1997, the programme covered 32 districts, and by 2003 its coverage will be nationwide. The Nepal NVAP is considered by many to be a highly successful, model programme. It consists primarily of distributing high-dose vitamin A capsules to all children 6 to 60 months of age during twice-yearly campaigns. The capsule distribution is carried out by a previously existing network of Female Community Health Volunteers (FCHVs) that has been reinvigorated by the highly visible and universally acclaimed success of the NVAP. An important strategy of the programme has been the empowerment of the FCHVs, which has been accomplished by organizing, training and motivating community workers and other representatives from education, agriculture and other sectors, as well as political representatives, to support the FCHVs. The annual cost of the NVAP is US$1.7 million. It costs $1.25 to deliver two vitamin A capsules to each participant. The cost per averted death is $327. The NVAP reduces the incidence and severity of diarrhoeal disease and measles, which in turn reduces the need for Ministry of Health services, thereby annually saving the Government of Nepal $1.5 million. Factoring in these cost savings, the net annual cost of the current NVAP is $167,000, and the net annual cost of the permanent, nationwide programme is estimated at $1.1 million. The NVAP is a highly cost-effective programme. The article concludes with a discussion of the sustainability and replicability of the programme.

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This paper describes the development of a theoretically based sex education programme currently undergoing a randomized controlled trial in the UK. It considers some of the practical difficulties involved in translating research-based conclusions into acceptable, replicable and potentially effective classroom lessons. The discussion acknowledges that the implications of social psychological research and the requirements of rigorous evaluation may conflict with accepted principles inherent in current sex education practice. It also emphasizes that theoretical ideas must be carefully embedded in lessons which are informed by an awareness of classroom culture, and the needs and skills of teachers. For example, the use of same-sex student groups to reflect on the gendered construction of sexuality may be problematic. Materials must be tailored to recipients' circumstances, which may require substituting for limited experience with the use of detailed scripts and scenarios. Furthermore, role-play techniques for sexual negotiation that work elsewhere may not be effective in the UK. The use of trigger video sessions and other techniques are recommended. Finally, the problems involved in promoting condom-related skills are discussed. The paper concludes that, if an intervention is to be sustainable beyond the research stage, it must be designed to overcome such problems while remaining theoretically informed.

PIP: This paper describes key aspects of the development of a theoretically based sex education program, which is currently undergoing a randomized controlled trial in the UK. It highlights some of the practical difficulties involved in translating psychosocial theory into acceptable, replicable, and potentially effective classroom lessons. The Sexual Health and Relationship--Safe, Happy, and Responsible Program included a teacher's resource pack of 20 lessons, to be delivered over 2 school years, and a 5-day teacher training course for those using the teacher¿s resources pack. The discussion acknowledges the significance of social psychological research and the requirements of rigorous evaluation may oppose with the accepted principles inherent in current sex education practice. It also emphasizes that theoretical ideas must be carefully embedded in the lessons which are informed by an awareness of classroom culture, and the needs and skills of teachers. Materials must be tailored to recipients' circumstances, which may require substituting for limited experience with the use of detailed scripts and scenarios. In UK, use of trigger video sessions and other techniques are recommended, since role-playing techniques for sexual negotiations is not effective. This paper concludes that it is possible to develop a potentially effective, research-based, teacher-led sex education program, which could be disseminated throughout schools in the UK.

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PIP: This study examined the perceptions of teenagers and young adults on condoms and condom use. By using two focus group sessions, 88 teenagers and young adults from South Africa were interviewed about their attitudes towards using condoms. The findings indicated that issues of image outweigh issues of risks in these groups. In obtaining condoms, these young adults did not trust free condoms and usually preferred anonymous points of purchase such as vending machines, which were also accessible at sites where they gathered for entertainment and socializing. In addition, the types of condoms available in the market were found to be unsuitable for these groups. Complaints on the color and size were noted, as well as the label of using condoms as boring and clinical. Lastly, to overcome the antipathy of using condoms, the paper suggests the following: development of black condoms, change of clinic and pharmacy staff attitude towards condom purchase, accessible distribution of condoms, and presentation of the product in such a way that it focuses on the fun aspect and less upon the clinical aspects.^ieng

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PIP: This article focuses on the response for all AIDS affected children in South Africa. In a study by the National HIV/AIDS Care and Support Task Team in South Africa and the Save the Children Fund by the UK, a variety of categories were identified when defining Children Living with AIDS/HIV. Among the most threatened groups identified were those children from infected households where children carry the burden of caring for their dying parents. In response, the government must incorporate planning for the future of children who will be orphaned as well as provide support for those children who act as caregivers while their parents are still alive. Another group are those from uninfected households who are affected by reduced access to core services and decline in economic capacity. Moreover, the escalating phenomenon is worsened by the prevailing sexual abuse cases in the country. The situation is further aggravated by the lack of policy framework that acts as a barrier to an effective and coordinated action. This article advocates the mainstreaming of HIV/AIDS and children's issues into all key program and development areas across all sectors. Likewise, moving the children from the peripheries of the planning process and acknowledging their pivotal role, practitioners will immeasurably strengthen the capacity of South Africa in its fight against AIDS.^ieng

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PIP: This article reports on the initiatives that were undertaken by the International Partnership Against HIV/AIDS in Africa (IPAA). The IPAA has taken the resolutions that were developed during the conference of the Joint UN Program on HIV/AIDS held during 1999 and used them as a framework for setting its own objectives. On the latter part of 1999, initial phases of consultation were initiated, which revolved around a series of panel presentations and plenary discussions, which aimed to refine some of the principles and objectives set out in the IPAA Framework Development. During the meeting the vision of IPAA was confirmed, which includes larger-scale, sustained, and more effective national responses to HIV/AIDS. These collective efforts would substantially reduce HIV infections and provide a continuum of care for those infected and affected by HIV/AIDS. Furthermore, the Partnership aims at the creation of partnerships, combined with a massive mobilization of resources that can efficiently be targeted at HIV prevention, by improving access to information, counseling, HIV testing and treatment. The potential of IPAA in its attempt to set a pan-African framework for HIV/AIDS prevention is still vague. The success of the program; however, lies on the ability of every individual, organization and government to use the IPAA to strengthen its own activities and for the program to meet its demands in creating assistance.^ieng

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