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Nimesh Tailor
Nimesh Tailor

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As for the features of the relationship between AAS use and somatoform and/or eating disorders, Pope and Katz [54] showed that 18.2% of 88 male weightlifters who abused AASs reported a history of muscle dysmorphia, compared to none of the 68 male weightlifters who did not use AASs (controls). Blouin and Goldfield [105] examined the relationship between body image disturbances, eating attitudes, and AAS use in 43 male bodybuilders vs. 48 runners and 48 martial artists of the same sex, all recruited from fitness centers. Bodybuilders showed significantly greater body dissatisfaction, with a high tendency to bulk and thinness, and increased inclinations towards bulimia than the other two groups. Additionally, they reported higher perfectionism and ineffectiveness, as well as lower self-esteem. They also consumed more AASs and had freer attitudes towards AAS use. The main reason for taking AASs, according to AAS users, was physical improvement: AAS users reported a stronger drive to put on muscle mass in the form of bulk, more maturity fears, and greater tendencies towards bulimia than AAS nonusers. Thus, male bodybuilders seem to be at risk for body image disturbances and the associated psychopathological characteristics that have been commonly observed in patients with eating disorders. These psycho-pathological characteristics also appear to predict AAS use in this group of men.

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The risks and benefits of different screening tests vary. See Table 1 for characteristics of recommended screening strategies, which may include combinations of screening tests. Because of limited available evidence,9,10 the USPSTF recommendation does not include serum tests, urine tests, or capsule endoscopy for colorectal cancer screening. Recommended stool-based and direct visualization screening tests are described below.

Two prospective cohort studies (n?=?436,927) in US-based populations reported on colorectal cancer outcomes after colonoscopy screening.9,10 One study among health professionals found that after 22 years of follow-up, colorectal mortality was lower in persons who reported receiving at least 1 colonoscopy (adjusted hazard ratio, 0.32 [95% CI, 0.24-0.45]),39 although findings were no longer significant after 5 years for adults with a first-degree relative with colorectal cancer. This study included persons younger than 50 years, although results for this age group were not reported separately. Another cohort study among Medicare beneficiaries reported that the risk of colorectal cancer was significantly lower in adults aged 70 to 74 years (but not aged 75 to 79 years) 8 years after receiving a screening colonoscopy (standardized risk, 0.42% [95% CI, 0.24%-0.63%]).40 One large, prospective cohort study (n?=?5,417,699) from Taiwan reported on colorectal cancer mortality after introduction of a nationwide screening program with FIT in adults aged 50 to 69 years.41 After 1 to 3 rounds of biennial FIT screening, lower colorectal cancer mortality was found at 6 years of follow-up (adjusted relative risk, 0.90 [95% CI, 0.84-0.95]).

Harms from CT colonography are uncommon (19 studies; n?=?90,133), and the reported radiation dose for CT colonography ranges from 0.8 to 5.3 mSv (compared with an average annual background radiation dose of 3.0 mSv per person in the US).9,10 Accurate estimates of rates of serious harms from colonoscopy following abnormal CT colonography results are not available. Extracolonic findings on CT colonography are common. Based on 27 studies that included 48,235 participants, 1.3% to 11.4% of examinations identified extracolonic findings that required workup.9,10 Three percent or less of individuals with extracolonic findings required definitive medical or surgical treatment for an incidental finding. A few studies suggest that extracolonic findings may be more common in older age groups. Long-term clinical follow-up of extracolonic findings was reported in few studies, making it difficult to know whether it represents a benefit or harm of CT colonography.

Role of the Funder/Sponsor: AHRQ staff assisted in the following: development and review of the research plan, commission of the systematic evidence review from an Evidence-based Practice Center, coordination of expert review and public comment of the draft evidence report and draft recommendation statement, and the writing and preparation of the final recommendation statement and its submission for publication. AHRQ staff had no role in the approval of the final recommendation statement or the decision to submit for publication.

This work may not be reproduced, reprinted, or redistributed for a fee, nor may the work be sold for profit or incorporated into a profit-making venture without the express written permission of AHRQ. This work is subject to the restrictions of Section 1140 of the Social Security Act, 42 U.S.C. 320b-10. When parts of a recommendation statement are used or quoted, the USPSTF Web page should be cited as the source.

On this site, the term "country" does not in all cases refer to a territorial entity that is a state as understood by international law and practice. As used here, the term also covers some territorial entities that are not states. Dependent territories of member countries are listed alphabetically followed by a description of the constitutional relationships with their member countries.

Afghanistan is currently going through a severe third wave of infections, with the number of cases and deaths topping the peaks of the first wave a year ago. Almost a third of the individuals tested recently had the infection. In response, the authorities have closed schools until further notice and are trying to speed up vaccinations. In consultation with the neighboring countries, they have also halted the movement of people across borders while keeping them open to trade and cargo transit.

The authorities aim to vaccinate 60 percent of the population. Essential workers and groups prioritized by the National Technical Committee based on their vulnerability to COVID-19 will be vaccinated first. Inoculations using 500,000 doses of the AstraZeneca vaccine donated by India started in February. The COVAX facility aims to provide vaccines covering 20 percent of the population, with the first shipments of 468,000 doses delivered in early March. Vaccination of another 28 percent of population is expected to be funded by World Bank and ADB grants. That said, less than one percent of the population has been fully vaccinated so far, and Afghanistan is facing a vaccine shortage after a large shipment has been delayed significantly. In response, China donated 700,000 doses, and the U.S. is delivering 3 million doses of the single-dose Johnson & Johnson COVID vaccine this week. In addition to the vaccine shortage, the inoculation campaign is also facing administrative challenges and vaccine hesitancy in rural areas.

The authorities rolled out about 0.8 percent of GDP social assistance under the World Bank-funded REACH program in 2020, with the remaining 0.6 percent of GDP continuing in 2021. The program targets Afghan households with incomes of $2 per day or lower (twice the national poverty line), with households in rural areas receiving an equivalent of $50 in essential food staples and hygiene products, while those in urban areas a combination of cash and in-kind equivalent to $100, in two tranches. .

The government adopted two support packages in 2020 for people and businesses affected by the COVID-19 pandemic of a combined size of Lek 45 billion (2.8 percent of GDP) consisting of budget spending, sovereign guarantees and tax deferrals. The first package adopted on March 19, 2020 through a normative act had support measures of Lek 23bn (1.4 percent of GDP) through a combination of spending reallocations, spending increases and sovereign guarantees to support affected businesses. The key measures are: (i) additional funding for health sector in the amount of Lek 2.5 billion (ii) Lek 6.5bn for the support of small businesses/self-employed that are forced to close activities due to the COVID-19 pandemic by paying them minimum salaries (up to two in the case of family businesses with unpaid family members), doubling of the unemployment benefits and social assistance layouts. (iii) Lek 2bn of defense spending reallocated toward humanitarian relief for the most vulnerable which were not used, (iv) Lek 11bn (0.6 percent of GDP) sovereign guarantee fund for companies to access overdrafts in the banking system to pay wages for their employees for up to 3 months with an interest rate capped at 2.85 percent for a maturity of up to 2 years. The government will bear the interest costs. The second package adopted on April 15 2020, includes (i) Lek 7bn (0.4 percent of GDP) fund to pay for a one-off transfer of Lk40,000 to employees of small businesses affected by the pandemic not covered in the first package, employees of large businesses laid off due to the pandemic, and employees in the tourism sector; (ii) a sovereign guarantee of Lek 15 billion (0.9 percent of GDP) to provide loans for working capital for all private companies that were tax-compliant and solvent before the pandemic. The government will guarantee 60 percent of the loans, and interest are capped at 5 percent. As of November 3, almost 98 percent of the overall budgeted direct support measures had been paid out while the take up for the first guarantee scheme was 59 percent and for the second scheme 42 percent. A third smaller support package was adopted on August 13, providing an additional minimum wage to public transport workers who resumed work one month later than the rest. The measure costing Lk135m is accommodated within the existing transport budget.

A gradual easing of containment measured started in early June 2020. The authorities have continued to monitor and adapt the lockdown measures as needed, including during the second wave of the pandemic in Algeria in late 2020. International borders partially reopened in June 2021. The number of daily new cases, which had fallen sharply through late March 2021 following a peak during the second wave, is ticking up again. Algeria started the vaccination campaign in late-January 2021 and has since received additional doses through the COVAX Facility and other sources for a total of 2.7 million doses as at end-May 2021. Domestic production of the Sputnik V vaccine is expected to start in September, according to an official government announcement. 041b061a72


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