Background: According to recent statistics, the number of people who had fled their own home by 2015 was 59.5 million. In this context, the number of people who need a third person as a language link in communication with health care services has increased dramatically. This issue has led to a major challenge to healthcare providers to fulfill immigrants’ needs in communication with health care services in resettlement countries. Aim: To study Kurdish refugees’ experiences concerning communication with health care services in resettlement countries. Methods: Focus group interviews carried out with five groups of Kurdish refugees (N=21). The group interviews were transcribed, interpreted, analyzed and the text was categorized according to the content analysis method. Results: A number of difficulties regarding communication with health care services with the use of an interpreter, as well as with immigrants’ independent communication, were highlighted by the present study. Participants’ dissatisfaction with interpreters, and their competence in communication through an interpreter were reasons why some of them avoided using an interpreter although their language knowledge was limited. The other group finally had to use interpreters following their exaggeration of their language ability, meanwhile the third group waited until their language skills were good enough for independent communication. Conclusion: A number of difficulties concerning the Kurdish refugees’ communication with health care services in Scandinavian countries were revealed by the present study. Interpreters’ linguistic incompetence, their relatives’ impartially and lack of language knowledge in communication through interpreters were problems mentioned by participants. Dissatisfaction with professional interpreters’ competence, exaggeration of their own language ability by some of the participants and sufficient language knowledge were motives for Kurdish refugees’ tendency to make independent communication with health care services.

Introduction: The aim of this study was to assess core stabilization exercise effects in reducing functional disability in patients with chronic low back pain (CLBP).Methods: This study included total of 90 patients aged 40 to 60 years. After a ten-day rehabilitation program the patients from an examination group (n = 30) performed home exercise program five times a week, patients from a first control group (n = 30) three times a week, while patients from a second control group (n = 30) did not perform the exercises at all. The patients performed core stabilization exercises of moderate intensity once a day in 30 minutes sessions. The patient's functional disability was estimated using the Oswestry Disability Index (ODI).Results: After two months of rehabilitation there was a statistically significant increase in functional ability in patients who performed the core stabilization exercises five times a week(p = 0.0001) and in patients who performed the core stabilization exercises three times per week (p = 0.0001). A statistically significant difference in functional ability was not recorded in patients who did not perform the exercises. The analysis of the average values of the ODI differences at the beginning and after two months of rehabilitation showed a statistically significant difference between the group who did not perform the exercises and the group who performed the core stabilization exercises three times a week (p = 0.0001), and between the group who did not perform the exercises and the group who performed the core stabilization exercises five times a week (p = 0.0001).Conclusions: The implementation of the core stabilization exercises leads to a reduction of functional disability in patients with CLBP.

The connection of distributed sources and their impact on distribution grid has been the subject of intensive research in the last two decades. Creating a favorable environment for the production of electrical energy from renewable energy sources in many countries around the world made an evident increase in electrical energy production from renewable sources. Connecting these generators to distribution grid is not always an easy task, and often, in cases of inadequate analysis and poor choice of ways of connecting these sources, can have a negative impact on the quality of electrical energy in local distribution grids. In this paper, using a realistic test system, the focus of research is to identify the behavior of group synchronous generators connected to the medium-voltage distribution grid in "cascade" manner. The s elected test system presents the real power distribution system of the Municipality of Gornji Vakuf-Uskoplje, to which six synchronous generators are connected at the moment. Analyses results of the work of this power distribution system in the previous period indicate that there have been significant changes in the existing distribution grid (significant change in voltage, increased losses, etc.) after these generators were connected. Dynamic simulations are conducted on the basis of the appropriate mathematical models, and the response of the generators and changes in the voltage value in the distribution grid were simulated for several types of disturbances. The results show that generators remain in synchronism while tested on selected simulated disturbances, where the oscillations of the generator rotor disappear over a period of several seconds. Also, the changes of voltage value in distribution grids for simulated disturbances are within the permitted limits.

In addition to their role as effector cells in virus control, natural killer (NK) cells have an immunoregulatory function in shaping the antiviral T-cell response. This function is further pronounced in perforin-deficient mice that show the enhanced NK-cell proliferation and cytokine secretion upon mouse cytomegalovirus (MCMV) infection. Here, we confirmed that stronger activation and maturation of NK cells in perforin-deficient mice correlates with higher MCMV load. To further characterize the immunoregulatory potential of perforin, we compared the response of NK cells that express or do not express perforin using bone-marrow chimeras. Our results demonstrated that the enhanced proliferation and maturation of NK cells in MCMV-infected bone-marrow chimeras is an intrinsic property of perforin-deficient NK cells. Thus, in addition to confirming that NK-cell proliferation is virus load dependent, our data extend this notion demonstrating that perforin plays an intrinsic role as a feedback mechanism in the regulation of NK-cell proliferation during viral infections.

Summary Background One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. Methods We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. Findings We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Interpretation Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Funding Wellcome Trust.