#create more issues for the children & ours was no different. it was both strict n neglectful? tere wer clear time tables set in day2day life | Explore Tumblr Posts and Blogs

gallivantingheart · 4 years

Photo

Me, a Princess? Shut Up!

masterlist | next

⏮️ chapter 1: no way ⏭️

who?: jihoon/woozi x (f)reader

word count: 2195

genre/s: fluff, humour

warnings: none

synopsis: Life’s pretty good for y/n. Easy, even. Until someone claiming to be her grandmother says she is the queen of a small island country - and y/n, a princess.

a/n: thanks for your patience everyone!

**please ignore the timestamps - they are not accurate**

The doorbell rings with the stupid song your dad picked and you flinch, jostling your coffee. Too early for any of that kind of noise. Still, you look at your mother, brow quirked. “You weren’t expecting anyone, were you?” She shakes her head. “Mingyu wasn’t picking you up?” You don’t have a class with him today. The doorbell switches to knocking, becoming a touch more firm and impatient. Your mum turns the corner to the short hallway. Her voice is muffled and stilted, making you shrink with your hot drink in hand. Obviously not a warm welcome. When she gets around the corner, you’re shocked when two others follow. A chic elderly woman and a tall man you swear shouldn’t have been able to fit in the doorway. The pastel dress blazer alone makes you feel underdressed in your own house. There is a sharp glint to your mother’s eyes that you don’t like as she glances at them.

“It would have been better if you called beforehand. We would have made a bit more time.” There is a downward turn to her lips as she says it over her shoulder, rounding the kitchen counter to return to her tea. “I know you, dear. I would never have seen you, had you been notified of my arrival.” The elderly woman says. You stand silently, watching the strained conversation pass back and forth. You note that the woman has the same eyes as your mother and that the man dressed in black hasn’t left the entry to the hallway. Your mum pulls out two more mugs, one plain with strict edges, the other quite stout yet sophisticated. “Please, sit. Do you want anything to drink? Tea, coffee?” “Tea. One sugar.” You gape as she pours one coffee, black into the taller mug, pushing it across the bench to the man. He takes it with a nod. The elderly woman sitting at your dining table eyes you heavily, squinting and scanning your half-asleep frame. It makes your shoulders crawl as you look away. You’re a bit confused as to the small talk; it was something your mother hated. Why is she suddenly letting this woman in and indulging her every whim? Your phone vibrates over the bench - Minghao. You’re going to be late for class if you keep at this any longer.

You turn to sneak to the back of the house to get ready, ignoring the fact you hadn’t even been introduced. Frankly, you’re pretty sure you have been forgotten. “Ah-ah. Not so fast. Come here.” You screw your nose up at your mother’s tone. Turning, you seat yourself next to her tentatively,. She sighs. “Y/n, this is your grandmother. My mother.” You have to consciously keep your teeth together so your jaw doesn’t drop. No one talked about your mother’s side of the family. Your dad avoided it on a weak presumption of ignorance. You could see why now. The pastel woman holds her thin hand out across the table. “Y/n, my name is Park Soonhee. A pleasure to meet you.” Her tone of voice booked no argument and you shake her hand firmly despite your trepidation. It’s cold, but not clammy. You’re still too busy watching Soonhee and your mum exchange looks, whole conversations filled between them. Soonhee nods with the breath of a smile, relaxing back to her place. She folds her hands neatly in her lap, her tea untouched despite accepting the offer. The lavender blazer and skirt are still off-putting and you note she has some kind of gold coat of arms pinned to her chest. “Firm handshake. Very good.”

She turns to look between your mother and yourself. “I’m glad you’re both here. This is a discussion for the women of our family.” You hate how dismissive Soonhee is of the tension she creates with every word. The aura around your mother is tensing, stretching to the point of snap. Your mother’s agitation always sets you off as well, far more than you’d like. The more she speaks, the more the questions grow. Soonhee speaks as if you’re already halfway through the conversation. “Mother, what is it?” Your mum sighs. “Younghee, I am asking for you to take your rightful place as queen of our country. As of now, I am a widowed queen with no official heir. You are first in line. You cannot turn your back on your people.”

Snap. You mother pushes up, grabbing her tea and chucking it down the drain. Once she rinses her cup, it clatters into the sink loudly. When she looks back, you swear you can see a fire in her eyes. It distracts from the fact that Soonhee, your grandmother, is saying she and your mother are royalty. “We talked about this years ago. Many times. When I married Sunghoon. When Y/N was born. When my son was born. Every time I have said no. Why do you think it would be any different now? It’s been over twenty-five years. Enough.” She snarls. With fury like that, you expect the man in the entry to make a move. No such action happens, so it seems he doesn’t consider her a threat. A mistake on his part, you think - you’ve seen how violently she can cut carrots for dinner when she’s angry. “Younghee. Our family is a long and proud line of leaders, the backbone and foundation to our country’s existence. Every law and system is in part due to our hand. If you reject this, it may jeopardise the entirety of Amaide’s monarchy and result in the deterioration of the country itself.” Soonhee finally raises her voice and it feels like it should threaten more than it does. “Well, I guess you should have thought about that before coming into my home and expecting your sort of answer.” Your mother is taut in the way she stands, her anger showing her age like no other emotion does. She doesn’t even properly face the queen when she speaks. You have to break the tension - there’s too much going on not to.

“Uh, what are we talking about, exactly? I’m hearing royalty? Mum, we’re not royalty. I can’t even do my hair properly on the best of days.” You murmur. Soonhee spins on you, aghast. “Younghee. Do they not know?” Even the guard looks uncomfortable now, subtly pushing his coffee back to the bench and checking behind him to the front of the house. You hear the heavy sigh from the kitchen, the under breath whispering that your mother does when she’s stressed. Carefully, she sits on your edge of the sofa, sandwiching you between the two women. “You heard right. Soonhee is the Queen of Amaide. That makes me a princess.” She says, eyes steady on you. You gape and splutter, pointing slowly between them. “You, a princess, mum? No way.” She nods, eerily calm. “It’s true. My full name and title are Princess Younghee Park, Heir to Amaide. I passed this title on years ago though, when I met your father. Therefore, the title falls to the next blood heir.” Your mind whirls. You knew your uncle had no children or a partner of any sort, resulting in many a summer spoiled rotten in ways you never fully understood. Your mum has no other siblings other than him. You were the eldest. Which meant … “No. No way. No way! I’m not -” Soonhee nods for you. “Yes. Technically you are. Princess Y/N Y/L/N, of Amaide.”

You stand up. “No, I don’t understand. What about dad? How much - where - what?” “Baby, your father hasn’t done anything. He knows about all of this but I made these choices. When I met your father here and married him, I was supposed to go back to Amaide and take my place as queen. Instead, I chose to step down and abdicate to live a normal life - to give you a normal life. For your father and the rest of our family. But, some people just don’t take no for an answer.” She glares at the queen. “Were you ever going to tell us?” You say in a breath. She shrugs. “One day. When it wouldn’t be a problem anymore. But, I would never lie to you if you found out on your own.” She had a point. It was never lied about, just never discussed. Soonhee looks quite disgruntled at the whole situation but you can’t find yourself to be sympathetic, what with the way she barged in.

You stand and shake your head at the crumpled expression turning your mother’s lips. “So, uh, we’re royalty. R-right. This is a lot to take in. I have, um, class. Can we talk about this more when I get home?” Mum smiles and nods. “Sure, baby. Be quick.” It’s a fumbled rush down the hall and through your room to get your bag and your jeans on, not catch your toes in the knee rip. When you get out, the conversation has turned to a murmur, which doesn’t settle you any less. “‘Kay, going!”

“What about Y/N?” Soonhee says suddenly, louder than expected. You still and swallow a sigh. You thought you got out of this conversation for the time being. “What about me?” “Y/N, just because your mother has passed the crown on, doesn’t mean you have to. You could be the queen.” Soonhee says with a trace of smugness settled into her spine on your bowing sofa. Your mum jumps in, waving her hands and all. “Uh-uh. Not so fast, Soonhee. Didn’t you hear her? We would talk about this later. You can’t just spring something like that on us when she’s just found out.” “Which wouldn’t have been an issue, had you told her in the first place. She deserves the right to know about her heritage.” You shift on your feet, socks balled up in a hand as you watch the conversational tennis continue to play out. As usual, you’re on the fence.

“I-I don’t know. Mum’s right. I only just found out about this and I don’t understand any of what’s going on.” You mumble. “Princess Lessons!” Soonhee cries out, reminiscent of a mad scientist - just as persistent as one, too. “I shall be in the country for the next two months for political engagements. Plenty of time to learn about Amaide’s rich history and our family. Give her a taste of the life she was born for. And if all goes well, announce her out to polite society at the Independence Gala.” You hold your socks out to pause the situation. “Okay, hold on. Hold on. To be clear: I do get a choice in all of this, yes?” “Yes, of course. Take the lessons and then make your decision at the Gala whether or not to accept the crown.” Your mother steps up, curling around your side. “Baby, I do agree that I want you to know who your family is, now that you know. But you’re being given the one thing I never had, that I had to take - a choice. You get to decide your future.”

You watch the elderly woman, haughty and still. Something felt too simple. Too easy. “But, of course, no one can know. As of this moment, your existence is a classified, government secret. If the press heard about this-” Your mum gasps, rolling her eyes. “God no. If anybody got wind of this I can’t imagine the mess it would make for all of us. I don’t want the rest of the family going through that, after all the efforts made to keep a sense of normality.” “Oh, but it’s alright if I do.” You grumble, mimicking your mother’s actions. The fire sparks back in your mother’s eyes, stifling you. You nod and mime zipping your mouth with a sigh. “Good. Don’t you have class?” You shrug. “Yeah, I’m gonna be late though.” Soonhee waves over the man still hovering in the entryway. “Junwoo, can you get the car ready? Y/N has class.”

The great hulking man has kind honey brown eyes as he frowns at the queen. His coffee is long gone and you wonder if he’s sweating underneath all that thick black uniform. Honestly, he seems too cool for that inconvenience. “Your Majesty?” His voice rumbles carefully. “Oh, I’ll be here. We still have matters to discuss. Y/N, this is Junwoo, head of my guard and driver. Let him know where your school is.” You nod and wave them off, leaning in to the kiss your mother plants on your cheek. Junwoo walks with a scary amount of grace through your house, waiting at the door while you put your socks on at the step and wriggle on your shoes. You turn the corner out from the walking lane to the street, your jaw hitting the sidewalk at the sight of the small convoy of limousines lining the road. “A-are we taking all of these?” You rasp. Junwoo slides on his shades and shakes his head with a smile. “No, just the first one. We’ll be there before you know it.”

TAGLIST: @amarachi-luv

don’t hesitate to send an ask or dm to be added!

#caratwritersclub #seventeen au #seventeen fic #seventeen social media au #jihoon fic #woozi fic #mapsu fic #written

82 notes · View notes

douchebagbrainwaves · 3 years

Text

WHEN YOU NOTICE A WHIFF OF DISHONESTY COMING FROM SOME KIND OF FUNDAMENTAL LIMIT EVENTUALLY

When you're working on language design, I think it may be possible in principle to design a language is to just write down the program you'd like to be able to get into the deals they want. So here we had two levels of interpretation, one of which is: You shouldn't put the blame on one parent, because divorce is never only one person's fault. Semantically, strings are more or less a subset of lists in which the elements are characters. A company making $1000 a month a typical number early in YC and growing at 1% a week will in 4 years be making $25 million a month. What really bothers parents about their teenage kids having sex is that they make deals close faster. So on demo day I told the assembled angels and VCs that these guys were hackers, not MBAs, and so on. When IBM introduced the PC, they thought they were going to make money selling hardware at high prices. People hiring for a startup to a single problem. But few tell their kids about the differences between the real world and the cocoon they grew up in. And so it proved this summer. Power is shifting from the people who create technology, and if our experience this summer is any guide, this will be a good deal of programming of the type that we do today. The future is pretty long.

I'm sure they find it constraining, but think how valuable it will be dark most of the 1970s. He seemed to have lost their virginity at an average of about 14 and by college had tried more drugs than I'd even heard of. It would cost something to run, and it seems to bother a lot of the spread of modern religions, and explains why their doctrines are a combination of the useful and the bizarre. But in the US.1 If you make software to teach Tibetan to Hungarians, you won't ordinarily need to bother with this sort of calming lie is that we get on average only about 5-7% of a much larger number. The course of people's lives in the US.2 His motive is partly that it would worry them, partly that this would introduce the topic of sex, and partly because startups early on need frequent feedback from their users to tweak what they're doing, just as you can't find north using a compass with a magnet sitting next to it. The catch is that people will hold you to it. If the idea still seems unbearable in a hundred years.3 Indeed, the more interesting sort of convergence that's coming is between shows and games.

One of the most spectacular lies our parents told us was about the death of my grandfather.4 And the probability of a group of sufficiently smart and determined founders succeeding on that scale might be significantly over 1%. For example, Y Combinator has now invested in 80 startups, 57 of which are still alive. And I admit that it is, if you get growth, everything else tends to fall into place. So I'm not suggesting you be good in the usual sanctimonious way. What do parents hope to protect their children from by raising them in suburbia?5 A painting familiar from reproductions looks more familiar from ten feet away; close in you see details that get lost in reproductions, and which you're therefore seeing for the first time.6

What happens to fast growing startups tends to surprise even the founders. It's hard to predict what life will be like in a hundred years, maybe it won't in a thousand.7 Kids, almost by definition, lack self-control. One of main causes of the decay of the corporate ladder. The other is that some companies broke ranks and started to speculate about what they'd produce when they converged. But because the lies are indirect we don't keep a very strict accounting of them.8 A parent added: In our country, college entrance exams determine 70 to 80 percent of a person's future. I had no idea what he was talking about—that he was on the list because he was too young. If you want to create for a newborn child will be quite unlike the streets of a big city. The test of any investment is the ratio of return to risk, if both were lower.9 Synchronicity and locality are tied together. The other way to get returns from an investment is in the form of dividends.

It was also a test of wealth, because they don't have sufficient flexibility to adapt to them. My father's entire industry breeder reactors disappeared that way. They seemed a little surprised at having total freedom. All they're tasting is the peppers. And, of course. It's hard to find something that grows consistently at several percent a week, but if I were a boss making people work this hard. So someone investigated, and sure enough, that patent application had continued in the pipeline for several years after, and finally issued in 2003, but no one's preferences are any better than anyone else's.

That never works unless you have a monopoly or cartel to enforce it, and so on. If some applications can be increasingly inefficient while others continue to demand all the speed the hardware can deliver, faster computers will mean that languages have to cover an ever wider range of efficiencies. Actor too is a trend we see happening already: many recent languages are compiled into byte code. Languages today assume infrastructure that didn't exist in 1960. When we were starting a startup seems impossible as surely as starting a startup: to be a vehicle for experimenting with its own design. As well as working hard, the groups all turned out to vary a lot. Which will tend to push even the organizations issuing credentials into line.10 Should you spend two days at a conference? Most adults make some effort to conceal their flaws from children. It's already a successful language.

Notes

It is a matter of outliers, are not in the construction industry. In both cases you catch mail that's near spam, for an IPO. Angels and super-angels will snap up stars that VCs may begin to conserve board seats by switching to what you have no way of calculating real income statistics calculated in the 1920s to financing growth with the founders' salaries to the customer: you are listing in order to test whether that initial impression holds up.

A country called The Socialist People's Democratic Republic of X is probably a real partner.

But that oversimplifies his role. Some of the edge case where something spreads rapidly but the meretriciousness of the river among the largest in the definition of politics: what determines rank in the past, it's cool with us he would have. Most computer/software startups are usually about things you've written or talked about convergence.

And though they have to spend all your time working on such an interview, I'd say the raison d'etre of prep schools improve kids' admissions prospects. If they were getting results. At one point they worried Lotus was losing its startup edge and turning into a few that are up there.

It will require more than they expected and they would implement it and make a conscious effort to extract money from the initial investors' point of saying that because a quiet, earnest place like Cambridge will one day be able to at all.

N Goo: df foo n n _ Arc: def foo n n _ Arc: def foo n op incf n _ Arc: def foo n lambda i set! I used to retrieve orders, view statistics, and this was the first duty of the money they're paid isn't a picture of anything.

No central goverment would put its two best universities in your next round.

Don't be fooled by grammar. A deal flow, then over the internet.

Startups that don't raise money?

But having more of the war, tax rates, which is a very noticeable change in the mid 1980s. And while they think they're just mentioning the possibility is that Digg is Slashdot with voting instead of bookmarking. 107. There may be common in, we don't use Oracle.

0 notes

theticklishpear · 7 years

Photo

(A table of contents is available. This series will remain open for additional posts and the table of contents up-to-date as new posts are added.)

Part Eight: Knowing the Outer Family

Family is typically thought of as being those individuals contained within the nuclear family scope: parents, siblings, and the character. Individuals outside of that core take up the title of extended family. This could include grandparents, aunts, uncles, cousins, n-th-removed individuals, and great- individuals. How well a character may know their extended family will depend on quite a few things, not the least of which is the relationship between the extended family members and the character’s parents, as well as the society’s kinship system and their understanding of what is required of extended family.

Establishing Family Ties Outside the Nuclear Family:

All extended family will have some relationship with the character’s parents, whether it’s direct bloodline such as an aunt who is the sister of a parent, or whether it’s through marriage such as step-grandparents. Despite that there are these ties that connect each of these individuals, your character may or may not have any knowledge of them. What they know of each other, how well they know them, and how well they all get along boils down to having a good grasp on your character’s parents. You must know what kind of people they were and what kind of relationship they fostered between their own siblings and parents in order to best assess how your character relates to their extended family, but you also need to assess how important history--specifically family history--is to each of those people, and to the family as a whole. The more interested someone, or a couple someones, is to remembering that history, the more likely your relatives will be to keep in contact. Of course, it helps as well to consider family values and whether certain individuals have irrevocably broken those values, but that should be determined on a case-by-case basis.

Taking my own family as an example again, our ties are very close: My grandfather’s cousins regularly attended family functions such as high school and college graduations and weddings for my sister and I despite my family frequently not living a convenient distance from them. I still consider my deceased step-grandmother’s daughters my aunts, despite not being related at all except for a few years of being married into the family. My mother’s cousin’s children are still points of interest in my life. This expanded knowledge of ... let’s be real, pretty much the entire extent of my extended family all boils down to two things: Good and friendly relationships between my parents and their families, and a shared family passion for history and maintained knowledge.

What does this mean for your characters? Well, it means that you can choose all kinds of complex backstories for your characters without having to completely cut out family! You may be able to build relationships within the extended family that are stronger for your character than the relationships built between the nuclear family members, a new take on family for literature that’s not all that uncommon in our own world. You can also choose to introduce conflict to your story based around these extended relationships if there are members the character’s parents didn’t get along with. With large and complex families, there’s even the possibility for both! The current trend for stories is for characters to gain their support systems around and beneath themselves from the individuals they gather along their journeys, but you may find that if they bothered to reach out, there’s a grand opportunity within their own family.

Expectations of the Extended Family:

The relationship between your character and their extended family members is automatically different than the relationship between themselves and their nuclear family solely from the fact that they weren’t raised day-in-and-day-out with each other and the extended family isn’t responsible for the discipline of the character. You have an opportunity to establish relationships with your character from an adult perspective, without the strictness of the parent-child relationship. Where parents are trying their hardest to keep a child safe and make sure they go down a good path in life (whatever that equates to), an aunt, uncle, or even so far as a great-uncle can give advice to a character without as much fear of the backlash that often accompanies a parent’s attempt.

In many kinship systems around the world, aunts and uncles are afforded what’s termed a joking relationship. This type of relationship allows for teasing and mocking--making jokes--with or at the other individual, and is often used to diffuse situations, teach lessons through playing tricks, or as an emotional outlet. Individuals in joking relationships generally don’t take offense at the needling of the other since it’s expected and made in good faith. These types of relationships often help establish trust since the adult family member is free from the responsibility of discipline or judgment. They’re free to sympathize--and can sympathize if it’s an issue arising in the character’s life from their parents, since they also have dealt with many of the same things at various times from the character’s parents. Thinking specifically of aunts and uncles, these were the siblings of your character’s parents, and can probably very easily understand the frustration caused by a pushed button, having pushed it themselves several times. There’s a shared history through the character’s parents between them, and that history can create strong bonds--and usually safe bonds as well. Extended family members generally care in a way that holds both investment--the family line--but also an objective distance--not their nuclear family--that allows them to guide and comfort in a meaningful way.

Something else to keep in mind is the cultural idea of what extended family members are responsible for in their niece/nephew/nibling/etc.’s life. Some systems give the aunts and uncles the spiritual lives of their niblings to look after, while others place birthday celebrations for their niblings solely in the hands of the aunts/uncles/piblings, and out of the parents’ hands entirely. Perhaps that’s why the Strange Uncle who’s always traveling turns up only for birthdays, who knows, but the idea that the responsibilities of family members and extended members don’t have to align with those listed by modern interpretations of kinship is an important factor to consider. How can you use that to your advantage within your story?

Next up: Writing piblings!

#writing #writing tips #relationships #posts by pear

259 notes · View notes

juniperpublishers-oajnn-blog · 5 years

Text

Hydrocephalus in Sudan; Types, Management and Outcome

Authored by Mohammed Awad Elzain*

Abstract

The incidence of congenital hydrocephalus is still very high in Sudan. Most of the patients present late with large head and malnutrition, which make the management very difficult. Materials and method: This study is a retrospective review joining all children younger than 15 years of age who have been operated at the National Center for Neurological Sciences during the period from Aug 2011 to December 2013. The data obtained from a computerized data record system in the center and the patients were clinically assessed by the author when during follow up in the refer clinic. Results: Most patients lie in the age group (birth â€“ 3 months) 40.5%. The majority of the cases presented with large head 71.8%. Hydrocephalus secondary to Chiari II malformation represented the commonest etiology of congenital hydrocephalus (42.7%) while postmeningitic hydrocephalus was the commonest etiology of secondary hydrocephalus (82.1%). Fortunately 10.7% had shunt complications, but only 6% had early postoperative shunt infection. The commonly found associated congenital CNS anomaly was myelomeningocele (35.1%).

Folic acid and supplements were defective in 72.5% of the pregnant ladies who started to take the folic acid after the end of the first trimester. Four patients found to have problems during pregnancy, 2 of them had malaria, one PIH and one recurrent UTI, however none of the patient had FH of similar condition. Discussion: Most of the patients were from Khartoum and the central area (68.7%). This is followed by those from the Western part of Sudan (Darfur and Kordofan), as there is a lot of wars and refugees which has created nutritional impact on the ladies in the childbearing age As a result of the poor antenatal follow up and the illiteracy of most of the parents, most of the diagnoses were made late when they notice their baby’s head increasing. The presence of associated congenital anomalies makes the management much more difficult. Conclusion: Early detection and management of hydrocephalus should be considered by increasing the awareness of the medical professionals and the general populations. The use of strict meticulous aseptic technique during the operative procedure is crucial in preventing shunt infection and most other serious complications. The ventriculoperitoneal shunt procedure is not an easy one and should be performed by the most experienced neurosurgeon under the most optimum condition.

Keywords: Congenital hydrocephalus; Large head; Folic acid deficiency

Go to

Introduction

Hydrocephalus is a common health problem that is associated with aggressive morbidity and mortality [1]. Different types of hydrocephalus may be managed with the placement of the ventriculoperotineal shunt, but the complications related to shunt placement should be identified and managed properly particularly in the first 5 years following shunt placement. A survey done by Albright A.L. in 2010 recruiting seven pediatric neurosurgeons proved that there is no standardized technique or shunt type to prevent shunt complications and the most important issue after shunt implantation is the patient follow up. It was also noticed that, none of the pediatric neurosurgeons operate on asymptomatic patient or do annual follow up images for shunted patients with hydrocephalus beyond 5 years [2].

The most annoying shunt complication is shunt infection which requires urgent shunt removal as the bacterial growth affects the shunt hardware [3]. However when the shunted patients develop meningitis, they should be managed the same as those who have meningitis without shunts and shunt removal here is controversial [3]. Shunt infection caused by coryenebacterium species represents a special challenge as it was found to be resistant to most antibiotics and requires shunt removal [4]. In cases of delayed shunt infections,Propionibacterium acnes is believed to be the causative agent and was also found to be very difficult to eradicate even with prolonged antibiotics therapy and also requires shunt removal [5]. Bayston R. suggested that the antibiotic impregnated shunts use may prevent this later type of shunt infections [6].

Brydon H.L. in his study emphasizes the fact that the high CSF protein content does not increase the risk for shunt infection [7]. However these findings are still theoretical and more studies are needed to confirm this. Furthermore, Brydon also published another study 2 years later stating that protein deposition in shunted patients is not the main cause for shunt obstruction [8].

Numerous advances were done to improve the shunt valve manufacturing starting from fixed pressure valves to programmable valves. However, the later have the problem that the valve pressure may be accidently changed upon exposure to a high magnetic power [9]. This problem has been solved with the provision of the ProGAV valve system and its efficiency was proved in the study done by Allin, D.M. in 2006 [9]. Two years later Allin D.M. discovered that Polaris valve may also overcome the problem of accidental re-adjustment and this has been evaluated at UK Shunt Evaluation Laboratory in Cambridge [10].

Shunt nephritis is another rare form of shunt complications and up to the year 1996 only 115 patients were reported in the literature11. This is a reversible form of renal disease caused by shunt infection and can be managed by either prescribing antibiotics only or by both shunt replacement and antibiotic treatment11. The CSF over-drainage upon changing from horizontal to vertical position ( Siphoning effect ) has been known as one of the shunt complication that necessitated the evolution of new shunt devices with anti-siphoning effect like Z flow hydrocephalus system and Diamond valve [12,13].

Silicon hypersensitivity, an immune response mediated towards the implanted silicone catheters has been also believed to increase the risk for shunt failure. Eymann has suggested the use of animal models to study that immune response in order to understand this phenomenon and to help in improving shunt system manufacturing [14,15]. Shunt obstruction is a common complication of shunt implantation that may be diagnosed clinically and confirmed by different imaging techniques. Due to the high dose of radiations associated with repeated CT brains, Goetz suggested the use of infrared-thermography a noninvasive tool to verify shunt patency and this was found to be sensitive in more than 85% of patients [16].

The nutritional status of the patients with hydrocephalus is an important overlooked factor that may have negative influence on shunt surgery. In India Jain G. found that the post-operative shunt complication rates were significantly higher in the poorly nourished children [17].

Most of the Sudanese children with hydrocephalus were malnourished this is due to fact that the incidence of congenitalhydrocephalus together with post meningitic type is still very high in Sudan. Beside that most of the patients present late with large heads this also lead to increase incidence of the complications associated with shunt placement which make the management much more difficult. Therefore we conducted this study to reflect and publish our experience in diagnosing and managing hydrocephalus in Sudan and to show the magnitude of the problem, there are no previous published studies discussing the problems of patients with hydrocephalus in Sudan.

This study is a retrospective review joining all children younger than 15 years of age who have been operated at the National Center for Neurological Sciences during the period from Aug 2011 to December 2013. The data obtained from a computerized data record system entered by the neurosurgical residents and a trained information technology person in the center. Data entered include that obtained from the file, while operative and postoperative data was obtained from the authors and the operating neurosurgeons and entered in the system immediately after surgery and during follow up in the referred clinics. The patients were regularly clinically and radiologically assessed by the authors over 3 years follow up period.

Go to

Results

Sex distribution

The total number of the patients studied was 131 patients 81 of them were males (61.8%), and 50 patients (38.2%) were females (Table 1) (Figure 1).

Age distribution

The youngest patient operated was 15 days old and the oldest was 12 years old with average presentation at 1 year of age (Table 2.1).

When patients were ranked in groups, it was found that most of them were in the age groups from birth to 6 months (n=89/131, 68%) (Table 2.2) (Figure 2).

Go to

Residence

Most of the patients in the series were from Khartoum and central areas around Khartoum (the capital of North Sudan) (n=90/131, 68.7%) (Table 3) (Figure 3).

Presentation with large head

Almost three quarters of patients (n=94/131, 71.8%) presented with larger head (more than 2 SD “98%” Head Circumference for age, one percentile for boys and one for girls) as their first presentation and as the first abnormality noticed with their parents (Table 4) (Figure 4).

Causes and types of hydrocephalus

Most of the children in this study were having hydrocephalus secondary to Chiari Type II malformation caused by their associated myelomeningocele (n=44, 33.6%) followed by those with congenital acquiductal stenosis (n=40/131, 30.5%). Secondary (acquired) hydrocephalus was mainly in a form of postmeningitic hydrocephalus , the diagnosis was made utilizing both clinical and radiological data using CT and MRI scans (n=20/131, 15.3%) (Table 5.1 & 5.2) (Figure 5.1 & 5.2).

Associated CNS congenital anomalies

We only mentioned here in this study the congenital CNS anomalies while the other non related congenital anomalies were not mentioned (Table 6).

Type of surgery done

Most of the patients were operated through posterior approach through Keen’s point using medium pressure (MP) valves and the ventricular catheters were placed at the occipital horn of the lateral ventricle. In some few cases like those with posterior fossa tumors the ventricular catheter was placed at the frontal horn of the lateral ventricle through Kocher’s point. The Y connecter in this study was used mainly for those with Dandy Walker variant in which the posterior fossa cyst was not communicating with the IV ventricle, the EVD was resorted to in patients where frank features of infection like pus or turbid CSF or hemorrhage were encountered during surgery in the stage of ventricular tapping .also cystoperitoneal shunt is patients with localized hydrocephalus . Dandy walker patients were treated with shunts with double ventricular catheters and Y shaped connection (Table 7) (Figure 6).

Intraoperative CSF opening pressure

The CSF opening pressure was assessed clinically intraoperatively upon tapping the ventricles and almost all of the patients were having high opening pressure (Table 8) (Figure 7).

Type of shunt used

Different types of shunt systems have been used in our center but Medtronic was the commonly used one for being supported for free for under 5 years kids by some non-governmental organizations (Table 9).

Shunt Complications

The complications encountered were in a form of infected CSF (4 patients), shunt exposure (4 patients), bloody CSF (2 patients, one of them had S.D.H. with I.V.H.) and shunt dysfunction (4 patients) (Table 10).

For the reason that shunt implantation is a lifelong commitment we considered all patients who improved after shunt procedure or during follow up within “improved” category. The late shunt complications after 3 years are not included in this study (Table 11) (Figure 8 & 9).

The improvement parameters

The improvement parameters used in this study were mainly clinical in a form of depressed Anterior fontanelle (AF) stoppage of CSF leak, Stoppage of Vomiting (V), lax AF (soft fontanelle neither bulging nor depressed), other parameters of improvement include improvement of developmental milestones whether mental or physical (Table 12) (Figure 10).

Antenatal Care (A.N.C.)

We divided the patients from thee antenatal care and tonics and vitamins supplement points of view into 3 main categories (Figure 11)

Patients with good antenatal care: Those are children of mothers who attended regularly ante natal care visits and who received the tonics from the early beginning of the pregnancy (the first month of pregnancy)

Patients with poor antenatal care: Those are children of mothers who did not attended regularly antenatal care visits and who started to receive the tonics after the end of the first trimester.

Patients without antenatal care: Those who did not attend antenatal care visits and/or who did not receive tonics throughout the pregnancy.

Pregnancy complications

Mothers of four patients were found to have problems during pregnancy, two of them had malaria, one has Pregnancy Induced Hypertension (PIH) and the last recurrent Urinary Tract Infection (UTI).

Family history of similar condition

None of the patients was found to have FH of similar condition.

Go to

Discussion

The average age at presentation was Eleven months. This late presentation may be attributed to the lack of the neurosurgical services in the remote areas. The youngest child operated was Fifteen days old and the oldest was Twelve years old. However, most of the patients present between birth up to Three months, followed with those between Four to Six months and that is why most of the operated patients were children in the pre-school age. Male sex was the dominant, but this may not have very much significance in this study.

Most of the patients were from Khartoum and the central area because the national center for neurosciences beside the two other governmental centers and some other private centers are all in Khartoum. This is followed by those from the Western part of Sudan (Darfur and Kordofan) as these regions has the highest number of population in Sudan after Khartoum and the possibility of the effect of political conflicts and war refugees which has created nutritional and health impacts on the ladies in the childbearing age.

As a result of the poor antenatal follow up and the illiteracy the diagnosis was usually late and made only after the child head increases. That is why those who presented with large head were representing the majority of our patients. 78.6% percent of the patients were found to have congenital problems like Chiari malformation accompanying spina bifida followed by acquiductal stenosis, and in 17.6% it was postmeningitic type of hydrocephalus. Therefore the congenital etiology was on the top of the list followed with the infectious etiology and this can also justify the presentation with large head. Furthermore, most of the cases were young children and a many of them had large occipital horns and small frontal horn (colpocephaly) that is why we approached most of the patient through Keen’s point using fixed medium pressure valves despite the fact that the opening CSF pressure in the vast majority of patients intra-operatively was relatively high pressure. Although in the literature Sinha et al studied Tourty patients with pediatric hydrocephalus and they discovered that there is no difference in the outcome with low or medium pressure valves [18]. But still this point is not clear in treating hydrocephalus as logically high opening pressure hydrocephalus treated with placement of low pressure shunt may lead to Medtronic, BMI, Chabra and antibiotic impregnated shunts were all used with Medtronic being the most commonly used one as it was provided free for the patients with nongovernmental organizations.

Fortunately, we had an acceptable outcome as those who had shunt complications were only 10.7% and those with postoperative shunt infection were only 6.1%. This is because we adopted a rigid protocol to prevent shunt infection (short preoperative admission one night before surgery, and discharge two days after surgery, baby wash with soap the day before surgery, first operation in the day, few number of personnels in the room not more than 6, scrubbing with 2 different solutions, non touch technique and change of gloves upon shunt insertion and using 2 different types of antibiotics postoperatively). The final outcome was promising as most of the patients improved postoperatively. We used simple clinical assessment ways to primary assess the improvement like depressed Anterior fontanelle (AF) stoppage of CSF leak, relieve of headache (H/A), Stoppage of Vomiting (V), lax AF. The strongest parameter was lax or depressed AF.

The presence of associated congenital anomalies makes the management much more difficult. More than one third of the patients in this study were having associated myelomeningocele with few of them had other congenital CNS anomalies.

Most of the mothers (72.5%) of the affected children started to receive the folic acid after the end of the first trimester while considerable number of them did not receive any folic acid throughout the pregnancy. This may reflect the association of folic acid deficiency with the development of hydrocephalus. Only few of the mothers were found to have problems during pregnancy like malaria, PIH recurrent UTI. However, the association of these conditions with the development of hydrocephalus needs further studies to evaluate the pathogenesis and the correlations if any.

Go to

Conclusion

Early detection and management of hydrocephalus, is associated with easy treatment and better outcome.

It is important to increase the awareness of the medical professionals and the general populations will decrease the overall incidence of hydrocephalus. Involvement of the general media is incredibly important.

The use of strict meticulous aseptic technique during the operative procedure is crucial in preventing shunt infection and most other serious complications. The ventriculoperitoneal shunt procedure is not an easy one and should be performed by the most experienced neurosurgeon under the most optimum condition.

The follow up of the patients should be adequate as those children might have long term complications and disabilities.

Go to

Recommendations

Fortification of the wheat flour will help the ladies in childbearing age to have good maternal serum folic acid level. Otherwise the mothers should be taught the importance of taking folic acid early in the beginning of pregnancy. Proper antenatal care is mandatory for women in child bearing age specially who has history of child birth with CNS deformities the role of media medical education in this matter is so valuable. Adopting rigid national protocol to prevent shunt infection will be useful even in the presence of associated risk factors like malnutrition.

For more open access journals in juniper publishers please click https://juniperpublishers.com/

For more articles on Open Access Journal of Neurology & Neurosurgery Please click on https://juniperpublishers.com/oajnn/

Open Access Journal of Neurology & Neurosurgery in Full text in Juniper Publishers

#juniper publishers Reviews #juniper Publishers peer review journlas Open acess journal Juniper publishers in USA Neurology

0 notes

thanx4comin2mytedtalk · 5 years

Text

Lets talk about the Arab situation around the world - mostly discrimination to muslims - (please read)

[ So, i had to write an essay for my school about anything that i wanted to, and i really liked the idea of sharing this with more people, because everybody needs to know about this problem. It’s getting worse every year, and not just whit muslims ]

Please help sharing this. -k

A/N: I’m really sorry if there’s any grammatical mistake, english is not my first language so i tried my best

Throughout this essay, the stigmatization that has spread throughout the world around the Muslim religion will be discussed. First of all, the stigma is known as a discreditor that makes a person undesirable, representing negative responses; and in extreme cases, it can turn the person into a malignant and / or the dangerous legitimacy that is morally excluded from the social sphere, and that you get an instill fear or hatred in the population. This ideology of hatred begins at to extend itself in a great way in the year 2001 after the day of September 11 in the World Trace Center-twin springs-in which more than 2000 people were classified. This was attributed to the extremist group of Al Qaeda and Osama Bin Laden. After this, the groups that sounded against Muslims, and even those who opposed all immigrants regardless of their nationality or religion, arose and / or increased in large numbers. To the aforementioned, Harem Abudayyeh2, says the following: "We have to be prepared, as Latinos, for the requirements in our jobs and in the presence of Immigration agents in our homes." Faces of terrorists to all immigrants, and not just Arabs and Muslims.

To the previous point, we can summarize the fact that in the last 5 years, the number of attacks and recruitments of young people with extremist jihadist groups have increased exponentially, most of the cause of the massive level of internet diffusion , by which you can recruit young people from all over the world, change their way of thinking and see the world.

For this very reason, it should be noted, that, people, more, than, for example, "holy wars" and Muslim children, since, less than 20% of all people who profess religion, the field of the branch that It is believed that religion. It must be expanded by whatever means necessary; Even for the violence. Although, this same hatred has not been generated only within the same religion, but also, mass media, such as television, radios, newspapers; as also actions of governmental services have been generalizers around the subject, often dismissing all followers of religion as terrorists.

In the first place, it must be explained that within Islam there is the concept of jihad, which is the effort that Muslims must make in order for the kingdom of God - Allah - to rule on earth; that is, his holy war, but there are those who interpret the Koran in a more literal and extreme way, leading them to convert and subject all who profess another religion that does not be yours, even though this must be done through violence. Knowing this, it can be explained that there are different branches and subdivisions within Islam; of which the two most extreme currents are Salafism and Wahhabism. Salafism is the oldest ideology of Muslims, which consists of following, imitating and reviving the way of being of the first Muslims; This group turns to jihad around the year 1300, when an invasion war against Damascus takes place4, where the foundations and foundations of jihad are established in an organized way as if it were a war manual. On the other hand, Wahhabism is the "clean and pure" form of Salafism, which moves it away from other currents such as Sufism and Shiism. This belief was modernized to achieve a control of the masses to expand as a nation and religion. These two became more violent with respect to the jihad, arriving to form the terrorist groups recognized today, such as Daesh and Al Qaeda. This ideology of primitive Muslims, can be seen now in Saudi Arabia, where you still cut someone's hand when he steals, or beheaded whoever shows his rejection of Islam. These beliefs and customs so old and extremist, they produce that the world-wide society sees the Muslims like very violent people, that realize public executions that soon publish in Internet realizing threats to different countries.

As a second point, we can mention the lack of acceptance and protection of the mosques present in the countries where attacks have been carried out or even in different countries of the Middle East, since every time an attack occurs by extremists from that area, segregation begins against the Muslim population around the world; they are persecuted, at airports they are inspected more than any other traveler, they are interrogated frequently; and also, they suffer attacks in their temples. The attack on a sacred place of prayer, whether it be a Christian church, mosques, Orthodox cathedrals, Mormons, Jews, among others; for any religion, it is a very serious offense, but Muslims, in the vast majority of counties in the United States, instead of receiving protection in their temples, are spied on, and mosques are controlled because they are of suspicious appearance or administration. . Even if they are the target of a large number of attacks, and like any other religion, they should receive respect, many people, because of this stigma, do not respect them because they label all Muslims equally. Personally, I had the possibility to visit a mosque and learn how everything works within them, and it is very different in comparison to other places of prayer, being from a dress code for women, as it is also, where to look while praying, or the way in which the Qur'an is professed. It is a strict religion within all its branches, from the most peaceful Muslims to the most extreme, but the strictness of a religion must never be confused with extremism and violence, that within Islam, less than 20% of its followers, they belong to extremist groups. Even in one of his public appearances, Pope Francis said the following words "I want to reiterate firmly that the path of violence and hatred does not resolve the

problems of humanity, and to use the name of God to justify this way, is a blasphemy "

Thirdly, I want to explain in greater detail the most relevant factor of the stigma created against the followers of Islam, whether due to misinformation or overexposure with respect to these issues; leaving two as the main factors, the discourse of hatred and misinformation-manipulation-about events and cyber-bullying in both mass media and social networks. First, the discourse of hatred and disinformation focuses mainly on the way in which these issues are addressed within the mass media, since, for example, the conflicts that occur in the Middle East (Attacks in Syria and Afghanistan) do not they appear as relevant news that we should be aware of, since in these places countries that are great powers are involved, such as the United States, Russia, Germany, China, among others, not even in order to solve this problem and serve as mediator between all the sides that face; but they intervene for their economic and acquisitive interests in the area. On the contrary of when an attack occurs in a crowded sector of one of the countries mentioned above, events are constantly repeated, long-term news programs of an urgent nature are made, where what is happened is overexposed, and hate speech begins with disqualifications. and threats against those who belong to the same religion. Faced with this series of attacks, in May 2016, in the United Kingdom, a simulation of a possible risk situation was carried out in front of a suicide bomber, who shouted Allahu Akbar, which was criticized, as it was stereotyped that the attackers would be Muslims, or of Arab origin, to which the citizens reacted, making it clear that they could all be terrorists and not just Muslims. Along with this mass and overexposure of attacks by Arabs, the level of hatred that is promoted through social networks, especially on Twitter, since in this place everyone can display all their thoughts no matter how extreme or generalizing these be; disqualifications that may fall within the concept known as Islamophobia. This concept does not have a clear definition, but it is accepted in the European Union, being recognized as the rejection towards Islam and therefore, to Muslims, but specifically a UN committee that is responsible for the elimination of all forms of racial discrimination, which defines it as "[...] a form of racism and xenophobia manifested through hostility, exclusion, rejection and hatred against Muslims, especially when the Muslim population is a minority, something that happens with greater impact in Western countries. "Also inside this cyber

use of bots within social networks, for the mass dissemination of manipulated images with which Islam is represented as an imminent threat.

This same cyber, is justified and backed by recognized Islamophobes, among them, Robert Spencer, who faces jihad; Pamella Geller, who sabotaged the construction of a mosque in Ground Zero; and Bruce Bawer, who is the writer of a book called "While Europe sleeps: how radical Islam is destroying the West from within." All these characters, who share ultra-conservative ideals, were exposed by Niham Awad, who is the director executive and founder of the Council of American Islamic Relations, who said "We see politicians trying to get points by marginalizing Muslim Americans and questioning their loyalty and love of the country."

To conclude, after all the above, it is clear that the world society tends to think and generalize that the followers of Islam are terrorists, although not even 30% of all of them really is. It should be noted that currently, specifically in Europe, the Muslim population is largely accepted, as, for example, 15.8% of the population of Manchester is. But, on the other hand, in the United States has increased the number of audits to immigrants, and even the number of people who have not been able to enter the country, for reasons of reforms and / or different factors.

Finally, it should be clear that although the Muslim religion is so strict in its practices because it is guided by ancient customs, this is not a determinant that justifies that all are terrorists; terrorist Muslims are those who are part of Wahhabism, even giving their lives for jihad, but not even 20% of the entire population that professes Islam, which are approximately 2 billion people around the world.

#midle east #muslim #arab #saudiarabia #islam #islamophobia #help #sharethelove #be positive #stay together #please help #help others #eeuu #trump #china #afghanistan #syrian armed force #syria news #love

0 notes

newstfionline · 7 years

Text

Russia’s Villages, and Their Way of Life, Are ‘Melting Away’

By Neil MacFarquhar, NY Times, July 29, 2017

BARUTA, Russia--With its winding dirt lanes framed by lilacs, quaint wooden houses and graceful onion-domed church, the tiny farming hamlet of Baruta was once a veritable postcard of Russian bucolic bliss.

No longer. More people lie in the tightly packed church cemetery than inhabit the village. Agriculture is slowly withering, too--the roofs of handsome stone barns have collapsed, while untamed forests invade the surrounding fields.

With Russia’s natural population growth entering an extended period of decline, villages like Baruta are disappearing from across the country’s continental expanse.

“We have not had a wedding or a baptism for quite some time--we mostly have funerals,” said a grizzled resident, Alexander Fyodorov, 59, one of just 17 men left in what was a thriving collective of some 500 farmers.

President Vladimir V. Putin frequently cites hardy population growth as a pillar of restoring Russia’s place atop the global order. “Demography is a vital issue that will influence our country’s development for decades to come,” he said at a recent economic conference, also calling it an important gauge of social and economic well-being.

There is a pronounced gap, however, between the positive terms in which Mr. Putin and his advisers habitually discuss demographic trends and the reality of the numbers.

Basically, Russians are dying faster than they are being born, demographers said. Given the general hostility toward immigration, the question is to what degree the population of 146 million, including annexed Crimea, might shrink.

The number of deaths exceeded the number of births in 2016 by a few thousand, and the prognosis for the years ahead is poor. From 2013 to 2015, extremely modest natural growth peaked in 2015 with just 32,038 more births than deaths. By comparison, Mexico, with a population approximately 10 percent smaller, recorded some 1.7 million more births than deaths in 2015.

“The statistics and the propaganda are very different things,” said Natalya V. Zubarevich, an expert in social and political geography at Moscow State University.

On the world stage, Russia is flexing its newly restored military and political might in places like Syria and Ukraine, and is using cyberwarfare to distort politics in the United States and Europe. But it often seems far less robust at home.

In particular, its rural areas--long considered the wellspring of Russian culture and identity--are dying.

Valentin Kurbatov, a specialist in village prose, moved to the Pskov region in northwest Russia in 1964. At that time, the entire region was known for cultivating flax, from which linen is made.

“Linen has this heavenly blue color, and when I came here the skies were reflected in the linen fields,” Mr. Kurbatov said over a long discussion that finally ended because he said it was too distressing. “Now the brush and swamps have returned. Even when you ride the train to Moscow, all you see is this black forest with nothing in it.”

Similar to a tire with a slow leak, villages like Baruta, 375 miles northwest of Moscow in Pskov, began to deflate after the end of the Soviet Union.

The Freedom Collective Farm, the glue that held the village together, disbanded. No longer bound by strict Soviet residency rules, the young fled to big cities with better prospects.

The school closed, and the church stopped holding regular services. The only gathering point left for the 160 year-round residents is a small general store that stocks plenty of vodka and a little bit of everything else.

“Just as fish seek deeper water, so people seek better places to live,” said Mr. Fyodorov, the farmer, showing the pithy rural wisdom that Russians hold dear.

Russia’s demographic problem dates back at least 100 years, to the upheaval of the 1917 revolution, followed by Stalin’s purges in the 1930s. Both events curbed population growth, foreshadowing the devastating impact of World War II, when Russia lost some 20 million people. More recently, birthrates plunged in the years after the chaotic 1991 collapse of the Soviet Union.

These sorts of demographic catastrophes return to stunt population growth two decades after they happen, as the number of women reaching their childbearing years drops. Russia is entering one of those periods now, recording 83,300 fewer births in the first five months of 2017 than a year ago.

In terms of population loss, Pskov, which borders Latvia and parts of Estonia, is among the worst hit regions in Russia. The population peaked at around 1.8 million in the 1920s, said Andrei Manakov, a demographer at Pskov State University. It is down to 642,000, and projected to drop to about 513,000 by 2033.

Researchers estimate that out of 8,300 area villages in 1910, 2,000 no longer have permanent residents.

The region’s defense industry factories closed in the 1990s, but residents anticipated the area would become a gateway to Europe as the newly independent Baltic States next door joined the European Union.

The region failed to become a hub, however, and then came the 2014 crisis over Ukraine, which brought tense relations and interrupted trade.

“The border has become very unfriendly,” said Lev M. Shlosberg, an opposition politician in the local legislature. “Because of the politics, the region is turning into the boondocks.”

In Baruta, Dmitri Mikhailov, 40, is among the youngest full-time residents. Asked what life was like, he said, “Bread, but no butter,” adding, “It is not completely awful, and there is not much good.”

A few well-maintained wooden houses dot the village, painted bright colors and surrounded by small orchards. These belong to dachniki, descendants of village inhabitants who moved to St. Petersburg or Moscow and turned their family homes into summer homes, or dachas. They keep countless villages on life support.

Some of Baruta’s satellite hamlets are deserted, or almost. Trees grow up through the old roads, rendering them impassable. Even local taxi drivers have trouble navigating, and mobile phone signals fade.

In the cemetery of Baruta’s 18th-century church, headstones are heaped with mostly faded plastic flowers. Antonia M. Levedova, 73, worked surrounded by a cloud of mosquitoes, sweeping a winter’s worth of accumulated debris off the graves of her husband, grandmother, aunt and sister.

Of 50 houses in the neighboring village of Seletskoe, where she was born, Ms. Levedova said, just three are inhabited all year, and a few more in the summer. It will soon disappear, she predicted.

“The young left, and the old die,” she said, shrugging with resignation.

Her own daughter and grown grandchildren no longer visit. “She is very well educated. She does not need a village,” Ms. Levedova said of her daughter. “She prefers to travel abroad.”

The Pskov region has four maternity hospitals, down from 26 a decade ago, with the wealthy now usually giving birth in specialized, Russian-speaking clinics across the border in Estonia, Mr. Shlosberg said. Closing hospitals pushes people to leave even faster than closing schools, he said, adding, “We understand that the Pskov region is melting away.”

The trend is similar across Russia. Under the most optimistic projections by demographers, the population by 2050 will stay the same, about 146 million, if immigration from Central Asia--which has also been dropping--balances out low birthrates. Less optimistic figures put the population around 130 million by 2050, and the most pessimistic say fewer than 100 million.

“We understand that if the population is going to be small, Russia will not be able to play a role in world politics, in the economy,” said Professor Manakov at Pskov State. “That is why the authorities want the birthrate to increase.”

Aside from fewer births, problems at the other end of life also hold down the population. Mortality rates in Russia have improved markedly in the last decade, yet remain stubbornly higher than in most Western countries. Average life expectancy just reached 72, a record for Russia, yet in the developed world it is often about 76 for men and 85 or higher for women.

High vodka consumption and uneven health care still cut life short. Alexander N. Tkachev, the agriculture minister, caused a stir this summer by saying that the trend toward drinking more wine and less vodka would improve the demographic situation.

The government created various incentives to have more children, in particular a one-time payment of about $7,500 for a second child. It also established a medal, the Order of Parental Glory, for seven or more children, which Mr. Putin awards to parents at a nationally televised Kremlin ceremony. But such measures have not spurred sufficient change.

While birthrates are declining in much of the developed world, most Western states replenish their populations with immigration. But even many of the most liberal Russians balk at welcoming immigrants from beyond the former Soviet states.

Some Russians lament that something deeper, an essential part of Russian culture, will ebb along with the rural population.

Baruta sits close to the string of rural estates where Alexander Pushkin, the author credited with inventing the modern Russian language, wrote some of his most famous works.

Mr. Kurbatov, the specialist in village writing, said he mourned the demise of rural Russia as the very death of the roots of the language and the unique Russian soul.

“Russia herself is a village from birth,” he said. “Everything that was best--the national way of thinking, the national economy--everything was rooted in our existence on the land.”

#Russia #Russian villages #Baruta #Pskov

0 notes