Good morning all. So today I'm here before you presenting our study on the health-related quality of life among drug-resistant tuberculosis patients which was done in Mumbai. So just to give you a brief about, we all know that India has a very high burden of tuberculosis and a very high burden of drug-resistant tuberculosis also. And Mumbai, which you can see here is on the western part of this country, is a mega-police economic hub. But it also has a very high burden of tuberculosis along with very severe drug-resistant strains in the community there. So now we had already seen, Philip mentioned before me that the treatment for drug-resistant tuberculosis, the 20 month old with injectables, a lot of side effects. So one of the questions is how did it affect the quality of life? So before that let's actually see what is health-related quality of life. So health-related quality of life, it's a patient reported outcome measure. It's the perceived illness of the patient. How does the patient actually perceive the illness that he has from the disease that a doctor sees in the clinic? And it includes how the illness has affected the physical, psychological, emotional, social and the role functioning of this patient. What exactly are the effects of the illness, how he perceives the effect of the illness on all these different factors? And why is it important to study the quality of life? Well, as a patient, their functional capacity, well-being and the experience of their illness, it's much more important to the patient than just getting a bacteriological cure. So this background and just have to say that to put it in very short term, in very short, patients want to live and not just merely survive and that's what quality of life is all about. So with background, what we aimed was to assess the quality of life among drug-resistant tuberculosis patients. What were the factors associated with it? And we also to explore the patient's perspectives about the quality of life. The methods that we use, we use the mixed method study. Actually today I won't be presenting the quantitative part in detail. So we used the cross-sectional interviews for quantitative and we did in-depth interviews for qualitative. We conducted the study in two different settings in Mumbai. One is MSF, Private Clinic and other is Jupiter Hospital which is a multi-speciality hospital in Mumbai. Both these settings have a multidisciplinary teams of nurses, psychologists, counsellors, social workers and psychiatrists who are on board and all the patients are provided individualized tailored treatment with a very patient-centered treatment modules are used. So all the participants in the study are drug-resistant TB patients and they are more than 18 years of age. For in-depth interviews, what we have done is we have selected a subset of patients who actually represent like to get the highest data that we can actually get from it. And for data collection, for quantitative use, a WHOQL graph that's the World Health Organization's quality of life brief questioner. It has 26 questions with four different domains and for in-depth interviews we used an interview guide. In the patient characteristics, we enrolled 95 patients in total 12 of whom were enrolled for the qualitative phase and if we look at the bottom the TB resistance pattern, half of our patients are XDR-TBR, like which is one of the worst resistance patterns that you can have. A brief about the quantitative part of this, so what we see here is like the zero, the minimum score for WHOQL graph can be zero, range up to 100 which is the maximum score and these are the four domains that we have and if we look here in the physical and the psychological domains are the ones which were most affected. One interesting thing about quantitative that I would like to mention is that having to quit your job because of tuberculosis, if a patient actually had to quit their job because of taking TB treatment or before because of their disease, it affected a lot quantitatively a significant association with the social relations, it really affected that domain very badly. Now going into the quantitative or the brief framework of this study, so we have four domains which you can see that we have focused which affect the quality of life, the physical domain I am not going to concentrate today due to lack of time. Let's go to the second one here which is the psychological domain, so in the psychological domain the most affected we see that yes we had patients who were suffered from lot of anxiety, lot of depression, also what we had seen was that TB affected the self-image, the side effects and all the other things, it affected the way the patients perceived about themselves and all of this in turn led that the uncertainty with the treatment about the disease, it led that they had no hopes from their self, from their career or from their children, the only thing that they wanted, the only hope which they had was that I want to get better and I should never get this disease again. One of our patients said that I have asked my husband to remarry and not to expect anything from me, that was the situation in the region and there was a different aspect also to this part where one patient said that yes TB did slow down my life to a certain extent but it also gave me time to think about what's important for me. He says that earlier it was more of quantity but now it's more of quality of my life. The next part is the social and the role functioning which we have seen was affecting and one of the main thing was the fear of stigmatization and the treatment side effects which led to self-imposed psychological and social isolation of the patients from all the other and this affected even their psychological domain at the end of the day. One of a 23-year-old female young girl she said that I have failed as a daughter and a sister. However we have seen that if a patient was able to assume the role of a supporter that if the patient could actually go and support someone, it helped them cope with their own illness. A 52-year-old female she said that helping others with their problems helped me. I get courage from that. The next part that I would like to focus on are the environmental factors which included knowledge, finance and health systems. So in this I would like to focus first on the health system part of this. And the health system factor the support that the patients received from the health system from the doctors that they say every day from the nurses was seen to be very important factor which affected a patient's quality of life. One of our patients 55-year-old male he said doctors would not even touch me or talk directly with me at times. I was made to sit far away from the doctor's desk. I felt untouchable. When I came here the doctor kept his hand on my shoulder and assured me that you would get better and I felt half cured. So just simple reassurance, humane treatment at the health facilities for the patient can actually go a long way in helping the patients complete this very hardest treatment of DRTB. Other environmental factors I would like to focus is the directly observed therapy. So going every day to take their pills was seen to be something that interfered with their daily life and especially work and this was a major stressor for all of the participants. The other factor is pill burden. Philip said how long the treatment is injections. Just to give an idea DRTB patient takes about 14 and a half thousand pills to get his treatment cured and I cannot put it better than one of my participants what is the effect of pill burden on their quality of life. She said a 29-year-old female. My entire schedule revolves around medicine timings. I cannot do anything for myself or anyone else. It's like my injections, my pills, then pills, then food, then I sleep and on waking up again it's injections and pills and food that's all that is left in my life now. Last and very important part I would like to focus and spend some time as the support component. So the support from family, from close friends, help patients in overcoming the negativity or the oppression that they had about the treatment and this helped them to take the treatment regularly and still continue on medicines and the other part was the support at workplace. As I mentioned even earlier with the quantitative results, whenever the patients could actually continue their job they got support from the workplace, from their boss or from their colleagues to complete their treatment. This gave a much higher motivation to them and purpose to complete this treatment. Social support in the form of counselling was also mentioned, some patients also needed psychiatric care and it was seen to be something that helped patients. So what do these results actually mean? So all the quantitative part, so yes the quality of life scores were reduced, it was lower than what you would expect in normal people. But what was surprising even for us was that the quality of life scores were not actually as low as what had been reported in the literature earlier and the quality part really helped us to get a hang on why the scores could have been better. So I would like to say that DRTB patients who have received good standards of comprehensive patient-centered care who are empowered and knowledgeable about their disease and who receive support from family workplace and the health systems can have a reasonable quality of life despite the grave challenges imposed upon them by their disease and treatment. I would like to acknowledge all my participants, all my colleagues and everyone who has helped me with the study. Thank you. Thank you Chinmay for focusing on such an important part of the management of the DRTB cases. Usually it is missed in the hospitals, in the national programs and elsewhere. So we have time for taking one or two quick questions. Yes. More of a comment than a question, would like to share our experience, I'm from basically from Kerala. Please if I can interrupt you, we are here to ask questions. There's something called treatment support groups which we have experimented in Patananda district of Kerala. With the local self-government, we provide for most of the things that a PTB patient wants in the course of treatment and with that treatment support group, it's a formalized system whereby the local self-government, civil society, everybody is engaged at the Punjayat level. With that we have been able to reduce the initial loss to follow-up rates to zero, loss to follow-up rates to zero. The paper has been published in 2015. So if we can scale it up to a national level probably, you know, be helpful. Thank you so much. And again, emphasize please if you have questions you can ask because we have limited time. Yes. I am Dr. Dhyan. My question is as far as you mentioned, the support, family support and the social support, was there any study which shows was there any bias in the support between a male and a female patient, which is a common problem in our society? Is there any data which shows that this gender got this much support? Thank you. Wonderful point actually and we have not studied this and I am not actually not even aware of a literature which distinguishes between the support that the males and the females receive. So thank you. So I think you can take it in your next project but this is a very important part about this study. Yes. Last question please. Hi. My name is Yogish. My interest is you consider even XDR TB patients. So have you noticed any difference in the quality of life between among different resistance groups like MDR, pre-XDR and XDR? Yes, we have done that analysis and there is no difference actually with the resistance pattern. The resistance pattern was not seen to affect the quality of life in any of the four domains which we have seen. So as I said, it's something more than it's like a patient perceived thing and we do not, the quantitative or the qualitative reader do not show that the resistance pattern make a difference. Okay. Thank you, Chennai. Thank you very much on focusing for this very important point in the management. Thank you.


What will be the price of Bitcoin in one year from now? What about in 10, 20 years? Guessing the future price of Bitcoin is like looking into a crystal ball. Its high volatility makes Bitcoin one of the world's most unpredictable assets. Bitcoin is very volatile, so... Oh my God, this is so loud. Still, an early unlimited upside potential is what keeps people speculating on Bitcoin's future highs. Some of these predictions are based on research and data analysis. Others are mantras that toddlers keep repeating to strengthen the collective belief in the asset. Let's have a look at the most popular Bitcoin price predictions around. This is Plan B's stock-to-flow model. It says the value of Bitcoin will increase over time thanks to its decreasing supply rate, which is cut in half every four years. The supply, of course, is fixed and then it gets halved. And after that halving, there's a non-linear dynamic that sharply increases its shortage and it's like a wave that's hitting the beach. It gets higher and higher and higher. If Plan B is correct, we should expect Bitcoin to hit $288,000 by the end of 2021. One of the strongest supporters of the stock-to-flow is Dan Morehead, CEO at CryptoHedgeFund Pantera Capital. He's convinced that Bitcoin should reach the $115,000 benchmark by next August. The biggest news is PayPal. They just brought the ability to buy crypto to three times as many people as have it. That's a demand shift that just jacks up the demand curve because there's just a lot more people that can buy it. Anthony Pompliano, co-founder at Morgan Creek Digital, is looking at similar targets. He predicted Bitcoin will reach $100,000 in 2021. According to Pompliano, only a relatively small portion of Bitcoin supply is actually available for buying and selling. That would make the asset even more scarce and valuable. If all of a sudden, only about 8 million Bitcoin are available and all this new demand is showing up, you're gonna have a pretty aggressive price increase. And yet, no matter how much Bitcoin goes up, there will be always naysayers predicting its imminent collapse. For Nouriel Rubini and Peter Schiff, Bitcoin is a speculative bubble that will lead most investors to financial ruin.  It doesn't matter that the price has gone up, eventually the supply of fools runs out and the greatest fool ends up as the bag holder. It's true, Bitcoin happens to crash, and when it does, it's usually a pretty bad crash. Still, looking at Bitcoin's past, the main cryptocurrency came back stronger after each downfall. In fact, Bitcoin's history can be seen as a succession of bull and bear market cycles. So the question is, where are we right now? According to unconfirmed reports, Wall Street giant Citibank predicts that Bitcoin is currently in the middle of a bull run, which could peak at $318,000 by December 2021. Scott Minard, CIO at financial services firm Guggenheim, is more bearish in the short term. He said that the current price levels of Bitcoin are unsustainable, and the price will retrace all the way to $20,000 by the end of 2021. Who cares about 2021? We're going to the moon! The moon? But that's so far away, it's taking so much time to get there. So what? We get there when we get there. Are you coming? Well, actually I should finish the video first. So, what is Bitcoin's end game? Despite his short term bearish prediction, Guggenheim CIO Scott Minard thinks that Bitcoin could eventually establish itself as digital gold, more scarce and easily transportable than gold itself. At that point, the main cryptocurrency will be worth from $400,000 to $600,000. $400,000 is also the long term price target of Frank Holmes, CEO and chief investment officer of U.S. global investors. However, he sees Bitcoin becoming as a rare collectible, like a piece of art. It's going to be like having an original Andy Warhol, one of those prints. It is a piece of art. It's amazing. Welcome, brother brother. But there is one prediction that trumps them all, that Bitcoin will become something even beyond digital gold or artworks, something the world hasn't seen in a thousand years. You heard it here first, Bitcoin is going to zero, zero. When it comes out, zero. No, no, no, play the other one, the other one. What would be like if you owned 10% of all the electricity that was ever going to be pumped? Or what if you could buy 1% of all the running water that's ever going to be pumped? This is our once in a thousand year opportunity. Michael Saylor, the CEO of MicroStrategy, thinks that Bitcoin will take over most safe haven assets and become the world's ultimate store value. By then he said it will be worth over $14 million. In theory, all monetary energy that's simply looking for a store of value safe haven index should presumably drain out of real estate, cash, stocks and bonds into the Bitcoin network. Let's not get too ahead of ourselves though, ultimately the future price of Bitcoin will depend on many factors like global economic conditions, government regulations and mainstream adoption.


Hi guys welcome back to my channel Drew here from Lone Fox I am very excited about this video because I didn't get to do one of these last year I was actually moving in the process of packing right after Christmas We moved like right at the beginning of January and this year I am excited to share with you guys trends that I essentially excited about for 2024 in the home design realm However, these definitely transfer into a bunch of other ones. I feel like fashion art These trends are probably gonna flow throughout many different industries But today I wanted to share with you guys the 10 that I'm extremely excited about and in no way am I a trend expert I just want to preface that at the start of this video Now I'm also somebody that really only likes to do trend videos like this once a year because although trends are fun I don't feel like it's necessary to change up your house all the time and so with the rise of social media I definitely feel like trends have come and go a lot quicker always do whatever you want for your own home I hope one of these can help you out. So let's dive on into our first honestly I'm kind of wearing our first trend and I work for a reason because our first trend is all about color And I really do feel like the colors of 2024 are going to be red and brown And I also feel like these colors did start making their way into 2023. However in 2024 I really feel like you're gonna be seeing a lot of this in terms of shopping So a bunch of these trends are things you might be seeing in stores And I'm sure a bunch of you know I am ecstatic about this because I absolutely love red and brown Brown is probably my favorite color to design with after I did my brown kitchen a while back But as my kitchen actually were in quite a few different trend articles this year for the color brown Which I was excited to see so I felt like I made a great decision in that but not only brown But also red tone brown so ranging all the way from the color red to brown So kind of going throughout in terms of burgundy you kind of have those brick colors And then you also go all the way to brown can also think of them in terms of materials So feel like red really leans towards terracotta You can go into those darker red stones then with brown you can go into what I immediately think of which is wood But then you can also go into other types of browns such as really pretty brown marble They have one called bronze fantasy that I've been wanting to use I do know the color of the year this year is peach fuzz, which it's just it's not there for me I don't know if that's going to you know impact what we see in stores I don't know if we're gonna see a bunch of peachy toned items I think it would be cute maybe for spring summer jumping into number two with this one's all about patterns and textiles this year I really feel like from designers and just in general We're going to be seeing a lot more prints and layering print on print layering them together in different sizes and scales whether that be through You know reupholstering a chair or a bench or just adding in some layers of pattern on a bed That's how I see it the best even like these curtains for example this white linen I feel like doing something more fun a bolder pattern here Would just create much more of an impact definitely in 2024 We're kind of leaning into creating our very own spaces and not following what everyone is doing And that's kind of always been the motto of lone fox You know not following the pack going off and being the lone fox doing your own thing pattern play and mixing up patterns can be a little challenging So I definitely do feel like it's going to be something fun to play around with this year I know master at mixing patterns, but I think it's a fun challenge when we were coming up with a tagline for my online shop Lone Fox it ended up resulting in crafted curated Collected which I love so much because that's how I feel like all of my spaces are or kind of creating a collection of items in your home So this could be really anywhere whether it be a collection of wall art like this I did this little gallery wall my parents house a while back But leaning even further because I feel like gallery walls and collections of art have always been a thing This is more so creating little small moments or collections of kind of oddities or random pieces such as plates on a wall Or candlestick holders on a shelf or bookcase filled with all different types of vessels kind of creating little collections that really Added that personality to a space. It just really adds this feeling of collected to a home, which I love I really like when you can walk into a space and really tell who lives there think about that Maybe even like a little mug collection could be on display something that adds a little personality And I feel like a lot of people are starting to show that a bit more and just not following these major major trends like Farmhouse or this major kind of style of interior design. They're really injecting their own personal styles again Adding a little collection could be a great way to do that It's fourth one it kind of connects to the one previous but this is about bespoke pieces I've been doing this so much you guys see throughout my entire house I always have collections of just random stuff when I did my dining room recently I styled it with kind of random pieces I found from a flea market But every single piece it just stuck out to me It kind of brought me joy as Marie Kondo would say so handmade and DIY kind of one of a kind elements in terms of studio pottery Handmade wall art tapestries, you know handmade rugs anything that really has that handmade or that DIY kind of feel to it A big styling element and a big thing that we're going to be seeing throughout 2024 Which again is something that I love. I'm a huge crafter. I'm a huge DIYer So a look of that imperfection and the look of that kind of hand-done quality I do feel like kind of adds that crafted curated collected feel to a home always looking for those little details whenever I go into a house Those are the things I love to look at before coming into the next one I do want to talk about today's video sponsor which is better help and I thought what a better video to put this in Than this one because we're starting the new year right around the corner And I feel like the new year for a lot of people including myself is a fresh start You just feel you need someone to talk to or you just kind of been putting that off throughout the year Especially with the holiday season always a little stressful So it's something to start for the new year that could be great for you is better help And if you've never heard of better help before it is a great great platform There's an app you can even do it on the computer But it is a way to connect with licensed therapists over your phone So you don't have to go in it's really super convenient because you can actually take your meetings with your therapist However, you'd like whether it be a video call Messaging a phone call and the biggest thing for me when I started better Help a while back when I was going through my really rough time with anxiety was because I could not find a therapist that had Availability right away and for me I felt like I needed someone to talk to right then and there So I actually signed up for better help and it gave me access to a therapist and talking to them by the next day Now it can take up to 48 hours But normally it's less than that over 4 million people have used better help to start living a healthier and happier lifestyle Including myself and I just got to say that mental health is extremely important And if you feel like you need a little help with that better help is definitely here for you So take advantage and use my link. I'm going to pop it up on the screen right here for you guys It is better help comm slash loan fox also at the link to the top of the description box below But let's go ahead and jump on in to our next trend number five We are talking about mid-tone wood. I feel like this last year was the year of dark wood It was really like those deep rich colors. Everyone was staining everything dark I do feel like there's going to be a shift in the trendy kind of wood color for the year I've also really been gravitating towards this so much and that is mid-tone wood in my home I have so so much dark wood. That's because the original kind of cathedral ceiling was all done dark So I've been coordinating and designing to the dark wood of the house But I've also really been loving and leaning into mid-tone wood And I also feel like a designer that does this so well is jake arnold He always does mid-toned wood flooring furniture pieces that he finds and sources for his spaces And I have just been loving that very mid-tone not too light Not too dark where you can really see all that graining. It kind of has more of that warm honey feel to it So if you are doing, you know an update this year It might be nice to introduce a little bit of that mid-toned wood So that way you don't lean too light or too dark This next trend that I want to talk about is one that I have really just kind of seen personally So I don't know if this is going to be an actual huge trend in 2024 But I will say that the whole coquette style and coquette aesthetic I feel like has really been transferring into interior design And we saw that so much in christmas time in terms of all the silk ribbons and kind of these large Super feminine accents and this really extra super romantic feel you can kind of think and thank bridgerton for this I feel like they brought back and almost popularized this kind of style And I've been loving it and just seeing it transfer into the realm of interior design I personally love mixing those with the more harsher elements of my home Like the whole gothic spanish revival and then mixing that with kind of the coquette really feminine romantic girly look I do feel like that coquette style is kind of coming into interior design It almost can be seen a little bit shabby chic However, I feel like it's a bit more polished almost a bit more cool in a sense It has this kind of edge to it at the same time So maybe coquette style could be something fun to add to your home this year Next trend we are talking about crown molding and I just feel like crown molding It kind of left for a while and I wasn't seeing a lot of people do it However, I feel like crown molding has been coming back and I also feel like it's a lot more accessible now because Before crown molding was only you know wood molding pieces that you had to cut There's a certain term for like creating these corners Which is actually quite a bit harder than you actually think to do But now they have a crown molding that's done in foam So you can actually like get this foam put it up and of course no one's touching your crown molding So you could paint it to match it kind of adds a little bit of that french or european flair Which we all love or I love of course in interior design I'm stemming off of crown molding and the upper part of a room I guess We're talking about sealing treatments next because I definitely feel like people are really going all out with their sealing treatments I just feel like paint for everyone has kind of come a little bit boring. It's like you can always paint There's so many colors you could do and you can do this again so many different ways You can plaster you can wallpaper Stencil add a mural to it. There's a lot of different elements But I've been seeing so much more that impact or that pop on the ceiling Which is again a great way to draw the eye up But it's also a really nice way if you want to have more simple walls and kind of keep all your furniture and everything Lower to then add some more visual weight to the top of a room by adding a darker color All my walls are stuck out But the only thing that's not in two of the rooms are the ceilings and they have this molding around So those rooms have to have some special stealing addition, which I will definitely be adding 2024 is going to be the year of silver brass and just warm metal has been such a huge huge trend Ever since I kind of made my way into interior design You know, I've never really gravitated or wanted to use silver and any of my projects ever since I've kind of started Doing interior design. However lately I have been wanting to reach for everything silver I really like silver when it's kind of more of that putery and teak almost buffed silver I think that's super pretty. I've been incorporating it a lot in my decor as well or kind of serving pieces in the kitchen I have these little silver bowls and candlesticks. I recently got I've just been loving those silver accents It kind of brings in this element also of this country club kind of luxe bougie ask feel But it doesn't have to be that you can get a lot of these silver bits at the thrift store Or you know the flea market and my last trend has been one that I also have been wondering why I haven't been doing this lately But I've just been not styling with a bunch of throw pillows and I've been noticing myself kind of restricting or wanting myself Not to put throw pillows on things like when I shot the living room tour I just didn't want to style any pillows on the upper sofa Which was so unlike me But it's just it feels right at the moment for some reason and I'm not saying do not use throw pillows But I just feel like the look of layered throw pillows and making your throw pillows a statement in a room Having a throw pillows more blend into a space and not stand out as a throw pillow is kind of the way to go And I've just been pairing them down a little bit more if that was a whole bunch of talking I hope that you guys liked this video and I hope it gave you kind of a fresh mindset for the new year Maybe if you are someone that loves incorporating new trends in your spaces trying out new things I am someone that have always rearranged my rooms like when I was younger I was rearranging it every couple of months. I just love trends. I love trying new things out And I wanted to share those with you So if you did enjoy this video or if you feel like there's going to be any other trends throughout the new year Please leave them in the comment section below. I love chatting with you guys down there It's just a great conversation area down there and I will catch you all in my next one. Bye