Mozambique has the 4
highest malaria incidence and mortality globally. Despite the existing malaria control strategies, malaria prevalence remains stagnant. These challenges have increased calls for ...innovative strategies in areas with the highest disease burden. Community mass treatment with anthelmintic agents have been used as an effective tool for the control of major helminth infections and has emerged as a potential tool for vector control in the fight against malaria.
This was an analysis of data from a cross-sectional community-based survey designed to study malaria risk, prevention, and health seeking behaviors in Sussundenga, Mozambique. Using logistic regression models, we quantified the association between ever receiving anthelmintic treatment and
infection. We also fit models to determine the association between recent anthelmintic treatment and malaria infection.
Two-hundred, seventy-seven (277) participants from 83 households were included in this analysis. The prevalence of
infection measured by rapid diagnostic test (RDT) was 30%. 77% of participants reported having ever received anthelmintics. The prevalence of malaria was slightly higher among participants who reported ever taking anthelmintics. There was no statistically significant association between prior receipt of anthelmintic and
malaria infection after adjusting for age, ITN use and head of household full-time employment (OR = 1.37, 95% CI, 0.70-2.70, p = 0.36). However, recent intake of anthelmintics was associated with lower odds of testing positive for in the adjusted models (OR = 0.35, 95% CI, 0.07-1.80, p = 0.21), but this was not statistically significant.
Our findings show that the benefit of anthelmintics treatment as a control tool for
malaria infection is likely tied to when it is administered rather than if it was ever administered. These findings offer evidence for making decisions in planning mass community deworming in sub-Saharan Africa.
While models of integrated care for people with chronic conditions have demonstrated promising results, there are still knowledge gaps about
these models are implemented in different contexts and ...which strategies may best support implementation. We aimed to evaluate the implementation of a multidisciplinary diabetes Community Specialist Team (CST) to support delivery of integrated type 2 diabetes care during COVID-19 in two health networks.
A mixed methods approach was used. Quantitative data included administrative data on CST activity and caseload, and questionnaires with GPs, practice nurses (PN) and people with type 2 diabetes. Qualitative data were collected using semi-structured interviews and focus groups about the service from CST members, GPs, PNs and people with type 2 diabetes. We used the Consolidated Framework for Implementation Research framework to explain what influences implementation and to integrate different stakeholder perspectives.
Over a 6-month period (Dec 2020-May 2021), 516 patients were seen by podiatrists, 435 by dieticians, and 545 by CNS. Of patients who had their first CST appointment within the previous 6 months (n=29), 69% (n=20) waited less than 4 weeks to see the HCP. During initial implementation, CST members used virtual meetings to build '
with general practice staff, supporting '
and referrals to the CST. Leadership from the local project team and change manager provided guidance on how to work as a team and '
issues. Where available, shared space enhanced networking between CST members and facilitated joint appointments. Lack of administrative support for the CST impacted on clinical time.
This study illustrates how the CST benefited from shared space, enhanced networking, and leadership. When developing strategies to support implementation of integrated care, the need for administrative support, the practicalities of co-location to facilitate joint appointments, and relative advantages of different delivery models should be considered.
There are limited data on the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in African populations. Here we report the immunogenicity and safety of the ChAdOx1 nCoV-19 (AZD1222) ...vaccine from a phase 1/2 single-blind, randomised, controlled trial among adults in Kenya conducted as part of the early studies assessing vaccine performance in different geographical settings to inform Emergency Use Authorisation.
We recruited and randomly assigned (1:1) 400 healthy adults aged ≥18 years in Kenya to receive ChAdOx1 nCoV-19 or control rabies vaccine, each as a two-dose schedule with a 3-month interval. The co-primary outcomes were safety, and immunogenicity assessed using total IgG enzyme-linked immunosorbent assay (ELISA) against SARS-CoV-2 spike protein 28 days after the second vaccination.
Between 28
October 2020 and 19
August 2021, 400 participants were enrolled and assigned to receive ChAdOx1 nCoV-19 (n=200) or rabies vaccine (n=200). Local and systemic adverse events were self-limiting and mild or moderate in nature. Three serious adverse events were reported but these were deemed unrelated to vaccination. The geometric mean anti-spike IgG titres 28 days after second dose vaccination were higher in the ChAdOx1 group (2773 ELISA units EU, 95% CI 2447, 3142) than in the rabies vaccine group (61 EU, 95% CI 45, 81) and persisted over the 12 months follow-up. We did not identify any symptomatic infections or hospital admissions with respiratory illness and so vaccine efficacy against clinically apparent infection could not be measured. Vaccine efficacy against asymptomatic SARS-CoV-2 infection was 38.4% (95% CI -26.8%, 70.1%; p=0.188).
The safety, immunogenicity and efficacy against asymptomatic infection of ChAdOx1 nCoV-19 among Kenyan adults was similar to that observed elsewhere in the world, but efficacy against symptomatic infection or severe disease could not be measured in this cohort.
PACTR202005681895696 (11/05/2020).
Background:
Subtitles are produced through different workflows and technologies: from fully automatic to human in open source web editors or in-house platforms, and increasingly through hybrid ...human-machine interaction. There is little agreement regarding subtitle copyright beyond the understanding that it is a derivative work. While same language verbatim subtitles may have little room for creativity, interlingual subtitling is heavily dependent on the subtitler skills to translate, prioritise, and condense information. These days creative subtitles are increasingly being used as one more aesthetic element in audiovisual narrative. Though they may be in the same language, the visual attributes that contribute to the narrative development make creative subtitles one more element that should be acknowledged and copyright protected.
Methods:
The paper will present a short introduction to subtitling copyright. It will then describe centralised and decentralised copyright management — where blockchain technology can be applied to aid subtitler identification. A focus group with expert professional subtitlers was organised, and feedback is reported.
Conclusions:
Subtitle copyright is country dependent, still subtitling working practices and media asset distribution have no geographical borders. Blockchain technology -as a concept- could aid subtitle traceability. This can be useful beyond financial and moral right management and work towards media sustainability, allowing for reuse and repurpose of existing media assets.
There are important public debates on how—or even whether—to regulate information about previous transactions in different markets. Examples are the regulation of cookies in online markets, secrecy ...laws in financial markets, and transparency directives in government purchases. In these debates, considerations of economic efficiency and fairness are central. Do more lenient information policies increase market efficiency? Do internet users benefit from cookies? Does more secrecy increase trade volume in financial markets? Does transparency on previous agreements deteriorate the bargaining power of public agencies?
This essay sheds light on the answers to these questions using insights from economic theory. We do so by analyzing a simple, stylized setting where the incentives of different agents in the market will be clear. Our focus is on the dynamic effects of information regulations, as a trader's incentive to reveal or conceal information is driven by its future use by other traders. We use our setting to assess the implications of information regulations on behavior, trade efficiency, or social welfare.
Antimicrobial resistance is a persistent challenge in human and veterinary medicine, which is often encoded on plasmids which are transmissible between bacterial cells. Incompatibility is the ...inability of two plasmids to be stably maintained in one cell which is caused by the presence of identical or closely related shared determinants between two plasmids originating from partition or replication mechanisms. For I-complex plasmids in
, replication- based incompatibility is caused by the small antisense RNA stem-loop structure called RNAI. The I-complex plasmid group IncK consists of two compatible subgroups, IncK1 and IncK2, for which the RNAI differs only by five nucleotides. In this study we focussed on the interaction of the IncK1 and IncK2 RNAI structures by constructing minireplicons containing the replication region of IncK1 or IncK2 plasmids coupled with a kanamycin resistance marker. Using minireplicons excludes involvement of incompatibility mechanisms other than RNAI. Additionally, we performed single nucleotide mutagenesis targeting the five nucleotides that differ between the IncK1 and IncK2 RNAI sequences of these minireplicons. The obtained results show that a single nucleotide change in the RNAI structure is responsible for the compatible phenotype of IncK1 with IncK2 plasmids. Only nucleotides in the RNAI top loop and interior loop have an effect on minireplicon incompatibility with wild type plasmids, while mutations in the stem of the RNAI structure had no significant effect on incompatibility. Understanding the molecular basis of incompatibility is relevant for future
predictions of plasmid incompatibility.
It is indisputable that every day it is demonstrated that natural products present diverse therapeutic benefits, which has boosted their incorporation within various products for clinical use. ...However, this must be accompanied by knowledge of their effect on cell lines to ensure their use is safe. The objective of this study was to evaluate the cytotoxic effect of two ethanolic extracts based on Peruvian natural products, on three human cell lines. Cervical cancer cell lines (HeLa), human gingival fibroblasts (HGF-1 - ATCC CRL-2014) (HGF-1) and peripheral blood mononuclear cells (PBMCs) were cultured and subsequently treated with preparations of ethanolic extracts of propolis (EEP) and Psidium guajava (EEG) from a concentration of 50 mg/mL to 0.024 mg/mL, by the 3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyltetrazole bromide reduction assay. At a concentration of 0.24 mg/mL EEG, viability of 99.7±1.24%, 99.8±2.2% and 99.7±2.7% was observed in HeLa, HGF-1 and PBMCs, respectively; >90% cell viability values were observed with EPP at 0.024 mg/mL, with HGF-1 showing the highest viability (96.9±1.15%). A dose-dependent effect was observed for both extracts with a decrease in cell viability as concentrations increased (up to 50 mg/mL). EEP and EEG extracts at low concentrations do not show cytotoxicity in human cell lines, these findings are an advance in the preclinical evaluation on their safety and open a continuity to further studies for their potential applications in dentistry and medicine.
Background:
Globally, India is the country with the highest tuberculosis (TB) burden with respect to the number of new cases occurring each year. Annual incident cases of TB in India accounts for ...more than 25% of total TB morbidity and mortality worldwide. Several factors have been associated with the adherence of TB medication, which can be broadly classified as patient/personal, social, structural and health service. The aims of the present study were to determine the compliance to daily regimen of directly observed treatment, short-course (DOTS) therapy among TB patients registered at the Tuberculosis Unit (TU) of Mangalore and to identify the factors influencing non-compliance for treatment.
Methods: A cross sectional study was performed. The study sample was drawn from the TUs, General Hospital, Mangalore, after taking permission from District TB Officer. The names and addresses of TB patients were collected from treatment cards. The TB patients were approached at their homes/DOTS centers/Primary Health Centre's (PHCs) with the help of senior treatment supervisors.
Results: It was found that patients positive for human immunodeficiency virus (HIV) were more likely to be non-adherent, which was statistically significant. Amongst the participants, 66 (33%) were diabetic and 28.8% of them were found to be non-adherent. The proportion of non-adherence was 27 times higher in those with poor patient provider relationships. Patients who reported to have side effects of TB medication were 5.23 times more likely to be non-adherent.
Conclusions: Advice on routine consultation with the health care facility, adherence to treatment regimen and education about its benefits should be the prime focus of providing health education to all TB patients, both at the individual and community levels.
This article aims to unravel the dynamics of social influence by examining the processes that occur when one person is the target of another's influence. We hypothesized that these processes are part ...of a feedback loop system in an individual. This loop involves the situation (input), a goal state (reference), a comparator, a selection mechanism, a feedback predictor, and an action (output). Each element can become the target of social influence, and different types of social influence can be classified and explained by how these elements are targeted. For instance, attempting to persuade another person with strong arguments targets the goal state of the affected individual, while obedience targets the selection mechanism, and violence targets the action. In summary, this article aims to categorize, order, and explain phenomena in social influence research using a feedback loop framework focusing on the influenced individual.
As a key partner of Ministry of Health (MOH) Ethiopia, The Clinton Health Access Initiative (CHAI) had been implementing the Child Survival Project (CSP) since October 2015. Strengthening DTC was one ...of its focuses to improve overall supply chain management (SCM). The objective of this study are to review the evolution of DTCs in Ethiopia from their early years to current practice and identify the major driving and hindering factors for their functionality.
A descriptive mixed study design was employed. The study made use of qualitative data supplemented with quantitative data, generated from both primary and secondary sources through key informant interviews and desk review methods.
DTCs were introduced in Ethiopia in the early 1980s. The mandate of DTCs has been given to four different government organizations during that time. As a result, due to a lack of coordination among these organizations, its implementation was lagging. Recently, the government and its partners have given attention to DTCs. More than 5847 professionals underwent DTC training from 2016 onwards. DTC establishment in health facilities improved from 85% to 98% between 2015 and 2019 during baseline and end-line assessments carried out by CHAI/CSP. Similarly, DTC functionality in HFs improved from 20% to 63%. The CHAI/CSP regular supervision data analysis revealed that DTC establishment improved from 83% to 100% of HFs, while its functionality improved from 5% to 72% between 2016 and 2019, respectively. A chi-square test of independence examining the relationship between facility and pharmacy head training on DTCs and functionality of DTC in the same facility revealed a significant association between the two variables at p<0.0001.
Conclusions:
Providing consistent capacity building and availing strong monitoring and evaluation system improves functionality of DTCs. Moreover, national coordinating bodies for DTCs and similar structures at Regional Health Bureaus and woreda health offices should be established.
