Background In the 21.sup.st century, understanding how population migration impacts human health is critical. Namibia has high migration rates and HIV prevalence, but little is known about how these ...intersect. We examined the association between migration and HIV-related outcomes using data from the 2017 Namibia Population-based HIV Impact Assessment (NAMPHIA). Methods and findings The NAMPHIA survey selected a nationally representative sample of adults in 2017. All adults aged 15-64 years were invited to complete an interview and home-based HIV test. Recent infection (1000 copies/mL) and antiretroviral analyte data. Awareness of HIV status and antiretroviral use were based on self-report and/or detectable antiretrovirals in blood. Viremia was defined as having a viral load greater than or equal to1000 copies/mL, including all participants in the denominator regardless of serostatus. We generated community viremia values as a weighted proportion at the EA level, excluding those classified as recently infected. Significant migrants were those who had lived outside their current region or away from home >one month in the past three years. Recent cross-community in-migrants were those who had moved to the community two years ago to determine the association of migration and timing with recent infection or viral load suppression (VLS). All proportions are weighted. Of eligible adults, we had HIV results and migration data on 9,625 (83.9%) of 11,474 women and 7,291 (73.0%) of 9,990 men. Most respondents (62.5%) reported significant migration. Of cross-community in-migrants, 15.3% were recent. HIV prevalence was 12.6% and did not differ by migration status. Population VLS was 77.4%. Recent cross-community in-migration was associated with recent HIV infection (aOR: 4.01, 95% CI 0.99-16.22) after adjusting for community viremia. Significant migration (aOR 0.73, 95% CI: 0.55-0.97) and recent cross-community in-migration (aOR 0.57, 95% CI: 0.35-0.92) were associated with lower VLS, primarily due to lack of awareness of HIV infection. The study was limited by lack of precise data on trajectory of migration. Conclusions Despite a high population-level VLS, Namibia still has migrant populations that are not accessing effective treatment for HIV. Targeting migrants with effective prevention and testing programs in communities with viremia could enable further epidemic control.
Ascaris is a genus of parasitic nematodes that can cause infections in humans and pigs. During 2010-2013, we identified 14 cases of ascariasis in persons who had contact with pigs in Maine, USA. ...Ascaris spp. are important zoonotic pathogens, and prevention measures are needed, including health education, farming practice improvements, and personal and food hygiene.
The 2014-2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and ...Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise. Team members are offered emergency response training, technical training, foreign language training, and responder readiness support. Recent response missions illustrate the breadth of support the team provides. GRRT serves as a model for other countries and is committed to strengthening emergency response capacity to respond to outbreaks and emergencies worldwide, thereby enhancing global health security.
In late September 2017, Bwabwata National Park in Namibia experienced a sudden die-off of hippopotamuses and Cape buffalo. A multiorganizational response was initiated, involving several ministries ...within Namibia and the US Centers for Disease Control and Prevention. Rapid interventions resulted in zero human or livestock cases associated with this epizootic.
Introduction
Hazardous alcohol use (HAU), defined as a pattern of alcohol consumption that increases the risk of harmful consequences for the user or others, is associated with an elevated risk of ...human immunodeficiency virus (HIV) infection and poor health outcomes. We describe the association between people living with HIV (PLHIV) who report HAU and key HIV indicators. Gaps in current literature in estimating HAU on HIV outcomes at the regional level of Eastern and Southern Africa still exist and our analysis aims to address this issue.
Methods
We used weighted pooled data (2015–2017) from the nationally representative Population‐based HIV Impact Assessments among adults who provided written consent aged 18–59 years from Eswatini, Malawi, Namibia, Tanzania, Zambia and Zimbabwe. We estimated differences in the prevalence of HIV infection and The Joint United Nations Programme on HIV and AIDS (UNAIDS) 90‐90‐90 indicators between PLHIV by HAU status using log‐binomial regression, stratified by sex. HAU was determined using the Alcohol Use Identification Test—Consumption.
Results
Among the 9755 women and 4444 men who tested HIV positive, 6.6% of women and 21.8% of men engaged in HAU. Women who reported HAU were more likely to be HIV positive (adjusted prevalence ratio aPR = 1.31, 95% CI: 1.18–1.46) compared to those who did not report HAU. For the UNAIDS 90‐90‐90 targets, women who engaged in HAU were more likely to be unaware of their HIV‐positive status (aPR = 1.22, 95% CI: 1.01–1.47) and not on antiretroviral therapy (ART) (aPR = 1.73, 95% CI: 1.26–2.37). Men who engaged in HAU were more likely to be unaware of their HIV‐positive status (aPR = 1.56, 95% CI 1.39–1.76) and not on ART (aPR = 1.72, 95% CI: 1.30–2.29). No difference in viral load suppression, defined as <1000 copies/ml of HIV RNA, was seen by sex.
Conclusions
PLHIV who engage in HAU were more likely to have suboptimal outcomes along the HIV care continuum when compared to those who did not engage in HAU. Targeted interventions, such as alcohol screening for HAU in HIV testing and treatment settings and HIV prevention efforts in alcohol‐based venues, may help countries reach HIV epidemic control by 2030.
ABSTRACT IMPACT: o The Indiana Clinical and Translational Sciences Institute K-12 STEM Outreach Program’s pivoted to a virtual program in summer 2020 which yielded novel approaches that could be ...retained in future years to extend the reach/impact of our pipeline program. OBJECTIVES/GOALS: o Provide students with a meaningful and safe research experience during the COVID Pandemic. o Develop new modules and approaches that could be delivered virtually. o Engage students from communities that were not possible in previous years when in person meetings were required. METHODS/STUDY POPULATION: o The program has historically supported over 100 high school students per year in a summer research internship for the last 5 years. Students are placed with academic research mentors in various Schools and Departments across the IUPUI campus, and also with industry laboratories. o COVID-related restrictions required development of 100% virtual program. Key aspects of the virtual program included: cohort-based research mentor assignments with 1-4 mentees matched per research mentor, research projects that could be conducted virtually, heavy engagement of high-school teachers to facilitate the research experience with cohorts of mentees, a more rigorous virtual seminar series that included new modules such as COVID-specific programming and thus enhancing public education about COVID. RESULTS/ANTICIPATED RESULTS: o The program served 130 students in summer 2020. o We were able to recruit new faculty and industry mentors involved in data science research. As a result, we have now increased our mentor pool to serve more students in the future. o Because student participation was virtual, we were able to accept students from further distances (up to 120 miles away) across the state. We were also able to accept local economically disadvantaged students that may have not been able to participate because of lack of reliable transportation. o A positive unanticipated outcome was that mentees relationships with the mentors was established virtually thus increasing the potential for students to remain engaged in their research. DISCUSSION/SIGNIFICANCE OF FINDINGS: o Adapting to a virtual platform provided research experience to high school students during a time when traditional approaches were not possible. Given some research experiences do not require in-person activities, this newly established model could be used moving forward to allow more statewide engagement in research experiences.
Vortex Dynamics in Trabeculated Embryonic Ventricles Battista, Nicholas A; Douglas, Dylan R; Lane, Andrea N ...
Journal of cardiovascular development and disease,
01/2019, Letnik:
6, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Proper heart morphogenesis requires a delicate balance between hemodynamic forces, myocardial activity, morphogen gradients, and epigenetic signaling, all of which are coupled with genetic regulatory ...networks. Recently both in vivo and in silico studies have tried to better understand hemodynamics at varying stages of veretebrate cardiogenesis. In particular, the intracardial hemodynamics during the onset of trabeculation is notably complex-the inertial and viscous fluid forces are approximately equal at this stage and small perturbations in morphology, scale, and steadiness of the flow can lead to significant changes in bulk flow structures, shear stress distributions, and chemical morphogen gradients. The immersed boundary method was used to numerically simulate fluid flow through simplified two-dimensional and stationary trabeculated ventricles of 72, 80, and 120 h post fertilization
zebrafish embryos and
-inhibited embryos at seven days post fertilization. A 2D idealized trabeculated ventricular model was also used to map the bifurcations in flow structure that occur as a result of the unsteadiness of flow, trabeculae height, and fluid scale ( R e ). Vortex formation occurred in intertrabecular regions for biologically relevant parameter spaces, wherein flow velocities increased. This indicates that trabecular morphology may alter intracardial flow patterns and hence ventricular shear stresses and morphogen gradients. A potential implication of this work is that the onset of vortical (disturbed) flows can upregulate Notch1 expression in endothelial cells in vivo and hence impacts chamber morphogenesis, valvulogenesis, and the formation of the trabeculae themselves. Our results also highlight the sensitivity of cardiac flow patterns to changes in morphology and blood rheology, motivating efforts to obtain spatially and temporally resolved chamber geometries and kinematics as well as the careful measurement of the embryonic blood rheology. The results also suggest that there may be significant changes in shear signalling due to morphological and mechanical variation across individuals and species.
Namibia faces a critical shortage of skilled public health workers to perform emergency response operations, preparedness activities and real-time surveillance. The Namibia Field Epidemiology and ...Laboratory Training Programme (NamFELTP) increases the number of skilled public health professionals and strengthens the public health system in Namibia. We describe the NamFELTP during its first 7 years, assess its impact on the public health workforce and provide recommendations to further strengthen the workforce. We reviewed disease outbreak investigations and response reports, field projects and epidemiological investigations conducted during 2012–2019. The data were analysed using descriptive methods such as frequencies and rates. Maps representing the geographical distribution of NamFELTP workforce were produced using QGIS software V.3.2. There were no formally trained field epidemiologists working in Namibia before the NamFELTP. In its 7 years of operation, the programme graduated 189 field epidemiologists, of which 28 have completed the Advanced FELTP. The graduates increased epidemiological capacity for surveillance and response in Namibia at the national and provincial levels, and enhanced epidemiologist-led outbreak responses on 35 occasions, including responses to outbreaks of human and zoonotic diseases. Trainees analysed data from 51 surveillance systems and completed 31 epidemiological studies. The NamFELTP improved outcomes in the Namibia’s public health systems; including functional and robust public health surveillance systems that timely and effectively respond to public health emergencies. However, the current epidemiological capacity is insufficient and there is a need to continue training and mentorship to fill key leadership and strategic roles in the public health system.
Shnabel and Nadler (2008) assessed a needs-based model of reconciliation suggesting that in conflicts, victims and perpetrators have different psychological needs that when satisfied increase the ...chances of reconciliation. For instance, Shnabel and Nadler found that after a conflict, perpetrators indicated that they had a need for social acceptance and were more likely to reconcile after their sense of social acceptance was restored, whereas victims indicated that they had a need for power and were more likely to reconcile after their sense of power was restored. Gilbert (2016), as a part of the Reproducibility Project: Psychology (RP:P), attempted to replicate these findings using different study materials but did not find support for the original effect. In an attempt to reconcile these discrepant findings, we conducted two new sets of replications—one using the RP:P protocol and another using modified materials meant to be more relatable to undergraduate participants. Teams from eight universities contributed to data collection (N = 2,738). We did find moderation by protocol; the focal interaction from the revised protocol, but not from the RP:P protocol, replicated the interaction in the original study. We discuss differences in, and possible explanations for, the patterns of results across protocols.
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