Multicentre observational cohort study of NSAIDs as risk factors for postoperative adverse events in gastrointestinal surgery

Introduction: Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as postoperative analgesia by the Enhanced Recovery After Surgery Society. Recent studies have raised concerns that NSAID administration following colorectal anastomosis may be associated with increased risk of anastomotic leak. This multicentre study aims to determine NSAIDs' safety profile following gastrointestinal resection. Methods and analysis: This prospective, multicentre cohort study will be performed over a 2-week period utilising a collaborative methodology. Consecutive adults undergoing open or laparoscopic, elective or emergency gastrointestinal resection will be included. The primary end point will be the 30-day morbidity, assessed using the Clavien-Dindo classification. This study will be disseminated through medical student networks, with an anticipated recruitment of at least 900 patients. The study will be powered to detect a 10% increase in complication rates with NSAID use. Ethics and dissemination: Following the Research Ethics Committee Chairperson's review, a formal waiver was received. This study will be registered as a clinical audit or service evaluation at each participating hospital. Dissemination will take place through previously described novel research collaborative networks

Research report: "Using what you have to get what you want": Vulnerability to HIV and prevention needs of female post‐secondary students engaged in transactional sex in Kumasi, Ghana

This study was implemented by Boston University in collaboration with the Kwame Nkrumah University of Science and Technology with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 2010. The content and views expressed here are the authors’ and do not necessarily reflect the opinion or policy of USAID or the U.S. Government.This report presents findings from a qualitative study examining vulnerability to HIV of female post‐secondary students engaged in transactional sex in Kumasi, Ghana and their prevention needs. The study was conducted by Boston University’s Center for Global and Health and Development (CGHD) and the Kwame Nkrumah University of Science and Technology (KNUST) as part of Project SEARCH funded by the United States Agency for International Development Ghana. Participants were recruited from five post‐secondary institutions in the greater Kumasi area. Our objective is to provide academic institutions, the Ghana AIDS Commission (GAC), the National AIDS Control Program, donors, and other stakeholders with rich data to inform research and programmatic efforts in Kumasi specifically, as well as academic institutions in general. We set out to document what forms of transactional sex female students are engaging in, who their partners are, and what motivates them to participate. We asked students about the individual and structural vulnerabilities for HIV reported by female post‐secondary students involved in transactional sex and what their prevention needs are. We also interviewed a small sample of faculty, residence hall matrons, and hotel staff to get their perspective on the behavior of female students practicing transactional sex that might put them at risk for HIV. The findings of this study can be used as well to inform the design of future studies of young women engaging in transactional sex in Ghana. With such limited understanding of HIV transmission among young female post‐secondary students engaged in transactional sex, research is needed to determine how this group contributes to the overall HIV epidemic. The Ghana AIDS Commission has recognized the need for further research among communities engaged in less well‐defined risky sex practices in the National Strategic Plan for Most‐at – Risk Populations (MARP) 2011‐2015.4 This study attempts to fill in gaps in the research regarding transactional sex, taking into account the complexities and nuances of the practice, in addition to examining the needs of female students for targeted HIV prevention programs.Support from the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development under Project SEARCH Task Order No. GHH‐I‐00‐07‐00023‐00, beginning August 27, 201

Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice to describe the assets and barriers to sexual and reproductive health among Latinos in North Carolina

Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a viable strategy to address disparities

Mapping road network communities for guiding disease surveillance and control strategies

Human mobility is increasing in its volume, speed and reach, leading to the movement and introduction of pathogens through infected travelers. An understanding of how areas are connected, the strength of these connections and how this translates into disease spread is valuable for planning surveillance and designing control and elimination strategies. While analyses have been undertaken to identify and map connectivity in global air, shipping and migration networks, such analyses have yet to be undertaken on the road networks that carry the vast majority of travellers in low and middle income settings. Here we present methods for identifying road connectivity communities, as well as mapping bridge areas between communities and key linkage routes. We apply these to Africa, and show how many highly-connected communities straddle national borders and when integrating malaria prevalence and population data as an example, the communities change, highlighting regions most strongly connected to areas of high burden. The approaches and results presented provide a flexible tool for supporting the design of disease surveillance and control strategies through mapping areas of high connectivity that form coherent units of intervention and key link routes between communities for targeting surveillance.Comment: 11 pages, 5 figures, research pape

Behavior Change and HIV Prevention: (Re)Considerations for the 21st Century

Outlines the evidence base for the effectiveness of HIV-prevention programs aimed at reducing high-risk behaviors. Discusses elements of successful programs, challenges and limitations, and recommendations for expanding behavioral prevention programs

Disease Surveillance Networks Initiative Global: Final Evaluation

In August 2009, the Rockefeller Foundation commissioned an independent external evaluation of the Disease Surveillance Networks (DSN) Initiative in Asia, Africa, and globally. This report covers the results of the global component of the summative and prospective1 evaluation, which had the following objectives:[1] Assessment of performance of the DSN Initiative, focused on its relevance, effectiveness/impact, and efficiency within the context of the Foundation's initiative support.[2] Assessment of the DSN Initiative's underlying hypothesis: robust trans-boundary, multi-sectoral/cross-disciplinary collaborative networks lead to improved disease surveillance and response.[3] Assessment of the quality of Foundation management (value for money) for the DSN Initiative.[4] Contribute to the field of philanthropy by:a. Demonstrating the use of evaluations in grantmaking, learning and knowledge management; andb. Informing the field of development evaluation about methods and models to measure complex networks

Sudden spreading of infections in an epidemic model with a finite seed fraction

We study a simple case of the susceptible-weakened-infected-removed model in regular random graphs in a situation where an epidemic starts from a finite fraction of initially infected nodes (seeds). Previous studies have shown that, assuming a single seed, this model exhibits a kind of discontinuous transition at a certain value of infection rate. Performing Monte Carlo simulations and evaluating approximate master equations, we find that the present model has two critical infection rates for the case with a finite seed fraction. At the first critical rate the system shows a percolation transition of clusters composed of removed nodes, and at the second critical rate, which is larger than the first one, a giant cluster suddenly grows and the order parameter jumps even though it has been already rising. Numerical evaluation of the master equations shows that such sudden epidemic spreading does occur if the degree of the underlying network is large and the seed fraction is small.Comment: 9 page