Improving the Supply Distribution and Use of Antimalarial Drugs by the Private Sector in Tanzania. Report prepared for the National Malaria Control Programme, United Republic of Tanzania

Private pharmacies or shops are the source of 60% of the drugs bought to treat suspected cases of malaria. At the same time 59% of children fail to be treated within 24 hours of onset. The private sector is the primary source for antimalarials, but parents and carers are failing to administer those drugs sufficiently early to minimise morbidity and mortality. This review focused on the way in which antimalarial drugs reach the patient. It also examined ways in which the delivery system could be improved and how the private facilities can become more effective sources of both drugs and advice. It has found that there are many problems with the way that drugs are distributed. Many unregistered drugs are readily available, and poor storage conditions are likely to reduce the efficacy of drugs even if they were of good quality at the time of manufacture. For many people the cost of even the cheapest antimalarial is an issue and purchase of part doses is common. The knowledge of the staff in pharmacies is poor and in shops woefully inadequate. Nonetheless most people use shops and private pharmacies as their source for drugs. There are two overarching requirements: • First of all the needs and capabilities of the private sector must always be taken into account before any decision is made about how to make antimalarials more available. • Secondly, educating the staff and public will only be achieved through a subtle communications package regularly repeated and brought up to date. For example we found that many workers in Part II pharmacies remain in post for no more than one year. Unlike their counterparts in the public sector, staff in the private sector do not find incentives in attending training courses. Staff in the public sector spend so much time on courses that their time to actually implement what they have learned is limited. To reach the private sector staff will require subtler and more cost effective methods. The report is full of detailed recommendations for the improvement of the supply systems and for educating both staff and public

Toward gas exhaustion in the W51 high-mass protoclusters

Reproduced with permission from Astronomy & Astrophysics, © 2016 ESOWe present new JVLA observations of the high-mass cluster-forming region W51A from 2 to 16 GHz with resolution θfwhm ≈ 0.3−0.5″. The data reveal a wealth of observational results: (1) Currently forming, very massive (proto-O) stars are traced by o - H2CO21,1−21,2 emission, suggesting that this line can be used efficiently as a massive protostar tracer; (2) there is a spatially distributed population of ≲mJy continuum sources, including hypercompact H ii regions and candidate colliding wind binaries, in and around the W51 proto-clusters; and (3) there are two clearly detected protoclusters, W51e and W51 IRS2, that are gas-rich but may have most of their mass in stars within their inner ≲0.05 pc. The majority of the bolometric luminosity in W51 most likely comes from a third population of OB stars between these clusters. The presence of a substantial population of exposed O-stars coincident with a population of still-forming massive stars, together with a direct measurement of the low mass loss rate via ionized gas outflow from W51 IRS2, implies that feedback is ineffective at halting star formation in massive protoclusters. Instead, feedback may shut off the large-scale accretion of diffuse gas onto the W51 protoclusters, implying that they are evolving toward a state of gas exhaustion rather than gas expulsion. Recent theoretical models predict gas exhaustion to be a necessary step in the formation of gravitationally bound stellar clusters, and our results provide an observational validation of this process.Peer reviewedFinal Published versio

Mapping the column density and dust temperature structure of IRDCs with Herschel

Infrared dark clouds (IRDCs) are cold and dense reservoirs of gas potentially available to form stars. Many of these clouds are likely to be pristine structures representing the initial conditions for star formation. The study presented here aims to construct and analyze accurate column density and dust temperature maps of IRDCs by using the first Herschel data from the Hi-GAL galactic plane survey. These fundamental quantities, are essential for understanding processes such as fragmentation in the early stages of the formation of stars in molecular clouds. We have developed a simple pixel-by-pixel SED fitting method, which accounts for the background emission. By fitting a grey-body function at each position, we recover the spatial variations in both the dust column density and temperature within the IRDCs. This method is applied to a sample of 22 IRDCs exhibiting a range of angular sizes and peak column densities. Our analysis shows that the dust temperature decreases significantly within IRDCs, from background temperatures of 20-30 K to minimum temperatures of 8-15 K within the clouds, showing that dense molecular clouds are not isothermal. Temperature gradients have most likely an important impact on the fragmentation of IRDCs. Local temperature minima are strongly correlated with column density peaks, which in a few cases reach NH2 = 1 x 10^{23} cm^{-2}, identifying these clouds as candidate massive prestellar cores. Applying this technique to the full Hi-GAL data set will provide important constraints on the fragmentation and thermal properties of IRDCs, and help identify hundreds of massive prestellar core candidates.Comment: Accepted for publication in A&A Herschel special issu

Herschel Observations of the W43 "mini-starburst"

Aims: To explore the infrared and radio properties of one of the closest Galactic starburst regions. Methods: Images obtained with the Herschel Space Observatory at wavelengths of 70, 160, 250, 350, and 500 microns using the PACS and SPIRE arrays are analyzed and compared with radio continuum VLA data and 8 micron images from the Spitzer Space Telescope. The morphology of the far-infrared emission is combined with radial velocity measurements of millimeter and centimeter wavelength transitions to identify features likely to be associated with the W43 complex. Results: The W43 star-forming complex is resolved into a dense cluster of protostars, infrared dark clouds, and ridges of warm dust heated by massive stars. The 4 brightest compact sources with L > 1.5 x 10^4 Lsun embedded within the Z-shaped ridge of bright dust emission in W43 remain single at 4" (0.1 pc) resolution. These objects, likely to be massive protostars or compact clusters in early stages of evolution are embedded in clumps with masses of 10^3 to 10^4 Msun, but contribute only 2% to the 3.6 x 10^6 Lsun far-IR luminosity of W43 measured in a 16 by 16 pc box. The total mass of gas derived from the far-IR dust emission inside this region is ~10^6 Msun. Cometary dust clouds, compact 6 cm radio sources, and warm dust mark the locations of older populations of massive stars. Energy release has created a cavity blowing-out below the Galactic plane. Compression of molecular gas in the plane by the older HII region near G30.684-0.260 and the bipolar structure of the resulting younger W43 HII region may have triggered the current mini-star burst.Comment: 5 pages, 3 figures, accepted for A&A Special Issu

Embodied Knowledge: Writing Researchers’ Bodies Into Qualitative Health Research

After more than a decade of postpositivist health care research and an increase in narrative writing practices, social scientific, qualitative health research remains largely disembodied. The erasure of researchers’ bodies from conventional accounts of research obscures the complexities of knowledge production and yields deceptively tidy accounts of research. Qualitative health research could benefit significantly from embodied writing that explores the discursive relationship between the body and the self and the semantic challenges of writing the body by incorporating bodily details and experiences into research accounts. Researchers can represent their bodies by incorporating autoethnographic narratives, drawing on all of their senses, interrogating the connections between their bodily signifiers and research processes, and experimenting with the semantics of self and body. The author illustrates opportunities for embodiment with excerpts from an ethnography of a geriatric oncology team and explores implications of embodied writing for the practice of qualitative health research