Prevalence and health care–seeking behavior for childhood diarrheal disease in Bangladesh

In Bangladesh, the burden of diarrheal diseases is significant among children <5 years old. The objective of this study is to capture the prevalence of and health care–seeking behavior for childhood diarrheal diseases (CDDs) and to identify the factors associated with CDDs at a population level in Bangladesh. We use a logistic regression approach to model careseeking based on individual characteristics. The overall diarrhea prevalence among children <5 years old was found to be 5.71%. Some factors found to significantly influence the health care–seeking pattern were age and sex of the children, nutritional score, age and education of mothers, wealth index, and access to electronic media. The health care service could be improved through working in partnership with public facilities, private health care practitioners, and community-based organizations, so that all strata of the population get equitable access in cases of childhood diarrhoea

Cost-effectiveness analysis of introducing universal childhood rotavirus vaccination in Bangladesh

Diarrhoea is one of the world's leading killers of children, and globally, rotavirus is the most common cause of severe diarrhoea among under five children. In Bangladesh, rotavirus kills nearly 6,000 under five children in each year. To reduce the burden of childhood rotavirus diseases, universal rotavirus vaccination is recommended by World Health Organization. The objective of this study is to assess the cost-effectiveness of introducing universal childhood rotavirus vaccination with the newly developed ROTAVAC vaccine in national Expanded Programme of Immunization in Bangladesh. We developed a decision model to examine the potential impact of vaccination in Bangladesh and to examine the effect if the vaccination is applied in the nationwide immunization program schedule. Introduction of childhood universal rotavirus vaccination in Bangladesh scenario appears as highly cost-effective and would offer substantial future benefits for the young population if vaccinated today. The cost per DALY averted of introducing the rotavirus vaccine compared to status quo is approximately US$740.27 and US$ 728.67 per DALY averted from the health system and societal perspective respectively which is “very cost-effective” using GDP threshold level according to World Health Organization definition. The results of this analysis seek to contribute to an evidence-based recommendation about the introduction of universal rotavirus vaccination in national Expanded Programme of Immunization (EPI) in Bangladesh

Ketorolac and pethidine in post-operative pain relief

The study was designed to compare the analgesic efficacy and safety of ketorolac and pethidine in pain relief after major surgeries. A prospective, interventional study was conducted on 71 patients under-going major surgical intervention. Thirty six patients received ketorolac (15 mg, intramuscularly 6 hourly) and the rest 35 patients received pethidine (100 mg, intramuscularly 6 hourly) for 48 hours post-operatively. Analgesic efficacy and safety of ketorolac were compared with that of pethidine after 1, 6, 12, 24, 32 and 48 hours of drug administration. Analgesic efficacy was measured using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Safety of the drugs was assessed by using sedation score and also recording adverse drug events. Ketorolac showed equianalgesic effect as pethidine estimated by VAS score at 12th and 48th hour and by VRS score at 1st and 48th hour of post-operative period. In other periods of observation, pethidine exhibited better analgesic effects than ketorolac. Ketorolac was better tolerated than pethidine and had less adverse effects compared to pethidine. This study showed that post-operative pain during the first 48 hours can be relieved by either ketorolac or pethidine. Ketorolac appeared safer than pethidine while pethidine appeared more effective analgesic than ketorolac in the management of post-operative pain. Further studies including double-blind randomized trial have been suggested to confirm the present study

Diarrhea in young children from low-income countries leads to large-scale alterations in intestinal microbiota composition

Acknowledgments This work was funded in part by the William and Melinda Gates Foundation, award 42917 to JPN and OCS; US National Institutes of Health grants 5R01HG005220 to HCB, 5R01HG004885 to MP; US National Science Foundation Graduate Research Fellowship award DGE0750616 to JNP; AWW and JP are funded by The Wellcome Trust (Grant No. WT098051).Peer reviewedPublisher PD

An Experimental Investigation of Electrical Conductivities in Biopolymers

Tuberculosis is a devastating infectious disease causing many deaths worldwide. Recent investigations have implicated neutrophil extracellular traps (NETs) in the host response to tuberculosis. The aim of the current study was to obtain evidence for NETs release in the circulation during human tuberculosis. For this we measured the plasma concentrations of nucleosomes in conjunction with neutrophil elastase, in 64 patients with active pulmonary tuberculosis and 32 healthy controls. Patients with active tuberculosis had elevated plasma levels of nucleosomes and elastase when compared with local healthy blood donors. Furthermore nucleosome and elastase levels showed a positive correlation. These findings provide the first evidence for the release of NETs in the circulation of patients with active pulmonary tuberculosis

Non-invasive monitoring of Streptococcus pyogenes vaccine efficacy using biophotonic imaging.

Streptococcus pyogenes infection of the nasopharynx represents a key step in the pathogenic cycle of this organism and a major focus for vaccine development, requiring robust models to facilitate the screening of potentially protective antigens. One antigen that may be an important target for vaccination is the chemokine protease, SpyCEP, which is cell surface-associated and plays a role in pathogenesis. Biophotonic imaging (BPI) can non-invasively characterize the spatial location and abundance of bioluminescent bacteria in vivo. We have developed a bioluminescent derivative of a pharyngeal S. pyogenes strain by transformation of an emm75 clinical isolate with the luxABCDE operon. Evaluation of isogenic recombinant strains in vitro and in vivo confirmed that bioluminescence conferred a growth deficit that manifests as a fitness cost during infection. Notwithstanding this, bioluminescence expression permitted non-invasive longitudinal quantitation of S. pyogenes within the murine nasopharynx albeit with a detection limit corresponding to approximately 10(5) bacterial colony forming units (CFU) in this region. Vaccination of mice with heat killed streptococci, or with SpyCEP led to a specific IgG response in the serum. BPI demonstrated that both vaccine candidates reduced S. pyogenes bioluminescence emission over the course of nasopharyngeal infection. The work suggests the potential for BPI to be used in the non-invasive longitudinal evaluation of potential S. pyogenes vaccines

Wolbachia Symbiont Infections Induce Strong Cytoplasmic Incompatibility in the Tsetse Fly Glossina morsitans

Tsetse flies are vectors of the protozoan parasite African trypanosomes, which cause sleeping sickness disease in humans and nagana in livestock. Although there are no effective vaccines and efficacious drugs against this parasite, vector reduction methods have been successful in curbing the disease, especially for nagana. Potential vector control methods that do not involve use of chemicals is a genetic modification approach where flies engineered to be parasite resistant are allowed to replace their susceptible natural counterparts, and Sterile Insect technique (SIT) where males sterilized by chemical means are released to suppress female fecundity. The success of genetic modification approaches requires identification of strong drive systems to spread the desirable traits and the efficacy of SIT can be enhanced by identification of natural mating incompatibility. One such drive mechanism results from the cytoplasmic incompatibility (CI) phenomenon induced by the symbiont Wolbachia. CI can also be used to induce natural mating incompatibility between release males and natural populations. Although Wolbachia infections have been reported in tsetse, it has been a challenge to understand their functional biology as attempts to cure tsetse of Wolbachia infections by antibiotic treatment damages the obligate mutualistic symbiont (Wigglesworthia), without which the flies are sterile. Here, we developed aposymbiotic (symbiont-free) and fertile tsetse lines by dietary provisioning of tetracycline supplemented blood meals with yeast extract, which rescues Wigglesworthia-induced sterility. Our results reveal that Wolbachia infections confer strong CI during embryogenesis in Wolbachia-free (GmmApo) females when mated with Wolbachia-infected (GmmWt) males. These results are the first demonstration of the biological significance of Wolbachia infections in tsetse. Furthermore, when incorporated into a mathematical model, our results confirm that Wolbachia can be used successfully as a gene driver. This lays the foundation for new disease control methods including a population replacement approach with parasite resistant flies. Alternatively, the availability of males that are reproductively incompatible with natural populations can enhance the efficacy of the ongoing sterile insect technique (SIT) applications by eliminating the need for chemical irradiation

Has management accounting research been critical?

This paper examines the contributions Management Accounting Research (MAR) has (and has not) made to social and critical analyses of management accounting in the twenty-five years since its launch. It commences with a personalised account of the first named author’s experiences of behavioural, social and critical accounting in the twenty-five years before MAR appeared. This covers events in the UK, especially the Management Control Workshop, Management Accounting Research conferences at Aston, the Inter-disciplinary Perspectives on Accounting Conferences; key departments and professors; and elsewhere the formation of pan-European networks, and reflections on a years’ visit to the USA. Papers published by MAR are analysed according to year of publication, country of author and research site, research method, research subject (type of organization or subject studied), data analysis method, topic, and theory. This revealed, after initial domination by UK academics, increasing Continental European influence; increasing use of qualitative methods over a wide range of topics, especially new costing methods, control system design, change and implementation, public sector transformation, and more recently risk management and creativity. Theoretical approaches have been diverse, often multi-disciplinary, and have employed surprisingly few economic theories relative to behavioural and social theories. The research spans mainly large public and private sector organisations especially in Europe. Seven themes perceived as of interest to a social and critical theory analysis are evaluated, namely: the search for ‘Relevance Lost’ and new costing; management control, the environment and the search for ‘fits’; reconstituting the public sector; change and institutional theory; post-structural, constructivist and critical contributions; social and environmental accounting; and the changing geography of time and space between European and American research. The paper concludes by assessing the contributions of MAR against the aspirations of groups identified in the opening personal historiography, which have been largely met. MAR has made substantial contributions to social and critical accounting (broadly defined) but not in critical areas endeavouring to give greater voice and influence to marginalised sectors of society worldwide. Third Sector organisations, politics, civil society involvement, development and developing countries, labour, the public interest, political economy, and until recently social and environmental accounting have been neglected