Probiotic Yoghourt for Health, Nutrition and Women\u27s Empowerment in Kenya: A Community-Based Approach

The dissertation aims to examine the impacts of probiotic yoghourt on health, nutrition and women’s empowerment within the context of HIV/AIDS in Kenya. Mixed methods that combine quantiative and qualitative approaches are used to understand the effects of probiotic yoghourt on the health, nutrition and quality of life for men and women. Results of the quantiative analysis (n=227) demonstrated that the probiotic yoghourt confers a variety of health benefits – physiological (fewer urogenital conditions and digestive problems; reduced dependence on medical treatment), and psychological (perceived improvements with bodily appearance, felt an increased meaningfulness with life). Results of the qualitative analysis (n=26) revealed an overall improved quality of life based on the six domains of the WHOQOL assessment tool. A supplemental qualtiative study and analysis that examines the ways in which this health and development initiative promotes empowerment, social and economic development revealed that while there are substantial and important direct and indirect benefits, there are challenges with group dynamics, class, and power structures. Theoretically, the study highlights the need to revisit the group approach of health and development projects. While this method undebiably empowers the women at the individual level within a number of domains, the group structure can be cosnidered to counteract some of the gains and positive effects. Methodologically, the research shows the value of employing a mixed methods design. Usually, biomedical research using clinical study designs do not adopt mixed methods to describe the experiences of the participants. Building on the survey findings, deeper and richer insights into the impacts of the probiotic yoghourt on the health and quality of life of participants is gained. Lastly, the findings from this research provides a platform for policy makers to re-examine the importance and need to incorporate nutritional support programmes that are holistic and mutli-faceted, targeting marginalized groups

Probiotics in Tanzania: A review

The report is organized in five sections: Stakeholders, Context, Project, Outcomes, and Project Sustainability. The Stakeholders section provides background information on the Canadian and Tanzanian institutional partners and the expertise each brings to the Western Heads East project. The project participants, operating as a Community Based Organization under the name Tukwamuane, are also introduced in this section. For any development project or research programme to be successful it must be both context-specific and context-appropriate; therefore, in Context the project setting is documented. The impact of the AIDS epidemic on Tanzania and its citizens, the nutritional status of the population, social and economic realities, and the current level of gender equity are all explored in this section. The Project section begins with an explanation of probiotics and the role researchers believe beneficial bacteria can play in combating HIV and alleviating diarrhoea. There is a brief explanation of why, from among the many available media, yoghurt was chosen as the preferred delivery method for the probiotics. Rationale for the selection of the project planning and reporting framework and the selection of a gender analysis tool are given and, following this, the project document and the completed gender analysis are presented in their entirety. As Western Heads East organizers prepare to enter the research phase of the project, two preliminary studies were undertaken to measure results thus far. In Outcomes, the results of a Rapid Health Impact Assessment and an Economic Empowerment & Health case study, and a Community Readiness Assessment are presented. A key goal of the Western Heads East collaborators was to create a sustainable project, thereby ensuring that the health and nutritional benefits of probiotic yoghurt would continue to be available to Tanzanian citizens for years to come. To assess Project Sustainability, stakeholders were surveyed on the steps necessary to reach sustainability. This section of the report will be of interest to other groups interested in launching similar initiatives, allowing them to leverage WHE’s successes and avoid unnecessary pitfalls

Program planning and evaluation framework for a community based food project in Mwanza, Tanzania / by Ellena Andoniou.

The ravaging effects of the HIV/AIDS epidemic in Sub-Saharan Africa are well known. Countries in the region are facing a crisis of unprecedented proportions further compounded by poverty, malnutrition and social inequalities. This is especially true in Tanzania, one of the world’s poorest countries - where the majority of the population lives in absolute poverty; there is a disproportionately high level of food insecurity and poor nutritional standards are extensive. Initiated in 2003, The University of Western Ontario (UWO) in partnership with the National Institute for Medical Research (NIMR), the Kivulini Women’s Rights Organization (KWRO) and a local women’s group, the Tukwamuane, launched a probiotic food based community project in Mwanza, Tanzania - a high-need area as defined by the Canadian International Development Agency. The Western Heads East (WHE) probiotic yoghurt project is an international collaboration fostering community health and development. The project is a microenterprise initiative which aims to improve health and nutrition, while alleviating suffering from malnutrition, diarrhoeal diseases, and urogenital disorders in vulnerable social groups in the context of the HIV/AIDS epidemic. Women with little or no formal education are trained to produce probiotic yoghurt for sale and subsidized distribution to People Living with HIV/AIDS (PLWHAs) at the community level. The project has the potential to foster health improvement, as well as empowerment, advocacy skills among women and promote knowledge transfer to future generations. However, at the inception of WHE, the necessary steps to develop key planning and evaluation frameworks were not taken. As such, the purpose of this project is to prepare a program planning and evaluation framework which will enable project planners, stakeholders, and researchers to evaluate project outcomes, the health impacts and improvements in quality of life for the women making the yoghurt, their families and the broader community; as well as to explore women’s perceptions (if any) of empowerment, and how the project is enabling them to achieve their everyday life objectives

The experiences and challenges of community health volunteers as agents for behaviour change programming in Africa: a scoping review

ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a synthesis of key challenges and considerations that can inform efforts to reduce attrition and improve the sustainability of community health volunteers in Africa. This scoping review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews checklist to achieve the objectives. A comprehensive search of six databases returned 2140 sources. After screening, 31 peer-reviewed studies were selected for final review. Analytical themes were generated based on the reviewers’ extraction of article data into descriptive themes using an inductive approach. In reviewing community health volunteers’ accounts of providing health services, five key challenges become apparent. These are: (1) challenges balancing work responsibilities with family obligations; (2) resource limitations; (3) exposure to stigma and harassment; (4) gendered benefits and risks; and (5) health-system level challenges. This scoping review highlights the extent of challenges community health volunteers must navigate to provide services in communities. Sustained commitment at the national and international level to understand the lived experiences of community health volunteers and mitigate common stressors these health actors face could improve their performance and inform future programs

The murine natural cytotoxic receptor NKp46/NCR1 controls TRAIL protein expression in NK cells and ILC1

TRAIL is an apoptosis-inducing ligand constitutively expressed on liver resident type 1 innate lymphoid cells (ILC1) and a subset of Natural Killer (NK) cells where it contributes to NK cell anti-tumor, anti-viral and immunoregulatory functions. Yet the intrinsic pathways involved in TRAIL expression in ILC remain unidentified. Here we demonstrate that the murine natural cytotoxic receptor mNKp46/NCR1, expressed on ILC1 and NK cells, controls TRAIL protein expression. Using NKp46-deficient mice, we show that liver ILC1 lack constitutive expression of TRAIL protein and that NK cells activated in vitro and in vivo fail to upregulate cell-surface TRAIL in the absence of NKp46. We show that NKp46 regulates TRAIL expression in a dose-dependent manner and that the reintroduction of NKp46 in mature NK cells deficient for NKp46 is sufficient to restore TRAIL surface expression. These studies uncover a link between NKp46 and TRAIL expression in ILC with potential implications in pathologies involving NKp46-expressing cells

A novel checkpoint in the Bcl-2–regulated apoptotic pathway revealed by murine cytomegalovirus infection of dendritic cells

Infection with murine cytomegalovirus (MCMV) has contributed to understanding many aspects of human infection and, additionally, has provided important insight to understanding complex cellular responses. Dendritic cells (DCs) are a major target for MCMV infection. Here, we analyze the effects of MCMV infection on DC viability, and show that infected DCs become resistant to apoptosis induced by growth factor deprivation. The precise contribution of changes in the expression of Bcl-2 family proteins has been assessed and a new checkpoint in the apoptotic pathway identified. Despite their resistance to apoptosis, MCMV-infected DCs showed Bax to be tightly associated with mitochondria and, together with Bak, forming high molecular weight oligomers, changes normally associated with apoptotic cell death. Exposure of a constitutively occluded Bax NH2-terminal epitope was blocked after infection. These results suggest that MCMV has evolved a novel strategy for inhibiting apoptosis and provide evidence that apoptosis can be regulated after translocation, integration, and oligomerization of Bax at the mitochondrial membrane

The importance of colour on the communication of financial data in management

Purpose – The purpose of this paper is to explore the importance of colour on the communication of financial data in management and to encourage future discussion on related topic. Design/methodology/approach – Hypothesis was designed building on relevant literatures. Quantitative discrete data were collected through a mini-test activity in a lecture from students. The results were reviewed and evaluated by relevant statistical tool. Findings – The authors found consistent statistical significance results in the mini-test. The findings support that users prefer to choose the financial data presented in cool colours in business management context. Research limitations/implications – Gaining the understanding of colour’s influence on decision making and behaviour is subjected to complexity. There are many other contextual factors should be taken into consideration in practice. Although the design of the mini-test in this study is relatively simple, it still provides clues for the issue. With the discussions and findings of this paper, the authors shed some light on the direction of potential uses of colour on the communication of financial data in management context. The findings could also be used by management educators to facilitate related discussions among students regarding the complexity of business communication and the importance of perception in decision making. For example, decision making could be affected by various factors (such as colour) outside verbal and text. Originality/value – Managers often need to use financial data in communication for various purposes in work place. The authors believe this is the first time that a study like this had been conducted to specifically review and discuss the importance of colour on the communication of financial data in management. Hopefully, the work reported in this paper could be viewed as reference for management educators, researchers and managers in future research or practical applications on related topics

A Contribution of Mouse Dendritic Cell–Derived IL-2 for NK Cell Activation

Dendritic cells (DCs) play a predominant role in activation of natural killer (NK) cells that exert their functions against pathogen-infected and tumor cells. Here, we used a murine model to investigate the molecular mechanisms responsible for this process. Two soluble molecules produced by bacterially activated myeloid DCs are required for optimal priming of NK cells. Type I interferons (IFNs) promote the cytotoxic functions of NK cells. IL-2 is necessary both in vitro and in vivo for the efficient production of IFNγ, which has an important antimetastatic and antibacterial function. These findings provide new information about the mechanisms that mediate DC–NK cell interactions and define a novel and fundamental role for IL-2 in innate immunity

A Natural Genetic Variant of Granzyme B Confers Lethality to a Common Viral Infection

Many immune response genes are highly polymorphic, consistent with the selective pressure imposed by pathogens over evolutionary time, and the need to balance infection control with the risk of auto-immunity. Epidemiological and genomic studies have identified many genetic variants that confer susceptibility or resistance to pathogenic micro-organisms. While extensive polymorphism has been reported for the granzyme B (GzmB) gene, its relevance to pathogen immunity is unexplored. Here, we describe the biochemical and cytotoxic functions of a common allele of GzmB (GzmBW) common in wild mouse. While retaining ‘Asp-ase ’ activity, GzmBW has substrate preferences that differ considerably from GzmBP, which is common to all inbred strains. In vitro, GzmBW preferentially cleaves recombinant Bid, whereas GzmBP activates pro-caspases directly. Recombinant GzmBW and GzmBP induced equivalent apoptosis of uninfected targets cells when delivered with perforin in vitro. Nonetheless, mice homozygous for GzmBW were unable to control murine cytomegalovirus (MCMV) infection, and succumbed as a result of excessive liver damage. Although similar numbers of anti-viral CD8 T cells were generated in both mouse strains, GzmBW-expressing CD8 T cells isolated from infected mice were unable to kill MCMV

Interleukin-17D and Nrf2 mediate initial innate immune cell recruitment and restrict MCMV infection.

Innate immune cells quickly infiltrate the site of pathogen entry and not only stave off infection but also initiate antigen presentation and promote adaptive immunity. The recruitment of innate leukocytes has been well studied in the context of extracellular bacterial and fungal infection but less during viral infections. We have recently shown that the understudied cytokine Interleukin (IL)-17D can mediate neutrophil, natural killer (NK) cell and monocyte infiltration in sterile inflammation and cancer. Herein, we show that early immune cell accumulation at the peritoneal site of infection by mouse cytomegalovirus (MCMV) is mediated by IL-17D. Mice deficient in IL-17D or the transcription factor Nuclear factor (erythroid-derived 2)-like 2 (Nrf2), an inducer of IL-17D, featured an early decreased number of innate immune cells at the point of viral entry and were more susceptible to MCMV infection. Interestingly, we were able to artificially induce innate leukocyte infiltration by applying the Nrf2 activator tert-butylhydroquinone (tBHQ), which rendered mice less susceptible to MCMV infection. Our results implicate the Nrf2/IL-17D axis as a sensor of viral infection and suggest therapeutic benefit in boosting this pathway to promote innate antiviral responses