Association between diabetes mellitus and active tuberculosis in Africa and the effect of HIV.

OBJECTIVE: To determine current evidence for the association between diabetes and active tuberculosis in Africa, and how HIV modifies, or not, any association between diabetes and active tuberculosis. METHODS: We conducted a systematic review by searching the EMBASE, Global Health and MEDLINE databases. Studies were eligible for inclusion if they explored the association between diabetes mellitus prevalence and active tuberculosis incidence or prevalence, used a comparison group, were conducted in an African population and adjusted the analysis for at least age. Study characteristics were compared, and risk of bias was assessed. The range of effect estimates was determined for the primary association and for effect modification by HIV. RESULTS: Three eligible studies were identified: two investigated the primary association and two investigated HIV as a potential effect modifier. All studies were case-control studies, including a combined total of 1958 tuberculosis cases and 2111 non-tuberculosis controls. Diabetes diagnostic methods and analysis strategies varied between studies. Individual study adjusted odds ratios of active tuberculosis for the effect of diabetes mellitus (unstratified) ranged from 0.88 (95% CI 0.17-4.58) to 10.7 (95% CI 4.5-26.0). Individual study P-values for HIV interaction ranged from 0.01 to 0.83. Quantitative synthesis of individual study data was not performed due to heterogeneity between studies. CONCLUSIONS: Few data currently exist on the association between diabetes and active tuberculosis in Africa, and on the effect of HIV on this association. Existing data are disparate. More regional research is needed to guide policy and practice on the care and control of tuberculosis and diabetes in Africa

Conformación de una estrategia para la revolución socialista en Argentina: Partido Revolucionario de los Trabajadores (1965-1970)

En el presente artículo analizamos el proceso de conformación de la estrategia de lucha armada del Partido Revolucionario de los Trabajadores (PRT) entre los años 1965 y 1970. Las fuentes analizadas son publicaciones de la propia organización: el periódico La Verdad (1965-1968), los documentos del IV y V Congreso partidario y el periódico El Combatiente (1968-1970). En las fuentes mencionadas rastreamos las tradiciones políticas reivindicadas por el PRT, los sucesos históricos contemporáneos que la organización adoptó como hitos fundantes y la definición de su estrategia de lucha. En particular, nos detendremos en comprender la fundamentación política que ofrece el propio PRT para su estrategia de guerra civil revolucionaria; la combinación de la vía armada con otras formas de luchas; los debates con otras fuerzas de izquierda; las conclusiones extraídas a partir de los azos; las relaciones campo-ciudad y la concepción de poder dual

Key Factors in the establishment of an academia-government center of public sector administrative data and policy research

A collaborative between the Government of New Brunswick (GNB) and the University of New Brunswick to establish a center of public sector administrative data and policy research was envisioned in 2012. Subsequent work between the parties led to the establishment of the New Brunswick Institute for Research, Data and Training (NB-IRDT) in 2014. Academia-government partnerships are not unique in Canada, however what sets this apart is: 1) the legislative approach used to support research, 2) scope of administrative data made available, 3) value placed on anonymized linked data, 4) governance overseeing the partnership, and 5) measures taken to ensure the protection of citizens’ data. In 2017, the New Brunswick Act Respecting Research received proclamation. This Act serves to provide clarity and addresses gaps in access and use of personal / health data for research. The Act has opened the doors for NB-IRDT with data owners of public sector organizations. NB-IRDT may now receive pseudonymous personal data from any public sector program collecting personal information. The partnership is governed by several advisory committees each serving a different role in overseeing the growth of NB-IRDT; overall direction setting being led by a panel of Deputy Ministers and the Clerk (the senior ranking civil servant in GNB.) The collaboration is well positioned to support public policy research and fosters the use of evidence-based information in the development of government programs and services. The partnership has also helped to encourage new and innovative thinking within GNB about the value of linkable data to support decision-making

The impact of HIV on tuberculosis control--towards concerted action.

The well-established international control strategy for tuberculosis is based upon passive case-finding of the most infectious cases followed by effective chemotherapy with sufficient support to ensure and record a successful outcome. However, no country with a severe HIV epidemic is successfully controlling tuberculosis. HIV exerts a double blow. Not only must the health service manage a greatly increased number of patients (as many as fourfold higher in many African settings) but each individual patient needs to be managed more effectively if the control programme is to have a similar impact on transmission as it did in the pre-HIV era. In this paper, we discuss some of the effects of increased burden and stigmatization. We consider the potential of preventive therapy to reduce the impact of HIV on tuberculosis control and describe a more integrated approach to both infections that is being piloted in several sites in Southern Africa

You Bought Me With Money (Yet You Complain)

Contains advertisements and/or short musical examples of pieces being sold by publisher.https://digitalcommons.library.umaine.edu/mmb-vp/6942/thumbnail.jp

ZAMSTAR, The Zambia South Africa TB and HIV Reduction study: Design of a 2 × 2 factorial community randomized trial

BACKGROUND: TB and HIV form a deadly synergy in much of the developing world, especially Africa. Interventions to reduce the impact of these diseases at community level are urgently needed. This paper presents the design of a community randomised trial to evaluate the impact of two complex interventions on the prevalence of tuberculosis (TB) in high HIV prevalence settings in Zambia and South Africa. METHODS: The interaction between TB and HIV is reviewed and possible interventions that could reduce the prevalence of TB in HIV-endemic populations are discussed. Two of these interventions are described in detail and the design of a 2 x 2 factorial community randomised trial to test these interventions is presented. The limitations and challenges of the design are identified and discussed. CONCLUSION: There is an urgent need to reduce the prevalence of TB in communities highly affected by HIV. Potential interventions are complex and require innovative trial designs to provide the rigorous evidence needed to inform health policy makers and to ensure that resources are used optimally. TRIAL REGISTRATION: Number: ISRCTN36729271

The measurement of household socio-economic position in tuberculosis prevalence surveys: a sensitivity analysis.

OBJECTIVE: To assess the robustness of socio-economic inequalities in tuberculosis (TB) prevalence surveys. DESIGN: Data were drawn from the TB prevalence survey conducted in Lusaka Province, Zambia, in 2005-2006. We compared TB socio-economic inequalities measured through an asset-based index (Index 0) using principal component analysis (PCA) with those observed using three alternative indices: Index 1 and Index 2 accounted respectively for the biases resulting from the inclusion of urban assets and food-related variables in Index 0. Index 3 was built using regression-based analysis instead of PCA to account for the effect of using a different assets weighting strategy. RESULTS: Household socio-economic position (SEP) was significantly associated with prevalent TB, regardless of the index used; however, the magnitude of inequalities did vary across indices. A strong association was found for Index 2, suggesting that the exclusion of food-related variables did not reduce the extent of association between SEP and prevalent TB. The weakest association was found for Index 1, indicating that the exclusion of urban assets did not lead to higher extent of TB inequalities. CONCLUSION: TB socio-economic inequalities seem to be robust to the choice of SEP indicator. The epidemiological meaning of the different extent of TB inequalities is unclear. Further studies are needed to confirm our conclusions

Canadian Beaufort Sea 2000: The Environmental and Social Setting

The Beaufort Sea Conference 2000 brought together a diverse group of scientists and residents of the Canadian Beaufort Sea region to review the current state of the region's renewable resources and to discuss the future management of those resources. In this paper, we briefly describe the physical environment, the social context, and the resource management processes of the Canadian Beaufort Sea region. The Canadian Beaufort Sea land area extends from the Alaska-Canada border east to Amundsen Gulf and includes the northwest of Victoria Island and Banks Island. The area is defined by its geology, landforms, sources of freshwater, ice and snow cover, and climate. The social context of the Canadian Beaufort Sea region has been set by prehistoric Inuit and Gwich'in, European influence, more recent land-claim agreements, and current management regimes for the renewable resources of the Beaufort Sea.La Conférence de l'an 2000 sur la mer de Beaufort a attiré un groupe hétérogène de scientifiques et de résidents de la région de la mer de Beaufort en vue d'examiner le statut actuel des ressources renouvelables de cette zone et de discuter de leur gestion future. Dans cet article, on décrit brièvement l'environnement physique, le contexte social et les processus de gestion des ressources de la zone canadienne de la mer de Beaufort. La superficie terrestre de la mer de Beaufort au Canada s'étend de la frontière entre ce pays et l'Alaska jusqu'au golfe Amundsen à l'est, et elle englobe le nord-ouest de l'île Victoria et de l'île Banks. Cette zone est définie par sa géologie, son relief, ses sources d'eau douce, son couvert glaciel et nival ainsi que son climat. Le contexte social de la région de la mer de Beaufort canadienne a été établi par les Inuits et Gwich'in préhistoriques, l'influence européenne, les récentes ententes territoriales ainsi que les régimes actuels de gestion des ressources renouvelables de la mer de Beaufort

The Beaufort Sea Conference 2000 on the Renewable Marine Resources of the Canadian Beaufort Sea

The Beaufort Sea Conference 2000, held in Inuvik, Northwest Territories, in September 1999, had three objectives: to review our current understanding of the renewable aquatic resources of the Beaufort Sea; to review the factors that affect those resources; and to develop a vision that will guide management of those resources for the benefit of present and future generations. To achieve these objectives, the conference brought together representatives of the full range of groups interested in the renewable resources of the Beaufort Sea. These included hunters and fishers, other resource users, scientists, government managers, educators, students, and the public. The conference was structured to encourage interaction between participants so that they could jointly discuss opportunities for the future. ... This special issue of the journal "Arctic" presents the formal scientific papers on each resource species or group and the presentation by Inuvialuit elder Billy Day. The paragraphs below summarize the conference discussions under the four themes, as well as the discussions of the youth delegation. The Canadian Beaufort Sea region pioneered and put into practice the theory of co-management in the Canadian Arctic, beginning with the signing of the Inuvialuit Final Agreement in 1984 and the Gwich'in Final Agreement eight years later. Workshop discussions considering the role of co-management of renewable resources in this region focused on the following challenges for the future: Community engagement .... Youth and elders .... Communication .... Good governance .... Research .... Traditional ecological knowledge .... Chaos and innovation ...