Reasons for default from treatment of chronic illnesses in a primary healthcare program in rural Tamil Nadu.

Chronic illnesses are an increasing cause of morbidity and mortality in rural India. Many patients default from treatment, and exploring their reasons for the same may suggest strategies to improve service accessibility and acceptability. A qualitative study was conducted of 22 patient interviews, six key informant interviews, and two patient focus group discussions for investigating the reasons for default at the KC Patty Primary Health Centre and surrounding villages in Kodaikanal Taluk, Dindigul district, Tamil Nadu. The reasons included money or transport difficulties, frequent travel, feeling healthy, focus on work, fear of scolding from clinic staff, medication side effects, preference for alternative therapy, and depression. Some reasons were only divulged after an extended discussion. Support from families and village-level health workers (VLHWs) were also identified as important. Recommendations include more open and patient communication between health workers and defaulting patients, in addition to recruitment of more VLHWs

Arresting HIV: Fostering Partnerships between Sex Workers and Police to Reduce HIV Risk and Promote Professionalization within Policing Institutions: A Realist Review

In many countries around the world sex work is criminalised and its regulatory control is therefore often in the hands of the police. In addition to the impact of this criminalised legal environment, much literature describes the negative impact that certain police practices can have on the ability of sex workers and the programs that work with sex workers to access essential HIV prevention, treatment, care and support services. This situation has resulted in persistent concentrated HIV epidemics among sex workers in many countries of the world. The need for multi-sector partnerships between police and HIV programs is increasingly recognised in various UN declarations and resolutions yet descriptions of the process or key ingredients required to actually establish and sustain these necessary partnerships between police and sex workers [or the programs that provide essential services to sex workers] are sparse. The paper seeks to establish key considerations and critical processes that are required to foster partnerships that if further investigated and scaled up, could result in an enhanced enabling environment for the provision of essential HIV services for sex workers around the globe. This paper is based on a realist review that investigated isolated examples of partnership formation between law enforcement and HIV programs working with sex workers. This methodology research is designed to work with complex social interventions and is based on the emerging 'realist' approach to evaluation. A realist review methodology was chosen given the paucity of relevant literature in this vein and the authors' familiarity with the grey literature and relationships with experts who work in this sphere. The review found that political and police leadership, civil society strengthening and police reform in relation to HIV, are critical factors and key ingredients in changing the enabling environment in which sex work takes place to ensure that HIV prevention, individual and public health as well as HIV prevention and the promotion of human rights are the number one priority. Further research into this relationship is needed to provide evidence for effective HIV programming with police

Corporate social responsibility and mining industry in Thailand

Corporate social responsibility (CSR) can create value among stakeholders in both private and public sectors. In the international mining business, CSR concept plays an important role in enhancing relationships among various mining stakeholders. This paper reports on motivations and strategies of CSR by mining companies in Thailand. It argues that the CSR‟s value creation process in Thailand is complex and culturally bound. To understand motivation and types of CSR activities in the mining industry, the researchers used secondary data sources from two mining MNCs. Results show that, similar to CSR in many countries, CSR activities by mining MNCs in Thailand seem to focus on participatory actions, communitarian approach and the promotion of engagement among various stakeholders. The top CSR priorities by mining MNCs in this study include social development and economic promotions

Pre-column derivatisation method for the measurement of glycosylated hydroxylysines of collagenous proteins

Measurement of the glycosylated hydroxylysines galactosyl- and glucosylgalactosylhydroxylysine (GH and GGH) in combination with other amino acids has been based on ion-exchange chromatography followed by reaction with ninhydrin. Here, a rapid and sensitive high-performance liquid chromatographic method with fluorimetric detection has been developed and employed to determine the glycosylated hydroxylysine residues in alkaline collagen hydrolysates. After hydrolysis, amino acids were derivatised with 9- fluorenylmethyl chloroformate and separated on a Micropak ODS-80TM reversed- phase column (150 x 4.6 mm). With a multistep gradient system all amino acids were separated in less than 30 min, including the collagen-specific hydroxylysine, hydroxyproline and the glycosylated hydroxylysines. The method was used to evaluate the glycosylation levels of human articular cartilage derived from femoral head, femoral condyle, tibial plateau and ankle. GGH was highest in cartilage from femoral head and ankle. GH showed no differences between the different sources of cartilage. Chemicals/CAS: Collagen, 9007-34-5; Hydroxylysine, 28902-93-

International mining and development: lesson learnt from Mekong

Extraction of natural resources such as mining is limited within a particular geographical area. Often its activities are conducted in or near communities and have direct or indirect impacts on community resources, capabilities and well-being, thus leading to a state of poverty, violent behavior and resentment by communities towards business, and other forms of human deprivation. By adopting within-text literature analysis, this paper explores actions and consequences of mining multinational corporations (MNCs) in two countries in Mekong region, Thailand and Lao PDR. The focus is given to key corporate social responsibility (CSR) actions by international mining companies in both countries. This paper also examines key principles of CSR programs from mining MNCs, particular their activities on socio-economic and environmental development. Data is collected from two major sources (1) annual and CSR reports from mining MNCs, and (2) key academic journals in international business and social studies. This paper argues that CSR approaches by mining MNCs can affect the outcomes of the programs in terms of MNCs’ relationship with key stakeholders in the communities, practices of the CSR projects, and the improvement of socio-economic and environmental conditions in Thailand and Lao PDR

The potential for intelligent decision support systems to improve the quality and consistency of medication reviews

What is known and Objective: Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Methods: Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided.Results and Discussion: The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. What is new and conclusion: These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into improved medication usage if they were implemented into routine use