Self-diagnosis of malaria by travellers: a cohort study on the use of malaria rapid diagnostic tests provided by a Swiss travel clinic

The WHO recommends that all suspect malaria cases be tested before receiving treatment. Rapid diagnostic tests (RDT) for malaria can be performed reliably by community health workers with no formal medical background and thus, RDTs could also be provided to travellers for self-diagnosis during visits to endemic regions.; RDTs were proposed during pre-travel consultations to pre-defined categories of travellers. A training run on their own blood was performed and, if carried out correctly, the traveller was given a written procedure on how to perform the test and act on its result. The travellers were then proposed to buy a malaria RDT kit and were interviewed upon their return.; From February 2012 to February 2017, 744 travellers were proposed RDTs and 692 performed the training run (one could not complete it due to a hand tremor). Among the 691 subjects included, 69% travelled to moderate- or low-risk areas of malaria, 18% to high-risk areas and 13% to mixed-risk areas. The two most frequent categories of travellers to whom RDTs were proposed were long-term travellers (69%) and those travelling to remote areas (57%). 543 travellers (79%) were interviewed upon return. During their trip, 17% (91/543) had a medical problem with fever and 12% (65/543) without fever. Among 91 febrile patients, 57% (52/91) performed an RDT, 22% (20/91) consulted immediately without using the test, and 21% (19/91) did neither. Four RDTs (4/52; 8%) were positive: 2 in low-risk and 2 in high-risk areas (0.7% attack rate of self-documented malaria). Two travellers could not perform the test correctly and attended a facility or took standby emergency treatment. Four travellers with negative results repeated the test after 24 h; all were still negative. Carrying RDTs made travellers feel more secure, especially when travelling with children.; 1/6 travellers experienced fever and 4/5 of those reacted appropriately: more than half used RDTs and a quarter consulted immediately. Four travellers (including 2 from low-risk areas) diagnosed themselves with malaria and self-treated successfully. This strategy allows prompt treatment for malaria in high-risk groups and may avoid over-diagnosis (and subsequent inappropriate treatment) of malaria on-site

A solid-phase extraction method for rapidly determining the adsorption coefficient of pharmaceuticals in sewage sludge

AbstractThe partitioning of pharmaceuticals in the environment can be assessed by measuring their adsorption coefficients (Kd) between aqueous and solid phases. Measuring this coefficient in sewage sludge gives an indication of their partitioning behaviour in a wastewater treatment plant and hence contributes to an understanding of their subsequent fate. The regulatory approved method for measuring Kd in sewage sludge is the US Environmental Protection Agency's Office of Prevention, Pesticides and Toxic Substances (OPPTS) guideline 835.1110, which is labour intensive and time consuming. We describe an alternative method for measuring the Kd of pharmaceuticals in sewage sludge using a modified solid-phase extraction (SPE) technique. SPE cartridges were packed at different sludge/PTFE ratios (0.4, 6.0, 24.0 and 40.0% w/w sludge) and eluted with phosphate buffer at pH 7.4. The approach was tested initially using three pharmaceuticals (clofibric acid, diclofenac and oxytetracycline) that covered a range of Kd values. Subsequently, the sorption behaviour of ten further pharmaceuticals with varying physico-chemical properties was evaluated. Results from the SPE method were comparable to those of the OPPTS test, with a correlation coefficient of 0.93 between the two approaches. SPE cartridges packed with sludge and PTFE were stable for up to one year; use within one month reduced variability in measurements (to a maximum of 0.6 log units). The SPE method is low-cost, easy to use and enables the rapid measurement of Kd values for a large number of chemicals. It can be used as an alternative to the more laborious full OPPTS test in environmental fate studies and risk assessments

The Maunakea Spectroscopic Explorer Book 2018

(Abridged) This is the Maunakea Spectroscopic Explorer 2018 book. It is intended as a concise reference guide to all aspects of the scientific and technical design of MSE, for the international astronomy and engineering communities, and related agencies. The current version is a status report of MSE's science goals and their practical implementation, following the System Conceptual Design Review, held in January 2018. MSE is a planned 10-m class, wide-field, optical and near-infrared facility, designed to enable transformative science, while filling a critical missing gap in the emerging international network of large-scale astronomical facilities. MSE is completely dedicated to multi-object spectroscopy of samples of between thousands and millions of astrophysical objects. It will lead the world in this arena, due to its unique design capabilities: it will boast a large (11.25 m) aperture and wide (1.52 sq. degree) field of view; it will have the capabilities to observe at a wide range of spectral resolutions, from R2500 to R40,000, with massive multiplexing (4332 spectra per exposure, with all spectral resolutions available at all times), and an on-target observing efficiency of more than 80%. MSE will unveil the composition and dynamics of the faint Universe and is designed to excel at precision studies of faint astrophysical phenomena. It will also provide critical follow-up for multi-wavelength imaging surveys, such as those of the Large Synoptic Survey Telescope, Gaia, Euclid, the Wide Field Infrared Survey Telescope, the Square Kilometre Array, and the Next Generation Very Large Array.Comment: 5 chapters, 160 pages, 107 figure

Les miroirs de l'adolescence. Anthropologie du placement juvénile

Comment se prépare et s'expérimente la transition à l'âge adulte lors de placements juvéniles? Ce livre est une invitation à entrer dans la réalité institutionnelle d'adolescentes et d'adolescents proches de leur majorité, placés dans des structures d'hébergement socio-­éducatives, appelées aussi foyers. Basé sur un riche matériel de terrain, il dévoile toute la complexité du travail d'accompagnement en interrogeant la place centrale accordée à la notion d'autonomie dans les prises en charge éducatives. Il prend appui autant sur le point de vue des professionnel·le·s que sur celui des jeunes placé·e·s pour montrer comment les dimensions identitaires, civiles et citoyennes viennent s'adosser à la mission de ces institutions, en particulier lors des nombreuses séquences ritualisées qui rythment le vivre ensemble jour après jour. Il en résulte une analyse anthropologique originale du placement juvénile qui intéressera le monde professionnel directement aux prises avec les réalités de ces adolescentes et de ces adolescents souvent issus de groupes socio­-économiques défavorisés. Les réflexions proposées intéresseront également le monde des sciences sociales soucieux de comprendre la façon dont les institutions articulent des vécus singuliers aux attentes politiques et sociales qui pèsent sur une partie de la jeunesse

A solid-phase extraction approach for the identification of pharmaceuticalâsludge adsorption mechanisms

It is important to understand the adsorption mechanism of chemicals and active pharmaceutical ingredients (API) on sewage sludge since wastewater treatment plants are the last barrier before the release of these compounds to the environment. Adsorption models were developed considering mostly hydrophobic APIâsludge interaction. They have poor predictive ability, especially with ionisable compounds. This work proposes a solid-phase extraction (SPE) approach to estimate rapidly the APIâsludge interaction. Sludge-filled SPE cartridges could not be percolated with API spiked mobile phases so different powders were tested as SPE sludge supports. Polytetrafluoroethylene (PTFE) was selected and tested at different PTFE/sludge ratios under eight different adsorption conditions with three API ionisable compounds. The PTFE/sludge mixtures with 50% or less sludge could be used in SPE mode for API sorption studies with methanol/water liquid phases. The results gave insights into APIâsludge interactions. It was found that ÏâÏ, hydrogen-bonding and chargeâcharge interactions were as important as hydrophobicity in the adsorption mechanism of charged APIs on sludge. Keywords: Pharmaceuticals, Sewage sludge, Adsorption coefficient, Binding, Solid-phase extraction, Polytetrafluoroethylen

En quête d'éthique ::dispositions légales et enjeux empiriques pour l'anthropologie

Ce document est la traduction de l’article « Searching for Ethics: Legal requirements and empirical issues for anthropology » (voir Perrin et al. 2018). Il analyse les nouvelles dispositions légales qui impactent les pratiques de recherche qualitative et contribuent à l’institutionnalisation de l’éthique de la recherche en Suisse. Après avoir contextualisé l’émergence de nouvelles formes de régulation de la recherche, il montre comment leurs présupposés épistémologiques affectent l’anthropologie. Il explore ensuite les enjeux liés à l’articulation entre éthique procédurale et éthique processuelle. Enfin, il examine les différentes postures qui pourraient être adoptées par les anthropologues et en sociales qualitatives

Searching for ethics ::legal requirements and empirical issues for anthropology

This paper analyses the new legal provisions impacting qualitative research practices and contributing to the institutionalization of research ethics in Switzerland. After contextualizing the emergence of new forms of research regulation, it shows how their epistemological assumptions challenge anthropology. It then explores the issues related to the articulation between procedural ethics and processual ethics. Finally, it discusses the different postures which might possibly be adopted by scholars in anthropology and other qualitative social sciences

Nouvelles approches pour la prévention de la malaria chez le voyageur

Malaria is declining in many tropical countries. This reduction challenges our usual preventive strategies. In moderate to low risk areas, the Swiss guidelines recommend a stand-by emergency treatment. Controversies between experts are numerous though. Professionals at the Travel Clinic in Lausanne has explored shared-decision making through three clinical studies. The first showed that travelers visiting moderate to low risk malaria areas prefer a standby emergency treatment rather than chemoprophylaxis. The second study investigates the use of rapid diagnostic tests by travelers. The third focuses on the prospects of tropical telemedicine. Involving the traveler into the debate is a priority, until a vaccine becomes available