524 research outputs found
Evidence-informed surgical systems strengthening with meaningful stakeholder involvement in low-resource settings: a response to recent commentaries
Environmental drivers of spatio-Temporal dynamics in floodplain vegetation: grasslands as habitat for megafauna in Bardia National Park (Nepal)
Disturbance-dependent grasslands, often associated with hydromorphological and fire dynamics, are threatened, especially in subtropical climates. In the Nepalese and Indian Terai Arc Landscape at the foot of the Himalayas, natural and cultural grasslands serve a viable role for greater one-horned rhinoceros (Rhinoceros unicornis) and for grazers that form prey of the Royal Bengal tiger (Panthera tigris). The grasslands are vulnerable to encroachment of forest. We aimed to establish the effects of environmental drivers, in particular river discharge, river channel dynamics, precipitation and forest fires, on the spatio-Temporal dynamics of these grasslands. The study area is the floodplain of the eastern branch of the Karnali River and adjacent western part of Bardia National Park. We created annual time series (1993-2019) of land cover with the use of field data, remotely sensed LANDSAT imagery and a supervised classification model. Additionally, we analysed the pattern of grassland patches and aerial photographs of 1964. Between 1964 and 2019, grassland patches decreased in abundance and size due to encroachment of forest. Outside the floodplain, conversion of grassland to bare substrate coincides with extreme precipitation events. Within the floodplain, conversion of grassland to bare substrate correlates with the magnitude of the annual peak discharge of the bifurcated Karnali River. Since 2009, however, this correlation is absent due to a shift of the main discharge channel to the western branch of the Karnali River. Consequently, alluvial tall grasslands (Saccharum spontaneum dominant) have vastly expanded between 2009 and 2019. Because the hydromorphological processes in the floodplain have become more static, other sources of disturbances-local flooding of ephemeral streams, anthropogenic maintenance, grazing and fires-are more paramount to prevent encroachment of grasslands. Altogether, our findings underscore that a change in the environmental drivers impact the surface area and heterogeneity of grassland patches in the landscape, which can lead to cascading effects for the grassland-dependent megafauna
Government or Donor: The Budget for HIV/AIDS Control and Financial Commitment in Bandung City, Indonesia
The number of HIV/AIDS cases in Indonesia has steadily increased since 1987. West Java Province, especially Bandung City, had the highest HIV/AIDS cases among other districts/cities in 2016. Some stakeholders' interventions overlap with others, leading to inefficient use of the limited government budget and flattening international donor funding. This study aimed to estimate the HIV/AIDS budget in Bandung City and then segregate the share of the budget by funding source and objectives. This study was a part of the Priority Setting Involving Stakeholder Using Multiple Criteria (PRISMA) project in 2017 to prioritize HIV/AIDS interventions knowing that Bandung City had the highest HIV/AIDS cases. Data from several institutions and relevant budget allocations were obtained before (2016) and after (2018-2019) the PRISMA project. HIV/AIDS control programs in Bandung City largely depend on international funding: 49% in 2016 (~USD208,898), 85% in 2018 (~USD386,132), and 71% in 2019 (~USD389,943) for a total of ~USD1,433,216. The largest budget was allocated to core interventions, with prevention dominating the budget since 2018. The budget allocated for prevention increased significantly from 2016-2019, most likely under the influence of the PRISMA project
The political dimension of sexual rights:Commentary on the paper by Chandra-Mouli et al.: a never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it
BACKGROUND: The recent commentary article in this journal by Chandra-Mouli et al. speaks of a never-before opportunity to strengthen investment and action on adolescent contraception. We endorse the positive 'can-do' tone of the article, but noticed that at least four issues, which in our view are crucial, merit a comment. MAIN BODY: First of all, the article suggests that there is some sort of shared interest, based on a presumed global consensus around the use of contraceptives by adolescents - which is not the case: sexual rights are controversial. Secondly, for real progress in adolescent contraception to occur, we believe it is critical to thoroughly investigate and mention the factors, including political ones, that would need to be overcome. Thirdly, new avenues need to be explored that allow for accurate and positive teaching of adolescents about contraception in socio-cultural and political environments that are ambivalent about the issue. Fourthly, barriers at the global level that we already know of should not be silenced. There is sufficient evidence to call upon donors and international agencies to choose position and stop obstructing women's - including young women's - access to a broad range of contraceptives. The 'She Decides' movement is a heartening example. CONCLUSION: It is crucial to acknowledge the political dimension of sexual rights. It requires solutions not only at national levels, but also at the global level
Global Surgery – Informing National Strategies for Scaling Up Surgery in Sub-Saharan Africa
Abstract
Surgery has the potential to address one of the largest, neglected burdens of disease in low- and middle-income
countries (LMICs), especially in sub-Saharan Africa (SSA). The Lancet Commission on Global Surgery (LCoGS)
has provided a blueprint for a systems approach to making safe emergency and elective surgery accessible and
affordable and has started to enable African governments to develop national surgical plans. This editorial
outlines an important gap, which is the need for surgical systems research, especially at district hospitals which
are the first point of surgical care for rural communities, to inform the implementation of country plans. Using
the Lancet Commission as a starting point and illustrated by two European Union (EU) funded research projects,
we point to the need for implementation research to develop and evaluate contextualised strategies. As illustrated
by the case study of Zambia, coordination by global and external stakeholders can enable governments to lead
national scale-up of essential surgery, supported by national partners including surgical specialist associations
Mapping of research on maternal health interventions in low- and middle-income countries: a review of 2292 publications between 2000 and 2012
Background: Progress in achieving maternal health goals and the rates of reductions in deaths from individual conditions have varied over time and across countries. Assessing whether research priorities in maternal health align with the main causes of mortality, and those factors responsible for inequitable health outcomes, such as health system performance, may help direct future research. The study thus investigated whether the research done in low- and middle-income countries (LMICs) matched the principal causes of maternal deaths in these settings.
Methods: Systematic mapping was done of maternal health interventional research in LMICs from 2000 to 2012. Articles were included on health systems strengthening, health promotion; and on five tracer conditions (haemorrhage, hypertension, malaria, HIV and other sexually transmitted infections (STIs)). Following review of 35,078 titles and abstracts in duplicate, data were extracted from 2292 full-text publications.
Results: Over time, the number of publications rose several-fold, especially in 2004–2007, and the range of methods used broadened considerably. More than half the studies were done in sub-Saharan Africa (55.4 %), mostly addressing HIV and malaria. This region had low numbers of publications per hypertension and haemorrhage deaths, though South Asia had even fewer. The proportion of studies set in East Asia Pacific dropped steadily over the period, and in Latin America from 2008 to 2012. By 2008–2012, 39.1 % of articles included health systems components and 30.2 % health promotion. Only 5.4 % of studies assessed maternal STI interventions, diminishing with time. More than a third of haemorrhage research included health systems or health promotion components, double that of HIV research.
Conclusion: Several mismatches were noted between research publications, and the burden and causes of maternal deaths. This is especially true for South Asia; haemorrhage and hypertension in sub-Saharan Africa; and for STIs worldwide. The large rise in research outputs and range of methods employed indicates a major expansion in the number of researchers and their skills. This bodes well for maternal health if variations in research priorities across settings and topics are corrected
A C2HC zinc finger is essential for the RING-E2 interaction of the ubiquitin ligase RNF125
The activity of RING ubiquitin ligases (E3s) depends on an interaction between the RING domain and ubiquitin conjugating enzymes (E2), but posttranslational events or additional structural elements, yet largely undefined, are frequently required to enhance or regulate activity. Here, we show for the ubiquitin ligase RNF125 that, in addition to the RING domain, a C2HC Zn finger (ZnF) is crucial for activity, and a short linker sequence (Li2(120-128)) enhances activity. The contribution of these regions was first shown with truncated proteins, and the essential role of the ZnF was confirmed with mutations at the Zn chelating Cys residues. Using NMR, we established that the C2HC ZnF/Li2(120-128) region is crucial for binding of the RING domain to the E2 UbcH5a. The partial X-ray structure of RNF125 revealed the presence of extensive intramolecular interactions between the RING and C2HC ZnF. A mutation at one of the contact residues in the C2HC ZnF, a highly conserved M112, resulted in the loss of ubiquitin ligase activity. Thus, we identified the structural basis for an essential role of the C2HC ZnF and conclude that this domain stabilizes the RING domain, and is therefore required for binding of RNF125 to an E2
- …