Social and Cultural Factors Affecting Uptake of Interventions for Malaria in Pregnancy in Africa: A Systematic Review of the Qualitative Research

Malaria during pregnancy (MiP) results in adverse birth outcomes and poor maternal health. MiP-related morbidity and mortality is most pronounced in sub-Saharan Africa, where recommended MiP interventions include intermittent preventive treatment, insecticide-treated bednets and appropriate case management. Besides their clinical efficacy, the effectiveness of these interventions depends on the attitudes and behaviours of pregnant women and the wider community, which are shaped by social and cultural factors. Although these factors have been studied largely using quantitative methods, qualitative research also offers important insights. This article provides a comprehensive overview of qualitative research on social and cultural factors relevant to uptake of MiP interventions in sub-Saharan Africa.A systematic search strategy was employed: literature searches were undertaken in several databases (OVID SP, IS Web of Knowledge, MiP Consortium library). MiP-related original research, on social/cultural factors relevant to MiP interventions, in Africa, with findings derived from qualitative methods was included. Non-English language articles were excluded. A meta-ethnographic approach was taken to analysing and synthesizing findings. Thirty-seven studies were identified. Fourteen concentrated on MiP. Others focused on malaria treatment and prevention, antenatal care (ANC), anaemia during pregnancy or reproductive loss. Themes identified included concepts of malaria and risk in pregnancy, attitudes towards interventions, structural factors affecting delivery and uptake, and perceptions of ANC.Although malaria risk is associated with pregnancy, women's vulnerability is often considered less disease-specific and MiP interpreted in locally defined categories. Furthermore, local discourses and health workers' ideas and comments influence concerns about MiP interventions. Understandings of ANC, health worker-client interactions, household decision-making, gender relations, cost and distance to health facilities affect pregnant women's access to MiP interventions and lack of healthcare infrastructure limits provision of interventions. Further qualitative research is however required: many studies were principally descriptive and an in-depth comparative approach is recommended

Indigenous footprints along the career journey between adolescence and adulthood

Career development and transitions are hot topics at this time. Research into First Nation's culture has also begun to receive the attention it deserves. However these two concepts have rarely been researched simultaneously as one phenomenon. Notable gaps occur in career development and First Nation's literature. Cultural influences, worldview differences, experiences, beliefs, and attitudes are all elements of life for anyone. For First Nation's people these multiple realities are further imbued with complexities not widely understood by non-Aboriginal peoples and as such the concepts of "career", "success", "transition" and "career development" may not fit with Aboriginal paradigms of research and with the Aboriginal population in general. Little is known about career development with regard to minority populations and even less is known about First Nations' career development. Similarly another rarely researched phenomenon in any population is career development during the transition from adolescence to adulthood. With high rates of unemployment, low rates of high school graduation, drug and alcohol abuse, high suicidality and other difficulties faced by many First Nation's youth this issue is of crucial importance to future success (Royal Commission on Aboriginal Health, 1996). Consequently it is important that positive stories from this culture be heard. Most research up to this juncture has been focussed upon non-minority population adolescent employment rather than the outcomes of schooling and other factors during the transition from adolescence to adulthood (Leventhal, Graber, & Brooks-Gunn, 2001). My study has attempted to shed light on some of the factors that have helped and hindered First Nation's youth during this transitional period. A sample of 8 (n=8) First Nations young adults, aged 20 to 28 years, were interviewed using a Critical Incident Technique. The participants were recruited from local Vancouver populations. The research involved the collection of data by interviewing participants using an open-ended question format to record each participant's story and to explore critical influences upon their career development. Findings from this research were found to be relevant to a range of settings including First Nations' employment counselling services, therapy for youth-at-risk, school counselling for First Nation's youth, and multicultural therapy.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat

Purified TPC Isoforms Form NAADP Receptors with Distinct Roles for Ca2+ Signaling and Endolysosomal Trafficking

Intracellular Ca2+ signals constitute key elements in signal transduction. Of the three major Ca2+ mobilizing messengers described, the most potent, nicotinic acid adenine dinucleotide phosphate (NAADP) is the least well understood in terms of its molecular targets [1]. Recently, we showed that heterologous expression of two-pore channel (TPC) proteins enhances NAADP-induced Ca2+ release, whereas the NAADP response was abolished in pancreatic beta cells from Tpcn2 gene knockout mice [2]. However, whether TPCs constitute native NAADP receptors is unclear. Here we show that immunopurified endogenous TPC complexes possess the hallmark properties ascribed to NAADP receptors, including nanomolar ligand affinity [3–5]. Our study also reveals important functional differences between the three TPC isoforms. Thus, TPC1 and TPC2 both mediate NAADP-induced Ca2+ release, but the subsequent amplification of this trigger Ca2+ by IP3Rs is more tightly coupled for TPC2. In contrast, TPC3 expression suppressed NAADP-induced Ca2+ release. Finally, increased TPC expression has dramatic and contrasting effects on endolysosomal structures and dynamics, implicating a role for NAADP in the regulation of vesicular trafficking. We propose that NAADP regulates endolysosomal Ca2+ storage and release via TPCs and coordinates endoplasmic reticulum Ca2+ release in a role that impacts on Ca2+ signaling in health and disease [6]