22 research outputs found
Criss-crossing the Irish Sea: shifting Traveller womensâ identities in home and school environments
In recent years there have been increasing demands to acknowledge the heterogeneity of Gypsy/Romani/Traveller communties (e.g., Levinson, 2014; Tong, 2015; Tremlett, 2013). There have also been suggestions of a need for more gendered analyses. A growing number of sources (KĂłczĂ©, 2009, 2011, 2015; Magyari-Vincze, 2006, 2007; Oprea, 2005a, 2005b) have focused on Gypsy/Romani/Traveller womenâs identities, studies that are all outside of the UK and Ireland. This article addresses that gap, highlighting the differences within Irish Traveller communities, showing the ways in which identities fluctuate as participants criss-cross over the Irish Sea between Ireland and England. It shows ways in which participants use identities of âIrishnessâ while in England, so as to distinguish themselves from other Travellers, while back in Ireland, they revert to Traveller identities, or use strategies such as âPolishingâ to distance themselves from those (disadvantaged) identities. Using data gathered from an ethnographic study of Irish Traveller women in the fictional townland of Baile Lucht SiĂșil in the Republic of Ireland, the authors consider the implications for participants and their communities through such transitions
Remote ischaemic preconditioning in coronary artery bypass surgery: a meta-analysis
Aim Randomised trials exploring remote ischaemic preconditioning (RIPC) in patients undergoing coronary artery bypass graft (CABG) surgery have yielded conflicting data regarding potential cardiovascular and renal protection, and are individually flawed by small sample size.
Methods Three investigators independently searched the MEDLINE, EMBASE and Cochrane databases to identify randomised trials testing RIPC in patients undergoing CABG.
Results Nine studies with 704 patients were included. Standardised mean difference of troponin I and T release showed a significant decrease ( 120.36 (95% CI 120.62 to 120.09)). This difference held true after excluding the trials with cross-clamp fibrillation, the study with off-pump CABG and studies using a flurane as anaesthetic agent ( 120.41 (95% CI 120.69 to 120.12), 120.38 (95% CI 120.70 to 120.07) and 120.37 (95% CI 120.63 to 120.12), respectively). A similar trend was also obtained for patients with multivessel disease ( 120.41 (95% CI 120.73 to 120.08)). The trials evaluating postoperative creatinine reported a non-significant reduction (0.02 (95% CI 120.09 to 0.13)). Moreover, the length of in-hospital stay was not influenced by the kind of treatment (weighted mean difference 0.27 (95% CI 120.24 to 0.79)).
Conclusion RIPC reduced the release of troponin in patients undergoing CABG. Larger randomised trials are needed to clarify the presence of a causal relationship between RIPC-induced troponin release and clinical adverse events
Leprosy Post-Exposure Prophylaxis (LPEP) Programme : study protocol for evaluating the feasibility and impact on case detection rates of contact tracing and single dose rifampicin
Introduction: The reported number of new leprosy patients has barely changed in recent years. Thus, additional approaches or modifications to the current standard of passive case detection are needed to interrupt leprosy transmission. Large-scale clinical trials with single dose rifampicin (SDR) given as post-exposure prophylaxis (PEP) to contacts of newly diagnosed patients with leprosy have shown a 50â60% reduction of the risk of developing leprosy over the following 2â
years. To accelerate the uptake of this evidence and introduction of PEP into national leprosy programmes, data on the effectiveness, impact and feasibility of contact tracing and PEP for leprosy are required. The leprosy post-exposure prophylaxis (LPEP) programme was designed to obtain those data.
Methods and analysis: The LPEP programme evaluates feasibility, effectiveness and impact of PEP with SDR in pilot areas situated in several leprosy endemic countries: India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. Complementary sites are located in Brazil and Cambodia. From 2015 to 2018, contact persons of patients with leprosy are traced, screened for symptoms and assessed for eligibility to receive SDR. The intervention is implemented by the national leprosy programmes, tailored to local conditions and capacities, and relying on available human and material resources. It is coordinated on the ground with the help of the in-country partners of the International Federation of Anti-Leprosy Associations (ILEP). A robust data collection and reporting system is established in the pilot areas with regular monitoring and quality control, contributing to the strengthening of the national surveillance systems to become more action-oriented.
Ethics and dissemination: Ethical approval has been obtained from the relevant ethics committees in the countries. Results and lessons learnt from the LPEP programme will be published in peer-reviewed journals and should provide important evidence and guidance for national and global policymakers to strengthen current leprosy elimination strategies
Leprosy Post-Exposure Prophylaxis (LPEP) programme: Study protocol for evaluating the feasibility and impact on case detection rates of contact tracing and single dose rifampicin
Introduction: The reported number of new leprosy patients has barely changed in recent years. Thus, additional approaches or modifications to the current standard of passive case detection are needed to interrupt leprosy transmission. Large-scale clinical trials with single dose rifampicin (SDR) given as post-exposure prophylaxis (PEP) to contacts of newly diagnosed patients with leprosy have shown a 50-60% reduction of the risk of developing leprosy over the following 2 years. To accelerate the uptake of this evidence and introduction of PEP into national leprosy programmes, data on the effectiveness, impact and feasibility of contact tracing and PE
Minimal essential data to document contact tracing and single dose rifampicin (SDR) for leprosy control in routine settings
In leprosy control there is a renewed interest in active case finding, which is increasingly being combined with chemoprophylactic interventions to try and reduce M. leprae transmission. The Leprosy Post-Exposure Prophylaxis (LPEP) programme, currently ongoing in eight endemic countries, pilots the provision of single-dose rifampicin (SDR) to eligible contacts of leprosy patients. LPEP has developed a surveillance system including data collection, reporting and regular monitoring for every participating country. This system is still largely programmespecific to LPEP. To facilitate continuity after completion of the project phase and start-up in other interested countries, we aim at identifying the minimal set of data required to appropriately document contact tracing activities and SDR administration for leprosy control in a routine setting. We describe four indicators for the index case (plus four already routinely collected) and seven indicators for household/neighbour screening, and community surveys. We propose two generic forms to capture all relevant information required at field and district level to follow-up on individuals or data if needed, provide gu
Leprosy post-exposure prophylaxis with single-dose rifampicin
_Objective:_ Leprosy post-exposure prophylaxis with single-dose rifampicin (SDRPEP) has proven effective and feasible, and is recommended by WHO since 2018. This SDR-PEP toolkit was developed through the experience of the leprosy postexposure prophylaxis (LPEP) programme. It has been designed to facilitate and standardise the implementation of contact tracing and SDR-PEP administration in regions and countries that start the intervention.
_Results:_ Four tools were developed, incorporating the current evidence for SDRPEP and the methods and learnings from the LPEP project in eight countries.
(1) th
Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme
Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of
Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools.
We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose
rifampicin (SDR) into routine leprosy control activities.
Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility
study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka,
and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of
individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible
contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates.
Findings Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of
whom 174782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from
SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per
10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with
SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported.
Interpretation Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes
with minimal additional efforts once contact tracing has been established; and is generally well accepted by index
patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through
the availability of a prophylactic intervention; therefore,
LeishVet guidelines for the practical management of canine leishmaniosis
The LeishVet group has formed recommendations designed primarily to help the veterinary clinician in the management of canine leishmaniosis. The complexity of this zoonotic infection and the wide range of its clinical manifestations, from inapparent infection to severe disease, make the management of canine leishmaniosis challenging. The recommendations were constructed by combining a comprehensive review of evidence-based studies, extensive clinical experience and critical consensus opinion discussions. The guidelines presented here in a short version with graphical topic displays suggest standardized and rational approaches to the diagnosis, treatment, follow-up, control and prevention of canine leishmaniosis. A staging system that divides the disease into four stages is aimed at assisting the clinician in determining the appropriate therapy, forecasting prognosis, and implementing follow-up steps required for the management of the leishmaniosis patient
Arboreal methodologies: Getting lost to explore the potential of the non-innocence of ânatureâ
This paper recounts a workshop that took place in a polytunnel in a forest school in Sligo, North-West Ireland on a cold day in early-December. The event sought to materialise âarboreal methodologiesâ (Osgood, 2019; Osgood & Odegard, 2022; Osgood & Axelsson, 2023) which are characterised by the enactment of feminist posthumanist praxis to engage in world-making (Haraway, 2008) intended to unsettle recognisable tropes of biophilia that have come to frame both child and nature in narrow ways. The arboreal methodologies that adult participants were invited to mobilise were situated, material, affective, and involved metaphorical and material practices of âgetting lostâ through âchildingâ. The workshop invited a sense of wonder at the ways arboreal methodologies might offer possibilities to confront human exceptionalism and wrestle with our complex, often contradictory relationships to ânatureâ that might then go on to inform practice with young children. The approach taken involves methodologies without method (Koro-Ljunberg, 2016) to bring speculative, embodied encounters in the forest, together with unlikely tales of how forests work on and through us. We pursue a critical, tentacular engagement with the forest and take seriously its potential to agitate familiarity and strangeness, wonder and fear, nature and culture. In this paper we re-encounter embodied becomings-with the forest to think and sense other ways to take life in the Plantationocene (Tsing, 2015) seriously
Canine leishmaniosis in Cyprus due to Leishmania infantum MON 1
During a serological survey in 1996, a total of 601 dogs (group I) distributed all over the government controlled southern area of Cyprus was examined using an enzyme-linked immunosorbent assay (ELISA) for the presence of specific antibodies directed against soluble antigens of promastigote stages of Leishmania infantum. The overall seroprevalence rate in this group was 1.7%. A second group (group II) of dogs was selected from regions where seropositive dogs where determined within the first group. In group II specific anti-Leishmania antibodies could be detected in 30 of 301 dogs investigated (10%). The highest seroprevalence rates were found in the regions of Agios Georgios (26.2%) and Limnatis (12.2%). Ten parasite isolates from ten dogs (six with typical symptoms of canine leishmaniosis and four without symptoms) originating from five locations could be characterised by zymodeme analysis. All ten isolates were identified as L. infantum zymodeme MON 1