A critical analysis of Peru's HIV grant proposals to the Global Fund.

Peru has applied to six of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) rounds for funding, achieving success on four occasions. The process of proposal development has, however, been criticised, especially concerning the use of evidence, relevance/consistency and performance indicators. We aimed to analyse the Peruvian Global Fund proposals according to those dimensions, providing feedback to improve future local efforts and inform global discussions around Global Fund procedures. We analysed the content of four HIV-focused proposals (rounds 2, 5, 6 and 8) regarding epidemic context, needs identification and prioritisation and monitoring and evaluation systems. Peruvian proposals submitted after round 1 were described as resulting from collaborative inputs involving formerly unrepresented sectors, principally 'vulnerable populations'. However, difficulties arose regarding the amount and quality of evidence about the epidemiological context; limited consideration of social determinants of the epidemic; lack of theory-driven interventions, and little synergy across projects and the inclusion of weak monitoring and evaluation systems, with poor indicators and measurement procedures. Prioritising the development of analytical and technical skills to generate Global Fund proposals would enhance the country's capacity to produce and utilise evidence, improve the technical-political interface, strengthen information systems and lead to more informed decision making and accountability

After the Global Fund: who can sustain the HIV/AIDS response in Peru and how?

Peru has received around $70 million from Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund). Recent economic growth resulted in grant ineligibility, enabling greater government funding, yet doubts remain concerning programme continuity. This study examines the transition from Global Fund support to increasing national HIV/AIDS funding in Peru (2004-2012) by analysing actor roles, motivations and effects on policies, identifying recommendations to inform decision-makers on priority areas. A conceptual framework, which informed data collection, was developed. Thirty-five in-depth interviews were conducted from October to December 2011 in Lima, Peru, among key stakeholders involved in HIV/AIDS work. Findings show that Global Fund involvement led to important breakthroughs in the HIV/AIDS response, primarily concerning treatment access, focus on vulnerable populations and development of a coordination body. Nevertheless, reliance on Global Fund financing for prevention activities via non-governmental organisations, compounded by lack of government direction and weak regional governance, diluted power and caused role uncertainty. Strengthening government and regional capacity and fostering accountability mechanisms will facilitate an effective transition to government-led financing. Only then can achievements gained from the Global Fund presence be maintained, providing lessons for countries seeking to sustain programmes following donor exit

Antiseptics and disinfectants for the treatment of vaginal discharge in non-pregnant women (Protocol)

Q1Q1Paciente femeninoThis is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the safety and effectiveness of antiseptics and disinfectants for the treatment of vaginal discharge in non‐pregnant women. Description of the condition A normal and healthy vaginal ecosystem is defined by an acidic environment (pH less than 4.5), which is inhospitable for most bacteria and viruses. This acidic environment is associated with the presence of lactobacilli and hydrogen peroxide (H2O2); a decrease of these buffer agents is linked with vaginal infections (Verstraelen 2009). Vaginal discharge syndrome represents a group of vaginal infections that are characterized by abnormal vaginal secretion, irritation, vulvar itching and sometimes vaginal odour (CDC 2017). In most cases, it is diagnosed by clinical signs (Gaitán‐Duarte 2013). The most common vaginal infections with vaginal discharge as the main clinical symptom are: bacterial vaginosis (BV), vulvovaginal candidiasis (VC), and trichomoniasis (TV), which is a sexually transmitted infection (Gaitán‐Duarte 2013; Sherrard 2011). Prevalence varies from 40% for BV, to 12% for VC and less than 1% for trichomoniasis (Angel 2012). Bacterial vaginosis is an infection characterized by a change in the vaginal flora due to the decrease of lactobacilli, an increase in vaginal pH and anaerobic bacteria such as Gardnerella vaginalis, genital mycoplasma, anaerobic Gram‐negative rods, Gram‐positive cocci (Beigi 2004; Petersen 2002; Verstraelen 2012). Symptomatic patients are evidenced by foul‐smelling, profuse vaginal discharge (which is thin, white and homogenous, and coats the walls of the vagina and vestibule) and no signs of vulvar or vaginal inflammation (Verstraelen 2009). BV is not a sexual infection, though it is associated with sexual intercourse (Amaya‐Guio 2016). It can remit spontaneously or it can be persistent or recurrent, especially when the woman engages in vaginal douching or frequent sexual activity (which can cause changes in vaginal pH and lead to the decrease or lack of lactobacilli), or when lactobacilli are attacked by specific viruses and are subsequently unable to recolonize the vagina due to the overgrowth of anaerobic bacteria (Sherrard 2011). Bacterial vaginosis is a significant genital tract infection; published studies have found it to be associated with pelvic inflammatory disease, intrauterine infections, post‐procedural gynaecological infections, and predisposition to an increased risk of sexually transmitted diseases, such as trichomoniasis, gonorrhea, chlamydia and the human immunodeficiency virus (HIV) (Verstraelen 2009). Vulvovaginal candidiasis is caused by an overgrowth of Candida albicans (90%), C. glabrata,C. tropicalis, and other species (Sherrard 2011). This infection has inflammatory symptoms such as edema, erythema, vulvar excoriation, fissure formation, pruritus, superficial dyspareunia, dysuria, irritation, curdy vaginal discharge and soreness (Molteni 2004). Trichomoniasis is the most common non‐viral sexually transmitted infection, caused by an anaerobic protozoan called Trichomonas vaginalis (humans are the only known hosts). The symptoms include dysuria, itching, vulvar irritation, "strawberry" cervix visible to naked eye (2%), and occasionally, abdominal pain and greenish‐yellow, foamy, foul‐smelling vaginal discharge (KIissinger 2015; Jeffery 2017). The diagnosis of VB as the other two infections (VC and TV) in the vaginal discharge syndrome is by manly clinical symptoms. Treatment for vaginal discharge syndrome mainly includes antimicrobials, such as imidazoles (metronidazole or tinidazole) for VB and TV, or used as antifungal agents (clotrimazole or fluconazole) and lincosamines (clindamycin) for VB.Revista Nacional - Indexad

The role of snow in scavenging aerosol particles: A physical-chemical characterization

[EN] The below cloud scavenging of aerosols by snow has been analysed in León (NW Spain). Six snow events were registered over the course of one year of study. Ultrafine and accumulation aerosol particles were measured using a scanning mobility particle sizer spectrometer, while hydrometeors were characterized using a disdrometer. Furthermore, the chemical composition of the melted snow-water samples (soluble and insoluble fractions) was analysed. The scavenging coefficient (λ) showed a great variability among events. An effective washing of particles was observed during the first 30 min of snowfall. The mean change in the scavenging efficiency (%ΔC) of particle number concentration (PNC) and λ coefficient during this time interval were: i) nucleation mode: 36.3 % and 3.02 · 10−4 s−1; ii) Aitken mode: 30.4 % and 2.37 · 10−4 s−1 and iii) accumulation mode: 22.4 % and 1.77 · 10−4 s−1. The range of particle sizes that is less efficiently scavenged by snowfall was observed between 400 and 600 nm. When analyzing the whole snow event, an increase of PNC was observed. Two possible explanations underlie this behaviour: it could be caused by changes in air masses or by the resuspension of aerosol particles scavenged by snowflakes upon reaching the ground. A clear relationship was observed between Ca2+, SO42− and NO3− concentrations of aerosol particles before the snow event and the concentrations registered in the melted snow-water. The largest and smallest changes in aerosol number concentrations were caused by snowflakes of 3 and 6 mm in diameter, respectively. The particle size distributions (PSD) were fitted to log-normal distributions and the parameters were compared before and after snowfall.S

Genome of the Avirulent Human-Infective Trypanosome—Trypanosoma rangeli

Background: Trypanosoma rangeli is a hemoflagellate protozoan parasite infecting humans and other wild and domestic mammals across Central and South America. It does not cause human disease, but it can be mistaken for the etiologic agent of Chagas disease, Trypanosoma cruzi. We have sequenced the T. rangeli genome to provide new tools for elucidating the distinct and intriguing biology of this species and the key pathways related to interaction with its arthropod and mammalian hosts.  Methodology/Principal Findings: The T. rangeli haploid genome is ,24 Mb in length, and is the smallest and least repetitive trypanosomatid genome sequenced thus far. This parasite genome has shorter subtelomeric sequences compared to those of T. cruzi and T. brucei; displays intraspecific karyotype variability and lacks minichromosomes. Of the predicted 7,613 protein coding sequences, functional annotations could be determined for 2,415, while 5,043 are hypothetical proteins, some with evidence of protein expression. 7,101 genes (93%) are shared with other trypanosomatids that infect humans. An ortholog of the dcl2 gene involved in the T. brucei RNAi pathway was found in T. rangeli, but the RNAi machinery is non-functional since the other genes in this pathway are pseudogenized. T. rangeli is highly susceptible to oxidative stress, a phenotype that may be explained by a smaller number of anti-oxidant defense enzymes and heatshock proteins.  Conclusions/Significance: Phylogenetic comparison of nuclear and mitochondrial genes indicates that T. rangeli and T. cruzi are equidistant from T. brucei. In addition to revealing new aspects of trypanosome co-evolution within the vertebrate and invertebrate hosts, comparative genomic analysis with pathogenic trypanosomatids provides valuable new information that can be further explored with the aim of developing better diagnostic tools and/or therapeutic targets

Probiotic yogurt offers higher immune-protection than probiotic whey beverage

AbstractThe probiotics can be useful to improve the immune response in experimental challenges, like the exhausting exercise, that cause immunosuppression. We have evaluated a probiotic yogurt and a probiotic whey beverage using an exhausting physical-exercise protocol with rats. Wistar rats were given a daily 4-mL supplement of each type of conventional or probiotic yogurt and whey beverage, manufactured with lactic culture Streptococcus thermophilus TA040 and Lactobacillus bulgaricus LB340, and probiotic culture Lactobacillus acidophilus LA 14 and Bifidobacterium longum BL 05. The effects on the immune system were compared to those of pair-treated cohorts receiving for 14days. Results demonstrated that the probiotic yogurt outperformed the probiotic whey beverage in blood-cell indicators (neutrophils and lymphocytes), cytokines (TNF-α and IL-1β) and various standard health parameters. In conclusion, in this study, the treadmill exercise assay successfully produced immunosuppression in the rat and the combination of the nutrients and probiotic bacteria of the yogurt reduces more effectively the adverse effects developed over the prolonged strenuous exercise than did a similar probiotic whey beverage

Physicians' migration in Europe: an overview of the current situation

<p>Abstract</p> <p>Background</p> <p>The migration of medical professionals as a result of the expansion of the European Union is cause for concern. But there is a significant lack of information available about this phenomenon.</p> <p>Methods</p> <p>Search of secondary databases about the presence of european doctors working abroad, through two search engines in the Internet (Google and Pubmed) and a survey of professional organisations and regulators in countries of the European Union.</p> <p>Results</p> <p>The United Kingdom has more foreign doctors than all other European countries for which figures are available (Ireland, France, Germany, Norway, Portugal, Italy, Austria and Poland). Some 74,031 foreign doctors are registered in the UK, 30.94% of the total. European countries with the highest percentage of doctors working abroad are Ireland (47.5%, or 10,065 doctors) and Malta (23.1%, 376 doctors). The data obtained from Norway, France and Germany do not indicate an increase in the migration of professionals from countries recently incorporated into the EU.</p> <p>Conclusion</p> <p>There is significant mobility and heterogeneous distribution of doctors within the EEA and it should be cause for concern among health care authorities. However, there is no evidence about a possible increase in this phenomenon after the recent expansion of the EU.</p

Black list and Alert list of the Aquatic Invasive Alien Species in the Iberian Peninsula: an action of the LIFE INVASAQUA

Resumen del trabajo presentado en VI Congreso Nacional sobre Especies Exóticas Invasoras y I Congreso Ibérico sobre EEI (EEI 2022) celebrado en Navarra del 20 al 23 de abril de 2022.One of the objectives of LIFE INVASQUA project is to develop tools that will be more efficient the Early Warning and Rapid Response (EWRR) framework for Invasive Alien Species in the Iberian Peninsula. Horizon scanning for high-risk IAS is basic in implementing measures to reduce new invasions, developing Alert lists, and to focus effort in the species already established, for instance making a Black list. We developed a trans national horizon scanning exercise focused on inland waters of Spain and Portugal in order to provide a prioritized lists (Black list and Alert list) of aquatic IAS that may pose a threat to aquatic ecosystems and socio economic sectors in the future. We followed a step approach of existing information about IAS (Plants, Freshwater Invertebrates, Estuarine Invertebrates and Vertebrates; 127 established taxa in Black list; 90 non established taxa in Alert list) combining with an expert scoring of prioritized taxa. IAS established in the Iberian aquatic system consistently highlighted as the worst included vertebrates (e.g. Cyprinus carpio, Gambusia holbrooki, Silurus glanis), freshwater and estuarine invertebrates (e.g. Procambarus clarkii, Dreissena polymorpha, Pacifastacus leniusculus, Ficopomatus enigmaticus, Callinectes sapidus, Corbicula fluminea) and plants (e.g. Eichhornia crassipes, Azolla filiculoides, Ludwigia grandiflora). Amongst taxa not yet established (Alert list), expert pointed to Perna viridis, Hydroides dirampha, Dreissena bugensis, Procambarus fallax f. virginallis, Perccottus glenii with higher risk of invasion, ecological and socioeconomic impacts. Over 20.6% of the taxa in the preliminary black list received no votes (no prioritization) by experts, 17.8% in the innitial alert list. Our horizon scanning approach is inclusive of all-taxa, prioritizes both established and emerging biological threats across trans-national scales, and considers not only the ecological impact, but also potential direct economic consequences as well as the manageability of invasive species.This work received funds from the LIFE Programme (LIFE17 GIE/ES/000515)