What Africa can do to accelerate and sustain progress against malaria

After a longstanding global presence, malaria is now largely non-existent or suppressed in most parts of the world. Today, cases and deaths are primarily concentrated in sub-Saharan Africa. According to many experts, this persistence on the African continent reflects factors such as resistance to insecticides and drugs as well as insufficient access to essential commodities such as insecticide-treated nets and effective drugs. Crucially, however, this narrative ignores many central weaknesses in the fight against malaria and instead reinforces a narrow, commodity-driven vision of disease control. This paper therefore describes the core challenges hindering malaria programs in Africa and highlights key opportunities to rethink current strategies for sustainable control and elimination. The epidemiology of malaria in Africa presents far greater challenges than elsewhere and requires context-specific initiatives tailored to national and sub-national targets. To sustain progress, African countries must systematically address key weaknesses in its health systems, improve the quality and use of data for surveillance-responses, improve both technical and leadership competencies for malaria control, and gradually reduce overreliance on commodities while expanding multisectoral initiatives such as improved housing and environmental sanitation. They must also leverage increased funding from both domestic and international sources, and support pivotal research and development efforts locally. Effective vaccines and drugs, or other potentially transformative technologies such as genedrive modified mosquitoes, could further accelerate malaria control by complementing current tools. However, our underlying strategies remain insufficient and must be expanded to include more holistic and context-specific approaches critical to achieve and sustain effective malaria control

Rethinking human resources and capacity building needs for malaria control and elimination in Africa

Despite considerable success in controlling malaria worldwide, progress toward achieving malaria elimination has largely stalled. In particular, strategies to overcome roadblocks in malaria control and elimination in Africa are critical to achieving worldwide malaria elimination goals-this continent carries 94% of the global malaria case burden. To identify key areas for targeted efforts, we combined a comprehensive review of current literature with direct feedback gathered from frontline malaria workers, leaders, and scholars from Africa. Our analysis identified deficiencies in human resources, training, and capacity building at all levels, from research and development to community involvement. Addressing these needs will require active and coordinated engagement of stakeholders as well as implementation of effective strategies, with malaria-endemic countries owning the relevant processes. This paper reports those valuable identified needs and their concomitant opportunities to accelerate progress toward the goals of the World Health Organization's Global Technical Strategy for Malaria 2016-2030. Ultimately, we underscore the critical need to re-think current approaches and expand concerted efforts toward increasing relevant human resources for health and capacity building at all levels if we are to develop the relevant competencies necessary to maintain current gains while accelerating momentum toward malaria control and elimination

Healthy ageing education across Europe: a survey of ENPHE members

Background and Purpose Healthy ageing is an optimal status that people could achieve when they currently adapt their physical and psychological evolution that allow them to participate socially with a high level of autonomy. The process of becoming older is a personal process that can be very heterogeneous. This heterogeneity generates different approaches depending on the needs, capacities of adaptation and subject possibilities. Therefore, it is important that any kind of intervention should adapt specifically to each patient. Description With the goal to develop and offer updated education in Healthy Ageing, a group of five universities: Ecole d’Assas (France), Blanquerna-Universitat Ramón Lull (Spain), Univerzita Palackého v Olomouci (Czech Republic), Kolegji Heimerer (Kosovo) and Escola de Saúde do Alcoitão (Portugal) decided to set up a joint adventure as encouraged by ENPHE. Our first step is to benchmark and characterise within Europe the tendencies, the offers and models of best practices. Material / Methods An online questionnaire was developed and sent to all the ENPHE members between January and February of 2017. The survey was composed of twenty close and open questions related to the participant identification, course description and identification of institutional projects in healthy ageing Summary of Results From a population of 136 EMPHE member's we receive 39 complete responses (27%) and the main results are: 69% of the respondents offer courses about healthy ageing; 88% Integrated in the bachelor degree ; mainly for Physiotherapists students (92%); and with the most prevalent topics (above 80%) - Assessment and intervention of clients/populations, multidisciplinary issues and Prevention; the main pedagogical approaches used are lectures (88%), clinical training/field work (77%) and casebased learning (74%); being written or oral examination (81%) the main assessment strategies used. Importance It is very important to empower the individual to become autonomous in deciding how to manage their own ageing process in a healthy way. Any curricula should take in account this reality in order to transform the role of health care professionals and provide them competences to support individuals in this process.N/

Root hydrotropism is controlled via a cortex-specific growth mechanism

Plants can acclimate by using tropisms to link the direction of growth to environmental conditions. Hydrotropism allows roots to forage for water, a process known to depend on abscisic acid (ABA) but whose molecular and cellular basis remains unclear. Here, we show that hydrotropism still occurs in roots after laser ablation removed the meristem and root cap. Additionally, targeted expression studies reveal that hydrotropism depends on the ABA signalling kinase, SnRK2.2, and the hydrotropism-specific MIZ1, both acting specifically in elongation zone cortical cells. Conversely, hydrotropism, but not gravitropism, is inhibited by preventing differential cell-length increases in the cortex, but not in other cell types. We conclude that root tropic responses to gravity and water are driven by distinct tissue-based mechanisms. In addition, unlike its role in root gravitropism, the elongation zone performs a dual function during a hydrotropic response, both sensing a water potential gradient and subsequently undergoing differential growth

A Novel fry1 Allele Reveals the Existence of a Mutant Phenotype Unrelated to 5′->3′ Exoribonuclease (XRN) Activities in Arabidopsis thaliana Roots

International audienceBackgroundMutations in the FRY1/SAL1 Arabidopsis locus are highly pleiotropic, affecting drought tolerance, leaf shape and root growth. FRY1 encodes a nucleotide phosphatase that in vitro has inositol polyphosphate 1-phosphatase and 3′,(2′),5′-bisphosphate nucleotide phosphatase activities. It is not clear which activity mediates each of the diverse biological functions of FRY1 in planta.Principal FindingsA fry1 mutant was identified in a genetic screen for Arabidopsis mutants deregulated in the expression of Pi High affinity Transporter 1;4 (PHT1;4). Histological analysis revealed that, in roots, FRY1 expression was restricted to the stele and meristems. The fry1 mutant displayed an altered root architecture phenotype and an increased drought tolerance. All of the phenotypes analyzed were complemented with the AHL gene encoding a protein that converts 3′-polyadenosine 5′-phosphate (PAP) into AMP and Pi. PAP is known to inhibit exoribonucleases (XRN) in vitro. Accordingly, an xrn triple mutant with mutations in all three XRNs shared the fry1 drought tolerance and root architecture phenotypes. Interestingly these two traits were also complemented by grafting, revealing that drought tolerance was primarily conferred by the rosette and that the root architecture can be complemented by long-distance regulation derived from leaves. By contrast, PHT1 expression was not altered in xrn mutants or in grafting experiments. Thus, PHT1 up-regulation probably resulted from a local depletion of Pi in the fry1 stele. This hypothesis is supported by the identification of other genes modulated by Pi deficiency in the stele, which are found induced in a fry1 background.Conclusions/SignificanceOur results indicate that the 3′,(2′),5′-bisphosphate nucleotide phosphatase activity of FRY1 is involved in long-distance as well as local regulatory activities in roots. The local up-regulation of PHT1 genes transcription in roots likely results from local depletion of Pi and is independent of the XRNs.

Vell Frágil / Identify risk factors

Objetivo. Describir si a las personas mayores con diagnóstico de fragilidad se les han realizado las intervenciones preventivas de los factores de riesgo en las consultas de enfermería del Centro de Atención Primaría de Raval Nord. Material y Método. Se realizó una muestra aleatoria simple del total de personas mayores que acudían a las consultas de enfermería durante el periodo de febrero de 2008 a febrero de 2009 y constaba el diagnostico de fragilidad. Se elaboró una base de datos de las diferentes variables analizadas y se realizó la explotación de los datos a través del programa informático Statistical Package for the Social Sciencies (SPSS). Resultados. De un total de 469 personas en las que constaba el diagnóstico de personas frágiles se observó que el 15,7% de dicha población había pasado al programa de Atención domiciliaria (ATDOM) y el resto, un total de 395, seguían acudiendo de forma autónoma a las consultas. Del total se analizó el 20% (representó 79 casos). Observándose que la media de edad fue de 82,52 años con una desv.tip de 5,7 años y la franja de edades comprendida entre 63 y 94 años. Que el 67,1% pertenecía al sexo femenino y que 29,6% vivía sola/o. Al analizar si a dicha población se le había realizado tests de valoración, se observó que solo a un 25,3% se había realizado el test de Barthel, a un 19% el test de Pfeiffer y que el Plan de Cura de Enfermería se había aplicado al 43% de la población. Al analizar si constaba el cuidador o persona referente se observó que solo constaba en un 29,1%, En relación a ayudas sociales, se observó que el 7,6% constaba que tenía en su domicilio tele-alarma y que solo un 6,3% había acudido a solicitar ayudas o valoración en servicios sociales. Al analizar la frecuentación al centro de salud (AP) o al hospital de referencia, se observó una elevada hiperfrecuentacion. En el centro de AP un 54,5% había realizado más de 12 visitas a las consultas y un 37,7% había acudido al servicio de urgencias. Y en relación al servicio de urgencias hospitalarias se observó que el 39,2% había sido atendido, y un 22,8% ingresado. También se destacó que la historia informatizada a través del sistema Ecap no es sensible a las variables cualitativas, observándose que puede ser causa de pérdida de información de la actividad de enfermería. Conclusiones. Se puede observar que existe una buena captación de la fragilidad de las personas atendidas, pero por otra parte se debe incidir más en la captación de las causas de la fragilidad para realizar intervenciones dirigidas a la promoción y prevención de salud, para que la fragilidad no se reconvierta en incapacidades evitables.ABSTRACT Objective. To describe whether older people diagnosed with frailty have undergone preventive interventions for the factors identified in the nursing consultation of the Primary Care Center of Raval Nord. Matter and method. A simple random sample of all older people with record of frailty diagnosis that attended nursing visits during the period February 2008 to February 2009 was made. A data base of the different analyzed variables was created and the data was run through the computer program Statistical Package for the Social Sciences, (SPSS). Results. The total number of persons with frailty diagnosis was 469. It was noted that 15.7% of the mentioned population had begun to participate in the Home Care Program (ATDOM, initials in Spanish), and the other 395 persons continued going to nursing visits independently. 79 cases,20% of the total, were analyzed. It was observed that the average age was 82.52 years; that the deviation was 5.7 years; that the age range was between 63 and 94; that 67.1% were female; and that 29.6% lived alone. In analyzing the population an assessment test was carried out. It was noted that only 25.3% carried out the Barthel test and 19% the Pfeiffer test, and that the Nursing Cure Plan had been made to 43% of the population. In analyzing whether a carer or a person of reference was registered in the record, it was found that in 29.1% of the cases one of these people were on the register. In relation to social assistance, it was noted that 7.6% had at home tele-alarm, and that only 6.3% had gone to social services. In analyzing the frequency with which the population went to the health center or the reference hospital, a high frequent use was detected. In the Center AP, 54.5% made over 12 visits in the consultation, and 37.7% had gone to the emergency services. In relation to the hospital emergency department, it was observed that 39.2% had been treated, and 22.8% admitted to hospital. It was also noted that computerized history through the Ecap system is not sensitive to qualitative variables, noting that can cause loss of information from the nursing activity Conclusions. It is possible to note that there is a good grasp of the frailty of the people attended to but it should be more focused on capturing the causes of frailty for interventions aimed at health promotion and prevention so that the frailty is not reconverted into avoidable disabilities