39 research outputs found
Projektdokumentation - support Dienstleistungsnetzwerk für die sächsische KMU: Solidarisch - Sozial - Stark
Der Kommunale Sozialverband Sachsen - Integrationsamt dankt allen Behörden, Verwaltungen und Institutionen, Verbänden und Organisationen, parlamentarischen Gremien, Vertretern der Wirtschaft, Bildungseinrichtungen sowie Einzelpersonen für ihre wertvolle Unterstützung und ihre verlässliche Partnerschaft bei der Entwicklung und erfolgreichen Erprobung des Modellprojektes support in Südwestsachsen sowie seiner Übertragung als dauerhaftes Dienstleistungsangebot auf den gesamten Freistaat Sachsen
Staff experiences of Providing Maternity Services in Rural Southern Tanzania -- A Focus on Equipment, Drug and Supply Issues.
The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse maternal outcomes through delaying care provision. We aim to describe staff experiences of providing maternal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures that carried potential health risks to themselves as a result. Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions
The unmet need for Emergency Obstetric Care in Tanga Region, Tanzania
<p>Abstract</p> <p>Background</p> <p>Improving maternal health by reducing maternal mortality constitutes the fifth Millennium Development Goal and represents a key public health challenge in the United Republic of Tanzania. In response to the need to evaluate and monitor safe motherhood interventions, this study aims at assessing the coverage of obstetric care according to the Unmet Obstetric Need (UON) concept by obtaining information on indications for, and outcomes of, major obstetric interventions. Furthermore, we explore whether this concept can be operationalised at district level.</p> <p>Methods</p> <p>A two year study using the Unmet Obstetric Need concept was carried out in three districts in Tanga Region, Tanzania. Data was collected prospectively at all four hospitals in the region for every woman undergoing a major obstetric intervention, including indication and outcome. The concept was adapted to address differentials in access to emergency obstetric care between districts and between rural and urban areas. Based upon literature and expert consensus, a threshold of 2% of all deliveries was used to define the expected minimum requirement of major obstetric interventions performed for absolute maternal indications.</p> <p>Results</p> <p>Protocols covering 1,260 complicated deliveries were analysed. The percentage of major obstetric interventions carried out in response to an absolute maternal indication was only 71%; most major obstetric interventions (97%) were caesarean sections. The most frequent indication was cephalo-pelvic-disproportion (51%). The proportion of major obstetric interventions for absolute maternal indications performed amongst women living in urban areas was 1.8% of all deliveries, while in rural areas it was only 0.7%. The high proportion (8.3%) of negative maternal outcomes in terms of morbidity and mortality, as well as the high perinatal mortality of 9.1% (still birth 6.9%, dying within 24 hours 1.7%, dying after 24 hours 0.5%) raise concern about the quality of care being provided.</p> <p>Conclusion</p> <p>Based on the 2% threshold, Tanga Region – with an overall level of major obstetric interventions for absolute maternal indications of 1% and a caesarean section rate of 1.4% – has significant unmet obstetric need with a considerable rural-urban disparity. The UON concept was found to be a suitable tool for evaluating and monitoring the coverage of obstetric care at district level.</p
Molecular characterisation and clinical outcome of B-cell precursor acute lymphoblastic leukaemia with IG-MYC rearrangement
Rarely, immunophenotypically immature B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) carries an immunoglobulin-MYC rearrangement (IG-MYC-r). This can result in diagnostic confusion with Burkitt lymphoma/leukaemia and use of unproven individualised treatment schedules. Here we contrast the molecular characteristics of these conditions and investigate historic clinical outcome data. We identified 90 cases registered on a national BCP-ALL clinical trial/registry. Where present, diagnostic material underwent cytogenetic, exome, methylome and transcriptome analysis. Outcome was analysed to define 3-year event free survival (EFS) and overall survival (OS). IG-MYC-r was identified in diverse cytogenetic backgrounds, co-existing with either: established BCP-ALL specific abnormalities (high hyperdiploidy n=3, KMT2A-rearrangement n=6, iAMP21 n=1, BCR-ABL n=1); BCL2/BCL6-rearrangements (n=15); or, most commonly, as the only defining feature (n=64). Within this final group, precursor-like V(D)J breakpoints predominated (8/9) and KRAS mutations were common (5/11). DNA methylation identified a cluster of V(D)J rearranged cases, clearly distinct from Burkitt leukaemia/lymphoma. Children with IG-MYC-r within that subgroup had 3-year EFS of 47% and OS of 60%, representing a high-risk BCP-ALL. To develop effective management strategies this patient group must be allowed access to contemporary, minimal residual disease adapted, prospective clinical trial protocols
The Crowdsourced Replication Initiative: Investigating Immigration and Social Policy Preferences. Executive Report.
In an era of mass migration, social scientists, populist parties and social movements raise concerns over the future of immigration-destination societies. What impacts does this have on policy and social solidarity? Comparative cross-national research, relying mostly on secondary data, has findings in different directions. There is a threat of selective model reporting and lack of replicability. The heterogeneity of countries obscures attempts to clearly define data-generating models. P-hacking and HARKing lurk among standard research practices in this area.This project employs crowdsourcing to address these issues. It draws on replication, deliberation, meta-analysis and harnessing the power of many minds at once. The Crowdsourced Replication Initiative carries two main goals, (a) to better investigate the linkage between immigration and social policy preferences across countries, and (b) to develop crowdsourcing as a social science method. The Executive Report provides short reviews of the area of social policy preferences and immigration, and the methods and impetus behind crowdsourcing plus a description of the entire project. Three main areas of findings will appear in three papers, that are registered as PAPs or in process
Projektdokumentation - support Dienstleistungsnetzwerk für die sächsische KMU: Solidarisch - Sozial - Stark
Der Kommunale Sozialverband Sachsen - Integrationsamt dankt allen Behörden, Verwaltungen und Institutionen, Verbänden und Organisationen, parlamentarischen Gremien, Vertretern der Wirtschaft, Bildungseinrichtungen sowie Einzelpersonen für ihre wertvolle Unterstützung und ihre verlässliche Partnerschaft bei der Entwicklung und erfolgreichen Erprobung des Modellprojektes support in Südwestsachsen sowie seiner Übertragung als dauerhaftes Dienstleistungsangebot auf den gesamten Freistaat Sachsen
Projektdokumentation - support Dienstleistungsnetzwerk für die sächsische KMU: Solidarisch - Sozial - Stark
Der Kommunale Sozialverband Sachsen - Integrationsamt dankt allen Behörden, Verwaltungen und Institutionen, Verbänden und Organisationen, parlamentarischen Gremien, Vertretern der Wirtschaft, Bildungseinrichtungen sowie Einzelpersonen für ihre wertvolle Unterstützung und ihre verlässliche Partnerschaft bei der Entwicklung und erfolgreichen Erprobung des Modellprojektes support in Südwestsachsen sowie seiner Übertragung als dauerhaftes Dienstleistungsangebot auf den gesamten Freistaat Sachsen
The glycyl-radical enzyme 2-ketobutyrate formate-lyase, TdcE, interacts specifically with the formate-translocating FNT-channel protein FocA
AbstractFormate is a major product of mixed-acid fermentation in Escherichia coli. Because formate can act as an uncoupler at high concentration it must be excreted from the cell. The FNT (formate-nitrite transporter) membrane channel FocA ensures formate is translocated across the cytoplasmic membrane. Two glycyl-radical enzymes (GREs), pyruvate formate-lyase (PflB) and 2-ketobutyrate formate-lyase (TdcE), generate formate as a product of catalysis during anaerobic growth of Escherichia coli. We demonstrate in this study that TdcE, like PflB, interacts specifically with FocA. His-tagged variants of two other predicted GREs encoded in the genome of E. coli were over-produced and purified and were shown not to interact with FocA, indicating that interaction with FocA is not a general property of GREs per se. Together, these data show that only the GREs TdcE and PflB interact with the FNT channel protein and suggest that, like PflB, TdcE can control formate translocation by FocA
Gazing rituals in body dysmorphic disorder
Möllmann A, Hunger A, Schulz C, Wilhelm S, Buhlmann U. Gazing rituals in body dysmorphic disorder. Journal of Behavior Therapy and Experimental Psychiatry. 2020;68: 101522.Background and objectives:
Gazing rituals and selective attention to perceived flaws during gazing are considered as maintaining factors in cognitive-behavioral models for body dysmorphic disorder (BDD). This study investigated different durations of BDD-like gazing at different facial stimuli (an unfamiliar face, the participant's own face, and the participant's own reflection in the mirror) with regard to effects on dissociation, attractiveness evaluations and perceptual uncertainty. The aim of this study was to examine the hypothesized causal effects of gazing rituals on appearance preoccupation.
Methods:
We asked 115 females to complete a face gazing paradigm with three different facial stimuli and, depending on the condition, different gazing durations. We also examined the influence of BDD symptom severity on the reactions to different facial stimuli.
Results:
Five minutes of gazing significantly increased dissociation. Participants rated the attractiveness of self-relevant stimuli, especially the own photographed face, below average and lower than the unfamiliar face.
Limitations:
Limitations with regard to sample characteristics and experimental design are discussed.
Conclusions:
Our findings support cognitive-behavioral models for BDD and indicate that therapists may extend therapeutic interventions like mirror retraining by specific perceptual retraining with photographs of the patients