The Histories Volume 16, Spring 2020

A collection of undergraduate research from 2019 to 2020 academic year at La Salle University

Implementation Research on Community Health Workers’ Provision of Maternal and Child Health Services in Rural Liberia

OBJECTIVE: To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. METHODS: The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. FINDINGS: Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. CONCLUSION: We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes

Physical Activity As a Mediator Between Race/ethnicity and Changes in Multimorbidity.

Studies report racial/ethnic disparities in multimorbidity (≥2 chronic conditions) and their rate of accumulation over time as well as differences in physical activity. Our study aimed to investigate whether racial/ethnic differences in the accumulation of multimorbidity were mediated by physical activity among middle-aged and older adults

Polymerase Bypass of <i>N</i>⁶‑Deoxyadenosine Adducts Derived from Epoxide Metabolites of 1,3-Butadiene

<i>N</i>⁶-(2-Hydroxy-3-buten-1-yl)-2′-deoxyadenosine (<i>N</i>⁶-HB-dA I) and <i>N</i>⁶,<i>N</i>⁶-(2,3-dihydroxybutan-1,4-diyl)-2′-deoxyadenosine (<i>N</i>⁶,<i>N</i>⁶-DHB-dA) are exocyclic DNA adducts formed upon alkylation of the <i>N</i>⁶ position of adenine in DNA by epoxide metabolites of 1,3-butadiene (BD), a common industrial and environmental chemical classified as a human and animal carcinogen. Since the <i>N</i>⁶-H atom of adenine is required for Watson–Crick hydrogen bonding with thymine, <i>N</i>⁶-alkylation can prevent adenine from normal pairing with thymine, potentially compromising the accuracy of DNA replication. To evaluate the ability of BD-derived <i>N</i>⁶-alkyladenine lesions to induce mutations, synthetic oligodeoxynucleotides containing site-specific (<i>S</i>)-<i>N</i>⁶-HB-dA I and (<i>R</i>,<i>R</i>)-<i>N</i>⁶,<i>N</i>⁶-DHB-dA adducts were subjected to <i>in vitro</i> translesion synthesis in the presence of human DNA polymerases β, η, ι, and κ. While (<i>S</i>)-<i>N</i>⁶-HB-dA I was readily bypassed by all four enzymes, only polymerases η and κ were able to carry out DNA synthesis past (<i>R</i>,<i>R</i>)-<i>N</i>⁶,<i>N</i>⁶-DHB-dA. Steady-state kinetic analyses indicated that all four DNA polymerases preferentially incorporated the correct base (T) opposite (<i>S</i>)-<i>N</i>⁶-HB-dA I. In contrast, hPol β was completely blocked by (<i>R</i>,<i>R</i>)-<i>N</i>⁶,<i>N</i>⁶-DHB-dA, while hPol η and κ inserted A, G, C, or T opposite the adduct with similar frequency. HPLC-ESI-MS/MS analysis of primer extension products confirmed that while translesion synthesis past (<i>S</i>)-<i>N</i>⁶-HB-dA I was mostly error-free, replication of DNA containing (<i>R</i>,<i>R</i>)-<i>N</i>⁶,<i>N</i>⁶-DHB-dA induced significant numbers of A, C, and G insertions and small deletions. These results indicate that singly substituted (<i>S</i>)-<i>N</i>⁶-HB-dA I lesions are not miscoding, but that exocyclic (<i>R</i>,<i>R</i>)-<i>N</i>⁶,<i>N</i>⁶-DHB-dA adducts are strongly mispairing, probably due to their inability to form stable Watson–Crick pairs with dT

Implementation research on community health workers’ provision of maternal and child health services in rural Liberia

Abstract Objective: To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods: The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings: Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion: We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes

PEM Fuel Cell Technology (Semester Unknown) IPRO 318: PEMFuelCellTechnologyIPRO318Poster1Sp09

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable

PEM Fuel Cell Technology (Semester Unknown) IPRO 318: PEMFuelCellTechnologyIPRO318ProjectPlanSp09

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable

PEM Fuel Cell Technology (Semester Unknown) IPRO 318

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable

PEM Fuel Cell Technology (Semester Unknown) IPRO 318: PEMFuelCellTechnologyIPRO318MidTermPresentationSp09

1. Evaluate the feasibility of PEM fuel cells in commercial application, including military and defense, automotive, aerospace, and other specialties 2. Investigate industrial and commercial technicalities of PEM fuel cells and study methods of improving the robustness of catalysts and reducing fuel impurities 3. Compare and contrast the performance and cost of fuel cell and internal combustion engines 4. Design and incorporate a PEM fuel cell system into commercial application and perform a cost and benefit analysis utilizing engineering design principlesDeliverable