The Other Maine Guides: How the Humanities Create Sense of Place and Enrich Tourism

When we speak of a “sense of place,” we often mean how local residents see their environment and their place within it. But for many visitors, their sense of place about the sites they visit has more to do with what they have read or seen or heard than what they have actually experienced. Cultural tourists in particular are often well versed in the literature, art, music, and other creative works produced about, in, or by people who are from the places they choose to visit. This sense of place drives their travel choices and feeds their expectations of what they will see and experience on their travels. In this article Kreg Ettenger describes some of the ways in which tourism could be better served through closer ties with the humanities, including products that could be developed to reflect the goals of the “purposeful cultural tourist.” He also describes the value of humanities-based tourism education for residents of Maine, including those in the tourism industry

Finding Inspiration (and Profit) in Maine’s Living Heritage: New Entrepreneurs Drawing upon the Past

Maine has a rich heritage of traditional arts and industries that derive from its Indigenous and settler populations and the ways its people have used its natural resources and adapted to its diverse environments. This heritage continues today in a variety of forms, from economic activities like resource harvesting to artistic expressions such as music, dance, storytelling, and the visual arts. This essay looks at how traditional or folk activities, including foods, beverages, and other artisanal industries, continue to play an important role in Maine’s economic, social, and cultural landscape. Far from being quaint traditions maintained for cultural reasons, they are an important part of Maine’s new economy, helping to define its future through connections with its past

Health insurance for the poor decreases access to HIV testing in antenatal care: evidence of an unintended effect of health insurance reform in Colombia

Prevention of mother-to-child transmission of HIV was added to standard antenatal care (ANC) in 2000 for Colombians enrolled in the two national health insurance schemes, the ‘subsidized regime’ (covering poor citizens) and the ‘contributory regime’ (covering salaried citizens with incomes above the poverty threshold), which jointly covered 80% of the total Colombian population as of 2007. This article examines integration of HIV testing in ANC through the relationship between ordering an HIV test with the type of health insurance, including lack of health insurance, using data from the nationally representative 2005 Colombia Demographic and Health Survey. Overall, health-care providers ordered an HIV test for only 35% of the women attending ANC. We regressed the order of an HIV test during ANC on health systems characteristics (type of insurance and type of ANC provider), women’s characteristics (age, wealth, educational attainment, month of pregnancy at first antenatal visit, HIV knowledge, urban vs. rural residence and sub-region of residence) and children’s characteristics (birth order and birth year). Women enrolled in the subsidized regime were significantly less likely to be offered and receive an HIV test in ANC than women without any health insurance (adjusted odds ratio = 0.820, P < 0.001), when controlling for the other independent variables. Wealth, urban residence, birth year of the child and the type of health-care provider seen during the ANC visit were significantly associated with providers ordering an HIV test for a woman (all P < 0.05). Our findings suggest that enrolment in the subsidized regime reduced access to HIV testing in ANC. Additional research is needed to elucidate the mechanisms through which the potential effect of health insurance coverage on HIV testing in ANC occurs and to examine whether enrolment in the subsidized regime has affected access to other essential health services

Pediatric Transplantation in the United States, 1996–2005

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73448/1/j.1600-6143.2007.01780.x.pd

2-(1,2,3,4-Tetra­hydro­phenanthren-1-yl­idene)malononitrile

In the title complex, C17H12N2, the non-aromatic six-membered ring adopts an envelope conformation. The dihedral angle between the eight-membered plane containing the malononitrile group and the aromatic system is 25.88 (4)°. The distance from the central C atom of the malononitrile group to the centroid of the n-glide-related distal aromatic ring is 3.66 Å, suggesting π–π inter­actions

Focused Ultrasonication-Assisted Preparation of Aqueous Nanodispersions for Selected Novel C-type Lectin Receptor Ligands

Purpose: Mycobacterium tuberculosis (Mtb), the causative pathogen of tuberculosis (TB), is a global pathogenic threat. In 2017, 10 million people were affected by TB infections, resulting in 1.6 million deaths worldwide. With about one-quarter of the global population infected with latent TB, tuberculosis remains one of the top ten causes of death worldwide according to a 2018 World Health Organization report. Despite the availability of a TB vaccine, new cases of multidrug-resistant TB arise yearly, threatening the efficacy of traditional treatments used to combat this disease. Recent evidence has suggested Th17 response may be protective, but no Th17 adjuvants are clinically approved. Adjuvants, substances which boost immune response to an antigen, are added to vaccines to enhance immune cross-protection, induce humoral or cell-mediated immunity, reduce reactogenicity and toxicity, reduce antigen dosing, and ameliorate side effects of vaccination for at-risk populations. Most approved vaccine adjuvants drive a Th2 or Th1 mediated immune response, which have not proven protective against Mtb. C-type lectin receptors (CLRs) show promise as targets able to drive a Th17-response upon stimulation. Agonists of this family include many glycolipids derived from trehalose 6,6’-dimycolate (TDM), the main immunostimulatory component of the Mtb cell wall. TDM is a potent Mincle agonist but remains too toxic. Therefore, we have been developing novel synthetic analogues of TDM with equivalent immunostimulatory activity but diminished toxicity and assessed their ability to modulate innate immunity in several innovative aqueous formulations. Methods: A focused ultrasonication technique was utilized to prepare nanodispersions of the studied CLR ligands. These aqueous formulations were characterized via dynamic light scattering, transmission electron cryomicroscopy, and high-performance liquid chromatography before in vitro and in vivo testing. Significance: In this study, immune responses were tested for an array of CLR-based adjuvant formulations to identify lead CLR adjuvant candidates for use in next-generation TB vaccines

Should Pediatric Patients Wait for HLA-DR-Matched Renal Transplants?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74900/1/j.1600-6143.2008.02320.x.pd

Cyclosporine absorption profiles in pediatric kidney and liver transplant patients

Cyclosporine absorption profiling uses either the area under the concentration curve in the first 4 h post dose, AUC(0–4), or the concentration 2 h post dose (C2) to optimize immunosuppression in adult kidney and liver transplantation. We characterized C2 versus AUC(0–4) relationships over time after transplant and across transplant indications in 56 pediatric transplant patients. There were 36 kidney transplant patients aged 9.7±3.9 years. Nineteen of these patients were studied in the de novo period on day 7 post transplant and 17 in the maintenance phase more than 1 year post transplant. In addition, 20 liver transplant patients aged 8.9±4.2 years were studied in the maintenance phase. All patients had five blood samples collected over the 12-h dose interval that were analyzed by validated assay methods at a central laboratory. Pediatric C2 values were 1,463±658 ng/ml for de novo kidney, 954±322 ng/ml for maintenance kidney, and 619±339 ng/ml for maintenance liver transplant patients. C2 was a strong predictor of AUC(0–4) in all three pediatric groups, with coefficients of determination ( r 2 ) ranging from 0.861 to 0.936. Although data were limited from the de novo period, the C2 versus AUC(0–4) regression was consistent over time after transplant and between transplant indications, with a regression slope of 2.50 in de novo kidney, 2.54 in maintenance kidney, and 2.76 in maintenance liver transplant recipients. These slopes were also comparable to that in adult maintenance kidney transplant patients (2.60). In conclusion, C2 versus AUC(0–4) relationships demonstrated consistency over time (de novo vs. maintenance phase), between transplant indications (kidney vs. liver), and across age groups (pediatric vs. adult patients). Average C2 values achieved with current pediatric cyclosporine dosing practices cluster around the target C2 ranges recommended for adults.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47821/1/467_2003_Article_1260.pd

Can a community health worker administered postnatal checklist increase health-seeking behaviors and knowledge?: evidence from a randomized trial with a private maternity facility in Kiambu County, Kenya

Background: Since the 2009 WHO and UNICEF recommendation that women receive home-based postnatal care within the first three days after birth, a growing number of low-income countries have explored integrating postnatal home visit interventions into their maternal and newborn health strategies. This randomized trial evaluates a pilot program in which community health workers (CHWs) visit or call new mothers three days after delivery in peri-urban Kiambu County, Kenya. Methods: Participants were individually randomized to one of three groups: 1) early postnatal care three days after delivery provided in-person with a CHW using a simple checklist, 2) care provided by phone with a CHW using the same checklist, or 3) a standard of care group. Surveys were conducted ten days and nine weeks postnatal to measure outcomes related to compliance with referrals, self-reported health problems for mother and baby, care-seeking behaviors, and postnatal knowledge and practices around the recognition of danger signs, feeding, nutrition, infant care and family planning. Results: The home visit administration of the checklist increased the likelihood that women recognized postnatal problems for themselves and their babies and increased the likelihood that they sought care to address those problems identified for the child. In both the home visit and mobile phone implementation of the checklist, actions taken for postnatal problems happened earlier, particularly for infants. Knowledge was found to be high across all groups, with limited evidence that the checklist impacted knowledge and postnatal practices around the recognition of danger signs, feeding, nutrition, infant care and family planning. Conclusion: We find evidence that CHW-administered postnatal checklists can lead to better recognition of postnatal problems and more timely care-seeking. Furthermore, our results suggest that CHWs can affordably deliver many of the benefits of postnatal checklists. Trial Registration: ClinicalTrials.gov NCT02104635; registered April 2, 2014