Track E Implementation Science, Health Systems and Economics

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138412/1/jia218443.pd

Conventional early infant diagnosis in Lesotho from specimen collection to results usage to manage patients: Where are the bottlenecks?

<div><p>Introduction</p><p>Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade.</p><p>Methods</p><p>We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means (with 95% CI) were calculated and compared by region using linear mixed models.</p><p>Results</p><p>1,187 individual infant records from 25 facilities were reviewed. Overall, early infant diagnosis turnaround time was 61.7 days (95%CI: 55.3–68.7). Mean time from specimen collection to district laboratory was 14 days (95%CI: 12.1–16.1); from district to central laboratory, 2 days (95%CI 0.8–5.2); results from central laboratory to district hospital, 23.3 days (95%CI: 18.7–29.0); from district hospital to health facility, 3.2 days (95%CI 1.9–5.5); and from health facility to caregiver, 10.4 days (95%CI, 7.9–13.5). Mean times from specimen transfer to the central laboratory and for result transfer from central laboratory to district hospital were significantly shorter in the Lowlands Region (0.9 and 16.2 days, respectively), compared to Highlands Region (6.0 [P = 0.030] and 34.3 days [P = 0.0099]. Turnaround time from blood draw to receipt of results was significantly shorter for HIV infected infants compared to HIV uninfected infants [p = 0.0036] at an average of 47.1 days (95%CI: 38.9–56.9) and 62 days (95%CI: 55.9–68.7) respectively. Of 47 HIV-infected infants, 36 were initiated on antiretroviral therapy at an average of 1.3 days (95%CI: 0.3, 5.7) after caregiver received the result.</p><p>Conclusion</p><p>HIV-infected infants received results earlier and were rapidly initiated on antiretroviral therapy once the result was delivered to caregiver. However, average early infant diagnosis turnaround time was two months; the longest period of delay was transfer of results from central laboratory to district hospital. Turnaround time of results based on geographical regions or between hospitals and health centres varied but did not reach statistical significance.</p></div

Turnaround time (TAT) for the stages in the EID cascade calculated from linear mixed models.

<p>Turnaround time (TAT) for the stages in the EID cascade calculated from linear mixed models.</p

2MN9 : peptoid analogue of maculatin G15 - peptoid trans-Nleu at position 13

Experimental Technique/Method:SOLUTION NMR Resolution: Classification:ANTIMICROBIAL PROTEIN Release Date:2014-07-23 Deposition Date:2014-03-29 Revision Date:2014-12-03 Molecular Weight:2121.53 Macromolecule Type:Protein Residue Count:22 Atom Site Count:151 DOI:10.2210/pdb2mn9/pdb Abstract: The inclusion of peptoid monomers into antimicrobial peptides (AMPs) increases their proteolytic resistance, but introduces conformational flexibility (reduced hydrogen bonding ability and cis/trans isomerism). We here use NMR spectroscopy to answer how the insertion of a peptoid monomer influences the structure of a regular α-helical AMP upon interaction with a dodecyl phosphocholine (DPC) micelle. Insertion of [(2-methylpropyl)amino]acetic acid in maculatin-G15 shows that the structural change and conformational flexibility depends on the site of insertion. This is governed by the micelle interaction of the amphipathic helices flanking the peptoid monomer and the side chain properties of the peptoid and its preceding residue

2MN8 : NMR structure of a peptoid analogue of maculatin G15 containing cis-Nleu at position 13

Experimental Technique/Method:SOLUTION NMR Resolution: Classification:ANTIMICROBIAL PROTEIN Release Date:2014-07-23 Deposition Date:2014-03-29 Revision Date:2014-12-03 Molecular Weight:2121.53 Macromolecule Type:Protein Residue Count:22 Atom Site Count:151 DOI:10.2210/pdb2mn8/pdb Abstract: The inclusion of peptoid monomers into antimicrobial peptides (AMPs) increases their proteolytic resistance, but introduces conformational flexibility (reduced hydrogen bonding ability and cis/trans isomerism). We here use NMR spectroscopy to answer how the insertion of a peptoid monomer influences the structure of a regular α-helical AMP upon interaction with a dodecyl phosphocholine (DPC) micelle. Insertion of [(2-methylpropyl)amino]acetic acid in maculatin-G15 shows that the structural change and conformational flexibility depends on the site of insertion. This is governed by the micelle interaction of the amphipathic helices flanking the peptoid monomer and the side chain properties of the peptoid and its preceding residue

International Social Survey Programme: Work Orientations IV - ISSP 2015

Attitude towards work. Work orientation. Conflict and social exclusion. Subjective experience of job. Work satisfaction. Non-standard employment. Work life balance. Job and working flexibility. Human capital. Outcome of work. Employability, new job. Topics: work centrality (a job is just a way of earning money vs. would enjoy having a paid job even if the money is not needed); importance of selected demands of a job like job security, high income, etc. (work values); work life balance: willingness to give up good job opportunities for the benefit of the family; willingness to remain in a job that is not satisfying for the benefit of the family; conflict and social exclusion: experience of discrimination with regard to work, for instance when applying for a job; main reason for the discrimination; experience of harassment at the workplace by superiors or co-workers (for example bullying, physical or psychological abuse); solidarity and conflict with regard to trade unions (workers need strong trade unions to protect their interests vs. strong trade unions are bad for the country´s economy); preferred employment arrangements (full-time, part-time, less than 10 hours a week, no paid job at all); currently working for pay (employment status); preference for more work (and money) or for reduction in working hours (work longer hours and earn more money, work the same number of hours and earn the same money, or work fewer hours and earn less money); characteristics (social dimension) of own job; subjective experience of job: frequency of hard physical work and stressful work; non-standard employment: frequency of working at home during the usual working hours and working on weekends; job and working flexibility concerning starting and finishing times; non-standard employment: usual working schedule in the main job; job and working flexibility: organisation of daily work (free decision, decision within certain limits, no free decision); work life balance: difficult to take an hour off during working hours to take care of personal or family matters; demands of the job interfere with the family life and the demands of family life interfere with the job; human capital: usefulness of the abilities learned from past work experience for the present job; job training over the past twelve months to improve job skills; judgement on the relations between management and employees and the relations between workmates/ colleagues (working atmosphere); outcome of work: work satisfaction in the main job; identification with firm or organisation; occupational commitment (would change the present type of work for something different, proud of the present type of work); employability/ new job: expected difficulties in finding a new job at least as good as the current one; likeliness of job search in the next twelve months; worried about the possibility of losing own job; job and working flexibility: accepted concessions to avoid unemployment (acceptance of a job that requires new skills, acceptance of a lower paid position, acceptance of temporary employment, longer travel to reach the place of work, movement within the country, movement to a different country); existence of a side job in addition to the main job; earning from the additional job(s) in total compared with the main job. Respondents who are not currently employed were asked: ever worked for pay for one year or more; month and year the last paid job ended; work satisfaction in the last job; main reason for the end of last employment; interest in finding a paid job; expected difficulties in finding a new job; worried about the possibility of not finding a job; accepted concessions in order to get a job (acceptance of a job that requires new skills, acceptance of a lower paid position, acceptance of temporary employment, longer travel to reach the place of work, movement within the country, movement to a different country); job seeking activities in the past twelve months and training to improve own job skills; currently looking for a job; main source of economic support; worried about the possibility of losing this main economic support. Optional items: recent work histories: ever worked for pay over the past five years; experience of selected changes in working life (unemployment for a period longer than three months, change of the employer, change of the occupation, started own business/ became self-employed, took up an additional job); self-assessment of current financial situation; change of current financial situation compared to five years ago; expected financial situation in five years; attitude towards senior citizens´ work (good for the country´s economy, employed people aged 60 and over take jobs away from younger people). Optional background variable: self-assessment of physical and mental health. Additional compulsory background variable: age of the youngest child in the household. Demography: sex; age; year of birth; years in school; education (country specific); highest completed degree; work status; hours worked weekly; employment relationship; number of employees; supervision of employees; number of supervised employees; type of organisation: for-profit vs. non profit and public vs. private; occupation (ISCO-08); main employment status; living in steady partnership; union membership; religious affiliation or denomination (country specific); groups of religious denominations; attendance of religious services; top-bottom self-placement; vote in last general election; country specific party voted in last general election; party voted (left-right); self-assessed affiliation of ethnic group 1 and 2 (country specific); number of children; number of toddlers; size of household; earnings of respondent (country specific); family income (country specific); father´s and mother´s country of birth; marital status; place of living: urban – rural; region (country specific). Information about spouse/ partner on: work status; hours worked weekly; employment relationship; supervises other employees; occupation (ISCO-08); main employment status. Additionally encoded: respondent-ID number; date of interview (year, month, day); case substitution flag; mode of data collection; weight

International Social Survey Programme: Citizenship II - ISSP 2014

Bürger und Staat: Eigenschaften eines guten Bürgers; Einstellung zur Versammlungsfreiheit für religiöse Extremisten, Revolutionäre und Ethnozentristen; soziale und politische Partizipation; Häufigkeit der Mediennutzung für politische Informationen; Anzahl direkter Kontaktpersonen an einem typischen Wochentag (gruppiert); aktive bzw. passive Mitgliedschaften in ausgewählten Gruppen oder Vereinigungen (politische Partei, Gewerkschaft, Kirche oder andere religiöse Organisation, Sportgruppe, Freizeitgruppe oder Kulturgruppe, andere freiwillige Vereinigung); Wichtigkeit verschiedener Bürgerrechte; Beeinflussbarkeit des politischen Systems und politische Informiertheit; Einschätzung von Einflussmöglichkeiten auf die nationale Politik bzw. Gesetzgebung (political efficacy); Politikinteresse; Links-Rechts-Selbsteinstufung; politisches Vertrauen: Vertrauen in Angehörige der Regierung und in Politiker; Häufigkeit des Gefühls der Übervorteilung und der fairen Behandlung durch Menschen; allgemeines Personenvertrauen; Häufigkeit politischer Diskussionen mit Freunden, Verwandten oder Kollegen; politische Meinungsführerschaft; Meinung zu politischen Parteien und Volksentscheid (politische Parteien ermutigen Menschen zu politischer Aktivität, politische Parteien bieten keine wirklichen Wahlmöglichkeiten, Volksentscheid als guter Weg bei wichtigen politischen Fragen); Bewertung der letzten nationalen Wahlen im Hinblick auf den Wahlprozess und die Möglichkeiten der Kandidaten und Parteien den Wahlkampf zu führen; Einschätzung der Bürgernähe des öffentlichen Dienstes im Land; Einschätzung der Verbreitung von Korruption im öffentlichen Dienst; Funktionieren der Demokratie im Land derzeit, vor zehn Jahren und zukünftig in 10 Jahren. Optional: Häufigkeit der Rezeption politischer Inhalte einer Tagesszeitung, politischer Nachrichten im Fernsehen und im Radio sowie der Internetnutzung für politische Informationen. Demographie: Geschlecht; Alter; Geburtsjahr; Jahre der Schulbildung; Bildung (länderspezifisch); höchster Abschluss; Erwerbsstatus; Wochenarbeitszeit; Arbeitsverhältnis; Zahl der Beschäftigten (Unternehmensgröße); Weisungsbefugnis; Anzahl der Mitarbeiter für die Weisungsbefugnis besteht; Art des Unternehmens: Profit vs. Non-Profit und öffentlich vs. privat; Beruf (ISCO-08); Hauptbeschäftigungsstatus; Zusammenleben mit einem Partner; Gewerkschaftsmitgliedschaft; Religionszugehörigkeit oder Konfession (länderspezifisch); Konfessionsgruppen; Kirchgangshäufigkeit; Oben-Unten-Selbsteinstufung; Wahlbeteiligung bei der letzten allgemeinen Wahl und gewählte länderspezifische Partei; Links-Rechts-Einstufung der gewählten Partei; Selbsteinschätzung der Zugehörigkeit zu einer ethnischen Gruppe 1 und 2 (länderspezifisch); Anzahl der Kinder; Anzahl der Kleinkinder; Haushaltsgröße; Einkommen des Befragten (länderspezifisch); Familieneinkommen (länderspezifisch); Geburtsland von Vater und Mutter; Familienstand; Urbanisierungsgrad; Region (länderspezifisch). Angaben zum Ehepartner bzw. Partner hinsichtlich: Erwerbsstatus; Wochenarbeitszeit; Arbeitsverhältnis; Weisungsbefugnis; Beruf (ISCO-08); Hauptbeschäftigungsstatus. Zusätzlich verkodet wurde: Interviewdatum; Case substitution flag; Erhebungsmethode; Gewicht; Gruppe (Mixed-Mode-Methoden der Datenerhebung)

International Social Survey Programme: Work Orientations IV - ISSP 2015

Attitude towards work. Work orientation. Conflict and social exclusion. Subjective experience of job. Work satisfaction. Non-standard employment. Work life balance. Job and working flexibility. Human capital. Outcome of work. Employability, new job. Topics: work centrality (a job is just a way of earning money vs. would enjoy having a paid job even if the money is not needed); importance of selected demands of a job like job security, high income, etc. (work values); work life balance: willingness to give up good job opportunities for the benefit of the family; willingness to remain in a job that is not satisfying for the benefit of the family; conflict and social exclusion: experience of discrimination with regard to work, for instance when applying for a job; main reason for the discrimination; experience of harassment at the workplace by superiors or co-workers (for example bullying, physical or psychological abuse); solidarity and conflict with regard to trade unions (workers need strong trade unions to protect their interests vs. strong trade unions are bad for the country´s economy); preferred employment arrangements (full-time, part-time, less than 10 hours a week, no paid job at all); currently working for pay (employment status); preference for more work (and money) or for reduction in working hours (work longer hours and earn more money, work the same number of hours and earn the same money, or work fewer hours and earn less money); characteristics (social dimension) of own job; subjective experience of job: frequency of hard physical work and stressful work; non-standard employment: frequency of working at home during the usual working hours and working on weekends; job and working flexibility concerning starting and finishing times; non-standard employment: usual working schedule in the main job; job and working flexibility: organisation of daily work (free decision, decision within certain limits, no free decision); work life balance: difficult to take an hour off during working hours to take care of personal or family matters; demands of the job interfere with the family life and the demands of family life interfere with the job; human capital: usefulness of the abilities learned from past work experience for the present job; job training over the past twelve months to improve job skills; judgement on the relations between management and employees and the relations between workmates/ colleagues (working atmosphere); outcome of work: work satisfaction in the main job; identification with firm or organisation; occupational commitment (would change the present type of work for something different, proud of the present type of work); employability/ new job: expected difficulties in finding a new job at least as good as the current one; likeliness of job search in the next twelve months; worried about the possibility of losing own job; job and working flexibility: accepted concessions to avoid unemployment (acceptance of a job that requires new skills, acceptance of a lower paid position, acceptance of temporary employment, longer travel to reach the place of work, movement within the country, movement to a different country); existence of a side job in addition to the main job; earning from the additional job(s) in total compared with the main job. Respondents who are not currently employed were asked: ever worked for pay for one year or more; month and year the last paid job ended; work satisfaction in the last job; main reason for the end of last employment; interest in finding a paid job; expected difficulties in finding a new job; worried about the possibility of not finding a job; accepted concessions in order to get a job (acceptance of a job that requires new skills, acceptance of a lower paid position, acceptance of temporary employment, longer travel to reach the place of work, movement within the country, movement to a different country); job seeking activities in the past twelve months and training to improve own job skills; currently looking for a job; main source of economic support; worried about the possibility of losing this main economic support. Optional items: recent work histories: ever worked for pay over the past five years; experience of selected changes in working life (unemployment for a period longer than three months, change of the employer, change of the occupation, started own business/ became self-employed, took up an additional job); self-assessment of current financial situation; change of current financial situation compared to five years ago; expected financial situation in five years; attitude towards senior citizens´ work (good for the country´s economy, employed people aged 60 and over take jobs away from younger people). Optional background variable: self-assessment of physical and mental health. Additional compulsory background variable: age of the youngest child in the household. Demography: sex; age; year of birth; years in school; education (country specific); highest completed degree; work status; hours worked weekly; employment relationship; number of employees; supervision of employees; number of supervised employees; type of organisation: for-profit vs. non profit and public vs. private; occupation (ISCO-08); main employment status; living in steady partnership; union membership; religious affiliation or denomination (country specific); groups of religious denominations; attendance of religious services; top-bottom self-placement; vote in last general election; country specific party voted in last general election; party voted (left-right); self-assessed affiliation of ethnic group 1 and 2 (country specific); number of children; number of toddlers; size of household; earnings of respondent (country specific); family income (country specific); father´s and mother´s country of birth; marital status; place of living: urban – rural; region (country specific). Information about spouse/ partner on: work status; hours worked weekly; employment relationship; supervises other employees; occupation (ISCO-08); main employment status. Additionally encoded: respondent-ID number; date of interview (year, month, day); case substitution flag; mode of data collection; weight