Eradication of poliomyelitis in South Africa

An international campaign under the leadership of the World Health Organisation is underway to eradicate polio from the world by the year 2000. South Africa may already be free of polio. However, to ensure eradication we need to move from a polio control programme to a polio eradication programme. This necessitates the institution of a surveillance programme for acute flaccid paralysis (AFP) and improvement of the delivery of polio vaccine. All children with AFP (including those with suspected GuillainBarre syndrome) should be investigated with stool culture to exclude polio. Primary care services need strengthening so that oral polio vaccine coverage greater than 90% is achieved in all regions by all authorities. Outbreak response activities need to be developed. Consideration needs to be given to national immunisation days and mopping-up activities

AURKB-mediated effects on chromatin regulate binding versus release of XIST RNA to the inactive chromosome

How XIST RNA strictly localizes across the inactive X chromosome is unknown; however, prophase release of human XIST RNA provides a clue. Tests of inhibitors that mimic mitotic chromatin modifications implicated an indirect role of PP1 (protein phosphatase 1), potentially via its interphase repression of Aurora B kinase (AURKB), which phosphorylates H3 and chromosomal proteins at prophase. RNA interference to AURKB causes mitotic retention of XIST RNA, unlike other mitotic or broad kinase inhibitors. Thus, AURKB plays an unexpected role in regulating RNA binding to heterochromatin, independent of mechanics of mitosis. H3 phosphorylation (H3ph) was shown to precede XIST RNA release, whereas results exclude H1ph involvement. Of numerous Xi chromatin (chromosomal protein) hallmarks, ubiquitination closely follows XIST RNA retention or release. Surprisingly, H3S10ph staining (but not H3S28ph) is excluded from Xi and is potentially linked to ubiquitination. Results suggest a model of multiple distinct anchor points for XIST RNA. This study advances understanding of RNA chromosome binding and the roles of AURKB and demonstrates a novel approach to manipulate and study XIST RNA

Viewpoints on Factors for Successful Employment for Adults with Autism Spectrum Disorder

This article explores the key factors for successful employment from the viewpoints of adults with autism spectrum disorder (ASD) and employers. Two groups of individuals participated in this study, 40 adults with ASD and 35 employers. Q method was used to understand and contrast the viewpoints of the two groups. Data were analysed using by-person varimax rotation factor analysis. Results showed that although both groups appear committed to the employment process, the difference in their understanding regarding the type of workplace support required, job expectations and productivity requirements continues to hinder successful employment. These results highlight the need to facilitate communication between employees and employers to ensure a clear understanding of the needs of both groups are met. The use of an ASD-specific workplace tool may assist in facilitating the necessary communication between these two groups

The positive outlook study- a randomised controlled trial evaluating the effectiveness of an online self-management program targeting psychosocial issues for men living with HIV: a study protocol

Background: The emergence of HIV as a chronic condition means that people living with HIV are required to takemore responsibility for the self-management of their condition, including making physical, emotional and socialadjustments. This paper describes the design and evaluation of Positive Outlook, an online program aiming toenhance the self-management skills of gay men living with HIV.Methods/design: This study is designed as a randomised controlled trial in which men living with HIV in Australiawill be assigned to either an intervention group or usual care control group. The intervention group willparticipate in the online group program ‘Positive Outlook’. The program is based on self-efficacy theory and uses aself-management approach to enhance skills, confidence and abilities to manage the psychosocial issues associatedwith HIV in daily life. Participants will access the program for a minimum of 90 minutes per week over seven weeks.Primary outcomes are domain specific self-efficacy, HIV related quality of life, and outcomes of health education.Secondary outcomes include: depression, anxiety and stress; general health and quality of life; adjustment to HIV;and social support. Data collection will take place at baseline, completion of the intervention (or eight weeks postrandomisation) and at 12 week follow-up.Discussion: Results of the Positive Outlook study will provide information regarding the effectiveness of onlinegroup programs improving health related outcomes for men living with HIV

Australian health care providers' views on opt-out HIV testing

Background: Opt-out HIV testing is a novel concept in Australia. In the opt-out approach, health care providers (HCPs) routinely test patients for HIV unless they explicitly decline or defer. Opt-out HIV testing is only performed with the patients' consent, but pre-test counselling is abbreviated. Australian national testing guidelines do not currently recommend opt-out HIV testing for the general population. Non-traditional approaches to HIV testing (such as opt-out) could identify HIV infections and facilitate earlier treatment, which is particularly important now that HIV is a chronic, manageable disease. Our aim was to explore HCPs' attitudes toward opt-out HIV testing in an Australian context, to further understanding of its acceptability and feasibility. Methods: In this qualitative study, we used purposeful sampling to recruit HCPs who were likely to have experience with HIV testing in Western Australia. We interviewed them using a semi-structured guide and used content analysis as per Graneheim to code the data. Codes were then merged into subcategories and finally themes that unified the underlying concepts. We refined these themes through discussion among the research team. Results: Twenty four HCPs participated. Eleven participants had a questioning attitude toward opt-out HIV testing, while eleven favoured the approach. The remaining two participants had more nuanced perspectives that incorporated some characteristics of the questioning and favouring attitudes. Participants' views about opt-out HIV testing largely fell into two contrasting themes: normalisation and routinisation versus exceptionalism; and a need for proof versus openness to new approaches. Conclusion: Most HCPs in this study had dichotomous attitudes toward opt-out HIV testing, reflecting contrasting analytical styles. While some HCPs viewed it favourably, with the perceived benefits outweighing the perceived costs, others preferred to have evidence of efficacy and cost-effectiveness

Palaeoclimatic events, dispersal and migratory losses along the Afro-European axis as drivers of biogeographic distribution in Sylvia warblers

<p>Abstract</p> <p>Background</p> <p>The Old World warbler genus <it>Sylvia </it>has been used extensively as a model system in a variety of ecological, genetic, and morphological studies. The genus is comprised of about 25 species, and 70% of these species have distributions at or near the Mediterranean Sea. This distribution pattern suggests a possible role for the Messinian Salinity Crisis (from 5.96-5.33 Ma) as a driving force in lineage diversification. Other species distributions suggest that Late Miocene to Pliocene Afro-tropical forest dynamics have also been important in the evolution of <it>Sylvia </it>lineages. Using a molecular phylogenetic hypothesis and other methods, we seek to develop a biogeographic hypothesis for <it>Sylvia </it>and to explicitly assess the roles of these climate-driven events.</p> <p>Results</p> <p>We present the first strongly supported molecular phylogeny for <it>Sylvia</it>. With one exception, species fall into one of three strongly supported clades: one small clade of species distributed mainly in Africa and Europe, one large clade of species distributed mainly in Africa and Asia, and another large clade with primarily a circum-Mediterranean distribution. Asia is reconstructed as the ancestral area for <it>Sylvia</it>. Long-distance migration is reconstructed as the ancestral character state for the genus, and sedentary behavior subsequently evolved seven times.</p> <p>Conclusion</p> <p>Molecular clock calibration suggests that <it>Sylvia </it>arose in the early Miocene and diverged into three main clades by 12.6 Ma. Divergence estimates indicate that the Messinian Salinity Crisis had a minor impact on <it>Sylvia</it>. Instead, over-water dispersals, repeated loss of long-distance migration, and palaeo-climatic events in Africa played primary roles in <it>Sylvia </it>divergence and distribution.</p

Emplacement and deformation of mesozoic Gabbros of the High Atlas (Morocco): paleomagnetism and magnetic fabrics

A paleomagnetic and magnetic fabric study is performed in Upper Jurassic gabbros of the central High Atlas (Morocco). These gabbros were emplaced in the core of preexisting structures developed during the extensional stage and linked to basement faults. These structures were reactivated as anticlines during the Cenozoic compressional inversion. Gabbros from 19 out of the 33 sampled sites show a stable characteristic magnetization, carried by magnetite, which has been interpreted as a primary component. This component shows an important dispersion due to postemplacement tectonic movements. The absence of paleoposition markers in these igneous rocks precludes direct restorations. A novel approach analyzing the orientation of the primary magnetization is used here to restore the magmatic bodies and to understand the deformational history recorded by these rocks. Paleomagnetic vectors are distributed along small circles with horizontal axes, indicating horizontal axis rotations of the gabbro bodies. These rotations are higher when the ratio between shales and gabbros in the core of the anticlines increases. Due to the uncertainties inherent to this work (the igneous bodies recording strong rotations), interpretations must be qualitative. The magnetic fabric is carried by ferromagnetic (s.s.) minerals mimicking the magmatic fabric. Anisotropy of magnetic susceptibility (AMS) axes, using the rotation routine inferred from paleomagnetic results, result in more tightly clustered magnetic lineations, which also become horizontal and are considered in terms of magma flow trend during its emplacement: NW-SE (parallel to the general extensional direction) in the western sector and NE-SW (parallel to the main faults) in the easternmost structures

Factors associated with the lack of antiretroviral therapy initiation among eligible HIVpositive pregnant women in Swaziland

Background. Antiretroviral therapy (ART) initiation is critical for the prevention of mother-to-child transmission (PMTCT) of HIV.Objectives. To quantify factors that were barriers or facilitators to the initiation of ART in pregnant HIV-infected women in Swaziland.Methods. We conducted a cross-sectional survey in HIV-infected women with at least one antenatal care (ANC) visit, who had delivered in maternity wards between April and August 2013 in Swaziland. Variables collected included intrapersonal, interpersonal and organisational factors. Logistic regression models were used to calculate univariate and adjusted multivariate measures of association between ART initiation and the independent variables.Results. Among the 163 pregnant women who were eligible for ART, 110 (67.5%) were initiated on ART by the time of delivery. The most commonly cited reason for not initiating ART (n=53) was women not being ready to initiate life-long treatment (24.5%). On multivariate logistic regression, favourable perceptions of the benefits of ART (adjusted odds ratio (AOR) 3.04; 95% CI 1.55 - 5.96) and presence of partner support (AOR 4.75; 95% CI 2.11 - 10.67) remained significantly and independently associated with ART initiation.Conclusion. ART initiation among ART-eligible pregnant women in Swaziland was independently associated with the presence of partner support and favourable perceptions of the benefits of ART. Stronger counselling and education for pregnant women and male involvement strategies need to be implemented as universal life-long ART for all HIV-infected pregnant women is implemented

Factors associated with the lack of antiretroviral therapy initiation among eligible HIV-positive pregnant women in Swaziland

BACKGROUND. Antiretroviral therapy (ART) initiation is critical for the prevention of mother-to-child transmission (PMTCT) of HIV. OBJECTIVES. To quantify factors that were barriers or facilitators to the initiation of ART in pregnant HIV-infected women in Swaziland. METHODS. We conducted a cross-sectional survey in HIV-infected women with at least one antenatal care (ANC) visit, who had delivered in maternity wards between April and August 2013 in Swaziland. Variables collected included intrapersonal, interpersonal and organisational factors. Logistic regression models were used to calculate univariate and adjusted multivariate measures of association between ART initiation and the independent variables. RESULTS. Among the 163 pregnant women who were eligible for ART, 110 (67.5%) were initiated on ART by the time of delivery. The most commonly cited reason for not initiating ART (n=53) was women not being ready to initiate life-long treatment (24.5%). On multivariate logistic regression, favourable perceptions of the benefits of ART (adjusted odds ratio (AOR) 3.04; 95% CI 1.55 - 5.96) and presence of partner support (AOR 4.75; 95% CI 2.11 - 10.67) remained significantly and independently associated with ART initiation. CONCLUSION. ART initiation among ART-eligible pregnant women in Swaziland was independently associated with the presence of partner support and favourable perceptions of the benefits of ART. Stronger counselling and education for pregnant women and male involvement strategies need to be implemented as universal life-long ART for all HIV-infected pregnant women is implementedSchool of Health Systems and Public Health, University of Pretoria, Pretoria, South Africahttp://sajog.org.za/index.php/SAJOGhttp://www.journals.co.za/content/journalam2017School of Health Systems and Public Health (SHSPH