People with learning difficulties and their healthcare encounters.

This study aims to explore the healthcare experiences of people with learning difficulties and their carers. This area has become highly topical as a result of recent national health and social care policies that have emphasised the social inclusion agenda and the right of individuals to have a say in decisions that directly affect their health and wellbeing. This study exposes tensions between individual and social models in accounting for the healthcare experiences of people with learning difficulties. The decision-making process is complex and traditionally many people with learning difficulties have been judged incompetent to make their own healthcare decisions. However, the recent Mental Capacity Act 2005 proposes that people with learning difficulties should, like other people, be presumed to be competent (to make decisions) unless there are strong contraindicators. This proposition is tested in the study. To capture the voices of people with learning difficulties, particularly those with limited articulacy and no speech, ethnographic and narrative methods are used to include voices that may otherwise remain unheard. These methods were informed by a constructivist approach that involved working as closely as possible with informants in order to reach a shared understanding of their experiences. Recent policy proposals suggest that all parties within the healthcare encounter need to work 'in partnership' and 'collaboratively' to provide a more 'person-centred' healthcare encounter for people with learning difficulties. An attempt is therefore made to deconstruct these ideas and to examine what light they shed on the lived experiences of people with learning difficulties in relation to their healthcare encounters in mainstream and specialist services. The study can be seen as adding to the growing literature about the lived experiences of people with learning difficulties, to narratives about their everyday lives, to a questioning of tacit assumptions by staff about capacity and best interest, and to the power struggles people with learning difficulties continue to face in their everyday lives. The findings also demonstrate how situational and contextual factors mediate experiences, re-emphasising the importance of the social model of disability

Heard and Seen: Developing Inclusive Activities for Enabling the Voices of Children with Disabilities in Oral Health Research

The Convention on the Rights of the Child argues for children’s involvement in research. Oral health research frequently excludes children with disabilities and their voices. This study takes a rights-based approach by devising methods to include disabled children in oral health research. This is an ethnographic study. Methods utilized interviews, guided tours, symbols, drawings, pictures, and games. The selection of method depended on the ability and preference of each child. Using pictures and games as prompts enabled child participation. The guided tour activity facilitated the development of relationships with the children. It also increased their ability to chat informally and appeared to reduce power imbalances compared to formal, structured interviewing. Focus group interviews, symbols, and drawings acted as barriers to children’s participation. Involving children with disabilities in oral health research requires using appropriate methodological designs and innovative, pluralistic methods drawn from differentdisciplines. This promotes a rights-based approach, which recognizes diversity and aims to reduce the discrimination and disempowerment of children with disabilities

Female genital mutilation and cutting in the Arab League and diaspora: A systematic review of preventive interventions

Objectives Female Genital Mutilation and Cutting (FGM/C) is an act of gender-based violence (GBV) and a global public health issue with well-documented adverse outcomes. With the rise in global migration, there is an increasing prevalence of FGM/C among Arab diaspora living in the West and Global South. What remains unclear is how to reduce the practice. This study was designed to identify interventions exerting an effect on reducing the practice of FGM/C. Methods A systematic review of peer-reviewed articles was conducted on interventions targeting individuals and/or the broader community to prevent FGM/C within the Arab League and its diaspora, up to December 2021. Databases searched included PubMed, Medline, Web of Science, PsycINFO, EMBASE, CINAHL, BIOSIS, ASSIA, and Scopus. Quality assessment used the Mixed Methods Appraisal Tool (MMAT) 2018. Results Twelve of 896 studies met the inclusion criteria. Eight interventions relied entirely on education with short-term gains but unchanged practices. Three interventions used social marketing and mixed media. Only one study took a multi-sectoral approach. Conclusions At a macro level, opportunities to reduce or end the practice of FGM/C exist through legislation, policy, a public-health approach grounded in gender equality and human rights. Using multi-sectoral actions that consider the social context and challenge social norms at macro, meso and micro levels appears more effective than individual-level interventions. Promoting advocacy and developing supportive environments to reduce GBV, enhance gender equality and empower communities is crucial for interventions to succeed and achieve the Sustainable Development Goal target of FGM/C abandonment by 2030

Malocclusion characteristics amongst individuals with autism spectrum disorder: a systematic review and meta‑analysis

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Reducing Violence Against Women and Girls in the Arab League: A Systematic Review of Preventive Interventions

The UN’s Sustainable Development Goal #5 (Gender Equity) includes violence against women and girls (VAWG), considering it as a violation of the rights of women and girls. The variety of risk factors for VAWG in Arab countries suggests the need to identify effective interventions to guide practitioners and policy makers. A systematic review of preventive interventions across the Arab League examined the outcomes of VAWG. Authors registered the study on the prospective register of systematic reviews database. Authors conducted the search for evidence up to 2023. Database searching identified 1,502 studies and after application of the eligibility criteria, 17 studies remained for inclusion. Quality appraisal used the Mixed Methods Appraisal Tool. Evidence emerged from eight Arab countries. Interventions occurred at the primary, secondary, and tertiary levels of prevention. However, only two studies employed interventions using more than one level of prevention, which considered systems strengthening and the development of community solidarity networks. The evidence revealed a lack of clear evaluation and evidence for the effectiveness of interventions and prevention alongside reactive approaches, with no evidence as to how systems may reduce or prevent VAWG. One main issue is patriarchal dominance in Arab countries creating the lack of a collective female voice in any of the evidence. However, Arab countries can change with support. Achieving the UN’s Sustainable Development Goal #5 by 2030 means interventions and programs need to include more than one prevention level, consider systems and include the collective female voice

Automated identification of insect vectors of Chagas disease in Brazil and Mexico: the Virtual Vector Lab

Identification of arthropods important in disease transmission is a crucial, yet difficult, task that can demand considerable training and experience. An important case in point is that of the 150+ species of Triatominae, vectors of Trypanosoma cruzi, causative agent of Chagas disease across the Americas. We present a fully automated system that is able to identify triatomine bugs from Mexico and Brazil with an accuracy consistently above 80%, and with considerable potential for further improvement. The system processes digital photographs from a photo apparatus into landmarks, and uses ratios of measurements among those landmarks, as well as (in a preliminary exploration) two measurements that approximate aspects of coloration, as the basis for classification. This project has thus produced a working prototype that achieves reasonably robust correct identification rates, although many more developments can and will be added, and—more broadly—the project illustrates the value of multidisciplinary collaborations in resolving difficult and complex challenges

Identification of Residues in the Lipopolysaccharide ABC Transporter That Coordinate ATPase Activity with Extractor Function

ABSTRACT The surface of most Gram-negative bacteria is covered with lipopolysaccharide (LPS), creating a permeability barrier against toxic molecules, including many antimicrobials. To assemble LPS on their surface, Gram-negative bacteria must extract newly synthesized LPS from the inner membrane, transport it across the aqueous periplasm, and translocate it across the outer membrane. The LptA to -G proteins assemble into a transenvelope complex that transports LPS from the inner membrane to the cell surface. The Lpt system powers LPS transport from the inner membrane by using a poorly characterized ATP-binding cassette system composed of the ATPase LptB and the transmembrane domains LptFG. Here, we characterize a cluster of residues in the groove region of LptB that is important for controlling LPS transport. We also provide the first functional characterization of LptFG and identify their coupling helices that interact with the LptB groove. Substitutions at conserved residues in these coupling helices compromise both the assembly and function of the LptB2FG complex. Defects in LPS transport conferred by alterations in the LptFG coupling helices can be rescued by changing a residue in LptB that is adjacent to functionally important residues in the groove region. This suppression is achieved by increasing the ATPase activity of the LptB2FG complex. Taken together, these data identify a specific binding site in LptB for the coupling helices of LptFG that is responsible for coupling of ATP hydrolysis by LptB with LptFG function to achieve LPS extraction

Absent otoacoustic emissions predict otitis media in young Aboriginal children: A birth cohort study in Aboriginal and non-Aboriginal children in an arid zone of Western Australia

AbstractBackground: Otitis media (OM) is the most common paediatric illness for which antibiotics areprescribed. In Australian Aboriginal children OM is frequently asymptomatic and starts at a youngerage, is more common and more likely to result in hearing loss than in non-Aboriginal children.Absent transient evoked otoacoustic emissions (TEOAEs) may predict subsequent risk of OM.Methods: 100 Aboriginal and 180 non-Aboriginal children in a semi-arid zone of WesternAustralia were followed regularly from birth to age 2 years. Tympanometry was conducted atroutine field follow-up from age 3 months. Routine clinical examination by an ENT specialist wasto be done 3 times and hearing assessment by an audiologist twice. TEOAEs were measured at ages<1 and 1–2 months. Cox proportional hazards model was used to investigate the associationbetween absent TEOAEs and subsequent risk of OM.Results: At routine ENT specialist clinics, OM was detected in 55% of 184 examinations inAboriginal children and 26% of 392 examinations in non-Aboriginal children; peak prevalence was72% at age 5–9 months in Aboriginal children and 40% at 10–14 months in non-Aboriginal children.Moderate-severe hearing loss was present in 32% of 47 Aboriginal children and 7% of 120 non-Aboriginal children aged 12 months or more.TEOAE responses were present in 90% (46/51) of Aboriginal children and 99% (120/121) of non-Aboriginal children aged <1 month and in 62% (21/34) and 93% (108/116), respectively, inAboriginal and non-Aboriginal children at age 1–2 months. Aboriginal children who failed TEOAEat age 1–2 months were 2.6 times more likely to develop OM subsequently than those who passed.Overall prevalence of type B tympanograms at field follow-up was 50% (n = 78) in Aboriginalchildren and 20% (n = 95) in non-Aboriginal children

Curcumin activates the p38MPAK-HSP25 pathway in vitro but fails to attenuate diabetic nephropathy in DBA2J mice despite urinary clearance documented by HPLC

<p>Abstract</p> <p>Background</p> <p>Curcumin has anti-inflammatory, anti-oxidant, and anti-proliferative properties, and depending upon the experimental circumstances, may be pro- or anti-apoptotic. Many of these biological actions could ameliorate diabetic nephropathy.</p> <p>Methods/Design</p> <p>Mouse podocytes, cultured in basal or high glucose conditions, underwent acute exposure to curcumin. Western blots for p38-MAPK, COX-2 and cleaved caspase-3; isoelectric focusing for HSP25 phosphorylation; and DNase I assays for F- to G- actin cleavage were performed for <it>in vitro </it>analyses. <it>In vivo </it>studies examined the effects of dietary curcumin on the development of diabetic nephropathy in streptozotocin (Stz)-induced diabetes in DBA2J mice. Urinary albumin to creatinine ratios were obtained, high performance liquid chromatography was performed for urinary curcuminoid measurements, and Western blots for p38-MAPK and total HSP25 were performed.</p> <p>Results</p> <p>Curcumin enhanced the phosphorylation of both p38MAPK and downstream HSP25; inhibited COX-2; induced a trend towards attenuation of F- to G-actin cleavage; and dramatically inhibited the activation of caspase-3 in <it>vitro</it>. In curcumin-treated DBA2J mice with Stz-diabetes, HPLC measurements confirmed the presence of urinary curcuminoid. Nevertheless, dietary provision of curcumin either before or after the induction of diabetes failed to attenuate albuminuria.</p> <p>Conclusions</p> <p>Apart from species, strain, early differences in glycemic control, and/or dosing effects, the failure to modulate albuminuria may have been due to a decrement in renal HSP25 or stimulation of the 12/15 lipoxygenase pathway in DBA2J mice fed curcumin. In addition, these studies suggest that timed urine collections may be useful for monitoring curcumin dosing and renal pharmacodynamic effects.</p

The Role of the Qur'an and Sunnah in Oral Health.

The aim of this study was to explore the ways in which the main texts in Islam, Holy Qur'an and the Sunnah of the Prophet Mohammed (pbuh), contribute to understandings of oral health. The AHadith provide guidance for oral health-related behaviour but were written at a time when their symbolic meanings were perhaps vastly different to those of today. In gaining more insight into the ways Islamic HRB shape oral health-related practices and outcomes, if at all, we may be better placed to develop a more culturally sensitive and diverse dental public health and oral health promotion which takes into account religious dimensions, mediating factors, HRB and salutogenic mechanisms