Is the Alma Ata vision of comprehensive primary health care viable? Findings from an international project

BACKGROUND: The 4-year (2007 2011) Revitalizing Health for All international research program (http://www. globalhealthequity.ca/projects/proj_revitalizing/index.shtml) supported 20 research teams located in 15 lowand middle-income countries to explore the strengths and weaknesses of comprehensive primary health care (CPHC) initiatives at their local or national levels. Teams were organized in a triad comprised of a senior researcher, a new researcher, and a 'research user' from government, health services, or other organizations with the authority or capacity to apply the research findings. Multiple regional and global team capacityenhancement meetings were organized to refine methods and to discuss and assess cross-case findings. OBJECTIVE: Most research projects used mixed methods, incorporating analyses of qualitative data (interviews and focus groups), secondary data, and key policy and program documents. Some incorporated historical case study analyses, and a few undertook new surveys. The synthesis of findings in this report was derived through qualitative analysis of final project reports undertaken by three different reviewers. RESULTS: Evidence of comprehensiveness (defined in this research program as efforts to improve equity in access, community empowerment and participation, social and environmental health determinants, and intersectoral action) was found in many of the cases. CONCLUSION: Despite the important contextual differences amongst the different country studies, the similarity of many of their findings, often generated using mixed methods, attests to certain transferable health systems characteristics to create and sustain CPHC practices. These include: 1. Well-trained and supported community health workers (CHWs) able to work effectively with marginalized communities 2. Effective mechanisms for community participation, both informal (through participation in projects and programs, and meaningful consultation) and formal (though program management structures) 3. Co-partnership models in program and policy development (in which financial and knowledge supports from governments or institutions are provided to communities, which retain decision-making powers in program design and implementation) 4. Support for community advocacy and engagement in health and social systems decision making These characteristics, in turn, require a political context that supports state responsibilities for redistributive health and social protection measures.IS

Two-photon interference between disparate sources for quantum networking

Quantum networks involve entanglement sharing between multiple users. Ideally, any two users would be able to connect regardless of the type of photon source they employ, provided they fulfill the requirements for two-photon interference. From a theoretical perspective, photons coming from different origins can interfere with a perfect visibility, provided they are made indistinguishable in all degrees of freedom. Previous experimental demonstrations of such a scenario have been limited to photon wavelengths below 900 nm, unsuitable for long distance communication, and suffered from low interference visibility. We report two-photon interference using two disparate heralded single photon sources, which involve different nonlinear effects, operating in the telecom wavelength range. The measured visibility of the two-photon interference is 80+/-4%, which paves the way to hybrid universal quantum networks

The role of antibiosis in the antagonism of different bacteria towards Helminthosporium solani, the causal agent of potato silver scurf

Bacterial antagonists of Helminthosporium solani were submitted to different tests in order to determine the role of antibiosis in their antagonistic interaction. Among the bacterial strains tested, seven (Alcaligenes piechaudii, Aquaspirillum autotrophicum, Cellulomonas fimi, Pseudomonas chlororaphis, Pseudomonas putida (strains 94-19 and E-30) and Streptomyces griseus) were shown to produce agar diffusible metabolites inhibiting H. solani mycelial growth and/or conidial germination. Differential activity was revealed when diffusible metabolites were extracted from either pure cultures of these antagonists or dual culture in the presence of H. solani. The results presented indicate that the methodology employed could be a decisive factor in whether or not antibiosis can be identified as a mode of action of biocontrol agents.Des antagonistes bactériens envers Helminthosporium solani ont été soumis à différents essais en vue de déterminer le rôle de l'antibiose dans l'antagonisme observé. Parmi les souches bactériennes évaluées, sept (Alcaligenes piechaudii, Aquaspirillum autotrophicum, Cellulomonas fimi, Pseudomonas chlororaphis, Pseudomonas putida (souches 94-19 et E-30) et Streptomyces griseus) ont produit dans le milieu gélosé des métabolites inhibant la croissance mycélienne et/ou la germination des conidies de H. solani. Les métabolites produits en culture pure et en culture mixte ont présenté une activité différente sur la croissance mycélienne de H. solani. Les résultats présentés indiquent que la méthodologie employée peut être un facteur déterminant dans l'identification de l'antibiose comme mode d'action d'un agent antagoniste

Dietary Mediators of the Genetic Susceptibility to Obesity—Results from the Quebec Family Study

BACKGROUND: Recent studies showed that eating behaviors such as disinhibition, emotional and external eating, and snacking mediate genetic susceptibility to obesity. It remains unknown if diet quality and intake of specific food groups also mediate the genetic susceptibility to obesity. OBJECTIVE: This study aimed to assess if diet quality and intakes of specific food groups mediate the association between a polygenic risk score (PRS) for BMI and BMI and waist circumference (WC). We hypothesized that poor diet quality, high intakes of energy-dense food groups, and low intakes of nutrient-dense food groups mediate the genetic susceptibility to obesity. METHODS: This cross-sectional study included 750 participants (56.3% women, aged 41.5 ± 14.9 y, BMI 27.8 ± 7.5 kg/m2) from the Quebec Family Study. A PRSBMI based on >500,000 genetic variants was calculated using LDpred2. Dietary intakes were assessed with a 3-d food record from which a diet quality score (i.e. Nutrient Rich Food Index 6.3) and food groups were derived. Mediation analyses were conducted using a regression-based and bootstrapping approach. RESULTS: The PRSBMI explained 25.7% and 19.8% of the variance in BMI and WC, respectively. The association between PRSBMI and BMI was partly mediated by poor diet quality (β = 0.33 ± 0.12; 95% CI: 0.13, 0.60), high intakes of fat and high-fat foods (β = 0.46 ± 0.16; 95% CI: 0.19, 0.79) and sugar-sweetened beverages (β = 0.25 ± 0.14; 95% CI: 0.05, 0.60), and low intakes of vegetables (β = 0.15 ± 0.08; 95% CI: 0.03, 0.32), fruits (β = 0.37 ± 0.12; 95% CI: 0.17, 0.64), and dairy products (β = 0.17 ± 0.09; 95% CI: 0.02, 0.37). The same trends were observed for WC. CONCLUSIONS: The genetic susceptibility to obesity was partly mediated by poor diet quality and intakes of specific food groups. These results suggest that improvement in diet quality may reduce obesity risk among individuals with high genetic susceptibility and emphasize the need to intervene on diet quality among these individuals

On Passion and Sports Fans:A Look at Football

The purpose of the present research was to test the applicability of the Dualistic Model of Passion (Vallerand et al., 2003) to being a sport (football) fan. The model posits that passion is a strong inclination toward an activity that individuals like (or even love), that they value, and in which they invest time and energy. Furthermore, two types of passion are proposed: harmonious and obsessive passion. While obsessive passion entails an uncontrollable urge to engage in the passionate activity, harmonious passion entails a sense of volition while engaging in the activity. Finally, the model posits that harmonious passion leads to more adaptive outcomes than obsessive passion. Three studies provided support for this dualistic conceptualization of passion. Study 1 showed that harmonious passion was positively associated with adaptive behaviours (e.g., celebrate the team’s victory), while obsessive passion was rather positively associated with maladaptive behaviours (e.g., to risk losing one’s employment to go to the team’s game). Study 2 used a short Passion Scale and showed that harmonious passion was positively related to the positive affective life of fans during the 2006 FIFA World Cup, psychological health (self-esteem and life satisfaction), and public displays of adaptive behaviours (e.g., celebrating one’s team victory in the streets), while obsessive passion was predictive of maladaptive affective life (e.g., hating opposing team’s fans) and behaviours (e.g., mocking the opposing team’s fans). Finally, Study 3 examined the role of obsessive passion as a predictor of partner’s conflict that in turn undermined partner’s relationship satisfaction. Overall, the present results provided support for the Dualistic Model of Passion. The conceptual and applied implications of the findings are discussed

Reflections on the ethics of recruiting foreign-trained human resources for health

<p>Abstract</p> <p>Background</p> <p>Developed countries' gains in health human resources (HHR) from developing countries with significantly lower ratios of health workers have raised questions about the ethics or fairness of recruitment from such countries. By attracting and/or facilitating migration for foreign-trained HHR, notably those from poorer, less well-resourced nations, recruitment practices and policies may be compromising the ability of developing countries to meet the health care needs of their own populations. Little is known, however, about actual recruitment practices. In this study we focus on Canada (a country with a long reliance on internationally trained HHR) and recruiters working for Canadian health authorities.</p> <p>Methods</p> <p>We conducted interviews with health human resources recruiters employed by Canadian health authorities to describe their recruitment practices and perspectives and to determine whether and how they reflect ethical considerations.</p> <p>Results and discussion</p> <p>We describe the methods that recruiters used to recruit foreign-trained health professionals and the systemic challenges and policies that form the working context for recruiters and recruits. HHR recruiters' reflections on the global flow of health workers from poorer to richer countries mirror much of the content of global-level discourse with regard to HHR recruitment. A predominant market discourse related to shortages of HHR outweighed discussions of human rights and ethical approaches to recruitment policy and action that consider global health impacts.</p> <p>Conclusions</p> <p>We suggest that the concept of corporate social responsibility may provide a useful approach at the local organizational level for developing policies on ethical recruitment. Such local policies and subsequent practices may inform public debate on the health equity implications of the HHR flows from poorer to richer countries inherent in the global health worker labour market, which in turn could influence political choices at all government and health system levels.</p

Birefringence analysis of multilayer leaky cladding optical fibre

We analyse a multilayer leaky cladding (MLC) fibre using the finite element method and study the effect of the MLC on the bending loss and birefringence of two types of structures: (i) a circular core large-mode-area structure and (ii) an elliptical-small-core structure. In a large-mode-area structure, we verify that the multilayer leaky cladding strongly discriminates against higher order modes to achieve single-mode operation, the fibre shows negligible birefringence, and the bending loss of the fibre is low for bending radii larger than 10 cm. In the elliptical-small-core structure we show that the MLC reduces the birefringence of the fibre. This prevents the structure from becoming birefringent in case of any departures from circular geometry. The study should be useful in the designs of MLC fibres for various applications including high power amplifiers, gain flattening of fibre amplifiers and dispersion compensation.Comment: 18 page