Physicians’ compliance with malaria treatment guidelines of under-five children in a secondary maternal and child care centre in Lagos State

Background: The global malaria agenda has the ultimate goal of eliminating malaria in all countries of the world by 2030 through universal access to malaria prevention, diagnosis and treatment. Presumptive treatment of malaria with Artemisinin Combination Therapy (ACT) has been associated with the development of resistance, therefore parasitological confirmation of all fevers is crucial in the context of eliminating malaria. This study assessed physicians’ compliance with the national guidelines in the treatment of malaria among under-five (U-5) children and their prescription pattern in a Maternal and Child Care (MCC) centre in Lagos State.Methods: This was a descriptive cross-sectional study conducted as an exit interview among 427 mothers/caregivers of febrile U-5 children who were consecutively sampled.The data was collected using a pre-tested interviewer-administered questionnaire and a proforma. Epi-info version 7.2.1 was used to analyze the data and the level of significance was set as p<0.05.Results: Malaria Rapid Diagnostic Test (mRDT) was done for 75 17.6%) of the children and 37 (49.3%) was positive. Anti-malarial drugs were prescribed at consultation to 400 (93.7%) of the febrile children. Artemisinin Combination Therapy (ACT) was prescribed for 364 (91.0%) of the children. The most prescribed ACT was Artemether-Lumefantrine (AL) in 222 (60.9%).Conclusion: The physician’s compliance with malaria treatment guidelines for febrile illnesses in U-5 children was poor with regards to parasitological confirmation before treatment. However, the use of ACTs was adhered to in almost all cases. Regular training workshops are recommended for health workers to improve adherence to parasitological confirmation before treatment.Keywords: Malaria, Under-fives, Compliance, mRDT, ACTs, Guideline

Brazilian Think Tanks and the Rise of Austerity Discourse

This article discusses the role of think tanks in the production of ideas guiding recent change in Brazil’s economic policy. It claims that think tanks are significant policy-making agents preparing the society for change – via their communicative discourse – but also attempting to influence the interaction between political elites – via their coordinative discourse. The polarization of think tanks’ communicative discourse in regard to austerity during two critical junctures for Brazil is analysed. Discursive institutionalism is applied in order to interpret data from four Brazilian think tanks: the Institute of Applied Economic Research, the Inter-Union Department of Statistics and Socioeconomic Studies, the Fernand Braudel Institute and the Brazilian Institute of Economy. These think tanks have very different organizational and ideological characteristics but a polarization of the discussion around austerity can be observed in the discourse of all four of them. The scale ranges from an active defence of the Brazilian development model to a full-scale endorsement of austerity

Pemberian Hidrolisat Protein Kacang Polong Terhadap Kadar Superoksida Dismutase dan Perbaikan Kerusakan Ginjal Tikus Laboratorium

Antioksidan merupakan substansi yang dapat mencegah kerusakan sel akibat stres oksidatif. Hidrolisat protein dari kacang polong hijau (Pisum sativum) dengan bromelain (HPPHB) diharapkan meningkatkan kadar antioksidan superoxide dismutase (SOD) dan mampu mencegah kerusakan ginjal. Tujuan penelitian adalah mengetahui pengaruh HPPHB terhadap kadar SOD, kadar kreatinin plasma dan histopatologis ginjal tikus yang diinduksi Cisplatin. Penelitian dilakukan dalam dua tahap, pemberian HPPHB dosis 100, 200 dan 400 mg/kgBB/h selama 28 hari terhadap kadar SOD tikus jantan dan betina Sprague Dawley (SD) tanpa induksi dan tikus yang diinduksi Cisplatin dengan parameter kadar kreatinin plasma dan histopatologis ginjal dengan pewarnaan Hematoksilin Eosin (HE). Hasil menunjukkan kadar SOD kelompok tikus kontrol berbeda bermakna dan sangat bermakna dengan kelompok perlakuan. Hasil pemeriksaan kreatinin plasma menunjukkan terdapat perbedaan yang sangat bermakna (p<0,01) antara kontrol positip dengan kelompok dosis 400 mg/kgBB. Hasil analisis mikroskopis histopatologis parameter nekrosis: kelompok perlakuan dosis 200 menunjukkan paling sedikit nekrosis di antara ke tiga dosis,  berbeda signifikan dengan kontrol positip, maupun kontrol negatip (p<0,05). Parameter densitas sel mesangium, semua kelompok dosis perlakuan tidak berbeda signifikan dengan kontrol negatip maupun kontrol positip. Simpulan, HPPHB meningkatkan kadar SOD dan menunjukkan efek perbaikan kadar kreatinin plasma dan nekrosis sel tubulus ginjal tikus SD yang diinduksi Cisplatin.Antioksidan merupakan substansi yang dapat mencegah kerusakan sel akibat stres oksidatif. Hidrolisat protein dari kacang polong hijau (Pisum sativum) dengan bromelain (HPPHB) diharapkan meningkatkan kadar antioksidan superoxide dismutase (SOD) dan mampu mencegah kerusakan ginjal. Tujuan penelitian adalah mengetahui pengaruh HPPHB terhadap kadar SOD, kadar kreatinin plasma dan histopatologis ginjal tikus yang diinduksi Cisplatin. Penelitian dilakukan dalam dua tahap, pemberian HPPHB dosis 100, 200 dan 400 mg/kgBB/h selama 28 hari terhadap kadar SOD tikus jantan dan betina Sprague Dawley (SD) tanpa induksi dan tikus yang diinduksi Cisplatin dengan parameter kadar kreatinin plasma dan histopatologis ginjal dengan pewarnaan Hematoksilin Eosin (HE). Hasil menunjukkan kadar SOD kelompok tikus kontrol berbeda bermakna dan sangat bermakna dengan kelompok perlakuan. Hasil pemeriksaan kreatinin plasma menunjukkan terdapat perbedaan yang sangat bermakna (p<0,01) antara kontrol positip dengan kelompok dosis 400 mg/kgBB. Hasil analisis mikroskopis histopatologis parameter nekrosis: kelompok perlakuan dosis 200 menunjukkan paling sedikit nekrosis di antara ke tiga dosis,  berbeda signifikan dengan kontrol positip, maupun kontrol negatip (p<0,05). Parameter densitas sel mesangium, semua kelompok dosis perlakuan tidak berbeda signifikan dengan kontrol negatip maupun kontrol positip. Simpulan, HPPHB meningkatkan kadar SOD dan menunjukkan efek perbaikan kadar kreatinin plasma dan nekrosis sel tubulus ginjal tikus SD yang diinduksi Cisplatin

Ekstrak Kedelai Detam 1, Daun Jati Belanda Serta Kombinasinya Terhadap Berat Badan Dan Histopatologis Hepar Tikus Wistar

Latar Belakang Biji kedelai Detam 1 dan daun jati Belanda berefek menghambat kenaikan berat badan, akan tetapi dikhawatirkan mempengaruhi organ hepar. Tujuan penelitian Tujuan penelitian untuk mengetahui efek ekstrak etanol biji kedelai Detam 1 (EEKD), ekstrak etanol daun jati Belanda (EEJB) dan kombinasinya terhadap penghambatan kenaikan berat badan dan gambaran histopatologis hepar pada tikus Wistar yang diberi pakan tinggi lemak (PTL). Metode penelitian Penelitian merupakan eksperimental laboratorium dengan rancangan acak lengkap bersifat komparatif. Sebanyak 40 ekor tikus Wistar jantan dibagi secara acak menjadi 8 kelompok perlakuan, masing masing terdiri dari 5 ekor. Selanjutnya diberi perlakuan selama 28 hari, semua kelompok kecuali kelompok kontrol negatif (KN), tetap diberi PTL. Pada hari ke-29, seluruh tikus dikorbankan dan semua hepar tikus, kecuali kelompok Orlistat (K6), dibuat sediaan histopatologis dengan pewarnaan Haematoxylin Eosin (HE). Hasil Penghambatan kenaikan berat badan terjadi pada semua kelompok perlakuan, kelompok K3 (EEKD 10 mg : EEJB 20 mg) menunjukkan penghambatan kenaikan berat badan yang paling baik dan potensinya setara dengan kontrol positip (KP) atau Orlistat. Pada semua kelompok perlakuan (K1, K2, K3, K4 dan K5) terjadi Perubahan struktur arsitektur dan inflamasi di daerah portal namun tidak menyebabkan bengkak keruh dan degenerasi lemak. Kesimpulan: Pemberian kombinasi EEKD 10 mg : EEJB 20 mg menunjukkan penghambatan kenaikan berat badan yang paling baik. EEJB sediaan tunggal menyebabkan Perubahan gambaran histopatologis hepar paling buruk pada tikus Wistar jantan yang diinduksi pakan tinggi lemak

The divergent DSL ligand Dll3 does not activate Notch signaling but cell autonomously attenuates signaling induced by other DSL ligands

Mutations in the DSL (Delta, Serrate, Lag2) Notch (N) ligand Delta-like (Dll) 3 cause skeletal abnormalities in spondylocostal dysostosis, which is consistent with a critical role for N signaling during somitogenesis. Understanding how Dll3 functions is complicated by reports that DSL ligands both activate and inhibit N signaling. In contrast to other DSL ligands, we show that Dll3 does not activate N signaling in multiple assays. Consistent with these findings, Dll3 does not bind to cells expressing any of the four N receptors, and N1 does not bind Dll3-expressing cells. However, in a cell-autonomous manner, Dll3 suppressed N signaling, as was found for other DSL ligands. Therefore, Dll3 functions not as an activator as previously reported but rather as a dedicated inhibitor of N signaling. As an N antagonist, Dll3 promoted Xenopus laevis neurogenesis and inhibited glial differentiation of mouse neural progenitors. Finally, together with the modulator lunatic fringe, Dll3 altered N signaling levels that were induced by other DSL ligands

The impact of negative selection on thymocyte migration in the medulla

Developing thymocytes are screened for self-reactivity before they exit the thymus, but how thymocytes scan the medulla for self antigens is unclear. Using two-photon microscopy, we observed that medullary thymocytes migrated rapidly and made frequent, transient contacts with dendritic cells. In the presence of a negative selecting ligand, thymocytes slowed, became confined to areas of approximately 30 mum in diameter and had increased contact with dendritic cells surrounding confinement zones. One third of polyclonal medullary thymocytes also showed confined, slower migration and may correspond to autoreactive thymocytes. Our data suggest that many autoreactive thymocytes do not undergo immediate arrest and death after encountering a negative selecting ligand but instead adopt an altered migration program while remaining in the medullary microenvironment

Global public policy, transnational policy communities, and their networks

Public policy has been a prisoner of the word "state." Yet, the state is reconfigured by globalization. Through "global public–private partnerships" and "transnational executive networks," new forms of authority are emerging through global and regional policy processes that coexist alongside nation-state policy processes. Accordingly, this article asks what is "global public policy"? The first part of the article identifies new public spaces where global policies occur. These spaces are multiple in character and variety and will be collectively referred to as the "global agora." The second section adapts the conventional policy cycle heuristic by conceptually stretching it to the global and regional levels to reveal the higher degree of pluralization of actors and multiple-authority structures than is the case at national levels. The third section asks: who is involved in the delivery of global public policy? The focus is on transnational policy communities. The global agora is a public space of policymaking and administration, although it is one where authority is more diffuse, decision making is dispersed and sovereignty muddled. Trapped by methodological nationalism and an intellectual agoraphobia of globalization, public policy scholars have yet to examine fully global policy processes and new managerial modes of transnational public administration

Regulation of thymocyte positive selection and motility by GIT2

Thymocytes are highly motile cells that migrate under the influence of chemokines in distinct thymic compartments as they mature. The motility of thymocytes is tightly regulated; however, the molecular mechanisms that control thymocyte motility are not well understood. Here we report that G protein–coupled receptor kinase-interactor 2 (GIT2) was required for efficient positive selection. Notably, Git2−/− double-positive thymocytes showed greater activation of the small GTPase Rac, actin polymerization and migration toward the chemokines CXCL12 (SDF-1) and CCL25 in vitro. By two-photon laser-scanning microscopy, we found that the scanning activity of Git2−/− thymocytes was compromised in the thymic cortex, which suggests GIT2 has a key role in regulating the chemokine-mediated motility of double-positive thymocytes.National Institutes of Health (U.S.) (R01AI064227)Leukemia & Lymphoma Society of Americ

The Critical Juncture Concept’s Evolving Capacity to Explain Policy Change

This article examines the evolution of our understanding of the critical junctures concept. The concept finds its origins in historical intuitionalism, being employed in the context of path dependence to account for sudden and jarring institutional or policy changes. We argue that the concept and the literature surrounding it—now incorporating ideas, discourse, and agency—have gradually become more comprehensive and nuanced as historical institutionalism was followed by ideational historical institutionalism and constructivist and discursive institutionalism. The prime position of contingency has been supplanted by the role of ideas and agency in explaining critical junctures and other instances of less than transformative change. Consequently, the concept is now capable of providing more comprehensive explanations for policy change