Coping with tuberculosis and directly observed treatment : a qualitative study among patients from South India

Background: In India, the Revised National TB control programme (RNTCP) offers free diagnosis and treatment for tuberculosis (TB), based on the Directly Observed Treatment Short course (DOTS) strategy. We conducted a qualitative study to explore the experience and consequences of having TB on patients enrolled in DOTS and their caretakers in Tumkur district, located in a southern state of India, Karnataka. Methods: We conducted 33 in-depth interviews on a purposive sample of TB patients from three groups: (1) patients who reached RNTCP directly on their own and took DOTS at RNTCP; (2) patients who were referred by private practitioners (PPs) to RNTCP and took DOTS at RNTCP; and (3) patients diagnosed by RNTCP and took DOTS from PPs. Data was analyzed using a thematic approach with the support of NVivo9. Results: The study revealed that TB and DOTS have a large impact on patient's lives, which is often extended to the family and caretakers. The most vulnerable patients faced the most difficulty in accessing and completing DOTS. The family was the main source of support during patient's recovery. Patients residing in rural areas and, taking DOTS from the government facilities had to overcome many barriers to adhere to the DOTS therapy, such as long travelling distance to DOTS centers, inconvenient timings and unfavorable attitude of the RNTCP staff, when compared to patients who took DOTS from PPs. Advantages of taking DOTS from PPs cited by the patients were privacy, flexibility in timings, proximity and more immediate access to care. Patients and their family had to cope with stigmatization and fear and financial hardships that surfaced from TB and DOTS. Young patients living in urban areas were more worried about stigmatisation, than elderly patients living in rural areas. Patients who were referred by PPs experienced more financial problems compared to those who reached RNTCP services directly. Conclusion: Our study provided useful information about patient's needs and expectations while taking DOTS. The development of mechanisms within RNTCP towards patient centered care is needed to enable patients and caretakers cope with disease condition and adhere to DOTS

Petrology of Matthew and Hunter volcanoes, South New Hebrides island arc (Southwest Pacific)

Matthew and Hunter, the two southernmost active volcanoes of the New Hebrides island arc (southwest Pacific) differ markedly from the other (mainly tholeitic) Quaternary volcanoes of this arc. Geodynamically related to the New Hebrides subduction zone, they also lie close to the southern limb of the active expanding ridge of the North Fiji Basin. Both volcanoes are made up of acid, medium-K, calcalkaline orogenic andesites, containing a variety of inclusions (pyroxene- and gabbroic cumulates, as well as doleritic cognate inclusions). This paper presents the first systematic petrographic and chemical study of these volcanics and their inclusions. Trace-element geochemistry and rare-earth element modelling suggest that the two volcanoes developed from successive batches of similar parental magmas, originating from limited partial fusion of garnet peridotite in the mantle wedge. Various degrees of fractional crystallization ot these batches led to the formation of three volcanic suites: Hunter (little fractionated), West-Matthew (moderately fractionated) and East-Matthew (highly fractionated). Moreover, on Matthew island, no correlation exists between the degree of fractionation and the eruptive chronology, the youngest edifice (West-Matthew) being less evolved than the older on (East-Matthew). (Résumé d'auteur

Insecticide treated curtains and residual insecticide treatment to control Aedes aegypti : an acceptability study in Santiago de Cuba

Background : Within the context of a field trial conducted by the Cuban vector control program (AaCP), we assessed acceptability of insecticide-treated curtains (ITCs) and residual insecticide treatment (RIT) with deltamethrin by the community. We also assessed the potential influence of interviewees' risk perceptions for getting dengue and disease severity. Methodology/principal findings : We embedded a qualitative study using in-depth interviews in a cluster randomized trial (CRT) testing the effectiveness of ITCs and RIT in Santiago de Cuba. In-depth interviews (N = 38) were conducted four and twelve months after deployment of the tools with people who accepted the tools, who stopped using them and who did not accept the tools. Data analysis was deductive. Main reasons for accepting ITCs at the start of the trial were perceived efficacy and not being harmful to health. Constraints linked to manufacturer instructions were the main reason for not using ITCs. People stopped using the ITCs due to perceived allergy, toxicity and low efficacy. Few heads of households refused RIT despite the noting reasons for rejection, such as allergy, health hazard and toxicity. Positive opinions of the vector control program influenced acceptability of both tools. However, frequent insecticide fogging as part of routine AaCP vector control actions diminished perceived efficacy of both tools and, therefore, acceptability. Fifty percent of interviewees did feel at risk for getting dengue and considered dengue a severe disease. However, this did not appear to influence acceptability of ITCs or RIT. Conclusion/significance : Acceptability of ITCs and RIT was linked to acceptability of AaCP routine vector control activities. However, uptake and use were not always an indication of acceptability. Factors leading to acceptability may be best identified using qualitative methods, but more research is needed on the concept of acceptability and its measurement

LU : La deuxième vie de l’entreprise par l’image

Affiche de l’exposition universelle. Collection familiale Pour suivre le patrimoine de l’entreprise familiale Lefèvre-Utile LU, le travail se fait indépendamment du groupe Danone, propriétaire aujourd’hui de la marque LU, mais en parfait accord avec ce dernier. Un certain nombre d’opérations ont été réalisées, en particulier une exposition complète des collections regroupant les collections et archives personnelles et les anciennes collections de l’entreprise. Elles ont été montrées au comple..

DTN based Management Framework for Green On/Off Networks

National audienceThe increasing cost of powering high performance networking infrastructure has led to the proposal of various energy saving schemes. The On/Off technique, being the most common energy saving scheme, consists of powering down partially or entirely a network infrastructure for energy saving purposes. Despite their capability to achieve great energy savings, On/Off networks experience high packet-loss rates due to the absence of reliability on packet delivery. Moreover, they cannot guarantee any response time to user applications. This paper presents the design and implementation of MFO2N; Experimental results show a correlation between offered quality of service and overall network power consumption, revealing that a trade-off should be made

Origin of sulphated grey crusts on glass in polluted urban atmosphere: stained glass Windows of Tours Cathedral (France)

The grey crusts covering some places of the weathered stained glass Windows of Tours Cathedral were studied by Analytical Scanning Electron Microscopy These crusts are constituted by a gypsum cement embedding many particles: microspherules (fly ash generated by combustion processes, rounded particles of leached glass, hypersiliceous spherules from tuffeau stone); angular fragments of leached glass; organic objects; siliceous and sulphated aggregates. The particles contained in the sulphated black crusts covering the stone, in the air and in the rain in Tours were studied simultaneously and compared with those of the stained glass Windows' grey crusts. In all cases, similar kinds of fly ash are present demonstrating the action of atmospheric microparticulate pollution both on the stained glass Windows and on the stone. Furthermore, the presence of hypersiliceous particles in crusts on glass and in the rain suggests transfers from stone to glass by rainwater run-off and possibly directly from the atmosphere. The presence of leached glass in the sulphated crusts on glass leads also to conclude on the modifying of the glass surface by the action of the rainwater run-off. Moreover, calcium and sulphur needed to form superficial gypsum crusts come both from the nearby calcareous stone, from the atmospheric gases and particles, and probably partially from calcium contained in unweathered glass

To the bone : comment on 'I wanted a skeleton … they brought a prince' : a qualitative investigation of factors mediating the implementation of a performance based incentive program in Malawi

Recently, McMahon and colleagues set out to build on a widely-used fidelity framework, assessing the role of moderating factors during the implementation of performance-based financing programs in Malawi. Their attempt draws again the attention to the importance of approaching real word implementation issues from a theoretical perspective. It also highlights the importance of fidelity assessment within process evaluation of health programs. In this comment we argue that theoretical developments in the field of implementation science in global health would benefit from an accurate understanding of existing conceptual frameworks as well as from taking into account all contemporary contributions

Le développement comme arène : implications pour l'évaluation des projets

IntroductionCet article a pour objectif d'explorer les conséquences que les analyses de projets ou programmes de développement, effectuées en termes d'acteurs, peuvent avoir sur l'évaluation des interventions et, particulièrement, sur le développement de méthodes d'évaluation de type participatives. Nous nous situons donc résolument à l'interface entre une anthropologie du développement fondamentale et la mise en œuvre concrète d'actions de développement Nous nous limiterons cependant à ce q..

Le développement comme arène : implications pour l'évaluation des projets

IntroductionCet article a pour objectif d'explorer les conséquences que les analyses de projets ou programmes de développement, effectuées en termes d'acteurs, peuvent avoir sur l'évaluation des interventions et, particulièrement, sur le développement de méthodes d'évaluation de type participatives. Nous nous situons donc résolument à l'interface entre une anthropologie du développement fondamentale et la mise en œuvre concrète d'actions de développement Nous nous limiterons cependant à ce q..