Willingness to Pay for Community Health Fund Card in Mtwara Rural District,Tanzania

\ud The Ministry of Health in Tanzania has established a new programme in the primary health care service. CHF is a district-level prepayment scheme targeted at the rural population.CHF starts in 1995 on a pilot basis in one district and in 2003 has to be implemented in all districts. Mtwara Rural District is in the implantation stage. This study was proposed for assisting the district in pricing the health service and developing recommendations for the process of CHF implementation. It is focused primarily on the willingness of the population to pay for a CHF card.Price is not the only factor related to willingness to join the CHF. Complex human behavior,choices and motivation can also determine it. The result of the survey have drawn up the demand curve and constructed the chart of expected revenues from CHF card. Next stage was estimating the health Facility costs in order to find out the amount of funds to be collected. The CHF card rates proposed are based in maximizing the population under the health care system and covering the HF costs. The questionnaire prepared for the survey includes a section to know the opinion of respondents about the quality of care provided by MoH health facilities. According to the data obtained, the study proposed to establish the Tanzania national drug programme(Indent System),before CHF. Indent System changes the drug supply system and might improve the health quality. Experiences in Africa countries are also reviewed. This section contents the constraints identifies in other studies about different systems of payment. Evidence demonstrates the dangers associated with charging clients at the point of use of health service. Almost invariably payment systems have the affect of dissuading the poor from ccessing this services. Exemption mechanisms attempting to mitigate this impact have not tended to work. The experiences suggests querying some issues about CHF. The study is addressed to two audiences , MRD and MSF. This factor made complex drawing up the document. It was prepared with a view to: Pricing the health care services ,Developing recommendations for the CHF implementation in MRD and Providing qualitative information about the side effects of payment systems in the health care sector.\u

Nanopaper-Based Organic Inkjet-Printed Diodes

AbstractThe rise of internet of things (IoTs) applications has led to the development of a new generation of light‐weight, flexible, and cost‐effective electronics. These devices and sensors have to be simultaneously easily replaceable and disposable while being environmentally sustainable. Thus, the introduction of new functionalized materials with mechanical flexibility that can be processed using large‐area and facile fabrication methods (as, for example, printing technologies) has become a matter of great interest in the scientific community. In this context, cellulose nanofibers (CNFs) are renewable, affordable, robust, and nontoxic materials that are rapidly emerging as components for eco‐friendly electronics. Their combination with conductive polymers (CPs) to obtain conductive nanopapers (CNPs) allows moving their functionality from just substrates to active components of the device. In this work, a route for the inkjet‐printing of organic diodes is outlined. The proposed strategy is based on the use of CNPs as both substrates and bottom electrodes onto which insulator and organic semiconducting layers are deposited to fabricate novel diode structures. Remarkable rectification ratios of up to 1.2 × 103 at |3 V| and a current density up to 5.1 µA cm−2 are achieved. As a proof‐of‐concept of the potentiality of the approach for versatile, low‐temperature, and disposable sensing applications, an NO2 gas sensor is presented

Adenosine A2A Receptors and A2A Receptor Heteromers as Key Players in Striatal Function

A very significant density of adenosine A2A receptors (A2ARs) is present in the striatum, where they are preferentially localized postsynaptically in striatopallidal medium spiny neurons (MSNs). In this localization A2ARs establish reciprocal antagonistic interactions with dopamine D2 receptors (D2Rs). In one type of interaction, A2AR and D2R are forming heteromers and, by means of an allosteric interaction, A2AR counteracts D2R-mediated inhibitory modulation of the effects of NMDA receptor stimulation in the striatopallidal neuron. This interaction is probably mostly responsible for the locomotor depressant and activating effects of A2AR agonist and antagonists, respectively. The second type of interaction involves A2AR and D2R that do not form heteromers and takes place at the level of adenylyl cyclase (AC). Due to a strong tonic effect of endogenous dopamine on striatal D2R, this interaction keeps A2AR from signaling through AC. However, under conditions of dopamine depletion or with blockade of D2R, A2AR-mediated AC activation is unleashed with an increased gene expression and activity of the striatopallidal neuron and with a consequent motor depression. This interaction is probably the main mechanism responsible for the locomotor depression induced by D2R antagonists. Finally, striatal A2ARs are also localized presynaptically, in cortico-striatal glutamatergic terminals that contact the striato-nigral MSN. These presynaptic A2ARs heteromerize with A1 receptors (A1Rs) and their activation facilitates glutamate release. These three different types of A2ARs can be pharmacologically dissected by their ability to bind ligands with different affinity and can therefore provide selective targets for drug development in different basal ganglia disorders

Advances and Pitfalls of Specialized Pain Care through Public and Private Health Care Providers in Catalonia and the Balearic Islands: A Physician’s Survey

Optimal diagnosis and treatment of pain require a multidisciplinary approach that demands considerable coordination and forethought. A cross-sectional physician survey based on an online questionnaire was carried out to assess the adoption of multidisciplinary working patterns, compare the public and private models, and provide an update on the resources and organization of specialized pain care in Catalonia and the Balearic Islands. Active pain practitioners identified through the Catalan Health Service and Pain Society databases were sent an invitation in December 2020. Of the 321 physicians contacted, 91 (28.3%) answered and 71 provided complete responses (commonly anesthesiologists, representing 92 different sites; some worked at public and private sites). Up to 78.7% reported working in pain management teams, but only 53.5% were regularly involved in teaching or research activities. Thus, the proportion of multidisciplinary sites lies somewhere in-between. Median wait times were significantly shorter and within the recommended standards in private practices (e.g., 15 vs. 90 days in public practices for noncancer patients). In turn, private practices were slightly less staffed and equipped, albeit the differences did not reach statistical significance. Respondents made a median of 530 regular and 30 emergency visits per year, of which 190 involved interventional procedures. They offered a wide range of pharmacological and interventional therapies, although psychotherapy and the most sophisticated procedures were only available in <= 50% of sites. Pain clinicians and facilities are reasonably available in Catalonia, but barely more than half are truly multidisciplinary. Public and private practices differ in some aspects; the latter seems to be more accessible, but it is restricted to patients who can afford it. Compared to previous reports, this update shows both advances and outstanding issues. Multidisciplinary care could be expanded by incorporating more psychologists and some interventional procedures. The public practices should reduce wait times

Structural and mechanistic insights into the catalytic-domain-mediated short-range glycosylation preferences of GalNAc-T4

17 pags, 4 figs, 2 tabsMucin-type O-glycosylation is initiated by a family of polypeptide GalNAc-transferases (GalNAc-Ts) which are type-II transmembrane proteins that contain Golgi luminal catalytic and lectin domains that are connected by a flexible linker. Several GalNAc-Ts, including GalNAc-T4, show both long-range and short-range prior glycosylation specificity, governed by their lectin and catalytic domains, respectively. While the mechanism of the lectin-domain-dependent glycosylation is well-known, the molecular basis for the catalytic-domain-dependent glycosylation of glycopeptides is unclear. Herein, we report the crystal structure of GalNAc-T4 bound to the diglycopeptide GAT GAGAGAGT TPGPG (containing two α-GalNAc glycosylated Thr (T ), the PXP motif and a "naked" Thr acceptor site) that describes its catalytic domain glycopeptide GalNAc binding site. Kinetic studies of wild-type and GalNAc binding site mutant enzymes show the lectin domain GalNAc binding activity dominates over the catalytic domain GalNAc binding activity and that these activities can be independently eliminated. Surprisingly, a flexible loop protruding from the lectin domain was found essential for the optimal activity of the catalytic domain. This work provides the first structural basis for the short-range glycosylation preferences of a GalNAc-T.We thank synchrotron radiation sources DLS (Oxford) and in particular beamline I03 (experiment number MX10121-15). We thank ARAID, MEC (CTQ2013-44367-C2-2-P, BFU2016-75633-P, CTQ2015-67727-R, CTQ2015-70524-R, and CTQ2017-85496-P), AGAUR (SGR2017-1189), the National Institutes of Health (R01-GM113534, and instrument Grant GM113534-01S to T. A. Gerken), the Danish National Research Foundation (DNRF107), the FCT-Portugal [UID/Multi/04378/2013 cofinanced by the FEDER (POCI- 01-0145-FEDER-007728)], and the DGA (E34_R17) for financial support. I. Compañón thanks Universidad de La Rioja for the FPI grant. F. Marcelo thanks FCT-Portugal for IF Investigator grant (IF/00780/2015) and PTNMR supported by Project 022161. E. Lira-Navarrete acknowledges her postdoctoral EMBO fellowship ALTF 1553-2015 cofunded by the European Commission (LTFCOFUND2013, GA-2013-609409) and Marie Curie Actions. H. Coelho and J. Jiménez-Barbero thank EU for the TOLLerant project. The research leading to these results has also received funding from the FP7 (2007−2013) under BioStruct-X (Grant agreement 283570 and BIOSTRUCTX_5186). We would also like to acknowledge the assistance of Juwan Lee in obtaining the GalNAc-T4 random peptide motif

GOIA Abordatge de l'obesitat infantil a la comarca de l'Anoia: la nostra experiència

Obesitat infantil; Abordatge multidisciplinar; Sessions grupalsObesidad infantil; Abordaje multidisciplinar; Sesiones grupalesChildhood obesity; Multidisciplinary approach; Group sessionsDescripción de la creación del Grupo de Obesidad Infantil en la comarca del Anoia (GOIA), dirigido a los niños con sobrepeso, obesidad y a sus familias con la promoción de hábitos saludables y un tratamiento multidisciplinar y grupal. Los resultados iniciales se muestran poco efectivos. Proponemos nuevas estrategias y adaptación del plan de trabajo para poder conseguir los objetivos iniciales.Descripció de la creació del Grup d’Obesitat Infantil a la comarca de l’Anoia (GOIA), dirigit als nens amb sobrepès, obesitat i a les seves famílies amb la promoció d’hàbits saludables i un tractament multidisciplinari i grupal. Els resultats inicials es mostren poc efectius. Es proposen noves estratègies i adaptar del pla de treball per a poder aconseguir els objectius inicialsDescription of the creation of the Group of Childhood Obesity in the region of Anoia (GOIA), aimed at children with overweight, obesity and their families with the promotion of healthy habits and a multidisciplinary and group therapy, The initial results are ineffective. We propose new strategies and adaptation of the work plan to be able to achieve the initial objectives

Adenosine Receptor Heteromers and their Integrative Role in Striatal Function

By analyzing the functional role of adenosine receptor heteromers, we review a series of new concepts that should modify our classical views of neurotransmission in the central nervous system (CNS). Neurotransmitter receptors cannot be considered as single functional units anymore. Heteromerization of neurotransmitter receptors confers functional entities that possess different biochemical characteristics with respect to the individual components of the heteromer. Some of these characteristics can be used as a “biochemical fingerprint” to identify neurotransmitter receptor heteromers in the CNS. This is exemplified by changes in binding characteristics that are dependent on coactivation of the receptor units of different adenosine receptor heteromers. Neurotransmitter receptor heteromers can act as “processors” of computations that modulate cell signaling, sometimes critically involved in the control of pre- and postsynaptic neurotransmission. For instance, the adenosine A1-A2A receptor heteromer acts as a concentration-dependent switch that controls striatal glutamatergic neurotransmission. Neurotransmitter receptor heteromers play a particularly important integrative role in the “local module” (the minimal portion of one or more neurons and/or one or more glial cells that operates as an independent integrative unit), where they act as processors mediating computations that convey information from diverse volume-transmitted signals. For instance, the adenosine A2A-dopamine D2 receptor heteromers work as integrators of two different neurotransmitters in the striatal spine module

Mesures excepcionals d’optimització i alternatives als EPI en situació d’emergència de COVID-19

Equips de protecció individual; EPI; Mesures d'optimització; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoVEquipos de protección individual; EPI; Medidas de optimización; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoVPersonal protective equipment; EPI; Optimization measures; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoVEl propòsit del present document és facilitar les recomanacions més segures possibles relacionades amb l’optimització dels equips de protecció individual (EPI) en el present context de pandèmia per COVID-19 i per actuar davant de possibles desabastiments d’aquests equipaments