Barriers to prompt and effective treatment of malaria in northern Sri Lanka.

BACKGROUND: For the past 18 years, northern Sri Lanka has been affected by armed ethnic conflict. This has had a heavy impact on displacement of civilians, health delivery services, number of health professionals in the area and infrastructure. The north of Sri Lanka has a severe malaria burden, with less than 5% of the national population suffering 34% of reported cases. Health care providers investigated treatment-seeking behaviour and levels of treatment failure believed to be the result of lack of adherence to treatment. METHODS: Pre- and post-treatment interviews with patients seeking treatment in the outpatient department (OPD) and focus groups. RESULTS: A total of 271 persons completed interviews: 54.4% sought treatment within 2 days of the onset of symptoms, and 91.9% self-treated with drugs with prior to seeking treatment, mainly with paracetamol. Self-treatment was associated with delaying treatment (RR 3.55, CI 1.23-10.24, P=0.002). In post-treatment interviews, self-reported default was 26.1%. The main reasons for not taking the entire regimen were side-effects (57.6%) and disappearance of symptoms (16.7%). Focus groups indicated some lack of confidence in chloroquine treatment and prophylaxis, and scant enthusiasm for prevention methods. CONCLUSIONS: A number of factors contribute to a lack of access and a lower quality of care for malaria: lack of medical staff and facilities because of the fighting; lack of confidence in treatment, and perception of malaria as a routine illness. Prevention efforts need to take into account certain beliefs and practices to be successful

Expression Patterns of BDNF with Central Anorexigenic Signaling Pathways Involving PACAP in the Hypothalamic Ventromedial Nuclei

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a 38-amino acid polypeptide belonging to the secretin super family of peptides. PACAP binds to its type 1 receptor (PAC1R) with greater affinity than for the receptors for vasoactive intestinal polypeptides (VIP), VPAC1 and VPAC2. Although mRNA for PACAP and its receptor PAC1R are found throughout the central nervous system, they are abundantly expressed in the hypothalamic ventromedial nuclei (VMN). In male Sprague Dawley rats, infusions of PACAP into the VMN produce a robust decrease in food intake with concomitant increased energy expenditure, decreased body weight, and significantly elevated brain-derived neurotrophic factor (BDNF) mRNA expression in the VMN. This latter effect of PACAP on BDNF mRNA expression has been shown to occur in other brain regions. Exogenous BDNF in the VMN regulates energy homeostasis in a manner similar to that of PACAP with decreased feeding and increased metabolism. Although the physiological responses to individual PACAP and BDNF infusions in the VMN lead to decreased feeding behavior and body weight loss, the anatomical distribution of these two cell signals in the VMN has not been established. PACAP-induced changes in BDNF mRNA expression in the VMN may reveal an important interaction with PACAP signaling in the control of feeding behavior. In the present study, we have employed double-labeled fluorescent in-situ hybridization (FISH) to examine the expression patterns of PACAP, PAC1R and BDNF mRNA containing neuronal cells. In the VMN, PACAP mRNA expressing cells co-express BDNF, PAC1R, and VGLUT2. BDNF mRNA expressing cells co-express PAC1R and PACAP. Coupled with previous behavioral data demonstrating PACAP- and BDNF-induced changes in feeding behavior, the co-expression of BDNF with PACAP and PAC1R mRNA in the VMN suggest a potential functional relationship between the two signaling peptides in the regulation of energy homeostasis. The specific and integrated contributions of PACAP and BDNF in the VMN towards regulating energy homeostasis and feeding behavior still remain to be studied

Multilevel modeling of undergraduate student attrition across the University of North Carolina system

The volume of articles, books, and studies about increasing the retention, persistence, and graduation of undergraduate college students is nothing short of prolific (Seidman, 2005). However, only modest gains in undergraduate graduation rates have been made nationally (Chen, 2012; Seidman, 2005). Six-year graduation rates at all four-year colleges and universities rose minimally from 54.4% for the entering cohort of 1996 to 54.9% for the cohort beginning fourteen years later (U.S. Department of Education, 2019) with 35% of institutions experiencing declines in graduation rates during part of this period (Brainard & Fuller, 2010). Persistently low graduation rates coupled with recent leaps forward in technology, including processing speeds, statistical software, and data warehousing, have led many higher education researchers, practitioners, and companies to apply statistical models to examine what variables have a relationship with graduation. Many multi-university models suffer from a variety of hurdles including large amounts of missing data, missing important variables, questionable data quality and lack of common definitions across colleges or universities, and/ or inappropriate statistical methods that do not account for the nested nature of the data (students within universities). This study sought to avoid many of the limitations of past studies and used a two-level logistic hierarchical generalized linear model to comprehensively model six-year graduation in the UNC System. Included in this study were 406,909 undergraduate students who began undergraduate degree-seeking enrollment in any of the 16 public universities in the state of North Carolina from 2000 until 2010. Each variable included in the model was selected based on evidence in the literature of significant relationships with retention and persistence found in regression-based models. In comparison to past literature, this study included a wider array of financial and financial aid-related variables and examined more closely the relationship between university characteristics and student characteristics. Most level-1, student, variables included in this study were significant. The level-2, university, characteristics residential status and selectivity were found to have a significant relationship with six-year graduation and to have an influence on the relationship between some of the student-level covariates and six-year graduation. The results confirmed many of the relationships in the literature between the variables studied and student attrition with some fascinating deviations explored in the discussion. Limitations and suggestions for future research are provided. The results of this study will equip university practitioners and policy-makers in North Carolina with information to improve graduation and further explore student attrition. This study can act as a model for how other states or higher education systems use their own administrative data for comprehensive, multi-institutional modeling

A New Obesity Model Reveals the Hypophagic Properties of PACAP Involve the Regulation of Homeostatic Feeding in the Ventromedial Hypothalamic Nucleus and Hedonic Feeding in the Nucleus Accumbens

Binge eating in humans is a complex disorder that often involves discrete, compulsive feeding sessions of highly palatable foods even in the absence of a deprivation state or hunger. Binging can be effectively modeled in rodents by providing subjects with limited access to a palatable food source (Western Diet; WD) as an adjunct to ad lib access to normal chow (Standard Chow; SC). Although this design recapitulates several fundamental characteristics observed in binge eating disorder, the binge eating observed in this paradigm is likely a product of both hedonic and homeostatic drives with the need to balance energy stores still present. To isolate these feeding drives, we have developed a novel feeding regimen that modifies the classic limited access binge model to effectively delineate and separate homeostatic feeding from motivational feeding. This is achieved by entraining male Sprague-Dawley rats to a restricted feeding schedule (two hours per day) of SC followed by a short 15 minute limited access meal of either SC or WD (Restrict Fed-Limited Access; RFLA). The RFLA paradigm allows for the examination of pituitary adenylate-cyclase activating polypeptide (PACAP) on palatable food consumption in a fully satiated subject. PACAP has previously been shown to suppress feeding behavior when injected into the hypothalamus. In the current study, PACAP injected into the ventromedial hypothalamic nuclei (VMN) suppressed the two hour homeostatic SC meal, but not the subsequent 15 minute limited access meal of WD. By contrast, PACAP bilaterally administered into the nucleus accumbens (NAc) produced the opposite effect with PACAP suppressing the consumption of WD but not SC. Thus, PACAP mediated signaling in the VMN appears to be involved in homeostatic regulation of energy stores, whereas PACAP signaling in the NAc regulates feeding driven by palatability or hedonic qualities

Beewild' bundleflower, a new summer-growing perennial legume for central and south Texas and Mexico

Last updated: 10/19/201

The genetic basis for panicle trait variation in switchgrass (Panicum virgatum)

Key message: We investigate the genetic basis of panicle architecture in switchgrass in two mapping populations across a latitudinal gradient, and find many stable, repeatable genetic effects and limited genetic interactions with the environment. Abstract: Grass species exhibit large diversity in panicle architecture influenced by genes, the environment, and their interaction. The genetic study of panicle architecture in perennial grasses is limited. In this study, we evaluate the genetic basis of panicle architecture including panicle length, primary branching number, and secondary branching number in an outcrossed switchgrass QTL population grown across ten field sites in the central USA through multi-environment mixed QTL analysis. We also evaluate genetic effects in a diversity panel of switchgrass grown at three of the ten field sites using genome-wide association (GWAS) and multivariate adaptive shrinkage. Furthermore, we search for candidate genes underlying panicle traits in both of these independent mapping populations. Overall, 18 QTL were detected in the QTL mapping population for the three panicle traits, and 146 unlinked genomic regions in the diversity panel affected one or more panicle trait. Twelve of the QTL exhibited consistent effects (i.e., no QTL by environment interactions or no QTL × E), and most (four of six) of the effects with QTL × E exhibited site-specific effects. Most (59.3%) significant partially linked diversity panel SNPs had significant effects in all panicle traits and all field sites and showed pervasive pleiotropy and limited environment interactions. Panicle QTL co-localized with significant SNPs found using GWAS, providing additional power to distinguish between true and false associations in the diversity panel

Attitudes and Performance: An Analysis of Russian Workers

This paper investigates the relationship between locus of control and performance among Russian employees, using survey data collected at 28 workplaces in 2002 in Taganrog and at 47 workplaces in 2003 in Ekaterinburg. We develop a measure that allows us to categorize the Russian employees participating in our survey as exhibiting an internal or external locus of control. We then assess the extent to which there are significant differences between “internals” and “externals” in work-related attitudes that may affect performance. In particular, we focus on (1) attitudes about outcomes associated with hard work, (2) level of job satisfaction, (3) expectation of receiving a desired reward, and (4) loyalty to and involvement with one’s organization. In each case we identify where gender and generational differences emerge. Our main objective is to determine whether Russian employees who exhibit an internal locus of control perform better than employees with an external locus of control. Our performance measures include earnings, expected promotions, and assessments of the quantity and quality of work in comparison to others at the same organization doing a similar job. Controlling for a variety of worker characteristics, we find that (1) individuals who exhibit an internal locus of control perform better, but this result is not always statistically significant; (2) even among “internals,” women earn significantly less than men and have a much lower expectation of promotion; (3) even among “internals,” experience with unemployment has a negative influence on performance.http://deepblue.lib.umich.edu/bitstream/2027.42/40144/3/wp758.pd

Lay beliefs of TB and TB/HIV co-infection in Addis Ababa, Ethiopia: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Knowledge about lay beliefs of etiology, transmission and treatment of TB, and lay perceptions of the relationship between TB and HIV is important for understanding patients' health seeking behavior and adherence to treatment. We conducted a study to explore lay beliefs about TB and TB/HIV co-infection in Addis Ababa, Ethiopia.</p> <p>Findings</p> <p>We conducted a qualitative study using in-depth interviews with 15 TB/HIV co-infected patients and 9 health professionals and focus group discussions with 14 co-infected patients in Addis-Ababa, Ethiopia. We found that a predominant lay belief was that TB was caused by exposure to cold. Excessive sun exposure, exposure to mud, smoking, alcohol, khat and inadequate food intake were also reported as causes for TB. Such beliefs initially led to self-treatment. The majority of patients were aware of an association between TB and HIV. Some reported that TB could transform into HIV, while others said that the body could be weakened by HIV and become more susceptible to illnesses such as TB. Some patients classified TB as either HIV-related or non-HIV-related, and weight loss was a hallmark for HIV-related TB. The majority of patients believed that people in the community knew that there was an association between TB and HIV, and some feared that this would predispose them to HIV-related stigma.</p> <p>Conclusion</p> <p>There is a need for culturally sensitive information and educational efforts to address misperceptions about TB and HIV. Health professionals should provide information about causes and treatment of TB and HIV to co-infected patients.</p