243 research outputs found
A review: Autodissemination of Pyriproxyfen as novel strategy to control dengue outbreaks
The new emergence and re-emergence of arbovirus infections transmitted by Aedes mosquitoes have been spreading across Southeast Asia, Central Africa, United States, tropical Oceania and has become a major of public health concern. These arbovirus diseases were found to have a similar vector, symptoms and environments. The situation is complex due to no specific vaccine or treatments being available for the diseases. Therefore, vector control is currently the best defense against arbovirus diseases, but with its own challenges such as the difficulty in controlling scattered breeding sites and biological behavior. Herein, we present a literature review of studies on current techniques proposed to combat dengue transmission that can fill a crucial gap in vector control programs, which is the inability of conventional control methods to eliminate and destroy cryptic breeding sites. In particular, we focused on the concept of autodissemination, which is a self-delivery technique by manipulating the behavior of mosquitoes, carrying the insecticide and disseminating it to cryptic breeding sites. This technique has shown promising results in some countries and can be considered as an additional tool in a vector control program. Therefore, we conducted Boolean searches in several electronic databases including Google Scholar, PubMed, SciELO and ScienceDirect to identify relevant published data regarding dengue and autodissemination techniques
Activation and discovery of earth-abundant metal catalysts using sodium tert-butoxide
First-row, earth-abundant metals offer an inexpensive and sustainable alternative to precious-metal catalysts. As such, iron and cobalt catalysts have garnered interest as replacements for alkene and alkyne hydrofunctionalization reactions. However, these have required the use of air- and moisture-sensitive catalysts and reagents, limiting both adoption by the non-expert as well as applicability, particularly in industrial settings. Here, we report a simple method for the use of earth-abundant metal catalysts by general activation with sodium tert-butoxide. Using only robust air- and moisture-stable reagents and pre-catalysts, both known and, significantly, novel catalytic activities have been successfully achieved, covering hydrosilylation, hydroboration, hydrovinylation, hydrogenation and [2π+2π] alkene cycloaddition. This activation method allows for the easy use of earth-abundant metals, including iron, cobalt, nickel and manganese, and represents a generic platform for the discovery and application of non-precious metal catalysis
Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: A qualitative study
This article is made available through the Brunel Open Access Publishing Fund - Copyright @ 2011 Barnett et al.Background: Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods: A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results: Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions: A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly.This research was supported financially by the Multidisciplinary Assessment of
Technology Centre for Healthcare (MATCH)
Internet-based medical education: a realist review of what works, for whom and in what circumstances
http://creativecommons.org/licenses/by/2.0
Evaluating the potential of pyriproxyfen dissemination using mosquito home system against Aedes albopictus at dengue hotspot area
Aedes mosquitoes were found to lay their eggs in the cryptic breeding sites. Eliminating cryptic and open breeding sites is essential in reducing dengue virus transmission. However, it is often challenging for health officers to assess these breeding sites which are usually missed during larval surveillance. The autodissemination approach may produce a better outcome by manipulating female mosquitoes to disperse insecticide to other Aedes spp. mosquito habitats. Thus, the present study aims to evaluate the effectiveness of the pyriproxyfen autodissemination technique using Mosquito Home System against the population of mosquitoes. This study was conducted in Bandar Baru Bangi, Selangor, Malaysia. The Mosquito Home System was deployed to control Aedes spp. populations at treatment sites using before-after-control-impact (BACI) design. The presence of pyriproxyfen distribution was confirmed using the WHO larval bioassay which resulted in 10-35% larvae mortalities. Autodissemination of pyriproxyfen significantly reduced the population size of mosquito eggs (p<0.05), larvae (p<0.05), and ovitrap index (p<0.05) at the treatment areas compared to the control areas. Moreover, rainfall was correlated positively against ovitrap index (r = 0.247), larvae (r = 0.420) and eggs (r = 0.422). The study provides promising results for controlling Aedes spp. populations and also highlights the potentials of this technique as an alternative in vector control programmes. However, further studies on larger scale field trials are warranted
Risk perceptions starting to shift? U.S. citizens are forming opinions about nanotechnology
This article presents early results from an opinion formation study based on a 76-member panel of U.S. citizens, with comparison data from a group of 177 nanotechnology experts. While initially similar to the expert group in terms of their perceptions of the risks, benefits, and need for regulation characterizing several forms of nanotechnology, the first follow-up survey indicates that the panel is beginning to diverge from the experts, particularly with respect to perceptions of the levels of various “societal” risks that nanotechnology might present. The data suggest that responding to public concerns may involve more than attention to physical risks in areas such as health and environment; concerns about other forms of risk actually appear more salient
Topical haemostatic agents for skin wounds: a systematic review
Background: Various agents and techniques have been introduced to limit intra-operative blood loss from skin lesions. No uniformity regarding the type of haemostasis exists and this is generally based on the surgeon's preference. To study the effectiveness of haemostatic agents, standardized wounds like donor site wounds after split skin grafting (SSG) appear particularly suitable. Thus, we performed a systematic review to assess the effectiveness of haemostatic agents in donor site wounds. Methods. We searched all randomized clinical trials (RCTs) on haemostasis after SSG in Medline, Embase and the Cochrane Library until January 2011. Two reviewers independently assessed trial relevance and quality and performed data analysis. Primary endpoint was effectiveness regarding haemostasis. Secondary endpoints were wound healing, adverse effects, and costs. Results: Nine relevant RCTs with a fair methodological quality were found, comparing epinephrine, thrombin, fibrin sealant, alginate dressings, saline, and mineral oil. Epinephrine achieved haemostasis significantly faster than thrombin (difference up to 2.5 minutes), saline or mineral oil (up to 6.5 minutes). Fibrin sealant also resulted in an up to 1 minute quicker haemostasis than thrombin and up to 3 minutes quicker than placebo, but was not directly challenged against epinephrine. Adverse effects appeared negligible. Due to lack of clinical homogeneity, meta-analysis was impossible. Conclusion: According to best available evidence, epinephrine and fibrin sealant appear superior to achieve haemostasis when substantial topical blood loss is anticipated, particularly in case of (larger) SSGs and burn debridement
Evidence-Based Mental Health Programs in Schools: Barriers and Facilitators of Successful Implementation
Although schools can improve children’s access to mental health services, not all school-based providers are able to successfully deliver evidence-based practices. Indeed, even when school clinicians are trained in evidence-based practices (EBP), the training does not necessarily result in the implementation of those practices. This study explores factors that influence implementation of a particular EBP, Cognitive Behavioral Intervention for Trauma in Schools (CBITS). Semi-structured telephone interviews with 35 site administrators and clinicians from across the United States were conducted 6–18 months after receiving CBITS training to discuss implementation experiences. The implementation experiences of participants differed, but all reported similar barriers to implementation. Sites that successfully overcame such barriers differed from their unsuccessful counterparts by having greater organizational structure for delivering school services, a social network of other clinicians implementing CBITS, and administrative support for implementation. This study suggests that EBP implementation can be facilitated by having the necessary support from school leadership and peers
Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain
BACKGROUND: The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. METHODS: Qualitative research with an ethnographic approach, through non-participant observation and focus groups within the context of a consensus workshop in which 19 CPG experts participated to evaluate the GRADE proposal using 12 evidence tables taken from hypertension, asthma and arthritis CPGs. The interventions were recorded, under a guarantee of confidentiality. The transcriptions and field notes were analyzed, based on a sociological discourse analysis model, and the provisional findings were re-sent to participants in order to improve their validity. RESULTS: 1) Certain problems over procedure and terminology hindered the acceptance of this new method as a common reference system for the preparation of CPGs. 2). A greater closeness to clinical practice was accompanied by concerns over value judgments and subjectivity, with a demand for greater explicitness in the consensus process. 3). The type of "evidence" on which the guidelines are based, how and by whom the evidence is prepared, and what the role of the different actors should be, all constitute unresolved concerns in the CPG preparation and implementation processes. 4). The grading process is not neutral: professional background, prior experience and the degree of leadership all condition the participants' input and interactions. CONCLUSION: The findings obtained allow the quantitative evaluation to be better interpreted and, in turn, go beyond the particularities of the GRADE method. Adaptation to the complexities of clinical practice, the need for carefully designed multi-disciplinary work and the reflexivity present in the CPG preparation process, all represent lines of debate that are necessary to improve the CPG quality in the Spanish health care sector
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