Health Services for Buruli Ulcer Control: Lessons from a Field Study in Ghana

Buruli ulcer (BU), caused by Mycobacterium ulcerans infection, is a debilitating disease of the skin and underlying tissue which starts as a painless nodule, oedema or plaque and could develop into painful and massive ulcers if left untreated. Using a combination of quantitative and qualitative methods, the study assessed the effectiveness of the BUPaT programme to improve early detection and management of BU in an endemic area in Ghana. The results of the study showed extensive collaboration across all levels, (national, municipality and community), which contributed to strengthening the programme. Health staff were trained to manage all BU cases. School teachers, municipal environmental staff and community surveillance volunteers were trained to give the right health messages, screen for detection of early cases and refer for medical treatment. WHO-recommended antibiotics improved treatment and cure, particularly for early lesions, and prevented recurrences. Improving access to antibiotic treatment is critical for early case management. Health education is required to emphasise the effectiveness of treatment with antibiotics to reduce deformities and the importance of seeking medical treatment for all skin lesions. Further research is needed to explain the role of environmental factors in BU contagion

MRI-derived g-ratio and lesion severity in newly diagnosed multiple sclerosis

Myelin loss is associated with axonal damage in established multiple sclerosis. This relationship is challenging to study in vivo in early disease. Here, we ask whether myelin loss is associated with axonal damage at diagnosis, by combining non-invasive neuroimaging and blood biomarkers. We performed quantitative microstructural MRI and single molecule ELISA plasma neurofilament measurement in 73 patients with newly diagnosed, immunotherapy naïve relapsing-remitting multiple sclerosis. Myelin integrity was evaluated using aggregate g-ratios, derived from magnetization transfer saturation (MTsat) and neurite orientation dispersion and density imaging (NODDI) diffusion data. We found significantly higher g-ratios within cerebral white matter lesions (suggesting myelin loss) compared with normal-appearing white matter (0.61 vs 0.57, difference 0.036, 95% CI 0.029 to 0.043, p < 0.001). Lesion volume (Spearman’s rho rs= 0.38, p < 0.001) and g-ratio (rs= 0.24 p < 0.05) correlated independently with plasma neurofilament. In patients with substantial lesion load (n = 38), those with higher g-ratio (defined as greater than median) were more likely to have abnormally elevated plasma neurofilament than those with normal g-ratio (defined as less than median) (11/23 [48%] versus 2/15 [13%] p < 0.05). These data suggest that, even at multiple sclerosis diagnosis, reduced myelin integrity is associated with axonal damage. MRI-derived g-ratio may provide useful additional information regarding lesion severity, and help to identify individuals with a high degree of axonal damage at disease onset. York, Martin et al. simultaneously measured g-ratio and plasma neurofilament in 73 relapsing-remitting multiple sclerosis patients at diagnosis using advanced MRI and single molecule ELISA. They demonstrate that g-ratio of cerebral white matter lesions varies at diagnosis, and show that high g-ratio of lesions is associated with elevated plasma neurofilament

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

A História da Alimentação: balizas historiográficas

Os M. pretenderam traçar um quadro da História da Alimentação, não como um novo ramo epistemológico da disciplina, mas como um campo em desenvolvimento de práticas e atividades especializadas, incluindo pesquisa, formação, publicações, associações, encontros acadêmicos, etc. Um breve relato das condições em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biológica, a econômica, a social, a cultural e a filosófica!, assim como da identificação das contribuições mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histórica, foi ela organizada segundo critérios morfológicos. A seguir, alguns tópicos importantes mereceram tratamento à parte: a fome, o alimento e o domínio religioso, as descobertas européias e a difusão mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rápido balanço crítico da historiografia brasileira sobre o tema

The Quest for Inclusive Governance of Global ICTs: Lessons from the ITU in the Limits of National Sovereignty

The construction of inclusive arrangements for governing global information and communication technologies (ICTs) has been a central concern of the international community for several years. However, in spite of much discussion and debate and various experiments in organizational innovation, very little real progress has been made in developing governance arrangements that include developed and developing countries, the private sector, and civil society in international agenda-setting and decision-making processes in a reasonably balanced fashion. This article analyzes lessons that can be learned from the experience of the International Telecommunication Union (ITU) regarding different strategies for reconciling national sovereignty with the inclusion of nonstate actors in governance processes. On this basis, it draws conclusions about the future course of ITU reform and about the implications of the ITU's experience for other international organizations and for the governance action plan to be produced by the World Summit on the Information Society. (c) 2003 Massachusetts Institute of Technology Information Technologies and International Development.

Conceptualizing IT Service Management as a Management Control System for Business-IT Alignment

The present paper advances a new conceptualization of IT Service Management (ITSM) as a Management Control System. The paper develops a conceptual model on the organizational impacts of ITSM. The model argues that reaching the organizational objectives of ITSM implementations, that is, increased IT function productivity, customer satisfaction and IT function responsiveness, requires the fit (conceptualized as profile deviation) of five ITSM controls which include: 1) values, 2) planning, 3) rewards and compensation, 4) cybernetic systems and 5) administrative controls. This paper helps unpack the black-box of ITSM by theorizing on the mechanisms that generate outcomes for organization

Internet Governance and Sustainable Development: Towards a Common Agenda

Includes CD-ROMThe table of contents for this item can be shared with the requester. The requester may then choose one chapter, up to 10% of the item, as per the Fair Dealing provision of the Canadian Copyright ActIn 2003, the World Summit on the Information Society declared its challenge “to harness the potential of information and communication technology to promote the development goals of the Millennium Declaration” with a “commitment to the achievement of sustainable development.” Governance of the Internet understandably emerged as a key issue from this process given its increasing importance to the global economy. Sustainable development efforts cannot be conceived without global communications and knowledge exchange. Therefore, the outcomes of the Internet governance debate will affect our ability to manage the social, environmental and economic aspects of sustainable development. These two historically disparate policy communities will each gain if they can discover and leverage the overlap in their respective visions for the future. However, the pervasive, complex and intricate nature of the linkages between Internet governance and sustainable development makes this nexus difficult to define. Can a dialogue between these two communities contribute to mitigating degradation of natural and human environments in developed and developing countries; help avoid the economic marginalization of developing countries facing digital exclusion from global markets; and help maintain and promote cultural diversity and traditional knowledge? Internet Governance and Sustainable Development contemplates such questions, and stimulates further dialogue