Role of traditional healers in the management of severe malaria among children below five years of age: the case of Kilosa and Handeni Districts, Tanzania

BACKGROUND: The current malaria control strategy of WHO centres on early diagnosis and prompt treatment using effective drugs. Children with severe malaria are often brought late to health facilities and traditional health practitioners are said to be the main cause of treatment delay. In the context of the Rectal Artesunate Project in Tanzania, the role of traditional healers in the management of severe malaria in children was studied. METHODOLOGY: A community cross-sectional study was conducted in Kilosa and Handeni Districts, involving four villages selected on the basis of existing statistics on the number of traditional health practitioners involved in the management of severe malaria. A total of 41 traditional health practitioners were selected using the snowballing technique, whereby in-depth interviews were used to collect information. Eight Focus Group Discussions (FGDs) involving traditional health practitioners, caregivers and community leaders were carried out in each district. RESULTS: Home management of fever involving sponging or washing with warm water at the household level, was widely practiced by caregivers. One important finding was that traditional health practitioners and mothers were not linking the local illness termed degedege, a prominent feature in severe malaria, to biomedically-defined malaria. The majority of mothers (75%) considered degedege to be caused by evil spirits. The healing process was therefore organized in stages and failure to abide to the procedure could lead to relapse of degedege, which was believed to be caused by evil spirits. Treatment seeking was, therefore, a complex process and mothers would consult traditional health practitioners and modern health care providers, back and forth. Referrals to health facilities increased during the Rectal Artesunate Project, whereby project staff facilitated the process after traditional medical care with the provision of suppositories. This finding is challenging the common view that traditional healers are an important factor of delay for malaria treatment, they actually play a pivotal role by giving "bio-medically accepted first aid" which leads to reduction in body temperature hence increasing chances of survival for the child. Increasing the collaboration between traditional healers and modern health care providers was shown to improve the management of severe malaria in the studied areas. INTERPRETATION AND CONCLUSION: Traditional health care is not necessarily a significant impediment or a delaying factor in the treatment of severe malaria. There is a need to foster training on the management of severe cases, periodically involving both traditional health practitioners and health workers to identify modalities of better collaboration

Memoria del Derecho y disciplinas jurídicas. Estudios

Esta es una obra colectiva que recoge las contribuciones realizadas en el III Seminario Internacional Memoria del derecho y disciplinas jurídicas (siglos XIX-XX) celebrado los días 25 y 26 de mayo de 2022 en la Sede de Santa María de la Rábida de la Universidad Internacional de Andalucía, en Palos de la Frontera, Huelva. En estas páginas se da cuenta de la memoria del jurista, así como de la formación de las disciplinas y enseñanzas jurídicas, durante el largo período que va de la Ley Moyano de Instrucción Pública (1857) hasta Ley de Reforma Universitaria (1983).This work collects the presentations made at the III International Seminar Memory of Law and Legal Disciplines (XIX-XX centuries) held on May 25 and 26, 2022 at the Santa María de la Rábida Campus of the International University of Andalusia, in Palos de la Frontera, Huelva. The following pages discuss the lives of legal scholars as well as the emergence of legal disciplines and legal education in Spain in the period spanning from the Moyano Law of Public Instruction (1857) to the University Reform Law (1983).Esta publicación forma parte de los proyectos de I+D+i PID2019-109351GB-C31 / PID2019-109351GB-C32 financiado por MCIN/AEI/10.13039/501100011033. Proyecto “Evolución en la comprensión de la víctima: de la compensación a la reparación”. Acción financiada por la Comunidad de Madrid a través de la línea de “Excelencia del Profesorado Universitario” del Convenio Plurianual con la UC3M (EPUC3M07), en el marco del V PRICIT (V Plan Regional de Investigación Científica e Innovación Tecnológica)”.Presentación / Víctor Saucedo (pp. 9-10).-- La represión de los docentes en regímenes despóticos. Purificación-depuración del profesorado universitario a la caída del Trienio Constitucional y en los inicios de la Dictadura Franquista / Clara Álvarez Alonso (pp. 13-106). -- Entre planes y manuales. La enseñanza penal en el siglo XIX en Cuba. / Adrian J. Cabrera Bibilonia (pp. 107-130). -- José María de Porcioles. El regionalismo franquista y la modernización del derecho catalán / Jaume Claret Miranda, Alfons Aragoneses (pp. 131-160). -- Catedráticos y asignaturas de derecho civil: 1847-1868 / Jesús Delgado Echeverría (pp. 161-194). -- El origen de los prolegómenos del derecho en la universidad española (1842) / Alessandra Giuliani (pp. 195-212). -- La lista de Rojas. Protección diplomática de los sefardíes en la Rumanía del Eje (1940-1943) / Dámaso de Lario (pp. 213-260). -- Reforma de la tutela y doctrina civilística (1983) / Elena López Barba (pp. 261-282). -- El CEU, vivero de catedráticos: 1932-1956 / Manuel Martínez Neira (pp. 283-320). -- El derecho mercantil de la Segunda República. Leyes, textos, figuras / Carlos Petit (pp. 321-376). -- El derecho laboral en las aulas de las escuelas sociales: del Ministerio de Trabajo al Ministerio de Educación, un periplo social / Eugenia Torijano (pp. 377-404). -- Los inicios de la escuela del profesor Girón en Valladolid (1945-1970) / Luis Antonio Velasco San Pedro (pp. 405-426

Long-Term Continuous Corticosterone Treatment Decreases VEGF Receptor-2 Expression in Frontal Cortex

Objective: Stress and increased glucocorticoid levels are associated with many neuropsychiatric disorders including schizophrenia and depression. Recently, the role of vascular endothelial factor receptor-2 (VEGFR2/Flk1) signaling has been implicated in stress-mediated neuroplasticity. However, the mechanism of regulation of VEGF/Flk1 signaling under longterm continuous glucocorticoid exposure has not been elucidated. Material and Methods: We examined the possible effects of long-term continuous glucocorticoid exposure on VEGF/Flk1 signaling in cultured cortical neurons in vitro, mouse frontal cortex in vivo, and in post mortem human prefrontal cortex of both control and schizophrenia subjects. Results: We found that long-term continuous exposure to corticosterone (CORT, a natural glucocorticoid) reduced Flk1 protein levels both in vitro and in vivo. CORT treatment resulted in alterations in signaling molecules downstream to Flk1 such as PTEN, Akt and mTOR. We demonstrated that CORT-induced changes in Flk1 levels are mediated through glucocorticoid receptor (GR) and calcium. A significant reduction in Flk1-GR interaction was observed following CORT exposure. Interestingly, VEGF levels were increased in cortex, but decreased in serum following CORT treatment. Moreover, significant reductions in Flk1 and GR protein levels were found in postmortem prefrontal cortex samples from schizophrenia subjects. Conclusions: The alterations in VEGF/Flk1 signaling following long-term continuous CORT exposure represents a molecula

Emergent Functional Properties of Neuronal Networks with Controlled Topology

The interplay between anatomical connectivity and dynamics in neural networks plays a key role in the functional properties of the brain and in the associated connectivity changes induced by neural diseases. However, a detailed experimental investigation of this interplay at both cellular and population scales in the living brain is limited by accessibility. Alternatively, to investigate the basic operational principles with morphological, electrophysiological and computational methods, the activity emerging from large in vitro networks of primary neurons organized with imposed topologies can be studied. Here, we validated the use of a new bio-printing approach, which effectively maintains the topology of hippocampal cultures in vitro and investigated, by patch-clamp and MEA electrophysiology, the emerging functional properties of these grid-confined networks. In spite of differences in the organization of physical connectivity, our bio-patterned grid networks retained the key properties of synaptic transmission, short-term plasticity and overall network activity with respect to random networks. Interestingly, the imposed grid topology resulted in a reinforcement of functional connections along orthogonal directions, shorter connectivity links and a greatly increased spiking probability in response to focal stimulation. These results clearly demonstrate that reliable functional studies can nowadays be performed on large neuronal networks in the presence of sustained changes in the physical network connectivity