856 research outputs found
Assessment of Peer-Based and Structural Strategies for Increasing Male Participation in an Antenatal Setting in Lilongwe, Malawi
In sub-Saharan Africa, although male involvement in antenatal care is associated with positive outcomes for HIV-infected women and their infants, men rarely accompany female partners. We implemented a project to increase the number of male partners attending an antenatal clinic at Bwaila Hospital in Lilongwe, Malawi. We evaluated changes in the proportion of women who came with a partner over three periods. During period 1 (January 2007 – June 2008) there was didactic peer education. During period 2 (July 2008 – September 2009) a peer-led  male-involvement drama was introduced into patient waiting areas. During period 3 (October 2009 – December 2009) changes to clinical infrastructure were introduced to make the clinic more male-friendly. The proportion of women attending ANC with a male partner increased from 0.7% to 5.7% to 10.7% over the three periods. Peer education through drama and male-friendly hospital infrastructure coincided with substantially greater male participation, although further gains are necessary. Afr J Reprod Health 2014; 18[2]: 97-104).Keywords: HIV, antenatal, male involvement, HIV counseling and testing, disclosure, prevention of mother to child transmission, coupl
Exploring the feasibility of engaging Traditional Birth Attendants in a prevention of Mother to Child HIV Transmission program in Lilongwe, Malawi
ObjectiveTo investigate the willingness of Traditional Birth Attendants (TBAs) to provide single dose antiretroviral prophylaxis to infants born to mothers with HIV and the feasibility of providing the TBAs with antiretroviral medication.Design2 focus groups with a total of 17 registered TBAs.SettingLilongwe, MalawiMethodsTBAs were recruited by local health workers and participated in focus groups assessing their attitudes towards participation in a PMTCT program.ResultsTBAs were willing to participate in this prevention of mother-to-child HIV transmission (PMTCT) program and helped identify barriers to their participation.ConclusionsGiven appropriate support and training, TBAs’ participation in PMTCT programs could be an additional way to deliver medication to mothers and neonates who might otherwise miss crucial doses of medication
Relativistic calculations of the lifetimes and hyperfine structure constants in Zn
This work presents accurate {\it ab initio} determination of the magnetic
dipole (M1) and electric quadrupole (E2) hyperfine structure constants for the
ground and a few low-lying excited states in Zn, which is one of
the interesting systems in fundamental physics. The coupled-cluster (CC) theory
within the relativistic framework has been used here in this calculations. Long
standing demands for a relativistic and highly correlated calculations like CC
can be able to resolve the disagreements among the lifetime estimations
reported previously for a few low-lying states of Zn. The role of
different electron correlation effects in the determination of these quantities
are discussed and their contributions are presented.Comment: 9 pages, 1 figure. submitted to J. Phys. B Fast Trac
Non-Steroidal Anti-inflammatory Drugs As Host-Directed Therapy for Tuberculosis: A Systematic Review
Lengthy, antimicrobial therapy targeting the pathogen is the mainstay of conventional tuberculosis treatment, complicated by emerging drug resistances. Host-directed therapies, including non-steroidal anti-inflammatory drugs (NSAIDs), in contrast, target host factors to mitigate disease severity. In the present Systematic Review, we investigate whether NSAIDs display any effects as therapy of TB and discuss possible mechanisms of action of NSAIDs as adjunctive therapy of TB. Ten studies, seven preclinical studies in mice and three clinical trials, were included and systematically reviewed. Our results point toward a beneficial effect of NSAIDs as adjunct to current TB therapy regimens, mediated by decreased lung pathology balancing host-immune reaction. The determination of the best timing for their administration in order to obtain the potential beneficial effects needs further investigation. Even if the preclinical evidence requires clinical evaluation, NSAIDs might represent a potential safe, simple, and cheap improvement in therapy of TB
Evaluating the benefits of incorporating traditional birth attendants in HIV Prevention of Mother to Child Transmission service delivery in Lilongwe, Malawi
The objective of our intervention was to examine the benefits of incorporating traditional birth attendants (TBA) in HIV Prevention of Mother to Child Transmission (PMTCT) service delivery. We developed a training curriculum for TBAs related to PMTCT and current TBA roles in Malawi. Fourteen TBAs and seven TBA assistants serving 4 urban health centre catchment areas were assessed, trained and supervised. Focus group discussions with the TBAs were conducted after implementation of the program. From March 2008 to August 2009, a total of 4017 pregnant women visited TBAs, out of which 2133 (53.1%) were directly referred to health facilities and 1,884 (46.9%) women delivered at TBAs and subsequently referred. 168 HIV positive women were identified by TBAs. Of these, 86/168 (51.2%) women received nevirapine and 46/168 (27.4%) HIV exposed infants received nevirapine. The challenges in providing PMTCT services included lack of transportation for referrals and absence of a reporting system to confirm the woman’s arrival at the health center. Non-disclosure of HIV status by patients to the TBAs resulted in inability to assist nevirapine uptake. TBAs, when trained and well-supervised, can supplement efforts to provide PMTCT services in communities. (Afr J Reprod Health 2014; 18[1]: 27-34).Keywords: Traditional Birth Attendants, PMTCT, Malaw
Superconducting-coil--resistor circuit with electric field quadratic in the current
It is shown for the first time that the observed [Phys. Lett. A 162 (1992)
105] potential difference Phi_t between the resistor and the screen surrounding
the circuit is caused by polarization of the resistor because of the kinetic
energy of the electrons of the superconducting coil. The proportionality of
Phi_t to the square of the current and to the length of the superconducting
wire is explained. It is pointed out that measuring Phi_t makes it possible to
determine the Fermi quasimomentum of the electrons of a metal resistor.Comment: 2 pages, 1 figur
Estimation of Plasmodium falciparum Transmission Intensity in Lilongwe, Malawi, by Microscopy, Rapid Diagnostic Testing, and Nucleic Acid Detection.
: Estimates of malaria transmission intensity (MTI) typically rely upon microscopy or rapid diagnostic testing (RDT). However, these methods are less sensitive than nucleic acid amplification techniques and may underestimate parasite prevalence. We compared microscopy, RDT, and polymerase chain reaction (PCR) for the diagnosis of Plasmodium falciparum parasitemia as part of an MTI study of 800 children and adults conducted in Lilongwe, Malawi. PCR detected more cases of parasitemia than microscopy or RDT. Age less than 5 years predicted parasitemia detected by PCR alone (adjusted odds ratio = 1.61, 95% confidence interval = 1.09-2.38, Wald P = 0.02). In addition, we identified one P. falciparum parasite with a false-negative RDT result due to a suspected deletion of the histidine-rich protein 2 (hrp2) gene and used a novel, ultrasensitive PCR assay to detect low-level parasitemia missed by traditional PCR. Molecular methods should be considered for use in future transmission studies as a supplement to RDT or microscopy.<br/
Thinking about Later Life: Insights from the Capability Approach
A major criticism of mainstream gerontological frameworks is the inability of such frameworks to appreciate and incorporate issues of diversity and difference in engaging with experiences of aging. Given the prevailing socially structured nature of inequalities, such differences matter greatly in shaping experiences, as well as social constructions, of aging. I argue that Amartya Sen’s capability approach (2009) potentially offers gerontological scholars a broad conceptual framework that places at its core consideration of human beings (their values) and centrality of human diversity. As well as identifying these key features of the capability approach, I discuss and demonstrate their relevance to thinking about old age and aging. I maintain that in the context of complex and emerging identities in later life that shape and are shaped by shifting people-place and people-people relationships, Sen’s capability approach offers significant possibilities for gerontological research
Utilization of family members to provide hospital care in Malawi: the role of hospital guardians
Aim:
Like most of sub-Saharan Africa, Malawi suffers from a paucity of human
resources in the health sector. With an average of one physician for every
50,000 persons, and a health care professional to in-patient population
ratio of 1:277, patient care suffers. At Kamuzu Central Hospital (KCH)
of Lilongwe, Malawi, family members, termed Hospital Guardians, are
utilized to provide basic care for patients. The aim of our study is to
characterize this population and explore their role in the health care
system of KCH.
Methods:
Seventy three semi-qualitative surveys and nineteen in-depth interviews
were conducted with hospital administrators, Guardians, nurses, and
physicians from these wards. The results were analyzed using descriptive
analysis and emergent coding.
Results:
It was found that Hospital Guardians were primarily female family
members of patients and have a low literacy rate. They performed a wide
range of daily tasks in patient care from wound care to advocacy. Despite
their essential role in the health care system, the Guardians were provided
with little support from the hospital. There was often conflict between the
Guardians and hospital personnel due to overcrowding with more than
one Guardian per patient; a lack of understanding of hospital rules and
regulations; and a lack of respect for the Guardian role by hospital staff.
Conclusions:
Until their role can be reduced by additional trained health care
professionals, patient care could be improved by institutional support
including a clarification of the role of the Hospital Guardians.
Recommendations include a one-patient one-guardian policy; Guardian
education; and enhancing Guardian resources
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