Policy and programme considerations for ARV-based prevention for women: Insights from key opinion leaders in Zimbabwe about tenofovir gel

Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. After nearly 20 years of microbicides research, 1 percent tenofovir gel is the first vaginal microbicide to show promise. Since 2011, Zimbabwe has been scaling up use of tenofovir-based regimens as first-line therapy for adults infected with HIV. A randomized, placebo-controlled, double-blind trial demonstrated that women assigned to use 1 percent tenofovir gel had a 39 percent lower risk of HIV infection compared with women in the placebo arm. Policymakers and other stakeholders need information to guide decision-making regarding introduction of new HIV-prevention products. The Population Council developed a toolkit to assist policymakers and program managers in identifying strategic opportunities for introducing tenofovir gel. The toolkit consists of a landscape analysis, discussion guide, and program planning guide. A key element of the toolkit development process has been to test it among key opinion leaders (KOLs) in several countries, including Zimbabwe. This report describes the process and outcomes of a systematic inquiry among KOLs in Zimbabwe

Day of dialogue—Insights and evidence from product introduction: Lessons for microbicides

This report summarizes key issues and themes emerging from a Population Council Day of Dialogue held in March 2007. The Council convened this meeting of experts in the fields of product development, introduction, and social marketing; clinical trials; and reproductive health and HIV/AIDS in order to identify key features that can be used to guide efforts to introduce microbicides

Day of dialogue on multipurpose prevention technologies: Toward clarity in nomenclature

The report summarizes a half-day meeting convened by the Population Council to clarify the wide variety of nomenclature and concepts associated with multipurpose prevention technologies (MPTs). The first section outlines where different types of products are reviewed within the FDA and existing processes that could be applied to MPTs. This is followed by a section that reviews what guidance exists and what else may be needed for review of products like MPTs that address two (or more) indications, including those with a single active, two actives, and multiple components. This meeting identified some of the specific opportunities and challenges for the regulatory pathway for MPTs, and helped the Council chart next steps for its work in this area. The lively and productive discussion helped inform how best to facilitate regulatory approval for MPTs for sexual and reproductive health, a critical component in developing and delivering these urgently needed products to women

Informing Research on HIV Prevention: A Consultation

According to a 1998 UNAIDS/WHO report, HIV infection among women is the fastest-growing segment of the AIDS pandemic, especially in developing countries. Unfortunately, the HIV-prevention strategies put forward by the public health community—monogamy, condom use, and treatment of sexually transmitted infections—are not feasible for many women. Women urgently need a means within their personal control to protect themselves against HIV. Recognizing this need, a number of international and nongovernmental organizations and government agencies have called for the development of microbicides, products that women could use vaginally to prevent infection with sexually transmitted infections, particularly HIV. The Population Council is one of the organizations working to develop a vaginal microbicide, and its lead compound has already undergone initial testing for safety and acceptability. An expanded safety and acceptability trial is now planned. To inform proposed research in South Africa, the Council consulted with government, research, activist, and community groups, and co-sponsored a consultative meeting with the Women’s Health Project. This report summarizes pertinent background information, highlights issues discussed during the consultation, and identifies recommendations made for proceeding with the research

One-pot ortho-amination of aryl C-H bonds using consecutive iron and copper catalysis: late-stage structural diversification of 3,4-dihydroquinolin-2-one

A one-pot approach for ortho-coupling of arenes with non-actived N-nucleophiles has been developed using sequential iron and copper catalysis. Regioselective ortho-activation of anisoles, anilines and phenols was achieved through iron(III) triflimide catalysed iodination, followed by a copper(I)-catalysed, ligand-assisted coupling reaction with N-heterocycle, amide and sulfonamide-based nucleophiles. The synthetic utility of this one-pot, two-step method for the direct amination of ortho-aryl C–H bonds was demonstrated with the late-stage functionalisation of 3,4-dihydroquinolin-2-ones. This allowed the preparation of a TRIM24 bromodomain inhibitor and a series of novel analogues

Toward a Consistent Description of the PNC Experiments in A=18-21 Nuclei

The experimental PNC results in $^{18}$F, $^{19}$F, $^{21}$Ne and the current theoretical analysis show a discrepancy . If one interprets the small limit of the experimentally extracted PNC matrix element for $^{21}$Ne as a destructive interference between the isoscalar and the isovector contribution, then it is difficult to understand why the isovector contribution in $^{18}$F is so small while the isoscalar + isovector contribution in $^{19}$F is relatively large. In order to understand the origin of this discrepancy a comparison of the calculated PNC matrix elements was performed. It is shown that the $^{18}$F and $^{21}$Ne matrix elements contain important contributions from 3$\hbar \omega$ and 4$\hbar \omega$ configuration and that the (0+1)$\hbar \omega$ calculations give distorted results.Comment: REVTEX, 16 pages, 1 postscriptum figure uuencoded and appende

A cross-center smoothness prior for variational Bayesian brain tissue segmentation

Suppose one is faced with the challenge of tissue segmentation in MR images, without annotators at their center to provide labeled training data. One option is to go to another medical center for a trained classifier. Sadly, tissue classifiers do not generalize well across centers due to voxel intensity shifts caused by center-specific acquisition protocols. However, certain aspects of segmentations, such as spatial smoothness, remain relatively consistent and can be learned separately. Here we present a smoothness prior that is fit to segmentations produced at another medical center. This informative prior is presented to an unsupervised Bayesian model. The model clusters the voxel intensities, such that it produces segmentations that are similarly smooth to those of the other medical center. In addition, the unsupervised Bayesian model is extended to a semi-supervised variant, which needs no visual interpretation of clusters into tissues.Comment: 12 pages, 2 figures, 1 table. Accepted to the International Conference on Information Processing in Medical Imaging (2019

Informed consent: From good intentions to sound practices—A report of a seminar

This report is a summary of presentations and discussions at a seminar entitled “Informed Consent: From Good Intentions to Sound Practices.” This two-day seminar brought together 65 individuals from nine countries in May 2001 to discuss challenges of informed consent in research. The goal of the meeting was to put informed consent into historical and contemporary perspective and to explore ways that the barriers to effective implementation can be overcome. The underlying premise of the seminar was that, as the issues around doing ethical research in health will only grow in scope and complexity, even when those who sponsor and conduct research start with good intentions, they may have difficulty translating them into practice. The report concludes with a number of suggestions that the community of people and institutions concerned about informed consent and charged with protecting the rights of research participants should consider in order to conduct ethical research

Sense of coherence moderates job demand‐resources and impact on burnout among nurses and midwives in the context of the COVID ‐19 pandemic: a cross‐sectional survey.

This study aimed to test the propositions using the job demands‐resources (JD‐R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. Cross-sectional quantitative survey. The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. There was no patient or public contribution in this study, as the focus was on nurses and midwives

Informed Consent in HIV Prevention Trials: Report of an International Workshop

This report summarizes key themes and issues on informed consent in HIV prevention trials as part of an international workshop co-hosted by Population Council and Family Health International in May 2005