Improving police integrity in Uganda: Impact assessment of the police accountability and reform project

Uganda and in particular the Ugandan police are perceived as highly corrupt. To address the integrity of police officers, an intervention called the Police Accountability and Reform Project (PARP) was implemented in selected police districts between 2010 and early 2013. This paper studies the impact of PARP for a sample of 600 police officers who were interviewed about police integrity by means of 12 hypothetical vignette cases depicting context-specific, undesirable behavior of varying degrees of severity. The assessments of the cases by the police officers are analyzed using propensity score matching, inverse probability weighting, and seemingly unrelated regression techniques. We show that the self-selection of police officers into the program is unlikely to drive the results. The results suggest that officers participating in PARP activities (1) judge the presented cases of misconduct more severely, (2) are more inclined to report misconduct, and (3) also expect their colleagues to judge misbehavior at the police level more critically although the latter two coefficient estimates are smaller in size. This suggests that PARP activities have affected the perception of police officers but only encouraged them moderately to actually take action against bad practices

Kajian Aspek Teknis pada Peraturan Pengelolaan Kualitas Air (Study Kasus Sungai Cisadane Kota Tangerang)

Sungai Cisadane merupakan salah satu sungai prioritas dari 15 sungai di Indonesia. Disepanjang daerah aliran sungai ini terdapat berbagai kegiatan seperti kegiatan industri, kegiatanperkantoran, kegiatan pertokoan dan kegiatan Perumahan. Berbagai kegiatan ini menyebabkan SungaiCisadane tidak hanya menampung curah hujan tetapi juga menampung limbah dari berbagai kegiatantersebut. Masuknya beban limbah dari berbagai kegiatan tersebut tidak didukung oleh kemampuandaya tampung sungai yang memadai sehingga terjadilah pencemaran. Hal ini dapat dilihat dari hasilpemantauan kualitas air Sungai Cisadane yang dilakukan Badan Lingkungan Hidup Kota Tangerangyang menunjukkan angka-angka konsentrasi pencemar relatif tinggiPenelitian ini dilatarbelakangi oleh rendahnya kualitas air sungai Cisadane di Kota Tangerang ProvinsiBanten. Walau pun Pemerintah Pusat dan Pemerintah daerah telah mengeluarkan aturan – aturan dankebijakan terkait pengelolaan sungai dan pengendalian pencemaraan air sungai, tingkat efektifitasdalam implementasi kebijakan masih dirasa rendah. Tujuan penelitian ini adalah mengetahui teknispengelolaan kualitas sungai, efektifitas dalam implementasi peraturan, kendala yang dihadapipemerintah, dan keberlanjutan peraturan tersebut.Metode analisis data yang dipergunakan adalah analisis data yang bersifat kualitatif. Data Sekunder diambil dari Peraturan Pemerintah No. 82 tahun 2001 tentang Pengelolaan Kualitas Air dan Pengendalian Pencemaran Air, Peraturan daerah Provinsi Banten No. 10 tahun 2012 tentang Perlindungan dan Pengelolaan Lingkungan, dan Peraturan Daerah Kota Tangerang No 2 tahun 2013 tentang Pengelolaan Kualitas Air dan Pengendaliaan Pencemaran Air. Penelitian ini diharapkanmampu memberikan informasi dan rekomendasi bagi semua pihak yang berkepentingan dengan pengelolaan kualitas air Sungai Cisadane

Holding Ugandan Police to Account: Case study of the Police Accountability and Reform Project

This chapter focuses on police accountability in Uganda, and in particular a project aimed at enhancing accountability

Improving Police Integrity in Uganda: Impact Assessment of the Police Accountability and Reform Project

Uganda and in particular the Ugandan police are perceived as highly corrupt. To address the integrity of police officers, an intervention called the Police Accountability and Reform Project (PARP) was implemented in selected police districts between 2010 and early 2013. This paper studies the impact of PARP for a sample of 600 police officers that were interviewed about police integrity by means of twelve hypothetical vignette cases depicting context-specific, undesirable behaviour of varying degrees of severity. The assessments of the cases by the police officers are analysed using propensity score matching, inverse probability weighting and seemingly unrelated regression techniques. We show that self-selection of police officers into the program is unlikely to drive the results. The results suggest that officers participating in PARP activities (i) judge the presented cases of misconduct more severely, (ii) are more inclined to report misconduct and (iii) also expect their colleagues to judge misbehaviour at the level of the police more critically although the latter two coefficient estimates are smaller in size. This suggests that PARP activities have affected the perception of police officers but only encouraged them moderately to actually take action against bad practices

Descriptive epidemiology of cholera outbreak in Nigeria, January-November, 2018: implications for the global roadmap strategy

Background: The cholera outbreak in 2018 in Nigeria reaffirms its public health threat to the country. Evidence on the current epidemiology of cholera required for the design and implementation of appropriate interventions towards attaining the global roadmap strategic goals for cholera elimination however seems lacking. Thus, this study aimed at addressing this gap by describing the epidemiology of the 2018 cholera outbreak in Nigeria. Methods: This was a retrospective analysis of surveillance data collected between January 1st and November 19th, 2018. A cholera case was defined as an individual aged 2 years or older presenting with acute watery diarrhoea and severe dehydration or dying from acute watery diarrhoea. Descriptive analyses were performed and presented with respect to person, time and place using appropriate statistics. Results: There were 43,996 cholera cases and 836 cholera deaths across 20 states in Nigeria during the outbreak period, with an attack rate (AR) of 127.43/100,000 population and a case fatality rate (CFR) of 1.90%. Individuals aged 15 years or older (47.76%) were the most affected age group, but the proportion of affected males and females was about the same (49.00 and 51.00% respectively). The outbreak was characterised by four distinct epidemic waves, with higher number of deaths recorded in the third and fourth waves. States from the north-west and north-east regions of the country recorded the highest ARs while those from the north-central recorded the highest CFRs. Conclusion: The severity and wide-geographical distribution of cholera cases and deaths during the 2018 outbreak are indicative of an elevated burden, which was more notable in the northern region of the country. Overall, the findings reaffirm the strategic role of a multi-sectoral approach in the design and implementation of public health interventions aimed at preventing and controlling cholera in Nigeri

Inhibition of the Progesterone Nuclear Receptor during the Bone Linear Growth Phase Increases Peak Bone Mass in Female Mice

Augmentation of the peak bone mass (PBM) may be one of the most effective interventions to reduce the risk of developing osteoporosis later in life; however treatments to augment PBM are currently limited. Our study evaluated whether a greater PBM could be achieved either in the progesterone nuclear receptor knockout mice (PRKO) or by using a nuclear progesterone receptor (nPR) antagonist, RU486 in mice. Compared to their wild type (WT) littermates the female PRKO mice developed significantly higher cancellous and cortical mass in the distal femurs, and this was associated with increased bone formation. The high bone mass phenotype was partially reproduced by administering RU486 in female WT mice from 1–3 months of age. Our results suggest that the inhibition of the nPR during the rapid bone growth period (1–3 months) increases osteogenesis, which results in acquisition of higher bone mass. Our findings suggest a crucial role for progesterone signaling in bone acquisition and inhibition of the nPR as a novel approach to augment bone mass, which may have the potential to reduce the burden of osteoporosis

Engaging community pharmacists in the primary prevention of cardiovascular disease: protocol for the Pharmacist Assessment of Adherence, Risk and Treatment in Cardiovascular Disease (PAART CVD) pilot study

Background: Cardiovascular disease (CVD) is the leading cause of death globally. Community pharmacist intervention studies have demonstrated clinical effectiveness for improving several leading individual CVD risk factors. Primary prevention strategies increasingly emphasise the need for consideration of overall cardiovascular risk and concurrent management of multiple risk factors. It is therefore important to demonstrate the feasibility of multiple risk factor management by community pharmacists to ensure continued currency of their role.Methods/Design: This study will be a longitudinal pre- and post-test pilot study with a single cohort of up to 100 patients in ten pharmacies. Patients aged 50-74 years with no history of heart disease or diabetes, and taking antihypertensive or lipid-lowering medicines, will be approached for participation. Assessment of cardiovascular risk, medicines use and health behaviours will be undertaken by a research assistant at baseline and following the intervention (6 months). Validated interview scales will be used where available. Baseline data will be used by accredited medicines management pharmacists to generate a report for the treating community pharmacist. This report will highlight individual patients&rsquo; overall CVD risk and individual risk factors, as well as identifying modifiablehealth behaviours for risk improvement and suggesting treatment and behavioural goals. The treating community pharmacist will use this information to finalise and implement a treatment plan in conjunction with the patient and their doctor. Community pharmacists will facilitate patient improvements in lifestyle, medicines adherence, and medicines management over the course of five counselling sessions with monthly intervals. The primary outcome will be the change to average overall cardiovascular risk, assessed using the Framingham risk equation.Discussion: This study will assess the feasibility of implementing holistic primary CVD prevention programs into community pharmacy, one of the most accessible health services in most developed countries.<br /

Schistosoma mansoni infection alters the host pre-vaccination environment resulting in blunted Hepatitis B vaccination immune responses

Schistosomiasis is a disease caused by parasitic flatworms of the Schistosoma spp., and is increasingly recognized to alter the immune system, and the potential to respond to vaccines. The impact of endemic infections on protective immunity is critical to inform vaccination strategies globally. We assessed the influence of Schistosoma mansoni worm burden on multiple host vaccine-related immune parameters in a Ugandan fishing cohort (n = 75) given three doses of a Hepatitis B (HepB) vaccine at baseline and multiple timepoints post-vaccination. We observed distinct differences in immune responses in instances of higher worm burden, compared to low worm burden or non-infected. Concentrations of pre-vaccination serum schistosome-specific circulating anodic antigen (CAA), linked to worm burden, showed a significant bimodal distribution associated with HepB titers, which was lower in individuals with higher CAA values at month 7 post-vaccination (M7). Comparative chemokine/cytokine responses revealed significant upregulation of CCL19, CXCL9 and CCL17 known to be involved in T cell activation and recruitment, in higher CAA individuals, and CCL17 correlated negatively with HepB titers at month 12 post-vaccination. We show that HepB-specific CD4(+) T cell memory responses correlated positively with HepB titers at M7. We further established that those participants with high CAA had significantly lower frequencies of circulating T follicular helper (cTfh) subpopulations pre- and post-vaccination, but higher regulatory T cells (Tregs) post-vaccination, suggesting changes in the immune microenvironment in high CAA could favor Treg recruitment and activation. Additionally, we found that changes in the levels of innate-related cytokines/chemokines CXCL10, IL-1 & beta;, and CCL26, involved in driving T helper responses, were associated with increasing CAA concentration. This study provides further insight on pre-vaccination host responses to Schistosoma worm burden which will support our understanding of vaccine responses altered by pathogenic host immune mechanisms and memory function and explain abrogated vaccine responses in communities with endemic infections.Author summarySchistosomiasis drives host immune responses for optimal pathogen survival, potentially altering host responses to vaccine-related antigen. Chronic schistosomiasis and co-infection with hepatotropic viruses are common in countries where schistosomiasis is endemic. We explored the impact of Schistosoma mansoni (S. mansoni) worm burden on Hepatitis B (HepB) vaccination of individuals from a fishing community in Uganda. We demonstrate that higher schistosome-specific antigen (circulating anodic antigen, CAA) concentration pre-vaccination, is associated with lower HepB antibody titers post-vaccination at month 7. We show higher pre-vaccination levels of CCL17 in instances of high CAA that negatively associate with HepB antibody titers month 12 post-vaccination and coincided with lower frequencies of circulating T follicular helper cell populations (cTfh), proliferating antibody secreting cells (ASCs), and higher frequencies of regulatory T cells (Tregs). We also show that monocyte function is important in HepB vaccine responses, and high CAA is associated with alterations in the early innate cytokine/chemokine microenvironment. Our findings suggest that in individuals with high CAA and likely high worm burden, schistosomiasis can create an environment that is polarized against optimal host immune responses to the vaccine, which puts many endemic communities at risk for infection against HepB and other diseases that are preventable by vaccines.Cancer Signaling networks and Molecular Therapeutic