Will I? won't I? Why do men who have sex with men present for post-exposure prophylaxis for sexual exposures?

Background: Failures of post-exposure prophylaxis following sexual exposure (PEPSE) to prevent seroconversion have been reported and are often associated with ongoing risk exposure. Understanding why men who have sex with men (MSM) access PEPSE on some occasions and not others may lead to more effective health promotion and disease prevention strategies Methods: A qualitative study design using semi-structured interviews of 15 MSM within 6 months of them initiating PEPSE treatment at an HIV outpatient service in Brighton, UK. Results: PEPSE seeking was motivated by a number of factors: an episode that related to a particular sexual partner and their behaviour; the characteristics of the venue where the risk occurred; the respondent’s state of mind and influences of alcohol and recreational drug use; and their perceived beliefs on the effectiveness of PEPSE. Help was sought in the light of a “one-off” or “unusual” event. Many respondents felt they were less likely to behave in a risky manner following PEPSE. Conclusion: If PEPSE is to be effective as a public health measure, at risk individuals need to be empowered to make improved risk calculations from an increased perception that they could be exposed to HIV if they continue their current behaviour patterns. The concern is that PEPSE was sought by a low number of MSM implying that a greater number are not using the service based on failure to make accurate risk calculations or recognise high-risk scenario

Physiology of virus-infected plants

Little information is available on the sequence of physiological changes from virus inoculation to full development of disease symptoms. In this paper, we discuss (1) activity of chlorophyllase, (2) ferrous and ferric iron changes, (3) inorganic and organic phosphorus, and (4) respiration in pigeon pea sterility mosaic infected pigeon pea plants and cassava mosaic infected cassava plants. In both healthy and diseased plants, chlorophylla andb increased with age. However, these were significantly lower in diseased plants than in healthy plants, from early stages. Chlorophyllase activity increased with age, such increase being much steeper in diseased plants. There appeared to be a progressive conversion of ferrous Fe to ferric Fe in diseased leaves. Diseased leaves at all ages had higher levels of total P. There was a greater conversion of inorganic P to the organic form as the disease progressed. Respiration increased with progress of disease up to the production of full symptoms, and dropped thereafter reaching levels lower than those in healthy leaves of corresponding age. In PSMV-affected pigeon pea leaves activity of catalase, peroxidase, ascorbic acid oxidase and cytochrome oxidase increased while polyphenol oxidase activity decreased. Mitochondrial nitrogen was much higher in diseased leaves than in healthy leaves

Impact of integrating local culture into language materials on communicative ability of Malaysian lower secondary learners

The importance of culture in learning a language is widely acknowledged even if the integration of culture into language learning and teaching materials has seen various opinions and approaches. Bearing in mind the ultimate aim of learning a language is for communication it is important materials developed for language learning consider content knowledge and linguistic knowledge. This paper discusses the impact of a supplementary reading module designed to improve communicative ability and cultural awareness with the integration of local culture. Focus group interviews were run over a three -year period with lower secondary students and English language teachers to elicit their perspectives on the value of the module and the benefits in helping to develop better communicative ability. Both teachers and students were asked similar questions about their opinions of the module, opinions about the lessons and on the use of English to teach the module. The responses matched with both claiming the module was interesting, attractive and varied in approach with a range of activities in each lesson that fostered communicative and collaborative skills. The findings imply improved cultural knowledge and awareness of local content did provide learners with ideas to harness which subsequently leads to improved communicative ability

New learning spaces and transformations in teacher pedagogy and student learning behavior in the language learning classroom

Many Malaysian classrooms have been redesigned to include technology and foster the development of twenty first century learning. The availability of this platform and the new learning space created by redesigning the language classroom has opened up new and exciting possibilities for teaching and learning the English language. This paper will investigate if the new learning space has impacted teacher’s pedagogical strategies and student’s learning behavior and engagement for English language teaching and learning. A qualitative approach employing a multiple case study research design was taken and data was collected using classroom observations, teacher interviews and teacher and student focus group discussions from eight English language teachers and 37 students. Findings reveal significant transformations in teachers’ teaching approaches, use of class activities and on students’ learning behavior and outcomes. Technology did feature in the learner centric approach with students functioning as facilitators and allowing more student participation and interaction. The use of multimedia and online materials helped make learning more interesting and improved student attention in class. Students in turn were more focused and engaged in the collaborative tasks and also reported developing better peer relationships and learning from each other

A comparison of nitrogen fixation in genotypes of groundnut (Arachis hypogaea L.) using 15N-isotope dilution

Nitrogen fixation in seven groundnut genotypes was measured by 15N-isotope dilution using a non-nodulating cultivar of groundnut as the nonfixing reference plant. Nitrogen fixation varied between 100 kg N ha−1 in genotype J-11 and 153 kg N ha−1 in Robut 33-1. The amount of plant-available soil N was small, so that 86%–92% of plant nitrogen was derived from N2-fixation. Thus differences in N2-fixation between genotypes closely reflected differences in their total N accumulatio

The NeoTree application: developing an integrated mHealth solution to improve quality of newborn care and survival in a district hospital in Malawi

More than two-thirds of newborn lives could be saved worldwide if evidence-based interventions were successfully implemented. We developed the NeoTree application to improve quality of newborn care in resource-poor countries. The NeoTree is a fully integrated digital health intervention that combines immediate data capture, entered by healthcare workers (HCW) on admission, while simultaneously providing them with evidence-based clinical decision support and newborn care education. We conducted a mixed-methods intervention development study, codeveloping and testing the NeoTree prototype with HCWs in a district hospital in Malawi. Focus groups explored the acceptability and feasibility of digital health solutions before and after implementation of the NeoTree in the clinical setting. One-to-one theoretical usability workshops and a 1-month clinical usability study informed iterative changes, gathered process and clinical data, System Usability Scale (SUS) and perceived improvements in quality of care. HCWs perceived the NeoTree to be acceptable and feasible. Mean SUS before and after the clinical usability study were high at 80.4 and 86.1, respectively (above average is >68). HCWs reported high-perceived improvements in quality of newborn care after using the NeoTree on the ward. They described improved confidence in clinical decision-making, clinical skills, critical thinking and standardisation of care. Identified factors for successful implementation included a technical support worker. Coproduction, mixed-methods approaches and user-focused iterative development were key to the development of the NeoTree prototype, which was shown to be an agile, acceptable, feasible and highly usable tool with the potential to improve the quality of newborn care in resource-poor settings

Action on the social determinants for advancing health equity in the time of COVID-19: perspectives of actors engaged in a WHO Special Initiative.

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in 'Pathfinder' countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants

Action on the social determinants for advancing health equity in the time of COVID-19: perspectives of actors engaged in a WHO Special Initiative

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in ‘Pathfinder’ countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of early country dialogues and promising entry points for implementation that involve model, network and capacity building. The insights communicated through this note from the field will be of interest for others aiming to advance health equity through taking action on the social determinants of health, in particular as regards structural determinants

Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK

The People Living with HIV StigmaSurvey UK 2015 was a community led national survey investigating experiences of people living with HIV in the UK in the past 12 months. Participants aged 18 and over were recruited through over 120 cross-sector community organisations and 46 HIV clinics to complete an anonymous online survey. Trans is an umbrella term which refers to individuals whose current gender identity is different to the gender they were assigned at birth. Trans participants self-identified via gender identity and gender at birth questions. Descriptive analyses of reported experiences in social and health care settings were conducted and multivariate logistic regression analyses were used to identify sociodemographic predictors of reporting being treated differently to non-HIV patients, and being delayed or refused healthcare treatment in the past 12 months. 31 out of 1576 participants (2%) identified as trans (19 trans women, 5 trans men, 2 gender queer/non-binary, 5 other). High levels of social stigma were reported for all participants, with trans participants significantly more likely to report worrying about verbal harassment (39% vs. 23%), and exclusion from family gatherings (23% vs. 9%) in the last 12 months, compared to cisgender participants. Furthermore, 10% of trans participants reported physical assault in the last 12 months, compared to 4% of cisgender participants. Identifying as trans was a predictor of reporting being treated differently to non-HIV patients (48% vs. 30%; aOR 2.61, CI 1.06, 6.42) and being delayed or refused healthcare (41% vs. 16%; aOR 4.58, CI 1.83, 11.44). Trans people living with HIV in the UK experience high levels of stigma and discrimination, including within healthcare settings, which is likely to impact upon health outcomes. Trans-specific education and awareness within healthcare settings could help to improve service provision for this demographic

Timed inhibition of CDC7 increases CRISPR-Cas9 mediated templated repair.

Repair of double strand DNA breaks (DSBs) can result in gene disruption or gene modification via homology directed repair (HDR) from donor DNA. Altering cellular responses to DSBs may rebalance editing outcomes towards HDR and away from other repair outcomes. Here, we utilize a pooled CRISPR screen to define host cell involvement in HDR between a Cas9 DSB and a plasmid double stranded donor DNA (dsDonor). We find that the Fanconi Anemia (FA) pathway is required for dsDonor HDR and that other genes act to repress HDR. Small molecule inhibition of one of these repressors, CDC7, by XL413 and other inhibitors increases the efficiency of HDR by up to 3.5 fold in many contexts, including primary T cells. XL413 stimulates HDR during a reversible slowing of S-phase that is unexplored for Cas9-induced HDR. We anticipate that XL413 and other such rationally developed inhibitors will be useful tools for gene modification