An Open Conversation with Traditional Birth Attendants in Rural Uganda: The Potential for Collaborative Care

Background: Imaging the World-Africa (ITWA) is a registered non-governmental organization aimed at distributing low-cost ultrasound services at health centres in rural Uganda. Yet, studies demonstrate that the majority of mothers continue to deliver with unregulated traditional birth attendants (TBAs) in their local villages. It has been suggested that the unregulated practices of TBAs has contributed to the high rate of maternal and fetal mortality. A greater understanding of the roles of TBAs in the management of pregnancy and delivery is needed. Purpose: The purpose of this report is to provide the international community with a greater understanding of TBA practices as well as an assessment of their willingness for future collaboration. Methods: Three TBAs from different nearby villages attended a meeting with ITWA in Kamuli District, Uganda. The meeting included an interview and an educational session. A test on the management principles of common obstetric complications was administered at the beginning and end of the meeting to assess baseline knowledge and the effect of the interaction. Results: The meeting with the TBAs provided valuable qualitative information about TBA clinical experience, the value of TBAs to the community and TBA understanding of ultrasound. On the pre-educational test, the TBAs had a limited understanding of pregnancy complications and conditions in which it would be safer for a mother to deliver at a hospital. After the educational session, the TBAs performed statistically significantly better on the post-test (p=0.03). Conclusion: The open conversation with the TBAs provided valuable information on the current role of TBAs in rural Uganda. Our experience with the TBAs demonstrates that TBAs are willing to engage with trained healthcare providers. Collaboration between TBAs and health centers in Uganda has the potential to bring to light previously unknown barriers and create solutions to better maternal and fetal care

Reversibilidade de bens na concessão do serviço telefônico fixo comutado : uma análise crítica na perspectiva da Teoria Responsiva da Regulação

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Direito, Curso de Pós-Graduação em Direito, 2017.A presente dissertação investiga as possíveis consequências de mutações paradigmáticas do direito administrativo no contorno jurídico de um instituto considerado, tradicionalmente, intrínseco às concessões de serviço de telecomunicações: a reversão de bens. O estudo evidencia a relação das alterações doutrinárias dos institutos jurídicos do direito administrativo com a persistência dos bens reversíveis nas concessões de serviços de telecomunicações. Destarte, a linha investigativa do trabalho identifica se o instituto da reversibilidade de bens na concessão de serviço público de telecomunicações é, ainda, a única ou melhor forma de se atingir os fins por ele visados, em especial a continuidade do serviço. Em relação ao marco teórico, adotou-se a teoria responsiva da regulação, tal como concebida por Ian Ayres e John Braithwaite no livro Responsive Regulation: Transcending the Deregulation Debate, de 1992, e desdobramentos de pesquisas posteriores. A pesquisa inicia com investigação sobre o novo papel a ser desempenhado pela Administração Pública em sua atuação em geral e, especificamente, no âmbito regulatório. Em seguida, propõe-se a adoção da teoria responsiva da regulação como modelagem teórica adequada para conciliar uma nova forma de atuação administrativa com a proteção dos interesses públicos. Após um aprofundamento sobre as principais proposições da teoria responsiva, foram analisados a doutrina e o arcabouço normativo sobre o tema dos bens reversíveis no setor de telecomunicações, propondo-se, ao final, uma crítica à regulamentação atual e fornecendo-se uma possível modelagem que seguisse os ditames da teoria responsiva da regulação.This study investigates the possible consequences of paradigmatic changes in Administrative Law in the legal context of an institute considered, at least traditionally, intrinsic to telecommunications service in Brazil: the reversal to the public domain or to a new service provider of assets owned by the current service provider. It is intended to highlight the relationship between the doctrinal changes in the legal institutes of Administrative Law and the persistence of the reversible assets in telecommunications service. Thus, the investigative line of the work will seek to know if the institute of the reversibility of asset in public telecommunications services is still the only or the better way to achieve its goals, especially the continuity of the service, from the perspective of the theory of responsive regulation, as conceived by Ian Ayres and John Braithwaite in the book Responsive Regulation: Transcending the Deregulation Debate, 1992. The research begins with developments on the new role to be played by the Public Administration, not least in the regulatory arena. Next, the study tackles the appropriateness of the theory of responsive regulation to reconcile a new form of administrative action with the protection of public interests. After that the main propositions of the theory of responsive regulation, the doctrine and the normative framework on the subject of reversible assets in the telecommunications sector were analyzed. Finally, a critique of current state of the art of the regulation and proposals providing a possible modeling that follows the dictates of the Responsive Theory of Regulation were made

Prothymosin alpha: a ubiquitous polypeptide with potential use in cancer diagnosis and therapy

The thymus is a central lymphoid organ with crucial role in generating T cells and maintaining homeostasis of the immune system. More than 30 peptides, initially referred to as “thymic hormones,” are produced by this gland. Although the majority of them have not been proven to be thymus-speciWc, thymic peptides comprise an eVective group of regulators, mediating important immune functions. Thymosin fraction Wve (TFV) was the Wrst thymic extract shown to stimulate lymphocyte proliferation and diVerentiation. Subsequent fractionation of TFV led to the isolation and characterization of a series of immunoactive peptides/polypeptides, members of the thymosin family. Extensive research on prothymosin (proT) and thymosin 1 (T1) showed that they are of clinical signiWcance and potential medical use. They may serve as molecular markers for cancer prognosis and/or as therapeutic agents for treating immunodeWciencies, autoimmune diseases and malignancies. Although the molecular mechanisms underlying their eVect are yet not fully elucidated proT and T1 could be considered as candidates for cancer immunotherapy. In this review, we will focus in principle on the eventual clinical utility of proT, both as a tumor biomarker and in triggering anticancer immune responses. Considering the experience acquired via the use of T1 to treat cancer patients, we will also discuss potential approaches for the future introduction of proT into the clinical setting

2021 roadmap for sodium-ion batteries

Abstract: Increasing concerns regarding the sustainability of lithium sources, due to their limited availability and consequent expected price increase, have raised awareness of the importance of developing alternative energy-storage candidates that can sustain the ever-growing energy demand. Furthermore, limitations on the availability of the transition metals used in the manufacturing of cathode materials, together with questionable mining practices, are driving development towards more sustainable elements. Given the uniformly high abundance and cost-effectiveness of sodium, as well as its very suitable redox potential (close to that of lithium), sodium-ion battery technology offers tremendous potential to be a counterpart to lithium-ion batteries (LIBs) in different application scenarios, such as stationary energy storage and low-cost vehicles. This potential is reflected by the major investments that are being made by industry in a wide variety of markets and in diverse material combinations. Despite the associated advantages of being a drop-in replacement for LIBs, there are remarkable differences in the physicochemical properties between sodium and lithium that give rise to different behaviours, for example, different coordination preferences in compounds, desolvation energies, or solubility of the solid–electrolyte interphase inorganic salt components. This demands a more detailed study of the underlying physical and chemical processes occurring in sodium-ion batteries and allows great scope for groundbreaking advances in the field, from lab-scale to scale-up. This roadmap provides an extensive review by experts in academia and industry of the current state of the art in 2021 and the different research directions and strategies currently underway to improve the performance of sodium-ion batteries. The aim is to provide an opinion with respect to the current challenges and opportunities, from the fundamental properties to the practical applications of this technology

Estradiol treatment altered anticholinergic-related brain activation during working memory in postmenopausal women

Estradiol has been shown to affect cholinergic modulation of cognition in human and nonhuman animal models. This study examined the brain-based interaction of estradiol treatment and anticholinergic challenge in postmenopausal women during the performance of a working memory task and functional MRI. Twenty-four postmenopausal women were randomly and blindly placed on 1mg oral 17-beta estradiol or matching placebo pills for three months after which they participated in three anticholinergic challenge sessions. During the challenge sessions, subjects were administered the antimuscarinic drug scopolamine, the antinicotinic drug mecamylamine, or placebo. After drug administration, subjects completed an fMRI session during which time they performed a visual verbal N-back test of working memory. Results showed that scopolamine increased activation in the left medial frontal gyrus (BA 10) and mecamylamine increased activation in the left inferior frontal gyrus (BA 46). Estradiol treatment compared to placebo treatment significantly reduced the activation in this left medial frontal region during scopolamine challenge. Estradiol treatment also increased activation in the precuneus (BA 31) during mecamylamine challenge. These data are the first to show that estradiol modulated antimuscarinic- and anitnicotinic-induced brain activity and suggest that estradiol affected cholinergic system regulation of cognition-related brain activation in humans

Increased memory load-related frontal activation after estradiol treatment in postmenopausal women

Prior research shows that menopause is associated with changes in cognition in some older women. However, how estrogen loss and subsequent estrogen treatment affects cognition and particularly the underlying brain processes responsible for any cognitive changes is less well understood. We examined the ability of estradiol to modulate the manipulation of information in working memory and related brain activation in postmenopausal women. Twenty healthy postmenopausal women (mean age (SD)=59.13 (5.5)) were randomly assigned to three months of 1mg oral 17-beta estradiol or placebo. At baseline and three months later each woman completed a visual verbal N-back sequential letter test of working memory during functional magnetic resonance imaging (fMRI). The fMRI data showed that women who were treated with estradiol for three months had increased frontal activation during the more difficult working memory load conditions compared to women treated with placebo. Performance on the verbal working memory task showed no difference between estradiol and placebo treated subjects. These data are consistent with prior work showing increases in frontal activation on memory tasks after estrogen treatment. However, this is the first study to show that estrogen-induced increases in brain activity were tied to cognitive load during a verbal working memory task. These data suggest that estradiol treatment effects on cognition may be in part produced through modulation of frontal lobe functioning under difficult task conditions