vitro and ex vivo testing of tenofovir shows it is effective as an HIV-1 microbicide

Abstract Background: Tenofovir gel has entered into clinical trials for use as a topical microbicide to prevent HIV-1 infection but has no published data regarding pre-clinical testing using in vitro and ex vivo models. To validate our findings with on-going clinical trial results, we evaluated topical tenofovir gel for safety and efficacy. We also modeled systemic application of tenofovir for efficacy

Evaluation Research and Institutional Pressures: Challenges in Public-Nonprofit Contracting

This article examines the connection between program evaluation research and decision-making by public managers. Drawing on neo-institutional theory, a framework is presented for diagnosing the pressures and conditions that lead alternatively toward or away the rational use of evaluation research. Three cases of public-nonprofit contracting for the delivery of major programs are presented to clarify the way coercive, mimetic, and normative pressures interfere with a sound connection being made between research and implementation. The article concludes by considering how public managers can respond to the isomorphic pressures in their environment that make it hard to act on data relating to program performance.This publication is Hauser Center Working Paper No. 23. The Hauser Center Working Paper Series was launched during the summer of 2000. The Series enables the Hauser Center to share with a broad audience important works-in-progress written by Hauser Center scholars and researchers

Improving vasectomy services in Kenya : lessons from a mystery client study

Much has been done to improve quality of care for women seeking family planning services,1 but less is known about quality of care for men in those services. With this in mind, researchers in Kenya designed a 'mystery client' study, in which men posed as potential vasectomy clients at clinics in different parts of the country. There was wide variation in how men were treated. Positive experiences included a courteous reception, full information on vasectomy, and private, sympathetic counselling that included discussion of other contraceptive methods. Negative experiences included ridicule, inadequate information, discomfort in describing the male body and bias against vasectomy. Real-life stories by men were found to have a positive effect on service providers and male clients; many improvements in the quality of service delivery for men are recommended.7 page(s

Facility-based active management of the third stage of labour: assessment of quality in six countries in sub-Saharan Africa

OBJECTIVE: To assess the quality of facility-based active management of the third stage of labour in Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and the United Republic of Tanzania. METHODS: Between 2009 and 2012, using a cross-sectional design, 2317 women in 390 health facilities were directly observed during the third stage of labour. Observers recorded the use of uterotonic medicines, controlled cord traction and uterine massage. Facility infrastructure and supplies needed for active management were audited and relevant guidelines reviewed. FINDINGS: Most (94%; 2173) of the women observed were given oxytocin (2043) or another uterotonic (130). The frequencies of controlled cord traction and uterine massage and the timing of uterotonic administration showed considerable between-country variation. Of the women given a uterotonic, 1640 (76%) received it within three minutes of the birth. Uterotonics and related supplies were generally available onsite. Although all of the study countries had national policies and/or guidelines that supported the active management of the third stage of labour, the presence of guidelines in facilities varied across countries and only 377 (36%) of 1037 investigated providers had received relevant training in the previous three years. CONCLUSION: In the study countries, quality and coverage of the active management of the third stage of labour were high. However, to improve active management, there needs to be more research on optimizing the timing of uterotonic administration. Training on the use of new clinical guidelines and implementation research on the best methods to update such training are also needed

Viability of explant cultures after a 24 hour exposure to tenofovir or vehicle control gels.

<p>Ectocervical and colorectal explants were polarized and tenofovir or vehicle control gels were diluted 1:5 in the appropriate culture medium and applied to the apical surface. A 1:5 dilution of nonoxynol-9 (N9) was applied apically to the explants at the same time as the tenofovir and vehicle control gels as a toxicity control. Untreated explants were the negative control tissues. The explants were cultured for 24 h, washed five times, and placed in either medium containing 1-(4,5-dimethylthiazol-2-yl)-3,5-diphenylformazan (MTT) to assess tissue viability by measuring mitochondrial activity (A) or formalin to fix the tissue for hematoxylin-eosin staining for histology (original magnification 20×; bar length 0.05 mm) (B). Explants from five tissue donors were evaluated for viability after exposure to topical gels. The % viability was determined by dividing the corrected optical density of the treated explant by the corrected optical density of the control explant. Histology shown is representative of the five tissues evaluated.</p