Provider Recommendations for Human Papillomavirus Vaccine (HPV) Among Adolescent Males in Southwest Georgia Counties and The Associated Hpv Prevalence in This Population

Objective: The purpose of this research study was to examine the variation in healthcare providers’ behavior in recommending the Human Papillomavirus (HPV) vaccine to young male adolescents (aged 11-12), middle male adolescents (aged 13-17) and late male adolescents (aged 18-26) in rural Southwest Georgia counties. This research also aimed to identify factors associated with providers’ behaviors concerning HPV vaccination recommendation to youth in various age groups. Methods: Upon IRB approval, secondary data were obtained from Albany Area Primary Care for a paper-based survey that was conducted in 2014 using a representative random sample of family physicians (n=12), pediatricians (n=6), and nurse practitioners (n=33). The survey had a response rate of 76% and the researcher employed descriptive statistics, paired t tests and analysis of variance (ANOVA) to describe the pediatricians’ (Peds), nurse practitioners’ (NPs/Nurses), and family physicians’ (FPs) recommendations to HPV vaccinations and the association of HPV prevalence in Rural Southwest GA. Results: Statistical testing and analysis show barriers such as healthcare providers’ and parents’ discomfort with the vaccination of pre-teens when it concerns a sexually transmitted disease, lack of awareness to the role that males play in the spread of HPV, absence of government mandates, and non-completion of the three-dose series of vaccination due to financial or logistical reasons. Provider specialty, age, ethnicity, and reported barriers were significantly associated with recommendations and association to HPV prevalence. Conclusions: Findings suggest missed HPV vaccination opportunities for adolescent males. Perceived barriers and support to HPV vaccination to providers may drive decisions about HPV vaccine uptake and completion of vaccination series. Findings also suggest the need for policy level interventions to increase HPV vaccination among US adolescent males

Incidence of advanced cutaneous malignant melanoma in the UK: a systematic review

Objectives: Cutaneous melanoma (CM) is one of the most aggressive forms of skin cancer. In 2008, CM was found to be the sixth most common cancer in the UK. The aim of this review was to systematically identify patients with advanced CM, limited to stage IIIc and stage IV disease. Methods: Literature searches were undertaken in the Cochrane Library, MEDLINE, CINAHL and EMBASE between December 2010 and March 2011. Webpages of the Office of National Statistics, Cancer Research UK and the Welsh Cancer Intelligence and Surveillance Unit were also scanned. A narrative synthesis was undertaken due to the heterogeneity of included studies. Results: Three observational studies were identified. One study was in East Anglia, England while the remaining two were in Scotland. Both studies in Scotland estimated that 2% of all melanoma patients had advanced CM at the time of diagnosis. It was also noted that, in East Anglia, the incidence of stage IV CM decreased from 0.42 to 0.13 per 100,000 population per year between 1991 and 2004. The review highlighted the challenges in identifying patients with advanced CM from available data. Conclusions: This review highlighted the lack of, and the need for primary studies to estimate the incidence of advanced CM in the UK. Defining this subgroup of patients is important for identifying patients for targeted treatment. We suggest that researchers must clearly define this population of patients in future studies

Foreign Direct Investment: A Journey To Economic Growth In Ghana - Empirical Evidence

Foreign Direct Investment (FDI) has been viewed as a major stimulus to economic growth in developing countries. Its ability to deal with two major obstacles; namely, shortages of financial resources and technology and skills, has made it the center of attention for policymakers in low-income countries in particular. In spite of the significance generated by FDI flows, the flow to developing countries and the world, in general, has witnessed persistent decline over the years. The implication for the drop means that competition to attract FDI has increased as developing countries continue to create the enabling environment to attract foreign investors. Ghana, in particular, has, over the last decade, pursued various forms of economic reforms and liberalization of trade regimes in order to become more competitive in the international financial market. A handful of papers has recently dealt with FDI flows in Ghana. However, most of these studies are concerned with strategic FDI policy to attract FDI flows. The purpose of this study is to empirically determine the factors that influence FDI flows in Ghana, using time series data from 1988 to 2011. Regression analysis was carried out using relevant econometric techniques. The results of the study capture trade openness, exchange rate, natural resources, and infrastructure as the drivers of FDI in Ghana. Macroeconomic variables, such as inflation and per capita gross domestic products, were also registered to impact the determinants of FDI flows in Ghana. The contribution of this paper is that economic liberalization was found to be significant, indicating that policymakers' efforts in liberalizing the economic activities may necessarily translate into significant FDI inflows into the country

Fighting HIV/AIDS: Reconfiguring the State?

The author wishes to thank the anonymous reviewers of the article and the ESRC for funding part of this research

Developing Novel Prognostic Biomarkers for Multivariate Fracture Risk Prediction Algorithms

Multivariate prediction algorithms such as FRAX® and QFracture Scores provide an opportunity for new prognostic biomarkers to be developed and incorporated, potentially leading to better fracture prediction. As more research is conducted into these novel biomarkers, a number of factors need to be considered for their successful development for inclusion in these algorithms. In this review, we describe two well-known multivariate prediction algorithms for osteoporosis fracture risk applicable to the UK population, FRAX and QFracture Scores, and comment on the current prognostic tools available for fracture risk; dual X-ray assessment, quantitative ultrasonography, and genomic/biochemical markers. We also highlight the factors that need to be considered in the development of new biomarkers. These factors include the requirement for prospective data, collected in new cohort studies or using archived samples; the need for adequate stability data to be provided; and the need for appropriate storage methods to be used when retrospective data are required. Area under the receiver operating characteristic curve measures have been found to have limited utility in assessing the impact of the addition of new risk factors on the predictive performance of multivariate algorithms. New performance evaluation measures, such as net reclassification index and integrated discrimination improvement, are increasingly important in the evaluation of the impact of the addition of new markers to multivariate algorithms, and these are also discussed. © Springer Science+Business Media, LLC 2012

Statins inhibit C-reactive protein-induced chemokine secretion, ICAM-1 upregulation and chemotaxis in adherent human monocytes

Objectives. We have recently shown that CRP induces chemokine secretion and adhesion molecule up-regulation in human primary monocytes cultured in adherence. Given the increasing evidence on direct immunomodulatory properties of statins, we investigated their possible anti-inflammatory role on CRP-treated human monocytes. Methods. Monocytes were isolated by Ficoll-Percoll gradients and cultured in adherence to polystyrene. Chemokine secretion and adhesion molecule expression were detected by ELISA and flow cytometry. Migration assays were performed in modified Boyden chambers. Intracellular kinase activation was assessed by western blot. Results. Treatment with simvastatin or atorvastatin decreased CRP-induced release of CCL2, CCL3 and CCL4. In addition, both statins reduced CRP-induced intercellular adhesion molecule (ICAM-1) up-regulation, but had no effects on CD11b and CD18. Treatments with 1 μM simvastatin or atorvastatin significantly inhibited monocyte migration in response to CRP. CD32 and CD64 (CRP receptors) expression on monocytes was not affected by statins. Statin-induced inhibition of CRP-mediated chemokine secretion, ICAM-1 up-regulation and migration occurred through the inhibition of extracellular signal-regulated kinase (ERK) 1/2. Treatment with l-mevalonate or farnesylpyrophosphate, but not geranylgeranyl-pyrophosphate reversed the statin-induced effect on CRP-mediated functions and ERK 1/2 phosphorylation, confirming that statins blocked CRP-induced ERK 1/2 phosphorylation through the inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. Conclusions. Statins inhibited CRP-induced chemokine secretion, ICAM-1 up-regulation and migration in human adherent monocytes, through the inhibition of HMG-CoA reductase-ERK 1/2 pathway. This pathway could represent a very promising target to reduce CRP-induced activities in monocyte-mediated diseases, such as atherosclerosis or R

Identification and Characterization of a Bovine Herpesvirus-1 (BHV-1) Glycoprotein gL Which Is Required for Proper Antigenicity, Processing, and Transport of BHV-1 Glycoprotein gH

AbstractDNA sequence analysis of the bovine herpesvirus-1 (BHV-1) genome revealed the presence of an open reading frame named UL1 which exhibited limited homology to glycoprotein gL of herpes simplex virus-1 (S. K. Khattar, S. van Drunen Littel-van den Hurk, L. A. Babiuk, and S. K. Tikoo,Virology213, 28–37). To identify the BHV-1 UL1 protein, rabbit antisera were prepared against two synthetic peptides that were predicted by computer analysis to encompass antigenic epitopes. Sera against both peptides immunoprecipitated a 16- to 17-kDa protein fromin vitrotranslatedin vitrotranscribed mRNA, BHV-1-infected MDBK cells, and purified virions. Enzymatic deglycosylation and lectin binding assays confirmed that the BHV-1 UL1 protein contains only O-linked oligosaccharides and was named glycoprotein gL. Sera against UL22 protein immunoprecipitated a protein of 108 kDa from BHV-1-infected MDBK cells and purified virions, which was modified only by N-linked oligosaccharides and was named glycoprotein gH. Glycoprotein gL expressed by recombinant vaccinia virus was properly processed and secreted into the medium. In contrast glycoprotein gH expressed by recombinant vaccinia virus was found to be retained in the rough endoplasmic reticulum. However, gH coexpressed with gL by recombinant vaccinia viruses was properly processed and transported to the cell surface, suggesting that complex formation between gH and gL is necessary for the proper processing and transport of gH but not gL. In addition gH–gL complex formation is also required for induction of neutralizing antibody response and anchoring of gL to the plasma membrane

Effectiveness And Safety Assessment Of Mist tonica, A Herbal Haematinic

Anaemia is a widespread public health problem, and in Ghana it is the fourth leading cause of hospital admissions and the second factor contributing to death. Mist Tonica, an herbal haematinic produced by the Centre for Scientific Research into Plant Medicine (CSRPM), Ghana, was assessed for its effectiveness and safety in humans after Ethics Committee approval. Clinically established anaemic-patients aged, 13 years and above, with haemoglobin levels less than 11.5 g/dl and 13.5g/dl for females and males respectively were treated with Mist tonica, 8.96 g/ 40 mls three times daily for two weeks . The mean haemoglobin rise per week caused by Mist Tonica was 1.92 (0.76) g/dl, range (1.66 - 2.55) g/dl/week and over 88 % of the patients on Mist Tonica had their appetite for food improved. Haematological profile, liver and kidney functions were not adversely affected by Mist tonica. Results of the study suggest that Mist Tonica is an effective and safe herbal haematinic. Keywords: Anaemia, haemoglobin, herbal, haematinic, safety, effectivenessAfr. Jnl of Trad Comp Alt medicine Vol. 5 (2) 2008: pp. 115-11

Clinical Risk Factors for Osteoporosis in Ireland and the UK: A Comparison of FRAX and QFractureScores

Recently two algorithms have become available to estimate the 10-year probability of fracture in patients suspected to have osteoporosis on the basis of clinical risk factors: the FRAX algorithm and QFractureScores algorithm (QFracture). The aim of this study was to compare the performance of these algorithms in a study of fracture patients and controls recruited from six centers in the United Kingdom and Ireland. A total of 246 postmenopausal women aged 50-85 years who had recently suffered a low-trauma fracture were enrolled and their characteristics were compared with 338 female controls who had never suffered a fracture. Femoral bone mineral density was measured by dual-energy X-ray absorptiometry, and fracture risk was calculated using the FRAX and QFracture algorithms. The FRAX algorithm yielded higher scores for fracture risk than the QFracture algorithm. Accordingly, the risk of major fracture in the overall study group was 9.5% for QFracture compared with 15.2% for FRAX. For hip fracture risk the values were 2.9% and 4.7%, respectively. The correlation between FRAX and QFracture was R = 0.803 for major fracture and R = 0.857 for hip fracture (P ≤ 0.0001). Both algorithms yielded high specificity but poor sensitivity for prediction of osteoporosis. We conclude that the FRAX and QFracture algorithms yield similar results in the estimation of fracture risk. Both of these tools could be of value in primary care to identify patients in the community at risk of osteoporosis and fragility fractures for further investigation and therapeutic intervention. © 2011 Springer Science+Business Media, LLC