Bayesian estimation of diagnostic accuracy of fecal culture and PCR-based tests for the detection of Salmonella enterica in California cull dairy cattle.

Epidemiological studies of low prevalence disease problems are often hindered by the high cost of diagnostic testing. The objective of this study was to evaluate PCR screening of both individual and pooled fecal samples from culled dairy cows for the invA gene of Salmonella followed by culture to determine if the sensitivity and specificity were comparable to the results from traditional culture methods applied to individual samples. Cows from six different dairies were sampled in all four seasons. A total of 240 individual cow fecal samples, 24 fecal pools and 24 pools of 24-hour tetrathionate enrichment broth were tested. Diagnostic sensitivity of PCR screening followed by culture of PCR positive or indeterminate samples (i.e PCR-CUL method) was lower than that of culture (CUL) when applied to individual fecal samples (94.8%, 99.5%), however the specificity was comparable (99.6% and 97.7% respectively). For pools of five fecal samples and pools of five, 24 h tetrathionate broth samples, the specificity of both tests were comparable (∼98%); however, their sensitivity was only comparable in pooled fecal samples (∼93%) but greater for culture compared to PCR-CUL in pooled broth samples (∼99% versus ∼93%). Compared to culture results from testing of individual fecal samples, testing pooled fecal samples by culture had a relative sensitivity of 74% and relative specificity of 96%, testing pooled fecal samples by PCR-CUL resulted in relative sensitivity of 90% and relative specificity of 96%. Testing of pooled 24-hour enrichment broth by PCR-CUL increased the relative sensitivity and specificity to 100%. PCR testing followed by culture of positive or indeterminate samples is a time saving alternative to traditional methods. In addition, pooling of samples may be a useful method for decreasing cost if study aims can accommodate a moderate loss of relative sensitivity

Factors Associated with The Use of Antenatal Care in East Sumba, East Nusa Tenggara

Background: Antenatal care (ANC) is very important to pregnant women as it helps prevent mother and child mortality, prevent complications, helps foster a good relationship between the husband and wife, mother and child and father. Good antenatal care includes regular screening which can detect and prevent early complications such as hypertension and pregnancy diabetes; both of which can dramatically affect the fetus. Early detection means regular monitoring and treatment. This study aimed to analyze factors associated with the use of ANC in East Sumba, East Nusa Tenggara. Subjects and Method: This was an cross sectional study conducted in East Sumba, East Nusa Tenggara. A sample of 254 pregnant women were selected for this study by simple random sampling. The dependent variable was use of ANC. The independent variables were being a housewife, receiving husband's support, and social support. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: The use of ANC was associated with being a housewife (b= 0.88; 95% CI= 1.30 to 4.48; p= 0.005), receiving husband's support (b= 0.72; 95% CI= 0.25 to 0.95; p= 0.035), and social support (b= 1.52; 95% CI= 0.10 to 0.51; p<0.001). Conclusion: The use of ANC is associated with being a housewife, receiving husband's support and social support. Keywords: housewife, husband's support, social support, antenatal care, utilizatio

Knowledge, Preventive Practice, and The Risk of Dengue Hemorrhagic Fever in Kupang, East Nusa Tenggara

Background: Dengue/dengue hemorrhagic fever (DHF) has been one of the most important resurgent tropical diseases in the past 17 years. Its incidence in East Nusa Tenggara has been increasing from 2011 to 2013. This study aimed to investigate the associations between knowledge, preventive practice, and the risk of dengue hemorrhagic fever in Kupang, East Nusa Tenggara. Subjects and Method: This was a case-control study conducted at 8 Puskesmas (Community Health Center) in Kupang, East Nusa Tenggara, Indonesia, from March to May 2016. A total of 72 subjects were selected for this study by fixed disease sampling, consisting of 36 DHF cases and 36 controls. The dependent variable was DHF. The independent variables were knowledge on DHF and DHF preventive practice including draining, hoarding and burying. The data were collected by questionnaire and interview. The data were analyzed by multiple logistic regression. Results: Poor knowledge on DHF (OR= 4.85; 95% CI= 1.62 to 14.49; p= 0.005) and poor DHF preventive practice (OR= 4.72; 95% CI= 1.60 to 13.91; p= 0.005) were associated with an increased risk of DHF. Conclusion: Poor knowledge of DHF and poor DHF preventive practice are associated with an increased risk of DHF. Keywords: knowledge, preventive practice, dengue hemorrhagic fever

The Effect of Wastewater Disposal Management System on Population Health at Tibar Village, Bazartete Sub-District, Liquiça District, Timor-Leste

Background: Poor waste disposal management is an important public health issue in developing countries including Timor Leste. Data from Posto Saúde Tibar, Liquiça sub-district, Liquiça district, Timor Leste showed that people who resided near final waste disposal were often affected by infectious diseases such as malaria acute respiratory infection, dengue, diarrhea, and skin disease. The purpose of this study was to determine the effect of wastewater disposal management system on population health at Tibar village, Bazartete sub-district, Liquiça district, Timor Leste. Subjects and Method: This was a cross setional study conducted at SucoTibar, Bazartete sub-district, Liquiça district, Timor Leste. A sample of 34 families were selected for this study. The dependent variable was population health status. The independent variables were reduce, reuse, and recycle management system. Data were collected by questionnaire and observation sheet. The data were analyzed by multiple logistic regression. Results: Absence of reduce (OR= 0.33; 95% CI= -1.53 to 2.19; p=0.004), reuse (OR= 0.23; 95% CI= -1.59 to 2.13; p= 0.009), and recycle (OR= 0.22; 95% CI= -1.64 to 2.08; p= 0.020) in the management system were associated with poorer population health status. Conclusion: Absence of reduce, reuse, and recycle in the management system are associated with poorer population health status. Keywords: reduce, reuse, recycle, management system, population health statu

Hygiene Sanitation and Detection Of Rhodamin B in Sauce and Formalin in Meatball at Meatball Tavern, Kupang, East Nusa Tenggara

Background: Food safety and sanitation is an essential part of the food industry. While it is important to be able to deliver food quickly and profitably, the importance of food safety and sanitation cannot be underestimated. Fast food retailers such as meatball tavern are common in Kupang, East Nusa Tenggara. Therefore it is worth studying the food safety and sanitation among the existing fast food retailers. This study aimed to examine hygiene sanitation and detection of rhodamin B in sauce and formalin in meatball at meatball tavern, Kupang, East Nusa Tenggara. Subjects and Method: This was a cross-sectional study conducted at meatball taverns, Kupang, East Nusa Tenggara, Indonesia. A total of 16 meatball taverns were selected for this study by total sampling. The dependent variables were hygiene sanitation, rhodamin B content in sauce, and formalin content in meatball. The independent variables were selection of foodstuff, food storage, processing place, equipment, food handlers, food transport, and food provision. The data were collected by observation and laboratory examination. The data were described accordingly. Results: Hygiene and sanitation in food selection and food storage were good (70-100%). Hygiene and sanitation in food handling and processing were fair (50-78%). Hygiene and sanitation of processing places were variable from poor to moderate (36-72%). Hygiene and sanitation of equipment were good (70-100%). Food stewardship was very good (87-100%). Rhodamin B content was absent in sauce. Formalin content was absent in meatball. Conclusion: Hygiene and sanitation levels in various aspect of food preparation and handling at meatball taverns were variable ranging from poor to very good level. Keywords: hygiene, sanitation, meatball, tavern, formalin, rhodamin B

Bradykinin improves postischaemic recovery in the rat heart: role of high energy phosphates, nitric oxide, and prostacyclin

Objective: The aim was to define: (1) whether bradykinin administration during reperfusion improves postischaemic myocardial recovery; (2) whether high energy phosphate compounds are involved in the protective effects of bradykinin; and (3) whether bradykinin-induced release of prostacyclin and nitric oxide mediate the protective effects of bradykinin. Methods: In the Langendorff rat heart preparation, coronary flow, left ventricular developed pressure, and, using 31P magnetic resonance spectroscopy, the high energy phosphate compounds phosphocreatine and β-ATP were assessed during 15 min of global ischaemia and 30 min of reperfusion. Administration of 10−7 M bradykinin was started before ischaemia and maintained throughout the experiment (BK-pre). This was compared to 10−7 M bradykinin given exclusively with reperfusion (BK-post). Then 10−7 M bradykinin was given simultaneously with 10−4 M Nω-nitro-L-arginine-methyl ester (BK-LNAME) or 10−5 M indomethacin (BK-indo). Results: In comparison to control hearts, BK-pre exerted a significant protective effect on the postischaemic recovery of coronary flow [71(5)% v 43(4)%, P < 0.05], left ventricular pressure [81(8)% v 42(5)%, P < 0.05], phosphocreatine [105(4)% v 67(8)%, P < 0.05], and β-ATP [78(9)% v 48(7)%, P < 0.05]. With BK-post, recovery of coronary flow [71(4)% v 43(4)%, P < 0.05] and left ventricular pressure [78(4)% v 42(5)%, P < 0.05] significantly improved; however the recovery of phosphocreatine [70(4)% v 67(8)%, NS] and β-ATP [58(2)% v 48(7)%, NS] was not different from control. When bradykinin and L-NAME or indomethacin was given the beneficial effects of bradykinin on ischaemic hearts were abolished. Conclusions: (1) Bradykinin improved postischaemic myocardial recovery when given before ischaemia or starting exclusively with reperfusion; (2) this was only partially related to a protective action on the high energy phosphate compounds during ischaemia; (3) the beneficial effects of bradykinin on ischaemic hearts are dependent from an unrestrained action of prostacyclin and nitric oxid

Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania.

Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers' shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants' practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based

Two-loop Yang-Mills diagrams from superstring amplitudes

Starting from the superstring amplitude describing interactions among D-branes with a constant world-volume field strength, we present a detailed analysis of how the open string degeneration limits reproduce the corresponding field theory Feynman diagrams. A key ingredient in the string construction is represented by the twisted (Prym) super differentials, as their periods encode the information about the background field. We provide an efficient method to calculate perturbatively the determinant of the twisted period matrix in terms of sets of super-moduli appropriate to the degeneration limits. Using this result we show that there is a precise one-to-one correspondence between the degeneration of different factors in the superstring amplitudes and one-particle irreducible Feynman diagrams capturing the gauge theory effective action at the two-loop level.Comment: 42 pages plus appendices, 10 figure

Canada-Africa Relations in Changing Core-Periphery Dynamics: A Chance to "Come Back" Differently

The Department of Foreign Affairs Canada sees the dynamism at play across the African continent as calling out for Canadian engagement. Africa in the twenty-first century is no longer the continent emerging from colonial rule; it seeks new forms of relationships with international partners. The African Development Bank, for instance, has identified five priorities for inclusive growth on the continent. The challenges are huge, as is the potential for transformative change. But the conditions for international collaboration in achieving these goals have changed; African leaders are seeking new forms of associations and teamwork. Canada has an opportunity to "come back" differently if it can look beyond its narrow mining interests and become an active partner working with public authorities in need of new and bold international partnerships. Unfortunately, Trudeau's "Canada is back" campaign does not look set to change the status quo. And, in a world where the political economic power is moving east, African countries do not have much reason to listen to Canada

Analysis of Risk Factors for Gestational Hypertension in Pregnant Women of the II And III Trimesters in the Coastal Area East Flores District

Introduction: Gestational hypertension is a condition in which blood pressure in pregnant women increases up to 140/90 mmHg or more for the first time at the 20 weeks of gestation, without a history of hypertension before pregnancy and no proteinuria. This study aimed to analyze the risk factors for gestational hypertension in pregnant women during the second and third trimesters who lived in the coastal areas of East Flores Regency.Method: Case-control studies were used in this study. Total the case group in this study was 16 mothers, while the control group was 16 mothers. Data were analyzed using a Chi-Square test.Results: The results of the analysis showed there are significant relationships between the age of mothers (p=0.000), parity (0.000), and the history of long-use of contraception (p=0.000 with the incidence of gestational hypertension in pregnant women in the second and third trimesters in the coastal area of East Flores Regency). The most dominant and significant variable causing gestational hypertension in pregnant women during the second and third trimesters was parity (OR=22.075; 95% CI: 0.712-684.613). However, the study also found there is no relationship of gestation hypertension with consumption of foods containing saturated fat, consumption of salty foods, fruit consumption and vegetables, coffee drinking habits, ANC visits, family support, and obesity.Recommendation: It is important for the health workers to increase mother’s knowledge and communities’ awareness about age at risk and parity at risk. Thus, health providers should carry out more routine monitoring and provide counseling about 4 important factors in planning pregnancy.