Gender Sensitive Blindness Prevention Intervention in the Niger Delta Region of Nigeria II: A report of a free cataract surgical service for women

Background: Gender issues in eye care are a global priority. Women have been recognized to face challenges in eye care. This includes a higher prevalence of disease conditions such as cataract to service delivery in which it is noted that they take up services especially for cataract surgery less than their male counterpart. This report seeks to document the experience and outcome of this organized gender-sensitive eye care project and in addition, make recommendations for future gender programmes. Women in the state were invited to participate in a free cataract surgical eye camp project. A talk on HIV was given at each centre and women willing to have free HIV testing were tested and counselled accordingly. Methods: A total of four thousand two hundred and thirty nine (4239) women were examined between 1st July and 30th September 2007. Eye operations were performed on 261 ( 6%) women during the duration of this project. Extra capsular cataract surgery with intraocular lens implantation was performed in 185 out of the 261 eye surgeries. Of the 4239 women who presented, a total of nine hundred and twenty three women (923) voluntarily screened for HIV. Out of these, thirty eight (38) women tested positive, of which 35 accepted counselling and commenced treatment. Two thousand five hundred and sixty-six (2566) 61% of participants at the eye camp were given reading glasses; most of these women were civil servants (teachers). Results: A female only surgical cataract eye camp is possible. It is convenient, economical and beneficial to have a collaborative programme with the committee on HIV/AIDS. This project was a successful strategy to reduce blindness, poverty and ensure empowerment of women. Recommendations are made towards a holistic approach in the organization of cataract surgical eye camps and for women.Key words: female, HIV, cataract, community eye cam

Prevention of Childhood Blindness through the Integration with Maternal Eye Care Programmes

Objective: The prevention of childhood blindness through the provision of preventive services at the community level, specialized surgical services in ophthalmic units and the provision of devices to correct low and services to children with established visual loss. Materials and methods: A series of free surgical cataract eye camps which focused on only women were conducted throughout Delta State in which children with eye problems were incidentally identified and treated. Of the 4239 women seen, 1006 (24%) brought their children along with them. Out of the 1006 children that accompanied their mothers, 840 (83%) of the children were seen based on their the request of their mothers for their ocular examination. Of these children, 28 (3%) had ocular morbidity. There were 19 boys and 9 girls. The majority of the children were between 2 to 5 years of age. The commonest causes of ocular morbidity were congenital and developmental cataract (24%), vernal conjunctivitis (28%), congenital glaucoma (14%) and corneal opacity from measles, harmful traditional eye practises and severe vernal keratoconjunctivitis. Others were refractive error, strabismus and optic atrophy. Results: A total of 10 children underwent surgery. Surgical procedures included 4 lensectomy and 3 lensectomy with intraocular lens implantation, 2 trabeculectomy and 1 optical iridectomy. One patient was given spectacles for juvenile onset myopia. Conclusion: there is a potential for a female gender focused eye programme, to promote child eye health and prevent childhood blindness.Key words: childhood blindness; community; cataract; glaucom

The mechanisms and processes of connection: developing a causal chain model capturing impacts of receiving recorded mental health recovery narratives.

BACKGROUND: Mental health recovery narratives are a core component of recovery-oriented interventions such as peer support and anti-stigma campaigns. A substantial number of recorded recovery narratives are now publicly available online in different modalities and in published books. Whilst the benefits of telling one's story have been investigated, much less is known about how recorded narratives of differing modalities impact on recipients. A previous qualitative study identified connection to the narrator and/or to events in the narrative to be a core mechanism of change. The factors that influence how individuals connect with a recorded narrative are unknown. The aim of the current study was to characterise the immediate effects of receiving recovery narratives presented in a range of modalities (text, video and audio), by establishing the mechanisms of connection and the processes by which connection leads to outcomes. METHOD: A study involving 40 mental health service users in England was conducted. Participants were presented with up to 10 randomly-selected recovery narratives and were interviewed on the immediate impact of each narrative. Thematic analysis was used to identify the mechanisms of connection and how connection leads to outcome. RESULTS: Receiving a recovery narrative led participants to reflect upon their own experiences or those of others, which then led to connection through three mechanisms: comparing oneself with the narrative and narrator; learning about other's experiences; and experiencing empathy. These mechanisms led to outcomes through three processes: the identification of change (through attending to narrative structure); the interpretation of change (through attending to narrative content); and the internalisation of interpretations. CONCLUSIONS: This is the first study to identify mechanisms and processes of connection with recorded recovery narratives. The empirically-based causal chain model developed in this study describes the immediate effects on recipients. This model can inform selection of narratives for use in interventions, and be used to support peer support workers in recounting their own recovery narratives in ways which are maximally beneficial to others

Changes in Seizure Frequency and Test-Retest Scores on the Wechsler Adult Intelligence Scale

Test-retest performance on the Wechsler Adult Intelligence Scale (WAIS) of two groups of adult epilepsy patients are presented and compared. In one group, Seizures Improved (SI) group, seizure frequency had decreased during the test-retest interval, and in the other group, Seizures Unimproved (SU) group, the number of seizures had either increased or stayed the same over the test-retest interval. The SI group showed a significant test-retest improvement on WAIS Verbal IQ, Performance 1Q, and Full Scale IQ, as well as on eight of 11 WAIS subtests. In comparison, the SU group showed significant increases only on the Performance IQ and Object Assembly subtest. Furthermore, differences between the two groups were observed in the pattern of test-retest changes seen on the Performance measures relative to the Verbal measures. The results suggest that change in seizure frequency is one of the factors associated with test-retest changes in the intellectual functioning of epilepsy patients. RÉSUMÉ Les rÉsultats obtenus À I‘Échelle de WAIS (Wechsler Adults Intelligence Scale) a partir d'une passation I (test) et d'une passation II (retest) chez deux groupes d'Épileptiques adultes sont prÉsentÉs et compares: (a) Dans un groupe la frequence des crises a diminue dur-ant I'intervalle “test-retest” (c'est a dire dans I'inter-valle separant la passation I (test) de la passation II (retest): Groupe des crises ameliorees (SI: seizures improved), (b) Dans l'autre groupe le nombre des crises au contraire a augmente ou bien est reste iden-tique au cours de I'intervalle “test-retest”: Groupe des crises non ameliorees (SU: seizures unimproved). Le groupe des “crises ameliorees” montre une amelioration significative tant sur le plan du QIV (quotient de I'echelle verbale), que du QIP (quotient de I'echelle performance) et du QIG (quotient global), ainsi que de 8 des subtests parmi les onze que contien I'echelle. En comparaison le groupe des “crises non ameliorees” ne montre une amelioration significative qu'au niveau du QIP et en particulier sur le subtest d'assemblage d'ob-jets (celui-ci faisant partie de I'echelle performance). De plus, on observe entre les deux groupes des differences du “type” des modifications entrainees par la situation “test-retest”, sur les rÉsultats obtenus a I'echelle performance et ceux obtensus a I'echelle verbale. Ces rÉsultats permettent de suggerer que, dans le fonctionnement intellectuel des sujets epileptiques, les changements dans la frequence des crises sont un des facteurs a mettre en correlation avec les changements observes a partir de la situation “test-retest”. RESUMEN Se compararon dos grupos de adultos con epilepsia por medio del rendimiento en dos tests de WAIS. En un grupo, la frecuencia de los ataques habia disminuido en el intervalo entre el primer test y el segundo [grupo con mejoria (SI)], mientras que en el otro el mimero de crisis no habia variado o habia au-mentado [grupo sin mejoria (SU)]. El grupo SI mostro una mejoria en laescala verbal CI, en la realizacion CI, en la escala total de CI y en los subtests WAIS. En comparacion, el grupo SU solo mostro un aumento significativo en la realizacion CI y en el subtest de Reunion de Objetos. Ademas, se observaron diferen-cias entre los dos grupos en lo que respecta a la prim-era y a la segunda prueba en la realizacion de las medidas verbales. Los resultados sugieren que los cambios en la frecuencia de los ataques juegan un papel en lo que respecta a funciÓn intelectual cuando se compara el primer WAIS con el segundo. ZUSAMMENFASSUNG Test und Retest Ergebnisse im WAIS von 2 Gruppen erwachsener Epileptiker werden dargestellt und ver-glichen. In einer Gruppe hatte die Anfallshaufigkeit wahrend des Test-Retest-Intervalls abgenommen– verbesserte Gruppe (SI)–und in einer anderen Gruppe war die Anfallshaufigkeit entweder gestiegen oder gleich geblieben wahrend des Test-Retest-Intervalls– unveranderte Gruppe (SU). Die SI-Gruppe zeigte signifikante Verbesserung zwischen Test und Retest im Verbal-IQ des WAIS, im Handlungsteil und im Gesamt-IQ ebenso wie in 8 von 11 WAIS Subtests. Im Vergleich hierzu zeigte die SU-Gruppe signifikante Verbesserung nur im Handlungs-IQ und im Objekte-zuordnungs-Subtest. Weiterhin wurden Unterschiede zwischen den beiden Gruppen im Muster der Test-Retest-Veranderungen im Verhaltnis des Handlung-steils zum Verbalteil bemerkt. Die Ergebnisse lassen vermuten, dalJ die Veranderung der Anfallshaufigkeit einer der Faktoren ist, der hinsichtlich der in-tellektuellen Funktion anfallskranker Patienten Bezie-hungen zu den Veranderungen des Test-Retest-Ergeb-nis aufweist.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65457/1/j.1528-1157.1981.tb04334.x.pd

Infrared light excites cells by changing their electrical capacitance

Optical stimulation has enabled important advances in the study of brain function and other biological processes, and holds promise for medical applications ranging from hearing restoration to cardiac pace making. In particular, pulsed laser stimulation using infrared wavelengths >1.5 μm has therapeutic potential based on its ability to directly stimulate nerves and muscles without any genetic or chemical pre-treatment. However, the mechanism of infrared stimulation has been a mystery, hindering its path to the clinic. Here we show that infrared light excites cells through a novel, highly general electrostatic mechanism. Infrared pulses are absorbed by water, producing a rapid local increase in temperature. This heating reversibly alters the electrical capacitance of the plasma membrane, depolarizing the target cell. This mechanism is fully reversible and requires only the most basic properties of cell membranes. Our findings underscore the generality of pulsed infrared stimulation and its medical potential

Differential Affinity and Catalytic Activity of CheZ in E. coli Chemotaxis

Push–pull networks, in which two antagonistic enzymes control the activity of a messenger protein, are ubiquitous in signal transduction pathways. A classical example is the chemotaxis system of the bacterium Escherichia coli, in which the kinase CheA and the phosphatase CheZ regulate the phosphorylation level of the messenger protein CheY. Recent experiments suggest that both the kinase and the phosphatase are localized at the receptor cluster, and Vaknin and Berg recently demonstrated that the spatial distribution of the phosphatase can markedly affect the dose–response curves. We argue, using mathematical modeling, that the canonical model of the chemotaxis network cannot explain the experimental observations of Vaknin and Berg. We present a new model, in which a small fraction of the phosphatase is localized at the receptor cluster, while the remainder freely diffuses in the cytoplasm; moreover, the phosphatase at the cluster has a higher binding affinity for the messenger protein and a higher catalytic activity than the phosphatase in the cytoplasm. This model is consistent with a large body of experimental data and can explain many of the experimental observations of Vaknin and Berg. More generally, the combination of differential affinity and catalytic activity provides a generic mechanism for amplifying signals that could be exploited in other two-component signaling systems. If this model is correct, then a number of recent modeling studies, which aim to explain the chemotactic gain in terms of the activity of the receptor cluster, should be reconsidered

Potent cytotoxic effects of Calomeria amaranthoides on ovarian cancers

<p>Abstract</p> <p>Background</p> <p>Ovarian cancer remains the leading cause of death from gynaecological malignancy. More than 60% of the patients are presenting the disease in stage III or IV. In spite of combination of chemotherapy and surgery the prognosis stays poor for therapy regimen.</p> <p>Methods</p> <p>The leaves of a plant endemic to Australia, <it>Calomeria amaranthoides</it>, were extracted and then fractionated by column chromatography. <it>In vitro </it>cytotoxicity tests were performed with fractions of the plant extract and later with an isolated compound on ovarian cancer cell lines, as well as normal fibroblasts at concentrations of 1-100 μg/mL (crude extract) and 1-10 μg/mL (compound). Cytotoxicity was measured after 24, 48 and 72 hours by using a non-fluorescent substrate, Alamar blue.</p> <p><it>In vivo </it>cytotoxicity was tested on ascites, developed in the abdomen of nude mice after inoculation with human OVCAR₃cells intraperitoneally. The rate of change in abdomen size for the mice was determined by linear regression and statistically evaluated for significance by the unpaired t test.</p> <p>Results</p> <p>Two compounds were isolated by chromatographic fractionation and identified by ¹H-NMR, ¹³C-NMR and mass spectrometry analyses, EPD, an α-methylene sesquiterpene lactone of the eremophilanolide subtype, and EPA, an α-methylene carboxylic acid.</p> <p>Cytotoxicity of EPD for normal fibroblasts at all time points IC₅₀was greater than 10 μg/mL, whereas, for OVCAR₃cells at 48 hours IC₅₀was 5.3 μg/mL (95% confidence interval 4.3 to 6.5 μg/mL).</p> <p>Both, the crude plant extract as well as EPD killed the cancer cells at a final concentration of 10 μg/mL and 5 μg/mL respectively, while in normal cells only 20% cell killing effect was observed. EPA had no cytotoxic effects.</p> <p>Changes in abdomen size for control versus Cisplatin treated mice were significantly different, P = 0.023, as were control versus EPD treated mice, P = 0.025, whereas, EPD versus Cisplatin treated mice were not significantly different, P = 0.13.</p> <p>Conclusions</p> <p>For the first time both crude plant extract from <it>Calomeria amaranthoides </it>and EPD have been shown to have potent anti-cancer effects against ovarian cancer.</p

Experience developing national evidence-based clinical guidelines for childhood pneumonia in a low-income setting - making the GRADE?

BACKGROUND: The development of evidence-based clinical practice guidelines has gained wide acceptance in high-income countries and reputable international organizations. Whereas this approach may be a desirable standard, challenges remain in low-income settings with limited capacity and resources for evidence synthesis and guideline development. We present our experience using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for the recent revision of the Kenyan pediatric clinical guidelines focusing on antibiotic treatment of pneumonia. METHODS: A team of health professionals, many with minimal prior experience conducting systematic reviews, carried out evidence synthesis for structured clinical questions. Summaries were compiled and distributed to a panel of clinicians, academicians and policy-makers to generate recommendations based on best available research evidence and locally-relevant contextual factors. RESULTS: We reviewed six eligible articles on non-severe and 13 on severe/very severe pneumonia. Moderate quality evidence suggesting similar clinical outcomes comparing amoxicillin and cotrimoxazole for non-severe pneumonia received a strong recommendation against adopting amoxicillin. The panel voted strongly against amoxicillin for severe pneumonia over benzyl penicillin despite moderate quality evidence suggesting clinical equivalence between the two and additional factors favoring amoxicillin. Very low quality evidence suggesting ceftriaxone was as effective as the standard benzyl penicillin plus gentamicin for very severe pneumonia received a strong recommendation supporting the standard treatment. CONCLUSIONS: Although this exercise may have fallen short of the rigorous requirements recommended by the developers of GRADE, it was arguably an improvement on previous attempts at guideline development in low-income countries and offers valuable lessons for future similar exercises where resources and locally-generated evidence are scarce

Impact of Lack of Breast Feeding during Neonatal Age on the Development of Clinical Signs of Pneumonia and Hypoxemia in Young Infants with Diarrhea

Hypoxemia is a grave sequel of pneumonia, and an important predictor of a fatal outcome. Pneumonia in the neonatal period is often associated with lack of breast feeding. However, there is no published report on the impact of the cessation of breast feeding in the neonatal period on the development of pneumonia and hypoxemia. The purpose of our study was to assess the impact of non-breast feeding or stopping breast feeding during the neonatal period (henceforth to be referred to as non-breast fed) on clinical features of pneumonia and hypoxemia in 0-6-month-old infants with diarrhea admitted to an urban hospital in Bangladesh.We prospectively enrolled all infants (n = 107) aged 0 to 6 months who were admitted to the Special Care Ward (SCW) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B) with diarrhea and pneumonia from September 2007 through December 2007.We compared the clinical features of pneumonia and hypoxemia of breast fed infants (n = 34) with those who were non-breast fed (n = 73).The median (inter-quartile range) duration of hypoxemia (hours) in non-breast-feds was longer than breast-fed infants [0.0 (0.0, 12.0) vs. 12.0 (0.0, 21.75); p = 0.021]. After adjusting for potential confounders such as inability to drink, fever, head nodding, cyanosis, grunting respiration, and lower chest wall in drawing, the non-breast-fed infants with pneumonia along with diarrhea had a higher probability of cough (OR 9.09; CI 1.34-61.71; p = 0.024), hypoxemia (OR 3.32; CI 1.23-8.93; p = 0.017), and severe undernutrition (OR 3.42; CI 1.29-9.12; p = 0.014).Non-breast feeding or cessation of breast feeding during the neonatal period may substantially increase the incidence of severe malnutrition, incidence of cough, and both the incidence and duration of hypoxemia in young infants presenting with pneumonia and diarrhea. The findings emphasize the paramount importance of the continuation of breast feeding in the neonatal period and early infancy

Comorbid substance abuse and brain morphology in recent-onset psychosis

The aim of the presented study was to compare schizophrenia and schizoaffective patients early in the course of the disease with and without comorbid substance abuse disorder (SUD vs. NSUD) with regard to brain morphology. In a prospective design 41 patients (20 SUD vs. 21 NSUD) diagnosed as recent-onset schizophrenia or schizoaffective disorder consecutively admitted to hospital received standardized psychopathological evaluation (BPRS, SANS, MADRS, CGI, GAF) and MRI scanning with volumetric measurement of superior temporal gyrus (STG), amygdala-hippocampal complex, and cingulum. Patients with SUD (primarily cannabis) were significantly younger, predominantly male and had a lower socioeconomic status. Despite less attentional impairment (SANS subscore) and elevated anxiety/depression (BPRS subscore) in patients with SUD compared to NSUD, no other psychopathological differences could be detected. There were no differences in the assessed temporolimbic brain morphology between the two subgroups. In conclusion, in this study substance abuse in recent-onset psychosis had no effect on brain morphology and the earlier onset of psychosis in patients with comorbid SUD could not be explained by supposed accentuated brain abnormalities in temporolimbic regions