Health Goals Malawi - Impact Report 2020

‘Health Goals Malawi’ is a three-year project using football as a convenor to engage adolescent and young males aged 14-24 with health services, particularly HIV self-testing. The project aims to reduce the transmission of HIV and other sexually transmitted diseases in Malawi, by raising awareness of support services and educating young people about the risks. The project works in partnership with Liverpool Football Club Foundation (LFC), the Malawi Liverpool Wellcome Trust (MLW) and Population Services International (PSI) to support local community leaders and coached to engage with local youth, who are predominantly hard to reach, and the least likely to access health education and services such as self-testing and treatment plans

Delivering through Diversity

Companies with diverse members in leadership positions are more than 20 percent likely to outperform on profitability and have superior value creation. Delivering through Diversity from McKinsey & Company discusses the relationship between diversity and business success and describes the inclusion and diversity (I&D) initiatives that seem to accelerate business performance. This report draws on public annual reports and websites of more than 1,000 companies worldwide and financial data from the Corporate Performance Analytics database of McKinsey and S&P Global. The authors also highlight the I&D efforts of 17 companies across multiple industries. Results show that companies in the top-quartile for gender diversity and ethnic/cultural diversity in their executive teams have better than predicted return on investments, outperform on profitability and are more likely to have superior value creation. Companies in the top-quartile for ethnic/cultural diversity in their executive teams, for example, were 33 percent more likely to lead industry profitability. Additionally, the report reveals that bottom-quartile companies are lagging in comparison to their competitors. The authors suggest that all levels of leadership commit to I&D goals, that managers connect I&D initiatives to growth strategies and company culture, and that I&D strategies should be tailored to local conditions to maximize their impact

Laplacian Pyramid of Conditional Variational Autoencoders

Variational Autoencoders (VAE) learn a latent representation of image data that allows natural image generation and manipulation. However, they struggle to generate sharp images.To address this problem, we propose a hierarchy of VAEs analogous to a Laplacian pyramid. Each network models a single pyramid level, and is conditioned on the coarser levels. The Laplacian architecture allows for novel image editing applications that take advantage of the coarse to fine structure of the model. Our method achieves lower reconstruction error in terms of MSE, which is the loss function of the VAE and is not directly minimised in our model. Furthermore, the reconstructions generated by the proposed model are preferred over those from the VAE by human evaluators

The economic status of older people’s households in urban and rural settings in Peru, Mexico and China: a 10/66 INDEP study cross-sectional survey

Few data are available from middle income countries regarding economic circumstances of households in which older people live. Many such settings have experienced rapid demographic, social and economic change, alongside increasing pension coverage. Population-based household surveys in rural and urban catchment areas in Peru, Mexico and China. Participating households were selected from all households with older residents. Descriptive analyses were weighted back for sampling fractions and non-response. Household income and consumption were estimated from a household key informant interview. 877 Household interviews (3177 residents). Response rate 68 %. Household income and consumption correlated plausibly with other economic wellbeing indicators. Household Incomes varied considerably within and between sites. While multigenerational households were the norm, older resident’s incomes accounted for a high proportion of household income, and older people were particularly likely to pool income. Differences in the coverage and value of pensions were a major source of variation in household income among sites. There was a small, consistent inverse association between household pension income and labour force participation of younger adult co-residents. The effect of pension income on older adults’ labour force participation was less clear-cut. Historical linkage of social protection to formal employment may have contributed to profound late-life socioeconomic inequalities. Strategies to formalise the informal economy, alongside increases in the coverage and value of non-contributory pensions and transfers would help to address this problem

Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

Background: Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods: Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results: None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions: Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection prevention; 4) improving referral systems to the hospitals; 5) advocating for changes in national RH policies and protocols; and 6) providing technical assistance for monitoring and evaluation of key RH indicators. Together, these initiatives will improve the quality and accessibility of RH services in the DRC - services which are urgently needed and to which Congolese women are entitled by international human rights law

Laplacian Pyramid of Conditional Variational Autoencoders

Variational Autoencoders (VAE) learn a latent representation of image data that allows natural image generation and manipulation. However, they struggle to generate sharp images. To address this problem, we propose a hierarchy of VAEs analogous to a Laplacian pyramid. Each network models a single pyramid level, and is conditioned on the coarser levels. The Laplacian architecture allows for novel image editing applications that take advantage of the coarse to fine structure of the model. Our method achieves lower reconstruction error in terms of MSE, which is the loss function of the VAE and is not directly minimised in our model. Furthermore, the reconstructions generated by the proposed model are preferred over those from the VAE by human evaluators

Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/66 Dementia Research Group population-based study123

Background: Evidence of an association between fish and meat consumption and risk of dementia is inconsistent and nonexistent in populations in developing countries

A journey without maps—Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru

Purpose of the study: Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability. Design & methods: We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person. Results: Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a ‘journey without maps’. Women were de facto caregivers but the traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched. Implications: Governments are lagging behind sociodemographic and social change. There is an urgent need for policy frameworks to support and supplement inputs from families. These should include community-based and residential care services, disability benefits and carers allowances. Further enhancement of health insurance schemes and scale-up of social pensions are an important component of bolstering the security of dependent older people and supporting their continued social and economic participation

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China

BACKGROUND: While links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China. METHODS: Households were classified from the evolution of the needs for care of older residents, over two previous community surveys, as 'incident care', 'chronic care' or 'no care', and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care). RESULTS: Household income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78-1.00) and government transfers (pCR 0.80, 95% CI 0.69-0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77-0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26-1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64-2.22) in care households. CONCLUSIONS: While endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people's needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age; incentivisation of informal care through compensation for direct and opportunity costs; and development of community care services to support, and, where necessary, supplement or substitute the central role of informal caregivers

Activation of Hsp90 Enzymatic Activity and Conformational Dynamics through Rationally Designed Allosteric Ligands

Hsp90 is a molecular chaperone of pivotal importance for multiple cell pathways. ATP-regulated internal dynamics are critical for its function and current pharmacological approaches block the chaperone with ATP-competitive inhibitors. Herein, a general approach to perturb Hsp90 through design of new allosteric ligands aimed at modulating its functional dynamics is proposed. Based on the characterization of a first set of 2-phenylbenzofurans showing stimulatory effects on Hsp90 ATPase and conformational dynamics, new ligands were developed that activate Hsp90 by targeting an allosteric site, located 65 æ from the active site. Specifically, analysis of protein responses to first-generation activators was exploited to guide the design of novel derivatives with improved ability to stimulate ATP hydrolysis. The molecules’ effects on Hsp90 enzymatic, conformational, cochaperone and client-binding properties were characterized through biochemical, biophysical and cellular approaches. These designed probes act as allosteric activators of the chaperone and affect the viability of cancer cell lines for which proper functioning of Hsp90 is necessary