A randomized comparison of branded sodium stibogluconate and generic sodium stibogluconate for the treatment of visceral leishmaniasis under field conditions in Sudan.

OBJECTIVE: To compare the outcome of treatment of Sudanese kala-azar patients treated under field conditions with either branded sodium stibogluconate (SSG) (Pentostam GlaxoWellcome) or generic SSG (Albert David Ltd, Calcutta, supplied by International Dispensary Association, Amsterdam). METHOD: Randomised comparison. 271 patients were treated with Pentostam and 245 with generic SSG. RESULTS: No statistically significant differences in cure rate or mortality were detected between Pentostam and generic SSG. No differences in side-effects between the two drugs were noted. The initial cure rate at the time of discharge was 93.7 and 97.6%, respectively; the death rate during treatment 5.9 and 2.4%. Six months follow up was achieved in 88.5% of the discharged patients. Two patients had died in the Pentostam group and two had died in the generic SSG group, giving a final death rate of 7.5 and 3.7%. The number of relapses in the Pentostam and generic SSG groups were 3 and 1, respectively. The final cure rates, calculated at 6 months after discharge, were 91.3% and 95.9%. CONCLUSION: No difference was observed in the performance of generic SSG compared to Pentostam for the treatment of visceral leishmaniasis in Sudan. Generic SSG can be routinely and safely used for the treatment of kala-azar. Generic SSG costs only 1/14 of the price of Pentostam. The use of generic SSG may make treatment of kala-azar affordable for national governments in Africa

Alcohol and healthy ageing: a challenge for alcohol policy

Objectives: This paper presents findings of a qualitative study of older people's use of alcohol during retirement and identifies ways that an improved understanding of older people's drinking can inform policy approaches to alcohol and active and healthy ageing. Study design: Qualitative semi-structured interviews conducted with a self-selecting sample of retired people. Methods: Participants were recruited from three geographical locations in the West of Scotland. A quota sampling design was used to ensure a broad spread of participants in terms of socio-economic position, age and gender. In total 40 participants were interviewed and the data analysed thematically using Braun and Clarke's (2006) approach. Results: Amongst those who used alcohol, it was most often framed in terms of pleasure, relaxation, socialising and as a way to mark the passage of time. Alcohol was often associated with social occasions and interactions both in private and in public spaces. There were also many examples of the use of imposed routines to limit alcohol use and of a decreasing volume of alcohol being consumed as participants aged. This suggests that older people are often active in constructing what they regard as ‘healthier’ routines around alcohol use. However, processes and circumstances associated with ageing can lead to risk of social isolation and/or increased alcohol consumption. Such processes include retirement from paid work and other ‘biographical disruptions’ such as caring for a partner, bereavement and/or loss of social networks. Conclusions: These findings highlight processes that can result in changes in drinking habits and routines. Whilst these processes can be associated with a reduction or cessation of alcohol use as people age, they can also be associated with increased risk of harmful alcohol consumption. Fractured or disrupted routines, particularly those associated with bereavement or the burden of caring responsibilities, through increasing the risk of loneliness and isolation, can construct increased risk of harmful alcohol consumption. These findings reframe the pathway of risk between ageing and alcohol-related harm by highlighting the vulnerability to harmful drinking practices brought by fracture or sudden change of routine. The findings point to a role for public health in supporting the reconstruction of routines that provide structure and meaning and can be used to actively manage the benefits and harms associated with drinking

Spline Fractional Polynomial for Computing Fractional Differential Equations

نقترح طريقة سبلاين الكسرية للمعادلات التفاضلية الكسرية الخاضعة للشروط الأبتدائية.  ان استخدام تكامل واشتقاق كابوتو(Caputo) الكسرية يؤدي الى انشاء استيفاء سبلاين بمعاملات متعددة الحدود. تمت دراسة حدود الخطأ لدالة سبلاين المفروضة و كان تحليل الأستقرار مكتملا. تم النظر في التفسير العددي للطريقة المقدمة بأستخدام ثلاثة أمثلة.  أظهرت النتائج أن طريقة سبلاين الكسرية التي تقحم المعامل مع متعددة الحدود الكسرية فريدة من نوعها.We propose a fractional spline method for solving fractional differential equations subject to initial conditions. Using the Caputo fractional integral and derivative have to construct the spline interpolation with polynomial coefficients. For the given spline function, error bounds were studied and a stability analysis was completed. The numerical explanation for the provided method was considered using three examples. The results show that the fractional spline function which interpolates data is productive and profitable in solving unique problems.&nbsp

Separation of lymphocytes by electrophoresis under terrestrial conditions and at zero gravity, phase 3

Electrophoretic mobilities (EPM) of peripheral lymphocytes were studied from normal subjects, chronic hemodialysis patients and kidney transplant recipients. A technique to separate B lymphocytes and null cells from non-T lymphocyte preparation was developed. The experiments were designed to determine which subpopulation of the non-T lymphocytes is primarily affected and shows a decreased EPM in chronic hemodialysis patients and kidney transplant recipients

Retaining consumer participation in the Fremantle Primary Prevention Study: a general practice team based cardiovascular risk reduction study

Recruitment and retention of participants to lifestyle modification studies can be challenging within a primary care setting. The management of factors such as travel, busy lifestyles and lack of regular follow up of participants can result in considerable attrition rates over the lifecycle of the project. The aim of the study was to understand from a research participant perspective the perceived barriers and facilitators in retaining community participants in primary health care research. This is a qualitative study with data collected from four focus groups facilitated at the end of each of three community forums focusing on sharing the findings of the Fremantle Primary Prevention Study. Overall twelve focus groups were facilitated with participants that had usual care or who were in the intervention arm of the Fremantle Primary Prevention study. Group size ranged from 6 to 10 participants with the interviewer following a semi structured focus group schedule. Thematic analysis extracted common themes from each focus group around contributing factors to participation. The key message was that relationships built over a longer time period with a GP, practice nurses and other practice staff was an important factor in retention of participants. In addition, ease of travel, convenience and regular check ups with the practice were all significant enticement to remain in a study over the course of the research. Being part of their regular GP practice’s involvement in a study was clearly worthwhile as an incentive for participants and offers hope for practice-based research networks undertaking other community-based studies in the future

An inquiry into the adoption of the best practices of Sarbanes-Oxley in institutions of higher education

The Sarbanes-Oxley Act is legislation enacted as a result of the financial criminal wrongdoings of companies such as Enron and WorldCom. As a result of such wrongdoings, the government intervened and legislation was passed in 2002 (the Sarbanes-Oxley act of 2002).Although the act only applies to publicly traded companies, many institutions, including institutions of higher education, have adopted the “best practices” of the Sarbanes-Oxley Act. The concept underpinning the “best practices” is that transparency, accountability and ethical conduct in financial policies and practices are prevalent in every organization, and institutions of higher education are not exempt.The research findings from our inquiry into institutions of Higher Education indicated that many of the institutions of higher education that implemented the best practices did so because they thought it was the “correct thing to do”- implying that best practices of the Sarbanes-Oxley Act - transparency, accountability and ethical conduct in financial polices and practices should be adopted.As a second step, this study attempts to qualitatively determine why institutions of higher education decided to implement any of the best practices. What, if any perceived benefits were gained, and if the institutions believed that they have achieved those benefits as of the time of the interviews.The findings made it clear that there is a general sense that implementing the best practices of Sarbanes-Oxley is important and the right thing to do. The implications of implementing the best practices of Sarbanes-Oxley will show employees and others outside the institution that the institution wants to do the right thing, that accountability and transparency are important. Also, it will likely help establish an ethical culture within the institutions of higher education through the institution’s code of conduct that improper behavior will not be tolerated.Based on current findings, we postulate that institutions of higher education that have implemented the best practices of Sarbanes-Oxley will be better poised should future regulation be enacted. Also, we expect that funding agencies will consider positively the fact that there are organizations that are exercising their fiduciary responsibilities by implementing the best practices of Sarbanes-Oxley.Ph.D., Educational Leadership and Learning Technology -- Drexel University, 200

Finite-well potential in the 3D nonlinear Schroedinger equation: Application to Bose-Einstein condensation

Using variational and numerical solutions we show that stationary negative-energy localized (normalizable) bound states can appear in the three-dimensional nonlinear Schr\"odinger equation with a finite square-well potential for a range of nonlinearity parameters. Below a critical attractive nonlinearity, the system becomes unstable and experiences collapse. Above a limiting repulsive nonlinearity, the system becomes highly repulsive and cannot be bound. The system also allows nonnormalizable states of infinite norm at positive energies in the continuum. The normalizable negative-energy bound states could be created in BECs and studied in the laboratory with present knowhow.Comment: 8 pages, 12 figure

Prediction of five-year mortality after COPD diagnosis using primary care records

Accurate prognosis information after a diagnosis of chronic obstructive pulmonary disease (COPD) would facilitate earlier and better informed decisions about the use of prevention strategies and advanced care plans. We therefore aimed to develop and validate an accurate prognosis model for incident COPD cases using only information present in general practitioner (GP) records at the point of diagnosis. Incident COPD patients between 2004–2012 over the age of 35 were studied using records from 396 general practices in England. We developed a model to predict all-cause five-year mortality at the point of COPD diagnosis, using 47,964 English patients. Our model uses age, gender, smoking status, body mass index, forced expiratory volume in 1-second (FEV1) % predicted and 16 co-morbidities (the same number as the Charlson Co-morbidity Index). The performance of our chosen model was validated in all countries of the UK (N = 48,304). Our model performed well, and performed consistently in validation data. The validation area under the curves in each country varied between 0.783–0.809 and the calibration slopes between 0.911–1.04. Our model performed better in this context than models based on the Charlson Co-morbidity Index or Cambridge Multimorbidity Score. We have developed and validated a model that outperforms general multimorbidity scores at predicting five-year mortality after COPD diagnosis. Our model includes only data routinely collected before COPD diagnosis, allowing it to be readily translated into clinical practice, and has been made available through an online risk calculator (https://skiddle.shinyapps.io/incidentcopdsurvival/)