57 research outputs found

    Job preferences among clinical officers in public sector facilities in rural Kenya: a discrete choice experiment

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    Background: Clinical officers (COs), a mid-level cadre of health worker, are the backbone of healthcare provision in rural Kenya. However, the vacancy rate for COs in rural primary healthcare facilities is high. Little is known about factors motivating COs' preferences for rural postings. Methods: A discrete choice experiment (DCE) questionnaire was used with 57 COs at public health facilities in nine districts of Nyanza Province, Kenya. The questionnaire was developed on the basis of formative qualitative interviews with COs (n = 5) and examined how five selected job attributes influenced COs' preferences for working in rural areas. Conditional logit models were employed to examine the relative importance of different job attributes. Results: Analysis of the qualitative data revealed five important job attributes influencing COs' preferences: quality of the facility, educational opportunities, housing, monthly salary and promotion. Analysis of the DCE indicated that a 1-year guaranteed study leave after 3 years of service would have the greatest impact on retention, followed by good quality health facility infrastructure and equipment and a 30% salary increase. Sub-group analysis shows that younger COs demonstrated a significantly stronger preference for study leave than older COs. Female COs placed significantly higher value on promotion than male COs. Conclusions: Although both financial incentives and non-financial incentives were effective in motivating COs to stay in post, the study leave intervention was shown to have the strongest impact on COs' retention in our study. Further research is required to examine appropriate interventions at each career stage that might boost COs' professional identity and status but without leading to larger deficits in the availability of generalist COs. 2016 Takemura et al.sch_iih14pub4260pub

    Functional Fv fragment of an antibody specific for CD28: Fv-mediated co-stimulation of T cells

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    AbstractThe most predominant co-stimulation pathway, which is critical for T cell activation and proliferation, is the CD28-B7 pathway. The anti-CD28 monoclonal antibody (mAb) also provides a co-stimulatory signal to T cells. In order to construct a functional Fv fragment (complex of VH and VL domains) of anti-CD28 antibody using a bacterial expression system, cDNA encoding the variable regions of immunoglobulin from 15E8 hybridoma cells was cloned and expressed in Escherichia coli. The Fv fragment was obtained as a soluble protein from the periplasmic fraction and showed a binding pattern similar to parental IgG. The Fv fragment induced proliferation of peripheral blood mononuclear cells in the presence of anti-CD3 or anti-CD2 mAb and enhanced anti-tumor activity of anti-MUC1×anti-CD3 bispecific antibody when tested with lymphokine-activated killer cells with T cell phenotype. Thus, the anti-CD28 Fv fragment will be promising not only for the study of co-stimulation, but also for cancer immunotherapy

    A disk-type dose imaging detector based on blue and orange RPL in Ag-activated phosphate glass for 2D and 3D dose imaging applications

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    A disk-type two- and three-dimensional (2D, 3D) X-ray dose imaging detector was developed based on the radiation-induced silver (Ag)-related species in Ag-activated phosphate glass. This luminescent detector is based on the blue and orange radiophotoluminescence (RPL) phenomena. A comparative study of the steady- and transient-state optical properties of blue and orange RPL, such as the time-resolved luminescence spectra and the RPL decay curves, was performed. In addition, the combination of a confocal optical detection system with a transparent glass detector enables 3D reconstruction through the stacking of dose images collected at different depths within the material. The capabilities of this detector for 2D and 3D dose imaging applications are discussed. © 2015 Published by Elsevier Ltd.Embargo Period 24 month

    〈Cases Reports〉Recurrent focal intestinal perforation in extremely-low-birth-weight infant

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    [Abstract] In recent years, the incidence of focal intestinal perforation (FIP) has been increasing, as the survival rate of extremely-low-birth-weight(ELBW) infants has been rising. We present a case of an ELBW infant who suffered three recurrences of FIP in a very short period of time. The patient was a female infant who was born at 24 weeks and 2 days of gestation, with a birth weight of 579 g. On her 22^nd day of life, abdominal X-rays revealed free air, which suggested intestinal perforation, and an intraperitoneal drainage tube was placed. Intraperitoneal lavage was performed on day 28 of life,and the drained fluid was turbid with feces, suggesting a recurrence of perforation. On day 30 of life, laparotomy revealed a perforation of approximately 1cm in diameter located at 6 cm from the ileocecum on the oral side. The X-ray taken on day 34 again revealed free air, and, through another laparotomy, a new perforation was found at about 15 cm from the stoma on the oral side. This case provides suggestions that may shed light on our approach to determine the pathogenesis of FIP, especially since no other case of FIP recurring three times has ever been reported
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