In Their Eyes: HIV prevention from an Islamic perspective in Lamu, Kenya.

Despite efforts to curb the spread of HIV amongst the youth and its positive indication of success in Kenya, the epidemic continues to pose serious challenges to these efforts amongst all demographic groupings across Kenya. This article presents findings of a qualitative study involving 45 youth and 23 Islamic leaders from Lamu, Kenya. The study looked at participant’s perceptions of HIV/AIDS. It also explored participant’s perceptions on what they see as the factors influencing HIV transmission amongst the Lamu youth. Additionally a literature review was used together with the study findings to identify elements for an Islamic based HIV prevention intervention. Our findings indicated that both the youth and religious leaders’ perceptions of HIV/AIDS comprise a mixture of facts and misconceptions. The participants identified idleness, drug abuse and premarital sex as key factors contributing to the risk of HIV infection amongst the Lamu youth. The symbiotic relationship between religious leaders and youth on various aspects of daily practices was evident throughout the study thereby suggesting the importance of working with both in addressing HIV/AIDS in Lamu.

Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa

BACKGROUND: Stunting and overweight are nutritional problems affecting most of sub-Saharan Africa. The region now has the world's highest rate of stunting among children (43%), while overweight and obesity are becoming a global epidemic, and Africa is not spared. The past two decades have seen a dramatic increase in obesity in sub-Saharan Africa. OBJECTIVE: The purpose of this systematic review is to explore the determinants of stunting and overweight in sub-Saharan Africa. METHODS: A literature search was conducted in PubMed using the key words stunting, overweight, obesity, Africa, sub-Saharan Africa, determinants, and prevalence. Limits were set to include articles published between 1990 and 2012. The systematic review resulted in 38 studies, and after selection based on title, content, and country of the study, 18 studies were eligible for this review. Data were analyzed by the chi-square test. RESULTS: The prevalence rates of stunting and overweight were dependent on socioeconomic, demographic, and environmental factors. Many studies indicate that male children and those living in a rural setting are more likely to be stunted, whereas overweight among children depends more on age, household composition, occupation of the mother, and the mother's body mass index. Stunting occurred together with overweight among both boys and girls from 1 to 5 years of age. Stunting was more prevalent among boys than among girls. Indicators of socioeconomic status, such as mother's education, mother's occupation, and household income, were some of the determinants directly linked to stunting, whereas environmental factors, such as rural or urban setting and sanitation, influenced both stunting and overweight. Concurrent stunting and overweight is influenced by maternal and household factors, such as maternal height, age, and education, large household size, and lower socioeconomic status. CONCLUSIONS: Although socioeconomic, demographic, and environmental factors were significant in determining stunting and overweight, other factors, such as nutrition and lifestyle, were important risk factors. Stunting in childhood is a risk factor that may result in overweight and obesity later in adolescence and adulthood, indicating the need to screen children below 1 year of age to identify stunting early in life. Promoting exclusive breastfeeding is reported to be important in preventing both stunting and overweight among children. More research is needed to explore the relationship between stunting and overweight and to explore policy guidelines to address the phenomenon

Determinants of communication between partners about STD symptoms: implications for partner referral in South Africa

BackgroundSTDs as preventable diseases are a major public health problem in South Africa, both in terms of their effect on quality of life, their economic costs and the fact that STDs as co-factors drive the HIV epidemic. Their widespread occurrence and high prevalence rates are cause for concern. It is argued that the duration of infection increases the probability of harmful sequelae and STD transmission, including HIV, to others. The promotion of seeking health care for STD symptoms at an early stage and partner referral for STD treatment are important strategies in preventing STD transmission to others and re-infection of partners. The cost implications of contact tracing by healthcare workers has resulted in patients being encouraged to refer their partners for STD treatment. This has not always been effective, despite efforts to improve partner referral rates by improved “contact cards” (i.e. a card with a code representing the STD that the patient has been treated for to be given to sexual partners as a way to speed up treatment) and more accessible healthcare services. Other studies have found that the proportion of clients who present with contact cards at STD services ranged from about 2% to 39%, while the proportion of partners who were referred for treatment range from 16% to 30%. Mathews et al. argue that returning contact cards might not be a sensitive enough proxy indicator for partner referral rates.Partner referrals have been found to be seriously compromised by patients' causal explanations for STDs, as well as by the unequal power of the genders in sexual relationships, which impacts on the patients' ability to communicate about sexual matters. Patients often lack an understanding of the importance of referring their asymptomatic partners for treatment. Women's inability to discuss sexual issues due to their unequal status in sexual relationships might impact on partner referral behaviour. Men have been found to blame the STD on the “outside women” (sexual partners outside the primary relationship) and are therefore less likely to refer these partners. The conflict that could arise from informing a partner about an STD was viewed by men as a reason not to communicate about having a STD.While the ability to communicate about STDs with sexual partners is an essential prerequisite for referring them for medical treatment, little attention has been paid to understanding this process. This study is aimed at gaining some understanding of the determinants of communication between partners about STD symptoms. In this study, “talking with a partner about STD symptoms” before seeking medical treatment was viewed as an indication of the likelihood of future partner referral behaviour.Methods A randomly selected sample of 1 477 patients with STD symptoms was interviewed using a structured questionnaire. Logistic regression analysis was used to identify the determinants of talking to a partner about the present STD.ResultsIt was found that patients who had talked with their partner about their current STD symptoms were more likely to be female, be employed, have a tertiary level of education, have had only one sexual partner in the preceding six months, have used condoms, albeit inconsistently during the last six months, and to have thought about abstaining from sex while infected. Those who talked were also more likely to have good knowledge about the effects of STDs and the transmission of STDs in the absence of symptoms, had positive attitudes towards condoms and perceived social support for partner referral.ConclusionImproved partner referral through health education interventions needs to focus specifically on a subgroup of patients, e.g. men and the unemployed, and on the improvement of knowledge regarding the consequences of STDs and asymptomatic transmission. Social and partner support for partner referral and perceived self-efficacy in this regard should be encouraged and maintained. In the absence of skills and counselling services to manage the consequences of STD partner referral, this prevention strategy will remain vulnerable.For full text, click here:SA Fam Pract 2006;48(7):17-17

SISTA South Africa: The adaptation of an efficacious HIV prevention trial conducted with African-American women for isiXhosa-speaking South African women

Although new HIV treatments continue to offer hope for individuals living with HIV, behavioural interventions shown to reduce HIV risk behaviour remain one of the most powerful tools in curbing the HIV epidemic. Unfortunately, the development of evidencebased HIV interventions is a resource-intensive process that has not progressed as quickly as the epidemiology of the disease. As the epidemic continues to evolve, there is a need to expedite the development of evidence-based HIV interventions for populations that are often disproportionately impacted by HIV/AIDS. One mechanism of accelerating the development process is to adapt evidence-based HIV interventions for vulnerable populations. The aim of this paper was to describe the adaptation process of a HIV intervention for African-American women for black South African Xhosa women. For African-American women the intervention was effective in increasing consistent condom use, sexual self-control, sexual communication, sexual assertiveness and partner adoption of norms supporting consistent condom use. Keywords: Intervention, women, cultural adaptation, HIV transmission risk behaviours.SAHARA-J Vol. 5 (4) 2008: pp. 186-19

High Environmental Temperature Increases Glucose Requirement in the Developing Chicken Embryo

Environmental conditions during the perinatal period influence metabolic and developmental processes in mammals and avian species, which could impact pre- and postnatal survival and development. The current study investigated the effect of eggshell temperature (EST) on glucose metabolism in broiler chicken embryos. Broiler eggs were incubated at a high (38.9°C) or normal (37.8°C) EST from day 10.5 of incubation onward and were injected with a bolus of [U-13C]glucose in the chorio-allantoic fluid at day 17.5 of incubation. After [U-13C]glucose administration, 13C enrichment was determined in intermediate pools and end-products of glucose metabolism. Oxidation of labeled glucose occurred for approximately 3 days after injection. Glucose oxidation was higher in the high than in the normal EST treatment from day 17.6 until 17.8 of incubation. The overall recovery of 13CO2 tended to be 4.7% higher in the high than in the normal EST treatment. An increase in EST (38.9°C vs 37.8°C) increased 13C enrichment in plasma lactate at day 17.8 of incubation and 13C in hepatic glycogen at day 18.8 of incubation. Furthermore, high compared to normal EST resulted in a lower yolk-free body mass at day 20.9 (-2.74 g) and 21.7 (-3.81 g) of incubation, a lower hepatic glycogen concentration at day 18.2 (-4.37 mg/g) and 18.8 (-4.59 mg/g) of incubation, and a higher plasma uric acid concentration (+2.8 mg/mL/+43%) at day 21.6 of incubation. These results indicate that the glucose oxidation pattern is relatively slow, but the intensity increased consistently with an increase in developmental stage of the embryo. High environmental temperatures in the perinatal period of chicken embryos increased glucose oxidation and decreased hepatic glycogen prior to the hatching process. This may limit glucose availability for successful hatching and could impact body development, probably by increased gluconeogenesis from glucogenic amino acids to allow anaerobic glycolysi

Tudásmenedzsment és a felsőoktatási intézmény, mint vállalat = Knowledge Management and the University as a Company

Purpose: ALK rearrangement detection using FISH is the standard test to identify patients with non–small cell lung carcinoma (NSCLC) eligible for treatment with ALK inhibitors. Recently, ALK protein expression in resectable NSCLC showed predictive value. We evaluated tumor response rate and survival after crizotinib treatment of patients with advanced NSCLC with ALK activation using both dichotomous immunohistochemical (IHC) staining and FISH. Experimental Design: Patients with stage IV NSCLC treated with crizotinib were selected. Tumor response was assessed. ALK rearrangements were detected by FISH (Vysis ALK-break-apart FISH-Probe KIT) and IHC [Ventana ALK (D5F3) CDx assay]. Cohorts of patients with ALK-FISH–positive advanced NSCLC from four other hospitals were used for validation. Results: Twenty-nine consecutive patients with ALK-positive advanced NSCLC diagnosed by FISH and/or IHC on small biopsies or fine-needle aspirations (FNA) were treated with ALK inhibitors. All ALK-IHC–positive patients responded to crizotinib except three with primary resistance. No tumor response was observed in 13 ALK-FISH–positive but ALK-IHC–negative patients. This was confirmed in an external cohort of 16 patients. Receiver operator characteristic (ROC) curves for ALK-IHC and ALK-FISH compared with treatment outcome showed that dichotomous ALK-IHC outperforms ALK-FISH [tumor response area under the curve: (AUC), 0.86 vs. 0.64, P ¼ 0.03; progression-free survival (PFS): AUC 0.86 vs. 0.36, P ¼ 0.005; overall survival (OS): AUC, 0.78 vs. 0.41, P ¼ 0.01, respectively]. Conclusions: Dichotomous ALK-IHC is superior to ALK-FISH on small biopsies and FNA to predict tumor response and survival to crizotinib for patients with advanced NSCLC. Our data strongly suggest adapting the guidelines and using dichotomous ALK-IHC as standard companion diagnostic test to select patients with NSCLC who benefit from ALK-targeting therapy

Mode-division-multiplexed 3x112-Gb/s DP-QPSK transmission over 80-km few-mode fiber with inline MM-EDFA and blind DSP

We show transmission of a 3x112-Gb/s DP-QPSK mode-multiplexed signal up to 80km, without and with multi-mode EDFA, using blind 6x6 MIMO digital signal processing. We show that the OSNR-penalty induced by mode-mixing in the multi-mode EDFA is negligible

Community mobilization for malaria elimination: application of an open space methodology in Ruhuha sector, Rwanda

Background Despite the significant reduction of malaria transmission in Rwanda, Ruhuha sector is still a highly endemic area for malaria. The objective of this activity was to explore and brainstorm the potential roles of various community stakeholders in malaria elimination. Methods Horizontal participatory approaches such as ‘open space’ have been deployed to explore local priorities, stimulate community contribution to project planning, and to promote local capacity to manage programmes. Two open space meetings were conducted with 62 and 82 participants in years 1 and 2, respectively. Participants included purposively selected community and local organizations’ representatives. Results Malaria was perceived as a health concern by the respondents despite the reported reduction in prevalence from 60 to 20% for cases at the local health centre. Some misconceptions of the cause of malaria and misuse of preventive strategies were noted. Poverty was deemed to be a contributing factor to malaria transmission, with suggestions that improvement of living conditions for poor families might help malaria reduction. Participants expressed willingness to contribute to malaria elimination and underscored the need for constant education, sensitization and mobilization towards malaria control in general. Active diagnosis, preventative strategies and prompt treatment of malaria cases were all mentioned by participants as ways to reduce malaria. Participants suggested that partnership of stakeholders at various levels could speed up programme activities. A community rewards system was deemed important to motivate engaged participants, i.e., community health workers and households. Establishment of malaria clubs in schools settings was also suggested as crucial to speed up community awareness and increase skills towards further malaria reduction. Conclusions This bottom-up approach was found useful in engaging the local community, enabling them to explore issues related to malaria in the area and suggest solutions for sustainable malaria elimination gains