A Season to Blossom Haiku

Student generated description: “This my description of my COVID-19 experience. I definitely did some self-reflection

Reproductive health outcomes: Insights from experts and verbal autopsies

Background: Reproductive health outcomes are a measure of maternal and neonatal health. South Africa’s state of maternal health is of particular concern because of the two Millennium Development Goals (MDGs) targets for monitoring maternal health, namely MDG 5a, to reduce the maternal mortality rate by three-quarters, and MDG 5b, to achieve universal access to reproductive health by 2015. Maternal mortality ratio and universal access to reproductive health receive unequal responsiveness from government. Monitoring the maternal mortality ratio has received favourable attention compared to ensuring universal access to reproductive health, hence the limited published research findings on the latter. Objectives: The purpose of this article is to report on the insights from reproductive health experts and verbal autopsies on the determinants of poor reproductive health outcomes. Method: Individual interviews with a purposively selected sample of six reproductive health experts were conducted, augmented by verbal autopsies of 12 next of kin of women and newborn babies who died within the previous 2 years period of the study. Burnard’s (1995) approach of content analysis was used to analyse the data. Results: The findings revealed lack of empowerment, inaccessible reproductive health services and separation of patients living with human immune deficiency virus and those patients diagnosed with acquired immune deficiency syndrome. Conclusion: To meet the reproductive health needs, especially of the rural population, urgent attention is needed to reduce their vulnerability to the risks of poor reproductive outcomes

A STUDY TO REVIEW THE APPROPRIATENESS OF DRUG DOSAGE IN RENALLY IMPAIRED PATIENT BY IDENTIFYING, ANALYSING AND ADJUSTING DOSAGES IN A TERTIARY CARE TEACHING HOSPITAL

 Objectives To identify and analyze drug dosing in renally impaired patient in a tertiary care teaching hospital and to categorize patients on the basis of gender, age, GFR (Glomerular Filtration Rate) and anemia.Methodology A prospective interventional study was conducted on the drug dosage in renally impaired patient by identifying, analyzing, and adjusting. Ethical clearance was obtained from the IEC (Institutional Ethical Committee). The study was conducted on 103 patients with renal impairment for a period of six months. During ward rounds, cases were collected and collected data were assessed and analysed by using Micromedex, Lexicomp. For the possible interventions, the dosage errors were reported along with the evidence.Results Out of the 103 patients, 73 were males and 30 were females and majority of patients belonged to the age group between 41- 65 yrs. 56.31% and 43.69% of patients were in the category B and category C of GFR respectively. A total of 244 co-morbidities were present in 103 patients with HTN (Hypertension) and Type 2 DM (Diabetes Mellitus) the foremost. In total, 983 drugs were prescribed to the total patient with an average of 9.54 drugs per patient, 175 drugs required dosage adjustment.Conclusion The present study effectively reports all the interventions to the physicians along with the supporting data. Continuous medical education to the physicians together with pharmacists may reduce the chances of incongruity in drugs given to the renally impaired patients.Key Words: Renal impairment, MDRD (Modification of Diet in Renal Disease), Creatinine Clearance, Dosage Adjustment Â

Prospects for e-democracy in Europe

The drivers behind e-participation are digitalisation, the development of digital tools that can be usedfor citizen involvement – social media, deliberative software, e-voting systems, etc. – and growingaccess to the internet. In European countries, especially those that rank prominently among the top 50performers, citizens have more and more opportunities to have their say in government and politics.According to the UN, the largest share of e-participation initiatives relates to central and localgovernments giving access to public sector information and public consultation via digital tools.Recently there has been a growing focus on citizen involvement in policy making, although progressin this field has been modest so far

REDD+ in the Philippines: Legal status and conservation of mangrove forests in the Philippines

Mangroves perform a crucial role in maintaining the ecological integrity of the coastal ecosystem. They  act as filters in the coastal zone, preventing the damaging effects of upland sediments on seagrass beds and coral reefs, minimise the effects of storm surges and act as carbon sinks that mitigate climate change. These essential services, however, are degraded through indiscriminate cutting, conversion of mangrove swamps to fishponds, reclamation projects and other coastal developments and pollution. Experts reveal that the Indo-Malay Philippine Archipelago has one of the highest rates of mangroves loss. From an estimated 500,000 hectares of mangrove cover in 1918, only 120,000 hectares of mangroves remain in the Philippines today. The country has had the legal and policy framework to protect and conserve mangroves. But weak implementation of laws, overlapping functions among agencies and, in general, poor management by the people and local governments have hindered the sustainable management of mangrove forests. Positive developments, however, are taking place with the promulgation of laws on climate change and executive orders which specifically include mangrove and protected areas under the National Greening Program (NGP) and addresses equity, food security and poverty issues by giving preference to NGP beneficiary communities as a priority in the Conditional Cash Transfer (CCT) Program.  Moreover, participatory Planning and Multi-stakeholder Approaches are among the strategies contemplated by the Philippine National REDD + Strategy. The article examines the implementation and effects of the Philippine National REDD+ Strategy, the National Climate Change Action Plan which specifically integrates REDD+ and ecosystem valuation into decision-making, and the executive orders which support the mainstreaming of the National Greening Program

PARENTS AND COMMUNITY LEADERS’ PERCEPTIONS OF TEENAGE PREGNANCY: A QUALITATIVE STUDY

The purpose of this qualitative study was to understand the perceptions and experiences of parents and community leaders of two communities in Nigeria regarding teenage pregnancy and their understanding of teenage sexuality and contraception. In addition, the study set out to ascertain whether teenage pregnancy prevention programmes were available within the communities. The study was qualitative, contextual and exploratory utilising the Community-as-Partner Model. Eighty participants who were parents and community leaders responded to the semi-structured interview and completed a questionnaire on demographic data. Tesch’s approach of data analysis was used, and descriptive statistics were used to display demographic data as well as the count of data segments that constitute categories. The fi ndings reveal that although limited teenage pregnancy prevention initiatives were in existence, most of the participants, especially those from the North Central (NC) region of Nigeria, were not informed about them. Almost half of the participants viewed teenage pregnancy as a common occurrence in their communities of which most were from the NC region. More than two-thirds of the participants discouraged teenagers from using contraceptives. Teenage pregnancy intervention programmes and strategies must be sensitive to differences among various ethnic and religious groups. The involvement of religious and community leaders in teenage pregnancy intervention programmes and initiatives is indispensable in curtailing the high incidence of teenage pregnancies and childbirths among teenagers

Bafilomycin A1 enhances NLRP3 inflammasome activation in human monocytes independent of lysosomal acidification

From Wiley via Jisc Publications RouterHistory: received 2020-03-02, rev-recd 2020-10-12, accepted 2020-11-02, pub-electronic 2020-11-21, pub-print 2021-05Article version: VoRPublication status: PublishedFunder: Medical Research Council; Id: http://dx.doi.org/10.13039/501100000265; Grant(s): MR/N029992/1The release of interleukin (IL)‐1β from primary human monocytes in response to extracellular LPS occurs through the NACHT, LRR and PYD domains‐containing protein 3 (NLRP3) inflammasome. In primary monocytes, in response to LPS, NLRP3 inflammasome activation is characterized by an independence of K+ efflux and ASC speck formation and has been termed the ‘alternative’ pathway. Here, we report that pharmacological inhibition of V‐ATPase with bafilomycin A1 exacerbated LPS‐induced NLRP3 inflammasome activation in primary human monocytes. Inhibition of V‐ATPase in the presence of extracellular LPS led to NLRP3‐dependent, K+ efflux‐independent, ASC oligomerization and caspase‐1 activation. Although V‐ATPases are required for lysosomal acidification, we found that acidic lysosomal pH and protease activity were dispensable for this altered response, suggesting that V‐ATPase inhibition triggered alternative signalling events. Therefore, V‐ATPases may serve additional roles during NLRP3 inflammasome activation in primary human monocytes