Prospects for Schistosomiasis Elimination

Current efforts to limit the ravages of schistosomiasis are pushing the world closer to eliminating a chronic infection that has been associated with human life in the tropics since time immemorial. This notwithstanding, the disease remains a scourge for large populations in sub-Saharan Africa, Latin America, and Southeast Asia, and the main part of this book is made up by papers dealing with its current distribution, discussing ways and means to establish and implement improved control approaches. While chemotherapy limits the symptoms caused by schistosomiasis, the number of infected people will not decrease until the parasite's life cycle is interrupted. To that end, some papers focus on the intermediate snail host, which is notoriously difficult to control, while others discuss human hygiene and sanitation. The latter approach not only prevents infection through avoiding people being infected from the snail, but more importantly, also stops people infecting the snail by leaving contagious feces and urine in nature. With morbidity reduced by chemotherapy, the immediate target now is the interruption of transmission to be achieved by new tools, such as the novel chemotherapies, improved diagnostics (for humans, animals, and snails), and vaccines discussed in several of the papers. As made clear in this book, a complex infection requires new tools as well as work on many fronts, above all; however, a clear idea is needed as to how to skillfully combine the tools available and sustain implemented control activities

Anomaly Reconciliation in Electronic Discussion Groups

According to public goods theory, there should be a deficiency of knowledge shared in electronic discussion groups (EDG) because self-interested individuals would be motivated to receive othersí knowledge but not to share their own. A number of motivators (such as generalized reciprocity, altruism, and normative obligations) have been proposed to explain why people actually do share their knowledge in such settings, and empirical research has confirmed that people do express these motivations for sharing their knowledge. However, the simple picture of individuals sharing knowledge that is known to be true limits our ability to understand what actually is going on in EDG. This paper develops a typology of interactions that may arise in electronic discussion groups and argues that several of these types of interactions confer benefits onto participants that may well motivate them to contribute their knowledge, even in settings where traditional motivators may be weak or absent. In particular, the process whereby anomalies are reconciled and the provision of knowledge to conduct remote-controlled experiments both stand to generate returns to those who contribute that are not available to those who ìlurk.i

E-learning at University of the Arts London

This report is a systematic exploration of staff relationships with e-learning. It presents a renewed evidence base from which e-learning provision and related support can be planned particularly in a rapidly changing HE terrain and an institutional context where e-learning and academic structures are emerging from large change programmes. The research is based on 25 interviews with programme directors (PD) evenly distributed across the 4 colleges, with representatives from all discipline groups, and levels of study. The interviewees provided rich insights into attitudes to, practices in and aspirations for e-learning, but in some instances, were also limited by the newness of the PD role. While some PDs had an intimate understanding of their programme areas, others, understandably, given the newness of posts, were in the process of familiarising themselves with the work of their teams

Schistosomiasis in the Philippines: Innovative Control Approach is Needed if Elimination is the Goal

In 1996, schistosomiasis due to Schistosoma japonicum was declared eradicated in Japan. In the People's Republic of China, S. japonicum transmission has been interrupted in the major endemic areas in the coastal plains but the disease persists in the lake and marshland regions south of the Yangtze River. The disease remains a public health problem in endemic areas in the Philippines and in isolated areas in Indonesia. Comprehensive multidisciplinary campaigns had led to eradication of schistosomiasis in Japan and have been successful in the interruption of disease transmission in the major endemic regions of the People's Republic of China. Unfortunately, the integrated measures cannot be duplicated in schistosomiasis endemic areas in the Philippines because of limited resources. The problem is also more complicated due to the topography in the Philippines and transmission is not seasonal as in China. An innovative approach is needed in the Philippines if schistosomiasis elimination is the goal

Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives

Objective To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Design Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October–November 2012 and April 2013); interviews with CPs (February–April 2013); follow-up interviews with patients (April–May 2013); interactive feedback sessions with general practice teams (October–November 2013). Setting 22 community pharmacies and 6 general practices in Northwest England. Participants 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Results Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were ‘loaned’ in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. Conclusions CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured and funded NHS emergency supply service from community pharmacies, with ongoing optimisation of repeat prescribing

Diagnosis and management of schistosomiasis

The authors’ studies on schistosomiasis have received financial support from various sources including: the UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases; the National Health and Medical Research Council of Australia; the Wellcome Trust (UK); the Sandler Foundation (USA); the Dana Foundation (USA); and the National Institute of Allergy and Infectious Diseases

Case studies emphasising the difficulties in the diagnosis and management of alveolar echinococcosis in rural China

<p>Abstract</p> <p>Background</p> <p>Human alveolar echinococcosis (AE) is caused by the accidental ingestion of the eggs of the fox tapeworm <it>Echinococcus multilocularis</it>. AE occurs frequently in rural western China due to the poor levels of hygiene, the close contact of people with dogs, and the lack of appropriate facilities for the correct and rapid diagnosis of the disease.</p> <p>Findings</p> <p>We describe a case of a patient with hepatic AE, and AE metastases of the brain. She was mistakenly diagnosed with suspected undifferentiated metastatic cancer of the liver and brain, and with a pulmonary bacterial infection, but was subsequently correctly diagnosed during a follow-up field survey for echinococcosis. The diagnosis of brain AE was confirmed by pathological examination of tissue biopsies removed during neurosurgery. We also briefly describe other symptomatic and asymptomatic AE cases, identified by chance, likely due to the inadequate facilities available in rural communities in China for AE diagnosis and management, since the rapid and accurate diagnosis of metastatic AE requires a high level of expertise in the appropriate diagnostic procedures.</p> <p>Conclusions</p> <p>This report highlights the necessity for an upgrade in the diagnosis, treatment, prevention and control of AE in rural China.</p

Knowledge sourcing methods

Abstract Many knowledge management (KM) initiatives in organizations seek to improve how employees draw on each others&apos; expertise, experience, advice, and opinions, which we call knowledge sourcing behavior. Employees can source knowledge recorded in document form, through dyadic conversations, or in-group settings. We proposed and tested a theory to support the idea that employees&apos; use of different classes of knowledge sourcing methods produced different kinds of performance outcomes. Our findings suggested that (1) different classes of knowledge sourcing methods are not as interchangeable as the KM literature might suggest, (2) technology-based methods are neither inherently superior nor inferior to traditional methods and (3) that group knowledge sourcing supports a wider range of performance outcomes than other methods. Together, these results highlight the importance of aligning KM efforts with their intended outcome. Before launching a project designed to enhance knowledge sourcing, managers should decide which performance outcome they wish to affect and select a KM tool that is aligned with the desired effect.