Management of malaria at Juba Teaching Hospital: a clinical audit

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Population health management in diabetes care: combining clinical audit, risk stratification, and multidisciplinary virtual clinics in a community setting to improve diabetes care in a geographically defined population. An integrated diabetes care pilot in the North East Locality, Oxfordshire, UK

Background: Disparities in diabetes care are prevalent, with significant inequalities observed in access to, and outcomes of, healthcare. A population health approach offers a solution to improve the quality of care for all with systematic ways of assessing whole population requirements and treating and monitoring sub-groups in need of additional attention. Description of the care practice: Collaborative working between primary, secondary and community care was introduced in seven primary care practices in one locality in England, UK, caring for 3560 patients with diabetes and sharing the same community and secondary specialist diabetes care providers. Three elements of the intervention included 1) clinical audit, 2) risk stratification, and 3) the multi-disciplinary virtual clinics in the community. Methods: This paper evaluates the acceptability, feasibility and short-term impact on primary care of implementing a population approach intervention using direct observations of the clinics and surveys of participating clinicians. Results and discussion: Eighteen virtual clinics across seven teams took place over six months between March and July 2017 with organisation, resources, policies, education and approximately 150 individuals discussed. The feedback from primary care was positive with growing knowledge and confidence managing people with complex diabetes in primary care. Conclusion: Taking a population health approach helped to identify groups of people in need of additional diabetes care and deliver a collaborative health intervention across traditional organisational boundaries

Core-Shell Electrospun Polycrystalline ZnO Nanofibers for Ultra-Sensitive NO2 Gas Sensing.

This Research Article discusses the growth of polycrystalline, self-supporting ZnO nanofibers, which can detect nitrogen dioxide (NO2) gas down to 1 part per billion (ppb), one of the smallest detection limits reported for NO2 using ZnO. A new and innovative method has been developed for growing polycrystalline ZnO nanofibers. These nanofibers have been created using core-shell electrospinning of inorganic metal precursor zinc neodecanoate, where growth occurs at the core of the nanofibers. This process produces contamination-free, self-supporting, polycrystalline ZnO nanofibers of an average diameter and grain size 50 and 8 nm, respectively, which are ideal for gas sensing applications. This process opens up an exciting opportunity for creating nanofibers from a variety of metal oxides, facilitating many new applications especially in the areas of sensors and wearable technologies.Llodys Register foundatio

Reasons for non-participation in a primary-care based physical activity trial: a qualitative study

Objectives: To explore reasons for non-participation in a primary-care based physical activity trial and understand how these may contribute to recruitment of non-representative research samples. We also aimed to elicit non-participants’ own recommendations for enhancing trial uptake in primary care. Design: Semi-structured telephone interviews with non-participants to a randomised controlled trial of a very brief intervention for promoting physical activity conducted in primary care (the VBI trial), with thematic analysis of interview transcripts. Setting: Five General Practice (GP) surgeries in the East of England, UK. Participants: Interviews were completed with ten female and six male non-participants of white ethnicity and aged between 40 and 71 years. Thirteen of the sixteen interviewees were either active or moderately active according to the GP Physical Activity Questionnaire (GPPAQ). Results: Interviewees discussed a range of reasons for non-participation. These included beliefs surrounding the personal relevance of the trial based on pre-conceptions of intervention content. Many interviewees considered themselves either sufficiently active or too functionally limited to increase activity levels further, so rendering participation pointless in their view. Other identified barriers included a lack of free time, both for trial participation and for increasing physical activity, and dissatisfaction with appointment scheduling systems in place at GP surgeries. Interviewees questioned the appropriateness of primary care as a context for delivering interventions to promote physical activity. In general, interviewees were positively disposed towards the idea of trial participation, especially if personal benefits are made salient, but suggested that interventions could be delivered in a different setting such as the internet. Conclusions: To increase participation in physical activity promotion trials conducted in primary care, both the content of invitation materials and procedures for contacting potential participants require reconsideration. Specific recommendations include streamlining intervention materials and enhancing their relevance to the health concerns of invitees.The work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This study was conducted on behalf of the Very Brief Interventions Programme Team. This work was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0608-10079). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.This is the final version of the article. It first appeared from BMJ Group via https://doi.org/ 10.1136/bmjopen-2016-01157

Is body dissatisfaction related to an attentional bias towards low weight bodies in non-clinical samples of women? A systematic review and meta-analysis

Body dissatisfaction is defined as the negative subjective evaluation of one’s body and is considered a risk factor for, and symptom of, eating disorders. Some studies show women with high body dissatisfaction display an attentional bias towards low weight bodies; however, this finding is not consistent, and results are yet to be systematically synthesised. We conducted a qualitative and quantitative synthesis of cross-sectional studies investigating the relationship between body dissatisfaction and attentional bias to low weight bodies in non-clinical samples of women. We searched PubMed, Scopus, Web of Science, PsycINFO, ProQuest, and OpenGrey for studies up until September 2022. We identified 34 eligible studies involving a total of 2857 women. A meta-analysis of 26 studies (75 effects) found some evidence from gaze tracking studies for a positive association between body dissatisfaction and attentional bias to low weight bodies. We found no evidence for an association from studies measuring attention using the dot probe task, electroencephalogram (EEG) recording, or the modified spatial cueing task. The results together provide partial support for the positive association between body dissatisfaction and attentional bias to low weight bodies in women. These findings can be used to inform future attentional bias research

Unfitness to Plead. Volume 1: Report.

This has been produced along with Volume 2: Draft Legislation as a combined document Presented to Parliament pursuant to section 3(2) of the Law Commissions Act 1965 Ordered by the House of Commons to be printed on 12 January 201

Sexed up: theorizing the sexualization of culture

This paper reviews and examines emerging academic approaches to the study of ‘sexualized culture’; an examination made necessary by contemporary preoccupations with sexual values, practices and identities, the emergence of new forms of sexual experience and the apparent breakdown of rules, categories and regulations designed to keep the obscene at bay. The paper maps out some key themes and preoccupations in recent academic writing on sex and sexuality, especially those relating to the contemporary or emerging characteristics of sexual discourse. The key issues of pornographication and democratization, taste formations, postmodern sex and intimacy, and sexual citizenship are explored in detail. </p

The phylogeography of Indoplanorbis exustus (Gastropoda: Planorbidae) in Asia

<p>Abstract</p> <p>Background</p> <p>The freshwater snail <it>Indoplanorbis exustus </it>is found across India, Southeast Asia, central Asia (Afghanistan), Arabia and Africa. <it>Indoplanorbis </it>is of economic importance in that it is responsible for the transmission of several species of the genus <it>Schistosoma </it>which infect cattle and cause reduced livestock productivity. The snail is also of medical importance as a source of cercarial dermatitis among rural workers, particularly in India. In spite of its long history and wide geographical range, it is thought that <it>Indoplanorbis </it>includes only a single species. The aims of the present study were to date the radiation of <it>Indoplanorbis </it>across Asia so that the factors involved in its dispersal in the region could be tested, to reveal potential historical biogeographical events shaping the phylogeny of the snail, and to look for signs that <it>I. exustus </it>might be polyphyletic.</p> <p>Results</p> <p>The results indicated a radiation beginning in the late Miocene with a divergence of an ancestral bulinine lineage into Assam and peninsular India clades. A Southeast Asian clade diverged from the peninsular India clade late-Pliocene; this clade then radiated at a much more rapid pace to colonize all of the sampled range of <it>Indoplanorbis </it>in the mid-Pleistocene.</p> <p>Conclusions</p> <p>The phylogenetic depth of divergences between the Indian clades and Southeast Asian clades, together with habitat and parasitological differences suggest that <it>I. exustus </it>may comprise more than one species. The timescale estimated for the radiation suggests that the dispersal to Arabia and to Southeast Asia was facilitated by palaeogeographical events and climate change, and did not require human involvement. Further samples from Afghanistan, Africa and western India are required to refine the phylogeographical hypothesis and to include the African Recent dispersal.</p

a therapeutic strategy for cystic fibrosis

The inhibition of ENaC may have therapeutic potential in CF airways by reducing sodium hyperabsorption, restoring lung epithelial surface fluid levels, airway hydration and mucociliary function. The challenge has been to deliver siRNA to the lung with sufficient efficacy for a sustained therapeutic effect. We have developed a self-assembling nanocomplex formulation for siRNA delivery to the airways that consists of a liposome (DOTMA/DOPE; L), an epithelial targeting peptide (P) and siRNA (R). LPR formulations were assessed for their ability to silence expression of the transcript of the gene encoding the α-subunit of the sodium channel ENaC in cell lines and primary epithelial cells, in submerged cultures or grown in air-liquid interface conditions. LPRs, containing 50 nM or 100 nM siRNA, showed high levels of silencing, particularly in primary airway epithelial cells. When nebulised these nanocomplexes still retained their biophysical properties and transfection efficiencies. The silencing ability was determined at protein level by confocal microscopy and western blotting. In vivo data demonstrated that these nanoparticles had the ability to silence expression of the α-ENaC subunit gene. In conclusion, these findings show that LPRs can modulate the activity of ENaC and this approach might be promising as co-adjuvant therapy for cystic fibrosis