Reproductive tract infections: A guide for programme managers

Reproductive tract infections (RTIs) including sexually transmitted infections represent a silent worldwide pandemic that adversely impacts the reproductive health (RH) of women and men. Various community- and hospital-based studies in India have provided insights into the magnitude of the problem. The International Conference on Population and Development (1994) emphasized integration of RH services to meet the needs of men and women especially with prevention and management of RTIs/STIs. The emergence of HIV and the identification of STIs as a risk factor for the spread of HIV have further lent a sense of urgency for a programmatic response to address this public health problem. Programmatic evidence from developing countries indicates that integration of RTI/STI prevention and management with existing health services is both feasible and cost effective. The National Population Policy 2000 also highlights the need for programs that include provision of RTI/STI and HIV/AIDS prevention, screening, and management in RH care settings. This report reviews global and regional experiences and provides strategic directions likely to be the most effective in addressing these problems in India

Antenatal syphilis control: people, programmes, policies and politics.

Antenatal syphilis control is an integral component of reproductive health policies in most countries. In many of these countries, however, the existence of a health policy does not automatically translate into an effective health programme. We argue that neglecting to take into account the perspectives of all stakeholders when planning programmes may be the reason that functional and sustained interventions for antenatal syphilis are lacking. Stakeholders may include health policy decision-makers, programme managers, service delivery personnel (on whom implementation depends), as well as the pregnant women, families, and communities who will most benefit from the intervention. We describe how to undertake a multilevel assessment in order to identify stakeholders, identify interlinked perspectives, and analyse these perspectives within the socioeconomic, cultural and political environment within which an intervention is designed to be delivered. Using this multidisciplinary approach, we propose that the barriers to, and opportunities for, turning health policy into effective practice will be identified, and the result will be the formulation of a broad programme response to ensure implementation of the policy. Undertaking a multilevel assessment is but the first step in identifying barriers to successful programmes. Currently there is a lack of strong political support for this intervention at national and international levels. Devising strategies to address these potential barriers requires a broad range of skills and approaches some of which are outlined in this paper

Antenatal syphilis control: people, programmes, policies and politics

Antenatal syphilis control is an integral component of reproductive health policies in most countries. In many of these countries, however, the existence of a health policy does not automatically translate into an effective health programme. We argue that neglecting to take into account the perspectives of all stakeholders when planning programmes may be the reason that functional and sustained interventions for antenatal syphilis are lacking. Stakeholders may include health policy decision-makers, programme managers, service delivery personnel (on whom implementation depends), as well as the pregnant women, families, and communities who will most benefit from the intervention. We describe how to undertake a multilevel assessment in order to identify stakeholders, identify interlinked perspectives, and analyse these perspectives within the socioeconomic, cultural and political environment within which an intervention is designed to be delivered. Using this multidisciplinary approach, we propose that the barriers to, and opportunities for, turning health policy into effective practice will be identified, and the result will be the formulation of a broad programme response to ensure implementation of the policy. Undertaking a multilevel assessment is but the first step in identifying barriers to successful programmes. Currently there is a lack of strong political support for this intervention at national and international levels. Devising strategies to address these potential barriers requires a broad range of skills and approaches some of which are outlined in this paper

Enrolling women into HIV preventive vaccine trials: an ethical imperative but a logistical challenge.

Mills and colleagues argue that the challenge of enrolling women into HIV vaccine trials must be overcome in order for trials to be considered ethical, valid, and generalizable

HIV Vaccine Awareness Day at the AIDS Community Health Initiative Enroute to a Vaccine Effort (Project ACHIEVE), 18 May 2005

<p>(Photo: Project ACHIEVE)</p

Heat Priming of Lentil (Lens culinaris Medik.) Seeds and Foliar Treatment with γ-Aminobutyric Acid (GABA), Confers Protection to Reproductive Function and Yield Traits under High-Temperature Stress Environments

Gradually increasing temperatures at global and local scales are causing heat stress for cool and summer-season food legumes, such as lentil (Lens culinaris Medik.), which is highly susceptible to heat stress, especially during its reproductive stages of development. Hence, suitable strategies are needed to develop heat tolerance in this legume. In the present study, we tested the effectiveness of heat priming (HPr; 6 h at 35 °C) the lentil seeds and a foliar treatment of γ-aminobutyric acid (GABA; 1 mM; applied twice at different times), singly or in combination (HPr+GABA), under heat stress (32/20 °C) in two heat-tolerant (HT; IG2507, IG3263) and two heat-sensitive (HS; IG2821, IG2849) genotypes to mitigate heat stress. The three treatments significantly reduced heat injury to leaves and flowers, particularly when applied in combination, including leaf damage assessed as membrane injury, cellular oxidizing ability, leaf water status, and stomatal conductance. The combined HPr+GABA treatment significantly improved the photosynthetic function, measured as photosynthetic efficiency, chlorophyll concentration, and sucrose synthesis; and significantly reduced the oxidative damage, which was associated with a marked up-regulation in the activities of enzymatic antioxidants. The combined treatment also facilitated the synthesis of osmolytes, such as proline and glycine betaine, by upregulating the expression of their biosynthesizing enzymes (pyrroline-5-carboxylate synthase; betaine aldehyde dehydrogenase) under heat stress. The HPr+GABA treatment caused a considerable enhancement in endogenous levels of GABA in leaves, more so in the two heat-sensitive genotypes. The reproductive function, measured as germination and viability of pollen grains, receptivity of stigma, and viability of ovules, was significantly improved with combined treatment, resulting in enhanced pod number (21–23% in HT and 35–38% in HS genotypes, compared to heat stress alone) and seed yield per plant (22–24% in HT and 37–40% in HS genotypes, in comparison to heat stress alone). The combined treatment (HPr+GABA) was more effective and pronounced in heat-sensitive than heat-tolerant genotypes for all the traits tested. This study offers a potential solution for tackling and protecting heat stress injury in lentil plants

Harnessing Genetic Variation in Physiological and Molecular Traits to Improve Heat Tolerance in Food Legumes

Plant genetic variations provide opportunity to develop new and improved cultivars with desired characteristics, hence gaining major attention from the scientists and breeders all over the world. Harnessing genetic variability is the key factor in the adaptation of plants to ever-rising temperature. Nowadays, such characteristic traits among the population can be used to develop various heat-resilient crop varieties and have a profound effect on restoring the balance between climate change and agriculture. Genetic variations in physiological and molecular traits proved to be the major components for breeding programs to augment the gene pool. With genetic variations, it is possible to identify the phenotypic variations governed either by a single gene or by many genes that will be helpful for mapping associated quantitative trait loci. Genetic variations can also be traced by examining various physiological traits of a crop plant like growth traits (biomass, plant height, and root growth), leaf traits (stomatal conductance, chlorophyll content, chlorophyll fluorescence, photosynthetic rate, membrane stability, sucrose content, and canopy temperature depression), and floral traits (mainly associated with male gametophyte). Yield traits can also display enormous variation, making it highly useful/reliable for screening purposes. Further, genetic variation at the biochemical level can be assessed by measuring the expression of enzymes (related to oxidative stress and antioxidants) and metabolites (both primary and secondary). Evaluating how genetic variation influences phenotype is the ultimate objective of genetics, and using omics approaches can improve the understanding of heat tolerance-governing mechanisms. Further, collecting molecular data at different levels of plant growth and development will help to accelerate our understanding of the mechanisms linking genotype to phenotype