The Implementation of Wraparound Model in Israel - An Alternative to Out-of-Home Placement of Delinquent Juveniles

Wraparound model refers to community-based programs designed to rehabilitate youth; characterized by multiple risk factors, through "wrapping" them with a variety of assistance agencies, first and foremost their families. The purpose of the current paper was to describe the way of implementation of the Wraparound model in Israel, named the Ma'atefet1, which is operated by the Juvenile Probation Service (JPS), as an alternative to out-of-home placement of convicted juvenile offenders. The paper presents an overview of the program's background, objectives and goals, as well as findings of evaluation studies designed to examine the program effectiveness, and case studies of convicted minors that participated in the program in Israel. In consistent with previous studies from different countries in the world, it was found that the program in Israel achieves its main goals, reflected in improvements in the educational, familial and mental condition of the treated youth; reducing recidivism; and preventing out-of-home placement. In light of these many advantages, we recommend policy-makers to expand the program, for the benefit of young offenders, their families and the community as a whole

Emotional Difficulties and Experiences of Stigma among Persons with Lymphatic Filariasis in Plateau State, Nigeria.

Lymphatic filariasis (LF) is a chronic and often disfiguring condition that predominantly affects the rural poor and leads to social exclusion, stigma, and discrimination. Little is currently known about the emotional difficulties and stigma experiences among persons living with LF in Nigeria. Our study evaluated the emotional difficulties and stigma experienced by persons with LF in Plateau State, Nigeria. We utilized a combination of qualitative data instruments comprising focus group discussions, McGill's Illness Narrative Interviews, and key informant interviews. We transcribed and analyzed the data using a combination of inductive and deductive coding approaches. Sixty-nine respondents were interviewed: 37 females and 32 males. The prevalent community perception of LF was the belief that it was a spiritual problem. Emotional reactions included feelings of sadness, hopelessness, anger, frustration, worry, and suicidal ideation. These experiences, including those of stigma, discrimination, and social exclusion, culminated in difficulties with occupational functioning, marital life, and community participation. Our findings highlight the value of a rights-based approach that emphasizes state and non-state actors' need to provide access to the highest attainable standard of health, including mental health, and to protect persons with LF from stigma, discrimination, and social exclusion

The Effect of Andrographolide on the Metabolism of Carbamazepine in Rats

Objective: To determine if andrographolide (AND) impacts the pharmacokinetics of carbamazepine (CBZ). Background: CBZ is an anticonvulsant medication that is metabolized in the liver by cytochrome P450 (CYP) enzymes. AND is an over-the-counter medication that is common in Eastern cultures to treat inflammation and is a CYP enzyme inhibitor. Because CBZ is metabolized in the liver by these specific CYP enzymes, coadministration of andrographolide and CBZ could result in a herb-drug interaction. Methods: Sprague-Dawley rats (N=12) aged between 3 months and 6 months (250-350 g) will be split into control (N=6) and treatment (N=6) groups. The treatment group will receive an AND injection (dissolved in dimethyl sulfoxide to 10 mg/mL) intraperitoneally for seven consecutive days. On the eighth day, another AND injection will be administered intraperitoneally as well as an injection of CBZ (CBZ powder prepared into a 20 mg/mL emulsion) administered via intravenous route. Plasma samples will be collected every 20 minutes for 4 hours and stored at -20℃. Analysis: HPLC analysis will yield a time vs. plasma concentration graph that will allow us to calculate the rate of elimination (K). The mean K value will be determined for both the control and treatment group. The mean K value of 6 rats in the treatment group will be compared to the mean value of K of the 6 rats in the control group. These will be analyzed using SPSS and utilizing an unpaired t test, with a p\u3c0.05 deemed statistically significant

Herb-Drug Interaction of Andrographolide on the Pharmacokinetics of Carbamazepine in Rats

Objective: To determine if andrographolide (AND) impacts the pharmacokinetics of carbamazepine (CBZ). Background: CBZ is an anticonvulsant medication that is metabolized in the liver by cytochrome P450 (CYP) enzymes. AND is an over-the-counter medication that is common in Eastern cultures to treat inflammation and is a CYP enzyme inhibitor. Because CBZ is metabolized in the liver by these specific CYP enzymes, coadministration of andrographolide and CBZ could result in a herb-drug interaction. Methods: Sprague-Dawley rats (N=12) aged between 3 months and 6 months (250-350 g) will be split into control (N=6) and treatment (N=6) groups. The treatment group will receive an AND injection (dissolved in dimethyl sulfoxide to 10 mg/mL) intraperitoneally for seven consecutive days. On the eighth day, another AND injection will be administered intraperitoneally as well as an injection of CBZ (CBZ powder prepared into a 20 mg/mL emulsion) administered via intravenous route. Plasma samples will be collected every 20 minutes for 4 hours and stored at -20℃. Analysis: HPLC analysis will yield a time vs. plasma concentration graph that will allow us to calculate the rate of elimination (K). The mean K value will be determined for both the control and treatment group. The mean K value of 6 rats in the treatment group will be compared to the mean value of K of the 6 rats in the control group. These will be analyzed using SPSS and utilizing an unpaired t test, with a

Characterization of methicillin-susceptible and -resistant staphylococci in the clinical setting: a multicentre study in Nigeria

BACKGROUND: The staphylococci are implicated in a variety of human infections; however, many clinical microbiology laboratories in Nigeria do not identify staphylococci (in particular coagulase negative staphylococci - CNS) to the species level. Moreover, data from multi-centre assessment on antibiotic resistance and epidemiology of the staphylococci are not available in Nigeria. This study investigated 91 non-duplicate staphylococcal isolates obtained from the microbiology laboratories of eight hospitals in Nigeria during the period January to April 2010. METHODS: Identification and antibiotic susceptibility testing was performed using the VITEK 2 system, detection of resistance genes by PCR, and molecular characterization was determined by SCCmec typing, spa and multilocus sequence typing (MLST). RESULTS: All the isolates were susceptible to mupirocin, tigecycline, vancomycin and linezolid, but 72.5% of CNS and 82.3% of Staphylococcus aureus were resistant to cotrimoxazole, while multiresistance was observed in 37 of the 40 CNS isolates. Untypeable SCCmec types (ccrC/Class A mec and ccr-negative/Class C2 mec gene complex) in two methicillin-resistant S. aureus (MRSA) were identified. Additionally, ccr-negative/Class A mec and ccr type 4/Class C2 mec gene complex was detected in one isolate each of S. sciuri and S. haemolyticus, respectively. The S. aureus isolates were classified into 21 spa types including two new types (t8987, t9008) among the methicillin-susceptible S. aureus (MSSA) isolates. Two (CC8-SCCmecnon-typeable and CC88-SCCmec IV) and four (CC8-SCCmec III/IV/V; CC30-SCCmec II/III; CC88-SCCmec IV; and ST152-SCCmecnon-typeable) MRSA clones were identified in Maiduguri (North-East Nigeria) and South-West Nigeria, respectively. The proportion of Panton-Valentine leukocidin (PVL)-positive MSSA was high (44.4%) and 56.3% of these strains were associated with sequence type (ST) 152. CONCLUSIONS: The identification of multiresistant mecA positive S. haemolyticus and S. sciuri from clinical samples indicates that characterization of CNS is important in providing information on their diversity and importance in Nigeria. There is the need to develop new SCCmec classification methods for non-typeable methicillin-resistant staphylococci, and to curtail the spread and establishment of the S. aureus ST152 clone in Nigeria. The study presents the first report of a PVL-positive ST152-SCCmecnontypeable MRSA and SCCmec typing of methicillin-resistant CNS in Nigeria

Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria.

BACKGROUND: Lymphatic filariasis is a chronic, disabling and often disfiguring condition that principally impacts the world's poorest people. In addition to the well-recognised physical disability associated with lymphedema and hydrocele, affected people often experience rejection, stigma and discrimination. The resulting emotional consequences are known to impact on the quality of life and the functioning of the affected individuals. However, the management of this condition has focused on prevention and treatment through mass drug administration, with scant attention paid to the emotional impact of the condition on affected individuals. This study aimed to determine the prevalence and severity of depression among individuals with physical disfigurement from lymphatic filariasis in Plateau State, Nigeria. METHODOLOGY: A cross-sectional 2-stage convenience study was conducted at 5 designated treatment centers across Plateau State, Nigeria. All available and consenting clients with clearly visible physical disfigurement were recruited. A semi-structured socio-demographic questionnaire, Rosenberg Self-esteem and a 9-item Patient Health Questionnaire (PHQ-9) were administered at the first stage. Those who screened positive (with a PHQ-9 score of five and above) were further interviewed using the Depression module of the Composite International Diagnostic Interview (CIDI). RESULTS: Ninety-eight individuals met the criteria and provided consent. Twenty percent of the respondents met criteria for depression, with the following proportions based on severity: Mild (42.1%), Moderate (31.6%) and Severe (26.3%). History of mental illness (OR 40.83, p = 0.008); Median duration of the illness was 17 years (IQR 7.0-30 years) and being unemployed (OR 12.71, p = 0.003) were predictive of depression. High self-esteem was negatively correlated (OR 0.09, p<0.004). CONCLUSION: Prevalence of depression is high among individuals with lymphatic filariasis and depression in sufferers is associated with low self-esteem and low levels of life satisfaction

Combining Microfluidics, Optogenetics and Calcium Imaging to Study Neuronal Communication In Vitro

International audienceIn this paper we report the combination of microfluidics, optogenetics and calcium imaging as a cheap and convenient platform to study synaptic communication between neuronal populations in vitro. We first show that Calcium Orange indicator is compatible in vitro with a commonly used Channelrhodopsine-2 (ChR2) variant, as standard calcium imaging conditions did not alter significantly the activity of transduced cultures of rodent primary neurons. A fast, robust and scalable process for micro-chip fabrication was developed in parallel to build micro-compartmented cultures. Coupling optical fibers to each micro-compartment allowed for the independent control of ChR2 activation in the different populations without crosstalk. By analyzing the post-stimuli activity across the different populations, we finally show how this platform can be used to evaluate quantitatively the effective connectivity between connected neuronal populations