bluuebunny/crossref_metadata_2025 huggingface dataset:
The Social Organization of Neonatal Nurses' Feeding Work
Authors: Ringham Catherine , Rankin Janet , Marcellus Lenora
Published: September 2020

Purpose

We report findings from an institutional ethnography (IE) of nurses' work of feeding infants within an increasingly technical organization of NICUs.

Sample

Five primary informants; 18 secondary informants.

Design

The institutional ethnographic approach included field observations, interviews, and phone and e-mail conversations. Our analysis followed accounts of what actually happened within the textual organization of nurses' work.

Main Outcome

Nurses' feeding practices are directed by protocols that arise within multiple documentation systems and clinical technologies. These systems produce barriers to nurses' efforts to skillfully feed infants.

Results

Prioritization of quality and safety perspectives can obscure and constrain the ordinary yet critical clinical reasoning neonatal nurses employ during feeding work. Clinical technologies that have been developed to improve safety can paradoxically disrupt the ability of nurses to respond in the moment to neonatal feeding cues. This finding provides nurses, leaders, and policymakers with insight into why policies and procedures may not be followed as expected.
Birth and the Big Bad Wolf: Biocultural Evolution and Human Childbirth, Part 2
Authors: Cheyney Melissa , Davis-Floyd Robbie
Published: September 2020

In Part 2 of this two-part article, we further employ the lens of evolutionary medicine to explore similarities in premodern biocultural features of birth, arguing that these were an outgrowth of our common evolutionary heritage as bipedal primates. These practices grew out of the empiricism of millennia of trial and error and supported humans to give birth in closer alignment with our evolved biology. We argue that many common obstetric procedures today work against this evolved biology. In seeking to manage birth, we sometimes generate anobstetric paradoxwherein we (over)intervene in human childbirth to try to keep it safe, yet thereby cause harm. We describe premodern birthing patterns in three sections: (a) eating and drinking at will and unrestrained movement in labor with upright pushing; (b) obligate midwifery and continuous labor support; and (c) the low-intervention birth/long-term breastfeeding/co-sleeping adaptive complex, and discuss how these are still relevant today. We conclude with a set of suggestions for improving the global technocratic treatment of birth and with a futuristic epilogue about a 7th, cyborgian pig that asks: What will become of birth as humans continue to coevolve with our technologies?
The Role of Antenatal Education in Promoting Maternal and Family Health Literacy
Authors: Downer Terri , McMurray Anne , Young Jeanine
Published: September 2020

BACKGROUND

Antenatal education (ANE) supports expectant parents in developing their knowledge, skills, and confidence in preparing for childbirth and early parenting. This is called health literacy, and it is part of the global healthcare system agenda that empowers women to participate fully in making decisions about their health and care before, during, and after birth. The aim of this study was to examine the perspectives of educators and ANE class participants on the extent to which existing courses are meeting this goal.

METHODS

A qualitative study, conceptualized within the health literacy framework, was conducted in Australia with 10 antenatal educators and 8 participants from antenatal classes. Data were collected through individual interviews and were analyzed using interpretive description.

RESULTS

The findings revealed five themes relating to the participants' experiences in either providing or attending antenatal classes. These included: “balancing provider influences with participant expectations,” “accommodating participant learning styles and preferences,” “influence of the environment on pedagogy and practice,” “empowering participants for decision-making,” and “reflections on what is and is not meaningful and effective.”

CONCLUSIONS

Findings from this study strongly suggest that to meet the needs of class participants, educators need to be mindful of their expectations. They should adopt a flexible approach to accommodate participants' knowledge, goals, and preferences as well as characteristics of the context. Conceptualizing ANE within the framework of health literacy provides a clear, targeted approach to meeting the information needs of this important population that is focused on evidence-based safe practice across the birthing continuum and beyond.
Domestic Violence Treatment in Colorado: An Overview of an Evidence-Based Approach
Authors: Radatz Dana L. , Hansen Jesse , Thomasson Carolina
Published: September 2020

In 2010, the State of Colorado revised its state standards to create consistency across the state for its domestic violence (DV) cases by placing emphasis on the integration of evidence-based practices into its DV treatment programming. Since then, Colorado has established a three-tiered differential treatment model informed by the principles of effective intervention (PEI), an evidence-based framework found in correctional programming. This article reviews the PEI framework, outlines the emerging research that explores the principles among DV offenders and their treatment, and provides an overview of Colorado's differentiated DV treatment model. Policy and research considerations are also discussed.
DESCRIPTION OF GADGET ADDICTION, SLEEP QUALITY, AND STUDENTS LEARNING ACHIEVEMENT AT SD NEGERI 1 SIDODADI LAWANG IN 2019
Authors: Wibowo Dimas Cahyo , Fitriani Della Wahyu , Kimresti Ananda Febina , Ahkami Alfan , Nastiti Isna Sandria , Auliani Syarifah Dwi , Ermawati Siti , Andriani Sabrina Rizki , Sulistiawati Sulistiawati , Raharjo Priyo
Published: September 2020

In this globalization era, technology is increasing rapidly. One of the technologies is a gadget/device. Gadget users come from various backgrounds, ranging from adults, the elderly, and even children. The Daily Mail reports that 70% of elementary school-aged children can easily use a gadget. The use of gadgets can have both positive and negative effects on children. The negative effect of using a gadget is affecting the quality of sleep and learning achievement on children. The study aimed to describe gadget addiction, sleep quality, and learning achievement of children focused on grades 5th and 6th at SD Negeri 1 Sidodadi Lawang. A descriptive study method. The total population of grade 5th and 6th students at SD Negeri 1 Sidodadi Lawang are 96 students. Data were taken by using Smart Addiction Scale, Pittsburgh Sleep Quality Index questionnaires, and students’ report cards. The distribution of gadget addiction levels in this study was 21 people (21,9%) with a low level, 72 people (75%) with a moderate level, and 3 people (3,1%) with a high level. There were 73 people (76%) with poor sleep quality and 49 people (51%) with poor learning achievement. The level of gadget addiction in 5th and 6th-grade students at SD Negeri 1 Sidodadi Lawang was dominant in the medium level, sleep quality was dominant in the poor level.
CORRELATION OF GADGETS ADDICTION WITH SLEEP QUALITY IN 4th – 6th GRADE STUDENTS AT SDN 01 SRIGADING LAWANG IN 2019
Authors: Niro Agustin J Nanda De , Pawitra Annisa , Faizah Novia Nurul , Putra Rendra Dwi , Arfiputri Veikha Fakhriya , Sihombing Renata Violia , Rachmi Shabrina Noor , Nuswantoro Djohar , Martha Ledy
Published: September 2020

The use of digital technology has increased rapidly. In Indonesia, gadget use by children has become very high and requires special attention. Many effects may occur due to gadget use, one of which is sleep quality disturbance. This study aims to analyze the correlation between gadget addiction and sleep quality in children grades 4-6 SDN 01 Srigading Lawang. This research is an analytic observational study with a cross-sectional design in a population of 4-6th graders of SDN 01 Srigading Lawang. A total of 126 students over 130 students were included. Data were collected using two questionnaires, which are Smartphone Addiction Scale and The Pittsburgh Sleep Quality Index, and tested using RxC Contingency. Gadget addiction has a significant correlation with sleep quality with a weak correlation. Children with mild levels of addiction to gadgets had a potential of 2,013 times to have good sleep quality, compared to children with moderate levels of addiction. In contrast, children with severe levels of addiction to gadgets were at risk 12.04-fold to have poor sleep quality compared to the mild level of addiction. There is a significant correlation with a weak correlation between gadget addiction and sleep quality in children grades 4-6 SDN 01 Srigading Lawang.
Hearing voices and strange noises after sleeve gastrectomy
Authors: Larionova Evgeniya , Jalisi Scharukh M. , Jones Daniel B.
Published: September 2020

Patulous eustachian tube (PET) dysfunction is a rare complication of weight loss, which can be easily misdiagnosed. We present a case of PET dysfunction after laparoscopic sleeve gastrectomy. A 36-year-old Caucasian female with Class III morbid obesity (131 kg, BMI 46.6 kg/m2) successfully underwent laparoscopic sleeve gastrectomy. At her postoperative follow-up appointment six months later, her weight dropped to 96 kg and she complained of severe autophony (hearing of self-generated sounds), leading to anxiety and insomnia. She was initially misdiagnosed with a sinus infection by her primary care provider and was started on antibiotics. She was subsequently seen by an otolaryngologist who diagnosed her with PET. Weight loss can be a predisposing factor for PET. Our patient did not notice onset of symptoms of PET until significant weight loss (35 kg, 59.5% EWL).
Human-Induced Vibration Control with TMDs for Guangzhou Asian Games Comprehensive Museum
Authors: Yin Xue-jun , Xu Zhao-dong , Yang Yang , Luo Yong , Wang Jian-li
Published: September 2020

Guangzhou Asian Games Comprehensive Museum is one of the permanent buildings for the 2010 Guangzhou Asian Games, whose bowl-shaped main body is a steel structure with the largest cantilever length of more than 30 meters. The structure has a low natural frequency, so it tends to be excited by people synchronizing walking with amplification of resonance, which will affect the serviceability. A large amount of analysis and field-tests are performed for this historical museum with tuned mass dampers (TMDs) being used to reduce human walking induced vibration. The results showed that TMDs can control the structure vertical vibration effectively, with the efficiency of over 50%. The research results have obvious significance for similar projects.
Potential Audibility of Three Acoustic Harassment Devices (AHDs) to Marine Mammals in Scotland, UK
Authors: Todd Victoria L.G. , Jiang Jian , Ruffert Maximilian
Published: September 2020

The modelled acoustic characteristics of three Acoustic Harassment Devices (AHDs) deployed from a fully operational salmonid fish farm, located in the Sound of Mull, Scotland (UK) are presented, using empirical seabed and water column measurements at the same location. In the Beaufort Sea state 0, the depth range of 10--50 m is the maximum range at which AHDs are potentially audible to five marine mammal species. The species present within this survey region are: the harbour porpoise, Phocoena phocoena (99.1 km), the killer whale, Orcinus orca (110 km), the bottlenose dolphin, Tursiops truncatus (89.6 km), the common seal, Phoca vitulina (88 km), and the grey seal, Halichoerus grypus (69 km). Consequently, within the Sound of Mull, all three AHDs could be heard throughout the water column by all species. For two models of AHDs, a behavioural disturbance level of between 140 dB-180 dB is observed at 1.3 km. Habitat displacement is a cause for concern, particularly if several fish farms within a small area all deploy AHDs simultaneously. This can create a confusing sound field of varying intensity, which has potential to deter harbour porpoises from sections of their habitat. If positioned effectively, AHDs have the potential to deter all five marine mammal species from industrial operations such as aquaculture facilities. Source levels, propagation and transmission loss measurements were highly variable and should be considered as site specific, meaning new estimates should be made for each situation.
Struktura populističke ideologije
Authors: Todosijević Bojan , Hristić Ljubomir
Published: September 2020

u literaturi je sve prisutnije shvatanje da se populizam može tumačiti kao ide- ologija koja ima specifičnu, iako ’tanku’, sadržinu. Smatra se da to važi ne samo za političke partije i pokrete, nego i da karakteriše stavove onih koji pružaju po- dršku populističkim partijama i ličnostima. Komparativna studija izbornih si- stema (CSeS, www.cses.org) je u svoj 5. modul uključila operacionalizaciju po- pulističke ideologije kao kombinaciju tri osnovne orijentacije: negativnog stava prema manjinama i imigrantima, negativnog stava prema političkim elitama, i isključive koncepcije nacionalnog identiteta. u ovom radu analiziramo u kojoj meri takva koncepcija populističke ideologije ima empirijsku podršku na osno- vu podataka iz Srbije. Podaci su prikupljeni nakon predsedničkih izbora 2017. godine, metodom on-line anketiranja. testirana je strukturna hipoteza o među- sobnoj povezanosti teorijskih komponenti populističke ideologije. nakon toga je analizirana povezanost dimenzija komponenti populističke ideologije sa par- tijskim preferencijama. rezultati su pokazali da navedene tri komponente ne konvergiraju ka jednoj opštijoj dimenziji populističke ideologije. Zaključeno je da skala anti-elitizma, u kontekstu Srbije, jeste indikator stava prema partijama na vlasti, a ne samo populističke antipatije prema političkoj eliti.
Therapeutic Implications for PDE2 and cGMP/cAMP Mediated Crosstalk in Cardiovascular Diseases
Authors: Sadek Mirna S. , Cachorro Eleder , Kämmerer Susanne , El-Armouche Ali
Published: September 2020

Phosphodiesterases (PDEs) are the principal superfamily of enzymes responsible for degrading the secondary messengers 3’,5’-cyclic nucleotides cAMP and cGMP. Their refined subcellular localization and substrate specificity contribute to finely regulate cAMP/cGMP gradients in various cellular microdomains. Redistribution of multiple signal compartmentalization components is often perceived under pathological conditions. Thereby PDEs have long been pursued as therapeutic targets in diverse disease conditions including neurological, metabolic, cancer and autoimmune disorders in addition to numerous cardiovascular diseases. PDE2 is a unique member of the broad family of PDEs. In addition to its capability to hydrolyze both cAMP and cGMP, PDE2 is the sole isoform that may be allosterically activated by cGMP increasing its cAMP hydrolyzing activity. Within the cardiovascular system, PDE2 serves as an integral regulator for the crosstalk between cAMP/cGMP pathways and thereby may couple chronically adverse augmented cAMP signalling with cardioprotective cGMP signalling. This review provides a comprehensive overview of PDE2 regulatory functions in multiple cellular components within the cardiovascular system and also within various subcellular microdomains. Implications for PDE2 mediated crosstalk mechanisms in diverse cardiovascular pathologies are discussed highlighting the prospective use of PDE2 as a potential therapeutic target in cardiovascular disorders.
Bilateral Popliteal Artery Entrapment Syndrome in a Young Female NCAA Division-I Collegiate Basketball Player
Authors: Koehler Rikki M. , Cimbak Nicole C. , Parisien Robert L. , Nicoletta Robert J. , Kalish Jeffrey A.
Published: September 2020

Case:

Popliteal artery entrapment syndrome (PAES) is rarely on the differential for exertional lower extremity pain in the young athlete. This article illustrates a case of a 20-year-old female National Collegiate Athletic Association (NCAA) Division-I college basketball player who was diagnosed with PAES after conservative treatment of medial tibial stress syndrome and comprehensive evaluation for chronic exertional compartment syndrome. She received bilateral popliteal artery releases through a posterior approach and made an asymptomatic return to Division-I collegiate basketball.

Conclusion:

PAES is a rare potentially limb-threatening disease that must be included on the differential of young athletes who present with exertional lower extremity pain.
Salvage of Distal Femoral Replacement Loosening with Massive Osteolysis Using Impaction Grafting
Authors: Carender Christopher N. , Bedard Nicholas A. , Malvitz Thomas A. , Callaghan John J.
Published: September 2020

Case:

Salvage of 2 cases of distal femoral replacement loosening with massive osteolysis using impaction grafting are presented with 9- and 11-year follow-ups.

Conclusion:

Surgeons should keep impaction grafting in their armamentarium for cases of failed DFR with severe osteolysis. Doing so may allow for preservation of the native hip and deferment of more radical procedures (i.e. total femur replacement) that have high rates of complication and poor survivorship.
Rates and Patterns of Playing-Related Musculoskeletal Disorders in Drummers
Authors: Azar Nadia R
Published: September 2020

AIMS: Playing-related musculoskeletal disorders (PRMDs) are a significant health concern for percussionists. Although many of the known risk factors for PRMDs likely apply to all percussion subgroups (e.g., weekly practice hours, warm-ups/cool-downs, etc.), the rates and injury patterns
in drummers (herein defined as ‘percussionists who play the drum set’) may differ due to differences in physical demands from those of other percussion subgroups. The goal of this study was to determine the drummer-specific rates and patterns of PRMDs. METHODS: An electronic survey
including questions on respondent demographics, history and patterns of PRMDs, and potential drummer-specific risk factors for reporting PRMDs was distributed via social media using a snowball sampling technique. The target population included individuals aged 18 years or older who exclusively
played the drum set (minimum 5 hrs/wk). The rates of PRMDs were analyzed by body region (e.g., upper/lower limb, etc.) and by location within body regions (e.g., shoulder, knee joint, etc.). RESULTS: The lifetime history of PRMDs in the study sample (n=831) was 68%, and 23% reported currently
experiencing a PRMD. Most respondents reported multiple PRMDs (59%). The upper limb was the most commonly-affected body region (59%). The wrist joint (25%) and low back (24%) were the most commonly affected locations within body regions. CONCLUSIONS: Drummers’ reporting of multiple PRMDs
is consistent with previous findings in percussionists, but differences in the lifetime histories and patterns of injury supports the notion that risk factors may differ between percussion subgroups. Analysis of survey responses pertaining to drummer-specific risk factors is currently underway.
Cyclohelenina Formosaensis Gen. Nov. ET SP. Nov.: a New Benthic foraminifer from Southern Taiwan
Authors: Chien Chih-Wei , Chang Yuan-Pin , Yang Kenn-Ming
Published: September 2020

A new benthic foraminiferal genus and species of Heleninidae was discovered in estuarine sediments of the Sihchong River, western Hengchun Peninsula, Southern Taiwan. Similar to the resembling genus Helenina, Cyclohelenina gen. nov. displays distinct sutural incisions on both spiral and umbilical sides. However, it exhibits relatively coarser perforation of the wall, more roundness along the equatorial outline, and a wider range in the number of chambers (7–10) in the last whorl compared to other Heleninidae genera. This new genus can provide a suitable taxonomical unit for the assignments of several undetermined species that were previously classified to but distinguishable from the genera “Pseudoeponides” and Helenina.

In this research, we examined and measured 58 syntypes and one ideotype (from the Kangkou River on the east flank of Hengchun Peninsula) of Cyclohelenina formosaensis sp. nov., the type species of the new genus. Under the concept of functional morphology, the hispid ornamentation found to be present around every opening on the test of C. formosaensis suggests that it may be an herbivore. Observations of yellowish-green stains within fresh tests (evidence for chlorophyll from their food source) are consistent with this inference. The test with low-trochospiral shape and sutural incisions on both sides indicated that C. formosaensis may prefer hyposaline habitats with sandy silt and sand substrates in tide-influenced environments, which is consistent with environment properties of the type locality of the new species.
Level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services
Authors: Aldebasi Bader , Alhassan Abdulaziz I. , Al-Nasser Sami , Abolfotouh Mostafa
Published: September 2020

Background. Many studies are available in the literature about e-health in Saudi Arabia, however, data is limited to a few organizations and does not necessarily reflect the current and potential use of e-health for health care organizations in the country. This study aimed to determine the level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services and significant predictors of their practice.Methods. A cross-sectional survey of 440 medical students in Riyadh, Saudi Arabia, was conducted, during October/November 2019, using a previously validated questionnaire, to assess: (1) knowledge in three domains; e-health definition (13 statements), fields of application of e-health (8 statements), methods of using e-health (7 statements), (2) attitude toward using e-health (8 statements) and (3) reported practice of e-health in medical training (5 statements). A scoring system was used to calculate the total and percentage score of knowledge, attitude, and practice for each student. Multiple regression analysis was applied to identify predictors of e-health practice. Significance was considered at p<0.05. Results. Of 440 medical students, the majority were females (55.7%) and from families whose monthly income was more than 10,000SR (82.8%). Overall knowledge about e-health was unsatisfactory (percentage mean score, PMS=71.6%), with only 43.6% of students reporting a satisfactory level. However, this level was satisfactory for fields of application (Percentage mean score-PMS=76.6%) and unsatisfactory for the definition of e-health (PMS=70.7%) and methods of its use (PMS=65.7%) domains. The overall attitude towards e-health use was positive (PMS=82.3%), with nearly three-quarters of students (73.4%) reporting a positive attitude. Generally, a good level of practice of e-health was reported by students (PMS=84.3%), with more than three-quarters of students (78.4%) reporting good practice. Adjusting for age, gender, stream, educational grade, and family monthly income, good practice was significantly predicted with higher knowledge (t=2.22, p=0.03) and attitude (t=2.11, p=0.04) scores.Conclusion. This study provides basic information regarding medical students' level of awareness of internet-based health-related information seeking and developing to support health services. More resources should be directed to elevate medical students' knowledge and to motivate them to practice e-health using the available tools.
Role of Sex Hormones And Their Receptors On Gastric Nrf2 And Neuronal Nitric Oxide Synthase Function In An Experimental Hyperglycemia Model
Authors: Sprouse Jeremy , Sampath Chethan , GANGULA PANDU
Published: September 2020

Background: Gastroparesis, a condition of abnormal gastric emptying, is most commonly observed in diabetic women. To date, the role of ovarian hormones and/or gastric hormone receptors on regulating nitrergic-mediated gastric motility remains inconclusive. Aim: The purpose of this study is to investigate whether sex hormones/their receptors can attenuate altered Nuclear factor (erythroid-derived 2)-like 2 (Nrf2), neuronal Nitric Oxide Synthase (nNOS) expression and nitrergic relaxation in gastric neuromuscular tissues exposed to in-vitro hyperglycemia (HG). Methods: Gastric neuromuscular sections from adult female C57BL/6J mice were incubated in normoglycemic (NG, 5mM) or hyperglycemic (30 mM or 50 mM) conditions in the presence or absence of selective estrogen receptor (ER) agonists (ERα /PPT or ERβ: DPN); or non-selective sex hormone receptor antagonists (ER/ICI 182,780, or progesterone receptor (PR)/ RU486) for 48 hours. mRNA, protein expression and nitrergic relaxation of circular gastric neuromuscular strips were assessed. Results: Our findings in HG, compared to NG, demonstrate a significant reduction in ER, Nrf2, and nNOS expression in gastric specimens. In addition, in-vitro treatment with sex hormones and/or their agonists significantly (*p<0.05) restored Nrf2/nNOSα expression and total nitrite production. Conversely, ER, but not PR, antagonist significantly reduced Nrf2/nNOSα expression and nitrergic relaxation. Conclusions: Our data suggest that ER’s can regulate nitrergic function by improving Nrf2/nNOS expression in experimental hyperglycemia.
Comparison of the Clinical Characteristics and Mortality of Adults Infected with Human Coronaviruses 229E and OC43
Authors: Choi Won-Il , Lee Choong Won
Published: September 2020

The authors have withdrawn this preprint due to erroneous posting.
Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia
Authors: Edward Anbrasi , Krishnan Aparna , Ettyang Grace , Jung Younghee , Perry Henry B , Ghee Annette E , Chege Jane
Published: September 2020

Background Skilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce. Methods A quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to determine the effect of integrated community investments on skilled birth attendance (SBA). In each country, communities in two districts/sub-districts received a package of community-oriented interventions comprised of timed CHW household health promotion for maternal, newborn and child health complemented by social accountability mechanisms using community scorecards. Two matched comparison districts/sub-districts received ongoing routine interventions. Data from the final evaluation were examined to determine the effect of timed CHW services and community-oriented interventions on SBA. Results Over 80% of the 3,037 women in Cambodia, 2,805 women in Kenya and 1,171 women in Zambia reported SBA. Women in intervention sites who received timely CHW health promotion and social accountability mechanisms in Cambodia showed significantly higher odds of SBA (aOR=7.48; 95% CI: 3.87, 14.5). The findings also indicated that women over the age of 24 in Cambodia, women with primary or secondary education in Cambodia and secondary education in Kenya, women from higher wealth quintiles in Cambodia, and women with four or more antenatal care (ANC) visits in all countries reported significantly higher odds of SBA. Inclusion of family members in pregnancy-related discussions in Kenya (aOR=2.12; 95% CI: 1.06, 4.26) and Zambia (aOR=6.78; 95% CI: 1.15, 13.9) and follow up CHW visits after a referral or health facility visit (aOR=2.44; 95% CI: 1.30, 4.60 in Cambodia; aOR=2.17; 95% CI 1.25, 3.75 in Kenya; aOR=1.89; 95% CI: 1.05, 2.02 in Zambia) also showed significantly greater odds of SBA.Conclusions Enhancing people-centered care through culturally appropriate community-oriented strategies integrating timely CHW health promotion and social accountability mechanisms shows some evidence for improving SBA during delivery. These strategies can accelerate the achievement of the sustainable development goals for maternal child and newborn health.
Challenges and prospects for implementation of community health volunteers’ digital health solutions in Kenya: a qualitative study
Authors: Bakibinga Pauline , Kamande Eva , Kisia Lyagamula , Omuya Milka , Matanda Dennis J , Kyobutungi Catherine
Published: September 2020

Background: The value of digital health technologies in delivering vital health care interventions, especially in low resource settings is increasingly appreciated. We co-developed and tested a decision support mobile health (m-Health) application (app);with some of the forms used by Community Health Volunteers (CHVs) in Kenya to collect data and connected to health facilities. This paper explores the experiences of CHVs, health workers and members of Sub-County Health Management Teams following implementation of the project.Methods: Data were collected in December 2017 through in-depth interviews and focus group discussions with CHVs and key informant interviews with health care workers and health managers in Kamukunji sub-County of Nairobi, Kenya. Data coding and analysis was performed in NVivo 12.Results: Regarding users and health managers’ perceptions towards the system; three main themes were identified: 1) variations in use, 2) barriers to use and 3) recommendations to improve use. Health workers at the private facility and some CHVs used the system more than health workers at the public facilities. Four sub-themes under barriers to use were socio-political environment, attitudes and behaviour, issues related to the system and poor infrastructure. A prolonged health workers’ strike, the contentious presidential election in the year of implementation, interrupted electricity supply and lack of basic electric fixtures were major barriers to use. Suggestions to improve usage were: 1) integration of the system with others in use and making it available on users’ regular phones, and 2) explore sustainable motivation models to users as well as performance based remuneration. Conclusions: The findings reveal the importance of considering the readiness of information and communication technologies (ICT) users before rollout of ICT solutions. The political and sociocultural environment in which the innovation is to be implemented and integration of new solutions into existing ones is critical for success. As more healthcare delivery models are developed, harnessing the potential of digital technologies, strengthening health systems is critical as this provides the backbone on which such innovations draw support.
High-throughput profiling of diapause regulated genes from Trichogramma dendrolimi, an important egg parasitoid
Authors: Zhang Xue , Du Wenmei , Zhang Junjie , Zou Zhen , Ruan Changchun
Published: September 2020

Background: The parasitoid wasp Trichogramma dendrolimi can successfully enter diapause at the prepupal stage. Thus, diapause is an efficient preservation method during the mass production of T. dendrolimi . Previous studies on diapause have focused largely on ecological characteristics, so the molecular mechanism of diapause in T. dendrolimi is mostly unknown. In this study, we compared transcriptomes of diapause and non-diapause T. dendrolimi to identify key genes and pathways involved in the development of diapause. Results: Transcriptome sequencing was performed using different samples, including diapause prepupae, pupae after diapause, normal prepupae, and pupae. Initially, it yielded a total of 87,022 unigenes with an average length of 1,604 bp. By removing redundant sequences and those without significant BLAST hits, a non-redundant dataset was generated, containing 7,593 sequences with an average length of 3,351 bp. Among them, 5,702 genes were differentially expressed. The result of Gene Ontology (GO) enrichment analysis revealed that regulation of transcription, DNA-templated, oxidation-reduction process, and signal transduction were significantly affected. Ten genes were selected for validation using a quantitative real-time PCR (qPCR). The changes showed the same trend between the qPCR and RNA-Seq results. Based on our data, several genes were identified to be involved in diapause, including ribosomal proteins, zinc finger proteins, homeobox proteins, forkhead box proteins, UDP-glucuronosyltransferase , Glutathione-S-transferase , p53 , DNA damage-regulated gene 1 ( pdrg1 ), and genes related to lipid metabolism were also included. Conclusions: In this study, we generated a great amount of transcriptome data from T. dendrolimi , providing a resource for gene function research. The diapause-related genes that we identified establish a valuable basis for future studies on the molecular mechanisms of diapause, not only for T. dendrolimi , but for other species as well.
Child acceptability of a novel provitamin A carotenoid, iron and zinc-rich complementary food blend prepared from pumpkin and common bean in Uganda: A randomised control trial
Authors: Buzigi Edward , Pillay Kirthee , Siwela Muthulisi
Published: September 2020

Background Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. Objective Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). Methods The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n=35) or 100 g of PB (n=35) on day one. After a washout period of one day, children crossed over to receive either BPB (n=35) or PB (n=35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥ 50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p= 0.05). Results The mean consumption of BPB and PB was 53.9 g and 54.4 g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 minutes, respectively. There was no significant difference in the amounts consumed, and duration of consumption in BPB and PB (p >0.05). The mean intake of vitamin A was significantly higher (p <0.00001) in PB (152.5 µgRAE) compared to BPB (100.9 µgRAE). The mean iron intake was significantly higher in BPB (1.1mg) (p <0.00001) compared to PB (0.3mg). Furthermore, zinc intake was significantly higher (p <0.00001) in BPB (0.58mg) compared to PB (0.13 mg). Conclusion A homemade complementary food, BPB, made from locally available common bean and pumpkin is rich in PVACs, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda.
Outdoor mesocosm experiments to improve understanding of risks to environmental health
Authors: Alexander A.C. , Bowser Emma , Hryn David , Halliwell Daryl , Heard Kristie , Luiker Eric , Culp Joseph M.
Published: September 2020

Mesocosms are outdoor experimental systems designed to separate and test environmental responses, in this case, cumulative effects to field-collected periphyton and macroinvertebrate communities from multiple stressors. This experimental system produces valuable, highly reproducible data, and along with field monitoring, laboratory bioassays and modeling results, provides a strong weight-of-evidence approach for aquatic risk assessment. Through the control of confounding environmental variables, this type of experiment permits the separation of interactions between multiple stressors in complex effluents or due to shifting ambient conditions. The system described is modular and was originally developed to facilitate transport of the entire system to remote or industrial test sites (e.g., for in situ 21-d chronic level testing). However, this setup is also appropriate for long term installations with suitable provision for routine maintenance and losses associated with regular wear-and-tear on equipment. The following protocol details a basic stream mesocosm system setup (e.g., 4 replicate streams per treatment-level) which is the foundation for the more than a dozen stream mesocosm experiments conducted by the authors since the 1990s.
Generation of AGM-derived Akt-EC (AGM-EC)
Authors: Dignum Tessa , Varnum-Finney Barbara , Dozono Stacey , Hadland Brandon
Published: September 2020

During murine embryonic development, the first hematopoietic stem cells (HSCs) emerge within the major arterial vasculature, including the aorta-gonad-mesonephros (AGM) region. Throughout their emergence and subsequent maturation, HSCs retain a close physical association with the surrounding endothelial cell layer, suggesting that signaling interactions between HSC and the surrounding vascular niche may play an integral role in HSC development. Indeed, we have previously shown that co-culture with AGM-derived endothelial cells (AGM EC) engineered to constitutively express Akt (AGM Akt-EC) is sufficient to mature non-engrafting HSC precursors from hemogenic endothelium to fully functional HSCs1-3. Here, we describe how to generate these AGM Akt-EC cells for use in co-culture experiments, providing detailed instructions from the isolation of AGM EC from embryonic tissues, to their infection with the PGK.myr-AKT lentivirus and subsequent characterization by flow cytometry.
Effect of a free healthy school meal on fruit, vegetables and unhealthy snacks intake in Norwegian 10- to 12-year-old children
Authors: Vik Frøydis Nordgård , Heslien Kaia Elisabeth Paulsen , Lippevelde Wendy Van , Øverby Nina Cecilie
Published: September 2020

Background: Norwegian children have a lower intake of fruit, vegetables, and a higher intake of unhealthy snacks compared to dietary guidelines. Such dietary inadequacies may be detrimental for their current and future health. Schools are favorable settings to establish healthy eating practices. Still, no school meal arrangement is provided in Norway, and most children typically bring packed lunches from home. The aim of this study was to investigate whether serving a free healthy school meal for one year resulted in a higher intake of fruit and vegetables and a lower intake of unhealthy snacks in total among 10-12-year-olds in Norway.Methods: The School Meal Project in Southern Norway was a non-randomized trial in two elementary schools in rural areas in the school year 2014/2015. The study sample consisted of 10- to 12-year-old children; an intervention group (N=55) and a control group (N=109) resulting in a total of 164 school children at baseline. A food frequency questionnaire was completed by the children at baseline, at five months follow-up and after one year to assess fruit, vegetable, and snacks intake. Multiple linear regression analyses were performed to assess intervention effects on overall intake of fruit and vegetables and unhealthy snacks.Results: Serving of a free healthy school meal for one year was associated with a higher weekly intake of vegetables on sandwiches in the intervention group compared to the control group, adjusted for baseline intake (B: 1.11 (95% CI: .38, 1.85)) at the end of the intervention. No other significant intervention effects were found for the remaining fruit and vegetables measures. Serving of a free healthy school meal was not associated with a lower weekly intake of unhealthy snacks (i.e. potato chips, candy, sugar sweetened beverages) in the intervention group compared to the control group.Conclusions: A free healthy school meal was associated with a higher weekly intake of vegetables on sandwiches but did not significantly change any other investigated dietary behaviors. However, given the inadequate intake of vegetables among children and that even moderate improvements have public health relevance, a free healthy school meal for all school children could be beneficial.Trial registration:ISRCTN61703361 Date of registration: December 3rd, 2018Retrospectively registered
Oral lactobacillus strains reduce cytotoxicity and cytokine release from peripheral blood mononuclear cells exposed to Aggregatibacter actinomycetemcomitans subtypes in vitro.
Authors: Pahumunto Nuntiya , Basic Amina , Östberg Anna-Karin , Teanpaisan Rawee , Dahlen Gunnar
Published: September 2020

Background: This study evaluated the effect of oral lactobacilli on the cytotoxicity and cytokine release from peripheral blood mononuclear cells (PBMCs) when exposed to Aggregatibacter actinomycetemcomitans subtypes in vitro. The supernatants and cell wall extracts (CWEs) of eight A. actinomycetemcomitans strains, representing different subtypes, and three Lactobacillus strains were used. The PBMCs from six blood donors were exposed to supernatants and CWEs of A. actinomycetemcomitans or Lactobacillus strains alone or combinations and untreated cells as control. The cytotoxicity was determined by trypan blue exclusion method and IL-1β secretion by ELISA. TNF-α, IL-6, and IL-8 secretions were measured using Bioplex Multiplex Immunoassay. Results: Supernatants or CWEs from all bacterial strains showed cytotoxicity and IL-1β secretion and the subtypes of A. actinomycetemcomitans showed generally a significantly higher effect on PBMCs than that of the Lactobacillus strains. Two highly toxic A. actinomycetemcomitans strains (JP2 and JP2-like) induced a higher response than all other strains. When combined, Lactobacillus significantly reduced the toxicity and the IL-1β secretion induced by A. acinomycetemcomitans. The effect varied between the subtypes and the reduction was highest for the JP2 and JP2-like strains. The Lactobacillus paracasei strain SD1 had a higher reducing effect than the other Lactobacillus strains. This strain had a consistent reducing effect on all subtypes of A. actinomycetemcomitans cytotoxicity, and release of IL-1β, IL-6, IL-8, and TNF-α from PBMCs of the blood donors. A strong and significant variation in cytokine release between the six blood donors was noticed.Conclusions: Lactobacillus spp. and L. paracasei SD1 in particular, showed a limited but statistically significant reducing interaction with A. actinomycetemcomitans toxicity and release of cytokines in vitro.
The relationship between a microfinance-based healthcare delivery platform, health insurance coverage, health screenings, and disease management in rural Western Kenya
Authors: Rosenberg Molly , Amisi James Akiruga , Szkwarko Daria , Tran Dan N. , Genberg Becky , Luetke Maya , Kianersi Sina , Namae Jane , Laktabai Jeremiah , Pastakia Sonak
Published: September 2020

Background: Structural barriers often prevent rural Kenyans from receiving healthcare and diagnostic testing. The Bridging Income Generation through grouP Integrated Care (BIGPIC) Family intervention facilitates microfinance groups, provides health screenings and treatment, and delivers education about health insurance coverage to address some of these barriers. This study evaluated the association between participation in BIGPIC microfinance groups and health screening/disease management outcomes.Methods: From November 2018 to March 2019, we interviewed a sample of 300 members of two rural communities in Western Kenya, 100 of whom were BIGPIC microfinance members. We queried participants about their experiences with health screening and disease management for HIV, diabetes, hypertension, tuberculosis, and cervical cancer. We used log-binomial regression models to estimate the association between microfinance membership and each health outcome, adjusting for key covariates.Results: Microfinance members were more likely to be screened for most of the health conditions we queried, including those provided by BIGPIC [e.g. diabetes: aPR (95% CI): 3.46 (2.60, 4.60)] and those not provided [e.g. cervical cancer: aPR (95% CI): 2.43 (1.21, 4.86)]. Microfinance membership was not significantly associated with health insurance uptake and disease management outcomes. Conclusions: In rural Kenya, a microfinance program integrated with healthcare delivery may be effective at increasing health screening. Interventions designed to thoughtfully and sustainably address structural barriers to healthcare will be critical to improving the health of those living in low-resource settings.
Mentoring in the clinical training of midwifery students. A focus study of the experiences and opinions of midwifery students at the Medical University of Warsaw participating in a mentoring programme
Authors: Stefaniak Małgorzata , Dmoch-Gajzlerska Ewa
Published: September 2020

Background: The current system of clinical training for midwifery students in Poland is in need of considerable revision to adapt it to the global standards and the expectations of healthcare providers, healthcare users and student midwives themselves. Aim of this study was to report the experiences of midwifery students participating in a mentor-led clinical training program and their opinions of mentoring as a novel training method.Methods: A qualitative descriptive study that used a focus group was undertaken in the period from October 2017 to June 2019. The participants were 12 second- and third-year midwifery students at the Medical University of Warsaw who at various times during the study period had their clinical training in the Department of Obstetrics, Solec Hospital in Warsaw, Poland. All students had previous experience of clinical training other than clinical mentorship. At the end of the study, a focus group interview was conducted with all 12 participants. Five questions were selected to guide the focus group discussion: Did you get any valuable learning experience during your clinical training? How did this clinical training differ from your previous clinical training? What was your experience of one-on-one mentoring? Did the mentoring program meet your expectations? What do you think could be changed to make the proposed mentor-led clinical training more effective? Results: Four themes were identified. The study demonstrated that mentoring was perceived by the participants as an innovative and effective method of clinical training for midwifery students. All students positively evaluated the quality of the mentor-led clinical training which allowed improving their clinical skills and building new competencies. Students believed they could effectively use their clinical skills and make informed decisions in a safe and supportive clinical learning environment. They felt that their inclusion in the therapeutic team contributed to better patient care.Conclusions: The use of innovative forms of clinical training at undergraduate level improves its effectiveness and in the future should be reflected in a high-quality maternity care. Mentoring has its advantages for both, mentor and mentee, but the main goal is to develop and improve professional competencies of the junior partner.