bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to caring parenting and adult mental health in extremely low birthweight survivors
Authors: Amani Bahar , Schmidt Louis A , Saigal Saroj , Van Lieshout Ryan J 
Published: April 2019

AimIndividuals born at extremely low birthweight (ELBW; <1000 g) are exposed to early adversities that increase the risk of mental health problems in later life. Caring parenting has been shown to offset the negative effects of early adversity in general population samples. However, the long‐term impact of caring parenting on the mental health of preterm survivors in adulthood is not known.MethodsUsing data from the world's oldest longitudinally followed cohort of ELBW survivors (n = 179) and matched normal birthweight (NBW) control participants (n = 145), we examined if caring parenting moderated the link between preterm birth and mental health at 30–35 years of age. Participants reported on the parenting they received from their mothers using the parental bonding instrument. Self‐esteem and internalising problems (i.e. depression, anxiety) were self‐reported at 30–35 years of age using the Coopersmith Self‐Esteem Inventory and Young Adult Self‐Report questionnaire, respectively.ResultsA statistically significant interaction was found between birthweight status and caring maternal parenting on self‐esteem and internalising psychopathology in adulthood. Stratified analyses demonstrated that caring parenting was associated with better self‐esteem (P < 0.001) and lower levels of internalising symptoms (P = 0.001), but in NBW participants only.ConclusionsWhile the receipt of caring maternal parenting promoted mental health in adults born at NBW, it did not have the same protective effect on ELBW survivors. More research is needed to elucidate the aspects of parenting and the family environment that promote the long‐term mental health of preterm survivors.
A new treatment for presumed corneal epithelial inclusion cyst in a shih‐tzu dog
Authors: Kang S. , Park E. , Seo K. 
Published: April 2019

An 8‐year‐old female shih‐tzu was assessed for a 3‐year history of yellow intrastromal material in the right eye. Slit‐lamp biomicroscopy showed a yellow lesion in the upper half of the cornea, superficial corneal neovascularisation and oedema with negative fluorescein staining in the right eye. Ultrasound biomicroscopy revealed a nearly anechoic cystic space surrounded by hyperechoic oedematous cornea separating the stroma at three‐quarters of the corneal depth. Two partial‐thickness corneal incisions were performed around the lesion under topical anaesthesia. After cytology and culture sampling, intrastromal flushing was performed. A yellow viscous necrotic tissue was identified with no microorganism or evidence of tumour formation. Antibiotics, anti‐inflammatories and a bandage contact lens were applied. Ultrasound biomicroscopy confirmed no recurrence 8 days later. Corneal neovascularisation and oedema gradually resolved through a 2‐week follow‐up. There was no recurrence in the subsequent 8 months.
The Expansion View of Thick Concepts
Authors: Kyle Brent G. 
Published: April 2019

AbstractThis paper proposes a new Separabilist account of thick concepts, called the Expansion View (or EV). According to EV, thick concepts are expanded contents of thin terms. An expanded content is, roughly, the semantic content of a predicate along with modifiers. Although EV is a form of Separabilism, it is distinct from the only kind of Separabilism discussed in the literature, and it has many features that Inseparabilists want from an account of thick concepts. EV can also give non‐cognitivists a novel escape from the Anti‐Disentangling Argument. §I explains the approach of all previous Separabilists, and argues that there's no reason for Separabilists to take this approach. §II explains EV. §III fends off objections. And §IV explains how non‐cognitivist proponents of EV can escape the Anti‐Disentangling Argument.
Sustainability Policy Research: A Review and Synthesis
Authors: Armstrong John H. , Kamieniecki Sheldon 
Published: April 2019

This paper reviews theoretical and empirical approaches drawn from influential journal articles and books on sustainability policy published over the last 10 years (2007 through 2017). Due to the widespread application of sustainability as a concept and space limitations, the paper more narrowly focuses on sustainability research in three critical policy areas: climate change, urban development, and agroecology and food systems. Drawing from information provided primarily by citation indexes, the study identifies and analyzes the research literature related to sustainability in these three fields. Future theoretical and empirical research approaches that can better integrate and connect the current diffuse and incongruent literature on sustainability are discussed in the paper. The findings of the literature review generate a number of possible future research directions that are discussed in the study.
PO 8467 IMPACT OF COMMUNITY CASE MANAGEMENT OF MALARIA (CCMM) AMONG CHILDREN UNDER FIVE YEARS OLD: AN EVALUATIVE STUDY IN KABONGA
Authors: Bonne Ciza , Husseni Kagozi , Muhigirwa Ciza Josephine 
Published: April 2019

BackgroundIn Burundi, malaria is considered a major public health concern and the leading cause of death. Malaria is responsible for up to 25% of all outpatient visits and up to 48% of all deaths in health facilities among children under five years old. Despite efforts made, timely access to health care is still limited, mainly due to geographic inaccessibility and lack of awareness about malaria complications. To increase timely access to malaria treatment, Burundi’s Ministry of Health implemented Community Case Management of Malaria (CCMM) since 2015 in Kabonga. We sought to assess the impact of CCMM in improving malaria outcomes following two years of its initiation.MethodsSelected community health workers (CHWs) were initially trained for simple malaria management among children under five years old using artemisinin-based combination therapy (ACT) and to perform rapid diagnostic tests for malaria (RDTs), and then equipped to provide service. This was a retrospective and prospective study using a mixed-methods approach between September-October 2017. Data before CCMM initiation (2013–2014) were collected from the Kabonga health centre, then compared to data from 2015–2016 corresponding to CCMM implementation. Data were from health records and stakeholders and were processed using SPSS.ResultsIn total, 5922 children were treated for malaria between 2013–2014 and 5249 between 2015–2016, an 11,3% case decrease. CHWs managed in total 1751 children using ACTs between 2015–2016. Of them, 1297 (74%) had a consult within 24 hours of fever onset and the cure rate was approximately 90%. Mortality decreased with up to 75%. Ownership level was encouraging among beneficiary communities and was low among district and health center’s staff. Some stock-outs were also reported.ConclusionUsing trained CHWs increased access to timely and appropriate treatment in sampled communities which was associated with improved health outcomes among children under 5 years old. However, regular supply to CHWs and strong ownership is needed.
PO 8470 FIRST INDEPENDENT ASSESSMENT OF PHARMACEUTICAL COMPANY ACTION ON AMR
Authors: Kisakye Jacqueline , Knoeff Josefien , Ruiz Adrian , Calcada Dulce , Iyer Jayasree , Gabrielle Breugelmans J 
Published: April 2019

BackgroundAntimicrobial resistance (AMR) is one of the most significant threats to public health globally. It will worsen without concerted efforts to spur the development of new antibiotics and ensure access and stewardship of existing ones. Pharmaceutical companies have a critical role to play in these efforts. The Access to Medicine Foundation developed the AMR Benchmark to measure how pharmaceutical companies are responding to AMR and to share and push best practices within the industry.MethodsThe AMR Benchmark assessed the AMR activities of 30 pharmaceuticalcompanies in 106 low- and middle-income countries. Survey data on company activities were collected across three research areas: research and development (R&D); manufacturing and production; and access and stewardship. For each research area, specific metrics were developed to evaluate company performance. These metrics were defined through consultation with experts working across the AMR field and represent a broad consensus on where companies can and should be taking action to limit AMR.ResultsThe Benchmark found that there are good practices in all research areas. Out of 276 R&D projects targeting infectious diseases, 175 target pathogens identified as priority by WHO/CDC. Of these, 88 are in preclinical stage, 87 are in clinical stage, and 54 target gram-negative bacteria. Out of 28 antibiotics in late clinical stage, only two have access and stewardship plans in place. Nearly half of companies evaluated are involved in AMR surveillance and eight companies set limits on antibiotic wastewater discharge. Lastly, four companies separate sales agent bonuses from antibiotics sales volumes to reduce overuse of antibiotics.ConclusionThe Benchmark identified the good ideas being implemented by companies to limit AMR and mapped opportunities to amplify current efforts. Although companies are taking some action, the R&D pipeline needs to be further strengthened and candidates reaching late clinical stage must be supported by concrete plans to ensure access and stewardship.
PO 8472 EACCR-2 INSTITUTIONAL CLINICAL RESEARCH CAPACITY ASSESSMENT: CASE STUDY OF SIAYA COUNTY REFERRAL HOSPITAL, WESTERN KENYA
Authors: Oduor Patience , Wambura Mary , Mwai Geoffrey , Wandiga Steve 
Published: April 2019

BackgroundInfrastructural inadequacies and lack of research management expertise impede optimal research participation by Ministries of Health in Africa. The East African Consortium for Clinical Research (EACCR-2) network champions research strengthening through capacity building and partnership with local institutions to improve research output in the region. The Siaya County Referral Hospital was evaluated for research needs in preparation for a future clinical trial.MethodsIn April 1018, we interviewed departmental in-charges or designees for administrative, financial and clinical data management, laboratory records and information technology (IT). Standardised assessment questionnaires were used.ResultsFive of the seven respondents interviewed were males. Patient populations such as children, adolescents and pregnant mothers were identified as having unique characteristics. They are to be considered for future inpatient and outpatient clinical trials. There is little research exposure among clinical, data and laboratory staff despite some of them receiving GCP and GCLP training.An Institutional Review Board (IRB) is in place and it reviews both academic research proposals and large multicentre clinical trials before studies are carried out. However, the members lack appropriate training in bioethics.Acute staff shortage, reagent stock-outs, space constraints, and faulty equipment limit the laboratory’s capacity. Insufficient IT support and internet access cause delays in data entry. A lack of expertise in monitoring, data analysis and statistics, of financial management systems and library services were also identified.ConclusionThe hospital’s capacity to conduct clinical research is low. Assessment findings highlighted funding constraints faced at the referral hospital in a country burdened by disease. North-South partnership through EDCTP will contribute towards addressing part of these gaps.
PO 8473 IMPACT OF EBOLA ON SLEEPING SICKNESS IN COASTAL GUINEA: A RETROSPECTIVE ANALYSIS (2012–2017) FROM THE GUINEAN NATIONAL CONTROL PROGRAMME
Authors: Camara Oumou , Ilboudo Hamidou , Camara Mariame , Ouattara Eric , Duvignaud Alexandre , Leno Amadou , Solano Philippe , Malvy Denis , Bucheton Bruno , Camara Mamadou 
Published: April 2019

BackgroundCoastal Guinea harbours the most active human African trypanosomiasis (HAT) foci in West Africa. The Guinean government and its partners are conducting HAT control activities to reduce the burden of this neglected tropical disease and, as set-up by WHO, to eliminate it as a public health problem by 2020. Unfortunately, control efforts were deeply impaired during the Ebola outbreak that struck the country in 2014–2015. The aim of the study was to evaluate the impact of this unprecedented outbreak on HAT screening and care activities and more generally onT. brucei gambiensetransmission.MethodsA retrospective analysis of the data collected by the HAT-NCP between 2012 and 2013 (pre-Ebola period) and 2014–2015 (Ebola outbreak) has shown an interruption of active HAT screening activities and a rapid decrease of passive HAT screening activities as the Ebola outbreak was spreading. During the Ebola epidemic, HAT patients were also diagnosed in a later stage of the disease and attendance to post-treatment control visits was also severely affected.ResultsOnly 59 HAT patients were diagnosed and treated during the Ebola outbreak (January 2014–October 2015) as compared to 154 before the outbreak (February 2012–December 2013). This potentially large undiagnosed human reservoir of trypanosomes may have contributed to increased transmission levels. After Guinea was declared free of Ebola virus disease, screening activities (both passive and active) were progressively resumed. In 2016 and 2017, Guinea reported 107 and 140 HAT cases, respectively (almost twice as much as during the pre-Ebola period) and became the second most affected country after the Democratic Republic of the Congo.ConclusionA major lesson taken from the Ebola outbreak is that disruption of medical care may lead to a quick HAT burst in areas of high transmission. Current HAT control measures combining screening and tsetse control interventions will help to stay on course for the elimination goal.
PO 8475 ENHANCING THE CAPACITY OF THE LIBERIA MEDICINES AND HEALTH PRODUCTS REGULATORY AUTHORITY IN POST-MARKETING SURVEILLANCE OFIN VITRODIAGNOSTICS
Authors: George Alexander E , Somwarbi Joseph N , Sumo David , Pérez Guillermo Martínez , Mayor Alfredo 
Published: April 2019

BackgroundThe Quality Control Laboratory (QCL) of the Liberia Medicines and Health Products Regulatory Authority (LMHRA) lacks capacity to assess the quality ofin vitrodiagnostics (IVDs). The LMHRA needs be strengthened to develop post-market surveillance (PostMS) regulations in order to fulfil its supervisory role for IVDs used in research and healthcare settings. IGORCADIA, an EDCTP-funded project of LMHRA and the Barcelona Institute for Global Health (ISGlobal) started in December 2017 with the aim of building LMHRA diagnostics assessment capacity.MethodsProject activities targeting the QCL include: the constitution of an in-house Technical Working Group and a Diagnostic Steering Committee involving national stakeholders to develop PostMS regulation; a Training Programme in Diagnostics Research (TPDxR) including a malaria diagnostics performance study as its post-TPDxR exercise.ResultsThe QCL is developing with its new knowledge and networks improved mechanisms to enact its supervisory mandate. QCL staff contributed to the development of guidance for Post-MS. Private sector and government stakeholders helped the LMHRA identify unlicensed premises where IVDs of presumably poor accuracy are available over the counter. Following the TPDxR, the QCL planned quality assurance to oversee the quality assessments on suspected substandard IVDs. Quality control tools, staff training requirements, standard inspection procedures, and PostMS registers and reports were re-designed in accordance with Good Laboratory Practice and guidance from the TPDxR.ConclusionThe LMHRA is strengthening its regulatory, inspection and PostMS capacities thanks to a partnership with a European research institution with expertise in malaria diagnostics development. To ensure that the Liberian population has access to safe quality diagnostics in routine healthcare provision and in future infectious diseases outbreaks, it is of utmost importance that the LMHRA has capacity to assess the accuracy of the non-WHO prequalified IVDs that are currently available outside the healthcare system, and is well-equipped to recall those IVDs identified as substandard.
PO 8476 USER EXPERIENCE OF SMS REMINDERS TO TAKE MEDICATION AMONG PREGNANT AND BREASTFEEDING WOMEN LIVING WITH HIV IN KILIMANJARO, TANZANIA
Authors: Ngowi Kennedy M , Maro Eusibious , Nieuwkerk Pythia T , Aarnoutse Rob E , Mmbaga Blandina T , Marion Sumari-De Boer I 
Published: April 2019

BackgroundPregnant women living with HIV have difficulties in reaching adequate levels of treatment adherence. One way to intervene is sending reminder cues using short message service (SMS) texts. We conducted a pilot study on the use of SMS among pregnant and breastfeeding women living with HIV in Kilimanjaro, Tanzania. One objective was to investigate user experiences of SMS reminders.MethodsWe enrolled adult (age 18–45) pregnant or breastfeeding women living with HIV from Kilimanjaro region, Tanzania. Women received a reminder SMS 30 min before usual time of intake. One hour after usual time of intake, they received an SMS asking whether medication was taken. SMSes were sent less-than-daily and randomly distributed over the week. During consultation we listened to their feedback on the system. After six-months, we interviewed women using a semi-structured exit interview.ResultsTwenty-five women were enrolled. Two women were lost to follow-up. We received feedback from 18 women. Sixteen (89%) said they were content about the SMS reminding. One said she had problems with privacy issues (6%), but 5 specifically mentioned no privacy issues (28%). Preliminary results of 18 exit interviews show that 16 women (89%) had a good experience with the SMS. Fourteen women (78%) found the content of SMS good; 2 women (11%) said it was not good at all due to risk of unwanted disclosure. Three women (17%) experienced stigma. Eleven women (61%) told they were always able to reply to the SMS and 16 (89%) believed it really improves adherence.ConclusionWe believe most women were satisfied with the SMS system. A few women had trouble with risks or fear of unwanted disclosure. One way to solve that, may be to send more neutral language messages. The results can be used for clinical trial design to investigate the effect on adherence.
PO 8483 ASSOCIATIONS BETWEEN HIV AND OTHER STIS AMONG GAY, BISEXUAL MEN AND TRANSGENDER WOMEN IN NAIROBI, KENYA
Authors: Wanjiru Rodah , Kimani Joshua , Smith Adrian 
Published: April 2019

BackgroundMen who have sex with men (MSM) are a key target population for HIV prevention and control in Kenya. Although male sex workers remain the focus of research in Nairobi, HIV/STI prevalence has not been assessed among the wider MSM population since 2010. This study set out to reassess prevalence and associations of HIV and other STIs.MethodsRespondent-driven sampling recruited 618 MSM. Eligibility criteria were age 18+, male (birth or currently), Nairobi residence and consensual oral or anal intercourse with a man in the last year. Consenting participants completed an online survey including current experience of STI symptoms. Participants tested for HIV [Determine, First Response [2ndgen] and GeneXpert HIV-Qual [4thgen]], syphilis [RPR/TPHA], hepatitis B and C [HBsAg and HCV ELISA], urine and rectal chlamydia and gonorrhea [GeneXpert CTNG]. Associations with prevalent HIV were assessed using multivariate logistic regression.ResultsHIV prevalence was 26.4% [22.6–30.6] including 0.5% [0.2–1.5] detected solely on 4th gen testing. Prevalent HIV was independently associated with age, lower education, Kenyan birth, transgender identity and exclusive sex with men in the past 3 months but dependently associated with STI symptoms. Prevalence of syphilis was 0.8% [0.3–1.9]; hepatitis B 4.4% [3.4–6.9]; hepatitis C 0.5% [0.2–1.5]. Current symptoms consistent with urethritis were reported by 6.4% [4.5–9.0] of participants. Prevalence of urethral GC and CT were 4.4% [2.9–6.7] and 7.3% [5.2–10.3] respectively. Symptoms consistent with proctitis were reported by 8.6% [6.3–11.6] of participants. The prevalence of rectal GC and CT were 13.3% [10.4–16.8] and 8.7% [6.7–11.2] respectively. Overall, only 17.7% [9.2–31.2] of participants with urethral CT/NG and 17.8% [10.7–28.0] rectal CT/NG were symptomatic.ConclusionThe burden of HIV among gay, bisexual and other MSM (GBMSM) remains considerably higher than other men in Nairobi, whilst the prevalence of syphilis and hepatitis C are relatively low. Chlamydia and gonorrhoea infections, particularly rectal, are common and frequently asymptomatic. Capacity of GBMSM-friendly and community-based providers to offer CT/NG screening should be prioritised.
PO 8485 INTERFERON GAMMA RESPONSE KINETICS IN TUBERCULOSIS PATIENTS AND HOUSEHOLD CONTACTS IN THE GAMBIA
Authors: Mbayo Georgetta , Garand Mathieu , Donkor Simon , Wathuo Miriam , Ottenhoff Tom , Owolabi Olumuyiwa , Sutherland Jayne 
Published: April 2019

BackgroundMethods which useMycobacterium tuberculosis(Mtb)-specific antigens to measure IFN-γ responses (IFN-γ release assays (IGRA)) have been useful in detecting Mtb infection in exposed individuals. We assessed infections in TB cases and their exposed household contacts (HHC) using an in-house optimised IGRA, the QuantiFERON-TB Gold in Tube (QFT-GIT) and QFT-Plus (QFT+).MethodsFor the in-house IGRA, we analysed 266 active TB patients and 759 HHC (256 tuberculin skin test-positive and 503 test-negative, TST+ and TST- respectively) at baseline and 6 months. In a separate study we assessed QFT-GIT and QFT-plus responses using samples from 72 TB cases and 69 HHC at baseline. QFT-GIT has 3 Mtb-specific antigens: ESAT6, CFP10 and TB7.7 while QFT-plus has long and short peptides of ESAT-6 and CFP-10, designed to induce CD4+ and CD8+T cell responses respectively.ResultsIFN-γ responses were lowest in TST- compared to both TST+ and TB patients at baseline (p<0.0001 for both), with 32% IGRA-positive compared to 76% and 73%, respectively using in-house IGRA. HHC sleeping in the same room with TB patient had a significantly higher IGRA conversion rate by 6 months compared to those sleeping further away (p=0.0004). We also observed a significant decline in IGRA IFN-γ levels by 6 months of TB treatment (p<0.0001). Among QFT-positive TB patients, smear-positive was 57% and culture-positive was 62%. The IFN-γ concentration between TB1 and TB 2 was similar, while, QFT-GIT had a significantly higher response than TB 1 and TB 2 for both TB patients (p=0.003) and HHC (p=0.0005).ConclusionOur findings show that IGRA conversion is significantly increased in HHC with highest exposure but that IGRA -positive cannot predict risk of progression to active TB. We also found that QFT-GIT was quantifiably better than QTF-plus in our setting, limiting the ‘grey zone’ of indeterminate results.