Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania : an open label prospective study

Background: Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. Methods: An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results: A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p <= 0.046). Conclusions: Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for scaling-up implementation of HMM with AL in Tanzania.

Personlighetsbedömning i samband med rekrytering : En studie om bemanningsbranschens personlighetsbedömning vid en rekrytering

Att medarbetare är av existentiell betydelse för en organisations överlevnad är sedan länge känt. Därmed är rekrytering en av de viktigaste funktionerna inom HR för att attrahera rätt kompetens till organisationen då en misslyckad rekrytering vanligen leder till bortkastad tid och dyra rekryteringsprocesser. Något som kommit att få allt större betydelse vid urvalet och bedömningen av nya medarbetare är kandidaters personlighet. Forskning visar att personlighetsdrag spelar en stor roll när det kommer till framtida arbetsprestationer och förmågan att göra rätt bedömningar av människor är därför central. Teorier om synen på personlighet, kompetens, kompetensbaserad rekrytering och urval samt bedömningsmetoder och personlighetsbedömning används för att analysera studiens resultat. Denna kvalitativa studies övergripande syfte var att öka förståelsen för hur rekryterare bedömer en kandidats personlighet vid en rekryteringsprocess inom bemanningsföretag. Bemanningsföretag är företag som ständigt arbetar med rekrytering och uthyrning av personal, varför ett proaktivt bemanningsarbete krävs för att skapa en konkurrensfördel på marknaden. Inför denna fallstudie kontaktades tre av den svenska bemanningsbranschens största aktörer varav två rekryterare på vardera företag deltog i semistrukturerade intervjuer. Personlighet ansågs generellt som något viktigt som samtliga rekryterare lade stor vikt vid under hela processens gång, från utformandet av kravprofilen till avslutande bedömning. Bedömningen skedde genom såväl test som intervju och referenstagning. Samtliga poängterade vikten av att alltid göra en helhetsbedömning av kandidaten och att det därmed var svårt att vikta exempelvis formella kompetenser mot personliga egenskaper. Resultatet visar att bemanningsbranschens arbete med personlighetsbedömning vid rekrytering utgår ifrån strukturerade bedömningsmetoder. Deras gedigna och proaktiva arbete med rekrytering lever upp till påståendet om att personalen är en organisations viktigaste resurs och vikten av att förstå innebörden av personlighetens betydelse i uttrycket ”rätt person på rätt plats”.

Must teachers be social workers, as well …? : Reflections on the current teacher role in the Swedish upper secondary school and how it affects teacher training

The Swedish upper secondary school has made a transition from a school for the elite to be a school for everybody. When almost every youth nowadays chooses to continue studying, for some of them this is not what they want to do most of all. However, as there in practice is no choice, there come up problems and many upper secondary school teachers experience a growing frustration. We will here discuss some aspects of the following questions: -  How do upper secondary schoolteachers handle their working-conditions in a new situation? - What possible consequences do this have on teacher education?

Negotiating collective and individual agency : a qualitative study of young women's reproductive health in rural India

The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.