Does mode of follow-up influence contraceptive use after medical abortion in a low-resource setting? Secondary outcome analysis of a non-inferiority randomized controlled trial

BACKGROUND: Post-abortion contraceptive use in India is low and the use of modern methods of contraception is rare, especially in rural areas. This study primarily compares contraceptive use among women whose abortion outcome was assessed in-clinic with women who assessed their abortion outcome at home, in a low-resource, primary health care setting. Moreover, it investigates how background characteristics and abortion service provision influences contraceptive use post-abortion. METHODS: A randomized controlled, non-inferiority, trial (RCT) compared clinic follow-up with home-assessment of abortion outcome at 2 weeks post-abortion. Additionally, contraceptive-use at 3 months post-abortion was investigated through a cross-sectional follow-up interview with a largely urban sub-sample of women from the RCT. Women seeking abortion with a gestational age of up to 9 weeks and who agreed to a 2-week follow-up were included (n = 731). Women with known contraindications to medical abortions, Hb < 85 mg/l and aged below 18 were excluded. Data were collected between April 2013 and August 2014 in six primary health-care clinics in Rajasthan. A computerised random number generator created the randomisation sequence (1:1) in blocks of six. Contraceptive use was measured at 2 weeks among women successfully followed-up (n = 623) and 3 months in the sub-set of women who were included if they were recruited at one of the urban study sites, owned a phone and agreed to a 3-month follow-up (n = 114). RESULTS: There were no differences between contraceptive use and continuation between study groups at 3 months (76 % clinic follow-up, 77 % home-assessment), however women in the clinic follow-up group were most likely to adopt a contraceptive method at 2 weeks (62 ± 12 %), while women in the home-assessment group were most likely to adopt a method after next menstruation (60 ± 13 %). Fifty-two per cent of women who initiated a method at 2 weeks chose the 3-month injection or the copper intrauterine device. Only 4 % of women preferred sterilization. Caste, educational attainment, or type of residence did not influence contraceptive use. CONCLUSIONS: Simplified follow-up after early medical abortion will not change women's opportunities to access contraception in a low-resource setting, if contraceptive services are provided as intra-abortion services as early as on day one. Women's postabortion contraceptive use at 3 months is unlikely to be affected by mode of followup after medical abortion, also in a low-resource setting. Clinical guidelines need to encourage intra-abortion contraception, offering the full spectrum of evidence-based methods, especially long-acting reversible methods. TRIAL REGISTRATION: Clinicaltrials.gov NCT01827995.

Visualising Spaces: The Illustrated Map as a Mode of Communicating Fact, Fiction and Feeling

Communicating thoughts, facts and narratives through visual devices such as allegory or symbolism was fundamental to early map making and this remains the case with contemporary illustration. Drawing was employed then as a way of describing historic narratives (fact and folklore) through the convenience of a drawn symbol or character. The map creators were visionaries, depicting known discoveries and anticipating what existed beyond the agreed boundaries. As we now have photographic and virtual reality maps at our disposal, how can illustration develop the language of what a map is and can be? How can we break the rules of map design and yet still communicate the idea of a sense of place with the aim to inform, excite and/or educate the ‘traveller’? As Illustrators we need to question the purpose of creating a ‘map’: what do we want to communicate and is representational image making the only way to present information of a location? Is creating a more personal interpretation a form of cartouche, reminiscent of elements within the Hereford Mappa Mundi and maps of Blaeu, and can this improve/hinder the communicative aspect of the map? Looking at a variety of historical and contemporary illustrated maps and artists (such as Grayson Perry), who track their journeys through drawing, both conventional journeys and emotional, I will aim to prove that the illustrated map is not mere decoration but is a visual language providing an allegorical response to tangible places and personal feelings.

Tracing the use of Communication Technologies in Higher Education

This chapter presents a comprehensive view of the main activities and findings of a research project entitled TRACER-Portuguese Public Higher Education Use of Communication Technologies, which focused on how the information about the use of Communication Technologies in Higher Education Institutions  can be collected, systematized, processed, and deployed to stakeholders. The project was carried out between 2011 and 2014 and its main results are a consolidated proposal of an analysis model to address the use of Communication Technologies in Higher Education institutions, as well as the U-TRACER® tool. This Web-based tool provides support to the process of collecting, processing, and deployment of data related with the use of Communication Technologies in a specific Higher Education or in a group of institutions, based on institutional or geographical criteria.

Lie detection and children: Impact of the mode of presentation

Although a great deal of research has examined lie-detection among adults, little research has examined the differences between audio and visual mediums for deception among children. In the current study participants were presented (n = 42) with recordings of four children, each describing his/her experience of getting glasses. Two of the accounts were truthful, two were fabricated. Half of the participants were presented with videos, half were presented with audio-recordings. Following the presentation of each recording, participants responded to questions regarding the truthfulness of each child’s account. Results showed that when evaluating truth-tellers, participants’ lie-detection accuracy was significantly greater than chance. Within the video condition, non-parents were shown to report significantly more lie-related cues than parents. Several deception cues were shown to be related to lie-detection accuracy.

Investigating the mode of action of AN5568, a novel therapeutic against African trypanosomiasis

No abstract available.

Sonic hedgehog signaling regulates mode of cell division of early cerebral cortex progenitors and increases

The morphogen Sonic Hedgehog (SHH) plays a critical role in the development of different tissues. In the central nervous system, SHH is well known to contribute to the patterning of the spinal cord and separation of the brain hemispheres. In addition, it has recently been shown that SHH signaling also contributes to the patterning of the telencephalon and establishment of adult neurogenic niches. In this work, we investigated whether SHH signaling influences the behavior of neural progenitors isolated from the dorsal telencephalon, which generate excitatory neurons and macroglial cells in vitro. We observed that SHH increases proliferation of cortical progenitors and generation of astrocytes, whereas blocking SHH signaling with cyclopamine has opposite effects. In both cases, generation of neurons did not seem to be affected. However, cell survival was broadly affected by blockade of SHH signaling. SHH effects were related to three different cell phenomena: mode of cell division, cell cycle length and cell growth. Together, our data in vitro demonstrate that SHH signaling controls cell behaviors that are important for proliferation of cerebral cortex progenitors, as well as differentiation and survival of neurons and astroglial cells.

Biosynthesis and mode of action of ribosomally synthesized and post-translationally modified antimicrobial peptides

One of the greatest sources of biologically active compounds is natural products. Often these compounds serve as platforms for the design and development of novel drugs and therapeutics. The overwhelming amount of genomic information acquired in recent years has revealed that ribosomally synthesized and post-translationally modified natural products are much more widespread than originally anticipated. Identified in nearly all forms of life, these natural products display incredible structural diversity and possess a wide range of biological functions that include antimicrobial, antiviral, anti-inflammatory, antitumor, and antiallodynic activities. The unique pathways taken to biosynthesize these compounds offer exciting opportunities for the bioengineering of these complex molecules. The studies described herein focus on both the mode of action and biosynthesis of antimicrobial peptides. In Chapter 2, it is demonstrated that haloduracin, a recently discovered two-peptide lantibiotic, possesses nanomolar antimicrobial activity against a panel of bacteria strains. The potency of haloduracin rivals that of nisin, an economically and therapeutically relevant lantibiotic, which can be attributed to a similar dual mode of action. Moreover, it was demonstrated that this lantibiotic of alkaliphile origin has better stability at physiological pH than nisin. The molecular target of haloduracin was identified as the cell wall peptidoglycan precursor lipid II. Through the in vitro biosynthesis of haloduracin, several analogues of Halα were prepared and evaluated for their ability to inhibit peptidoglycan biosynthesis as well as bacterial cell growth. In an effort to overcome the limitations of in vitro biosynthesis strategies, a novel strategy was developed resulting in a constitutively active lantibiotic synthetase enzyme. This methodology, described in Chapter 3, enabled the production of fully-modified lacticin 481 products with proteinogenic and non-proteinogenic amino acid substitutions. A number of lacticin 481 analogues were prepared and their antimicrobial activity and ability to bind lipid II was assessed. Moreover, site-directed mutagenesis of the constitutively active synthetase resulted in a kinase-like enzyme with the ability to phosphorylate a number of peptide substrates. The hunt for a lantibiotic synthetase enzyme responsible for installing the presumed dehydro amino acids and a thioether ring in the natural product sublancin, led to the identification and characterization of a unique post-translational modification. The studies described in Chapter 4, demonstrate that sublancin is not a lantibiotic, but rather an unusual S-linked glycopeptide. Its structure was revised based on extensive chemical, biochemical, and spectroscopic characterization. In addition to structural investigation, bioinformatic analysis of the sublancin gene cluster led to the identification of an S-glycosyltransferase predicted to be responsible for the post-translational modification of the sublancin precursor peptide. The unprecedented glycosyltransferase was reconstituted in vitro and demonstrated remarkable substrate promiscuity for both the NDP-sugar co-substrate as well as the precursor peptide itself. An in vitro method was developed for the production of sublancin and analogues which were subsequently evaluated in bioactivity assays. Finally, a number of putative biosynthetic gene clusters were identified that appear to harbor the necessary genes for production of an S-glycopeptide. An additional S-glycosyltransferase with more favorable intrinsic properties including better expression, stability, and solubility was reconstituted in vitro and demonstrated robust catalytic abilities.

Social support in cyberspace: A content analysis of communication within a Huntington’s Disease online support group

Objective: Huntington’s Disease (HD) is an inherited disorder, characterised by a progressive degeneration of the brain. Due to the nature of the symptoms, the genetic element of the disease and the fact that there is no cure, HD patients and those in their support network often experience considerable stress and anxiety. With an expansion in Internet access, individuals affected by HD have new opportunities for information retrieval and social support. The aim of this study is to examine the provision of social support in messages posted to a HD online support group bulletin board. Methods: In total, 1313 messages were content analysed using a modified version of the Social Support Behaviour Code developed by Cutrona & Suhr (1992). Results: The analysis indicates that group members most frequently offered informational (56.2%) and emotional support (51.9%) followed by network support (48.4%) with esteem support (21.7%) and tangible assistance (9.8%) least frequently offered. Conclusion: This study suggests that exchanging informational and emotional support represents a key function of this online group. Practice implications: Online support groups provide a unique opportunity for health professionals to learn about the experiences and views of individuals affected by HD and explore where and why gaps may exist between evidence-based medicine and consumer behaviour and expectations.

Rethinking Open Science: The Role of Communication

The first version of this text was presented in the “Philosophy of Communication” section at the ECREA’s 5th European Communication Conference, “Communication for Empowerment,” in Lisbon in November 2014. I would like to thank the audience for the lively post-presentation discussion.

Candidacidal potential of licorice phenolic extract: emphasis on its mode of action

Medicinal plants bave gained a special attention in the last years, due to its renowned health benefits, such as antimicrobial effects [I]. In fact, several natural matrices bave been increasingly studied, namely for its antifungal activity against opportunistic fungi [2,3]. Candida species, although commensa! microorganisms, have caused severe organic dysfunctions to the host, once current antifungal agents have lost their recognized efficiency [2]. So, numerous studies have been carried out focusing the mechanisms of acquired drug-resistance by Candida species [of an efficient multi-drug therapy (i.e. chemical drugs and also natural extracts combination), the discovery of the involved mechanisms of actions, morphological changes and related kinetic parameters are of major importance. Glycyrrhiza glabra L. (licorice) hydromethanolic extract have evidenced promissory candidacidal effects, and therefore, the involved mechanisms of action need to be clarified. Thus, in the present study these modes of action were assessed, by using flow cytometry.Overall, the licorice extract induced significant and irreversible primary damages on Candida cells, being membrane disruption and consequent unviability one of the main targets. In fact, after membrane destabilization, cells lost their proper homeostasis, their metabolic functions were blocked and, consequently cells lost functionality. The relevance and interest of the achieved results open new insights towards the upcorning use of the present phenolic matrix, being important to evaluate its in viva efficacy. Therefore, further studies are necessary to deepen knowledge on this field, aiming not only to establish therapeutic and prophylactic doses, but also to improve the clinical intervention in Candida infections.

Preferences in the use of communication technology: the influence of the gender dimension among higher education students

This paper presents some of the findings of a nationwide study, which was designed for understanding aspects related to the use of Communication Technology (CT) among higher education students in Portugal. This descriptive and exploratory study essentially focused on gender issues, particularly on how they influence the students’ perception regarding the use of CT. The data collection method selected was online survey. The findings reveal, among other results, students’ preferences regarding CT use and gender differences in that context.

Researching the Use of Communication Technologies in Higher Education Institutions in Portugal

This paper describes a research which main purpose was identifying and characterizing the use of Communication Technologies by Portuguese Public Higher Education Institutions to support learning activities. An analysis model was created and used to develop a nationwide online survey used to collect data from students, teachers and institutional managers. The results show that institutional policies and resources are in place and being used to support learning; learning management systems and interpersonal communication technologies are intensely used and widely adopted; and that there are gender differences as far as the students' use of Communication Technologies is concerned. The results of this project provide a useful insight on the use of Communication Technologies by Portuguese Public Higher Education Institutions and give valuable information for ongoing decision making processes regarding the institutional adoption and development of learning models that take advantage of these technologies.

Influence of application mode of universal adhesives on bond strength performances and enzymatic activity of coronal and radicular dentin

Objective: The aims of this thesis were to analyze the application mode of the universal adhesives (UA) and to give instructions for clinical procedures. The etching mode of UA on the bond strength to dentin and on the risk of retention, marginal discoloration, marginal adaptation and post-operative sensitivity (POS) was analyzed by two systematic reviews. Three in vitro studies were conducted: 1) evaporation mode of a UA on coronal dentin; 2) cementation approach on radicular dentin; 3) adhesion of metal brackets to enamel. Materials and methods: Two systematic review were conducted firstly, then in vitro study to investigate the evaporation mode in presence or not of pulpal pressure by means of μTBS, and the enzymatic activity using in situ zymography, at T0 and T6. The cementation of a fiber into radicular dentin with different resin-cements was studied, by push-out bond strength evaluation. Orthodontic brackets were cemented according to 4 adhesive protocols and shear bond strength test was conducted. Two adhesive removal techniques were evaluated, and spectrophotometry was used. Results: The probability of POS occurrence was less in SE. SEE approach seems to perform better than SE. Air-drying resulted in higher μTBS. Suction-evaporation, aging and ER mode increased MMPs activity. Differences in NL expression were present at T0 for fiber post study, and the aging produced an increase in marginal infiltration. Brackets cemented with new universal cement with previous etchant application showed good μTBS values. Conclusion: SEE performed better than SE and TE with UA in terms of uTBS. Evaporating with air-drying is better for UA in terms of uTBS and enzymatic activity. Aging and choice of resin cement for cementation of fiber posts influenced the PBS. Brackets cementation with a new resin- cement seems to offer the highest bond strength and leaves more cement remnants after the bracket removal.