Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Dependent Adult Abuse A Guide for Mandatory Reporters, July 2009

“Dependent adult” abuse allegations involve people who are aged 18 or over and are incapable of adequate self care due to physical or mental conditions and require assistance from other people. Dependent adults may be elderly or may have diminished physical or mental capacities that prevent them from meeting their own needs adequately. Researchers estimate that only 1 in 14 incidents of elder abuse actually come to the attention of law enforcement or human service agencies. Elder abuse is one of the most under-recognized and under-reported social problems in the United States. It is far less likely to be reported than child abuse because of the lack of public awareness. Nationally, it is estimated that over 55% of elder abuse is due to self-neglect. Such abuse can happen anywhere … in private homes, at health care facilities and in the community at large. Iowa has an increasing proportion of people who are aged 60 or over. The number of persons 80 or over is increasing more rapidly than any other age group. Iowa’s proportion of older adults in the population exceeds that of the United States as a whole.

The Blame Game: Perceptions of Blame, Responsibility and Seriousness in Cyberbullying

Cyberbullying is gaining increasing media attention. Victims may be reluctant to report such bullying due to the perception by others that these victims somehow play a role in their own victimization. This perception, often referred to as victim blame, has been commonly researched in child sexual abuse, rape and hate crime cases, but it has not really been examined in cases of cyberbullying. To assess victim blame, 241 participants were recruited and asked to read a scenario of cyberbullying that involved either a 14-year-old or a 20-year old victim. Perpetrator gender and victim gender were also manipulated. It was found that perceptions regarding the scenario were influenced by the gender of the perpetrator and the age of the victim. This was particularly the case when perceptions of the seriousness of the crime and the necessity for legal action were assessed.

INVESTIGATING THE POSTWAR DECLINE OF RACE IN SCIENCE

Race as a biological category has a long and troubling history as a central ordering concept in the life and human sciences. The mid-twentieth century has been marked as the point where biological concepts of race began to disappear from science. However, biological definitions of race continue to penetrate scientific understandings and uses of racial concepts. Using the theoretical frameworks of critical race theory and science and technology studies and an in-depth case study of the discipline of immunology, this dissertation explores the appearance of a mid-century decline of concepts of biological race in science. I argue that biological concepts of race did not disappear in the middle of the twentieth century but were reconfigured into genetic language. In this dissertation I offer a periodization of biological concepts of race. Focusing on continuities and the effects of contingent events, I compare how biological concepts of race articulate with racisms in each period. The discipline of immunology serves as a case study that demonstrates how biological concepts of race did not decline in the postwar era, but were translated into the language of genetics and populations. I argue that the appearance of a decline was due to events both internal and external to the science of immunology. By framing the mid-twentieth century disappearance of race in science as the triumph of an antiracist racial project of science, it allows us to more clearly see the more recent resurgence of race in science as a recycling of older themes and tactics from the racist science projects of the past.

Impact on human health of particulate matter emitted from burnings in the Brazilian Amazon region

OBJECTIVE: To analyze the impact on human health of exposure to particulate matter emitted from burnings in the Brazilian Amazon region. METHODS: This was an ecological study using an environmental exposure indicator presented as the percentage of annual hours (AH%) of PM2.5 above 80 μg/m3. The outcome variables were the rates of hospitalization due to respiratory disease among children, the elderly and the intermediate age group, and due to childbirth. Data were obtained from the National Space Research Institute and the Ministry of Health for all of the microregions of the Brazilian Amazon region, for the years 2004 and 2005. Multiple regression models for the outcome variables in relation to the predictive variable AH% of PM2.5 above 80 μg/m3 were analyzed. The Human Development Index (HDI) and mean number of complete blood counts per 100 inhabitants in the Brazilian Amazon region were the control variables in the regression analyses. RESULTS: The association of the exposure indicator (AH%) was higher for the elderly than for other age groups (β = 0.10). For each 1% increase in the exposure indicator there was an increase of 8% in child hospitalization, 10% in hospitalization of the elderly, and 5% for the intermediate age group, even after controlling for HDI and mean number of complete blood counts. No association was found between the AH% and hospitalization due to childbirth. CONCLUSIONS: The indicator of atmospheric pollution showed an association with occurrences of respiratory diseases in the Brazilian Amazon region, especially in the more vulnerable age groups. This indicator may be used to assess the effects of forest burning on human health.

Abuso sexual na infância e adolescência: perfil das vítimas e agressores em município do sul do Brasil

Estudo descritivo e de corte transversal que objetivou conhecer as características do abuso sexual em crianças e adolescentes de zero a 14 anos, a partir dos casos registrados nos Conselhos Tutelares e programas de atendimento do município de Londrina-PR, em 2006. Os dados foram coletados por meio de formulário e posteriormente analisados por frequência (absoluta e relativa) e proporção. Dos 186 casos, as vítimas foram predominantemente do sexo feminino (74,2%) e o risco de incidência foi maior na idade de 10 anos entre as meninas (coeficiente de cinco por 1.000); 97,3% dos agressores eram do sexo masculino; maior parte dos abusos ocorreu na residência das vítimas (52,7%) e durou menos de seis meses (57%). Houve lesão corporal em 90,3% dos casos, com seqüela física e psicológica em 97,8%. O abuso sexual entre crianças e adolescentes constitui-se um problema de saúde pública, além da estreita interface com as questões policiais e jurídicas.

Maus-tratos infantis: um resgate da história e das políticas de proteção

O estudo apresenta uma revisão bibliográfica, cujo objetivo foi conhecer e divulgar a evolução histórica da violência contra a criança, bem como as políticas desenvolvidas na atenção à violência contra menores, além de discutir a importância da prevenção e da atuação dos profissionais de saúde. A pesquisa bibliográfica foi realizada na base de dados MEDLINE, LILACS e SciELO, selecionando-se os estudos com os descritores: Violência, Agressão, Maus-Tratos, Síndrome da Criança Maltratada, Pediatria, não se fazendo restrição aos idiomas espanhol, inglês e francês. A literatura mostra a importância de ações preventivas e a necessidade de discussões e reflexões entre os diferentes setores que possam culminar em políticas e estratégias preventivas, diagnósticas e terapêuticas, além da relevância de incluir o tema na formação dos profissionais de saúde para que possam contribuir para o diagnóstico, tratamento e profilaxia do abuso infantil, rompendo as cadeias de determinação e fatalidade.

Desfecho dos casos de violência contra crianças e adolescentes no poder judiciário

Objetivos: Analisar, decorridos cinco anos da notificação, o desfecho dado pela Vara da Infância e da Juventude de Londrina (PR) aos casos de violência contra crianças e adolescentes; identificar os tipos de violência com maior taxa de encaminhamento à vara da Infância e Juventude. Métodos: Estudo descritivo, quantitativo, cuja população de estudo foram crianças e adolescentes de até 15 anos de idade, residentes em Londrina (PR), vítimas de violência notificada pelos Conselhos Tutelares à Vara da Infância e da Juventude, em 2002. Resultados: Dos 230 casos, dos quais 40,0% dos processos foram arquivados; 3,9% foram arquivados enquanto ainda inquéritos; em 1,7% houve condenação do réu; 31,7% dos processos encontravam-se em andamento. Conclusão: Os achados contribuem para ampliar o conhecimento das medidas de proteção adotadas pelo poder judiciário frente aos casos de violência contra crianças e adolescentes.

Violência física contra menores de 15 anos: estudo epidemiológico em cidade do sul do Brasil

OBJETIVO: apresentar o perfil de casos notificados de violência física contra menores de 15 anos em Londrina, Paraná, no ano de 2006. MÉTODO: Estudo transversal, com coleta retrospectiva nos prontuários dos Conselhos Tutelares e serviços de atendimento do município. Os dados foram processados e tabulados pelo programa Epi Info. RESULTADOS: Foram estudados 479 casos de violência por força corporal e 9 casos de violência por outros meios (7 por instrumentos, 1 por objeto cortante e 1 por substância corrosiva). Na violência por força corporal, predominaram vítimas do sexo feminino (53,4 por cento ) e maior risco na idade de seis anos (12,2 por 1.000). O pai foi o agressor mais frequente (48,8 por cento ) e o alcoolismo esteve presente em 64,0 por cento dos casos. A violência por instrumentos foi praticada através de cinta (42,9 por cento ), fio (28,6 por cento ), ferro (14,3 por cento ) e instrumento de cozinha (14,3 por cento ), com vítimas do sexo feminino (85,7 por cento ), na faixa etária de doze anos (33,3 por cento ), sendo o pai (71,4 por cento ) e a mãe (28,6 por cento ) os únicos agressores, com o alcoolismo presente em 57,1 por cento destas situações. A vítima de violência por objeto cortante era do sexo masculino, 13 anos e o agressor, desconhecido, tinha de 15 a 19 anos. A violência por substância corrosiva teve como vítima um adolescente de 13 anos, do sexo masculino, cujo agressor foi o pai, sendo o alcoolismo a situação presente. CONCLUSÕES: Os resultados apontam para a importância epidemiológica do abuso físico contra crianças e adolescentes e podem contribuir para a elaboração de estratégias de prevenção e acompanhamento das vítimas

Survival, population pize, and gonotrophic cycle duration of Nyssomyia neivai (Diptera: Psychodidae) at an endemic area of American Cutaneous Leishmaniasis in Southeastern Brazil

The survival, absolute population size, gonotrophic cycle duration, and temporal and spatial abundance of Nyssomyia neivai (Pinto) were studied in a rural area endemic for American cutaneous leishmaniasis (ACL) in Conchal, Sõo Paulo State, southeastern Brazil, using mark-release-recapture techniques and by monitoring population fluctuation. The monthly abundance exhibited a unimodal pattern, with forest and domicile habitats having the highest relative abundances. A total of 1,873 males and 3,557 females were marked and released during the six experiments, of which 4.1-13.0 per cent of males and 4.1-11.8 per cent of females were recaptured. Daily survivorship estimated from the decline in recaptures per day was 0.681 for males and 0.667 for females. Gonotrophic cycle duration was estimated to be 4.0 d. Absolute population size was calculated using the Lincoln Index and ranged from 861 to 4,612 males and from 2,187 to 19,739 females. The low proportion of females that reach the age when they are potentially infective suggests that N. neivai has a low biological capacity to serve as a vector and that factors such as high biting rates and opportunistic feeding behavior would be needed to enable Leishmania (Viannia) braziliensis Vianna transmission. This agreed with the epidemiological pattern of ACL in southeastern Brazil that is characterized by low incidence, with isolated cases acquired principally within domiciliary habitats

Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review

Objective To compare the efficacy of oral sweet solutions to water or no treatment in infants aged 1-12 months during immunisation. Methods Randomised controlled trials (RCTs) were retrieved through internet searches or manual searches of reference lists. Search terms included newborn, infant, pain, sucrose and alternative names for sweet solutions. Summary estimates with 95% CIs were calculated and included relative risk (RR), risk difference (RD) and number needed to treat to benefit (NNTB) for dichotomous outcomes, and weighted mean differences (WMD) for continuous outcomes. Where pooling of results was not possible, a narrative summary of study results is presented. Results Of the 695 studies identified, 14 RCTs with 1674 injections met the inclusion criteria. Sucrose or glucose, compared to water or no treatment decreased crying during or following immunisation in 13 of the 14 studies. Infants receiving 30% glucose (three trials, 243 infants) had a decreased RR in crying incidence following immunisation (typical RR 0.80, 95% CI 0.69 to 0.93; RD -0.17, 95% CI -0.29 to -0.05; NNTB 6, 95% CI 3 to 20). With sucrose or glucose, there was a 10% WMD reduction in proportion of crying time (95% CI - 18 to - 2) and a 12 s reduction in crying duration (95% CI - 23 to -0.7 s). An optimal dose of sucrose or glucose could not be ascertained due to the varied volumes and concentrations used. Conclusion Infants aged 1-12 months administered sucrose or glucose before immunisation had moderately reduced incidence and duration of crying. Healthcare professionals should consider using sucrose or glucose before and during immunisation.

Short-term nutritional counseling reduces body mass index, waist circumference, triceps skinfold and triglycerides in women with metabolic syndrome

Background: It is recognized that the growing epidemic of metabolic syndrome is related to dietary and lifestyle changes. Objective: The purpose of this study was to evaluate short-term application of nutritional counseling in women with metabolic syndrome. Methods: This follow-up study was conducted from September to November 2008 with thirty three women >= 35 years old screened clinically for nutritional counseling. Dietary intake was reported, and biochemical and body composition measures were taken at baseline and after three months of follow-up. Results: Of the 33 women evaluated, 29 patients completed the study. The prevalence of type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity was high at 38%, 72.4%, 55.2%, and 75.8%, respectively. At the end of three-months of follow-up, a significant decline in body mass index, waist circumference, triceps skinfold, and triglycerides was observed, as was an increase in calcium and vitamin D intake. The multiple regression analysis showed that changes in body mass index, triceps skinfold, waist circumference and triglyceride levels after nutritional intervention were positively associated with changes in anthropometric (loss of body weight) and biochemical (decrease of TG/HDL-c ratio) parameters. Moreover, waist circumference changes were negatively associated with changes in calcium and vitamin D intake. Conclusion: Short-term nutritional counseling improved some factors of metabolic syndrome. Moreover, the increases in calcium and vitamin D consumption can be associated with the improvement in markers of metabolic syndrome.

High levels of T lymphocyte activation in Leishmania-HIV-1 co-infected individuals despite low HIV viral load

Background: Concomitant infections may influence HIV progression by causing chronic activation leading to decline in T-cell function. In the Americas, visceral (AVL) and tegumentary leishmaniasis (ATL) have emerged as important opportunistic infections in HIV-AIDS patients and both of those diseases have been implicated as potentially important co-factors in disease progression. We investigated whether leishmaniasis increases lymphocyte activation in HIV-1 co-infected patients. This might contribute to impaired cellular immune function. Methods: To address this issue we analyzed CD4(+) T absolute counts and the proportion of CD8(+) T cells expressing CD38 in Leishmania/HIV co-infected patients that recovered after anti-leishmanial therapy. Results: We found that, despite clinical remission of leishmaniasis, AVL co-infected patients presented a more severe immunossupression as suggested by CD4(+) T cell counts under 200 cells/mm(3), differing from ATL/HIV-AIDS cases that tends to show higher lymphocytes levels (over 350 cells/mm(3)). Furthermore, five out of nine, AVL/HIV-AIDS presented low CD4(+) T cell counts in spite of low or undetectable viral load. Expression of CD38 on CD8(+) T lymphocytes was significantly higher in AVL or ATL/HIV-AIDS cases compared to HIV/AIDS patients without leishmaniasis or healthy subjects. Conclusions: Leishmania infection can increase the degree of immune system activation in individuals concomitantly infected with HIV. In addition, AVL/HIV-AIDS patients can present low CD4(+) T cell counts and higher proportion of activated T lymphocytes even when HIV viral load is suppressed under HAART. This fact can cause a misinterpretation of these laboratorial markers in co-infected patients.

MAMMALIAN TARGET OF RAPAMYCIN COMPLEX 1 IS INVOLVED IN DIFFERENTIATION OF REGENERATING MYOFIBERS IN VIVO

This work was undertaken to provide further insight into the role of mammalian target of rapamycin complex 1 (mTORC1) in skeletal muscle regeneration, focusing on myofiber size recovery. Rats were treated or not with rapamycin, an mTORC1 inhibitor. Soleus muscles were then subjected to cryolesion and analyzed 1, 10, and 21 days later. A decrease in soleus myofiber cross-section area on post-cryolesion days 10 and 21 was accentuated by rapamycin, which was also effective in reducing protein synthesis in these freeze-injured muscles. The incidence of proliferating satellite cells during regeneration was unaltered by rapamycin, although immunolabeling for neonatal myosin heavy chain (MHC) was weaker in cryolesion+rapamycin muscles than in cryolesion-only muscles. In addition, the decline in tetanic contraction of freeze-injured muscles was accentuated by rapamycin. This study indicates that mTORC1 plays a key role in the recovery of muscle mass and the differentiation of regenerating myofibers, independently of necrosis and satellite cell proliferation mechanisms. Muscle Nerve 42: 778-787,2010