Integrase, the central DNA flap and human immunodeficiency virus type 1 nuclear import

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Putting Adequate Financial and Human Resources in Healthcare for Effective Universal Health Coverage in Kenya: Lessons and Experiences from China

In recent years, most low and middle-income countries, have adopted different approaches to universal health coverage (UHC), to ensure equity and financial risk protection in accessing essential healthcare services. UHC-related policies and delivery strategies are largely based on existing healthcare systems, a result of gradual development (based on local factors and priorities). Most countries have emphasized on health financing, and human resources for health (HRH) reform policies, based on good practices of several healthcare plans to deliver UHC for their population.

Health financing and labor market frameworks were used, to understand health financing, HRH dynamics, and to analyze key health policies implemented over the past decade in Kenya’s effort to achieve UHC. Through the understanding, policy options are proposed to Kenya; analyzing, and generating lessons from health financing, and HRH reforms experiences in China. Data was collected using mixed methods approach, utilizing both quantitative (documents and literature review), and qualitative (in-depth interviews) data collection techniques.

The problems in Kenya are substantial: high levels of out-of-pocket health expenditure, slow progress in expanding health insurance among informal sector workers, inefficiencies in pulling of health are revenues, inadequate deployed HRH, maldistribution of HRH, and inadequate quality measures in training health worker. The government has identified the critical role of strengthening primary health care and the National Hospital Insurance Fund (NHIF) in Kenya’s move towards UHC. Strengthening primary health care requires; re-defining the role of hospitals, and health insurance schemes, and training, deploying and retaining primary care professionals according to the health needs of the population; concepts not emphasized in Kenya’s healthcare reforms or programs design. Kenya’s top leadership commitment is urgently needed for tougher reforms implementation, and important lessons from China’s extensive health reforms in the past decade are beneficial. Key lessons from China include health insurance expansion through rigorous research, monitoring, and evaluation, substantially increasing government health expenditure, innovative primary healthcare strengthening, designing, and implementing health policy reforms that are responsive to the population, and regional approaches to strengthening HRH.

Resistance and symbiosis : Québec discourses of resistance in the context of postcolonial theory

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Integrase, the central DNA flap and human immunodeficiency virus type 1 nuclear import

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Comments on “High-temperature creep resistance and effects on the austenite reversion and precipitation of 18 Ni (300) maraging steel” by dos Reis et al. [Materials Characterization 107 (2015) 350- 357]

This letter attempts to comment on an article by dos Reis et al., in the aspects of creep considerationand chemical analysis in maraging steels.

Surrogacy under Indian Legal System: Legal and Human Rights Concerns

The advancements in medical science and technology have proved to be a boon to mankind. At the same time they have raised numerous challenges before the legal systems of the world. One such advancement is that of assisted human reproductive technologies and particularly surrogacy, which have given a new meaning to the concept of procreation. These technologies have made it possible for individuals to beget a genetically related child with the help of a third party and without sexual intercourse. Among all the assisted human reproductive technologies, the practice of surrogacy, in which women agree to have their bodies used to undergo a pregnancy and give birth to a baby for another, has raised various legal and human right controversies and diverse legal responses all over the world. India has particularly become a top destination for individuals who wish to beget a child through surrogacy and hence it is imperative for the Indian government to address the challenges posed by surrogacy. This study is an attempt to examine the need and importance of surrogacy practices and the conflicting legal and human rights issues raised by surrogacy in contemporary times. It also examines the adequacy of existing legal framework in India and attempts to provide pragmatic solutions for regulating surrogacy and protecting the interests of various stakeholders involved in surrogacy.

Anti-N-methyl-D-Aspartate Receptor Encephalitis with Positive Serum Antithyroid Antibodies, IgM Antibodies Against Mycoplasma Pneumoniae and Human Herpesvirus 7 PCR in the CSF

We report the case of a boy with an encephalopathy associated with extrapyramidal and psychiatric symptoms and anti-N-methyl-D-aspartate receptor antibodies. He had positive serum antithyroid antibodies, IgM antibodies against Mycoplasma pneumoniae and human herpesvirus 7 polymerase chain reaction in the cerebrospinal fluid. He was successfully treated with rituximab, after steroids, intravenous immunoglobulin and plasma exchange. The pathophysiology of this disorder may be post-infectious and autoimmune.

Resources Grabbing and Human Rights: Building a Triangular Relationship Between States, Indigenous Peoples and Corporations

This is a pre-copyedited, author-produced PDF of a chapter accepted for publication in Angelica Bonfanti, Francesca Romanin Jacur, Francesco Seatzu (eds), Natural Resources Grabbing: Natural Resources Grabbing: An International Law Perspective, (Brill, 2016). The version of record is available at: http://www.brill.com/products/book/natural-resources-grabbing

Influence of Food Distribution and Human Disturbance on the Reproductive Success of Herring Gulls

A three year study of Herring Gull (Larus argentatus) reproductive success on four i~lands in Maine indicate.d that production of young was controlled by different factors operating on the eggs and chicks. Hatching success was inversely related to the disturbance of co.Ionics by pic~i~kers, which apparently caused the adults to leave their eggs exposed 10 sufficient solar rad1a11on to addle the eggs. The survival of chicks was lower on islands distant ~rom sources of edible r~~use (ou.ter. islands) than o.n. islands close to sources of waste (inner islands), regardless of visits by picnickers. The nutrition and growth rates of chicks on inner and outer islands were similar. The attendance of parents on the territories was found to be less o~ an out~r islan~ than on an inner island. It is concluded that differences in parental behavior associated with greater foraging effort were responsible for a higher loss of chicks to predation on the outer islands.

Bacterial biofilms, antibiotic resistance and healthcare-associated infections: a dangerous connection

In 2012, were estimated 6.7 million cases of healthcare-associated infections (HAI) either in long-term care facilities or acute-care hospitals from which result 37,000 deaths configuring a serious public health problem. The etiological agents are diverse and often resistant to antimicrobial drugs. One of the mechanisms responsible for the emergence of drug resistance is biofilm assembly. Biofilms are defined as thin layers of microorganisms adhering to the surface of a structure, which may be organic or inorganic, together with the polymers that they secrete. They are dynamic structures which experience different stages of organization with the ageing and are linked to an increase in bacterial resistance to host defense mechanisms, antibiotics, sterilization procedures other than autoclaving, persistence in water distribution systems and other surfaces. The understanding of bacteria organization within the biofilm and the identification of differences between planktonic and sessile forms of bacteria will be a step forward to fight HAIs.

Hyperinsulinism, Insulin Resistance and Impaired Fasting Glucose Revealing an Insulin Autoimmune Syndrome

We report a case of a 55-year-old woman who was evaluated for multiple episodes of late postprandial hypoglycaemia. We diagnosed her condition as insulin autoimmune syndrome (Hirata disease) because of a high insulin autoantibody (IAA) titre in association with high levels of plasmatic insulin and hypoglycaemia in a patient with no history of exogenous insulin administration and the exclusion of other causes of late postprandial hypoglycaemia.