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Poverty and inequality – But of what - As social determinants of health in Africa?
No full textBackground: Many African economies have achieved substantial economic growth over the past recent years, yet several of the Millennium Development Goals (MDGs) including those concerned with health, remain considerably behind target. This paper examines whether progress towards these goals is being hampered by existing levels of poverty and income inequality. It also considers whether the inequality hypothesis of Wilkinson and Pickett1 applies to population health outcomes in African states. Methods: Correlation analysis and scatter plots were used to assess graphically the link between variations in health outcomes, level of poverty and income inequality in different countries. Health status outcomes were measured by using four indicators: infant and under-five (child) mortality rates; maternal mortality ratios; and life expectancy at birth. In each of the 52 African nations, the proportion of the population living below the poverty line is used as an indicator of the level of poverty and Gini coefficient as a measure of income inequality. The study used a comprehensive review of secondary and relevant literature that are pertinent in the subject area. The data datasets obtained online from UNICEF2 and UNDP3 (2009) used to test the research questions. World Health Organization the three broad dimensions to consider when moving towards better population health outcome through Universal Health Coverage and the Social Determinants of Health framework reviewed to establish the poverty and income inequality link in African countries population health outcomes. Results: The study shows that poverty is strongly associated with all health outcome differences in Africa (IMR, cc = 0.63; U5MR, cc = 0.64; MMR, cc = 0.49; life expectancy at birth, cc = -0.67); income inequality with only one of the four indicators (IMR, cc = 0.14; U5MR, cc = 0.07; MMR, cc = 0.22; life expectancy at birth, cc = -0.49), whereas income inequality is associated with one of the four indicators. Conclusion: The study shows that tackling poverty should be the immediate concern in Africaas a means of promoting better health for all. There is a question mark over whether the findings of Wilkinson and Pickett1 on the relationship between income inequality and health apply to Africa. The reasons for this question mark are discussed. More research is needed to investigate whether the inequality results found in this study are replicated in other studies of African health
First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa
No full textBackground: There is a paucity of data on the national population-level effectiveness of preventing mother-tochild transmission (PMTCT) programmes in high-HIVprevalence, resource-limited settings. We assessed national PMTCT impact in South Africa (SA), 2010. Methods: A facility-based survey was conducted using a stratified multistage, cluster sampling design. A nationally representative sample of 10 178 infants aged 4-8 weeks was recruited from 565 clinics. Data collection included caregiver interviews, record reviews and infant dried blood spots to identify HIV-exposed infants (HEI) and HIV-infected infants. During analysis, self-reported antiretroviral (ARV) use was categorised: 1a: triple ARV treatment; 1b: azidothymidine \u3e10 weeks; 2a: azidothymidine ≤10 weeks; 2b: incomplete ARV prophylaxis; 3a: no antenatal ARV and 3b: missing ARV information. Findings were adjusted for non-response, survey design and weighted for live-birth distributions. Results: Nationally, 32% of live infants were HEI; early mother-to-child transmission (MTCT) was 3.5% (95% CI 2.9% to 4.1%). In total 29.4% HEI were born to mothers on triple ARV treatment (category 1a) 55.6% on prophylaxis (1b, 2a, 2b), 9.5% received no antenatal ARV (3a) and 5.5% had missing ARV information (3b). Controlling for other factors groups, 1b and 2a had similar MTCT to 1a (Ref; adjusted OR (AOR) for 1b, 0.98, 0.52 to 1.83; and 2a, 1.31, 0.69 to 2.48). MTCT was higher in group 2b (AOR 3.68, 1.69 to 7.97). Within group 3a, early MTCT was highest among breastfeeding mothers 11.50% (4.67% to 18.33%) for exclusive breast feeding, 11.90% (7.45% to 16.35%) for mixed breast feeding, and 3.45% (0.53% to 6.35%) for no breast feeding). Antiretroviral therapy or \u3e10 weeks prophylaxis negated this difference (MTCT 3.94%, 1.98% to 5.90%; 2.07%, 0.55% to 3.60% and 2.11%, 1.28% to 2.95%, respectively). Conclusions: SA, a high-HIV-prevalence middle income country achieved \u3c5% MTCT by 4-8 weeks post partum. The long-term impact on PMTCT on HIV-free survival needs urgent assessment
Molecular Physiognomies and Applications of Adipose-Derived Stem Cells
No full textAdipose-derived stromal/stem cells (ASC) are multipotent with abilities to differentiate into multiple lineages including connective tissue and neural cells. Despite unlimited opportunity and needs for human and veterinary regenerative medicine, applications of adipose-derived stromal/stem cells are at present very limited. Furthermore, the fundamental biological factors regulating stemness in ASC and their stable differentiation into other tissue cells are not fully understood. The objective of this review was to provide an update on the current knowledge of the nature and isolation, molecular and epigenetic determinants of the potency, and applications of adipose-derived stromal/stem cells, as well as challenges and future directions. The first quarter of the review focuses on the nature of ASC, namely their definition, origin, isolation and sorting methods and multilineage differentiation potential, often with a comparison to mesenchymal stem cells of bone marrow. Due to the indisputable role of epigenetic regulation on cell identities, epigenetic modifications (DNA methylation, chromatin remodeling and microRNAs) are described broadly in stem cells but with a focus on ASC. The final sections provide insights into the current and potential applications of ASC in human and veterinary regenerative medicine
Improving the Credibility of Child Sexual Assault Victims in Court: The Impact of a Sexual Assault Nurse Examiner
No full textThe present study investigated the influence of a sexual assault nurse examiner\u27s (SANE\u27s) testimony on mock juror perceptions of a child or adolescent victim of child sexual assault. Community members (N = 252, 156 females) read a fictional criminal trial summary of a child sexual assault case in which the victim was 6 or 15 years old and the prosecution presented medical testimony from a SANE or a traditional registered nurse (RN), or did not present medical testimony. Mock jurors were more likely to render guilty verdicts when a SANE testified compared with the other two testimony conditions. In addition, pro-victim judgments (e.g., sympathy toward the victim) and negative defendant judgments (e.g., anger toward the defendant) mediated this relation. Finally, cognitive network representations of the case demonstrated that the RN and no-medical-testimony groups were similar and the SANE group was distinct from the other two conditions. We discuss these results in terms of the implications of SANE testimony in child sexual assault court cases
Assessing measurement invariance of the personal growth initiative scale-ii among hispanics, African Americans, and European Americans
No full textThis study tested the cross-cultural validity of scores on the Personal Growth Initiative Scale-II (PGIS-II; Robitschek et al., 2012) with Hispanic, African American, and European American community samples. Multigroup confirmatory factor analyses were performed on data from 218 Hispanics, 129 African Americans, and 552 European Americans to examine measurement equivalence among these groups. Measurement invariance of the PGIS-II was established with the original 4 factors of readiness for change, planfulness, using resources, and intentional behavior. These findings suggest the PGIS-II can be administered across these groups and provide meaningful comparisons and interpretations. All samples yielded good internal consistency estimates. The African American sample reported higher means than Hispanic and European American samples for all subscale and total mean scores, and Hispanics scored higher in planfulness, readiness for change, and total score than European Americans, indicating potential cultural factors influencing the scores. Implications for research and clinical practice are discussed
A Survey of Nitrate and Nitrite Concentrations in Conventional and Organic-Labeled Raw Vegetables at Retail
No full textA national survey of the nitrate (NO 3-) and nitrite (NO 2-) concentrations in raw and highly consumed vegetables available at retail in the United States was conducted. A total of 194 samples of fresh broccoli, cabbage, celery, lettuce, and spinach categorized as conventional or organic by label were collected from 5 major cities in different geographic regions of the United States and analyzed to determine NO 3- and NO 2- concentrations. There were no differences in the mean NO 2- values of conventional compared with organic vegetables taken from the 5 metropolitan areas. However, significant differences in mean pairwise comparisons between some conventional and organic vegetables for NO 3- content were observed. The mean NO 2- concentration of both conventional and organic vegetables ranged between 0.1 and 1.2 mg/kg of fresh weight (FW) with the exception of conventional spinach that contained 8.0 mg/kg FW. Mean NO 3- contents of conventional broccoli, cabbage, celery, lettuce, and spinach were 394, 418, 1496, 851, and 2797 mg/kg FW, respectively, while their organic-labeled counterparts averaged 204, 552, 912, 844, and 1318 mg/kg FW. In most cases, organic vegetables were numerically lower in NO 3- content than their conventional counterparts. Based on survey results, the finding that low NO 3- levels were observed in some organic vegetables in different cities may warrant further study to determine if true differences exist, due to production practices, seasonal differences, and the magnitudes of those differences. Furthermore, the geographic differences in NO 3- content of vegetables may flaw estimates of daily NO 2- and NO 3- exposure
Synthesis and Pyrolysis of Selected Metal Levulinates
No full textEight metal levulinate salts of Mg2+, Ca2+, Sr2+, Ba2+, La3+, Fe3+, Cu2+, and Zn2+ were prepared by reacting the corresponding hydroxides with equivalent amounts of levulinic acid in water. Pyrolysis of the salts at 350 °C for 3.0 min produces colorless liquid pyrolysate oils in yields of 100–567 g kg−1 dry salt. The pyrolysates were analyzed by 1H NMR and GC-MS. The group II metal levulinates produced pyrolysate oils of similar composition with 3-methyl-2-cyclopentenone, 2,3-dimethyl-2-cyclopentenone, and γ-valerolactone as the major compounds. The La3+ and Fe3+ levulinates produced pyrolysates with 3-methyl-2-cyclopentenone, 2,3-dimethyl-2-cyclopentenone, γ-valerolactone, and levulinic acid as the major compounds. The Cu2+ and Zn2+ salts produced pyrolysates with levulinic acid as the major compound
Mathematical Modeling and Analysis of Leukemia: Effect of External Engineered T Cells Infusion
Get PDFIn this paper, a nonlinear model is proposed and analyzed to study the spread of Leukemia by considering the effect of genetically engineered patients T cells to attack cancer cells. The model is governed by four dependent variables namely; naive or susceptible blood cells, infected or dysfunctional blood cells, cancer cells and immune cells. The model is analyzed by using the stability theory of differential equations and numerical simulation. We have observed that the system is stable in the local and global sense if antigenicity rate or rate of stimulation of immune cells is greater than a threshold value dependent on the density of immune cells. Further, external infusion of T cells (immune cells) reduces the concentration of cancer cells and infected cells in the blood. It is observed that the infected cells decrease with the increase in antigenicity rate or stimulation rate of immune response due to abnormal cancer cells present in the blood. This indicates that immune cells kill cancer cells on being stimulated and as antigenicity rate increases rate of destruction of cancer cells also increase leading to decrease in the concentration of cancer cells in the body. This decrease in cancer cells further causes decrease in the concentration of infected or dysfunctional cells in the body
Analysis of repairable M[X]/(G1,G2)/1 - feedback retrial G-queue with balking and starting failures under at most J vacations
Get PDFIn this paper, we discuss the steady state analysis of a batch arrival feedback retrial queue with two types of services and negative customers. Any arriving batch of positive customers finds the server is free, one of the customers from the batch enters into the service area and the rest of them get into the orbit. The negative customer, is arriving during the service time of a positive customer, will remove the positive customer in-service and the interrupted positive customer either enters the orbit or leaves the system. If the orbit is empty at the service completion of each type of service, the server takes at most J vacations until at least one customer is received in the orbit when the server returns from a vacation. While the busy server may breakdown at any instant and the service channel may fail for a short interval of time. The steady state probability generating function for the system size is obtained by using the supplementary variable method. Numerical illustrations are discussed to see the effect of the system parameters