626 research outputs found
A Qualitative Evaluation of Volunteers' Experiences in a Phase I/II HIV Vaccine Trial in Tanzania.
No full textEvaluating experiences of volunteers in an HIV vaccine trial will be useful for the conduct of future trials. The purpose of this study among volunteers who participated in a phase I/II HIV vaccine trial in Dar es Salaam, Tanzania was to assess what characterized their experiences during the trial. We conducted four focus group discussions with 35 out of the 60 individuals (women and men) after the five scheduled vaccinations. An interpretive description approach was applied to data analysis. As a result of the trial interventions, both men and women gained confidence in their own abilities to have safer, less risky sexual behaviour. The participants experienced the trial as a way of accessing free [insured] medical services. Most of the men said they had gone from self-medication to professional medical consultation. Despite these benefits, the participants faced various challenges during the trial. Such challenges included mistrust of the trial shown by health care providers who were not connected to the trial and discouragement from friends, colleagues and family members who questioned the safety of the trial. However, they managed to cope with these doubts by using both personal and trial related interventions. We found that during the phase I/II HIV vaccine trial, participants had both the opportunities and the ability to cope with the doubts from the surrounding community. Follow up visits enhanced the opportunities and individuals' abilities to cope with the doubts during the trial. Understanding this discourse may be useful for the trial implementers when designing future trials.\ud
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A Qualitative Study of Perceived Risk for HIV Transmission among Police Officers in Dar es Salaam, Tanzania.
No full textUnderstanding people's views about HIV transmission by investigating a specific population may help to design effective HIV prevention strategies. In addition, knowing the inherent sexual practices of such a population, as well as the risky circumstances that may facilitate HIV transmission, is crucial for the said strategies to become effective. In this article, we report how police officers in Dar es Salaam, Tanzania, perceived the problem of HIV and AIDS in their local context, particularly in relation to unsafe sexual practices. The study was done with the view to recommending ways by which HIV transmission could be minimised within the police force. The study was conducted among members of the police force in Dar es Salaam, Tanzania. Eight focus group discussions (FGDs) were conducted, with a total of 66 participants who were mixed in terms of age, gender, and marital status. Some of these were caregivers to patients with AIDS. Data were analysed using the interpretive description approach. The participants believed that both individual sexual behaviour and work-related circumstances were sources of HIV infection. They also admitted that they were being tempted to engage in risky sexual practices because of the institutional rules that prohibit officers from getting married during their training and for three years after. Nevertheless, as members of the Police Force, they stressed the fact that the risky sexual behaviour that exposes them to HIV is not limited to the force; it is rather a common problem that is faced by the general population. However, they complained, the nature of their job exposes them to road accident victims, subjecting them further to possible infection, especially when they have to handle these road accident casualties without proper protective gear. Individual sexual behaviour and job-related circumstances are worth investigating if proper advice is to be given to the police regarding HIV prevention strategies. In order to improve the lives of these police officers, there is a need to review the existing institutional rules and practices to accommodate individual sexual needs. In addition, improving their working environment may minimize the risk of HIV transmission from handling casualties in emergency situations
The development of financial services and financial regulation in Angola
No full textThis dissertation examines developments in financial services in Angola, looking particularly at the role of the Banco Nacional de Angola (BNA) in achieving greater competence in the banking division, growth, and well organized financial regulation and corporate governance. The author considers the work of BNA, the government of Angola (GOA), and investors in providing more financial services and increased competence of the banking service, with reference to international models
Balancing Collective Responsibility, Individual Opportunities and Risks: A Qualitative Study on How Police Officers Reason Around Volunteering in an HIV Vaccine Trial in Dar es Salaam, Tanzania.
No full textResults from HIV vaccine trials on potential volunteers will contribute to global efforts to develop an HIV vaccine. The purpose of this study among police officers in Dar es Salaam, Tanzania, was to explore the underlying reasons that induce people to enrol in an HIV vaccine trial.\ud
We conducted discussions with eight focus groups, containing a total of 66 police officers. The information collected was analyzed using interpretive description. The results showed that participants were motivated to participate in the trial by altruism, and that the participants experienced some concerns about their participation. They stated that altruism in the fight against HIV infection was the main reason for enrolling in the trial. However, young participants were seriously concerned about a possible loss of close relationships if they enrolled in the HIV vaccine trial. Both men and women feared the effect of the trial on their reproductive biology, and they feared interference with pregnancy norms. They were unsure about risks such as the risks of acquiring HIV infection and of suffering physical harm, and they were unsure of the intentions of the researchers conducting the trial. Further, enrolling in the trial required medical examination, and this led some participants to fear that unknown diseases would be revealed. Other participants, however, saw an opportunity to obtain free health services.\ud
We have shown that specific fears are important concerns when recruiting volunteers to an HIV vaccine trial. More knowledge is needed to determine participants' views and to ensure that they understand the conduct of the trial and the reasons it is being carried out
In Vitro Studies of Factors Potentially Affecting Plasmodium Falciparum Infection : (Heparin and Anti-P. falciparum Immune Responses)
No full textPlasmodium falciparum malaria is considered one of the major infectious diseases in humans, with regard to mortality and morbidity. Growing resistance of malaria to most anti-malaria drugs and of the Anopheles mosquitoes to insecticides have resulted in a global resurgence of the disease. Therefore, the need to explore drugs with possible antimalarial effects or the development of vaccines against malaria are considered a high priority for control of the disease. In this thesis, the antimalarial effect of heparin and the identification of T- and B-cell epitopes in P. falciparum vaccine candidate antigens, Pf155/RESA and Pf332 have been addressed.Heparin, a drug included in the supportive or ancillary treatment of cerebral malaria, was tested for its anti-parasitic effect on the blood stages of P. falciparum malaria in vitro. Heparin was cleaved into fragments differing in molecular weight and in their affinity for antithrombin III. Both unfractionated heparin and heparin fractions inhibited the merozoite invasion into red blood cells. The mechanism by which heparin acts is not clear. However, the inhibition was reversible by washing heparin-treated P. falciparum cultures indicating a direct effect of heparin. The sensitivity of laboratory strains and/or fresh isolates obtained from individuals residing in malaria endemic areas was compared. Although varying in sensitivity none of the samples tested was found to be resistant to heparin and its derivates. A fraction of heparin with low affinity for antithrombin III was the most potent inhibitor of merozoite invasion. The fraction with low affinity for antithrombin III is devoid of anticoagulant activity, suggesting a potential role of this fraction for the treatment of malaria.For the development of subunit vaccines it is important to identify and characterise epitopes which activate relevant B- and T-cell functions. In this study we have investigated two putative malaria vaccine candidate antigens, Pf155/RESA and Pf332, for T- and B-cell reactive epitopes. A large number of donors had antibodies against the Pf155/RESA sequence 186-206. For the Pf332 derived fragment, EB200, the donors also exhibited high antibody levels in their plasma. In our studies we have measured multi parameters of T-cell activation (proliferation, IFN-g and/or IL-4 production). Peptides corresponding to the N-terminal region of Pf155 or to EB200, stimulated peripheral blood mononuclear cells from P. falciparum-immune donors to proliferate, to induce secretion of IFN-g and/or IL-4. In individual donors the cellular immune responses to the peptides varied considerably. However, there was no clear association between proliferation and production of the cytokines investigated. This lack of association underlines the importance of including multiple parameters when analysing T-cell responses to defined epitopes.In conclusion, the non-repeat region of Pf155/RESA and the EB200 fragment of Pf332 contains several B-cell epitopes as well as several epitopes inducing functionally distinct T-cell responses, which should be a useful tool for inclusion in a subunit malaria vaccine as well as in future immuno-epidemiological studies.</p
Regulatory tradeoffs in designing concession contracts for infrastructure networks
No full textNetwork activities typically involve collecting a good or service (such as electric utilities, phone services, and rail transportation) from many producers or distributing them to many users. Producers and users are often widely scattered, geographically. Close financial integration of networks is justified on the basis of economies of scope and scale and the benefits from pooling and coordinating. In many countries, network operators are completely integrated publicly-owned firms (private firms being deemed insufficiently efficient or equitable). Challengers of this practice contend that the inefficiency resulting from lack of competition outweighs the gain from economic integration. With reform, some competitive mechanisms can be introduced even when monopoly seems the best option for delivering a service. But conflicts between policymakers'objectives -including efficiency, equity, speed, speed of reform, and signaling- influence the design of concession contracts for infrastructure network services (including communications and transportation services). Competition begins with the unbundling of various stages of delivery. Then competitive bidding is popular, with the public authority keeping property rights on productive assets but conceding their operation to a private firm. The winner gets the right to maximize profits, within limits (having to provide universal services, for example, and avoid price discrimination). In liberalizing the delivery of a service, policymakers must consider not only efficiency but also social and fiscal feasibility. The authors discuss how relevant information asymmetry is in contract design and the award and regulatory processes. They also discuss how to design pricing to accommodate the obligation to provide universal service. To illustrate, they describe Argentina's experiment in liberalization, which is increasingly viewed as a model for changing private sector and government involvement in infrastructure services. Beginning in 1989, Argentina began privatizing utilities and transport services, because the government had decided that it could no longer afford to subsidize those services or finance the investments needed for their effective operation. To introduce competition, the government unbundled services and introduced competitive bidding. It also created sector-specific regulatory agencies to protect consumers from private monopolies and to protect the private concessionaires from government micromanagement. Making concession-based reform and contracted-based regulation of private monopolists sustainable will require strengthening regulatory agencies, clarifying their terms of reference and accountability, and better separating the responsibilities of sector ministers and regulators.Health Economics&Finance,Environmental Economics&Policies,Economic Theory&Research,Labor Policies,International Terrorism&Counterterrorism,Environmental Economics&Policies,Health Economics&Finance,Education for the Knowledge Economy,Knowledge Economy,Economic Theory&Research
Order and disorder in proteins
No full textIn contrast to the general view that proteins should have a specific 3D structure in solution for their activity, there are many proteins which do not have a folded “native” structure for a big portion of their sequence. While these intrinsically disordered regions are essential for protein function, they cause problems in efforts for determining the 3D structures for the folded domains. It has been shown that the removal of the disordered domains improved the structure determination success both by X-ray crystallography and by NMR. As part of Northeast Structural Genomics (NESG) effort I worked on identifying the disordered and flexible parts of the protein using Hydrogen/Deuterium Exchange with Mass Spectroscopy (HDX-MS) analysis for construct optimization for high-throughput structure determination. Using this method I also studied human Smad3, which is an important part of the TGF-β-signaling pathway; and provided the first experimental data on structural features of the linker domain. During my training, I also studied human Deleted in Oral Cancer (DOC-1) protein, which was one of the proteins I studied by HDX-MS for construct optimization. We determined the solution structure of the folded region of DOC-1, which was shown to be important in cell-cycle regulation and cancer biology; and I also studied structure-function relations. Additionally, we studied the solution structure of Methionine Sulfoxide Reductase B from Bacillus subtilis, an important protein for reversing oxidative damage in cells, by NMR as a part of methods development studies for NMR for large proteins.Ph. D.Includes bibliographical referencesby Asli Erteki
Health in a fragile state: a five-year review of mortality patterns and trends at Somalia’s Banadir Hospital
No full textAsli Kulane,1 Douglas Sematimba,1 Lul M Mohamed,2 Abdirashid H Ali,2 Xin Lu1,3,4 1Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; 2Women and Child Care Section, Banadir Maternity & Children Hospital, Mogadishu, Somalia; 3College of Information System and Management, National University of Defense Technology, Changsha, People’s Republic of China; 4Flowminder Foundation, Stockholm, Sweden Background: The recurrent civil conflict in Somalia has impeded progress toward improving health and health care, with lack of data and poor performance of health indicators. This study aimed at making inference about Banadir region by exploring morbidity and mortality trends at Banadir Hospital. This is one of the few functional hospitals during war. Methods: A retrospective analysis was conducted with data collected at Banadir Hospital for the period of January 2008–December 2012. The data were aggregated from patient records and summarized on a morbidity and mortality surveillance form with respect to age groups and stratified by sex. The main outcome was the number of patients that died in the hospital. Chi-square tests were used to evaluate the association between sex and hospital mortality. Results: Conditions of infectious origin were the major presentations at the hospital. The year 2011 recorded the highest number of cases of diarrhea and mortality due to diarrhea. The stillbirth rate declined during the study period from 272 to 48 stillbirths per 1,000 live births by 2012. The sum of total cases that were attended to at the hospital by the end of 2012 was four times the number at the baseline year of the study in 2008; however, the overall mortality rate among those admitted declined between 2008 and 2012. Conclusion: There was reduction in patient mortality at the hospital over the study period. Data from Banadir Hospital are consistent with findings from Banadir region and could give credible public health reflections for the region given the lack of data on a population level. Keywords: Banadir Hospital, Somalia, hospital mortality, sex, health indicator
Mobile payments for remittances in Africa: Benchmarking with Latin America
No full textIn this article the author seeks to explain the reasons backing the success of mobile technology in money transfers comparing Africa and Latin America.Remittances, Africa, Latin America, mobile phones
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