The impact of digital health technologies on tuberculosis treatment : a systematic review

Digital technologies are increasingly harnessed to support treatment of persons with tuberculosis (TB). Since in-person directly observed treatment (DOT) can be resource intensive and challenging to implement, these technologies may have the potential to improve adherence and clinical outcomes. We reviewed the effect of these technologies on TB treatment adherence and patient outcomes. We searched several bibliographical databases for studies reporting the effect of digital interventions, including short message service (SMS), video-observed therapy (VOT) and medication monitors (MMs), to support treatment for active TB. Only studies with a control group and which reported effect estimates were included. Four trials showed no statistically significant effect on treatment completion when SMS was added to standard care. Two observational studies of VOT reported comparable treatment completion rates when compared with in-person DOT. MMs increased the probability of cure (RR 2.3, 95% CI 1.6-3.4) in one observational study, and one trial reported a statistically significant reduction in missed treatment doses relative to standard care (adjusted means ratio 0.58, 95% CI 0.42-0.79). Evidence of the effect of digital technologies to improve TB care remains limited. More studies of better quality are needed to determine how such technologies can enhance programme performance

Ecological Science and Sustainability for the 21st Century

Ecological science has contributed greatly to our understanding of the natural world and the impact of humans on that world. Now, we need to refocus the discipline towards research that ensures a future in which natural systems and the humans they include coexist on a more sustainable planet. Acknowledging that managed ecosystems and intensive exploitation of resources define our future, ecologists must play a greatly expanded role in communicating their research and influencing policy and decisions that affect the environment. To accomplish this, they will have to forge partnerships at scales and in forms they have not traditionally used. These alliances must act within three visionary areas: enhancing the extent to which decisions are ecologically informed; advancing innovative ecological research directed at the sustainability of the planet; and stimulating cultural changes within the science itself, thereby building a forward-looking and international ecology. We recommend: (1) a research initiative to enhance research project development, facilitate large-scale experiments and data collection, and link science to solutions; (2) procedures that will improve interactions among researchers, managers, and decision makers; and (3) efforts to build public understanding of the links between ecosystem services and humans

Can we compete? Germany's assets in finance, trade, education, consular training, etc., and a proposed British war-cost reduction programme,

Mode of access: Internet

Enumeration and identification of heterotrophic bacteria in groundwater and in a mountain stream

Populations of heterotrophic bacteria were enumerated from stream and groundwater samples taken from an undisturbed catchment basin in southwestern Alberta. Direct counts using epifluorescence microscopy were compared with total viable counts using standard plate count methods, the iodonitrotetrazolium formazan method (reduction of 2-(p-iodophenyl)-3-(p-nitro phenyl)-5-phenyl tetrazolium chloride to iodonitrotetrazolium formazan), the nalidixic acid method, and the slide culture method. The nalidixic acid method gave the highest results, with total viable counts as high as 34.6% of the total direct count. Attempts to enumerate bacteria on media made from decaying leaves and algal–bacterial slime gave lower values, approximately 10% of the numbers obtained on enriched media. Stream waters were found to be dominated by Pseudomonas spp. and groundwaters were dominated by Bacillus spp. No differences were found in either numbers or species identified between tryptone – glucose – yeast extract agar, brain–heart infusion agar, nutrient agar, or casein–peptone–starch agar. </jats:p