Analyzing community responses to HIV and AIDS : operational framework and typology

This paper presents a framework for analyzing the community response to HIV and AIDS. On the basis of a review of the literature, six criteria are proposed for characterizing such community responses: (1) the types of organizations and structures implementing the response, (2) the types of activities or services implemented and the beneficiaries of these, (3) the actors involved in and driving community responses, (4) the contextual factors that influence community responses, (5) the extent of community involvement in the response, and (6) the extent to which community responses involve wider partnerships and collaboration.Disability,Civil Society,Community Development and Empowerment,HIV AIDS,Health Monitoring&Evaluation

Methodology for the assessment of data quality : application to HIV and AIDS programs in Latin America

Evidence is crucial in strategic planning for HIV response as well as the monitoring of results. This paper presents a simple tool that can be used to analyze the methodological quality of HIV data, its scope and limitations, and whether it can be accurately compared with other evidence. The tool, utilized as a questionnaire or checklist, first identifies the type of document containing the data; the status and means of its publication; the epidemiological design used; and the priority population. Next, the document is analyzed against a verification list based on eight methodological criteria: 1) objective; 2) inclusion and exclusion criteria; 3) sample size; 4) sampling technique; 5) error-reduction strategies; 6) data analysis technique; 7) limitations; and 8) confidence intervals and/or statistical significance. The paper also presents the results of implementing the tool in three Latin American countries.

Financiarización del capital en economías en desarrollo: análisis en México

El objetivo de esta investigación es analizar las condiciones actuales y el nuevo papel del sector financiero en el comportamiento de la economía mexicana, considerada como un país en desarrollo, sustentada en la Teoría de la Financiarización del Capital. Se argumenta que el actual comportamiento económico se debe al proceso de financiarizacion del capital girando en torno a la reestructuración financiera donde los mercados financieros, las instituciones financieras y los distintos ámbitos financieros adquieren una inmensa influencia sobre el comportamiento económico y la política económica. Lo anterior se explica por procesos como la desregulación, la globalización, la liberalización, entre otros cambios, constituyendo las principales modificaciones financieros de las últimas décadas. Los dos primeros capítulos se sustentan en forma teórica -metodológica, explicando los conceptos anteriores, y en el tercer capítulo la exposición gira hacia la caracterización de la economía mexicana como caso particular de análisis

Dreamwork with Children: Perceptions and Practice of School-Based Mental Health Professionals

Forty nine public school mental health practitioners (i.e., school counselors, school psychologists, and school social workers) completed a survey about working with dreams when counseling students. Most practitioners in this sample reported having at least one student bring up dreams during counseling and spent some time in counseling working with students\u27 dreams. Practitioners addressed dreams more frequently in situations where the student was having troubling dreams or nightmares, and/or was dealing with death and grief. They also acknowledged working with dreams with students who were diagnosed with Post Traumatic Stress Disorder, were emotionally disturbed, suffered from recurrent dreams, were depressed, and had learning disabilities. This study shows that practitioners were less likely to talk about dreams with students who had adjustment disorders, psychosis, were oppositional or ill, struggled with substance abuse problems, or had eating disorders. Furthermore, most practitioners indicated receiving no training and did not feel competent to work with children\u27s dreams. However, most surveyed practitioners were interested in learning more about dreams in general

Development of technological approaches based on supercritical fluids for the production of polymeric micro-nano particulate systems for wound healing

2017 - 2018he PhD project titled “Development of technological approaches based on supercritical fluids for the production of polymeric micro-nano particulate systems for wound healing” aimed to develop novel formulations for topical administration to wounds using innovative, inexpensive and environmentally-friendly technologies based on the use of supercritical-CO2 (sc-CO2): supercritical assisted atomization (SAA) and supercritical assisted extraction (SAE) in tandem with prilling. The specific goal of the project was the designing and development of “in-situ” gelling formulations in form of powders or aerogels using polysaccharide-based polymers as carriers for the encapsulated drugs, due to their biocompatibility, biodegradability, low cost and healing improving properties. Optimization of the process parameters were implemented to obtain either submicrometric particulate particles or aerogel beads with desired properties. Size distribution, textural properties, fluid uptake capability and controlled drug release profiles of the optimized formulations have been studied to evaluate the quality of the different wound healing devices. During the first year, supercritical assisted atomization (SAA) was investigated. SAA was applied for the production of “in-situ” gelling dry powders loaded with doxycycline used as antimicrobial drug due to its inhibiting activity against matrix metalloprotease-2 (MMP-2) and metalloprotease-9 (MMP-9) that could enhance the healing process. High mannnuronic content alginate, low methoxyl grade amidated pectin and low molecular weight chitosan, in different combinations, were used as excipients. Process optimization lead to high process yields (up to 89.0%) and the obtained powders showed good technological characteristics since were able to completely gel in three minutes when in contact with simulated wound fluid. Moreover, powders were able to prolong the release of the doxycycline until up to 21 hours after a fast release during the first two hours (“burst effect”). The second year was focused on the development and characterization of aerogel formulations, in form of beads or capsules, obtained by prilling technique in tandem with the supercritical antisolvent extraction (SAE). High mannuronic content alginate was used as carrier for these formulations. Alginate gel beads were produced by prilling using either aqueous or ethanolic calcium chloride solutions as gelling bath thus producing hydrogels or alcogels in a very narrow size distribution (about 2.4 mm ± 6.0%). Subsequently they were submitted to different supercritical-CO2 drying processes for the production of aerogel in form of spherical beads. The resulted aerogels showed very high porosities (98.4-99.8%) and surface areas (271.0-537.3%) for the different sc-CO2 drying processes. Moreover, influence of alginate molecular weight on aerogel properties was studied, resulting to influence the grade of shrinking and the porosity of the aerogels. In addition, the hydrogels and alcogels were also submitted to freeze-drying and oven drying with the purpose to make a comparison in terms of textural properties. Differently, the production of aerogels capsules with controllable shell tickness was designed with the purpose to increase the exudates absorption when beads gel in contact with wounds. For this purpose, core-shell gel microparticles were produced by prilling in co-axial configuration through the development of a new inverse gelation methodology optimized by Artificial Intelligent (AI) tools (Artificial Neural Networks, ANNs, and Neurofuzzy-Logic in combination with genetic algorithms). The obtained core-shell microparticles were formed by a hydrophilic alginate phase as the outer layer and a hydrophobic phase (water-in-oil emulsion) as the inner one of the particles; such core was subsequently removed by supercritical-CO2 drying producing alginate aerogels with an inner void cavity. The third year was focused on the development and characterization of drug-loaded aerogel capsules through supercritical antisolvent extraction (SAE) in tandem with prilling. Drug loaded microparticles were produced by the novel inverse gelation previously cited through prilling in co-axial configuration using ketoprofen lysinate, as model drug, and alginate as polymeric excipient. Aerogel capsules with a thin alginate shell layer and a hollow inner cavity, in which the ketoprofen was present, were produced after the supercritical drying of core-shell microparticles. Aerogel capsules showed good textural properties in terms of porosity (up to 93.1%) and surface area being promising formulations for high fluid uptake (about 500% the weight of the aerogel) from the wounds within seconds. The supercritical drying processes and the characterization of the textural properties of aerogels were carried out during a 7 months period in the University of Santiago de Compostela (Spain). Hence, such novel technologies, using polymers above mentioned, are promising technologies for the development of a new non-expensive generation of dressing formulations with small particle size (“in-situ” gelling powders) or large particles in order to be easily handled (aerogels) both with high surface areas that make them able to absorb high amount of exudate from wounds maintaining at the same time the moisture environment at the wound bed acting as non-traumatic dressings. [edited by Author]XXXI cicl

The effect of garlic oil, xylanase enzyme and yeast on biomethane and carbon dioxide production from 60-d old Holstein dairy calves fed a high concentrate diet

Ruminal fermentation is accompanied by production of methane (CH4) and carbon dioxide (CO2) which are greenhouse gases (GHG) that cause environmental pollution. The effect of natural feed additives on the in vitro fermentation and production of CH4 and CO2 in dairy calf has had less attention. Therefore, this study aimed to evaluate the effect of garlic oil, xylanase enzyme, and yeast on in vitro biogas production from dairy calves fed a high concentrate diet. Rumen contents from 60-d old Holstein calves fed a concentrate diet were used as inoculum source. Garlic oil was included at 30,120, 250 and 500 mL/g dry matter (DM), while xylanase was included at 3 and 6 mL/g DM and yeast at 2 and 4 mg/g DM. The substrate used was the same as the diet fed to calves. Garlic oil linearly decreased (P < 0.05) in vitro DM digestibility and there were no differences among levels of either xylanase or yeast. Garlic oil decreased (P < 0.05) DM degradability while xylanase and yeast had no effect. The lag phase was linearly increased (P < 0.05) with increasing level of garlic oil. Garlic oil quadratically decreased CH4 and CO2 production. The control treatment had the highest CH4 and CO2 production followed by xylanase, yeast and garlic oil. Increasing level of xylanase and yeast increased (P < 0.05) CO2 production. It can be concluded that garlic oil followed by yeast and then xylanase can be used to mitigate in vitro CH4 and CO2 production from dairy calves fed a high concentrate diet. However, further research is warranted to establish the efficacy of such feed additives in in vivo trials

Calidad del cuidado de enfermería y satisfacción de los padres de los pacientes en recuperación de un Hospital de Lima,2022

La presente investigación tuvo por objetivo determinar la relación entre la Calidad del cuidado de enfermería y satisfacción de los padres de los pacientes en recuperación de un hospital de Lima,2022. La metodología de tipo básica fue la utilizada para la presente investigación, además de un enfoque cuantitativo, con un diseño no experimental, de corte transversal, además la investigación es descriptiva correlacional, la muestra estuvo compuesta por 73 padres de familia, quiénes acompañaban a sus hijos en el área de recuperación, la técnica utilizada para el recojo de datos fue la encuesta, como instrumento se hizo uso de la Escala de Valoración sobre la calidad de Cuidado de Enfermería, para la variable Calidad del cuidado y para la variable satisfacción, se utilizó el Cuestionario sobre la satisfacción de padres de los pacientes en recuperación. Los instrumentos obtuvieron un valor de confiabilidad a través del Alfa de Combrach de .98. Valor el cual demuestra que los instrumentos son confiables, en respuesta a los objetivos planteados, los resultados obtenidos evidenciaron: la correlación significativa entre la variable calidad del cuidado de enfermería y la satisfacción, asi como también con las dimensiones del calidad del cuidado con la variable satisfacción

The effect of garlic oil, xylanase enzyme and yeast on biomethane and carbon dioxide production from 60-d old Holstein dairy calves fed a high concentrate diet

Ruminant nutritionists aim to manipulate the ruminal microbial ecosystems and fermentation to improve feed utilization and feed conversion to animal products. Antibiotics have good effects on feed utilization and production, but have been banned due to the increasing public concern for their usage. Thus, looking for natural alternative has gained interest and importance. Phytogenic extracts (Cedillo et al., 2015), exogenous enzymes (Vallejo et al., 2016), and yeast (Hassan et al., 2016) are gaining increasing interest as feed additive for animal feeding. Such feed additives can reduce energy losses as methane (CH4), and nitrogen (N) as ammonia, which reduce animal performance and contribute to the release of pollutants to the environment.Ruminal fermentation is accompanied by production of methane (CH4) and carbon dioxide (CO2) which are greenhouse gases (GHG) that cause environmental pollution. The effect of natural feed additives on the in vitro fermentation and production of CH4 and CO2 in dairy calf has had less attention. Therefore, this study aimed to evaluate the effect of garlic oil, xylanase enzyme, and yeast on in vitro biogas production from dairy calves fed a high concentrate diet. Rumen contents from 60-d old Holstein calves fed a concentrate diet were used as inoculum source. Garlic oil was included at 30,120, 250 and 500 mL/g dry matter (DM), while xylanase was included at 3 and 6 mL/g DM and yeast at 2 and 4 mg/g DM. The substrate used was the same as the diet fed to calves. Garlic oil linearly decreased (P < 0.05) in vitro DM digestibility and there were no differences among levels of either xylanase or yeast. Garlic oil decreased (P < 0.05) DM degradability while xylanase and yeast had no effect. The lag phase was linearly increased (P < 0.05) with increasing level of garlic oil. Garlic oil quadratically decreased CH4 and CO2 production. The control treatment had the highest CH4 and CO2 production followed by xylanase, yeast and garlic oil. Increasing level of xylanase and yeast increased (P < 0.05) CO2 production. It can be concluded that garlic oil followed by yeast and then xylanase can be used to mitigate in vitro CH4 and CO2 production from dairy calves fed a high concentrate diet. However, further research is warranted to establish the efficacy of such feed additives in in vivo trials

Clinical validation of the EndoPredict test in node-positive, chemotherapy-treated ER+/HER2− breast cancer patients: results from the GEICAM 9906 trial

INTRODUCTION: EndoPredict (EP) is an RNA-based multigene test that predicts the likelihood of distant recurrence in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2–negative (HER2−) breast cancer (BC) who are being treated with adjuvant endocrine therapy. Herein we report the prospective-retrospective clinical validation of EP in the node-positive, chemotherapy-treated, ER+/HER2− BC patients in the GEICAM 9906 trial. METHODS: The patients (N = 1,246) were treated either with six cycles of fluorouracil, epirubicin and cyclophosphamide (FEC) or with four cycles of FEC followed by eight weekly courses of paclitaxel (FEC-P), as well as with endocrine therapy if they had hormone receptor–positive disease. The patients were assigned to EP risk categories (low or high) according to prespecified cutoff levels. The primary endpoint in the clinical validation of EP was distant metastasis-free survival (MFS). Metastasis rates were estimated using the Kaplan-Meier method, and multivariate analysis was performed using Cox regression. RESULTS: The molecular EP score and the combined molecular and clinical EPclin score were successfully determined in 555 ER+/HER2− tumors from the 800 available samples in the GEICAM 9906 trial. On the basis of the EP, 25% of patients (n = 141) were classified as low risk. MFS was 93% in the low-risk group and 70% in the high-risk group (absolute risk reduction = 23%, hazard ratio (HR) = 4.8, 95% confidence interval (CI) = 2.5 to 9.5; P < 0.0001). Multivariate analysis showed that, in this ER+/HER2− cohort, EP results are an independent prognostic parameter after adjustment for age, grade, lymph node status, tumor size, treatment arm, ER and progesterone receptor (PR) status and proliferation index (Ki67). Using the predefined EPclin score, 13% of patients (n = 74) were assigned to the low-risk group, who had excellent outcomes and no distant recurrence events (absolute risk reduction vs high-risk group = 28%; P < 0.0001). Furthermore, EP was prognostic in premenopausal patients (HR = 6.7, 95% CI = 2.4 to 18.3; P = 0.0002) and postmenopausal patients (HR = 3.3, 95% CI = 1.3 to 8.5; P = 0.0109). There were no statistically significant differences in MFS between treatment arms (FEC vs FEC-P) in either the high- or low-risk groups. The interaction test results between the chemotherapy arm and the EP score were not significant. CONCLUSIONS: EP is an independent prognostic parameter in node-positive, ER+/HER2− BC patients treated with adjuvant chemotherapy followed by hormone therapy. EP did not predict a greater efficacy of FEC-P compared to FEC alone

A new nanomedicine platform to deliver a carnitine palmitoyl-transferase 1 (CPT1) inhibitor into glioma cells and neurons

Obesity and glioblastoma multiforme (GB) are two unmet medical needs where effective therapies are lacking. Carnitine palmitoyl transferase 1 (CPT1), an enzyme catalyzing the rate-lim- iting step in fatty acid oxidation (FAO), is a viable target for both diseases. C75, a fatty acid synthase (FAS) inhibitor, forms an adduct with coenzyme A (CoA) to form C75-CoA, which is a strong com- petitive inhibitor to CPT1 that is selective in its target. However, it is polar and charged, having low cell membrane permeability, and therefore needing a delivery system for intracellular transport. (±)-C75-CoA and its enantio-separated forms (+)- and (−)-C75-CoA were used to form poly-ion com- plex (PIC) micelles with the cationic block co-polymer PEG-PAsp(DET). The drug and polymer were mixed in a 1:1 anion/cation ratio to give 50-70 nm micelles with a unimodal size profile and narrow polydispersity. Size was maintained upon introduction of physiological saline. Micellar (±)-, (+)-, and (−)-C75-CoA were all significantly more cytotoxic compared to the respective free drugs in U87MG. We examined whether C75-CoA inhibits FAO by measuring ATP concentrations in U87MG and GT1-7. ATP generation was found to be hampered after adding C75-CoA in both cell types, with micelle-treated cells producing significantly lower ATP than those treated with free drug, suggesting that the effective intracellular delivery of C75-CoA leads to a more pronounced FAO inhibition. A fluorescent CoA derivative, Fluor-CoA, also yielded monodisperse micelles sim- ilar to C75-CoA. Micellar internalization was significantly greater than that of the free dye. Uptake of both increased with time, with this effect is more pronounced in U87MG than GT1-7. The %Fluor- CoA+ cells were also expressively higher for the micelle across cell lines. From this data, it can be convincingly concluded that neuronal and glioma cellular uptake of micelles is superior to that of the free dye, validating the need for cellular delivery systems for anionic, CoA-type molecules. The micellar form neutralized the negative charge of the cargo, promoting transport into the cell. These outcomes strongly support the effectiveness of using a PIC micelle-type system to deliver anionic small molecules into glioma cells and neurons meant to inhibit enzymes such as CPT1, for future applications in diseases like obesity and cancer