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Safer conception

Congxiu Ye, David Brand, Song G Zheng
Regulatory T cells (Treg) play a crucial role in maintaining immune homeostasis since Treg dysfunction in both animals and humans is associated with multi-organ autoimmune and inflammatory disease. While IL-2 is generally considered to promote T-cell proliferation and enhance effector T-cell function, recent studies have demonstrated that treatments that utilize low-dose IL-2 unexpectedly induce immune tolerance and promote Treg development resulting in the suppression of unwanted immune responses and eventually leading to treatment of some autoimmune disorders...
2018: Signal Transduction and Targeted Therapy
V A Levin, X Jiang, R Kagan
Menopause predisposes women to osteoporosis due to declining estrogen levels. This results in a decrease in bone mineral density (BMD) and an increase in fractures. Osteoporotic fractures lead to substantial morbidity and mortality, and are considered one of the largest public health priorities by the World Health Organization (WHO). It is therefore essential for menopausal women to receive appropriate guidance for the prevention and management of osteoporosis. The Women's Health Initiative (WHI) randomized controlled trial first proved hormonal therapy (HT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women...
March 8, 2018: Osteoporosis International
Yahel Segal, Yehuda Shoenfeld
Since the early 1800s vaccines have saved numerous lives by preventing lethal infections. However, during the past two decades, there has been growing awareness of possible adverse events associated with vaccinations, cultivating heated debates and leading to significant fluctuations in vaccination rates. It is therefore pertinent for the scientific community to seriously address public concern of adverse effects of vaccines to regain public trust in these important medical interventions. Such adverse reactions to vaccines may be viewed as a result of the interaction between susceptibility of the vaccinated subject and various vaccine components...
March 5, 2018: Cellular & Molecular Immunology
Corinne M Hohl, Serena S Small, David Peddie, Katherin Badke, Chantelle Bailey, Ellen Balka
BACKGROUND: Adverse drug events are unintended and harmful events related to medications. Adverse drug events are important for patient care, quality improvement, drug safety research, and postmarketing surveillance, but they are vastly underreported. OBJECTIVE: Our objectives were to identify barriers to adverse drug event documentation and factors contributing to underreporting. METHODS: This qualitative study was conducted in 1 ambulatory center, and the emergency departments and inpatient wards of 3 acute care hospitals in British Columbia between March 2014 and December 2016...
February 27, 2018: JMIR Public Health and Surveillance
Tessa J Roseboom
The advent of assisted reproduction has allowed the conception of millions of individuals who otherwise would not have existed. Although most ART children are born healthy, there is increasing awareness of the plasticity of the human embryo causing concerns about potential long-term consequences of ART for the growth, development and health of this growing population of individuals. Evidence from studies in animals and humans suggest that physiology and metabolism may be permanently affected by ART. It suggests that ART children may be at increased risk of later cardiometabolic diseases...
February 21, 2018: Human Reproduction
Kaylin M Greene
INTRODUCTION AND AIMS: Substance use contributes to motor vehicle crashes, the leading cause of death among young adults. The current qualitative study examined perceptions of the acceptability and harms associated with driving after marijuana versus alcohol use in rural America. Illuminating rural perspectives is critical given that the motor vehicle fatality rate is twice as high in rural as in urban areas in the USA. DESIGN AND METHODS: In 2015-2016, 72 young adults aged 18-25 years (Mage  = 20...
February 21, 2018: Drug and Alcohol Review
Kathy Goggin, Emily A Hurley, Glenn J Wagner, Vincent Staggs, Sarah Finocchario-Kessler, Jolly Beyeza-Kashesya, Deborah Mindry, Josephine Birungi, Rhoda K Wanyenze
High rates of fertility desires, childbearing and serodiscordant partnerships among people living with HIV (PLHIV) in Uganda underscore the need to promote use of safer conception methods (SCM). Effective SCM exist but few PLHIV benefit from provider-led safer conception counseling (SCC) and comprehensive national SCC guidelines are still lacking. Providers' self-efficacy, intentions and attitudes for SCC impact provision and should inform development of services, but there are no longitudinal studies that assess these important constructs...
February 20, 2018: AIDS and Behavior
Jolly Beyeza-Kashesya, Rhoda K Wanyenze, Kathy Goggin, Sarah Finocchario-Kessler, Mahlet Atakilt Woldetsadik, Deborah Mindry, Josephine Birungi, Glenn J Wagner
INTRODUCTION: Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda. METHODS: 400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis...
2018: PloS One
Kerry Hancuch, Jared Baeten, Kenneth Ngure, Connie Celum, Nelly Mugo, Edna Tindimwebwa, Renee Heffron
For HIV-1 serodiscordant couples, HIV-1 exposure and risk of transmission is heightened during pregnancy attempts, but safer conception strategies can reduce risk. As safer conception programs are scaled up, understanding couples' preferences and experiences can be useful for programmatic recommendations. We followed 1013 high-risk, heterosexual HIV-1 serodiscordant couples from Kenya and Uganda for two years in an open-label delivery study of integrated pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART), the Partners Demonstration Project...
February 17, 2018: AIDS Care
Amanda Lamp, Jane M C Chen, David McCullough, Gregory Belenky
In December 2014, the Federal Aviation Administration (FAA) completed a major revision of the rules and regulations governing flight and duty time in commercial aviation (Federal Aviation Regulation (FAR) Part 117). Scientists were included in the revision process and provided insights into sleep, sleep loss, the circadian rhythm, and their effects on performance that were incorporated into the new rule. If a planned flight was non-compliant with the regulation, for example if it exceeded flight and duty time limits, it could only be flown under an FAA-approved Fatigue Risk Management System (FRMS) as meeting an Alternative Method of Compliance (AMOC)...
February 7, 2018: Accident; Analysis and Prevention
Lotta J Seppala, Anne M A T Wermelink, Max de Vries, Kimberley J Ploegmakers, Esther M M van de Glind, Joost G Daams, Nathalie van der Velde
BACKGROUND AND OBJECTIVE: Falls are a major public health problem in older adults. Earlier studies showed that psychotropic medication use increases the risk of falls. The aim of this study is to update the current knowledge by providing a comprehensive systematic review and meta-analysis on psychotropic medication use and falls in older adults. METHODS AND DESIGN: This study is a systematic review and meta-analysis. A search was conducted in Medline, PsycINFO, and Embase...
February 2, 2018: Journal of the American Medical Directors Association
Dvora Leah Joseph Davey, Kristin M Wall, William Kilembe, Naw Htee Khu, Ilene Brill, Bellington Vwalika, Elwyn Chomba, Joseph Mulenga, Amanda Tichacek, Pamina M Gorbach, Susan Allen
INTRODUCTION: Attempts to conceive and pregnancy may increase HIV transmission to sex partners and infants. Our study evaluated the association between fertility intentions and HIV acquisition among Zambian HIV-serodiscordant couples. METHODS: We collected demographic, behavioral, clinical exposures, and data on fertility intentions in a cohort of HIV-serodiscordant couples in Lusaka, Zambia from 2005 to 2012. We evaluated factors associated with fertility intentions stratified by gender using multivariable logistic regression...
2018: PloS One
A Subastri, V Arun, Preeti Sharma, E Preedia Babu, A Suyavaran, S Nithyananthan, Ghedeir M Alshammari, B Aristatile, V Dharuman, C Thirunavukkarasu
Therapeutic applications of arsenic trioxide (ATO) are limited due to their severe adverse effects. However, nanoparticles of ATO might possess inimitable biologic effects based on their structure and size which differ from their parent molecules. Based on this conception, AsNPs were synthesized from ATO and comparatively analysed for their interaction mechanism with DNA using spectroscopic & electrochemical techniques. Finally, anti-proliferative activity was assessed against different breast cancer cells (MDA-MB-231 & MCF-7) and normal non-cancerous cells (HEK-293)...
December 22, 2017: Chemico-biological Interactions
Eric Chatelain, Jean-Robert Ioset
Introduction- Chagas disease, caused by the parasite Trypanosoma cruzi, is a global public health issue. Current treatments targeting the parasite are limited to two old nitroheterocyclic drugs with serious side effects. The need for new and safer drugs has prompted numerous drug discovery efforts to identify compounds suitable for parasitological cure in the last decade. Areas covered- Target-based drug discovery has been limited by the small number of well validated targets - the latest example being the failure of azoles, T...
December 13, 2017: Expert Opinion on Drug Discovery
Mariana Salgado, Melanie Wendland, Damaris Rodriguez, Meghan A Bohren, Olufemi T Oladapo, Olubunmi A Ojelade, Kidza Mugerwa, Bukola Fawole
OBJECTIVE: The "Better Outcomes in Labor Difficulty" (BOLD) project used a service design process to design a set of tools to improve quality of care during childbirth by strengthening linkages between communities and health facilities in Nigeria and Uganda. This paper describes the Passport to Safer Birth concept and the tools developed as a result. METHODS: Service design methods were used to identify facilitators and barriers to quality care, and to develop human-centered solutions...
December 2017: International Journal of Gynaecology and Obstetrics
Mariana Salgado, Melanie Wendland, Damaris Rodriguez, Meghan A Bohren, Olufemi T Oladapo, Olubunmi A Ojelade, Adebimpe A Olalere, Ronald Luwangula, Kidza Mugerwa, Bukola Fawole
OBJECTIVE: To demonstrate how a human-centered service design approach can generate practical tools for good-quality childbirth care in low-resource settings. METHODS: As part of the WHO "Better Outcomes in Labour Difficulty" (BOLD) project, a service design approach was used in eight Ugandan and Nigerian health facilities and communities to develop the "Passport to Safer Birth." There are three phases: Research for Design, Concept Design, and Detail Design...
December 2017: International Journal of Gynaecology and Obstetrics
Ryan A Todd, Sophie Soklaridis, Alice K Treen, Shree U Bhalerao, Michael D Cusimano
INTRODUCTION: Despite the known negative health outcomes of concussions in minor level boys' hockey, there has been significant resistance to creating a safer game with less body checking. METHODS: To better understand cultural barriers that prevent making the sport safer for youth and adolescents, semistructured interviews, with 20 ice hockey stakeholders, were conducted and analysed using thematic analysis. RESULTS: Through this analysis, two primary concepts arose from respondents...
November 27, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Shuguang Li, Daniel M Vogt, Daniela Rus, Robert J Wood
Artificial muscles hold promise for safe and powerful actuation for myriad common machines and robots. However, the design, fabrication, and implementation of artificial muscles are often limited by their material costs, operating principle, scalability, and single-degree-of-freedom contractile actuation motions. Here we propose an architecture for fluid-driven origami-inspired artificial muscles. This concept requires only a compressible skeleton, a flexible skin, and a fluid medium. A mechanical model is developed to explain the interaction of the three components...
December 12, 2017: Proceedings of the National Academy of Sciences of the United States of America
Jed Wolpaw, Deborah Schwengel, Nadia Hensley, Bommy Hong Mershon, Tracey Stierer, Anne Steele, Alexandra Hansen, Colleen G Koch
Healthcare increasingly is moving from volume- to value-based care, with an emphasis on linking a larger percentage of payments to the quality of care provided. There is a renewed interest in designing a focused, strategic approach to quality and safety education and engagement of trainees in hospital-wide quality, safety, and patient experience initiatives. Hospitals, trainees, and patients benefit as a result of engaging frontline learners in these activities. Hospitals can leverage the intelligence from the front line to contribute to improved hospital safety, increased employee and patient engagement, and better identification of vulnerable areas of safety risks...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
Beth Fylan, Gerry Armitage, Deirdre Naylor, Alison Blenkinsopp
INTRODUCTION: There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. METHODS: Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines...
November 16, 2017: BMJ Quality & Safety
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