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Hidden girl : the true story of a modern-day child slave
\"Shyima Hall was eight years old when her parents sold her into domestic slavery. One of eleven children, Shyima lived with her family in poverty in Egypt. When an older sister was dismissed from her job as a servant for stealing, Shyima's parents made a deal with her sister's employers. In order to repay the debt, Shyima would take her sister's place. This began Shyima's life as a slave. Her captors, a wealthy couple, referred to Shyima only as 'stupid girl' and forced her to wait hand and foot on their family. Any money she was paid for her work went directly to her parents, with whom she had very little contact. Two years into her bondage, Shyima's captors moved to the United States and illegally trafficked Shyima in with them. Modern-day slavery is a painful reality for thousands of adults and children in the world--and in the United States. This is Shyima's harrowing story of life as a child slave, and her long, inspiring road to freedom.\"--Page 4 of cover.
Book
A Long Noncoding RNA Mediates Both Activation and Repression of Immune Response Genes
An inducible program of inflammatory gene expression is central to antimicrobial defenses. This response is controlled by a collaboration involving signal-dependent activation of transcription factors, transcriptional co-regulators, and chromatin-modifying factors. We have identified a long noncoding RNA (lncRNA) that acts as a key regulator of this inflammatory response. Pattern recognition receptors such as the Toll-like receptors induce the expression of numerous lncRNAs. One of these, lincRNA-Cox2, mediates both the activation and repression of distinct classes of immune genes. Transcriptional repression of target genes is dependent on interactions of lincRNA-Cox2 with heterogeneous nuclear ribonucleoprotein A/B and A2/B1. Collectively, these studies unveil a central role of lincRNA-Cox2 as a broad-acting regulatory component of the circuit that controls the inflammatory response.
Journal Article
Contemporary plays by African American women : ten complete works
African American women have increasingly begun to see their plays performed from regional stages to Broadway. Yet many of these artists still struggle to gain attention. In this volume, Sandra Adell draws from the vital wellspring of works created by African American women in the twenty-first century to present ten plays by both prominent and up-and-coming writers. Taken together, the selections portray how these women engage with history as they delve into--and shake up--issues of gender and class to craft compelling stories of African American life. Gliding from gritty urbanism to rural landscapes, these works expand boundaries and boldly disrupt modes of theatrical representation.
Book
Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis
Background
The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community.
Objective
The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed.
Methods
A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies.
Results
Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms.
Conclusions
Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.
Journal Article
Eugene Richards : the run-on of time
The first publication to situate the work of Richards in the long photographic tradition that merges personal artistic vision with documentary practice. Eugene Richards (b. 1944) is a documentary photographer known for his powerful, unflinching exploration of contemporary social issues from the early 1970s to the present. This handsome book is the first comprehensive and critical look at Richards's lifelong achievements. Reproduced in tritone and color, the extraordinary images in this volume explore complicated and controversial subjects, including racism, poverty, drug addiction, cancer, aging, the effects of war and terrorism, and the erosion of rural America. The authors of the book situate Richards's work in the long photographic tradition that merges personal artistic vision with documentary practice, following in the tradition of W. Eugene Smith and Robert Frank.
Book
A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers
Influenza vaccination is a commonly used intervention to prevent influenza infection in healthcare workers (HCWs) and onward transmission to other staff and patients. We undertook a systematic review to synthesize the latest evidence of the direct epidemiological and economic effectiveness of seasonal influenza vaccination among HCW.
We conducted a systematic search of MEDLINE/PubMed, Scopus, and Cochrane Central Register of Controlled Trials from 1980 through January 2018. All studies comparing vaccinated and non-vaccinated (i.e. placebo or non-intervention) groups of HCWs were included. Research articles that focused on only patient-related outcomes or monovalent A(H1N1)pdm09 vaccines were excluded. Two reviewers independently selected articles and extracted data. Pooled-analyses were conducted on morbidity outcomes including laboratory-confirmed influenza, influenza-like illnesses (ILI), and absenteeism. Economic studies were summarized for the characteristics of methods and findings.
Thirteen articles met eligibility criteria: three articles were randomized controlled studies and ten were cohort studies. Pooled results showed a significant effect on laboratory-confirmed influenza incidence but not ILI. While the overall incidence of absenteeism was not changed by vaccine, ILI absenteeism was significantly reduced. The duration of absenteeism was also shortened by vaccination. All published economic evaluations consistently found that the immunization of HCW was cost saving based on crude estimates of avoided absenteeism by vaccination. No studies, however, comprehensively evaluated both health outcomes and costs of vaccination programs to examine cost-effectiveness.
Our findings reinforced the influenza vaccine effects in reducing infection incidence and length of absenteeism. A better understanding of the incidence of absenteeism and comprehensive economic program evaluations are required to ensure the best possible management of ill HCWs and the investment in HCW immunization in increasingly constrained financial environments. These steps are fundamental to establish sustainability and cost-effectiveness of vaccination programs and underpin HCW immunization policy.
Journal Article
No prescription? No problem: drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries: a systematic review of qualitative studies
Background
Non-prescription dispensing of antibiotics, one of the main sources of antibiotic misuse or over use, is a global challenge with detrimental public health consequences including acceleration of the development of antimicrobial resistance, and is facilitated by various intrinsic and extrinsic drivers. The current review aimed to systematically summarise and synthesise the qualitative literature regarding drivers of non-prescribed sale of antibiotics among community drug retail outlets in low and middle income countries.
Methods
Four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) and reference lists of the relevant articles were searched. The Joanna Briggs Institute’s Critical Appraisal Checklist for qualitative studies was used to assess the quality of included studies. The enhancing transparency in reporting the synthesis of qualitative research statement was used to guide reporting of results. Data were coded using NVivo 12 software and analysed using both inductive and deductive thematic analysis.
Results
A total of 23 articles underwent full text review and 12 of these met the inclusion criteria. Four main themes were identified in relation to facilitators of non-prescribed sale of antibiotics among community drug retail outlets: i) the business orientation of community drug retail outlets and tension between professionalism and commercialism; ii) customers’ demand pressure and expectation; iii); absence of or a lax enforcement of regulations; and iv) community drug retail outlet staff’s lack of knowledge and poor attitudes about antibiotics use and scope of practice regarding provision.
Conclusions
This review identified several potentially amendable reasons in relation to over the counter dispensing of antibiotics. To contain the rise of antibiotic misuse or over use by targeting the primary drivers, this review suggests the need for strict law enforcement or enacting new strong regulation to control antibiotic dispensing, continuous and overarching refresher training for community drug retail outlet staff about antibiotic stewardship, and holding public awareness campaigns regarding rational antibiotic use.
Journal Article
“Handing out non-prescribed antibiotics is storing up trouble for the next generation!” Unpacking multistakeholder views of drivers and potential solutions in Ethiopia
Background
Antibiotic resistance is a global health crisis, with inappropriate antibiotic use often being linked to non-prescribed antibiotic dispensing practices. This study aimed to examine the perspectives of multiple stakeholders on the drivers and potential solutions for non-prescribed antibiotic dispensing in Ethiopian community drug retail outlets (CDROs). Despite the prescription only use policies, the practice remains prevalent in Ethiopia. Many factors are thought to contribute to this issue, although little research is available for non-urban settings.
Methods
A phenomenological qualitative study was conducted. Pharmacy professionals (owners or employees) working in non-urban towns CDROs were selected through a simulated client study, which identified CDROs that had dispensed antibiotics without a prescription. Some high-level decision makers in the Ethiopian health system were also purposively selected. Interviews were conducted in-person and over the phone or via Zoom. The interview data were transcribed verbatim, translated to English, and thematically analysed. NVivo 12 software was used to assist with coding.
Results
CDRO pharmacy professionals (n = 18) and five decision makers were interviewed. Most professionals (61%) were pharmacists working in drug stores, with one to 11 years of work experience. Several contributing factors were identified at the level of patients, CDRO staff, and the healthcare system. These included economic interests, inadequate knowledge and inappropriate attitudes about antibiotic use or supply, and issues within the healthcare system included inaccessibility and insufficient capacity, absence of or a weak enforcement of prescription-only regulations or service supervision. Additionally, patient-related factors included a lack of knowledge and inappropriate attitudes about antibiotics use and their supply, previous successful treatment experience and a culture of seeking out antibiotics.
Conclusions
A complex set of modifiable factors related to patients, CDRO staff and healthcare system were identified that contribute to the non-prescribed supply of antibiotics. Due to this complexity, a single solution will not resolve the issues. Therefore, a range of multifaceted solutions have been suggested, including stricter regulation, increasing availability and accessibility of healthcare services, collaboration, and local consensus-building among CDROs, regular training for CDRO staff, and using community social events to educate the public about responsible use of antibiotics.
Journal Article
Effects of vitamin D deficiency in critically ill surgical patients
The incidence of vitamin D deficiency in critically ill patients is reported to be up to 50%, with a 3-fold increase in predicted mortality, but limited data exist concerning vitamin D deficiency in critically ill surgical patients.
Sixty-six adult surgical intensive care unit patients who had 25-hydroxyvitamin D serum levels evaluated from January 2010 to February 2011 were prospectively identified. Patients were divided into groups according to vitamin D level (<20 vs ≥20 ng/mL).
Of the 66 patients evaluated, 49 (74%) had vitamin D levels < 20 ng/mL, and 17 (26%) had vitamin D levels ≥ 20 ng/mL. Patients with vitamin D levels < 20 versus ≥ 20 ng/mL had longer lengths of hospital stay. Lengths of intensive care unit stay were clinically longer, although not significant. Infection rates tended to be higher (P = .09), and a higher incidence of sepsis was seen in the patients with vitamin D levels < 20 ng/mL.
Vitamin D levels < 20 ng/mL have a significant impact on length of stay, organ dysfunction, and infection rates. More data are needed on the value of supplementation to improve these outcomes.
Journal Article
What are the key ingredients for an effective and successful tertiary enabling program for Aboriginal and Torres Strait Islander students? An evaluation of the evolution of one program
Tertiary enabling programs have become an increasingly important part of the post-secondary schooling landscape. In recognition of the need for increased access for certain under-represented groups within the university population, enabling, bridging or foundational programs are offered by a large number of universities in Australia as alternative entry pathways. This paper explores the outcomes of an enabling program being offered to Aboriginal and Torres Strait Islander adults who are arguably one of the most under-represented groups within the university system in Australia. It explores, in two parts, the combination of factors that are resulting in these positive outcomes. Part one explores the 'data story' of the course and the factors that support retention and completion. Part two explores the 'stories of transformation' as told by the students themselves, providing insider accounts of richness and depth about the things that truly enable success in a tertiary learning environment for Aboriginal and Torres Strait Islander students. While not ignoring the limitations of evaluating a course that is still in its infancy, the students undertaking this course are completing and moving on into higher education courses at an impressive rate, empowered by the skills, strategies and confidence they have developed through the course. [Author abstract]
Journal Article