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Selected AbstractsNeuropsychiatric movement disorders following streptococcal infectionDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2005K G Walker MB BS The aim of this study was to describe post-streptococcal movement disorders that form part of the acute rheumatic fever complex. The clinical records of patients diagnosed with Sydenham's chorea were analyzed retrospectively to investigate epidemiology, the significance of socioeconomic deprivation, clinical manifestations, treatments, outcomes, long-term morbidity, and disease evolution. Forty-two patients (21 males, 21 females) were diagnosed with Sydenham's chorea. The median presentation age was 9 years 8 months (range 3y 5mo to 13y 2mo). Nineteen patients were of indigenous African ancestry; 23 were of mixed ancestry. All patients lived in poverty and had poor access to medical care. Twelve of the total group had disabling symptoms for longer than 2 years; six of these patients developed paediatric autoimmune neuropsychiatric disorder associated with Streptococcus (Paediatric autoimmune neuropsychiatric disorder associated with Streptococcus [PANDAS]), five Tourette syndrome (TS), and one learning difficulties. Poor outcome was significantly more prevalent in patients of mixed ancestry, in those with a positive family history, previous behavioural problems, or a failure to complete 10 days of penicillin and ,bed-rest'/hospitalization. Sydenham's chorea is one manifestation of post-streptococcal neuropsychiatric movement disorders. This study demonstrates that patients can present with one diagnosis and evolve other neuropsychiatric conditions such as TS and PANDAS. In the South African context, it is important to delineate neuropsychiatric movement disorders associated with streptococcal infections. The potential genetic susceptibility should be explored. [source] Response of the flora and macroinvertebrate fauna of a chalk stream site to changes in managementFRESHWATER BIOLOGY, Issue 5 2003J. F. Wright SUMMARY 1. Temporal changes in a series of habitats and their macroinvertebrate assemblages were examined on a 50-m section of a chalk stream in Berkshire, England between June 1975,79 and June 1997,2001. 2. The site was part of a trout fishery in 1975,79, when river management included instream weed cutting together with control of bankside trees and riparian vegetation. Management ceased in the 1980s and by 1997,2001, the site was heavily shaded by trees and riparian vegetation. 3. The mean area of instream macrophytes decreased by 50% between the first and second sampling period. In contrast, gravel and silt increased and invading marginal vegetation formed a new habitat. 4. Changes in macroinvertebrate family richness between sampling periods were scale dependant. Although there were, on average, significantly more families in individual replicates in 1975,79 than in 1997,2001, total family richness for the site in each year did not differ significantly between sampling periods. 5. Sixty families of macroinvertebrates were recorded during the study, 50 in both sampling periods, 53 in 1975,79 and 57 in 1997,2001. This small increase in site family richness may be due to the invading marginal plants. 6. Total macroinvertebrate abundance was significantly lower in the second sampling period. A major drought in 1976 resulted in significantly higher densities of macroinvertebrates, partly through the exploitation of epiphytic diatoms by chironomid larvae. A drought in 1997 failed to elicit a similar response because of the limited macrophytes and diatoms under heavy shading by trees and marginal vegetation. 7. Significant increases in important shredders and decreases in some scrapers between the early and later sampling years largely reflected changes in available food resources. 8. Whereas macroinvertebrate family richness has been conserved under the recent ,no management' regime, the site is now less attractive as a fishery because of poor access and lower densities of some macroinvertebrates taken by brown trout. [source] Acceptability, feasibility and affordability of infant feeding options for HIV-infected women: a qualitative study in south-west NigeriaMATERNAL & CHILD NUTRITION, Issue 3 2006Titilayo C. Abiona Abstract The objective of this study was to explore the acceptability, feasibility, affordability, safety and sustainability of replacement feeding options for HIV-infected mothers in Ile-Ife, in south-west Nigeria. Six focus group discussions were conducted with a purposive sample of mothers, fathers and grandmothers. The HIV status of all participants was unknown to investigators. All text data were analysed using the Text-based Beta Software program. With regard to the acceptability of replacement feeds, respondents perceived the stigma associated with not breastfeeding to be an important consideration. In this community, breastfeeding is the norm , even though it is not necessarily exclusive. For infected mothers who choose to breastfeed exclusively and then to wean their infants before 6 months of age, respondents did not anticipate early cessation of breastfeeding to be problematic. Respondents noted that acceptable replacement foods included infant formula, soy milk and cow's milk. Barriers to replacement feeding that were mentioned included: the high costs of replacement foods and fuel for cooking; an unreliable supply of electrical power; poor access to safe water; and poor access to storage facilities. The research confirms the difficulty of replacement feeding for HIV-infected mothers in sub-Saharan Africa. The results also provide the basis for new issues and hypothesis for future research in other communities with similar socio-cultural and economic characteristics. [source] Declining health insurance access among US hispanic workers: Not all jobs are created equalAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Kathryn E. McCollister PhD Abstract Introduction Approximately 18% of the U.S. population are uninsured, a proportion that may continue to rise, particularly among Hispanics, as the cost of medical care increases faster than the growth in wages. Methods Health insurance trends were analyzed by race,ethnic category, and among Hispanic workers by occupation type and industrial sector, using data on employed respondents ,18 years from 1997 to 2007 National Health Interview Survey (NHIS) (mean annual n,=,17,392, representing 123 million US workers on average over this 11 year period). Results From 1997 to 2007, the relative decline in health insurance coverage for US workers was greatest among Hispanics (7.0%). Hispanic workers in the Construction and Services industries had the greatest overall decline in coverage (24.9% and 14.7%), as well as Hispanic blue collar workers (14.0%). Conclusion Hispanic workers in general, and those employed in blue collar, construction, and services sectors in particular, are at greater risk for poor access to health care due to a lack of health insurance coverage. Am. J. Ind. Med. 53:163,170 2010. © 2009 Wiley-Liss, Inc. [source] Effects of parental perception of neighbourhood deprivation and family environment characteristics on pro-social behaviours among 4,12 year old childrenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2010Andre M. N. Renzaho Abstract Objective: To assess the effect family environment stressors (e.g. poor family functioning and parental psychological distress) and neighbourhood environment on child prosocial behaviour (CPB) and child difficulty behaviour (CDB) among 4-to-12 year old children. Methods: Analysis of the 2006 Victorian Child Health and Wellbeing Survey (VCHWS) dataset derived from a statewide cross-sectional telephone survey, with a final total sample of 3,370 children. Results: Only family functioning, parental psychological distress, child gender, and age were associated with CPB, explaining a total of 8% of the variance. Children from healthily functioning families and of parents without any psychological distress exhibited greater prosocial behaviours than those from poorly functioning families and of parents with mental health problems. Neighbourhood environment was not found to contribute to CPB. A total of eight variables were found to predict CDB, explaining a total of 16% of the variance. Poor family and parental psychological functioning as well as poor access to public facilities in the neighbourhood were associated with conduct problems in children. Conclusion: Our results point to the importance of the family environment in providing a context that fosters the development of empathic, caring and responsible children; and in buffering children in exhibiting behaviour difficulties during the formative years of life. Programs aimed at promoting prosocial behaviours in children need to target stressors on the family environment. [source] Violence against pregnant women: prevalence and characteristics.BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2005A population-based study in Nicaragua Objective This study aims to estimate the prevalence and characteristics of partner abuse during pregnancy as well as to investigate associated social factors in León, Nicaragua. Design Cross-sectional community-based study. Setting All pregnant women from 50 randomly selected geographical clusters out of 208 in the municipality of León, Nicaragua. Sample A total of 478 pregnant women were included; only one woman refused to participate. Method The domestic violence questionnaire from the WHO-co-ordinated Multi-Country Study on Women's Health and Life Events was used with each participant being interviewed twice during pregnancy. Main outcome measures Prevalence and characteristics of partner violence during pregnancy. Results The prevalence of emotional, physical and sexual abuse during pregnancy was 32.4%, 13.4% and 6.7%, respectively. Seventeen percent reported experience of all three forms of violence. Two-thirds of the victims reported repeated abuse. Half of the abused women had experienced punches and kicks directed towards the abdomen and 93% had been injured. Most women had not sought health care in relation to the abuse, but those who did were usually hospitalised. Factors such as women's age below 20 years, poor access to social resources and high levels of emotional distress were independently associated with violence during pregnancy. Conclusion Violence against pregnant women in Nicaragua is common and often repeated. Although these women have poor access to social resources and high levels of emotional distress, they are rarely assisted by the health services. Innovative strategies are needed to provide support and counselling. [source] TRIPS-Plus Implications for Access to Medicines in Developing Countries: Lessons from Jordan,United States Free Trade AgreementTHE JOURNAL OF WORLD INTELLECTUAL PROPERTY, Issue 6 2007Hamed El-Said Since the establishment of the World Trade Organization (WTO) in 1995 and implementation of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) as a result, the United States (US) sought to impose still higher levels of intellectual property rights on developing countries, a phenomenon that is commonly known today as TRIPS-Plus. The Jordan,US FTA, signed in 2001, contains several TRIPS-Plus rules that restrict the poor's access to medicines, and is today touted by US officials and the US Trade Representative (USTR) as a success, and providing a wide range of benefits. These benefits not only include a higher growth rate, but also more specific benefits to the pharmaceutical sector in particular, such as an improved ability to develop generic medicine and engage in new innovative research, as well as increasing the presence of and collaboration with multinational drug makers. This article analyzes in detail the TRIPS-Plus provisions of the Jordan,US FTA. It challenges the claims that the FTA brings general and specific benefits to developing countries, and provides fresh evidence which strongly suggests that benefits from the Jordan,US FTA have been largely exaggerated while the costs underestimated. [source] | ||||||||||