Pre-service midwifery education in sub-Saharan Africa: A scoping review

BackgroundIn response to a global call for more midwives, maternal health stakeholders have called for increased investment in midwifery pre-service education. Given the already long list of challenges and the increasing burden on health care systems due to the COVID-19 pandemic, the need to prioritize investment is acute, particularly in sub-Saharan Africa. An important first step is to examine the current evidence.MethodsWe conducted a scoping review of the peer-reviewed literature about pre-service midwifery education in sub-Saharan Africa. A search of studies published between 2015 and 2021 in French or English was conducted using six databases (PubMed, CINAHL, Embase, Scopus, Web of Science and African Index Medicus).ResultsThe search yielded 3061 citations, of which 72 were included. Most were a mix of qualitative and quantitative cross-sectional, country-specific studies. Organized by pre-service educational domain, the literature reflected a misalignment between international standards for midwifery education and what schools and clinical sites and the larger administrative systems where they operate, reliably provide. Inadequate infrastructure, teaching capacity in school and clinical settings and clinical site environment were factors that commonly impede learning. Literature related to faculty development and deployment were limited.ConclusionSchools, faculty and clinical sites are overwhelmed yet recommendations by key stakeholders for change are substantive and complex. Efforts are needed to help schools map their current status by pre-service education domain and prioritize where scarce resources should be directed. These results can inform research and investments in pre-service midwifery education in sub-Saharan Africa.     

Reducing the risk of HIV transmission among men who have sex with men: A feasibility study of the motivational interviewing counseling method

HIV prevalence among Chinese men who have sex with men has rapidly increased in recent years. In this randomized, controlled study, we tested the feasibility and efficacy of motivational interviewing to reduce high‐risk sexual behaviors among this population in Changsha, China. Eighty men who have sex with men were randomly assigned to either the intervention group, in which participants received a three‐session motivational interviewing intervention over 4 weeks, or the control group, in which participants received usual counseling from peer educators. High‐risk behavior indicators and HIV knowledge level were evaluated at baseline and 3 months after the intervention. Motivational interviewing significantly improved consistent anal condom use. However, there was no significant change in consistent condom use for oral sex or in the number of sexual partners over time. HIV knowledge scores improved equally in both groups. This study demonstrated that an intervention using motivational interviewing is feasible and results in increased condom use during anal sex for Chinese men who have sex with men. However, further work must be done to increase the use of condoms during oral sexual encounters.     

微小RNAs在骨与软骨组织中的调节作用

目的对微小RNAs(microRNAs,miRNAs)在骨与软骨组织中的调控作用和作用机制作一综述。方法广泛查阅近年来有关miRNAs在骨与软骨组织的调控作用及作用机制的文献,进行总结与分析。结果 miRNAs是近年来骨关节疾病研究的热点,越来越多研究显示其在骨与软骨组织形成和代谢过程中,对于细胞分化、细胞基质分泌等方面发挥重要的调控作用,但确切机制尚不清楚。结论 通过对miRNAs在骨与软骨组织中的调控作用及作用机制的研究,可能为了解退行性骨关节疾病开辟新的领域。     

Notchl、P21^WAF1／Cip1及活化caspase3在肝细胞癌中表达的相关性

目的研究Notct／1、P21^WAF1／Cip1及活化caspase3在肝细胞癌中表达的相关性。方法利用免疫组织化学检测60例肝细胞癌（HCC）和15例正常肝组织中Notchl、P21^WAF1／Cip1及活化caspase3的表达。结果HCA2中Notch1、P21^WAF1／Cip1及活化caspase3的阳性率和阳性表达强度显著低于正常肝组织（P〈0．01）;Notch1、P21^WAF1／Cip1及活化caspase3的表达强度与HCC分级和肿瘤大小密切相关,肿瘤分化愈差和肿瘤直径愈大,3种蛋白表达愈弱（P〈0．01）;在HCC中,P21^WAF1／Cip1和活化caspase3的表达强度与Notch1表达强度呈显著正相关（r分别为0．76和0．71）。结论提示Notch1信号通路可能是通过影响细胞周期和细胞凋亡在HCA2发生发展过程中发挥负性调控作用。     

隔药饼灸对动脉粥样硬化兔肠道菌群的影响

目的 观察隔药饼灸对高胆固醇饮食诱导的动脉粥样硬化（AS）兔肠道菌群的影响,并探讨其可能的作用机制。方法 36只健康雄性纯种新西兰兔随机分为空白组、模型组、益生菌组和隔药饼灸组,每组9只。空白组予正常饲料喂养,模型组予高胆固醇饲料喂养,益生菌组予高胆固醇饲料+乳杆菌喂养,隔药饼灸组喂食高胆固醇饲料同时予隔药饼灸,取穴Ⅰ组为“巨阙”、双侧“天枢”“丰隆”,Ⅱ组为双侧“心俞”“肝俞”“脾俞”,2组穴位隔日交替施灸,连续8周。ELISA检测兔血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）含量,HE染色观察腹主动脉病理变化,16S rDNA测序分析肠道菌群多样性。结果 与空白组比较,模型组兔血清TC、TG、LDL-C含量显著增加（P<0.01）,腹主动脉内膜受损,可见明显脂质沉积及斑块;与模型组比较,益生菌组和隔药饼灸组兔血清TC、TG、LDL-C含量显著减少（P<0.01）,腹主动脉内膜结构损伤有不同程度改善。α多样性结果表明,隔药饼灸可调节AS兔肠道菌群丰富度与多样性;β多样性结果显示,隔药饼灸对肠道菌群具有良性调节作用;物种差异分析结果表明,隔药饼灸...