Community-based situation analysis of maternal and neonatal care in South Africa to explore factors that impact utilization of maternal health services

This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies of women with no antenatal care and/or home birth, and verbal/social autopsies of maternal and infant deaths, conducted in three diverse sites across the country. Data analysis used quantitative statistics for the semistructured interviews and a qualitative thematic content approach for the case studies and verbal/social autopsies. Each component was analyzed separately and then triangulated. The following themes emerged: 1) transport and distance to care were the biggest problems, particularly in rural areas; 2) providers' communication with families was very poor; 3) health-seeking behavior was better than anticipated; 4) treatment by health providers and quality of care showed mixed results; 5) HIV/AIDS is a major issue; however, basic maternity and neonatal service quality cannot be overlooked; and 6) families and communities are an untapped resource for improving maternal and neonatal health. Implications for maternal and infant health care in developing countries are discussed, with a particular focus on barriers to utilization and involvement of communities and families in maternity care.     

Traumatic Events and HIV Sexual Risk Behaviors Among Migrant and Non-Migrant Male Market Workers in Central Asia

We examined potentially traumatic events (PTEs) and the relationship between PTEs and HIV risk behaviors among male market workers in Kazakhstan, comparing Kazakhstani to external migrants. Using respondent-driven sampling, participants were 1342 male marketplace workers in Almaty, Kazakhstan. Univariate, bivariate, and logistic regressions were conducted. We found high prevalence of PTEs among participants, and significant differences between PTEs and HIV risk by migrant status. Kazakhstanis reporting 1–2 or three-or-more traumatic events were more likely to report engaging in sex trading, compared to Kazakhstanis who reported no PTEs (OR = 3.65, CI 1.20–11.11, p = 0.022; OR = 8.17, 95% CI 2.66–25.09, p = 0.000, respectively). Kazakhstanis who reported three-or-more PTEs were more likely to report unprotected sex (OR = 2.17, CI 2.17–3.89, p = 0.009). Results did not support this relationship among external migrants. Findings underscore the need for attention on services that address trauma and HIV risk among this population and more research to understand differences by migrant status.     

Aggregation-induced polarization (AIP) of derivatives of BINOL and BINAP

The relationship between optical rotations of small chiral molecules with water% in THF has been established. The typical aggregation co-solvent systems resulted in optical rotation amplification and adjustment, defined as aggregation-induced polarization (AIP). The AIP work can serve as a new tool to determine molecular aggregation, especially for those that cannot display aggregation-induced emission (AIE). Therefore, AIP and AIE are anticipated to complement each other. In addition, AIP can also serve as a new transmission tool providing adjusting right- or left-hand polarized lights of a series of individual wavelengths. Since chiral phosphine derivatives are among the most important ligands, this work would benefit research using chiral aggregates to control asymmetric synthesis and catalysts. Therefore, it will find many applications in chemical and materials sciences.

The relationship between optical rotations of derivatives of BINOL and BINAP with water% in THF has been established resulting in optical rotation amplification and adjustment, defined as aggregation-induced polarization (AIP).     

Preventing Infectious Complications of Immunomodulation in COVID-19 in Foreign-Born Patients

Journal of Immigrant and Minority Health - Immunomodulating therapies for COVID-19 may carry risks of reactivating latent infections in foreign-born people. We conducted a rapid review of...     

The challenges of promoting osteogenesis in segmental bone defects and osteoporosis

Conventional clinical management of complex bone healing scenarios continues to result in 5–10% of fractures forming non‐unions. Additionally, the aging population and prevalence of osteoporosis‐related fractures necessitate the further exploration of novel ways to augment osteogenesis in this special population. This review focuses on the current clinical modalities available, and the ongoing clinical and pre‐clinical research to promote osteogenesis in segmental bone defects, delayed unions, and osteoporosis. In summary, animal models of fracture repair are often small animals as historically significant large animal models, like the dog, continue to gain favor as companion animals. Small rodents have well‐documented limitations in comparing to fracture repair in humans, and few similarities exist. Study design, number of studies, and availability of funding continue to limit large animal studies. Osteoinduction with rhBMP‐2 results in robust bone formation, although long‐term quality is scrutinized due to poor bone mineral quality. PTH 1‐34 is the only FDA approved osteo‐anabolic treatment to prevent osteoporotic fractures. Limited to 2 years of clinical use, PTH 1‐34 has further been plagued by dose‐related ambiguities and inconsistent results when applied to pathologic fractures in systematic human clinical studies. There is limited animal data of PTH 1‐34 applied locally to bone defects. Gene therapy continues to gain popularity among researchers to augment bone healing. Non‐integrating viral vectors and targeted apoptosis of genetically modified therapeutic cells is an ongoing area of research. Finally, progenitor cell therapies and the content variation of patient‐side treatments (e.g., PRP and BMAC) are being studied. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1559–1572, 2018.     

Preferences, Beliefs, and Self-Management of Diabetes

Objective. To assess relationships between self-assessed control over life events, subjective beliefs about longevity, time and risk preference, and other factors on use of recommended care for diabetes mellitus (DM), self-assessed control of diabetes, general health, and laboratory measures of HbA1c levels.
Data Sources. Health and Retirement Study (HRS) and 2003 HRS Diabetes Study (HRS-DS).
Study Design. We used logit and ordered logit analyses to assess use of recommended care, and subjective and objective measures of health outcomes.
Data Collection. Secondary analysis of HRS and HRS-DS data.
Principal Findings. Individuals with higher self-assessed control over life events and higher subjective probabilities of living 10 years engaged in more recommended DM care practices and had better self-assessed DM control and general health. However, these beliefs did not influence HbA1c levels. More highly educated and cognitively able persons were more likely to follow care recommendations. There were differences by race/ethnicity in health outcomes, but not in health investment among Hispanics.
Conclusions. Individuals' beliefs about control over life events and longevity influenced health investment and subjective health outcomes, although these beliefs did not translate into differences in HbA1c levels. Hispanics may realize lower returns on health investments, at least for diabetes care.