Unravelling the complexity of research capacity strengthening for health professionals in low- and middle-income countries: A concept analysis.

AIMS: Research capacity strengthening (RCS) is crucial in enhancing healthcare outcomes, particularly in low- and middle-income countries (LMICs), which face challenges due to limited resources, unequal access to care and the need for evidence-based decision-making. We seek to move beyond a surface-level understanding of RCS, unearthing the core attributes, the factors that precede its implementation and the transformative outcomes it generates within the LMIC healthcare landscape. DESIGN: This study employs the Walker and Avant approach to concept analysis to comprehensively explore the dimensions and attributes of RCS as it pertains to allied and public health professionals in LMICs, propose empirical referents and suggest an operational definition. DATA SOURCES: Ovid MEDLINE, Embase, CINAHL and Cochrane CENTRAL were searched from inception to 27 July 2023, to identify studies on RCS in LMICs. The Walker and Avant approach to concept analysis was selected because it provides a framework for systematically examining and clarifying the meaning and implications of RCS. This method involves a structured process of defining RCS, identifying its attributes, antecedents, consequences and cases, and ultimately providing a clear understanding of its meaning and implications. Identifying empirical referents offers measurable indicators that researchers and policymakers can use to assess the effectiveness of RCS initiatives in LMICs. CONCLUSION: RCS for health professionals in LMICs involves a sustainable process that equips them with essential research skills, fostering the ability to conduct high-quality research and improve healthcare delivery in resource-constrained settings. IMPLICATIONS: RCS aims to empower health professionals to apply evidence-based practices, reduce disparities and enhance the well-being of populations in LMICs. IMPACT: Ultimately, a concept analysis of RCS empowers us to harness the full potential of research to enhance healthcare delivery, improve patient outcomes and advance the well-being of populations worldwide.

Driving Cessation and Late-Life Depressive and Anxiety Symptoms: Findings from the National Health and Aging Trends Study.

OBJECTIVES: To describe the association between driving cessation and depressive and anxiety symptoms over time by assessing depression and anxiety at 1- and 4-years follow-up. METHODS: The study examined community-dwelling adults aged 65 years and older from the National Health and Aging Trends Study who were driving at the 2015 interview and completed 1-year (N = 4,182) and 4-year (N = 3,102) follow-up interviews. Outcomes were positive screens for depressive and anxiety symptoms in 2016 or 2019, and the primary independent variable was driving cessation within one year of the baseline interview. RESULTS: Adjusting for socio-demographic and clinical characteristics, driving cessation was associated with depressive symptoms at 1 year (OR = 2.25, 95% CI: 1.33-3.82) and 4-year follow-up (OR = 3.55, 95% CI: 1.72-7.29). Driving cessation was also associated with anxiety symptoms at 1 year (OR = 1.71, 95% CI: 1.05-2.79) and 4 year follow up (OR = 3.22, 95% CI: 1.04-9.99). CONCLUSIONS: Driving cessation was associated with an increased risk of developing depressive and anxiety symptoms in later life. However, reasons for this association remain unclear. CLINICAL IMPLICATIONS: Although the mechanism linking driving cessation with worse mental health symptoms is uncertain, driving facilitates many important activities. Clinicians should monitor the well-being of patients who stop or intend to stop driving.

Hospitalization's association with depression in adults over 50 years old: does living arrangement matter? Findings from the Health and Retirement Study.

OBJECTIVES: To examine how living arrangements are associated with depressive symptoms in late middle-life and older adults following hospitalization within the last two years. DESIGN: We used the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of adults over 50 years old living in the United States. METHODS: The dependent variable was whether HRS participants screened positive for having depressive symptoms. The primary independent variable was self-reported hospitalization in the prior two years. We stratified bivariate analyses and multivariate logistic regressions by living arrangement to examine hospitalizations' association with depressive symptoms. RESULTS: Depressive symptoms were less prevalent among participants who were married or partnered and living with a partner (14.0%) compared to those who were not married or partnered and were living with others (31.7%) and were not married or partnered and were living alone (27.8%). In multivariate analyses stratified by living arrangement, however, hospitalization was associated with depressive symptoms for those married or partnered and living with a partner (OR = 1.39, 95% CI: 1.14-1.69) but not for those who were not married and living with other(s) (OR = 0.88, 95% CI: 0.65-1.18) and not married or partnered and living alone (OR = 1.06, 95% CI: 0.82-1.36). CONCLUSIONS: Late middle-life and older adults residing with spouses or cohabitating appear at risk for having depressive symptoms following a hospitalization. A better understanding of how relationships and living arrangements may affect depression risk in the context of an acute medical illness is needed to identify points of intervention.

Nonsurgical Correction of Congenital Ear Deformities: The Relationship Between Age of Presentation and Regression.

PURPOSE: After 3 weeks of age, studies show ear molding to be unsuccessful due to increased regression rates. Studies have not differentiated success rates based on regression severity; partial regressions may be deemed successful and satisfactory by parents. We examined successful ear molding at different ages of presentation by measuring regression severity and parental satisfaction. METHODS: Patients who presented to [blinded for review] for ear molding from January 2017 to October 2018 were eligible for inclusion. Molds were applied on the initial visit and monitored biweekly. Treatment length was based on age, deformity type, and severity. One month after treatment completion, parents completed a satisfaction survey where they assessed regression on a 3-point severity scale. RESULTS: A total of 165 patients were included in this study. Sixty-seven were younger than 3 weeks of age and had an overall correction rate of 95%. The complete correction rate was 80% and only 5% saw complete regression. In the remaining 98, the overall correction rate was 94%, with a 63% complete correction rate. Only 6% saw complete regression. There was no statistical significance in parental satisfaction, perceived improvement, or likelihood to recommend ear molding between age groups. CONCLUSIONS: Regression rates are higher in children older than 3 weeks although not statistically significant. Most regressions were partial and ear molding still significantly corrected most deformities. We suggest that ear molding be offered past 3 weeks of age, with maximum age being dependent on deformity type, as it still leads to high parental satisfaction.

Conflict of Interest at Microsurgery Conferences: Disclosure of Its Extent and Nature.

BACKGROUND: Industry relationships and conflicts of interest can impact research funding, topics, and outcomes. Little research regarding the role of biomedical companies at microsurgery conferences is available. This study evaluates the role of industry at conferences by comparing payments received by speakers at the American Society for Reconstructive Microsurgeons (ASRM) meeting with those received by speakers at the American Society of Aesthetic Plastic Surgeons (ASAPS) meeting, the American Society of Plastic Surgeons (ASPS) meeting, and an average plastic surgeon. It also compares payments made by different companies. METHODS: General payments received by speakers at the 2017 ASAPS, ASPS, and ASRM conferences were collected from the Open Payments Database. Mean payments received at each conference were calculated and the Mann-Whitney U test evaluated differences between conference speakers and the average plastic surgeon. The total amount of payments from each company was collected through the Open Payments Database, and Z-tests identified which companies paid significantly more than others. RESULTS: The mean (and median) general payments made to conference speakers at ASAPS (n = 75), ASPS (n = 247), and ASRM (n = 121) were $75,577 ($861), $27,562 ($1,021), and $16,725 ($652), respectively. These payments were significantly greater (p < 0.001 for all) than those of the average plastic surgeon ($4,441 and $327), but not significantly different from each other. Allergan contributed significantly more than other companies to speakers at ASPS and ASAPS, while LifeCell Corporation, Zimmer Biomet Holdings, and Axogen contributed significantly more to speakers at ASRM. CONCLUSION: Payments to physicians at ASRM were significantly higher than those of an average plastic surgeon but not significantly different from those of speakers at ASAPS and ASPS. Certain companies paid significantly more than their peers at each conference. Given these findings, speakers should strive to make clear the nature and extent of their conflicts of interest when presenting at conferences.

Virtual Planning for Exchange Cranioplasty in Cranial Vault Remodeling.

ABSTRACT: The use of virtual surgical planning and computer-aided design/computer-aided manufacturing has gained popularity in the surgical correction of craniosynostosis. This study expands the use of virtual surgical planning and computer-aided design/computer-aided manufacturing in cranial vault reconstruction by using these methods to reconstruct the anterior vault using a single endocortically-plated unit constructed from the posterior calvarium. This technique was designed to reduce the risk of undesirable contour deformities that can occur when multiple bone grafts are used to reconstruct the anterior vault and fronto-orbital rim. Six patients were included in this study, all of which had nonsyndromic craniosynostosis. Excellent aesthetic outcomes were obtained in all patients, without complication. Additionally, the placement of a single reconstructive unit constructed from the posterior calvarium was efficient, aesthetically pleasing, and minimized postoperative contour deformities secondary to bone gaps, resorption, and often palpable resorbable plates.

Maximizing the Use of Scoring Systems in the Prediction of Outcomes in Acute Pancreatitis.

BACKGROUND/AIMS: No single classification system has so far effectively predicted the severity for Acute Pancreatitis (AP). This study compares the effectiveness of classification systems: Original Atlanta (OAC), Revised Atlanta (RAC), Determinant based classification (DBC), PANC 3, Harmless AP Score (HAPS), Japanese Severity Score (JSS), Symptoms Nutrition Necrosis Antibiotics and Pain (SNNAP), and Beside Index of Severity for AP (BISAP) in predicting outcomes in AP. METHODS: Scores for BISAP, Panc 3, HAPS, SNNAP, OAC, RAC, and DBC were calculated for 221 adult patients hospitalized for AP. Receiver Operating Characteristic curve analysis and Akaike Information Criteria were used to compare the effectiveness of predicting need for surgery, intensive care unit (ICU) admission, readmission within 30 days, and length of hospital stay. RESULTS: Both the RAC and the DBC strongly predict the length of hospital stay (p < 0.0001 for both) and ICU admission (p < 0.0001 for both). Additionally, both BISAP and PANC 3 showed weak predictive capacity at identifying length of stay and ICU admission. CONCLUSIONS: We suggest that BISAP and PANC3 be obtained within the initial 24 h of hospitalization to offer an early prediction of length of stay and ICU admission. Subsequently, RAC and DBC can offer further information later in the course of the disease.

Combined Surgery and Intraoperative Sclerotherapy for Vascular Malformations of the Head/Neck: The Hybrid Approach.

Vascular malformations (VMs) of the head and neck can lead to aesthetic problems as well as cranial nerve damage, airway compromise, and vision loss. Large VMs are typically managed surgically, with sclerotherapy or embolization performed in the perioperative period to decrease the risk of excessive blood loss and minimize the size of the VM. However, this initial treatment is frequently insufficient leading to excessive blood loss intraoperatively, poorer margin visualization for the surgeon, and decreased likelihood of complete resection. As a result, resections of large VMs are often performed in a multistage approach. This article introduces a new hybrid approach for the management of head and neck VMs entailing the use of an endovascular operating room where a neuroendovascular surgeon performs embolization or sclerotherapy intraoperatively as needed in conjunction with surgical excision. Three patients with large VMs in the facial region underwent successful use of the hybrid approach. The hybrid approach improved visualization, leading to complete resection in 1 patient and nearly complete resections (70% and 90%) in the other patients. The technique also helped minimize blood loss because only the youngest patient (23 months old) required a blood transfusion. Implications of these findings include the transition from a multistaged approach for large VMs to a single-stage approach. In addition, decreases in blood loss may allow for the development and use of minimal access techniques, leading to a decrease in visible scarring for patients. We suggest the consideration of the hybrid approach for large head and neck VMs.

Minimally Invasive Approach for Resection of Masseteric Vascular Malformations.

OBJECTIVE: Vascular malformations (VMs) in the head and neck region often cause esthetic as well as functional problems for patients. Intramuscular VMs (IVM), such as those in the masseter, can cause severe facial asymmetry and typically are excised transcutaneously to facilitate wide exposure and safe dissection from the facial nerve. This requires extensive dissection, prolonged healing, and can lead to suboptimal facial scarring. METHODS: We describe the technique of resecting large IVMs of the masseter muscle in 3 patients using an entirely intraoral approach with continuous nerve monitoring and without visible facial scarring or secondary deformity. Preoperative injection of sclerotherapy was performed to reduce intra-operative bleeding and optimize resection. RESULTS: Successful excision was performed without complication in 3 patients to date. Total average operating room time was 120 minutes (range 95-145 minutes). Estimated blood loss was 213 mL (range 180-240 mL). The patients were discharged home either post-operative day (POD) 1 or 2, with 1 returning to work POD 4. Facial nerve function was normal postoperatively and no hematomas developed. Subjective masticatory function was equivalent to preoperative levels in all patients. CONCLUSIONS: Intraoral excision of VMs of the masseter muscle can be safely performed without added risk or complication. Continuous facial nerve monitoring allows minimally invasive approaches to be considered with less risk of iatrogenic facial nerve injury. We purport that this is a safe and effective method with substantially better esthetic outcomes compared with traditional transcutaneous approaches.

Leveraging genomic load estimates to optimize captive breeding programmes.

Rapid biodiversity loss threatens many species with extinction. Captive populations of species of conservation concern (such as those housed in zoos and dedicated breeding centres) act as an insurance should wild populations go extinct or need supplemental individuals to boost populations. Limited resources mean that captive populations are almost always small and started from few founding individuals. As a result, captive populations require careful management to minimize negative genetic impacts, with decisions about which individuals to breed together often guided by the principle of minimizing relatedness. Typically this strategy aims to retain 90% of genetic diversity over 200 years (Soulé et al., Zoo Biology, 1986, 5, 101), but it has a weakness in that it does not directly manage for genetic load. In this issue of Molecular Ecology Resources, Speak et al. (Molecular Ecology Resources, 2024, e13967) present a novel proof-of-concept study for taking this next step and incorporating estimates of individual genetic load into the planning of captive breeding, using an approach that is likely to be widely applicable to many captive populations.

Partnering to Improve Mentorship Capacity for Ugandan Reproductive Health Researchers: Program Description and Evaluation.

Mentorship is essential to health researchers in achieving their full potential and advancing public health. In most low-resource settings, there is a paucity of training on how to be a successful mentor. The Center for International Reproductive Health Training at the University of Michigan conducted and evaluated a workshop at two universities in Uganda for mentors of new reproductive health research grant awardees. The program aimed to strengthen mentors' mentorship skills and to identify ways to foster institutional support for mentoring. Mentors rated their post-training skills using a 5-point Likert scale (not skilled to extremely skilled) immediately and 3 months after the training. Ten of 19 mentors who participated in the training completed the evaluation. The majority were 41 to 50 years old, male, midcareer faculty. Immediately after the training, mentors rated themselves (mean ± SD) highest in knowledge of research ethics (4.4 ± 0.5), fostering independence in mentees (4.3 ± 0.9), and understanding the benefits of mentoring (3.9 ± 1.1). Mentors felt least confident in fostering institutional change to support mentorship (3.3 ± 0.8), communication (3.5 ± 0.5), and overcoming adversity (3.5 ± 0.8). The two most important things the mentors learned were how to appreciate and manage diversity and how they can benefit from mentorship. Barriers to mentoring that persisted after the program ended included lack of time and institutional resources. Enhancing mentorship training opportunities will foster a generation of scientists who are more supported, skilled, and productive in research, leading to better reproductive and public health outcomes in their communities.

A scoping review of qualitative studies on sexual and reproductive health and rights in Uganda: Exploring factors at multiple levels.

BACKGROUND: Uganda is burdened by high unintended and teen pregnancies, high sexually transmitted infections, and harm caused by unsafe abortion. OBJECTIVES: Explore factors influencing sexual and reproductive health and rights (SRHR) in Uganda by synthesizing evidence from qualitative studies using a scoping review. ELIGIBILITY CRITERIA: Original qualitative peer-reviewed research studies published between 2002 and 2023 in any language exploring factors influencing SRHR in Uganda. SOURCES OF EVIDENCE: Eight databases searched using qualitative/mixed methods search filters and no language limits. CHARTING METHODS: Information extracted included author, article title, publication year, study aims, participant description, data collection type, sample size, main findings, factors at the individual, interpersonal, community, and policy levels, implications for SRHR in Uganda, and study limitations. Quality of the selected articles was assessed using the Critical Appraisal Skills Programme tool. RESULTS: One hundred seventy-three studies met inclusion criteria. At the individual level, knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were identified as critical factors influencing health outcomes. Interpersonal factors included communication with sexual partners and relationships with family, school, and community members. Healthcare organization factors included adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors included gendered norms and male involvement in SRHR. Policy-level factors included the importance of aligning policy and practice. CONCLUSIONS: Multiple factors at individual, interpersonal, community, healthcare, cultural, and policy levels were found to influence SRHR in Uganda. The findings suggest that interventions targeting multiple levels of the socio-ecological system may be necessary to improve SRHR outcomes. This review highlights the need for a holistic approach that considers the broader socio-ecological context. Reducing identified gaps in the literature, particularly between policy and practice related to SRHR, is urgently needed in Uganda. We hope this review will inform the development of policies and interventions to improve SRHR outcomes.

A scoping review of qualitative studies on sexual and reproductive health and rights in UgandaIn Uganda, there are significant challenges regarding sexual and reproductive health and rights (SRHR), including high rates of unintended and teen pregnancies, sexually transmitted infections, and unsafe abortions. To better understand these issues, we conducted a comprehensive review of qualitative studies published between 2002 and 2023. Our analysis identified 173 studies that revealed various factors influencing SRHR in Uganda across different levels. At the individual level, factors such as knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were found to significantly impact health outcomes. Interpersonal relationships also played a crucial role, with communication with sexual partners and relationships with family, school, and community members being identified as important influences. Furthermore, the organization of healthcare services was found to be vital, particularly regarding adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors, including gender norms and the involvement of males in SRHR, were noted as significant contributors to SRHR outcomes. Additionally, the alignment of policy and practice was emphasized as essential for improving SRHR outcomes in Uganda. Overall, the review concluded that addressing SRHR challenges in Uganda requires interventions that target multiple levels of the socio-ecological system. A holistic approach considering individual, interpersonal, community, healthcare, cultural, and policy factors is necessary. There is an urgent need to bridge gaps between policy and practice related to SRHR. Findings could inform the development of policies and interventions aimed at improving SRHR outcomes in Uganda.

Fatty links between multisystem proteinopathy and small VCP-interacting protein.

Multisystem proteinopathy (MSP) is a rare, dominantly inherited disorder that includes a cluster of diseases, including frontotemporal dementia, inclusion body myopathy, and Paget's disease of bone. MSP is caused by mutations in the gene encoding valosin-containing protein (VCP). Patients with the same mutation, even within the same family, can present with a different combination of any or all of the above diseases, along with amyotrophic lateral sclerosis (ALS). The pleiotropic effects may be linked to the greater than 50 VCP co-factors that direct VCP's many roles in the cell. Small VCP-interacting protein (SVIP) is a small protein that directs VCP to autophagosomes and lysosomes. We found that SVIP directs VCP localization to lysosomes in an acylation-dependent manner. We demonstrate that SVIP is myristoylated at Glycine 2 and palmitoylated at Cysteines 4 and 7. Acylation of SVIP is required to mediate cell death in the presence of the MSP-associated VCP variant (R155H-VCP), whereas blocking SVIP myristoylation prevents cytotoxicity. Therefore, SVIP acylation may present a novel target in MSP.

Scoping review of qualitative studies on family planning in Uganda.

Family planning (FP) is an essential component of public health programs and significantly impacts maternal and child health outcomes. In Uganda, there is a need for a comprehensive review of the existing literature on FP to inform future research and programmatic efforts. This scoping review aims to identify factors shaping the use of FP in Uganda. We conducted a systematic search of eight scholarly databases, for qualitative studies on FP in Uganda. We screened the titles and abstracts of identified articles published between 2002-2023 and assessed their eligibility based on predefined criteria. We extracted data from the 71 eligible studies and synthesized the findings using thematic analysis and the Ecological Systems Theory (EST) individual, interpersonal, community, institutional, and policy-level determinants. Findings reveal the interplay of factors at different socio-ecological levels influencing family planning decisions. At the individual level, the most common determinants related to the EST were knowledge and attitudes of FP. Interpersonal dynamics, including partner communication and social support networks, played pivotal roles. Community-level factors, such as cultural norms and accessibility of services, significantly influenced family planning practices. Institutional and policy-level factors, particularly a healthcare system's quality and policies, also shaped use. Other themes included the intersection of HIV/AIDS on FP practice and Ugandan views of comprehensive abortion care. This scoping review underscores the intricate socio-ecological fabric shaping FP in Uganda. The findings highlight the need for targeted interventions to increase knowledge and awareness of FP, improve access to services, and address social and cultural norms that discourage contraceptive use. Policymakers and program implementers should also consider gender dynamics and power imbalances in FP programs to ensure they are equitable and effective.

Sexual and reproductive health research capacity strengthening programs in low- and middle-income countries: A scoping review.

Sexual and reproductive health (SRH) research capacity strengthening (RCS) programs in low- and middle-income countries (LMICs) are needed to foster the discovery of context-specific solutions to improve patient outcomes and population health. There remains a limited understanding of SRH research strengthening programs to raise skill sets, publications, and infrastructure and ultimately influence health policy and patient outcomes in LMICs. More information is needed to understand how SRH research is sustained after program completion. To inform efforts to implement programs that strengthen SRH research and foster sustainability, we conducted a scoping review to identify and synthesize strategies used in SRH research strengthening programs in LMICs. A literature search of nine scholarly databases was conducted. We synthesized data extracted from included articles and presented results highlighting the format, duration, and topics covered of program interventions to strengthen SRH research in LMICs. We organized information about primary outcomes into themes and summarized how SRH research capacity was sustained after program completion. Twenty-four articles were included in the scoping review. The articles generally focused on outcomes within the themes of advocacy/capacity, education, policy, project life cycle, and writing/publication. Few articles reported metrics or other evidence of long-term program sustainability of SRH RCS projects in LMICs. Results from this scoping review can be used to strengthen SRH research programs in LMICs. More energy must be directed toward correcting power imbalances in capacity strengthening initiatives. To address additional gaps, future directions for research should include an exploration of SRH research mentorship, the cost of SRH RCS interventions, and how to foster institutional support.

Strengthening healthcare delivery in Rwanda: Implementation science training for reproductive health researchers.

BACKGROUND: Addressing the gap between research and practice is crucial for enhancing reproductive healthcare outcomes. In Rwanda and other low- and middle-income countries, bolstering health researchers' implementation science (IS) capacity is essential. We present a pre-post-intervention study assessing the influence of an intensive IS training program on Rwandan reproductive health researchers' perceived IS knowledge and self-efficacy in applying IS in their own research. METHODS: To introduce IS principles, we held a one-day training for a diverse cohort of 25 sexual and reproductive health researchers in Rwanda. The training encompassed modules on IS concepts, methodologies, and practical applications. Pre- and post-training assessments gauged changes in participants' perceived IS knowledge and self-efficacy in applying IS in their own work. RESULTS: The study revealed a significant improvement in self-efficacy related to performing IS related tasks. Researchers reported heightened confidence in designing and implementing evidence-based interventions. In terms of perceived knowledge, participants retained what they learned at 4 months. The training fostered a collaborative learning environment, encouraging participants to exchange ideas and experiences. CONCLUSION: Targeted training in IS appears to enhance reproductive health researchers' capacity to translate research into practice, potentially leading to improved healthcare outcomes in Rwanda. Moving forward, we advocate for the Ministry of Health to establish structures for IS research agenda-setting, particularly for sexual and reproductive health and rights. Ideally, universities, health systems, and research institutions will incorporate IS capacity strengthening into their routine activities. Ongoing training is crucial to reinforce and expand IS knowledge. Our findings are expected to inform future interventions and guide policy development.

Predicting Memory Score Using Paralinguistic Features.

An automated method of assessing short term memory can act as a dementia risk predictor, as poor short-term memory is strongly linked to early signs of dementia. While previous works show the feasibility of using speech to predict healthy and diagnosed dementia participants, there are still gaps in predicting 'dementia risk' and clear difficulties distinguishing early dementia with regular ageing. We extracted paralinguistic features from audio of individuals completing an over the phone episodic memory test, LOGOS. These paralinguistic features were used to discriminate between those with strong and poor short term memory performance. This work also explored various feature selection methods and tested this method across multiple datasets. Our best result was achieved using a Support Vector Machine (SVM) classifier, obtaining accuracy of 84% per audio recording.Clinical relevance- This work establishes the efficacy of using speech from older participants completing the LOGOS episodic memory test to estimate risk of dementia.

Development of a whole-cell biosensor for ß-lactamase inhibitor discovery.

The production of ß-lactamases by bacterial pathogens endangers antimicrobial therapy, and new inhibitors for ß-lactamases are urgently needed. We report the development of a luminescent-based biosensor that quantifies ß-lactamase inhibition in a cellular context, based on the activation of transcriptional factor AmpR following the exposure of bacterial cells to ß-lactams. This rapid method can account for factors like membrane permeability and can be employed to identify new ß-lactamase inhibitors.

Scoping review of qualitative studies investigating reproductive health knowledge, attitudes, and practices among men and women across Rwanda.

BACKGROUND: Research efforts in Rwanda to improve sexual and reproductive health and rights (SRHR) are increasing; however, comprehensive literature reviews on SRHR are limited. This scoping review examines individual and contextual factors shaping knowledge, attitudes, and practices in the domains of: 1) family planning, 2) abortion care, and 3) other SRHR in Rwanda. Recognizing that individual, community, and societal factors influence RH, this review is guided by Bronfenbrenner's Ecological Systems Theory. METHODS: Eligible studies were conducted in Rwanda, included males and/or females of any age, and were published within the past 20 years. Studies reporting views of only healthcare or other professionals were excluded. RESULTS: Thirty-six studies were included. The majority addressed individual and contextual considerations. At the individual level, studies explored knowledge about SRHR problems while at the interpersonal level, the support and attitudes of men and community members for adolescent SRHR were investigated. In terms of healthcare organization, maternal health practices, increased access to family planning programs, and the need for sexually transmitted infection programs was explored. At the social and cultural level, researchers investigated beliefs and traditional gender roles. Regarding public health policy, studies mentioned promoting and increasing funding for SRHR and reducing gender inequities. CONCLUSION: Our findings can inform SRHR research programs, public health campaigns, and policy advances in Rwanda.

A Randomized Control Trial to Test Dissemination of an Online Suicide Prevention Training For Intimate Partner Violence Hotline Workers.

Purpose: Suicide risk is higher among violence-involved individuals. Intimate Partner Violence hotline workers are a critical source of support and can potentially be suicide prevention champions. Our primary goal was to examine the effectiveness of disseminating a free, online IPV-Suicide Prevention curriculum, via a randomized control trial, to hotline workers in ten states with the highest suicide and IPV homicide rates. Method: We divided the country into five regions and, based on criterion, chose two states in each region to randomize into the two arms of the study. We examined training participation and engagement between the two approaches: (1) 'dissemination as usual' (control) using a National Domestic Violence Hotline email and a postcard to state/county IPV directors, versus (2) 'enhanced dissemination' (intervention) using a four-point touch method (postcard, phone call, email, and letter) to 'drive' participation. Results: Participation increased in the intervention arm as approaches became more personal (i.e., email and phone calls vs. letters). Results indicate that traditional dissemination strategies such as email announcements and invitations are not as effective as varied and multiple touchpoints for IPV hotline staff. Conclusion: Successful dissemination strategies to promote digital training should consider the value added by personalized connection. Future research is needed to understand how to offer effective and efficient web-based training to those providing IPV and child abuse services.