Experiences of care-seeking behaviour for sexually transmitted infections among gay and bisexual men: A phenomenological study.

Gay and bisexual men (GBM) are stigmatized in the Ghanaian society and that negatively affect their care-seeking behaviour. We sought to understand the experiences of care-seeking behaviour (CSB) for STIs among gay and bisexual men in Sunyani, capital of Bono Region, Ghana. A respondent-driven sampling was used to collect data from 17 gay and bisexual men in Sunyani based on phenomenological qualitative approach. The data were thematically analysed using the Atlas.ti software. Results were presented under various themes with appropriate accompanying excerpts. Two broad themes emerged from the data - personal and health system experiences of treating STIs. Personal experiences such as economic conditions, knowledge on STI, marital experiences and bisexual's partner awareness of sexual orientation had influences on CSB. Experience with cost of treatment, stigmatisation by health care workers (HCW) and perceived quality healthcare were the health system factors found to influence CSB. To help improve STIs care-seeking behaviour, government need to encourage and economically empower GBM, while at the same time, improving their knowledge on STI prevention and control. The National Health Authority should intensify and monitor the implementation of the national health insurance at the private healthcare sectors without favour and discrimination for gay and bisexual men.

Global gene expression changes reflecting pleiotropic effects of Irpex lacteus induced by low--intensity electromagnetic field.

A polysaccharide of Irpex lacteus, a white-rot fungus with lignocellulose-degrading activities, has been used as a commercial medicine for nephritis treatment. Previously, a low-intensity electromagnetic field (LI-EMF) was found to increase the biomass and polysaccharide content of Irpex lacteus and induce twists on the cell surface. In this study, RNA-sequencing (RNA-seq) technology was used to analyze the underlying mechanism of LI-EMF's influence on Irpex lacteus. We identified 3268, 1377, and 941 differentially expressed genes (DEGs) in the LI-EMF-treated samples at recovery times of 0 h, 3 h, and 6 h, respectively, indicating a significant decline in the influence of the LI-EMF treatment on Irpex lacteus with the passage of recovery time. Moreover, 30 upregulated and 14 downregulated DEGs overlapped in the LI-EMF-treated samples at the recovery times of 0 h, 3 h, and 6 h, implying the important lasting effects of LI-EMF. The reliability of the RNA-seq data were validated by quantitative real-time PCR (qRT-PCR). The DEGs related to transcription factors, cell proliferation, cell wall, membrane components, amino acid biosynthesis and metabolism, and polysaccharide biosynthesis and metabolism were significantly enriched in the LI-EMF-treated samples. The experiments confirmed that the LI-EMF treatment significantly increased the content of amino acids with a considerable increase in the content of essential amino acids. Therefore, the global gene expression changes explained the pleiotropic effects of Irpex lacteus induced by the LI-EMF treatment. These findings provide the requisite data for the appropriate design and application of LI-EMF in the fermentation of microorganisms to increase production. Bioelectromagnetics. 40:104-117, 2019. © 2019 Bioelectromagnetics Society.

Impact of occupational health coaching on irrational career beliefs and workplace deviant behaviors among school employees: Implications for Educational administrative policy.

BACKGROUND: Workplace-disruptive behavior is an important public and organizational health issue that calls for public discourse. The high rates in Nigeria and its associated career illogical assumptions among teachers brought about this study to investigate the impact of rational emotive occupational health coaching (REOHC) on irrational career beliefs and workplace deviant behaviors in a sample of Nigerian primary school teachers. METHODS: A sample of 128 primary school teachers in Nigeria was recruited as participants. They were assigned to REOHC and control groups. Work deviance behavior scale and teacher irrational belief scale were used to assess the participants at 3 points. A pretest-post-test and follow-up design was used in this study. RESULTS: The findings indicated that the REOHC program significantly reduced work-deviant behaviors and irrational career beliefs among primary school teachers. The outcome also demonstrates the connection between groups and gender. CONCLUSION: This study concluded that primary school teachers' work-related deviant behaviors and illogical beliefs were reduced as a result of the REOHC treatment. Therefore, occupational therapists should help teachers with deviant behaviors and irrational beliefs to change using rational emotive behavioral techniques.

A 22-Year Study to Assess Disparities in Place of Death Among Patients With Diabetes.

Background This study examines disparities in the place of death in patients in the United States with diabetes mellitus (DM) using data from the CDC WONDER (Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research) database covering a 22-year period (1999-2020). Looking at age, gender, ethnicity, and census location, among other variables, the study aims to understand trends and determinants of mortality at home or hospice care compared to mortality at a medical or nursing facilities. Materials and methods An online freely accessible mortality database, CDC WONDER database, was used to collect information regarding DM-related mortality, using the International Classification of Diseases, 11th Revision (ICD-11) code range E10-E14. To investigate patterns in location of death, the research population was split by census regions, racial categories, age groups, and gender. Statistical techniques such as univariate logistic regression and graphical representations were employed. Results Based on a study of 1,674,724 DM-related deaths, medical or nursing facilities recorded higher deaths (1,041,602) compared to home or hospice deaths (572,567). The highest number of deaths in home or hospice setting was recorded for the age group of 75-84 years (146,820), male gender (324,325), Census Region 3 (South) (225,636), and white race (458,690). Among the patients with death at home or a hospice center; the odds were highest for the age group of 55-64 years, male gender, Census Region 4 (West), and American Indian or Alaska Native race. Discussion The results showed a general upward trend in DM patients' deaths at home and in hospice care in the United States. Males, white people, and those in the age group of 75-84 years notably had the highest death rates. Regional differences also came into play, with the South showing the biggest trend in mortality. To better understand the underlying causes of these changes and to increase at-risk groups' access to healthcare facilities, more research is required. Conclusion There is an overall rising trend in home and hospice deaths in the United States for patients with DM, but with a steady dip between the years 2005 and 2010. Patient deaths from DM were categorized by age groups, gender, race, and census regions. The highest mortality trends are exhibited in whites, males, and those aged 75-84 years. Out of the census regions, the South has the highest mortality trend. Further studies could be carried out to determine the reasons for the rising trends in home or hospice deaths in the aforementioned groups and how to provide these groups with better access to healthcare facilities.

Health and Environmental Risks of Residents Living Close to a Landfill: A Case Study of Thohoyandou Landfill, Limpopo Province, South Africa.

The by-products of solid waste deposited in a landfill has adverse effects on the surrounding environment and humans living closer to landfill sites. This study sought to test the hypothesis that the deposition of waste on landfill has an impact on the surrounding environment and residents living closer to it. This was achieved by evaluating the perception of the respondents drawn from people living close (100-500 m) and far (1-2 km) from the landfill site, concerning environmental issues, health problems, and life satisfaction. Results from the study showed that 78% of participants living closer to the landfill site indicated serious contamination of air quality evident from bad odours linked to the landfill site. Illnesses such as flu, eye irritation and weakness of the body were frequently reported by participants living closer to the landfill than those living far from the landfill. More than half of the participants (56%) living closer to the landfill indicated fear of their health in the future. Thus, the participants living closer to the landfill site were less satisfied with the location of their community with respect to the landfill, than those living far from the landfill site. Therefore, the need for a landfill gas (LFG) utilisation system, proper daily covering of waste and odour diluting agents are necessary to reduce the problems of the residents living closer to the landfill site.

Novel role for IL-22 in protection during chronic Mycobacterium tuberculosis HN878 infection.

Approximately 2 billion people are infected with Mycobacterium tuberculosis (Mtb), resulting in 1.4 million deaths every year. Among Mtb-infected individuals, clinical isolates belonging to the W-Beijing lineage are increasingly prevalent, associated with drug resistance, and cause severe disease immunopathology in animal models. Therefore, it is exceedingly important to identify the immune mechanisms that mediate protection against rapidly emerging Mtb strains, such as W-Beijing lineage. IL-22 is a member of the IL-10 family of cytokines with both protective and pathological functions at mucosal surfaces. Thus far, collective data show that IL-22 deficient mice are not more susceptible to aerosolized infection with less virulent Mtb strains. Thus, in this study we addressed the functional role for the IL-22 pathway in immunity to emerging Mtb isolates, using W-Beijing lineage member, Mtb HN878 as a prototype. We show that Mtb HN878 stimulates IL-22 production in TLR2 dependent manner and IL-22 mediates protective immunity during chronic stages of Mtb HN878 infection in mice. Interestingly, IL-22-dependent pathways in both epithelial cells and macrophages mediate protective mechanisms for Mtb HN878 control. Thus, our results project a new protective role for IL-22 in emerging Mtb infections.

Quality of care in women's, children's, and adolescent health. Methods for assessing evaluation and implementation in West Africa. Experience in the Côte d'Ivoire.

A tool developed by WHO was used to assess the quality of care for mothers, newborns, and children in some healthcare facilities in French-speaking Africa; this study led to the development of recommendations for the implementation of actions intended to resolve the problems observed and to optimize patient management. We report here the experience of the maternity units of the university hospital center of Treichville, in Abidjan, discuss the presentation of the results of the assessment, and make some recommendations as part of an action program. The experience of the monthly review of referred cases is also reported.

Polyomavirus disease under new immunosuppressive drugs: a cause of renal graft dysfunction and graft loss.

BACKGROUND: Manifest polyomavirus (PV) renal graft infection is a rare complication. We diagnosed 5 cases among 70 kidney recipients undergoing transplants since December 1995; however, there were no cases at our institution before December 1995. METHOD: To identify risk factors promoting manifest PV graft infection, we compared those 5 patients with kidney recipients who had signs of PV replication but no manifest graft infection (n=23, control group). PV replication was judged by the presence of intranuclear inclusion cells in the urine. RESULTS: Before the infection, five of five patients had recurrent rejection episodes. All were switched from cyclosporine A to high dose tacrolimus as rescue therapy. Infection was diagnosed histologically 9+/-2 months posttransplantation; it persisted and led to graft loss in four of five patients. In control patients, graft function was stable, 1 of 23 patients were switched to tacrolimus as rescue therapy, and graft loss occurred in 4 of 23 patients. CONCLUSION: Recurrent rejection episodes and high dose immunosuppressive therapy, including tacrolimus, are risk factors for manifest PV kidney graft infection, which has an ominous prognosis.

A comparison of the genetic activity of pyrvinium pamoate with that of several other anthelmintic drugs in Saccharomyces cerevisiae.

Several anthelmintic drugs that are used routinely in oxyuriasis therapy were analyzed for genotoxicity in a diploid mitotic recombination and gene conversion assay (strain D5 of Saccharomyces cerevisiae), and in a haploid yeast reversion assay (strain XV185-14C). Piperazine citrate, piperazine adipate, mebendazole and thiabendazole did not appear to be genotoxic in either yeast strain. Pyrvinium pamoate induced the reversion of the missense, nonsense and frameshift alleles in strain XV185-14C, whereas pyrantel pamoate induced only the reversion of the frameshift allele. Pyrvinium pamoate was recombinogenic in strain D5, and there is an indication that pyrantel pamoate, at the lowest dose that was tested, might induce gene conversion or aneuploidy.

Speciation of selenium dietary supplements; formation of S-(methylseleno)cysteine and other selenium compounds.

Speciation of selenium is of interest because it is both essential and toxic to humans, depending on the species and the amount ingested. Following indications that selenium supplementation could reduce the incidence of some cancers, selenium-enriched yeast and other materials have been commercialized as supplements. Most dramatically however, the SELECT trial that utilized l-selenomethionine as the active supplement was terminated in 2008 and there is much debate regarding both the planning and the results of efficacy studies. Further, since dietary supplements are not regulated as pharmaceuticals, there are concerns about the quality, storage conditions, stability and selenium content in selenium supplements. Enzymatic hydrolysis enabled selenium speciation profiles to be obtained by high performance liquid chromatography with inductively coupled plasma mass spectrometry (HPLC-ICP-MS) and following derivatization gas chromatography with atomic emission detection (GC-AED). Coated fiber solid phase microextraction (SPME) was used to extract volatile selenium species for determination by GC-AED and GC-MS. Similar speciation patterns were observed between yeast-based supplements subject to extended storage and those heated briefly at elevated temperatures. All the yeast-based supplements and one yeast-free supplement formed S-(methylseleno)cysteine on heating. Evidence was obtained in support of the hypotheses that S-(methylseleno)cysteine is formed from a reaction between dimethyldiselenide and cysteine or cystine.

BK-virus nephropathy in renal transplants-tubular necrosis, MHC-class II expression and rejection in a puzzling game.

We review BK-virus nephropathy (BKN) as a new complication that increasingly affects renal allografts and causes dysfunction. Since starting in 1996, we have seen 11 cases. Currently, the prevalence of BKN is 3% in our graft biopsies. The diagnosis can only be made histologically. The virus affects tubular epithelial cells that show characteristic intranuclear inclusion bodies. The major reason for impaired graft function and a possible way for viral particles to gain access to the blood via peritubular capillaries is necrosis of infected epithelial cells. BK-virus DNA in the plasma, which can be detected by PCR, is closely associated with nephropathy. BK-virus does not stimulate tubular MHC-class II expression as judged by immunofluorescence double labelling. The inflammatory response is inconsistent and the frequency of rejection episodes is not increased during disease. Clinical manifestation of viral nephropathy evolves in several stages. (i) Initial, asymptomatic and reversible activation of the virus, judged by the presence of inclusion bearing cells in the urine. (ii) High dose immunosuppressive drug regimens, often including tacrolimus. (iii) Tubular injury and viraemia as additional promoting conditions. BKN nephropathy was associated with graft loss in 45% of our patients. The remaining patients with persistent viral nephropathy showed renal dysfunction (serum creatinine levels on average 150% above baseline readings). Currently, no established antiviral therapy is available. We discuss attempts to lower immunosuppression as a means to control viral replication. We propose a diagnostic algorithm for screening and monitoring the disease.

Polyomavirus infection of renal allograft recipients: from latent infection to manifest disease.

Polyomavirus (PV) exceptionally causes a morphologically manifest renal allograft infection. Five such cases were encountered in this study, and were followed between 40 and 330 d during persistent PV renal allograft infection. Transplant (Tx) control groups without PV graft infection were analyzed for comparison. Tissue and urine samples were evaluated by light microscopy, immunohistochemistry, electron microscopy, and PCR. The initial diagnosis of PV infection with the BK strain was made in biopsies 9+/-2 mo (mean +/- SD) post-Tx after prior rejection episodes and rescue therapy with tacrolimus. All subsequent biopsies showed persistent PV infection. Intranuclear viral inclusion bodies in epithelial cells along the entire nephron and the transitional cell layer were histologic hallmarks of infection. Affected tubular cells were enlarged and often necrotic. In two patients, small glomerular crescents were found. In 54% of biopsies, infection was associated with pronounced inflammation, which had features of cellular rejection. All patients were excreting PV-infected cells in the urine. PV infection was associated with 40% graft loss (2 of 5) and a serum creatinine of 484+/-326 micromol/L (mean +/- SD; 11 mo post-Tx). Tx control groups showed PV-infected cells in the urine in 5%. Control subjects had fewer rejection episodes (P<0.05) and stable graft function (P = 0.01). It is concluded that a manifest renal allograft infection with PV (BK strain) can persist in heavily immunosuppressed patients with recurrent rejection episodes. PV mainly affects tubular cells and causes necrosis, a major reason for functional deterioration. A biopsy is required for diagnosis. Urine cytology can serve as an adjunct diagnostic tool.