Procyanidin trimer C1 derived from Theobroma cacao reactivates latent human immunodeficiency virus type 1 provirus.

Despite remarkable advances in combination antiretroviral therapy (cART), human immunodeficiency virus type 1 (HIV-1) infection remains incurable due to the incomplete elimination of the replication-competent virus, which persists in latent reservoirs. Strategies for targeting HIV reservoirs for eradication that involves reactivation of latent proviruses while protecting uninfected cells by cART are urgently needed for cure of HIV infection. We screened medicinal plant extracts for compounds that could reactivate the latent HIV-1 provirus and identified a procyanidin trimer C1 derived from Theobroma cacao as a potent activator of the provirus in human T cells latently infected with HIV-1. This reactivation largely depends on the NF-κB and MAPK signaling pathways because either overexpression of a super-repressor form of IκBα or pretreatment with a MEK inhibitor U0126 diminished provirus reactivation by C1. A pan-PKC inhibitor significantly blocked the phorbol ester-induced but not the C1-induced HIV-1 reactivation. Although C1-induced viral gene expression persisted for as long as 48 h post-stimulation, NF-κB-dependent transcription peaked at 12 h post-stimulation and then quickly declined, suggesting Tat-mediated self-sustainment of HIV-1 expression. These results suggest that procyanidin C1 trimer is a potential compound for reactivation of latent HIV-1 reservoirs.

Promoting safe IV management in practice using H.A.N.D.S.

The aim of this article is to promote best practice for the insertion and care of intravascular (IV) devices. The H.A.N.D.S. acronym was created to serve as an aide memoire to general and specialist nurses regarding the 5 key interventions to prevent catheter-related bloodstream infections (CRBSIs). In order to promote safe and evidence-based practice in IV therapy a practical guide with clinical information about common IV procedures has been developed. This article provides back-to-basics guidance on how to deliver IV therapy safely and effectively.

Effects of the community-based health planning and services on anemia and acute malnutrition amongst under-fives in Ghana: A comparative study.

Background: Ghana implemented a community-based health planning and services (CHPS) in 2000 with the aim of bringing health services to the doorsteps of the deprived in the communities. Japan International Cooperation Agency (JICA) supported the implementation of the project with a distinct approach in the Upper West region, employing supportive supervision. Objective: To investigate the impact of the JICA CHPS model on anemia and acute malnutrition prevalence amongst children less than five years of age. Methods: This is a quasi-experimental study design that compares the upper west region with the two other regions of the North implementing the traditional model of CHPS. We used the Ghana demographic and health survey dataset for 2003 as the baseline and 2014 as the follow-up year and employed the difference-in-difference approach. We find a reduction in the likelihood of anemia and acute malnutrition prevalence among children less than five years by 17 and 8 percentage points respectively. We find the project to be cost-effective, at a cost of $7 per each anemia prevalence averted. Conclusions: The results indicate that the JICA model of CHPS is cost-effective in the reduction of anemia and acute malnutrition prevalence compared to the traditional model. We recommend a nationwide expansion of the JICA model to enhance the reduction of anemia and acute malnutrition in Ghana.

Effect of healthcare quality initiative on maternal healthcare service utilization: a case study of the SPRING Ghana project.

Background: Between 2014 and 2017, Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING), Ghana implemented a nutrition project in two regions of the country using a quality improvement approach. The quality improvement approach focused on improving antenatal care attendance and institutional births. Objectives: This study examines the effect of the quality improvement initiative on maternal healthcare service utilization in Ghana and whether the services provided were of quality. Method: We use the 2014 and the 2008 Ghana Demographic and Health Survey dataset, which is a cross sectional survey and the difference-in-difference approach. Results: We find strong positive association of the project impact on the probability of antenatal care attendance during the first trimester by 12% points while institutional births were seen to be 8% points. We also find a statistically significant impact of the care rendered by the nurse/midwife to be 13% points and the community health officer/nurse by 4.5% points. Conclusion: The findings indicate that pregnant women in the intervention regions were more likely to deliver at the health facilities than in the non-intervention regions. It is therefore recommended that Ghana and other low resource countries can better improve maternal health care service uptake with the incorporation of quality improvement tools in maternal health care policy designs.