More Diverse and Equal: Insights on Moving From "Real-Life" to "Remote" Practicum Experiences and Career Development From Undergraduate Global Public Health Students During COVID-19.

A key facet to typical undergraduate or graduate global public health programs is an applied practice experience (a practicum) that culminates in shared results and public presentations (e.g., research posters, conference and working papers, needs assessments). Requirements vary by program but may be between 80 and 200 hours of experiential learning. While not required by all undergraduate programs in global public health, a practicum occurs as part of a semester of coursework or internship experience after students have declared the major/minor or have completed an expected number of courses. Some students report that the practicum experience, while essential to their career development and future opportunities, presents certain challenges in terms of access. Practicum opportunities can be rife with assumptions that social networks, privilege, and implicit bias affect and even predict the ability to secure an effective, doable, and career-advantageous project. In 2020, the COVID-19 pandemic meant that much of the applied and experiential aspects of a practicum were necessarily shifted from "realworld" experiences to virtual and "remote" contexts. This article highlights insights from students enrolled in undergraduate global public health programs who were planning "real-life", more "traditional" practicum experiences, and had to necessarily move to "remote" and online engagement. These cases suggest that participation in virtual fieldsites is seen as legitimate, fulfilling for students and stakeholders, and can increase diversity, equity, and inclusion in the public health curricula; fostering best practices in career development.

Social and ecological determinants of antimicrobial resistance in Africa: a systematic review of epidemiological evidence.

Background: Antimicrobial resistance (AMR) is one of the greatest global health problems for humans, animals, and the environment. Although the association between various factors and AMR is being increasingly researched, the need to understand the contribution of social and ecological determinants, especially in developing nations, remains. This review fills these knowledge gaps by synthesizing existing evidence on the social and ecological determinants of AMR in Africa. Results: Twenty-four studies were selected based on predefined criteria from PubMed. 58.33% (n = 14) and 29.17% (n = 7) of the studies reported on ecological and social determinants of AMR, respectively, and 3 (12.5%) studies documented both social and environmental determinants of AMR. Sociodemographic factors include increased household size, poor knowledge, attitudes toward AMR, low educational levels, and rural residences. Indicators of poor water sanitation and hygiene, framing practices, and consumption of farm products were among the common ecological determinants of AMR and AM misuse in Africa. Conclusion: Our review demonstrates the importance of social and ecological determinants of AMR among African populations. The findings may be valuable to researchers, policymakers, clinicians, and those working in lower-income countries to implement AMR prevention programs utilizing a holistic approach.

'Mali Matters': reflections on a leadership and quality improvement project to improve blood transfusion safety at Maluti Adventist Hospital, Mapoteng, Lesotho.

INTRODUCTION: This report outlines a quality improvement (QI) project aiming to improve blood transfusion safety at Maluti Adventist Hospital (MAH), Lesotho, from August 2019 to January 2020.The project team comprised nine local staff members and two UK doctors working through the NHS 'Improving Global Health through Leadership Development' (IGH) programme. METHODS: Baseline data was gathered and a 'process mapping' meeting held to understand existing processes and identify methods for improvement.Improvements were implemented using Plan-Do-Study-Act (PDSA) methodology.The NHS Healthcare Leadership Model was used as a framework for leadership development and team members reflected on their personal learning. RESULTS: Varied interventions included introduction of a pre-transfusion bedside safety checklist and staff training.Documentation of critical patient identifiers for transfusion improved. Completion of the bedside safety checklist was 65.5% by 3 months. Knowledge scores improved post-transfusion training. 77% of staff strongly agreed and 21% agreed that the training was useful.Challenges and further work were reflected on. DISCUSSION: This collaborative system-strengthening project provided varied, reciprocal learning experiences including skills in leadership, teamwork, teaching, QI methodology, communication and IT.Our experiences will help to inform ongoing work at MAH and may be helpful to others conducting similar work in related settings.

Sterility and stigma in an era of HIV/AIDS: narratives of risk assessment among men and women in Botswana.

This paper examines the experience and interpretations of infertility and sterility in northern Botswana. Specifically it highlights the role of stigma and impression management among Tswana men and women through their narratives and discourse about childbearing and personhood in an era of HIV/AIDS. The paper demonstrates that in a country with one of the highest HIV/AIDS infection rates in the world, risky sexual practices are weighed against cultural norms that suggest being a full person and productive adult is to be a reproductive man or woman. Through longitudinal qualitative research the narratives and life histories of several individuals offer ethnographic evidence on the power of stigma. The research finds that even with ubiquitous HIV/AIDS education and prevention programmes throughout Botswana, Tswana engage in various kinds of risk taking behaviours as means through which impressions and identities as full persons of value may be managed successfully.

Cross-skilling training to support medical redeployment in the COVID-19 pandemic.

During the response to the COVID-19 pandemic, doctors will be redeployed into roles with which they are unfamiliar. Adequate training must be provided to reacquaint doctors with medical ward practice, supporting psychological wellbeing and patient safety. Here we describe a cross-skilling programme in North Bristol NHS Trust designed to address colleague anxiety and support wellbeing during redeployment.

Antagonists of the human adenosine A2A receptor. Part 3: Design and synthesis of pyrazolo[3,4-d]pyrimidines, pyrrolo[2,3-d]pyrimidines and 6-arylpurines.

A series of pyrazolo[3,4-d]pyrimidine, pyrrolo[2,3-d]pyrimidine and 6-arylpurine adenosine A(2A) antagonists is described. Many examples were highly selective against the human A(1) receptor sub-type and were active in an in vivo model of Parkinson's disease.

Antagonists of the human adenosine A2A receptor. Part 2: Design and synthesis of 4-arylthieno[3,2-d]pyrimidine derivatives.

We describe herein the discovery and development of a series of 4-arylthieno[3,2-d]pyrimidines which are potent adenosine A(2A) receptor antagonists. These novel compounds show high degrees of selectivity against the human A(1), A(2B) and A(3) receptor sub-types. Moreover, a number of these compounds show promising activity in vivo, suggesting potential utility in the treatment of Parkinson's disease.

Antagonists of the human adenosine A2A receptor. Part 1: Discovery and synthesis of thieno[3,2-d]pyrimidine-4-methanone derivatives.

The (-)-(11R,2'S)-enantiomer of the antimalarial drug mefloquine has been found to be a reasonably potent and moderately selective adenosine A(2A) receptor antagonist. Further investigation of this compound has led to the discovery of a series of keto-aryl thieno[3,2-d]pyrimidine derivatives, which are potent and selective antagonists of the adenosine A(2A) receptor. These derivatives show selectivity against the A(1) receptor. Furthermore, some of these compounds have been shown to have in vivo activity in a commonly used model, suggesting the potential for the treatment of Parkinson's disease.

Perceptions of and attitudes towards male infertility in northern Botswana: some implications for family planning and AIDS prevention policies.

This paper discusses the perceptions of male infertility in northern Botswana and their implications for efficacious family planning and AIDS prevention programmes in the country. HIV rates are rapidly increasing in northern Botswana and it is estimated that nearly 30% of the population are infected. A significant factor in these increases is the perception that infertility is caused by the use of contraceptives. Male infertility in particular is understood as a result of female contraceptive use and is highly stigmatised. In an area with such high HIV rates, these perceptions directly contribute to the lack of efficacious family planning and HIV prevention programmes in the country.

Antagonists of the human A(2A) adenosine receptor. 4. Design, synthesis, and preclinical evaluation of 7-aryltriazolo[4,5-d]pyrimidines.

Antagonism of the human A(2A) receptor has been implicated as a point of therapeutic intervention in the alleviation of the symptoms associated with Parkinson's disease. This is thought to occur, at least in part, by increasing the sensitivity of the dopaminergic neurons to the residual, depleted levels of striatal dopamine. We herein describe a novel series of functionalized triazolo[4,5-d]pyrimidine derivatives that display functional antagonism of the A(2A) receptor. Optimization of these compounds has resulted in improvements in potency, selectivity, and the pharmacokinetic properties of key derivatives. These efforts have led to the discovery of 60 (V2006/BIIB014), which demonstrates strong oral activity in commonly used models of Parkinson's disease. Furthermore, this derivative has shown excellent preclinical pharmacokinetics and has successfully completed phase I clinical studies. This compound is presently undergoing further clinical evaluation in collaboration with Biogen Idec.

Sterility and stigma in an era of HIV/AIDS: narratives of risk assessment among men and women in Botswana

This paper examines the experience and interpretations of infertility and sterility in northern Botswana. Specifically it highlights the role of stigma and impression management among Tswana men and women through their narratives and discourse about childbearing and personhood in an era of HIV/AIDS. The paper demonstrates that in a country with one of the highest HIV/AIDS infection rates in the world, risky sexual practices are weighed against cultural norms that suggest being a full person and productive adult is to be a reproductive man or woman. Through longitudinal qualitative research the narratives and life histories of several individuals offer ethnographic evidence on the power of stigma. The research finds that even with ubiquitous HIV/AIDS education and prevention programmes throughout Botswana, Tswana engage in various kinds of risk taking behaviours as means through which impressions and identities as full persons of value may be managed successfully (Afr J Reprod Health 2011; 15[1]: 95-100)

Potential for antipsychotic and psychotomimetic effects of A2A receptor modulation.

The discovery of antagonistic interactions between A2A adenosine receptors and D2 dopamine receptors in the ventral striatum suggested that A2A receptor activation might modulate the antipsychotic effects of dopamine receptor antagonists and could provide an opportunity for the development of A2A receptor agonists as novel antipsychotic drugs. However, there is limited evidence from preclinical and clinical studies that A2A receptor agonists can exert antipsychotic effects. Furthermore, it remains unclear whether A2A receptor agonists possess a sufficient safety margin or whether their potent hypotensive effects or extrapyramidal side effects would limit their therapeutic utility as antipsychotic agents. The interaction between A2A receptors and D2 receptors also raises the possibility that A2A receptor antagonists, which hold considerable promise as antiparkinsonian agents, may have dose-limiting psychotomimetic side effects. Preclinical studies using selective A2A receptor antagonists suggest that this class of compound has a low propensity to elicit psychotomimetic side effects or exacerbate those induced by D2 receptor agonists.

Lung heme oxygenase-1 is elevated in acute respiratory distress syndrome.

OBJECTIVE: We aimed to quantify concentrations of inducible heme oxygenase (HO)-1 in the lungs of patients with acute respiratory distress syndrome (ARDS) and to investigate its role as a source of ferrous iron and as a signaling agent for iron regulation. Control of such processes by heme oxygenase has implications for the onset, progression, and resolution of ARDS. DESIGN: Retrospective analysis of archived samples. SETTING: Adult intensive care unit of a postgraduate teaching hospital. PATIENTS: Patients admitted to the adult intensive care unit who fulfilled the American-European Consensus Conference criteria for ARDS. INTERVENTIONS: Biochemical and immunohistochemical studies using bronchoalveolar lavage fluid or lung tissue were performed in patients with established ARDS and in those undergoing lung resection (controls). MEASUREMENTS AND MAIN RESULTS: Concentrations of heme oxygenase protein were significantly elevated in lung tissue (193.7 +/- 13.27 vs. 81.0 +/- 16.0%, p < .01) and in bronchoalveolar lavage fluid (2.4 x 10(5) vs. 1.4 x 10(5) densitometric units, p = .047) taken from patients with ARDS compared with controls. Concentrations of heme oxygenase protein in bronchoalveolar lavage fluid from patients with ARDS correlated positively and significantly with changes in the concentrations of ferritin (r = .697, p = .02) and the iron saturation of transferrin (r = .8, p = .014) but correlated negatively and significantly with concentrations of bleomycin-detectable (redox-active) iron (r = -.73, p = .031). Significantly elevated (p < .05) concentrations of heme oxygenase staining in cell types expressing this protein were detected in patients with ARDS, compared with concentrations in the same cells taken from controls undergoing lung resection. CONCLUSIONS: Heme oxygenase protein is elevated in the lungs of patients with ARDS and may contribute to the changes in iron mobilization, signaling, and regulation seen in this condition.