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Maternal mind well being solutions in Sri Lanka: issues as well as options.
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Mobile health (mHealth) has the potential to improve access to healthcare, especially in developing countries. The proliferation of mHealth has not been accompanied by a corresponding growth in design guidelines for mHealth applications. This paper proposes a framework for mHealth application design that combines the Information Systems Research (ISR) framework and design thinking. We demonstrate a use case for the proposed framework in the form of an app to read the result of the tuberculin skin test (TST), which is used to screen for latent tuberculosis infection. The framework was used in the re-design of the TST reading app but could also be used in earlier stages of mHealth app design.

The ISR framework and design thinking were merged based on how the modes of design thinking integrate with the cycles of the ISR framework. Using the combined framework, we re-designed an mHealth app for TST reading, intended to be used primarily in a developing context by healthcare workers. Using the proposed framewoof this framework as a guide in the design of user-centred mHealth interventions.
The combined framework allowed for engagement with end-users and for low-cost, rapid development of the app while addressing contextual challenges and needs. The integration of design thinking modes with the ISR cycles was effective in achieving the objectives of each approach. The combined framework acknowledges the importance of engaging users when implementing mHealth technologies, especially in developing and under-resourced contexts. Findings from this study support the use of this framework as a guide in the design of user-centred mHealth interventions.In the last decade, house sparrow populations have shown a general decline, especially in cities. Avian malaria has been recently suggested as one of the potential causes of this decline, and its detrimental effects could be exacerbated in urban habitats. It was initially thought that avian malaria parasites would not have large negative effects on wild birds because of their long co-evolution with their hosts. However, it is now well-documented that they can have detrimental effects at both the primo- and chronical infection stages. In this study, we examined avian malaria infection and its physiological and morphological consequences in four populations of wild house sparrows (2 urban and 2 rural). We did not find any relationship between the proportions of infected individuals and the urbanisation score calculated for our populations. However, we observed that the proportion of infected individuals increased during the course of the season, and that juveniles were less infected than adults. We did not detect a strong effect of malaria infection on physiological, morphological and condition indexes. Complex parasite dynamics and the presence of confounding factors could have masked the potential effects of infection. Thus, longitudinal and experimental studies are needed to understand the evolutionary ecology of this very common, but still poorly understood, wild bird parasite.
Hypertensive disorders of pregnancy (HDP) are common complications of pregnancy globally, including sub-Saharan African (SSA) countries. Although it has a high burden of maternal and neonatal mortality and morbidity, evidence on the risk of the problem is limited. Therefore, the aim of this review was to systematically examine factors associated with HDP among women in SSA countries.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. Articles conducted in SSA and published in English from January 2000 to May 2020 from electronic databases including MEDLINE, EMBASE, PubMed, and CINAHL were included. Articles, which focused on HDP and found to be relevant through the reference check, were included. Additional articles found through a hand search of reference lists were also included. The quality of papers was appraised using the Critical Appraisal Skills Programme (CASP) scale. Two reviewers independently screened, extracted, and assessed the quality of the articles. S.
The prescription rate of antibiotics is high for febrile children visiting the emergency department (ED), contributing to antimicrobial resistance. Large studies at European EDs covering diversity in antibiotic and broad-spectrum prescriptions in all febrile children are lacking. A better understanding of variability in antibiotic prescriptions in EDs and its relation with viral or bacterial disease is essential for the development and implementation of interventions to optimise antibiotic use. As part of the PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union) project, the MOFICHE (Management and Outcome of Fever in Children in Europe) study aims to investigate variation and appropriateness of antibiotic prescription in febrile children visiting EDs in Europe.

Between January 2017 and April 2018, data were prospectively collected on febrile children aged 0-18 years presenting to 12 EDs in 8 European countries (Austria, Germany, Greece, Latviscriptions were inappropriate or inconclusive, with marked variation between EDs. Until better diagnostics are available to accurately differentiate between bacterial and viral aetiologies, implementation of antimicrobial stewardship guidelines across Europe is necessary to limit antimicrobial resistance.The mosquito microbiome alters the physiological traits of medically important mosquitoes, which can scale to impact how mosquito populations sustain disease transmission. The mosquito microbiome varies significantly within individual mosquitoes and among populations, however the ecological and environmental factors that contribute to this variation are poorly understood. To further understand the factors that influence variation and diversity of the mosquito microbiome, we conducted a survey of the bacterial microbiome in the medically important mosquito, Aedes albopictus, on the high Pacific island of Maui, Hawai'i. We detected three bacterial Phyla and twelve bacterial families Proteobacteria, Acitinobacteria, and Firmicutes; and Anaplasmataceae, Acetobacteraceae, Enterobacteriaceae, Burkholderiaceae, Xanthobacteraceae, Pseudomonadaceae, Streptomycetaceae, Staphylococcaceae, Xanthomonadaceae, Beijerinckiaceae, Rhizobiaceae, and Sphingomonadaceae. The Ae. this website albopictus bacterial microbiota varied among geographic locations, but temperature and rainfall were uncorrelated with this spatial variation. Infection status with an ampicomplexan pathosymbiont Ascogregarina taiwanensis was significantly associated with the composition of the Ae. albopictus bacteriome. The bacteriomes of mosquitoes with an A. taiwanensis infection were more likely to include several bacterial symbionts, including the most abundant lineage of Wolbachia sp. Other symbionts like Asaia sp. and several Enterobacteriaceae lineages were less prevalent in A. taiwanensis-infected mosquitoes. This highlights the possibility that inter- and intra-domain interactions may structure the Ae. albopictus microbiome.Maintaining social relationships depends on the ability to recognize partners or group members against other individuals. This is especially important in animals with relatively stable social groups. The amphisbaenian Trogonophis wiegmanni is a semi blind fossorial reptile that spends its entire life underground where it interacts with mates and social partners. In this environment, visual cues are limited. Chemosensory cues may rather allow conspecific social and partner recognition. We recorded the number of tongue-flick (TF) rates of T. wiegmanni amphisbaenians to scents of both sexes with different pairing social bonds (familiar vs. unfamiliar) presented on cotton swabs to test discrimination of social groups. As seen from a rise in the number of TFs, males discriminated unfamiliar females from unfamiliar males. This suggests that chemical cues may be used by males to locate new mates. In contrast, females detected scent of unfamiliar conspecifics, but did not show sex discrimination. Both males and females discriminated the scent of an individual with which they had formed a pair bond from an unfamiliar individual of the same sex as the partner. Also, males, but not females, were capable of self-recognition, suggesting that scent marks of males in home ranges may provide individual information in intrasexual relationships. We conclude that conspecific discrimination based on chemical cues may allow the maintenance of social relationships and relatively stable pairs in fossorial reptiles inhabiting visually restricted environments.The first excavations on Obi Island, north-east Wallacea, reveal three phases of occupation beginning in the terminal Pleistocene. Ground shell artefacts appear at the end of the terminal Pleistocene, the earliest examples in Wallacea. In the subsequent early Holocene occupation phase, ground stone axe flakes appear, which are again the earliest examples in Wallacea. Ground axes were likely instrumental to subsistence in Obi's dense tropical forest. From ~8000 BP there was a hiatus lasting several millennia, perhaps because increased precipitation and forest density made the sites inhospitable. The site was reoccupied in the Metal Age, with this third phase including quadrangular ground stone artefacts, as well as pottery and pigs; reflecting Austronesian influences. Greater connectivity at this time is also indicated by an Oliva shell bead tradition that occurs in southern Wallacea and an exotic obsidian artefact. The emergence of ground axes on Obi is an independent example of a broader pattern of intensification at the Pleistocene-Holocene transition in Wallacea and New Guinea, evincing human innovation in response to rapid environmental change.The sex ratio at birth (SRB) in India has been reported to be imbalanced since the 1970s. Previous studies have shown there is a great variation in the SRB between geographic locations across India till 2016. Considering the enormous population and regional heterogeneity of India, producing probabilistic SRB projections at the state level is crucial for policy planning and population projection. In this paper, we implement a Bayesian hierarchical time series model to project the SRB across India by state. We generate SRB probabilistic projections from 2017 to 2030 for 29 States and Union Territories (UTs) in India, and present results for 21 States/UTs with data available from the Sample Registration System. Our analysis takes into account two state-specific factors that contribute to sex-selective abortion in India, resulting in sex imbalances at birth the intensity of son preference and fertility squeeze. We project that the highest deficits in female births will occur in Uttar Pradesh, with a cumulative number of missing female births of 2.0 (95% credible interval [1.9; 2.2]) million from 2017 to 2030. The total female birth deficits during 2017-2030 for the whole of India is projected to be 6.8 [6.6; 7.0] million.Dengue fever occurs worldwide and about 1% of cases progress to severe haemorrhage and shock. Dengue is endemic in Guatemala and its surveillance system could document long term trends. We analysed 17 years of country-wide dengue surveillance data in Guatemala to describe epidemiological trends from 2000 to 2016.Data from the national dengue surveillance database were analysed to describe dengue serotype frequency, seasonality, and outbreaks. We used Poisson regression models to compare the number of cases each year with subsequent years and to estimate incidence ratios within serotype adjusted by age and gender. 91,554 samples were tested. Dengue was confirmed by RT-qPCR, culture or NS1-ELISA in 7097 (7.8%) cases and was IgM ELISA-positive in 19,290 (21.1%) cases. DENV1, DENV2, DENV3, and DENV4 were detected in 2218 (39.5%), 2580 (45.9%), 591 (10.5%), and 230 (4.1%) cases. DENV1 and DENV2 were the predominant serotypes, but all serotypes caused epidemics. The largest outbreak occurred in 2010 with 1080 DENV2 cases reported.
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