Saturday, October 20, 2007
BBC NEWS | Special Reports | 'They thought I was cursed': "Obstetric fistula, a hole linking the vagina with the bladder or rectum, occurs when women - often in their early teens - are in labour for days. Campaigners at a global conference on maternal health in London this week, entitled Women Deliver, have emphasised that a simple and cheap operation can cure it [...]"
Thursday, October 18, 2007
• Good participation by the class. Good discussion.
• Great with involving the class in discussion. Good time management. Extra props for being comfortable leading the class alone!
• Excellent presentation of a very broad set of topics; good class interaction and good contributions by class and professors.
• I enjoyed the presentation! She presented it very well. Slides need to have larger words though! Well-done.
• Given that the other presenter didn’t come, I think the presentation was good. It was nice having such extensive class conversation.
• Could have organized the slides a bit better.
• Very good presentation considering that you had to do it alone! I like the informal discussion set-up more than the lecture format in previous classes.
• Nice presentation. Good job getting group discussion going – putting good questions to the group. Nice job presenting on your own! Only suggestion – fewer words per PowerPoint slide.
• Great job! I enjoyed the balance of class involvement.
• “Empowered presentation” Excellent – raised may complex questions and good discussion – very good use of examples – very good relationship to other classes.
The continuum of care has become a rallying call to reduce the yearly toll of half a million maternal deaths, 4 million neonatal deaths, and 6 million child deaths. The continuum for maternal, newborn, and child health usually refers to continuity of individual care. Continuity of care is necessary throughout the lifecycle (adolescence, pregnancy, childbirth, the postnatal period, and childhood) and also between places of caregiving (including households and communities, outpatient and outreach services, and clinical-care settings). We define a population-level or public-health framework based on integrated service delivery throughout the lifecycle, and propose eight packages to promote health for mothers, babies, and children. These packages can be used to deliver more than 190 separate interventions, which would be difficult to scale up one by one. The packages encompass three which are delivered through clinical care (reproductive health, obstetric care, and care of sick newborn babies and children); four through outpatient and outreach services (reproductive health, antenatal care, postnatal care and child health services); and one through integrated family and community care throughout the lifecycle. Mothers and babies are at high risk in the first days after birth, and the lack of a defined postnatal care package is an important gap, which also contributes to discontinuity between maternal and child health programmes. Similarly, because the family and community package tends not to be regarded as part of the health system, few countries have made systematic efforts to scale it up or integrate it with other levels of care. Building the continuum of care for maternal, newborn, and child health with these packages will need effectiveness trials in various settings; policy support for integration; investment to strengthen health systems; and results-based operational management, especially at district level [...]"
New Malaria Vaccine Is Shown to Work in Infants Under 1 Year Old, a Study Finds
The world’s most promising malaria vaccine has been shown to work in infants less than a year old, the most vulnerable group, according to a study being published today.
The study, being published in The Lancet, a British medical journal, was small, comprising only 214 babies in Mozambique, and intended to show only that the vaccine was safe at such young ages. But it also indicated that the risk of catching malaria was reduced by 65 percent after the full course of three shots.
“We’re now a step closer to the realization of a vaccine that can protect African infants,” said Dr. Pedro Alonso, the University of Barcelona professor who leads clinical trials of the GlaxoSmithKline vaccine.
If it passes much larger clinical trials set to start in seven countries next year, and if it is accepted by national regulatory agencies, it could be ready for distribution by 2012, said Dr. W. Ripley Ballou, Glaxo’s vice president for international clinical trials.
In 2004, Dr. Alonso showed for the first time that the vaccine could protect children against infection or death. That study of 2,022 children aged 1 to 4 showed protection from infection about 45 percent of the time.
Such a relatively low level of protection would not be acceptable in a vaccine in the West, but malaria is a leading killer of African children, so even imperfect coverage is a major public health victory.
The vaccine, presently known as RTS,S and tentatively brand-named Mosquirix, is made by fusing a bit of outer protein of the deadly falciparum strain of the malaria parasite with a bit of hepatitis B virus and a chemical booster — the latter two added to provoke a stronger immune reaction.
At least nine malaria vaccine candidates are in development, but Mosquirix is the furthest along. Glaxo has been refining it for 20 years and expects to have spent up to $600 million on it by the time it comes to market. About $100 million has been paid by the Bill and Melinda Gates Foundation through the PATH Malaria Vaccine Initiative.
No decision has been made about the price to be offered to poor countries and international health agencies. But “if a child will benefit, price will not stand in the way,” said Dr. Christian Loucq, director of the vaccine initiative.
The vaccine is given in three injected doses. That is an obstacle in poor countries, which have difficulties immunizing even against polio — done with oral drops requiring no medical skill.
But even one dose has some protective effect, the Lancet study found.
It is unknown how long protection lasts. But because the youngest children are the most vulnerable, Dr. Alonso said, vaccination buys them time to build up natural immunity, which is acquired by surviving multiple mosquito bites.
Tuesday, October 16, 2007
Dr. Brown talked about the practice of widow cleansing in class and I equated it to 'wife-inheritance'; however after doing some reading it seems like widow cleansing and wife-inheritance are separate practices, though both involve having sexual relations with the dead husband's relatives.