Ethical issues in funding research and development of drugs for neglected tropical diseases.

PubMed

Oprea, L; Braunack-Mayer, A; Gericke, C A

2009-05-01

Neglected and tropical diseases, pervasive in developing countries, are important contributors to global health inequalities. They remain largely untreated due to lack of effective and affordable treatments. Resource-poor countries cannot afford to develop the public health interventions needed to control neglected diseases. In addition, neglected diseases do not represent an attractive market for pharmaceutical industry. Although a number of international commitments, stated in the Millennium Development Goals, have been made to avert the risk of communicable diseases, tropical diseases still remain neglected due to delays in international assistance. This delay can be explained by the form international cooperation has generally taken, which is limited to promoting countries' national interests, rather than social justice at a global level. This restricts the international responsibility for global inequalities in health to a humanitarian assistance. We propose an alternative view, arguing that expanding the scope of international cooperation by promoting shared health and economic value at a global level will create new opportunities for innovative, effective and affordable interventions worldwide. It will also promote neglected diseases as a global research priority. We build our argument on a proposal to replace the patenting system that currently regulates pharmaceutical research with a global fund to reward this research based on actual decreases in morbidity and mortality at a global level. We argue that this approach is beneficent because it will decrease global health inequalities and promote social justice worldwide.

Time for T? Immunoinformatics addresses vaccine design for neglected tropical and emerging infectious diseases

PubMed Central

Terry, Frances E; Moise, Leonard; Martin, Rebecca F; Torres, Melissa; Pilotte, Nils; Williams, Steven A; De Groot, Anne S

2015-01-01

Vaccines have been invaluable for global health, saving lives and reducing healthcare costs, while also raising the quality of human life. However, newly emerging infectious diseases (EID) and more well-established tropical disease pathogens present complex challenges to vaccine developers; in particular, neglected tropical diseases, which are most prevalent among the world’s poorest, include many pathogens with large sizes, multistage life cycles and a variety of nonhuman vectors. EID such as MERS-CoV and H7N9 are highly pathogenic for humans. For many of these pathogens, while their genomes are available, immune correlates of protection are currently unknown. These complexities make developing vaccines for EID and neglected tropical diseases all the more difficult. In this review, we describe the implementation of an immunoinformatics-driven approach to systematically search for key determinants of immunity in newly available genome sequence data and design vaccines. This approach holds promise for the development of 21st century vaccines, improving human health everywhere. PMID:25193104

Scrub Typhus: An Emerging Neglected Tropical Disease in Nepal.

PubMed

Upadhyaya, B P; Shakya, G; Adhikari, S; Rijal, N; Acharya, J; Maharjan, L; Marasini, B R

2016-05-01

Scrub typhus is a neglected tropical disease and is under reported from Nepal. The objective of this study was to investigate the sero-epidemiology of scrub typhus in patients suffering from acute febrile illness. A total of 434 specimens collected from July to November 2015 at National Public Health Laboratory (NPHL) were investigated for detection of immunoglobulin M (IgM) antibody to Orientiatsutsugamushi.The Scrub Typhus Detect TM kit (InBios, USA) was used to detect the antibodies to O.tsutsugamushi in human serum. Randomly selected 10% positive specimens were used for confirmation by dot- enzyme-linked immunosorbent assay and indirect immunofluorescence assay. Of the total, 175 (40.3%) were positive for IgM antibodies to O. tsutsugamushi. Positive results of scrub typhus were highest among female in 11-20 year followed by males in 41-50 years age group. The IgM antibodies to O. tsutusugamushi were positive in specimens of various geographical regions including 30 districts of Nepal. Positive cases were found in various ecological regions of Nepal. Scrub typhus is one of the neglected tropical diseases in Nepal. Patients with acute febrile illness should be investigated for scrub typhus with high priority. There is an urgent need of reliable and affordable diagnostic tests at all level of health facilities of Nepal. Surveillance and public health awareness about the disease transmission and preventive measures needs to be initiated.

Progress Report on Neglected Tropical Disease Drug Donation Programs.

PubMed

Cohen, Joshua P; Silva, Lisseth; Cohen, Alisa; Awatin, Josephine; Sturgeon, Robert

2016-05-01

Neglected tropical diseases (NTDs) impose a significant burden on public health, particularly in developing nations. Many can be treated cost-effectively with drugs donated or offered at or below marginal cost. In 2012, the World Health Organization published an NTD roadmap that outlined a strategy for the prevention, control, and eradication of 17 NTDs by 2020. Inspired by this roadmap, executives from 13 pharmaceutical companies, government agencies, and other interested parties signed the London Declaration on Neglected Tropical Diseases in January 2012. In this paper, we will assess progress in meeting commitments on drug donations laid out in the London Declaration. We conducted Medline and LexisNexis searches of peer-reviewed publications and trade journals, as well as product development partnership and government reports. Subsequently, we designed a survey instrument and surveyed 10 company signatories (companies with drug donation programs) to the London Declaration to determine current donations and pledges. Nine of 10 companies with donation programs responded to the survey. The respondents reported substantial progress in meeting the goals laid out in the London Declaration. Survey respondents maintained 17 drug donation programs across 10 disease categories. In 2014, companies donated >1 billion treatments, with a dollar value of nearly $1.5 billion. However, not all donated products were distributed to patients in need. In addition, 4 of the 17 programs were slated to end before 2020, three of the 17 programs did not report explicit program objectives, and 7 of 17 did not measure the impact of programs in terms of numbers of patients treated. None of our survey respondents reported on whether the programs were leading to a reduction in disease prevalence. Donations are a necessary but insufficient condition for patient access to neglected disease drugs. Additional resources must be allocated to ensure delivery of donated products to patients. In

Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution

PubMed Central

UTZINGER, J.; RASO, G.; BROOKER, S.; DE SAVIGNY, D.; TANNER, M.; ØRNBJERG, N.; SINGER, B. H.; N’GORAN, E. K.

2009-01-01

SUMMARY In May 2001, the World Health Assembly (WHA) passed a resolution which urged member states to attain, by 2010, a minimum target of regularly administering anthelminthic drugs to at least 75% and up to 100% of all school-aged children at risk of morbidity. The refined global strategy for the prevention and control of schistosomiasis and soil-transmitted helminthiasis was issued in the following year and large-scale administration of anthelminthic drugs endorsed as the central feature. This strategy has subsequently been termed ‘preventive chemotherapy’. Clearly, the 2001 WHA resolution led the way for concurrently controlling multiple neglected tropical diseases. In this paper, we recall the schistosomiasis situation in Africa in mid-2003. Adhering to strategic guidelines issued by the World Health Organization, we estimate the projected annual treatment needs with praziquantel among the school-aged population and critically discuss these estimates. The important role of geospatial tools for disease risk mapping, surveillance and predictions for resource allocation is emphasised. We clarify that schistosomiasis is only one of many neglected tropical diseases and that considerable uncertainties remain regarding global burden estimates. We examine new control initiatives targeting schistosomiasis and other tropical diseases that are often neglected. The prospect and challenges of integrated control are discussed and the need for combining biomedical, educational and engineering strategies and geospatial tools for sustainable disease control are highlighted. We conclude that, for achieving integrated and sustainable control of neglected tropical diseases, a set of interventions must be tailored to a given endemic setting and fine-tuned over time in response to the changing nature and impact of control. Consequently, besides the environment, the prevailing demographic, health and social systems contexts need to be considered. PMID:19906318

[Immunization for children travelling to the tropics: neglected vaccines].

PubMed

Imbert, P; Guérin, N; Sorge, F

2008-06-01

Each year hundreds of thousands of children leave France to travel to developing countries where they are exposed to infectious agents that can be prevented by vaccination. During the child's pre-travel check-up, practitioners should check that all mandatory immunizations are up-to-date and provide advice on relevant vaccines in function of the epidemiological situation at the chosen destination. However various factors hinder full compliance with this approach and some vaccines are underused. Underused vaccines are referred to as neglected vaccines. In the French vaccination schedule three vaccinations can be considered as neglected. The first is the hepatitis B vaccine that has a low coverage level in France due to strong reluctance to its use despite the fact that the virus is widespread in tropical areas. The second is pneumococcal vaccine that should be administered to all infants less than 2 years of age, especially for travel to areas where pneumonia and meningitis are frequent. The third is BCG vaccine that is now at greater risk of being neglected in child travellers because its use has been downgraded from a general requirement to a recommendation only for children at risk. A serious limitation on the use of travel vaccinations is cost that can lead families to neglect some infectious risk such as hepatitis A that is a major risk for child travellers as well as for their relatives during or after the trip and typhoid fever that is essentially an imported disease. Rabies vaccine is also underused due to its cost and to poor understanding of the risk by many practitioners and families. The purpose of this article is to underline the need to improve information and access to vaccines that are all too often neglected in child travellers.

The rise of neglected tropical diseases in the "new Texas".

PubMed

Hotez, Peter J

2018-01-01

Within the last five years, the State of Texas has experienced either transmission or outbreaks of Ebola, chikungunya, West Nile, and Zika virus infections. Autochthonous transmission of neglected parasitic and bacterial diseases has also become increasingly reported. The rise of such emerging and neglected tropical diseases (NTDs) has not occurred by accident but instead reflects rapidly evolving changes and shifts in a "new" Texas beset by modern and globalizing forces that include rapid expansions in population together with urbanization and human migrations, altered transportation patterns, climate change, steeply declining vaccination rates, and a new paradigm of poverty known as "blue marble health." Summarized here are the major NTDs now affecting Texas. In addition to the vector-borne viral diseases highlighted above, there also is a high level of parasitic infections, including Chagas disease, trichomoniasis, and possibly leishmaniasis and toxocariasis, as well as typhus-group rickettsiosis, a vector-borne bacterial infection. I also highlight some of the key shifts in emerging and neglected disease patterns, partly due to an altered and evolving economic and ecological landscape in the new Texas, and provide some preliminary disease burden estimates for the major prevalent and incident NTDs.

RRR for NNN-a rapid research response for the Neglected Tropical Disease NGDO Network: a novel framework to challenges faced by the global programs targeting neglected tropical diseases.

PubMed

Toledo, Chelsea E; Jacobson, Julie; Wainwright, Emily C; Ottesen, Eric A; Lammie, Patrick J

2016-03-01

While global programs targeting the control or elimination of five of the neglected tropical diseases (NTDs)-lymphatic filariasis, onchocerciasis, soil-transmitted helminthiasis, schistosomiasis and trachoma-are well underway, they still face many operational challenges. Because of the urgency of 2020 program targets, the Bill & Melinda Gates Foundation and the U.S. Agency for International Development devised a novel rapid research response (RRR) framework to engage national programs, researchers, implementers and WHO in a Coalition for Operational Research on NTDs. After 2 years, this effort has succeeded as an important basis for the research response to programmatic challenges facing NTD programs. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Economic and financial evaluation of neglected tropical diseases.

PubMed

Lee, Bruce Y; Bartsch, Sarah M; Gorham, Katrin M

2015-03-01

Economic and financing studies are particularly important for decision-making when resources are scarce or considerably limited. This is the case for neglected tropical diseases (NTDs). In fact, the definition of NTDs is an economic one. The shortage of resources for NTD control may be due in large part to the fact that the burden of NTDs and economic value of control measures have not been fully characterized. A number of economic study methodologies are available: cost of illness can quantify the extent, magnitude, and change of a problem; cost of intervention studies can outline the feasibility and guide the design of a policy or intervention; and cost-benefit, cost-effectiveness, and return-on-investment studies can determine the potential value of different interventions and policies. NTDs have unique characteristics that require special consideration in such analyses. Hence, approaches used for other diseases may need modifications to capture the full impact of NTDs. While the existing literature has made important findings, there is a need for substantially more work, as many NTDs and their associated interventions and policies require more evaluation. With increasing work in this area, NTDs may not be as 'neglected' in the future as they are now. Copyright © 2015 Elsevier Ltd. All rights reserved.

Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment.

PubMed

Mackey, Tim K; Liang, Bryan A; Cuomo, Raphael; Hafen, Ryan; Brouwer, Kimberly C; Lee, Daniel E

2014-10-01

In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Emerging and Reemerging Neglected Tropical Diseases: a Review of Key Characteristics, Risk Factors, and the Policy and Innovation Environment

PubMed Central

Liang, Bryan A.; Cuomo, Raphael; Hafen, Ryan; Brouwer, Kimberly C.; Lee, Daniel E.

2014-01-01

SUMMARY In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern. PMID:25278579

Neglected tropical diseases: is it time to add Helicobacter pylori to the list?

PubMed

Natuzzi, Eileen

2013-09-01

Neglected tropical diseases (NTDs) disproportionately affect disadvantaged populations as the 2012 World Health Organization (WHO) report on the global impact of NTDs points out. The same social determinants that impact the prevalence of the 17 current NTDs: inadequate drinking water and sanitation, crowded living conditions, environmental impacts on food and water, ethnicity as well as poverty contribute to Helicobacter pylori infections worldwide.

Ebola and Marburg Hemorrhagic Fevers: Neglected Tropical Diseases?

PubMed Central

MacNeil, Adam; Rollin, Pierre E.

2012-01-01

Ebola hemorrhagic fever (EHF) and Marburg hemorrhagic fever (MHF) are rare viral diseases, endemic to central Africa. The overall burden of EHF and MHF is small in comparison to the more common protozoan, helminth, and bacterial diseases typically referred to as neglected tropical diseases (NTDs). However, EHF and MHF outbreaks typically occur in resource-limited settings, and many aspects of these outbreaks are a direct consequence of impoverished conditions. We will discuss aspects of EHF and MHF disease, in comparison to the “classic” NTDs, and examine potential ways forward in the prevention and control of EHF and MHF in sub-Saharan Africa, as well as examine the potential for application of novel vaccines or antiviral drugs for prevention or control of EHF and MHF among populations at highest risk for disease. PMID:22761967

Overcoming the challenges of drug discovery for neglected tropical diseases: the A·WOL experience.

PubMed

Johnston, Kelly L; Ford, Louise; Taylor, Mark J

2014-03-01

Neglected tropical diseases (NTDs) are a group of 17 diseases that typically affect poor people in tropical countries. Each has been neglected for decades in terms of funding, research, and policy, but the recent grouping of them into one unit, which can be targeted using integrated control measures, together with increased advocacy has helped to place them on the global health agenda. The World Health Organization has set ambitious goals to control or eliminate 10 NTDs by 2020 and launched a roadmap in January 2012 to guide this global plan. The result of the launch meeting, which brought together representatives from the pharmaceutical industry, donors, and politicians, was the London Declaration: a series of commitments to provide more drugs, research, and funds to achieve the 2020 goals. Drug discovery and development for these diseases are extremely challenging, and this article highlights these challenges in the context of the London Declaration, before focusing on an example of a drug discovery and development program for the NTDs onchocerciasis and lymphatic filariasis (the anti-Wolbachia consortium, A·WOL).

Podoconiosis - non-filarial geochemical elephantiasis - a neglected tropical disease?

PubMed

Nenoff, Pietro; Simon, Jan Christoph; Muylowa, Grace K; Davey, Gail

2010-01-01

Podoconiosis or mossy foot is a form of non-filarial lymphedema. This geochemical elephantiasis is a disabling condition caused by the passage of microparticles of silica and aluminum silicates through the skin of people walking barefoot in areas with a high content of soil of volcanic origin. Podoconiosis is widespread in tropical Africa, Central America and North India, yet it remains a neglected and under-researched condition. The disabling effects of podoconiosis cause great hardship to patients. It adversely affects the economic (reduced productivity and absenteeism), social (marriage, education, etc.) and psychological (social stigma) well-being of those affected. Podoconiosis can be prevented; the main primary preventive measure is protective footwear. Secondary measures include a strict hygiene regimen and compression therapy, which can reverse initial lesions. Tertiary approaches include surgical management, such as shaving operations to reduce hyperplastic and verrucous elephantiasis.

Reviewing Dengue: Still a Neglected Tropical Disease?

PubMed Central

Horstick, Olaf; Tozan, Yesim; Wilder-Smith, Annelies

2015-01-01

Dengue is currently listed as a “neglected tropical disease” (NTD). But is dengue still an NTD or not? Classifying dengue as an NTD may carry advantages, but is it justified? This review considers the criteria for the definition of an NTD, the current diverse lists of NTDs by different stakeholders, and the commonalities and differences of dengue with other NTDs. We also review the current research gaps and research activities and the adequacy of funding for dengue research and development (R&D) (2003–2013). NTD definitions have been developed to a higher precision since the early 2000s, with the following main features: NTDs are characterised as a) poverty related, b) endemic to the tropics and subtropics, c) lacking public health attention, d) having poor research funding and shortcomings in R&D, e) usually associated with high morbidity but low mortality, and f) often having no specific treatment available. Dengue meets most of these criteria, but not all. Although dengue predominantly affects resource-limited countries, it does not necessarily only target the poor and marginalised in those countries. Dengue increasingly attracts public health attention, and in some affected countries it is now a high profile disease. Research funding for dengue has increased exponentially in the past two decades, in particular in the area of dengue vaccine development. However, despite advances in dengue research, dengue epidemics are increasing in frequency and magnitude, and dengue is expanding to new areas. Specific treatment and a highly effective vaccine remain elusive. Major research gaps exist in the area of integrated surveillance and vector control. Hence, although dengue differs from many of the NTDs, it still meets important criteria commonly used for NTDs. The current need for increased R&D spending, shared by dengue and other NTDs, is perhaps the key reason why dengue should continue to be considered an NTD. PMID:25928673

Climate Change and the Neglected Tropical Diseases.

PubMed

Booth, Mark

2018-01-01

Climate change is expected to impact across every domain of society, including health. The majority of the world's population is susceptible to pathological, infectious disease whose life cycles are sensitive to environmental factors across different physical phases including air, water and soil. Nearly all so-called neglected tropical diseases (NTDs) fall into this category, meaning that future geographic patterns of transmission of dozens of infections are likely to be affected by climate change over the short (seasonal), medium (annual) and long (decadal) term. This review offers an introduction into the terms and processes deployed in modelling climate change and reviews the state of the art in terms of research into how climate change may affect future transmission of NTDs. The 34 infections included in this chapter are drawn from the WHO NTD list and the WHO blueprint list of priority diseases. For the majority of infections, some evidence is available of which environmental factors contribute to the population biology of parasites, vectors and zoonotic hosts. There is a general paucity of published research on the potential effects of decadal climate change, with some exceptions, mainly in vector-borne diseases. © 2018 Elsevier Ltd All rights reserved.

Threats from emerging and re-emerging neglected tropical diseases (NTDs).

PubMed

Mackey, Tim K; Liang, Bryan A

2012-01-01

Neglected tropical diseases impact over 1 billion of the world's poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases requiring more detailed examination on potential global health risks. We reviewed the 17 NTDs classified by the WHO to determine if those NTDs were also categorized by the US Centers for Disease Control and Prevention as emerging and re-emerging infectious diseases (''EReNTDs''). We then identified common characteristics and risks associated with EReNTDs. Identified EReNTDs of dengue, rabies, Chagas Disease, and cysticercosis disproportionately impact resource-poor settings with poor social determinants of health, spread through globalization, are impacted by vector control, lack available treatments, and threaten global health security. This traditionally neglected subset of diseases requires urgent attention and unique incentive structures to encourage investment in innovation and coordination. Multi-sectorial efforts and targeted public-private partnerships would spur needed R&D for effective and accessible EReNTD treatments, improvement of social determinants of health, crucial low-income country development, and health system strengthening efforts. Utilization of One Health principles is essential for enhancing knowledge to efficaciously address public health aspects of these EReNTDs globally.

Social stigma towards neglected tropical diseases: a systematic review.

PubMed

Hofstraat, Karlijn; van Brakel, Wim H

2016-03-01

People affected by neglected tropical diseases (NTDs) are frequently the target of social stigmatization. To date not much attention has been given to stigma in relation to NTDs. The objective of this review is to identify the extent of social stigma and the similarities and differences in the causes, manifestations, impact of stigma and interventions used between the NTDs. A systematic review was conducted in Pubmed, ScienceDirect, PsycINFO and Web of Knowledge. The search encompassed 17 NTDs, including podoconiosis, but not leprosy as this NTD has recently been reviewed. However, leprosy was included in the discussion. The 52 selected articles provided evidence on stigma related to lymphatic filariasis (LF), podoconiosis, Buruli ulcer, onchocerciasis, schistosomiasis, leishmaniasis, Chagas disease, trachoma, soil-transmitted helminthiasis (STH) and human African trypanosomiasis. The similarities predominated in stigma related to the various NTDs; only minimal differences in stigma reasons and measures were found. These similarities suggest that joint approaches to reduce stigmatization may be feasible. Lessons from leprosy and other stigmatized health conditions can be used to plan such joint approaches. Further research will be necessary to study the efficacy of joint interventions and to investigate stigma related to NTDs for which no evidence is available yet. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Monitoring the efficacy of drugs for neglected tropical diseases controlled by preventive chemotherapy

PubMed Central

Albonico, M.; Levecke, B.; LoVerde, P.T.; Montresor, A.; Prichard, R.; Vercruysse, J.; Webster, J.P.

2017-01-01

In the last decade, pharmaceutical companies, governments and global health organisations under the leadership of the World Health Organization (WHO) have pledged large-scale donations of anthelmintic drugs, including ivermectin (IVM), praziquantel (PZQ), albendazole (ALB) and mebendazole (MEB). This worldwide scale-up in drug donations calls for strong monitoring systems to detect any changes in anthelmintic drug efficacy. This review reports on the outcome of the WHO Global Working Group on Monitoring of Neglected Tropical Diseases Drug Efficacy, which consists of three subgroups: (i) soil-transmitted helminthiases (ALB and MEB); (ii) onchocerciasis and lymphatic filariasis (IVM); and (iii) schistosomiasis (PZQ). Progress of ongoing work, challenges and research needs for each of the four main drugs used in helminthic preventive chemotherapy (PC) are reported, laying the ground for appropriate implementation of drug efficacy monitoring programmes under the co-ordination and guidelines of the WHO. Best practices for monitoring drug efficacy should be made available and capacity built as an integral part of neglected tropical disease (NTD) programme monitoring. Development of a disease-specific model to predict the impact of PC programmes, to detect outliers and to solicit responses is essential. Research studies on genetic polymorphisms in relation to low-efficacy phenotypes should be carried out to identify markers of putative resistance against all NTD drugs and ultimately to develop diagnostic assays. Development of combination and co-administration of NTD drugs as well as of new drug entities to boost the armamentarium of the few drugs available for NTD control and elimination should be pursued in parallel. PMID:27842865

Eliminating the Neglected Tropical Diseases: Translational Science and New Technologies.

PubMed

Hotez, Peter J; Pecoul, Bernard; Rijal, Suman; Boehme, Catharina; Aksoy, Serap; Malecela, Mwelecele; Tapia-Conyer, Roberto; Reeder, John C

2016-03-01

Today, the World Health Organization recognizes 17 major parasitic and related infections as the neglected tropical diseases (NTDs). Despite recent gains in the understanding of the nature and prevalence of NTDs, as well as successes in recent scaled-up preventive chemotherapy strategies and other health interventions, the NTDs continue to rank among the world's greatest global health problems. For virtually all of the NTDs (including those slated for elimination under the auspices of a 2012 London Declaration for NTDs and a 2013 World Health Assembly resolution [WHA 66.12]), additional control mechanisms and tools are needed, including new NTD drugs, vaccines, diagnostics, and vector control agents and strategies. Elimination will not be possible without these new tools. Here we summarize some of the key challenges in translational science to develop and introduce these new technologies in order to ensure success in global NTD elimination efforts.

Monitoring the efficacy of drugs for neglected tropical diseases controlled by preventive chemotherapy.

PubMed

Albonico, M; Levecke, B; LoVerde, P T; Montresor, A; Prichard, R; Vercruysse, J; Webster, J P

2015-12-01

In the last decade, pharmaceutical companies, governments and global health organisations under the leadership of the World Health Organization (WHO) have pledged large-scale donations of anthelmintic drugs, including ivermectin (IVM), praziquantel (PZQ), albendazole (ALB) and mebendazole (MEB). This worldwide scale-up in drug donations calls for strong monitoring systems to detect any changes in anthelmintic drug efficacy. This review reports on the outcome of the WHO Global Working Group on Monitoring of Neglected Tropical Diseases Drug Efficacy, which consists of three subgroups: (i) soil-transmitted helminthiases (ALB and MEB); (ii) onchocerciasis and lymphatic filariasis (IVM); and (iii) schistosomiasis (PZQ). Progress of ongoing work, challenges and research needs for each of the four main drugs used in helminthic preventive chemotherapy (PC) are reported, laying the ground for appropriate implementation of drug efficacy monitoring programmes under the co-ordination and guidelines of the WHO. Best practices for monitoring drug efficacy should be made available and capacity built as an integral part of neglected tropical disease (NTD) programme monitoring. Development of a disease-specific model to predict the impact of PC programmes, to detect outliers and to solicit responses is essential. Research studies on genetic polymorphisms in relation to low-efficacy phenotypes should be carried out to identify markers of putative resistance against all NTD drugs and ultimately to develop diagnostic assays. Development of combination and co-administration of NTD drugs as well as of new drug entities to boost the armamentarium of the few drugs available for NTD control and elimination should be pursued in parallel. Copyright © 2015 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Neglected tropical diseases: progress towards addressing the chronic pandemic.

PubMed

Molyneux, David H; Savioli, Lorenzo; Engels, Dirk

2017-01-21

The concept of neglected tropical diseases (NTDs) emerged more than a decade ago and has been recognised as a valid way to categorise diseases that affect the poorest individuals. Substantial progress in control and elimination has been achieved and policy momentum has been generated through continued bilateral, philanthropic, and non-governmental development organisation (NGDO) support, and donations of drugs from pharmaceutical companies. WHO has defined a Roadmap to reach 2020 targets, which was endorsed by member states in a World Health Assembly Resolution in 2013. NTDs have been included within the Sustainable Development Goal targets and are a crucial component of universal health coverage, conceptualised as "leaving no one behind". WHO reported that more than 1 billion people in 88 countries have benefited from preventive chemotherapy in 2014. The research agenda has defined the need for affordable products (diagnostics, drugs and insecticides). However challenges such as insecurity and weak health systems continue to prevail in the poorest countries, inhibiting progress in scaling up and also in achieving Roadmap goals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Diterpenes as lead molecules against neglected tropical diseases.

PubMed

Barros de Alencar, Marcus Vinícius Oliveira; de Castro E Sousa, João Marcelo; Rolim, Hercília Maria Lins; de Medeiros, Maria das Graças Freire; Cerqueira, Gilberto Santos; de Castro Almeida, Fernanda Regina; Citó, Antônia Maria das Graças Lopes; Ferreira, Paulo Michel Pinheiro; Lopes, José Arimatéia Dantas; de Carvalho Melo-Cavalcante, Ana Amélia; Islam, Md Torequl

2017-02-01

Nowadays, neglected tropical diseases (NTDs) are reported to be present everywhere. Poor and developing areas in the world have received great attention to NTDs. Drug resistance, safety profile, and various challenges stimulate the search for alternative medications. Plant-based drugs are viewed with great interest, as they are believed to be devoid of side effects. Diterpenes, a family of essential oils, have showed attractive biological effects. A systematic review of the literature was carried out to summarize available evidences of diterpenes against NTDs. For this, databases were searched using specific search terms. Among the 2338 collected reports, a total of 181 articles were included in this review. Of them, 148 dealt with investigations using single organisms, and 33 used multiple organisms. No mechanisms of action were reported in the case of 164 reports. A total of 93.92% were related to nonclinical studies, and 4.42% and 1.66% dealt with preclinical and clinical studies, respectively. The review displays that many diterpenes are effective upon Chagas disease, chikungunya, echinococcosis, dengue, leishmaniasis, leprosy, lymphatic filariasis, malaria, schistosomiasis, and tuberculosis. Indeed, diterpenes are amazing drug candidates against NTDs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Review shows that Icelandic society is taking firmer steps to tackle the diverse forms of child abuse and neglect that its children are exposed to.

PubMed

Gunnlaugsson, Geir; Einarsdóttir, Jónína

2018-04-04

This review examined and summarised the research published on child abuse in Iceland, which was mainly in the country's native language, to make the findings more accessible to English speakers. It specifically focused on child rearing and the physical, emotional and sexual abuse, neglect and intrafamilial conflicts suffered by children at the hands of their parents and other carers. The review drew on published research, books and reports and compared the findings with Nordic research and global estimates of child abuse. Qualitative and quantitative research revealed that the prevalence of different forms of child abuse, child neglect and intra-familial conflicts in Iceland was similar to, or higher than, global and Nordic estimates. Younger respondents reported less physical abuse than older respondents, but higher levels of emotional abuse. Legislation, greater awareness, public debates and research on child abuse in Iceland have contributed to the growing recognition of the negative consequences of child abuse and strengthened support for prevention strategies. Icelandic children have reportedly experienced diverse forms of child abuse and neglect from their parents and other carers. Diverse initiatives have been put in place that underline the urgent need to tackle such behaviour. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Pediatric Neglected Tropical Diseases in a Major Metropolitan Children's Hospital in the United States, 2004-2013.

PubMed

Sweet, Leigh R; Palazzi, Debra L

2016-12-01

We conducted a retrospective study of neglected tropical diseases (NTDs) diagnosed at Texas Children's Hospital between 2004 and 2013. Forty-three patients with an NTD were identified; 47% had never traveled outside of the United States. The results of this study highlight the importance of physician awareness of NTDs in children in the United States. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Preventive chemotherapy as a strategy for elimination of neglected tropical parasitic diseases: endgame challenges.

PubMed

Bockarie, Moses J; Kelly-Hope, Louise A; Rebollo, Maria; Molyneux, David H

2013-08-05

Global efforts to address neglected tropical diseases (NTDs) were stimulated in January 2012 by the London declaration at which 22 partners, including the Bill & Melinda Gates Foundation, World Bank, World Health Organization (WHO) and major pharmaceutical companies committed to sustaining and expanding NTD programmes to eliminate or eradicate 11 NTDs by 2020 to achieve the goals outlined in the recently published WHO road map. Here, we present the current context of preventive chemotherapy for some NTDs, and discuss the problems faced by programmes as they consider the 'endgame', such as difficulties of access to populations in post-conflict settings, limited human and financial resources, and the need to expand access to clean water and improved sanitation for schistosomiasis and soil-transmitted helminthiasis. In the case of onchocerciasis and lymphatic filariasis, ivermectin treatment carries a significant risk owing to serious adverse effects in some patients co-infected with the tropical eye worm Loa loa filariasis. We discuss the challenges of managing complex partnerships, and maintain advocacy messages for the continued support for elimination of these preventable diseases.

The Role of Natural Products in Drug Discovery and Development against Neglected Tropical Diseases.

PubMed

Cheuka, Peter Mubanga; Mayoka, Godfrey; Mutai, Peggoty; Chibale, Kelly

2016-12-31

Endemic in 149 tropical and subtropical countries, neglected tropical diseases (NTDs) affect more than 1 billion people annually, including 875 million children in developing economies. These diseases are also responsible for over 500,000 deaths per year and are characterized by long-term disability and severe pain. The impact of the combined NTDs closely rivals that of malaria and tuberculosis. Current treatment options are associated with various limitations including widespread drug resistance, severe adverse effects, lengthy treatment duration, unfavorable toxicity profiles, and complicated drug administration procedures. Natural products have been a valuable source of drug regimens that form the cornerstone of modern pharmaceutical care. In this review, we highlight the potential that remains untapped in natural products as drug leads for NTDs. We cover natural products from plant, marine, and microbial sources including natural-product-inspired semi-synthetic derivatives which have been evaluated against the various causative agents of NTDs. Our coverage is limited to four major NTDs which include human African trypanosomiasis (sleeping sickness), leishmaniasis, schistosomiasis and lymphatic filariasis.

Preventive chemotherapy as a strategy for elimination of neglected tropical parasitic diseases: endgame challenges

PubMed Central

Bockarie, Moses J.; Kelly-Hope, Louise A.; Rebollo, Maria; Molyneux, David H.

2013-01-01

Global efforts to address neglected tropical diseases (NTDs) were stimulated in January 2012 by the London declaration at which 22 partners, including the Bill & Melinda Gates Foundation, World Bank, World Health Organization (WHO) and major pharmaceutical companies committed to sustaining and expanding NTD programmes to eliminate or eradicate 11 NTDs by 2020 to achieve the goals outlined in the recently published WHO road map. Here, we present the current context of preventive chemotherapy for some NTDs, and discuss the problems faced by programmes as they consider the ‘endgame’, such as difficulties of access to populations in post-conflict settings, limited human and financial resources, and the need to expand access to clean water and improved sanitation for schistosomiasis and soil-transmitted helminthiasis. In the case of onchocerciasis and lymphatic filariasis, ivermectin treatment carries a significant risk owing to serious adverse effects in some patients co-infected with the tropical eye worm Loa loa filariasis. We discuss the challenges of managing complex partnerships, and maintain advocacy messages for the continued support for elimination of these preventable diseases. PMID:23798692

Quantitative analyses and modelling to support achievement of the 2020 goals for nine neglected tropical diseases.

PubMed

Hollingsworth, T Déirdre; Adams, Emily R; Anderson, Roy M; Atkins, Katherine; Bartsch, Sarah; Basáñez, María-Gloria; Behrend, Matthew; Blok, David J; Chapman, Lloyd A C; Coffeng, Luc; Courtenay, Orin; Crump, Ron E; de Vlas, Sake J; Dobson, Andy; Dyson, Louise; Farkas, Hajnal; Galvani, Alison P; Gambhir, Manoj; Gurarie, David; Irvine, Michael A; Jervis, Sarah; Keeling, Matt J; Kelly-Hope, Louise; King, Charles; Lee, Bruce Y; Le Rutte, Epke A; Lietman, Thomas M; Ndeffo-Mbah, Martial; Medley, Graham F; Michael, Edwin; Pandey, Abhishek; Peterson, Jennifer K; Pinsent, Amy; Porco, Travis C; Richardus, Jan Hendrik; Reimer, Lisa; Rock, Kat S; Singh, Brajendra K; Stolk, Wilma; Swaminathan, Subramanian; Torr, Steve J; Townsend, Jeffrey; Truscott, James; Walker, Martin; Zoueva, Alexandra

2015-12-09

Quantitative analysis and mathematical models are useful tools in informing strategies to control or eliminate disease. Currently, there is an urgent need to develop these tools to inform policy to achieve the 2020 goals for neglected tropical diseases (NTDs). In this paper we give an overview of a collection of novel model-based analyses which aim to address key questions on the dynamics of transmission and control of nine NTDs: Chagas disease, visceral leishmaniasis, human African trypanosomiasis, leprosy, soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. Several common themes resonate throughout these analyses, including: the importance of epidemiological setting on the success of interventions; targeting groups who are at highest risk of infection or re-infection; and reaching populations who are not accessing interventions and may act as a reservoir for infection,. The results also highlight the challenge of maintaining elimination 'as a public health problem' when true elimination is not reached. The models elucidate the factors that may be contributing most to persistence of disease and discuss the requirements for eventually achieving true elimination, if that is possible. Overall this collection presents new analyses to inform current control initiatives. These papers form a base from which further development of the models and more rigorous validation against a variety of datasets can help to give more detailed advice. At the moment, the models' predictions are being considered as the world prepares for a final push towards control or elimination of neglected tropical diseases by 2020.

Harnessing Big Data for Communicable Tropical and Sub-Tropical Disorders: Implications From a Systematic Review of the Literature.

PubMed

Gianfredi, Vincenza; Bragazzi, Nicola Luigi; Nucci, Daniele; Martini, Mariano; Rosselli, Roberto; Minelli, Liliana; Moretti, Massimo

2018-01-01

According to the World Health Organization (WHO), communicable tropical and sub-tropical diseases occur solely, or mainly in the tropics, thriving in hot, and humid conditions. Some of these disorders termed as neglected tropical diseases are particularly overlooked. Communicable tropical/sub-tropical diseases represent a diverse group of communicable disorders occurring in 149 countries, favored by tropical and sub-tropical conditions, affecting more than one billion people and imposing a dramatic societal and economic burden. A systematic review of the extant scholarly literature was carried out, searching in PubMed/MEDLINE and Scopus. The search string used included proper keywords, like big data, nontraditional data sources, social media, social networks, infodemiology, infoveillance, novel data streams (NDS), digital epidemiology, digital behavior, Google Trends, Twitter, Facebook, YouTube, Instagram, Pinterest, Ebola, Zika, dengue, Chikungunya, Chagas, and the other neglected tropical diseases. 47 original, observational studies were included in the current systematic review: 1 focused on Chikungunya, 6 on dengue, 19 on Ebola, 2 on Malaria, 1 on Mayaro virus, 2 on West Nile virus, and 16 on Zika. Fifteen were dedicated on developing and validating forecasting techniques for real-time monitoring of neglected tropical diseases, while the remaining studies investigated public reaction to infectious outbreaks. Most studies explored a single nontraditional data source, with Twitter being the most exploited tool (25 studies). Even though some studies have shown the feasibility of utilizing NDS as an effective tool for predicting epidemic outbreaks and disseminating accurate, high-quality information concerning neglected tropical diseases, some gaps should be properly underlined. Out of the 47 articles included, only 7 were focusing on neglected tropical diseases, while all the other covered communicable tropical/sub-tropical diseases, and the main determinant of

Neglected diseases amid wealth in the United States and Europe.

PubMed

Hotez, Peter

2009-01-01

Neglected tropical diseases are not exclusive to low-income countries. In the United States, such infections account for a sizable but largely hidden disease burden among minority populations living in poverty and among people of African descent in particular. Similar infections also occur in Europe. As efforts to control neglected tropical diseases expand throughout Africa, parallel efforts should also target poor and forgotten people in wealthy nations.

Cheaper faster drug development validated by the repositioning of drugs against neglected tropical diseases.

PubMed

Williams, Kevin; Bilsland, Elizabeth; Sparkes, Andrew; Aubrey, Wayne; Young, Michael; Soldatova, Larisa N; De Grave, Kurt; Ramon, Jan; de Clare, Michaela; Sirawaraporn, Worachart; Oliver, Stephen G; King, Ross D

2015-03-06

There is an urgent need to make drug discovery cheaper and faster. This will enable the development of treatments for diseases currently neglected for economic reasons, such as tropical and orphan diseases, and generally increase the supply of new drugs. Here, we report the Robot Scientist 'Eve' designed to make drug discovery more economical. A Robot Scientist is a laboratory automation system that uses artificial intelligence (AI) techniques to discover scientific knowledge through cycles of experimentation. Eve integrates and automates library-screening, hit-confirmation, and lead generation through cycles of quantitative structure activity relationship learning and testing. Using econometric modelling we demonstrate that the use of AI to select compounds economically outperforms standard drug screening. For further efficiency Eve uses a standardized form of assay to compute Boolean functions of compound properties. These assays can be quickly and cheaply engineered using synthetic biology, enabling more targets to be assayed for a given budget. Eve has repositioned several drugs against specific targets in parasites that cause tropical diseases. One validated discovery is that the anti-cancer compound TNP-470 is a potent inhibitor of dihydrofolate reductase from the malaria-causing parasite Plasmodium vivax.

Cheaper faster drug development validated by the repositioning of drugs against neglected tropical diseases

PubMed Central

Williams, Kevin; Bilsland, Elizabeth; Sparkes, Andrew; Aubrey, Wayne; Young, Michael; Soldatova, Larisa N.; De Grave, Kurt; Ramon, Jan; de Clare, Michaela; Sirawaraporn, Worachart; Oliver, Stephen G.; King, Ross D.

2015-01-01

There is an urgent need to make drug discovery cheaper and faster. This will enable the development of treatments for diseases currently neglected for economic reasons, such as tropical and orphan diseases, and generally increase the supply of new drugs. Here, we report the Robot Scientist ‘Eve’ designed to make drug discovery more economical. A Robot Scientist is a laboratory automation system that uses artificial intelligence (AI) techniques to discover scientific knowledge through cycles of experimentation. Eve integrates and automates library-screening, hit-confirmation, and lead generation through cycles of quantitative structure activity relationship learning and testing. Using econometric modelling we demonstrate that the use of AI to select compounds economically outperforms standard drug screening. For further efficiency Eve uses a standardized form of assay to compute Boolean functions of compound properties. These assays can be quickly and cheaply engineered using synthetic biology, enabling more targets to be assayed for a given budget. Eve has repositioned several drugs against specific targets in parasites that cause tropical diseases. One validated discovery is that the anti-cancer compound TNP-470 is a potent inhibitor of dihydrofolate reductase from the malaria-causing parasite Plasmodium vivax. PMID:25652463

Does Biodiversity-Ecosystem Function Literature Neglect Tropical Ecosystems?

PubMed

Clarke, David A; York, Paul H; Rasheed, Michael A; Northfield, Tobin D

2017-05-01

Current evidence suggests that there is a positive relationship between biodiversity and ecosystem functioning, but few studies have addressed tropical ecosystems where the highest levels of biodiversity occur. We develop two hypotheses for the implications of generalizing from temperate studies to tropical ecosystems, and discuss the need for more tropical research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Yeast as a potential vehicle for neglected tropical disease drug discovery.

PubMed

Denny, P W; Steel, P G

2015-01-01

High-throughput screening (HTS) efforts for neglected tropical disease (NTD) drug discovery have recently received increased attention because several initiatives have begun to attempt to reduce the deficit in new and clinically acceptable therapies for this spectrum of infectious diseases. HTS primarily uses two basic approaches, cell-based and in vitro target-directed screening. Both of these approaches have problems; for example, cell-based screening does not reveal the target or targets that are hit, whereas in vitro methodologies lack a cellular context. Furthermore, both can be technically challenging, expensive, and difficult to miniaturize for ultra-HTS [(u)HTS]. The application of yeast-based systems may overcome some of these problems and offer a cost-effective platform for target-directed screening within a eukaryotic cell context. Here, we review the advantages and limitations of the technologies that may be used in yeast cell-based, target-directed screening protocols, and we discuss how these are beginning to be used in NTD drug discovery. © 2014 Society for Laboratory Automation and Screening.

Drug Coverage Surveys for Neglected Tropical Diseases: 10 Years of Field Experience

PubMed Central

Worrell, Caitlin; Mathieu, Els

2012-01-01

Mass drug administration is one of the public health strategies recommended by the World Health Organization for the control and elimination of seven neglected tropical diseases (NTDs). Because adequate coverage is vital to achieve program goals, periodically conducting surveys to validate reported coverage to guide NTD programs is recommended. Over the past decade, the Centers for Disease Control and Prevention (CDC) and collaborators conducted more than 30 two-stage cluster household surveys across three continents. The questionnaires gathered coverage data and information relevant to improving NTD programs including NTD-related attitudes and practices. From the 37 coverage survey estimates obtained in those surveys, 73.3% indicated an over reporting of coverage, including all three that assessed school-based distributions. It took an average of 1 week to conduct a survey. Our experiences led us to conclude that coverage surveys are useful and feasible tools to ensure NTD elimination and control goals are reached. PMID:22855750

Earth Observation, Spatial Data Quality, and Neglected Tropical Diseases.

PubMed

Hamm, Nicholas A S; Soares Magalhães, Ricardo J; Clements, Archie C A

2015-12-01

Earth observation (EO) is the use of remote sensing and in situ observations to gather data on the environment. It finds increasing application in the study of environmentally modulated neglected tropical diseases (NTDs). Obtaining and assuring the quality of the relevant spatially and temporally indexed EO data remain challenges. Our objective was to review the Earth observation products currently used in studies of NTD epidemiology and to discuss fundamental issues relating to spatial data quality (SDQ), which limit the utilization of EO and pose challenges for its more effective use. We searched Web of Science and PubMed for studies related to EO and echinococossis, leptospirosis, schistosomiasis, and soil-transmitted helminth infections. Relevant literature was also identified from the bibliographies of those papers. We found that extensive use is made of EO products in the study of NTD epidemiology; however, the quality of these products is usually given little explicit attention. We review key issues in SDQ concerning spatial and temporal scale, uncertainty, and the documentation and use of quality information. We give examples of how these issues may interact with uncertainty in NTD data to affect the output of an epidemiological analysis. We conclude that researchers should give careful attention to SDQ when designing NTD spatial-epidemiological studies. This should be used to inform uncertainty analysis in the epidemiological study. SDQ should be documented and made available to other researchers.

Towards effective prevention and control of helminth neglected tropical diseases in the Western Pacific Region through multi-disease and multi-sectoral interventions.

PubMed

Nakagawa, Jun; Ehrenberg, John P; Nealon, Joshua; Fürst, Thomas; Aratchige, Padmasiri; Gonzales, Glenda; Chanthavisouk, Chitsavang; Hernandez, Leda M; Fengthong, Tayphasavanh; Utzinger, Jürg; Steinmann, Peter

2015-01-01

Neglected tropical diseases (NTDs) cause serious health, social and economic burdens in the countries of the World Health Organization Western Pacific Region. Among the NTDs, helminth infections are particularly prominent with regard to the number of infected individuals and health impact. Co-endemicity is common among impoverished and marginalized populations. To achieve effective and sustainable control of helminth NTDs, a deeper understanding of the social-ecological systems governing their endemicity and strategies beyond preventive chemotherapy are required to tackle the multiple causes of infection and re-infection. We discuss the feasibility of implementing multi-disease, multi-sectoral intervention packages for helminth NTDs in the Western Pacific Region. After reviewing the main determinants for helminth NTD endemicity and current control strategies, key control activities that involve or concern other programmes within and beyond the health sector are discussed. A considerable number of activities that have an impact on more than one helminth NTD are identified in a variety of sectors, suggesting an untapped potential for synergies. We also highlight the challenges of multi-sectoral collaboration, particularly of involving non-health sectors. We conclude that multi-sectoral collaboration for helminth NTD control is feasible if the target diseases and sectors are carefully selected. To do so, an incentive analysis covering key stakeholders in the sectors is crucial, and the disease-control strategies need to be well understood. The benefits of multi-disease, multi-sectoral approaches could go beyond immediate health impacts by contributing to sustainable development, raising educational attainment, increasing productivity and reducing health inequities. Copyright © 2013 Elsevier B.V. All rights reserved.

Informatics for neglected diseases collaborations.

PubMed

Bost, Frederic; Jacobs, Robert T; Kowalczyk, Paul

2010-05-01

Many different public and private organizations from across the globe are collaborating on neglected diseases drug-discovery and development projects with the aim of identifying a cure for tropical infectious diseases. These neglected diseases collaborations require a global, secure, multi-organization data-management solution, combined with a platform that facilitates communication and supports collaborative work. This review discusses the solutions offered by 'Software as a Service' (SaaS) web-based platforms, despite notable challenges, and the evolution of these platforms required to foster efficient virtual research efforts by geographically dispersed scientists.

Leaving no one behind: a neglected tropical disease indicator and tracers for the Sustainable Development Goals

PubMed Central

Fitzpatrick, Christopher; Engels, Dirk

2016-01-01

The Sustainable Development Goals (SDGs) have emerged as a global pledge to ‘leave no one behind’. Under SDG 3, ‘Ensure healthy lives and promote wellbeing for all’, target 3.3 extends the Millennium Development Goals (MDGs) beyond HIV, TB and malaria to ‘end the epidemic’ of neglected tropical diseases (NTDs) by 2030. Other targets are also relevant to NTDs, especially 3.8 (Universal Health Coverage), 6.1 (water) and 6.2 (sanitation). This commentary summarises the proposed NTD indicator (3.3) and tracers (3.8 and 6.1/6.2). These will help ensure that the world's poorest and most marginalized people are prioritized at every step on the path towards SDG targets. PMID:26940304

Recombinant snakebite antivenoms: A cost-competitive solution to a neglected tropical disease?

PubMed

Laustsen, Andreas H; Johansen, Kristoffer H; Engmark, Mikael; Andersen, Mikael R

2017-02-01

Snakebite envenoming is a major public health burden in tropical parts of the developing world. In sub-Saharan Africa, neglect has led to a scarcity of antivenoms threatening the lives and limbs of snakebite victims. Technological advances within antivenom are warranted, but should be evaluated not only on their possible therapeutic impact, but also on their cost-competitiveness. Recombinant antivenoms based on oligoclonal mixtures of human IgG antibodies produced by CHO cell cultivation may be the key to obtaining better snakebite envenoming therapies. Based on industry data, the cost of treatment for a snakebite envenoming with a recombinant antivenom is estimated to be in the range USD 60-250 for the Final Drug Product. One of the effective antivenoms (SAIMR Snake Polyvalent Antivenom from the South African Vaccine Producers) currently on the market has been reported to have a wholesale price of USD 640 per treatment for an average snakebite. Recombinant antivenoms may therefore in the future be a cost-competitive alternative to existing serum-based antivenoms.

Recombinant snakebite antivenoms: A cost-competitive solution to a neglected tropical disease?

PubMed Central

Johansen, Kristoffer H.; Engmark, Mikael; Andersen, Mikael R.

2017-01-01

Snakebite envenoming is a major public health burden in tropical parts of the developing world. In sub-Saharan Africa, neglect has led to a scarcity of antivenoms threatening the lives and limbs of snakebite victims. Technological advances within antivenom are warranted, but should be evaluated not only on their possible therapeutic impact, but also on their cost-competitiveness. Recombinant antivenoms based on oligoclonal mixtures of human IgG antibodies produced by CHO cell cultivation may be the key to obtaining better snakebite envenoming therapies. Based on industry data, the cost of treatment for a snakebite envenoming with a recombinant antivenom is estimated to be in the range USD 60–250 for the Final Drug Product. One of the effective antivenoms (SAIMR Snake Polyvalent Antivenom from the South African Vaccine Producers) currently on the market has been reported to have a wholesale price of USD 640 per treatment for an average snakebite. Recombinant antivenoms may therefore in the future be a cost-competitive alternative to existing serum-based antivenoms. PMID:28158193

Seroprevalence of five neglected parasitic diseases among immigrants accessing five infectious and tropical diseases units in Italy: a cross-sectional study.

PubMed

Martelli, G; Di Girolamo, C; Zammarchi, L; Angheben, A; Morandi, M; Tais, S; Degani, M; El Hamad, I; Caligaris, S; Ciannameo, A; Grilli, E; Urbinati, L; Monteiro, G B; Scarcella, C; Petrosillo, N; Digaetano, M; Rabbi, L; Bazzanini, N; Cacciatore, F; Marta, B L; Moro, M L; Bartoloni, A; Viale, P; Verucchi, G

2017-05-01

This multicentre cross-sectional study aims to estimate the prevalence of five neglected tropical diseases (Chagas disease, filariasis, schistosomiasis, strongyloidiasis and toxocariasis) among immigrants accessing health care facilities in five Italian cities (Bologna, Brescia, Florence, Rome, Verona). Individuals underwent a different set of serological tests, according to country of origin and presence of eosinophilia. Seropositive patients were treated and further followed up. A total of 930 adult immigrants were enrolled: 477 men (51.3%), 445 women (47.9%), eight transgender (0.8%); median age was 37.81 years (range 18-80 years). Most of them had come from the African continent (405/930, 43.5%), the rest from East Europe, South America and Asia, and 9.6% (89/930) were diagnosed with at least one of the infections under study. Seroprevalence of each specific infection varied from 3.9% (7/180) for Chagas disease to 9.7% (11/113) for toxocariasis. Seropositive people were more likely to be 35-40 years old and male, and to come from South East Asia, sub-Saharan Africa or South America. The results of our study confirm that neglected tropical diseases represent a substantial health problem among immigrants and highlight the need to address this emerging public health issue. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

How to deal with neglected tropical diseases in the light of an African ethic.

PubMed

Metz, Thaddeus

2017-11-07

Many countries in Africa, and more generally those in the Global South with tropical areas, are plagued by illnesses that the wealthier parts of the world (mainly 'the West') neither suffer from nor put systematic effort into preventing, treating or curing. What does an ethic with a recognizably African pedigree entail for the ways various agents ought to respond to such neglected diseases? As many readers will know, a characteristically African ethic prescribes weighty duties to aid on the part of those in a position to do so, and it therefore entails that there should have been much more contribution from the Western, 'developed' world. However, what else does it prescribe, say, on the part of sub-Saharan governments and the African Union, and are they in fact doing it? I particularly seek to answer these questions here, by using the 2013-16 Ebola crisis in West Africa to illustrate what should have happened but what by and large did not. © 2017 John Wiley & Sons Ltd.

De-Politicizing Parasites: Reflections on Attempts to Control the Control of Neglected Tropical Diseases

PubMed Central

Parker, Melissa; Allen, Tim

2014-01-01

Large amounts of funding are being allocated to the control of neglected tropical diseases. Strategies primarily rely on the mass distribution of drugs to adults and children living in endemic areas. The approach is presented as morally appropriate, technically effective, and context-free. Drawing on research undertaken in East Africa, we discuss ways in which normative ideas about global health programs are used to set aside social and biological evidence. In particular, there is a tendency to ignore local details, including information about actual drug take up. Ferguson’s ‘anti-politics’ thesis is a useful starting point for analyzing why this happens, but is overly deterministic. Anti-politics discourse about healing the suffering poor may shape thinking and help explain cognitive dissonance. However, use of such discourse is also a means of strategically promoting vested interests and securing funding. Whatever the underlying motivations, rhetoric and realities are conflated, with potentially counterproductive consequences. PMID:24761976

Leaving no one behind: a neglected tropical disease indicator and tracers for the Sustainable Development Goals.

PubMed

Fitzpatrick, Christopher; Engels, Dirk

2016-03-01

The Sustainable Development Goals (SDGs) have emerged as a global pledge to 'leave no one behind'. Under SDG 3, 'Ensure healthy lives and promote wellbeing for all', target 3.3 extends the Millennium Development Goals (MDGs) beyond HIV, TB and malaria to 'end the epidemic' of neglected tropical diseases (NTDs) by 2030. Other targets are also relevant to NTDs, especially 3.8 (Universal Health Coverage), 6.1 (water) and 6.2 (sanitation). This commentary summarises the proposed NTD indicator (3.3) and tracers (3.8 and 6.1/6.2). These will help ensure that the world's poorest and most marginalized people are prioritized at every step on the path towards SDG targets. © The author 2016. The World Health Organization has granted Oxford University Press permission for the reproduction of this article..

Integrating Neglected Tropical Disease and Immunization Programs: The Experiences of the Tanzanian Ministry of Health

PubMed Central

Mwingira, Upendo John; Means, Arianna Rubin; Chikawe, Maria; Kilembe, Bernard; Lyimo, Dafrossa; Crowley, Kathryn; Rusibamayila, Neema; Nshala, Andreas; Mphuru, Alex

2016-01-01

Global health practitioners are increasingly advocating for the integration of community-based health-care platforms as a strategy for increasing the coverage of programs, encouraging program efficiency, and promoting universal health-care goals. To leverage the strengths of compatible programs and avoid geographic and temporal duplications in efforts, the Tanzanian Ministry of Health and Social Welfare coordinated immunization and neglected tropical disease programs for the first time in 2014. Specifically, a measles and rubella supplementary vaccine campaign, mass drug administration (MDA) of ivermectin and albendazole, and Vitamin A were provisionally integrated into a shared community-based delivery platform. Over 21 million people were targeted by the integrated campaign, with the immunization program and MDA program reaching 97% and 93% of targeted individuals, respectively. The purpose of this short report is to share the Tanzanian experience of launching and managing this integrated campaign with key stakeholders. PMID:27246449

Can mobile phones help control neglected tropical diseases? Experiences from Tanzania.

PubMed

Madon, Shirin; Amaguru, Jackline Olanya; Malecela, Mwele Ntuli; Michael, Edwin

2014-02-01

The increasing proliferation of mobiles offers possibilities for improving health systems in developing countries. A case in point is Tanzania which has piloted a mobile phone-based Management Information System (MIS) for the control of neglected tropical diseases (NTDs) where village health workers (VHWs) were given mobile phones with web-based software to test the feasibility of using frontline health workers to capture data at point of source. Based on qualitative case study research carried out in 2011, we found that providing mobile phones to VHWs has helped to increase the efficiency of routine work boosting the motivation and self-esteem of VHWs. However, despite these advantages, the information generated from the mobile phone-based NTD MIS has yet to be used to support decentralised decision-making. Even with improved technology and political will, the biggest hindrance to local usage of information for health planning is the lack of synthesised and analysed health information from the district and national levels to the villages. Without inculcating a culture of providing health information feedback to frontline workers and community organisations, the benefits of the intervention will be limited. If not addressed, this will mean that mobiles have maintained the one-way upward flow of information for NTD control and simply made reporting more hi-tech. Copyright © 2013 Elsevier Ltd. All rights reserved.

Neglected Bacterial Zoonoses

PubMed Central

Chikeka, Ijeuru; Dumler, J. Stephen

2015-01-01

Bacterial zoonoses comprise a group of diseases in humans or animals acquired by direct contact with or by oral consumption of contaminated animal materials, or via arthropod vectors. Among neglected infections, bacterial zoonoses are among the most neglected given emerging data on incidence and prevalence as causes of acute febrile illness, even in areas where recognized neglected tropical diseases occur frequently. While many other bacterial infections could also be considered in this neglected category, five distinct infections stand out because they are globally distributed, are acute febrile diseases, have high rates of morbidity and case fatality, and are reported as commonly as malaria, typhoid or dengue virus infections in carefully designed studies in which a broad spectrum diagnoses are actively sought. Thus, this review will focus attention on leptospirosis, relapsing fever borreliosis, and rickettsioses, including scrub typhus, murine typhus and spotted fever group rickettsiosis. Of greatest interest is the lack of distinguishing clinical features among these infections when in humans, which confounds diagnosis where laboratory confirmation is lacking, and in regions where clinical diagnosis is often attributed to one of several perceived more common threats. As diseases such as malaria come under improved control, the real impact of these common and under-recognized infections will become evident, as will the requirement for the strategies and allocation of resources for their control. PMID:25964152

Ontology patterns for tabular representations of biomedical knowledge on neglected tropical diseases

PubMed Central

Santana, Filipe; Schober, Daniel; Medeiros, Zulma; Freitas, Fred; Schulz, Stefan

2011-01-01

Motivation: Ontology-like domain knowledge is frequently published in a tabular format embedded in scientific publications. We explore the re-use of such tabular content in the process of building NTDO, an ontology of neglected tropical diseases (NTDs), where the representation of the interdependencies between hosts, pathogens and vectors plays a crucial role. Results: As a proof of concept we analyzed a tabular compilation of knowledge about pathogens, vectors and geographic locations involved in the transmission of NTDs. After a thorough ontological analysis of the domain of interest, we formulated a comprehensive design pattern, rooted in the biomedical domain upper level ontology BioTop. This pattern was implemented in a VBA script which takes cell contents of an Excel spreadsheet and transforms them into OWL-DL. After minor manual post-processing, the correctness and completeness of the ontology was tested using pre-formulated competence questions as description logics (DL) queries. The expected results could be reproduced by the ontology. The proposed approach is recommended for optimizing the acquisition of ontological domain knowledge from tabular representations. Availability and implementation: Domain examples, source code and ontology are freely available on the web at http://www.cin.ufpe.br/~ntdo. Contact: fss3@cin.ufpe.br PMID:21685092

Estimating Burdens of Neglected Tropical Zoonotic Diseases on Islands with Introduced Mammals.

PubMed

de Wit, Luz A; Croll, Donald A; Tershy, Bernie; Newton, Kelly M; Spatz, Dena R; Holmes, Nick D; Kilpatrick, A Marm

2017-03-01

AbstractMany neglected tropical zoonotic pathogens are maintained by introduced mammals, and on islands the most common introduced species are rodents, cats, and dogs. Management of introduced mammals, including control or eradication of feral populations, which is frequently done for ecological restoration, could also reduce or eliminate the pathogens these animals carry. Understanding the burden of these zoonotic diseases is crucial for quantifying the potential public health benefits of introduced mammal management. However, epidemiological data are only available from a small subset of islands where these introduced mammals co-occur with people. We examined socioeconomic and climatic variables as predictors for disease burdens of angiostrongyliasis, leptospirosis, toxoplasmosis, toxocariasis, and rabies from 57 islands or island countries. We found strong correlates of disease burden for leptospirosis, Toxoplasma gondii infection, angiostrongyliasis, and toxocariasis with more than 50% of the variance explained, and an average of 57% (range = 32-95%) predictive accuracy on out-of-sample data. We used these relationships to provide estimates of leptospirosis incidence and T. gondii seroprevalence infection on islands where nonnative rodents and cats are present. These predicted estimates of disease burden could be used in an initial assessment of whether the costs of managing introduced mammal reservoirs might be less than the costs of perpetual treatment of these diseases on islands.

The Tropical Disease Priority Review Voucher: A Game-Changer for Tropical Disease Products.

PubMed

Berman, Jonathan; Radhakrishna, Tanya

2017-01-11

The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals-artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis-have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. © The American Society of Tropical Medicine and Hygiene.

Neglected tropical diseases: now more than just 'other diseases'--the post-2015 agenda.

PubMed

Molyneux, David H

2014-09-01

Neglected tropical diseases (NTDs) have become recognised as important health problems facing at least a billion people in the low-income countries and the poorest communities in middle-income countries. WHO plays a leading role in developing strategies to address these diseases, pharmaceutical companies provide drug donations to treat or control the NTDs and many partners from different constituencies have become increasingly committed to their control or elimination. This review looks to the post-2015 agenda and emphasises that despite the progress made over recent years, if the targets established are to be achieved, then not only will additional financial resources be required to up-scale treatments and increase access, but increased applied and operational research will be necessary to address problems and human capacity in NTD skills will need to be strengthened. Continuing advocacy for the relevance of control or elimination of NTDs must be placed in the context of universal health coverage and access to donated essential medicines for the poor as a right. The evidence that investment in NTD interventions are cost-effective and impact not only on health, but also to enhance socio-economic development, must be refined and promulgated. The global burden of disease attributable to NTDs requires reassessment to appropriately define the true burden, while the potential for unexpected events, political, climatic, environmental as well as biological, have the potential to reduce future progress towards the agreed post-2015 targets. NTD progress towards the WHO Roadmap targets and the fulfilment of the World Health Assembly Resolution 66.12 of 2013 demand continued commitment from all partner constituencies when challenges emerge. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Purinergic receptors and neglected tropical diseases: why ignore purinergic signaling in the search for new molecular targets?

PubMed

Pacheco, P A F; Dantas, L P; Ferreira, L G B; Faria, Robson Xavier

2018-06-07

Purinergic receptors are widespread in the human organism and are involved in several physiological functions like neurotransmission, nociception, platelet aggregation, etc. In the immune system, they may regulate the expression and release of pro-inflammatory factors as well as the activation and death of several cell types. It is already described the participation of some purinergic receptors in the inflammation and pathological processes, such as a few neglected tropical diseases (NTDs) which affect more than 1 billion people in the world. Although the high social influence those diseases represent endemic countries, most of them do not have an efficient, safe or affordable drug treatment. In that way, this review aims to discuss the current literature involving purinergic receptor and immune response to NTDs pathogens, which may contribute in the search for new therapeutic possibilities.

Seven challenges for modelling indirect transmission: vector-borne diseases, macroparasites and neglected tropical diseases.

PubMed

Hollingsworth, T Déirdre; Pulliam, Juliet R C; Funk, Sebastian; Truscott, James E; Isham, Valerie; Lloyd, Alun L

2015-03-01

Many of the challenges which face modellers of directly transmitted pathogens also arise when modelling the epidemiology of pathogens with indirect transmission--whether through environmental stages, vectors, intermediate hosts or multiple hosts. In particular, understanding the roles of different hosts, how to measure contact and infection patterns, heterogeneities in contact rates, and the dynamics close to elimination are all relevant challenges, regardless of the mode of transmission. However, there remain a number of challenges that are specific and unique to modelling vector-borne diseases and macroparasites. Moreover, many of the neglected tropical diseases which are currently targeted for control and elimination are vector-borne, macroparasitic, or both, and so this article includes challenges which will assist in accelerating the control of these high-burden diseases. Here, we discuss the challenges of indirect measures of infection in humans, whether through vectors or transmission life stages and in estimating the contribution of different host groups to transmission. We also discuss the issues of "evolution-proof" interventions against vector-borne disease. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Seven challenges for modelling indirect transmission: Vector-borne diseases, macroparasites and neglected tropical diseases

PubMed Central

Hollingsworth, T. Déirdre; Pulliam, Juliet R.C.; Funk, Sebastian; Truscott, James E.; Isham, Valerie; Lloyd, Alun L.

2015-01-01

Many of the challenges which face modellers of directly transmitted pathogens also arise when modelling the epidemiology of pathogens with indirect transmission – whether through environmental stages, vectors, intermediate hosts or multiple hosts. In particular, understanding the roles of different hosts, how to measure contact and infection patterns, heterogeneities in contact rates, and the dynamics close to elimination are all relevant challenges, regardless of the mode of transmission. However, there remain a number of challenges that are specific and unique to modelling vector-borne diseases and macroparasites. Moreover, many of the neglected tropical diseases which are currently targeted for control and elimination are vector-borne, macroparasitic, or both, and so this article includes challenges which will assist in accelerating the control of these high-burden diseases. Here, we discuss the challenges of indirect measures of infection in humans, whether through vectors or transmission life stages and in estimating the contribution of different host groups to transmission. We also discuss the issues of “evolution-proof” interventions against vector-borne disease. PMID:25843376

The Tropical Disease Priority Review Voucher: A Game-Changer for Tropical Disease Products

PubMed Central

Berman, Jonathan; Radhakrishna, Tanya

2017-01-01

The Neglected Tropical Disease Voucher Program is a Congressionally-mandated program intended to promote approval of products for tropical diseases because it provides spectacular financial compensation consequent to FDA approval of a priority product. Three drug approvals–artemether/lumifantrine for malaria, bedaquiline for multidrug resistant tuberculosis, miltefosine for leishmaniasis–have received Tropical Disease Vouchers to date. We give our view of the type of products that might qualify for a Tropical Disease Voucher, financial considerations in venturing capital to support product development, clinical ramifications of a successful product approval, and an overall evaluation of the Program. PMID:27573627

Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases.

PubMed

Bardosh, Kevin

2014-01-01

Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the "neglected" status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.

Neglected bacterial zoonoses.

PubMed

Chikeka, I; Dumler, J S

2015-05-01

Bacterial zoonoses comprise a group of diseases in humans or animals acquired by direct contact with or by oral consumption of contaminated animal materials, or via arthropod vectors. Among neglected infections, bacterial zoonoses are among the most neglected given emerging data on incidence and prevalence as causes of acute febrile illness, even in areas where recognized neglected tropical diseases occur frequently. Although many other bacterial infections could also be considered in this neglected category, five distinct infections stand out because they are globally distributed, are acute febrile diseases, have high rates of morbidity and case fatality, and are reported as commonly as malaria, typhoid or dengue virus infections in carefully designed studies in which broad-spectrum diagnoses are actively sought. This review will focus attention on leptospirosis, relapsing fever borreliosis and rickettsioses, including scrub typhus, murine typhus and spotted fever group rickettsiosis. Of greatest interest is the lack of distinguishing clinical features among these infections when in humans, which confounds diagnosis where laboratory confirmation is lacking, and in regions where clinical diagnosis is often attributed to one of several perceived more common threats. As diseases such as malaria come under improved control, the real impact of these common and under-recognized infections will become evident, as will the requirement for the strategies and allocation of resources for their control. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Impact of vectorborne parasitic neglected tropical diseases on child health.

PubMed

Barry, Meagan A; Murray, Kristy O; Hotez, Peter J; Jones, Kathryn M

2016-07-01

Chagas disease, leishmaniasis, onchocerciasis and lymphatic filariasis are all vectorborne neglected tropical diseases (NTDs) that are responsible for significant disease burden in impoverished children and adults worldwide. As vectorborne parasitic diseases, they can all be targeted for elimination through vector control strategies. Examples of successful vector control programmes for these diseases over the past two decades have included the Southern Cone Initiative against Chagas disease, the Kala-azar Control Scheme against leishmaniasis, the Onchocerciasis Control Programme and the lymphatic filariasis control programme in The Gambia. A common vector control component in all of these programmes is the use of adulticides including dichlorodiphenyltrichloroethane and newer synthetic pyrethroid insecticides against the insect vectors of disease. Household spraying has been used against Chagas disease and leishmaniasis, and insecticide-treated bed nets have helped prevent leishmaniasis and lymphatic filariasis. Recent trends in vector control focus on collaborations between programmes and sectors to achieve integrated vector management that addresses the holistic vector control needs of a community rather than approaching it on a disease-by-disease basis, with the goals of increased efficacy, sustainability and cost-effectiveness. As evidence of vector resistance to currently used insecticide regimens emerges, research to develop new and improved insecticides and novel control strategies will be critical in reducing disease burden. In the quest to eliminate these vectorborne NTDs, efforts need to be made to continue existing control programmes, further implement integrated vector control strategies and stimulate research into new insecticides and control methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Drug Discovery for Neglected Diseases: Molecular Target-Based and Phenotypic Approaches

PubMed Central

2013-01-01

Drug discovery for neglected tropical diseases is carried out using both target-based and phenotypic approaches. In this paper, target-based approaches are discussed, with a particular focus on human African trypanosomiasis. Target-based drug discovery can be successful, but careful selection of targets is required. There are still very few fully validated drug targets in neglected diseases, and there is a high attrition rate in target-based drug discovery for these diseases. Phenotypic screening is a powerful method in both neglected and non-neglected diseases and has been very successfully used. Identification of molecular targets from phenotypic approaches can be a way to identify potential new drug targets. PMID:24015767

Public-private partnerships in neglected tropical disease control: the role of nongovernmental organisations.

PubMed

Bush, S; Hopkins, A D

2011-09-01

Successful public-private partnerships for health control have usually included nongovernmental development organisations (NGDOs), and these have long been in the forefront of pinpointing particular social and health issues. The immensely successful control and elimination programmes for onchocerciasis are a case in point. NGDOs were the driving force in early advocacy for onchocerciasis control in West Africa, leading eventually to the remarkably effective and long lasting partnership of the Onchocerciasis Control Programme (OCP). With the donation of Mectizan(®), NGDOs were the driving force in developing onchocerciasis control in non-OCP countries, especially programmes for community based action. These were, further modified by the African Programme for Onchocerciasis Control (APOC) to become the successful Community Directed Interventions. NGDOs came together to coordinate activities in partnership with the World Health Organisation (WHO). Innovations by NGDOs led to integration of mass drug administration for Vitamin A deficiency and then for other parasitic diseases, leading to the current trend of preventive chemotherapy. The success of the NGDO Group for Onchocerciasis Control has led to the creation of similar groups for trachoma control and lymphatic filariasis elimination. These groups have now come together to form an NGDO Network for Neglected Tropical Disease control. Copyright © 2011 Elsevier B.V. All rights reserved.

Socioeconomic Inequalities in Neglected Tropical Diseases: A Systematic Review

PubMed Central

Houweling, Tanja A. J.; Karim-Kos, Henrike E.; Kulik, Margarete C.; Stolk, Wilma A.; Haagsma, Juanita A.; Lenk, Edeltraud J.; Richardus, Jan Hendrik; de Vlas, Sake J.

2016-01-01

Background Neglected tropical diseases (NTDs) are generally assumed to be concentrated in poor populations, but evidence on this remains scattered. We describe within-country socioeconomic inequalities in nine NTDs listed in the London Declaration for intensified control and/or elimination: lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminthiasis (STH), trachoma, Chagas’ disease, human African trypanosomiasis (HAT), leprosy, and visceral leishmaniasis (VL). Methodology We conducted a systematic literature review, including publications between 2004–2013 found in Embase, Medline (OvidSP), Cochrane Central, Web of Science, Popline, Lilacs, and Scielo. We included publications in international peer-reviewed journals on studies concerning the top 20 countries in terms of the burden of the NTD under study. Principal findings We identified 5,516 publications, of which 93 met the inclusion criteria. Of these, 59 papers reported substantial and statistically significant socioeconomic inequalities in NTD distribution, with higher odds of infection or disease among poor and less-educated people compared with better-off groups. The findings were mixed in 23 studies, and 11 studies showed no substantial or statistically significant inequality. Most information was available for STH, VL, schistosomiasis, and, to a lesser extent, for trachoma. For the other NTDs, evidence on their socioeconomic distribution was scarce. The magnitude of inequality varied, but often, the odds of infection or disease were twice as high among socioeconomically disadvantaged groups compared with better-off strata. Inequalities often took the form of a gradient, with higher odds of infection or disease each step down the socioeconomic hierarchy. Notwithstanding these inequalities, the prevalence of some NTDs was sometimes also high among better-off groups in some highly endemic areas. Conclusions While recent evidence on socioeconomic inequalities is scarce for

Can Neglected Tropical Diseases Compromise Human Wellbeing in Sex-, Age-, and Trait-Specific Ways?

PubMed Central

Geary, David C.

2016-01-01

Traits that facilitate competition for reproductive resources or that influence mate choice have evolved to signal resilience to infectious disease and other stressors. As a result, the dynamics of competition and choice can, in theory, be used to generate predictions about sex-, age-, and trait-specific vulnerabilities for any sexually reproducing species, including humans. These dynamics and associated vulnerabilities are reviewed for nonhuman species, focusing on traits that are compromised by exposure to parasites. Using the same approach, sex-, age-, and trait-specific vulnerabilities to parasitic disease are illustrated for children’s and adolescent’s physical growth and fitness. Suggestions are then provided for widening the assessment of human vulnerabilities to include age-appropriate measures of behavioral (e.g., children’s play) and cognitive (e.g., language fluency) traits. These are traits that are likely to be compromised by infection in age- and sex-specific ways. Inclusion of these types of measures in studies of neglected tropic diseases has the potential to provide a more nuanced understanding of how these diseases undermine human wellbeing and may provide a useful means to study the efficacy of associated treatments. PMID:27077746

Aquatic macroinvertebrate assemblages of Ghana, West Africa: understanding the ecology of a neglected tropical disease.

PubMed

Eric Benbow, M; Kimbirauskas, Ryan; McIntosh, Mollie D; Williamson, Heather; Quaye, Charles; Boakye, Daniel; Small, Pamela L C; Merritt, Richard W

2014-06-01

Buruli ulcer (BU) is an emerging, but neglected tropical disease, where there has been a reported association with disturbed aquatic habitats and proposed aquatic macroinvertebrate vectors such as biting Hemiptera. An initial step in understanding the potential role of macroinvertebrates in the ecology of BU is to better understand the entire community, not just one or two taxa, in relation to the pathogen, Mycobacterium ulcerans, at a large spatial scale. For the first time at a country-wide scale this research documents that M. ulcerans was frequently detected from environmental samples taken from BU endemic regions, but was not present in 30 waterbodies of a non-endemic region. There were significant differences in macroinvertebrate community structure and identified potential indicator taxa in relation to pathogen presence. These results suggest that specific macroinvertebrate taxa or functional metrics may potentially be used as aquatic biological indicators of M. ulcerans. Developing ecological indicators of this pathogen is a first step for understanding the disease ecology of BU and should assist future studies of transmission.

First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium.

PubMed

Musselwhite, Laura W; Maciag, Karolina; Lankowski, Alex; Gretes, Michael C; Wellems, Thomas E; Tavera, Gloria; Goulding, Rebecca E; Guillen, Ethan

2012-01-01

Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughput screening and medicinal chemistry research programs to identify lead compounds for small molecule drugs and novel drug targets. Furthermore, product development partnerships are emerging between academic institutions, non-profit entities, and biotechnology and pharmaceutical companies to create diagnostics, therapies, and vaccines for diseases of the poor. With not for profit mission statements, open access publishing standards, open source platforms for data sharing and collaboration, and a shift in focus to more translational research, universities and other public research institutions are well-placed to accelerate development of medical technologies, particularly for neglected tropical diseases.

First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium

PubMed Central

Musselwhite, Laura W.; Maciag, Karolina; Lankowski, Alex; Gretes, Michael C.; Wellems, Thomas E.; Tavera, Gloria; Goulding, Rebecca E.; Guillen, Ethan

2012-01-01

Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughput screening and medicinal chemistry research programs to identify lead compounds for small molecule drugs and novel drug targets. Furthermore, product development partnerships are emerging between academic institutions, non-profit entities, and biotechnology and pharmaceutical companies to create diagnostics, therapies, and vaccines for diseases of the poor. With not for profit mission statements, open access publishing standards, open source platforms for data sharing and collaboration, and a shift in focus to more translational research, universities and other public research institutions are well-placed to accelerate development of medical technologies, particularly for neglected tropical diseases. PMID:22232453

Arthropod Distribution in a Tropical Rainforest: Tackling a Four Dimensional Puzzle.

PubMed

Basset, Yves; Cizek, Lukas; Cuénoud, Philippe; Didham, Raphael K; Novotny, Vojtech; Ødegaard, Frode; Roslin, Tomas; Tishechkin, Alexey K; Schmidl, Jürgen; Winchester, Neville N; Roubik, David W; Aberlenc, Henri-Pierre; Bail, Johannes; Barrios, Héctor; Bridle, Jonathan R; Castaño-Meneses, Gabriela; Corbara, Bruno; Curletti, Gianfranco; Duarte da Rocha, Wesley; De Bakker, Domir; Delabie, Jacques H C; Dejean, Alain; Fagan, Laura L; Floren, Andreas; Kitching, Roger L; Medianero, Enrique; Gama de Oliveira, Evandro; Orivel, Jérôme; Pollet, Marc; Rapp, Mathieu; Ribeiro, Sérvio P; Roisin, Yves; Schmidt, Jesper B; Sørensen, Line; Lewinsohn, Thomas M; Leponce, Maurice

2015-01-01

Quantifying the spatio-temporal distribution of arthropods in tropical rainforests represents a first step towards scrutinizing the global distribution of biodiversity on Earth. To date most studies have focused on narrow taxonomic groups or lack a design that allows partitioning of the components of diversity. Here, we consider an exceptionally large dataset (113,952 individuals representing 5,858 species), obtained from the San Lorenzo forest in Panama, where the phylogenetic breadth of arthropod taxa was surveyed using 14 protocols targeting the soil, litter, understory, lower and upper canopy habitats, replicated across seasons in 2003 and 2004. This dataset is used to explore the relative influence of horizontal, vertical and seasonal drivers of arthropod distribution in this forest. We considered arthropod abundance, observed and estimated species richness, additive decomposition of species richness, multiplicative partitioning of species diversity, variation in species composition, species turnover and guild structure as components of diversity. At the scale of our study (2 km of distance, 40 m in height and 400 days), the effects related to the vertical and seasonal dimensions were most important. Most adult arthropods were collected from the soil/litter or the upper canopy and species richness was highest in the canopy. We compared the distribution of arthropods and trees within our study system. Effects related to the seasonal dimension were stronger for arthropods than for trees. We conclude that: (1) models of beta diversity developed for tropical trees are unlikely to be applicable to tropical arthropods; (2) it is imperative that estimates of global biodiversity derived from mass collecting of arthropods in tropical rainforests embrace the strong vertical and seasonal partitioning observed here; and (3) given the high species turnover observed between seasons, global climate change may have severe consequences for rainforest arthropods.

Arthropod Distribution in a Tropical Rainforest: Tackling a Four Dimensional Puzzle

PubMed Central

Basset, Yves; Cizek, Lukas; Cuénoud, Philippe; Didham, Raphael K.; Novotny, Vojtech; Ødegaard, Frode; Roslin, Tomas; Tishechkin, Alexey K.; Schmidl, Jürgen; Winchester, Neville N.; Roubik, David W.; Aberlenc, Henri-Pierre; Bail, Johannes; Barrios, Héctor; Bridle, Jonathan R.; Castaño-Meneses, Gabriela; Corbara, Bruno; Curletti, Gianfranco; Duarte da Rocha, Wesley; De Bakker, Domir; Delabie, Jacques H. C.; Dejean, Alain; Fagan, Laura L.; Floren, Andreas; Kitching, Roger L.; Medianero, Enrique; Gama de Oliveira, Evandro; Orivel, Jérôme; Pollet, Marc; Rapp, Mathieu; Ribeiro, Sérvio P.; Roisin, Yves; Schmidt, Jesper B.; Sørensen, Line; Lewinsohn, Thomas M.; Leponce, Maurice

2015-01-01

Quantifying the spatio-temporal distribution of arthropods in tropical rainforests represents a first step towards scrutinizing the global distribution of biodiversity on Earth. To date most studies have focused on narrow taxonomic groups or lack a design that allows partitioning of the components of diversity. Here, we consider an exceptionally large dataset (113,952 individuals representing 5,858 species), obtained from the San Lorenzo forest in Panama, where the phylogenetic breadth of arthropod taxa was surveyed using 14 protocols targeting the soil, litter, understory, lower and upper canopy habitats, replicated across seasons in 2003 and 2004. This dataset is used to explore the relative influence of horizontal, vertical and seasonal drivers of arthropod distribution in this forest. We considered arthropod abundance, observed and estimated species richness, additive decomposition of species richness, multiplicative partitioning of species diversity, variation in species composition, species turnover and guild structure as components of diversity. At the scale of our study (2km of distance, 40m in height and 400 days), the effects related to the vertical and seasonal dimensions were most important. Most adult arthropods were collected from the soil/litter or the upper canopy and species richness was highest in the canopy. We compared the distribution of arthropods and trees within our study system. Effects related to the seasonal dimension were stronger for arthropods than for trees. We conclude that: (1) models of beta diversity developed for tropical trees are unlikely to be applicable to tropical arthropods; (2) it is imperative that estimates of global biodiversity derived from mass collecting of arthropods in tropical rainforests embrace the strong vertical and seasonal partitioning observed here; and (3) given the high species turnover observed between seasons, global climate change may have severe consequences for rainforest arthropods. PMID:26633187

Epidemiology of Tropical Neglected Diseases in Ecuador in the Last 20 Years

PubMed Central

Cartelle Gestal, Monica; Holban, Alina Maria; Escalante, Santiago; Cevallos, Marcelo

2015-01-01

Background Tropical and zoonotic diseases are major problems in developing countries like Ecuador. Poorly designed houses, the high proportion of isolated indigenous population and under developed infrastructure represent a fertile environment for vectors to proliferate. Control campaigns in Ecuador over the years have had varying success, depending on the disease and vectors targeted. Aims In our study we analyse the current situation of some neglected diseases in Ecuador and the efficiency of the control campaigns (by measuring changes in numbers of cases reported) that the Ecuadorian government has been running to limit the spread of these infectious and parasitic diseases. Results Our study reveals that Brucellosis, Chagas Disease, Rabies and Onchocerciasis have been controlled, but small outbreaks are still detected in endemic areas. Leptospirosis and Echinococcosis have been increasing steadily in recent years in Ecuador since the first records. The same increase has been reported world-wide also. Better diagnosis has resulted in a higher number of cases being identified, particularly with regard to the linking of outdoor activities and contact with farm animals as contributing vectors. Improvements in diagnosis are due to regular professional training, implementation of automatized systems, establishing diagnosis protocols and the creation of an epidemiological vigilance network that acts as soon as a case is reported. Conclusion Control campaigns performed in Ecuador have been successful in recent years, although natural phenomena limit their efficiency. Leptospirosis and Echinococcosis infections remain a growing problem in Ecuador as it is worldwide. PMID:26394405

Epidemiology of Tropical Neglected Diseases in Ecuador in the Last 20 Years.

PubMed

Cartelle Gestal, Monica; Holban, Alina Maria; Escalante, Santiago; Cevallos, Marcelo

2015-01-01

Tropical and zoonotic diseases are major problems in developing countries like Ecuador. Poorly designed houses, the high proportion of isolated indigenous population and under developed infrastructure represent a fertile environment for vectors to proliferate. Control campaigns in Ecuador over the years have had varying success, depending on the disease and vectors targeted. In our study we analyse the current situation of some neglected diseases in Ecuador and the efficiency of the control campaigns (by measuring changes in numbers of cases reported) that the Ecuadorian government has been running to limit the spread of these infectious and parasitic diseases. Our study reveals that Brucellosis, Chagas Disease, Rabies and Onchocerciasis have been controlled, but small outbreaks are still detected in endemic areas. Leptospirosis and Echinococcosis have been increasing steadily in recent years in Ecuador since the first records. The same increase has been reported world-wide also. Better diagnosis has resulted in a higher number of cases being identified, particularly with regard to the linking of outdoor activities and contact with farm animals as contributing vectors. Improvements in diagnosis are due to regular professional training, implementation of automatized systems, establishing diagnosis protocols and the creation of an epidemiological vigilance network that acts as soon as a case is reported. Control campaigns performed in Ecuador have been successful in recent years, although natural phenomena limit their efficiency. Leptospirosis and Echinococcosis infections remain a growing problem in Ecuador as it is worldwide.

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

PubMed Central

Hürlimann, Eveline; Schur, Nadine; Boutsika, Konstantina; Stensgaard, Anna-Sofie; Laserna de Himpsl, Maiti; Ziegelbauer, Kathrin; Laizer, Nassor; Camenzind, Lukas; Di Pasquale, Aurelio; Ekpo, Uwem F.; Simoonga, Christopher; Mushinge, Gabriel; Saarnak, Christopher F. L.; Utzinger, Jürg; Kristensen, Thomas K.; Vounatsou, Penelope

2011-01-01

Background After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs. Methodology With an emphasis on schistosomiasis in Africa, we systematically searched the literature (peer-reviewed journals and ‘grey literature’), contacted Ministries of Health and research institutions in schistosomiasis-endemic countries for location-specific prevalence data and survey details (e.g., study population, year of survey and diagnostic techniques). The data were extracted, georeferenced, and stored in a MySQL database with a web interface allowing free database access and data management. Principal Findings At the beginning of 2011, our database contained more than 12,000 georeferenced schistosomiasis survey locations from 35 African countries available under http://www.gntd.org. Currently, the database is expanded to a global repository, including a host of other NTDs, e.g. soil-transmitted helminthiasis and leishmaniasis. Conclusions An open-access, spatially explicit NTD database offers unique opportunities for disease risk modeling, targeting control interventions, disease monitoring, and surveillance. Moreover, it allows for detailed geostatistical analyses of disease distribution in space and time. With an initial focus on schistosomiasis in Africa, we demonstrate the proof-of-concept that the establishment and running of a

Toward an open-access global database for mapping, control, and surveillance of neglected tropical diseases.

PubMed

Hürlimann, Eveline; Schur, Nadine; Boutsika, Konstantina; Stensgaard, Anna-Sofie; Laserna de Himpsl, Maiti; Ziegelbauer, Kathrin; Laizer, Nassor; Camenzind, Lukas; Di Pasquale, Aurelio; Ekpo, Uwem F; Simoonga, Christopher; Mushinge, Gabriel; Saarnak, Christopher F L; Utzinger, Jürg; Kristensen, Thomas K; Vounatsou, Penelope

2011-12-01

After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs. With an emphasis on schistosomiasis in Africa, we systematically searched the literature (peer-reviewed journals and 'grey literature'), contacted Ministries of Health and research institutions in schistosomiasis-endemic countries for location-specific prevalence data and survey details (e.g., study population, year of survey and diagnostic techniques). The data were extracted, georeferenced, and stored in a MySQL database with a web interface allowing free database access and data management. At the beginning of 2011, our database contained more than 12,000 georeferenced schistosomiasis survey locations from 35 African countries available under http://www.gntd.org. Currently, the database is expanded to a global repository, including a host of other NTDs, e.g. soil-transmitted helminthiasis and leishmaniasis. An open-access, spatially explicit NTD database offers unique opportunities for disease risk modeling, targeting control interventions, disease monitoring, and surveillance. Moreover, it allows for detailed geostatistical analyses of disease distribution in space and time. With an initial focus on schistosomiasis in Africa, we demonstrate the proof-of-concept that the establishment and running of a global NTD database is feasible and should be expanded

Interview with Dr Bernard Pécoul, Executive Director of the Drugs for Neglected Diseases Initiative.

PubMed

Pécoul, Bernard

2009-05-01

A significant number of product-development partnerships have arisen in the past 10 years to tackle diseases that mainly affect developing countries. With their coherent research and development leadership, they have become key players in identifying gaps and overcoming bottlenecks in order to deliver medicines to those who need them most in the developing world. Dr Bernard Pécoul is the Executive Director of one such partnership, the Drugs for Neglected Diseases Initiative (DNDi). Under his leadership, the DNDi has built the largest and most robust R&D portfolio for three of the most neglected diseases. He speaks to Future Medicinal Chemistry about challenges facing neglected disease R&D and the DNDi's ongoing work.

Noma: neglected, forgotten and a human rights issue.

PubMed

Leila Srour, M; Marck, Klaas W; Baratti-Mayer, Denise

2015-05-01

Noma, an orofacial gangrene and opportunistic infection, affects primarily malnourished children living in extreme poverty. Neglected, forgotten, unknown by most health workers, noma results in death, disfigurement and disability of some of the world's most vulnerable children. Noma is a biological indicator of multiple human rights violations, including the right to food. International support and national attention in countries with noma are lacking. The end of neglect of noma can lead to the elimination of this horrific childhood disease. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The poverty-related neglected diseases: Why basic research matters.

PubMed

Hotez, Peter J

2017-11-01

Together, malaria and the neglected tropical diseases (NTDs) kill more than 800,000 people annually, while creating long-term disability in millions more. International support for mass drug administration, bed nets, and other preventive measures has resulted in huge public health gains, while support for translational research is leading to the development of some new neglected disease drugs, diagnostics, and vaccines. However, funding for basic science research has not kept up, such that we are missing opportunities to create a more innovative pipeline of control tools for parasitic and related diseases. There is an urgent need to expand basic science approaches for neglected diseases, especially in the areas of systems biology and immunology; ecology, evolution, and mathematical biology; functional and comparative OMICs; gene editing; expanded use of model organisms; and a new single-cell combinatorial indexing RNA sequencing approach. The world's poor deserve access to innovation for neglected diseases. It should be considered a fundamental human right.

Interpretations of education about gene-environment influences on health in rural Ethiopia: the context of a neglected tropical disease.

PubMed

Tora, Abebayehu; Ayode, Desta; Tadele, Getnet; Farrell, David; Davey, Gail; McBride, Colleen M

2016-07-01

Misunderstandings of the role of genetics in disease development are associated with stigmatizing behaviors and fatalistic attitudes about prevention. This report describes an evaluation of community understanding of an educational module about genetic and environmental influences on the development of podoconiosis, a neglected tropical disease endemic in highland Ethiopia. A qualitative process assessment was conducted as part of a large prospective intervention trial in August 2013, in Wolaita Zone, southern Ethiopia. Sixty five participants were purposively selected from 600 households randomized to receive the inherited susceptibility module. The educational module used pictorial representations and oral explanations of the interaction of inherited sensitivity and soil exposure and was delivered by lay health educators in participants' homes. Data were collected using semi-structured individual interviews (IDIs) or focus group discussions (FGDs). Qualitative analyses showed that most participants improved their understanding of inherited soil sensitivity and susceptibility to podoconiosis. Participants linked their new understanding to decreased stigma-related attitudes. The module also corrected misconceptions that the condition was contagious, again diminishing stigmatizing attitudes. Lastly, these improvements in understanding increased the perceived value of foot protection. Taken together, these improvements support the acceptability, feasibility and potential benefits of implementing gene-environment education in low and middle income countries. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Lack of Clinical Pharmacokinetic Studies to Optimize the Treatment of Neglected Tropical Diseases: A Systematic Review.

PubMed

Verrest, Luka; Dorlo, Thomas P C

2017-06-01

Neglected tropical diseases (NTDs) affect more than one billion people, mainly living in developing countries. For most of these NTDs, treatment is suboptimal. To optimize treatment regimens, clinical pharmacokinetic studies are required where they have not been previously conducted to enable the use of pharmacometric modeling and simulation techniques in their application, which can provide substantial advantages. Our aim was to provide a systematic overview and summary of all clinical pharmacokinetic studies in NTDs and to assess the use of pharmacometrics in these studies, as well as to identify which of the NTDs or which treatments have not been sufficiently studied. PubMed was systematically searched for all clinical trials and case reports until the end of 2015 that described the pharmacokinetics of a drug in the context of treating any of the NTDs in patients or healthy volunteers. Eighty-two pharmacokinetic studies were identified. Most studies included small patient numbers (only five studies included >50 subjects) and only nine (11 %) studies included pediatric patients. A large part of the studies was not very recent; 56 % of studies were published before 2000. Most studies applied non-compartmental analysis methods for pharmacokinetic analysis (62 %). Twelve studies used population-based compartmental analysis (15 %) and eight (10 %) additionally performed simulations or extrapolation. For ten out of the 17 NTDs, none or only very few pharmacokinetic studies could be identified. For most NTDs, adequate pharmacokinetic studies are lacking and population-based modeling and simulation techniques have not generally been applied. Pharmacokinetic clinical trials that enable population pharmacokinetic modeling are needed to make better use of the available data. Simulation-based studies should be employed to enable the design of improved dosing regimens and more optimally use the limited resources to effectively provide therapy in this neglected area.

Global trends in neglected tropical disease control and elimination: impact on child health.

PubMed

Barry, Meagan A; Simon, Gregory G; Mistry, Neeraj; Hotez, Peter J

2013-08-01

The neglected tropical diseases (NTDs) are a group of 17 lesser known chronic infections which predominantly affect poor and disenfranchised communities. There are a number of NTDs that cause significant global morbidity in children, including the three major soil transmitted helminth (STH) infections (ascariasis, trichuriasis and hookworm infection), schistosomiasis and trachoma. These NTDs, together with lymphatic filariasis and onchocerciasis, are currently being targeted for global control and elimination through mass drug administration (MDA) campaigns. They represent the most common NTDs and share significant geographical overlap. Additionally, many individuals are polyparasitised with more than a single NTD. Integrated NTD control and elimination MDA programmes offer safe and efficacious treatments for all seven NTDs. However, the current global level of MDA coverage for the leading childhood NTDs, that is, STH infections, schistosomiasis and trachoma, remains well under 50%. Limiting factors for global coverage include insufficient global financial support, drug donation capacity of pharmaceutical companies and targeting school age children to the exclusion of other age groups in need of treatment, such as preschool age children. There is also a need for development of novel prevention and treatment modalities, such as next-generation small molecule drugs and vaccines. Efforts are underway to harness the momentum of a 2012 London Declaration on NTDs and a 2013 World Health Assembly (WHA) resolution as a means to control or in some cases eliminate by 2020 these NTDs that affect children worldwide.

The Potential Use of Natural and Structural Analogues of Antimicrobial Peptides in the Fight against Neglected Tropical Diseases.

PubMed

Lewies, Angélique; Wentzel, Johannes F; Jacobs, Garmi; Du Plessis, Lissinda H; Angélique, Lewies; Frederik, Wentzel Johannes; Garmi, Jacobs; Hester, Du Plessis Lissinda

2015-08-24

Recently, research into the development of new antimicrobial agents has been driven by the increase in resistance to traditional antibiotics and Emerging Infectious Diseases. Antimicrobial peptides (AMPs) are promising candidates as alternatives to current antibiotics in the treatment and prevention of microbial infections. AMPs are produced by all known living species, displaying direct antimicrobial killing activity and playing an important role in innate immunity. To date, more than 2000 AMPs have been discovered and many of these exhibit broad-spectrum antibacterial, antiviral and anti-parasitic activity. Neglected tropical diseases (NTDs) are caused by a variety of pathogens and are particularly wide-spread in low-income and developing regions of the world. Alternative, cost effective treatments are desperately needed to effectively battle these medically diverse diseases. AMPs have been shown to be effective against a variety of NTDs, including African trypanosomes, leishmaniosis and Chagas disease, trachoma and leprosy. In this review, the potential of selected AMPs to successfully treat a variety of NTD infections will be critically evaluated.

Exploring innovative ways to conduct coverage surveys for neglected tropical diseases in Malawi, Mali, and Uganda.

PubMed

Woodhall, Dana M; Mkwanda, Square; Dembele, Massitan; Lwanga, Harriet; Drexler, Naomi; Dubray, Christine; Harris, Jennifer; Worrell, Caitlin; Mathieu, Els

2014-04-01

Currently, a 30-cluster survey to monitor drug coverage after mass drug administration for neglected tropical diseases is the most common methodology used by control programs. We investigated alternative survey methodologies that could potentially provide an estimation of drug coverage. Three alternative survey methods (market, village chief, and religious leader) were conducted and compared to the 30-cluster method in Malawi, Mali, and Uganda. In Malawi, drug coverage for the 30-cluster, market, village chief, and religious leader methods were 66.8% (95% CI 60.3-73.4), 74.3%, 76.3%, and 77.8%, respectively. In Mali, results for round 1 were 62.6% (95% CI 54.4-70.7), 56.1%, 74.8%, and 83.2%, and 57.2% (95% CI 49.0-65.4), 54.5%, 72.2%, and 73.3%, respectively, for round 2. Uganda survey results were 65.7% (59.4-72.0), 43.7%, 67.2%, and 77.6% respectively. Further research is needed to test different coverage survey methodologies to determine which survey methods are the most scientifically rigorous and resource efficient. Published by Elsevier B.V.

A Portrait of the Transcriptome of the Neglected Trematode, Fasciola gigantica—Biological and Biotechnological Implications

PubMed Central

Young, Neil D.; Jex, Aaron R.; Cantacessi, Cinzia; Hall, Ross S.; Campbell, Bronwyn E.; Spithill, Terence W.; Tangkawattana, Sirikachorn; Tangkawattana, Prasarn; Laha, Thewarach; Gasser, Robin B.

2011-01-01

Fasciola gigantica (Digenea) is an important foodborne trematode that causes liver fluke disease (fascioliasis) in mammals, including ungulates and humans, mainly in tropical climatic zones of the world. Despite its socioeconomic impact, almost nothing is known about the molecular biology of this parasite, its interplay with its hosts, and the pathogenesis of fascioliasis. Modern genomic technologies now provide unique opportunities to rapidly tackle these exciting areas. The present study reports the first transcriptome representing the adult stage of F. gigantica (of bovid origin), defined using a massively parallel sequencing-coupled bioinformatic approach. From >20 million raw sequence reads, >30,000 contiguous sequences were assembled, of which most were novel. Relative levels of transcription were determined for individual molecules, which were also characterized (at the inferred amino acid level) based on homology, gene ontology, and/or pathway mapping. Comparisons of the transcriptome of F. gigantica with those of other trematodes, including F. hepatica, revealed similarities in transcription for molecules inferred to have key roles in parasite-host interactions. Overall, the present dataset should provide a solid foundation for future fundamental genomic, proteomic, and metabolomic explorations of F. gigantica, as well as a basis for applied outcomes such as the development of novel methods of intervention against this neglected parasite. PMID:21408104

Adverse event management in mass drug administration for neglected tropical diseases.

PubMed

Caplan, Arthur; Zink, Amanda

2014-03-01

The ethical challenges of reporting and managing adverse events (AEs) and serious AEs (SAEs) in the context of mass drug administration (MDA) for the treatment of neglected tropical diseases (NTDs) require reassessment of domestic and international policies on a global scale. Although the World Health Organization has set forth AE/SAE guidelines specifically for NTD MDA that incorporate suspected causality, and recommends that only SAEs get reported in this setting, most regulatory agencies continue to require the reporting of all SAEs exhibiting even a merely temporal relationship to activities associated with an MDA program. This greatly increases the potential for excess "noise" and undue risk aversion and is not only impractical but arguably unethical where huge proportions of populations are being treated for devastating diseases, and no good baseline exists against which to compare possible AE/SAE reports. Other population-specific variables that might change the way drug safety ought to be assessed include differing efficacy rates of a drug, background morbidity/mortality rates of the target disease in question, the growth rate of the incidence of disease, the availability of rescue or salvage therapies, and the willingness of local populations to take risks that other populations might not. The fact that NTDs are controllable and potentially eradicable with well-tolerated, effective, existing drugs might further alter our assessment of MDA safety and AE/SAE tolerability. At the same time, diffuseness of population, communication barriers, lack of resources, and other difficult surveillance challenges may present in NTD-affected settings. These limitations could impair the ability to monitor an MDA program's success, as well as hinder efforts to obtain informed consent or provide rescue therapy. Denying beneficial research interventions and MDA programs intended to benefit millions requires sound ethical justification based on more than the identification of

Rapid mapping of schistosomiasis and other neglected tropical diseases in the context of integrated control programmes in Africa

PubMed Central

BROOKER, S.; KABATEREINE, N. B.; GYAPONG, J. O.; STOTHARD, J. R.; UTZINGER, J.

2009-01-01

SUMMARY There is growing interest and commitment to the control of schistosomiasis and other so-called neglected tropical diseases (NTDs). Resources for control are inevitably limited, necessitating assessment methods that can rapidly and accurately identify and map high-risk communities so that interventions can be targeted in a spatially-explicit and cost-effective manner. Here, we review progress made with (i) mapping schistosomiasis across Africa using available epidemiological data and more recently, climate-based risk prediction; (ii) the development and use of morbidity questionnaires for rapid identification of high-risk communities of urinary schistosomiasis; and (iii) innovative sampling-based approaches for intestinal schistosomiasis, using the lot quality assurance sampling technique. Experiences are also presented for the rapid mapping of other NTDs, including onchocerciasis, loiasis and lymphatic filariasis. Future directions for an integrated rapid mapping approach targeting multiple NTDs simultaneously are outlined, including potential challenges in developing an integrated survey tool. The lessons from the mapping of human helminth infections may also be relevant for the rapid mapping of malaria as its control efforts are intensified. PMID:19450373

The use of the United States FDA programs as a strategy to advance the development of drug products for neglected tropical diseases.

PubMed

Sachs-Barrable, Kristina; Conway, Jocelyn; Gershkovich, Pavel; Ibrahim, Fady; Wasan, Kishor M

2014-11-01

Neglected tropical diseases (NTDs) are infections which are endemic in poor populations in lower- and middle-income countries (LMIC). Approximately one billion people have now or are at risk of getting an NTD and yet less than 5% of research dollars are focused on providing treatments and prevention of these highly debilitating and deadly conditions. The United States Food and Drug Administration (FDA) Orphan Drug Designation program (ODDP) provides orphan status to drugs and biologics, defined as those intended for the safe and effective treatment, diagnosis or prevention of rare diseases and/or disorders that affect fewer than 200 000 people in the United States, or that affect more than 200 000 persons but are not expected to recover the costs of developing and marketing a treatment drug. These regulations have led to the translation of rare disease knowledge into innovative rare disease therapies. The FDA Guidance for Industry on developing drugs for the treatment and prevention of NTDs describes the following regulatory strategies: Orphan Product Designation, Fast Track Designation, Priority Review Designation, Accelerated Approval and Tropical Disease Priority Review Voucher. This paper will discuss how these regulations and especially the ODDP can improve the clinical development and accessibility of drug products for NTDs.

Impacts of neglected tropical disease on incidence and progression of HIV/AIDS, tuberculosis, and malaria: scientific links.

PubMed

Simon, G G

2016-01-01

The neglected tropical diseases (NTDs) are the most common infections of humans in Sub-Saharan Africa. Virtually all of the population living below the World Bank poverty figure is affected by one or more NTDs. New evidence indicates a high degree of geographic overlap between the highest-prevalence NTDs (soil-transmitted helminths, schistosomiasis, onchocerciasis, lymphatic filariasis, and trachoma) and malaria and HIV, exhibiting a high degree of co-infection. Recent research suggests that NTDs can affect HIV and AIDS, tuberculosis (TB), and malaria disease progression. A combination of immunological, epidemiological, and clinical factors can contribute to these interactions and add to a worsening prognosis for people affected by HIV/AIDS, TB, and malaria. Together these results point to the impacts of the highest-prevalence NTDs on the health outcomes of malaria, HIV/AIDS, and TB and present new opportunities to design innovative public health interventions and strategies for these 'big three' diseases. This analysis describes the current findings of research and what research is still needed to strengthen the knowledge base of the impacts NTDs have on the big three. Copyright © 2015 The Author. Published by Elsevier Ltd.. All rights reserved.

Tackling antibiotic resistance in India.

PubMed

Wattal, Chand; Goel, Neeraj

2014-12-01

Infectious diseases are major causes of mortality in India. This is aggravated by the increasing prevalence of antimicrobial resistance (AMR) both in the community and in hospitals. Due to the emergence of resistance to all effective antibiotics in nosocomial pathogens, the situation calls for emergency measures to tackle AMR in India. India has huge challenges in tackling AMR, ranging from lack of surveillance mechanisms for monitoring AMR and use; effective hospital control policies; sanitation and non-human use of antimicrobial. The Ministry of Health and Family Welfare of Govt. of India has taken initiatives to tackle AMR. Extensive guidelines have been drafted and a model worksheet has been developed as a roadmap to tackle AMR.

Factors influencing tackle injuries in rugby union football

PubMed Central

Garraway, W. M.; Lee, A. J.; Macleod, D. A.; Telfer, J. W.; Deary, I. J.; Murray, G. D.

1999-01-01

OBJECTIVES: To assess the influence of selected aspects of lifestyle, personality, and other player related factors on injuries in the tackle. To describe the detailed circumstances in which these tackles occurred. METHODS: A prospective case-control study was undertaken in which the tackling and tackled players ("the cases") involved in a tackle injury were each matched with "control" players who held the same respective playing positions in the opposing teams. A total of 964 rugby matches involving 71 senior clubs drawn from all districts of the Scottish Rugby Union (SRU) were observed by nominated linkmen who administered self report questionnaires to the players identified as cases and controls. Information on lifestyle habits, match preparation, training, and coaching experience was obtained. A validated battery of psychological tests assessed players' trait anger and responses to anger and hostility. The circumstances of the tackles in which injury occurred were recorded by experienced SRU coaching staff in interviews with involved players after the match. RESULTS: A total of 71 tackle injury episodes with correct matching of cases and controls were studied. The following player related factors did not contribute significantly to tackle injuries: alcohol consumption before the match, feeling "below par" through minor illness, the extent of match preparation, previous coaching, or practising tackling. Injured and non- injured players in the tackle did not differ in their disposition toward, or expression of, anger or hostility. Some 85% of tackling players who were injured were three quarters, and 52% of injuries occurred when the tackle came in behind the tackled player or within his peripheral vision. Either the tackling or tackled player was sprinting or running in all of these injury episodes. One third of injuries occurred in differential speed tackles--that is, when one player was travelling much faster than the other at impact. The player with the lower

Prevalence of Neglected Tropical Diseases (Leishmaniasis and Lymphatic Filariasis) and Malaria Among a Migrant Labour Settlement in Kerala, India.

PubMed

George, Sobha; Joy, Teena Mary; Kumar, Anil; Panicker, K N; George, Leyanna Susan; Raj, Manu; Leelamoni, K; Nair, Prem

2018-06-02

Neglected tropical diseases (visceral leismaniasis, lymphatic filariasis) and malaria are endemic in northern states of India. Kerala has become a hub of construction activities employing a large number of migrants from these endemic states. Studies on morbidity pattern among migrants in Kerala are lacking. It is essential to look into the burden of these infections among migrant laborers who can act as reservoirs and are a threat to native population. A cross sectional study was done among migrant laborers in Ernakulam district, Kerala. After getting informed consent, a questionnaire was administered to each participant to collect sociodemographic details and 5 ml of blood was collected for detection of antigens using rapid diagnostic tests (RDT). Of the 309 migrants tested, none of them were positive for leishmaniasis, while 3.8% were positive for malaria and 3.6% for filariasis. With 2.5 million migrant laborers in Kerala, the magnitude of the problem in absolute numbers is enormous. Active surveillance and treatment is needed to prevent the reemergence of these diseases in Kerala.

Developing and financing neglected disease vaccines in our new era of "blue marble health" and the anthropocene epoch.

PubMed

Hotez, Peter J

2017-09-25

New findings of widespread neglected diseases among the poor living in wealthy group of 20 (G20) economies and the concept of "blue marble health" offer innovative mechanisms for financing urgently new vaccines, especially for vector-borne neglected tropical diseases (NTDs). This approach could complement or parallel a recently suggested global vaccine development fund for pandemic threats. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Neglect of Children--a neglected problem].

PubMed

Lucas, Steven; Jernbro, Carolina

2014-11-18

Although neglect is the most common form of child maltreatment in the home, it has received relatively little attention in both research and medical practice. Up to one in six children in the western world experience physical or psychological neglect during their upbringing. Severe neglect is associated with anatomical and physiological changes in the brain that in turn are coupled to cognitive impairment, impulsivity, and disturbances in concentration and social behavior. Reducing the risk of neglect requires the provision of preventive interventions at the individual and societal level, both universally and targeted to parents and children in need of special support. Health care services can play a key role in the prevention and early detection of neglect in childhood.

Innovation for the 'bottom 100 million': eliminating neglected tropical diseases in the Americas.

PubMed

Hotez, Peter J; Dumonteil, Eric; Heffernan, Michael J; Bottazzi, Maria E

2013-01-01

An estimated 100 million people in the Latin American and Caribbean (LAC) region live on less than US$2 per day, while another 46 million people in the US live below that nation's poverty line. Almost all of the 'bottom 100 million' people suffer from at least one neglected tropical disease (NTD), including one-half of the poorest people in the region infected with hookworms, 10% with Chagas disease, and up to 1-2% with dengue, schistosomiasis, and/or leishmaniasis. In the US, NTDs such as Chagas disease, cysticercosis, toxocariasis, and trichomoniasis are also common among poor populations. These NTDs trap the poorest people in the region in poverty, because of their impact on maternal and child health, and occupational productivity. Through mass drug administration (MDA), several NTDs are on the verge of elimination in the Americas, including lymphatic filariasis, onchocerciasis, trachoma, and possibly leprosy. In addition, schistosomiasis may soon be eliminated in the Caribbean. However, for other NTDs including hookworm infection, Chagas disease, dengue, schistosomiasis, and leishmaniasis, a new generation of 'anti-poverty vaccines' will be required. Several vaccines for dengue are under development by multinational pharmaceutical companies, whereas others are being pursued through non-profit product development partnerships (PDPs), in collaboration with developing country manufacturers in Brazil and Mexico. The Sabin Vaccine Institute PDP is developing a primarily preventive bivalent recombinant human hookworm vaccine, which is about to enter phase 1 clinical testing in Brazil, as well as a new therapeutic Chagas disease vaccine in collaboration with several Mexican institutions. The Chagas disease vaccine would be administered to seropositive patients to delay or prevent the onset of Chagasic cardiomyopathy (secondary prevention). Together, MDA and the development of new anti-poverty vaccines afford an opportunity to implement effective control and

Socio-ecological dynamics and challenges to the governance of Neglected Tropical Disease control.

PubMed

Michael, Edwin; Madon, Shirin

2017-02-06

The current global attempts to control the so-called "Neglected Tropical Diseases (NTDs)" have the potential to significantly reduce the morbidity suffered by some of the world's poorest communities. However, the governance of these control programmes is driven by a managerial rationality that assumes predictability of proposed interventions, and which thus primarily seeks to improve the cost-effectiveness of implementation by measuring performance in terms of pre-determined outputs. Here, we argue that this approach has reinforced the narrow normal-science model for controlling parasitic diseases, and in doing so fails to address the complex dynamics, uncertainty and socio-ecological context-specificity that invariably underlie parasite transmission. We suggest that a new governance approach is required that draws on a combination of non-equilibrium thinking about the operation of complex, adaptive, systems from the natural sciences and constructivist social science perspectives that view the accumulation of scientific knowledge as contingent on historical interests and norms, if more effective control approaches sufficiently sensitive to local disease contexts are to be devised, applied and managed. At the core of this approach is an emphasis on the need for a process that assists with the inclusion of diverse perspectives, social learning and deliberation, and a reflexive approach to addressing system complexity and incertitude, while balancing this flexibility with stability-focused structures. We derive and discuss a possible governance framework and outline an organizational structure that could be used to effectively deal with the complexity of accomplishing global NTD control. We also point to examples of complexity-based management structures that have been used in parasite control previously, which could serve as practical templates for developing similar governance structures to better manage global NTD control. Our results hold important wider

Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases.

PubMed

King, Charles H; Bertino, Anne-Marie

2008-03-26

The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs), in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities.

From Medicinal Chemistry to Human Health: Current Approaches to Drug Discovery for Cancer and Neglected Tropical Diseases.

PubMed

Ferreira, Leonardo G; Oliva, Glaucius; Andricopulo, Adriano D

2018-01-01

Scientific and technological breakthroughs have compelled the current players in drug discovery to increasingly incorporate knowledge-based approaches. This evolving paradigm, which has its roots attached to the recent advances in medicinal chemistry, molecular and structural biology, has unprecedentedly demanded the development of up-to-date computational approaches, such as bio- and chemo-informatics. These tools have been pivotal to catalyzing the ever-increasing amount of data generated by the molecular sciences, and to converting the data into insightful guidelines for use in the research pipeline. As a result, ligand- and structure-based drug design have emerged as key pathways to address the pharmaceutical industry's striking demands for innovation. These approaches depend on a keen integration of experimental and molecular modeling methods to surmount the main challenges faced by drug candidates - in vivo efficacy, pharmacodynamics, metabolism, pharmacokinetics and safety. To that end, the Laboratório de Química Medicinal e Computacional (LQMC) of the Universidade de São Paulo has developed forefront research on highly prevalent and life-threatening neglected tropical diseases and cancer. By taking part in global initiatives for pharmaceutical innovation, the laboratory has contributed to the advance of these critical therapeutic areas through the use of cutting-edge strategies in medicinal chemistry.

Strategic emphases for tropical diseases research: a TDR perspective.

PubMed

Remme, Jan H F; Blas, Erik; Chitsulo, Lester; Desjeux, Philippe M P; Engers, Howard D; Kanyok, Thomas P; Kengeya Kayondo, Jane F; Kioy, Deborah W; Kumaraswami, Vasanthapuram; Lazdins, Janis K; Nunn, Paul P; Oduola, Ayoade; Ridley, Robert G; Toure, Yeya T; Zicker, Fabio; Morel, Carlos M

2002-10-01

Setting priorities for health research is a difficult task, especially for the neglected diseases of the poor. A new approach to priority setting for tropical diseases research has been adopted by the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (known as the TDR). Priorities are defined on the basis of a comprehensive analysis of research needs and research opportunities for each of the ten major tropical diseases in the TDR portfolio. The resulting strategic emphases matrix reflects the priorities for tropical diseases research from the perspective of the TDR. Its purpose is not to impose global research priorities, but we believe the results could be useful to other organizations.

Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration.

PubMed

Freeman, Matthew C; Ogden, Stephanie; Jacobson, Julie; Abbott, Daniel; Addiss, David G; Amnie, Asrat G; Beckwith, Colin; Cairncross, Sandy; Callejas, Rafael; Colford, Jack M; Emerson, Paul M; Fenwick, Alan; Fishman, Rebecca; Gallo, Kerry; Grimes, Jack; Karapetyan, Gagik; Keene, Brooks; Lammie, Patrick J; Macarthur, Chad; Lochery, Peter; Petach, Helen; Platt, Jennifer; Prabasi, Sarina; Rosenboom, Jan Willem; Roy, Sharon; Saywell, Darren; Schechtman, Lisa; Tantri, Anupama; Velleman, Yael; Utzinger, Jürg

2013-01-01

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely "Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene." Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors.

Integration of Water, Sanitation, and Hygiene for the Prevention and Control of Neglected Tropical Diseases: A Rationale for Inter-Sectoral Collaboration

PubMed Central

Jacobson, Julie; Abbott, Daniel; Addiss, David G.; Amnie, Asrat G.; Beckwith, Colin; Cairncross, Sandy; Callejas, Rafael; Colford, Jack M.; Emerson, Paul M.; Fenwick, Alan; Fishman, Rebecca; Gallo, Kerry; Grimes, Jack; Karapetyan, Gagik; Keene, Brooks; Lammie, Patrick J.; MacArthur, Chad; Lochery, Peter; Petach, Helen; Platt, Jennifer; Prabasi, Sarina; Rosenboom, Jan Willem; Roy, Sharon; Saywell, Darren; Schechtman, Lisa; Tantri, Anupama; Velleman, Yael; Utzinger, Jürg

2013-01-01

Improvements of water, sanitation, and hygiene (WASH) infrastructure and appropriate health-seeking behavior are necessary for achieving sustained control, elimination, or eradication of many neglected tropical diseases (NTDs). Indeed, the global strategies to fight NTDs include provision of WASH, but few programs have specific WASH targets and approaches. Collaboration between disease control programs and stakeholders in WASH is a critical next step. A group of stakeholders from the NTD control, child health, and WASH sectors convened in late 2012 to discuss opportunities for, and barriers to, collaboration. The group agreed on a common vision, namely “Disease-free communities that have adequate and equitable access to water and sanitation, and that practice good hygiene.” Four key areas of collaboration were identified, including (i) advocacy, policy, and communication; (ii) capacity building and training; (iii) mapping, data collection, and monitoring; and (iv) research. We discuss strategic opportunities and ways forward for enhanced collaboration between the WASH and the NTD sectors. PMID:24086781

Neglected tropical diseases in Brazilian children and adolescents: data analysis from 2009 to 2013.

PubMed

Brandão, Eduardo; Romero, Sebastián; da Silva, Maria Almerice Lopes; Santos, Fred Luciano Neves

2017-11-03

Neglected tropical diseases (NTDs) prevail in conditions of poverty and contribute to the maintenance of social inequality. Out of the NTDs prioritized by the Brazilian Ministry of Health, four parasitic infections require mandatory notification: acute Chagas disease, leishmaniasis, malaria, and schistosomiasis. Data on the behaviour of these NTDs in the young population are currently limited. This study seeks to analyse the epidemiological aspects of these parasitic infections in children and adolescents in Brazil. A retrospective exploratory ecological study was conducted. A spatial analysis of the cases reported between 2009 and 2013 in individuals aged between 0 and 19 years that were notified through the Health Notification Aggravation Information System (SINAN) was performed. In total, 64,567 cases of cutaneous and visceral leishmaniasis, malaria, schistosomiasis, and acute Chagas disease were recorded in the SINAN database, representing a rate of 20.15 cases per 100,000 inhabitants. The average age of the cases was 12.2 years and 62.32% were male. Four hundred and three deaths related to these obligatorily reported parasites were recorded, indicating a case fatality rate of 0.62%. Visceral leishmaniasis and acute Chagas disease had the highest rates of lethality. A heterogeneous spatial distribution of the studied parasites was observed. The number of cases and the lethality rate described in this study show that these diseases still represent a serious problem for public health in Brazil. This points to the need to encourage new research and the reformulation of social, economic, and public health policies aimed at ensuring better health and living conditions for all individuals, especially those among the populations considered vulnerable, as is the case of the young.

Tackling in Youth Football.

PubMed

2015-11-01

American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for long-term sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk. Copyright © 2015 by the American Academy of Pediatrics.

PCT Databank: A Tool for Planning, Implementation and Monitoring of Integrated Preventive Chemotherapy for Control of Neglected Tropical Diseases (NTD)

PubMed Central

Mikhailov, Alexei; Yajima, Aya; Mbabazi, PS; Gabrielli, Albis F.; Montresor, Antonio; Engels, Dirk

2017-01-01

The integration of vertical control programmes of neglected tropical diseases (NTDs) aims at containing operational cost, simplifies the application of the control measures and extends the intervention coverage. The Preventive Chemotherapy and Transmission Control (PCT) Databank was established by the World Health Organization to facilitate the sharing of data among the different partners involved in control activities and collects and compiles historical and current information on disease-specific epidemiological situation, the geographical overlapping of NTDs and the progress of control activities in all the NTD-endemic countries. The summary of country-specific epidemiological maps and the progress of control activities is available online as the online PCT Databank and Country Profiles. The annual progress of preventive chemotherapy (PC) interventions targeting at specific NTDs is also annually reported in the Weekly Epidemiological Record (WER). In this paper, we elucidated the methodology of data collection, compilation and mapping to establish the PCT Databank and presented the key features of the associated three online outputs, i.e. the online PCT Databank, the Country Profile and the WER. PMID:22357399

Community Attitudes Toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases After the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia.

PubMed

Bogus, Joshua; Gankpala, Lincoln; Fischer, Kerstin; Krentel, Alison; Weil, Gary J; Fischer, Peter U; Kollie, Karsor; Bolay, Fatorma K

2016-03-01

The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD. © The American Society of Tropical Medicine and Hygiene.

The drug and vaccine landscape for neglected diseases (2000-11): a systematic assessment.

PubMed

Pedrique, Belen; Strub-Wourgaft, Nathalie; Some, Claudette; Olliaro, Piero; Trouiller, Patrice; Ford, Nathan; Pécoul, Bernard; Bradol, Jean-Hervé

2013-12-01

In 1975-99, only 1·1% of new therapeutic products had been developed for neglected diseases. Since then, several public and private initiatives have attempted to mitigate this imbalance. We analysed the research and development pipeline of drugs and vaccines for neglected diseases from 2000 to 2011. We searched databases of drug regulatory authorities, WHO, and clinical trial registries for entries made between Jan 1, 2000, and Dec 31, 2011. We defined neglected diseases as malaria, tuberculosis, diarrhoeal diseases, neglected tropical diseases (NTDs; WHO definition), and other diseases of poverty according to common definitions. Of the 850 new therapeutic products registered in 2000-11, 37 (4%) were indicated for neglected diseases, comprising 25 products with a new indication or formulation and eight vaccines or biological products. Only four new chemical entities were approved for neglected diseases (three for malaria, one for diarrhoeal disease), accounting for 1% of the 336 new chemical entities approved during the study period. Of 148,445 clinical trials registered in Dec 31, 2011, only 2016 (1%) were for neglected diseases. Our findings show a persistent insufficiency in drug and vaccine development for neglected diseases. Nevertheless, these and other data show a slight improvement during the past 12 years in new therapeutics development and registration. However, for many neglected diseases, new therapeutic products urgently need to be developed and delivered to improve control and potentially achieve elimination. None. Copyright © 2013 Pedrique et al. Open Access article distributed under the terms of CC BY-NC-SA. Published by .. All rights reserved.

Neglected tropical disease and emerging infectious disease: an analysis of the history, promise and constraints of two worldviews.

PubMed

Jackson, Yves; Stephenson, Niamh

2014-01-01

Emerging infectious diseases (EIDs) and neglected tropical diseases (NTDs) are medical terms referring to a group of diseases, yet they are simultaneously socio-political constructs (EID and NTD). When viewed as such, public health interest in EID has been criticised as prioritising free market, Global North interests. This paper asks if the recent turn to NTD, which directs attention and resources to 'the bottom billion' of the world's population, addresses the limitations of focusing on EID. Our approach involves comparing the specific socio-political framing, or 'worldview' of NTD, with that of EID. We examine the distinct history, rationales, morals, political and economic tensions and loci of power entailed in each worldview. This analysis suggests that efforts to foreground NTD constitute a site where humanitarian and biomedical industry actors and actions are increasingly blurred. We examine whether the NTD worldview constitutes a break with or a new version of a free market approach to global health, and whether it reworks or solidifies paternalistic Global North-South relations. We consider some of the limits of work on NTD to date, suggesting that although the NTD worldview does not escape the neo-colonial history of global health, it can actualise it under a different form.

Tropical grassy biomes: misunderstood, neglected, and under threat.

PubMed

Parr, Catherine L; Lehmann, Caroline E R; Bond, William J; Hoffmann, William A; Andersen, Alan N

2014-04-01

Tropical grassy biomes (TGBs) are globally extensive, provide critical ecosystem services, and influence the earth-atmosphere system. Yet, globally applied biome definitions ignore vegetation characteristics that are critical to their functioning and evolutionary history. Hence, TGB identification is inconsistent and misinterprets the ecological processes governing vegetation structure, with cascading negative consequences for biodiversity. Here, we discuss threats linked to the definition of TGB, the Clean Development Mechanism (CDM) and Reducing Emissions from Deforestation and Forest Degradation schemes (REDD+), and enhanced atmospheric CO2, which may facilitate future state shifts. TGB degradation is insidious and less visible than in forested biomes. With human reliance on TGBs and their propensity for woody change, ecology and evolutionary history are fundamental to not only the identification of TGBs, but also their management for future persistence. Copyright © 2014 Elsevier Ltd. All rights reserved.

The monetary value of human lives lost due to neglected tropical diseases in Africa.

PubMed

Kirigia, Joses Muthuri; Mburugu, Gitonga N

2017-12-18

Neglected tropical diseases (NTDs) are an important cause of death and disability in Africa. This study estimates the monetary value of human lives lost due to NTDs in the continent in 2015. The lost output or human capital approach was used to evaluate the years of life lost due to premature deaths from NTDs among 10 high/upper-middle-income (Group 1), 17 middle-income (Group 2) and 27 low-income (Group 3) countries in Africa. The future losses were discounted to their present values at a 3% discount rate. The model was re-analysed using 5% and 10% discount rates to assess the impact on the estimated total value of human lives lost. The estimated value of 67 860 human lives lost in 2015 due to NTDs was Int$ 5 112 472 607. Out of that, 14.6% was borne by Group 1, 57.7% by Group 2 and 27.7% by Group 3 countries. The mean value of human life lost per NTD death was Int$ 231 278, Int$ 109 771 and Int$ 37 489 for Group 1, Group 2 and Group 3 countries, respectively. The estimated value of human lives lost in 2015 due to NTDs was equivalent to 0.1% of the cumulative gross domestic product of the 53 continental African countries. Even though NTDs are not a major cause of death, they impact negatively on the productivity of those affected throughout their life-course. Thus, the case for investing in NTDs control should also be influenced by the value of NTD morbidity, availability of effective donated medicines, human rights arguments, and need to achieve the NTD-related target 3.3 of the United Nations Sustainable Development Goal 3 (on health) by 2030.

Patent landscape of neglected tropical diseases: an analysis of worldwide patent families.

PubMed

Akinsolu, Folahanmi Tomiwa; de Paiva, Vitor Nobre; Souza, Samuel Santos; Varga, Orsolya

2017-11-14

"Neglected Tropical Diseases" (NTDs) affect millions of people in Africa, Asia and South America. The two primary ways of strategic interventions are "preventive chemotherapy and transmission control" (PCT), and "innovative and intensified disease management" (IDM). In the last 5 years, phenomenal progress has been achieved. However, it is crucial to intensify research effort into NTDs, because of the emerging drug resistance. According to the World Health Organization (WHO), the term NTDs covers 17 diseases, namely buruli ulcer, Chagas disease, dengue, dracunculiasis, echinococcosis, trematodiasis, human African trypanosomiasis, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, rabies, schistosomiasis, soil-transmitted helminthes, taeniasis, trachoma, and yaws. The aim of this study is to map out research and development (R&D) landscape through patent analysis of these identified NTDs. To achieve this, analysis and evaluation have been conducted on patenting trends, current legal status of patent families, priority countries by earliest priority years and their assignee types, technological fields of patent families over time, and original and current patent assignees. Patent families were extracted from Patseer, an international database of patents from over 100 patent issuing authorities worldwide. Evaluation of the patents was carried out using the combination of different search terms related to each identified NTD. In this paper, a total number of 12,350 patent families were analyzed. The main countries with sources of inventions were identified to be the United States (US) and China. The main technological fields covered by NTDs patent landscape are pharmaceuticals, biotechnology, organic fine chemistry, analysis of biological materials, basic materials chemistry, and medical technology. Governmental institutions and universities are the primary original assignees. Among the NTDs, leishmaniasis, dengue, and rabies received the highest number of

Tackle technique and tackle-related injuries in high-level South African Rugby Union under-18 players: real-match video analysis.

PubMed

Burger, Nicholas; Lambert, Michael I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief

2016-08-01

The high injury rate associated with rugby union is primarily due to the tackle, and poor contact technique has been identified as a risk factor for injury. We aimed to determine whether the tackle technique proficiency scores were different in injurious tackles versus tackles that did not result in injury using real-match scenarios in high-level youth rugby union. Injury surveillance was conducted at the under-18 Craven Week tournaments (2011-2013). Tackle-related injury information was used to identify injury events in the match video footage and non-injury events were identified for the injured player cohort. Injury and non-injury events were scored for technique proficiency and Cohen's effect sizes were calculated and the Student t test (p<0.05) was performed to compare injury versus non-injury scores. The overall mean score for front-on ball-carrier proficiency was 7.17±1.90 and 9.02±2.15 for injury and non-injury tackle events, respectively (effect size=moderate; p<0.05). The overall mean score for side/behind ball-carrier proficiency was 4.09±2.12 and 7.68±1.72 for injury and non-injury tackle events, respectively (effect size=large; p<0.01). The overall mean score for front-on tackler proficiency was 7.00±1.95 and 9.35±2.56 for injury and non-injury tackle events, respectively (effect size=moderate; p<0.05). The overall mean score for side/behind tackler proficiency was 5.47±1.60 and 8.14±1.75 for injury and non-injury tackle events, respectively (effect size=large; p<0.01). Higher overall mean and criterion-specific tackle-related technique scores were associated with a non-injury outcome. The ability to perform well during tackle events may decrease the risk of injury and may manifest in superior performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Neglected Infections of Poverty in the United States of America

PubMed Central

Hotez, Peter J.

2008-01-01

In the United States, there is a largely hidden burden of diseases caused by a group of chronic and debilitating parasitic, bacterial, and congenital infections known as the neglected infections of poverty. Like their neglected tropical disease counterparts in developing countries, the neglected infections of poverty in the US disproportionately affect impoverished and under-represented minority populations. The major neglected infections include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus (CMV), toxoplasmosis, and syphilis. These diseases occur predominantly in people of color living in the Mississippi Delta and elsewhere in the American South, in disadvantaged urban areas, and in the US–Mexico borderlands, as well as in certain immigrant populations and disadvantaged white populations living in Appalachia. Preliminary disease burden estimates of the neglected infections of poverty indicate that tens of thousands, or in some cases, hundreds of thousands of poor Americans harbor these chronic infections, which represent some of the greatest health disparities in the United States. Specific policy recommendations include active surveillance (including newborn screening) to ascertain accurate population-based estimates of disease burden; epidemiological studies to determine the extent of autochthonous transmission of Chagas disease and other infections; mass or targeted treatments; vector control; and research and development for new control tools including improved diagnostics and accelerated development of a vaccine to prevent congenital CMV infection and congenital toxoplasmosis. PMID:18575621

Extent of Integration of Priority Interventions into General Health Systems: A Case Study of Neglected Tropical Diseases Programme in the Western Region of Ghana

PubMed Central

Mensah, Ernest O.; Aikins, Moses K.; Gyapong, Margaret; Anto, Francis; Bockarie, Moses J.; Gyapong, John O.

2016-01-01

Background The global health system has a large arsenal of interventions, medical products and technologies to address current global health challenges. However, identifying the most effective and efficient strategies to deliver these resources to where they are most needed has been a challenge. Targeted and integrated interventions have been the main delivery strategies. However, the health system discourse increasingly favours integrated strategies in the context of functionally merging targeted interventions with multifunctional health care delivery systems with a focus on strengthening country health systems to deliver needed interventions. Neglected Tropical Diseases (NTD) have been identified to promote and perpetuate poverty hence there has been global effort to combat these diseases. The Neglected Tropical Diseases Programme (NTDP) in Ghana has a national programme team and office, however, it depends on the multifunctional health delivery system at the regional and district level to implement interventions. The NTDP seeks further health system integration to accelerate achievement of coverage targets. The study estimated the extent of integration of the NTDP at the national, regional and district levels to provide evidence to guide further integration. Methodology/Principal Findings The research design was a descriptive case study that interviewed key persons involved in the programme at the three levels of the health system as well as extensive document review. Integration was assessed on two planes—across health system functions–stewardship and governance, financing, planning, service delivery, monitoring and evaluation and demand generation; and across three administrative levels of the health system–national, regional and district. A composite measure of integration designated Cumulative Integration Index (CII) with a range of 0.00–1.00 was used to estimate extent of integration at the three levels of the health system. Service delivery was

Extent of Integration of Priority Interventions into General Health Systems: A Case Study of Neglected Tropical Diseases Programme in the Western Region of Ghana.

PubMed

Mensah, Ernest O; Aikins, Moses K; Gyapong, Margaret; Anto, Francis; Bockarie, Moses J; Gyapong, John O

2016-05-01

The global health system has a large arsenal of interventions, medical products and technologies to address current global health challenges. However, identifying the most effective and efficient strategies to deliver these resources to where they are most needed has been a challenge. Targeted and integrated interventions have been the main delivery strategies. However, the health system discourse increasingly favours integrated strategies in the context of functionally merging targeted interventions with multifunctional health care delivery systems with a focus on strengthening country health systems to deliver needed interventions. Neglected Tropical Diseases (NTD) have been identified to promote and perpetuate poverty hence there has been global effort to combat these diseases. The Neglected Tropical Diseases Programme (NTDP) in Ghana has a national programme team and office, however, it depends on the multifunctional health delivery system at the regional and district level to implement interventions. The NTDP seeks further health system integration to accelerate achievement of coverage targets. The study estimated the extent of integration of the NTDP at the national, regional and district levels to provide evidence to guide further integration. The research design was a descriptive case study that interviewed key persons involved in the programme at the three levels of the health system as well as extensive document review. Integration was assessed on two planes-across health system functions-stewardship and governance, financing, planning, service delivery, monitoring and evaluation and demand generation; and across three administrative levels of the health system-national, regional and district. A composite measure of integration designated Cumulative Integration Index (CII) with a range of 0.00-1.00 was used to estimate extent of integration at the three levels of the health system. Service delivery was most integrated while financing and planning were

Prevention and control of neglected tropical diseases: overview of randomized trials, systematic reviews and meta-analyses

PubMed Central

Kappagoda, Shanthi

2014-01-01

Abstract Objective To analyse evidence from randomized controlled trials (RCTs) on the prevention and control of neglected tropical diseases (NTDs) and to identify areas where evidence is lacking. Methods The Cochrane Central Register of Controlled Trials and PubMed were searched for RCTs and the Cochrane Database of Systematic Reviews and PubMed were searched for meta-analyses and systematic reviews, both from inception to 31 December 2012. Findings Overall, 258 RCTs were found on American trypanosomiasis, Buruli ulcer, dengue, geohelminth infection, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, rabies, schistosomiasis or trachoma. No RCTs were found on cysticercosis, dracunculiasis, echinococcosis, foodborne trematodes, or human African trypanosomiasis. The most studied diseases were geohelminth infection (51 RCTs) and leishmaniasis (46 RCTs). Vaccines, chemoprophylaxis and interventions targeting insect vectors were evaluated in 113, 99 and 39 RCTs, respectively. Few addressed how best to deliver preventive chemotherapy, such as the choice of dosing interval (10) or target population (4), the population coverage needed to reduce transmission (2) or the method of drug distribution (1). Thirty-one publications containing 32 systematic reviews (16 with and 16 without meta-analyses) were found on American trypanosomiasis, dengue, geohelminths, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, schistosomiasis or trachoma. Together, they included only 79 of the 258 published RCTs (30.6%). Of 36 interventions assessed, 8 were judged effective in more than one review. Conclusion Few RCTs on the prevention or control of the principal NTDs were found. Trials on how best to deliver preventive chemotherapy were particularly rare. PMID:24839325

Neglected tropical diseases and the millennium development goals: why the "other diseases" matter: reality versus rhetoric.

PubMed

Molyneux, David H; Malecela, Mwele N

2011-12-13

Since 2004 there has been an increased recognition of the importance of Neglected Tropical Diseases (NTDs) as impediments to development. These diseases are caused by a variety of infectious agents - viruses, bacteria and parasites - which cause a diversity of clinical conditions throughout the tropics. The World Health Organisation (WHO) has defined seventeen of these conditions as core NTDs. The objectives for the control, elimination or eradication of these conditions have been defined in World Health Assembly resolutions whilst the strategies for the control or elimination of individual diseases have been defined in various WHO documents. Since 2005 there has been a drive for the expanded control of these diseases through an integrated approach of mass drug administration referred to as Preventive Chemotherapy via community-based distribution systems and through schools. This has been made possible by donations from major pharmaceutical companies of quality and efficacious drugs which have a proven track record of safety. As a result of the increased commitment of endemic countries, bilateral donors and non-governmental development organisations, there has been a considerable expansion of mass drug administration. In particular, programmes targeting lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminth infections have expanded to treat 887. 8 million people in 2009. There has been significant progress towards guinea worm eradication, and the control of leprosy and human African trypanosomiasis. This paper responds to what the authors believe are inappropriate criticisms of these programmes and counters accusations of the motives of partners made in recently published papers. We provide a detailed response and update the information on the numbers of global treatments undertaken for NTDs and list the success stories to date.The paper acknowledges that in undertaking any health programme in environments such as post

Interpretations of education about gene-environment influences on health in rural Ethiopia: the context of a neglected tropical disease

PubMed Central

Tora, Abebayehu; Ayode, Desta; Tadele, Getnet; Farrell, David; Davey, Gail; McBride, Colleen M.

2016-01-01

Background Misunderstandings of the role of genetics in disease development are associated with stigmatizing behaviors and fatalistic attitudes about prevention. This report describes an evaluation of community understanding of an educational module about genetic and environmental influences on the development of podoconiosis, a neglected tropical disease endemic in highland Ethiopia. Methods A qualitative process assessment was conducted as part of a large prospective intervention trial in August 2013, in Wolaita Zone, southern Ethiopia. Sixty five participants were purposively selected from 600 households randomized to receive the inherited susceptibility module. The educational module used pictorial representations and oral explanations of the interaction of inherited sensitivity and soil exposure and was delivered by lay health educators in participants' homes. Data were collected using semi-structured individual interviews (IDIs) or focus group discussions (FGDs). Results Qualitative analyses showed that most participants improved their understanding of inherited soil sensitivity and susceptibility to podoconiosis. Participants linked their new understanding to decreased stigma-related attitudes. The module also corrected misconceptions that the condition was contagious, again diminishing stigmatizing attitudes. Lastly, these improvements in understanding increased the perceived value of foot protection. Conclusions Taken together, these improvements support the acceptability, feasibility and potential benefits of implementing gene-environment education in low and middle income countries. PMID:27114426

A perspective on targeting non-structural proteins to combat neglected tropical diseases: Dengue, West Nile and Chikungunya viruses.

PubMed

Bhakat, Soumendranath; Karubiu, Wilson; Jayaprakash, Venkatesan; Soliman, Mahmoud E S

2014-11-24

Neglected tropical diseases are major causes of fatality in poverty stricken regions across Africa, Asia and some part of America. The combined potential health risk associated with arthropod-borne viruses (arboviruses); Dengue virus (DENV), West Nile Virus (WNV) and Chikungunya Virus (CHIKV) is immense. These arboviruses are either emerging or re-emerging in many regions with recent documented outbreaks in the United States. Despite several recent evidences of emergence, currently there are no approved drugs or vaccines available to counter these diseases. Non-structural proteins encoded by these RNA viruses are essential for their replication and maturation and thus may offer ideal targets for developing antiviral drugs. In recent years, several protease inhibitors have been sourced from plant extract, synthesis, computer aided drug design and high throughput screening as well as through drug reposition based approaches to target the non-structural proteins. The protease inhibitors have shown different levels of inhibition and may thus provide template to develop selective and potent drugs against these devastating arboviruses. This review seeks to shed light on the design and development of antiviral drugs against DENV, WNV and CHIKV to date. To the best of our knowledge, this review provides the first comprehensive update on the development of protease inhibitors targeting non-structural proteins of three most devastating arboviruses, DENV, WNV and CHIKV. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

46 CFR 184.300 - Ground tackle and mooring lines.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Ground tackle and mooring lines. 184.300 Section 184.300... Ground tackle and mooring lines. A vessel must be fitted with ground tackle and mooring lines necessary for the vessel to be safely anchored or moored. The ground tackle and mooring lines provided must be...

46 CFR 184.300 - Ground tackle and mooring lines.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Ground tackle and mooring lines. 184.300 Section 184.300... Ground tackle and mooring lines. A vessel must be fitted with ground tackle and mooring lines necessary for the vessel to be safely anchored or moored. The ground tackle and mooring lines provided must be...

Tackle mechanisms and match characteristics in women's elite football tournaments.

PubMed

Tscholl, P; O'Riordan, D; Fuller, C W; Dvorak, J; Junge, A

2007-08-01

Several tools have been used for assessing risk situations and for gathering tackle information from international football matches for men but not for women. To analyse activities in women's football and to identify the characteristics and risk potentials of tackles. Retrospective video analysis. Video recordings of 24 representative matches from six women's top-level tournaments were analysed for tackle parameters and their risk potential. 3531 tackles were recorded. Tackles in which the tackling player came from the side and stayed on her feet accounted for nearly half of all challenges for the ball in which body contact occurred. 2.7% of all tackles were classified as risk situations, with sliding-in tackles from behind and the side having the highest risk potential. Match referees sanctioned sliding-in tackles more often than other tackles (20% v 17%, respectively). Tackle parameters did not change in the duration of a match; however, there was an increase in the number of injury risk situations and foul plays towards the end of each half. Match properties provide valuable information for a better understanding of injury situations in football. Staying on feet and jumping vertically tackle actions leading to injury were sanctioned significantly more times by the referee than those not leading to injury (p<0.001), but no such difference was seen for sliding-in tackles (previously reported to have the highest injury potential in women's football). Therefore, either the laws of the game are not adequate or match referees in women's football are not able to distinguish between sliding-in tackles leading to and those not leading to injury.

Tropical savannas and dry forests.

PubMed

Pennington, R Toby; Lehmann, Caroline E R; Rowland, Lucy M

2018-05-07

In the tropics, research, conservation and public attention focus on rain forests, but this neglects that half of the global tropics have a seasonally dry climate. These regions are home to dry forests and savannas (Figures 1 and 2), and are the focus of this Primer. The attention given to rain forests is understandable. Their high species diversity, sheer stature and luxuriance thrill biologists today as much as they did the first explorers in the Age of Discovery. Although dry forest and savanna may make less of a first impression, they support a fascinating diversity of plant strategies to cope with stress and disturbance including fire, drought and herbivory. Savannas played a fundamental role in human evolution, and across Africa and India they support iconic megafauna. Copyright © 2018 Elsevier Ltd. All rights reserved.

Productivity Loss Related to Neglected Tropical Diseases Eligible for Preventive Chemotherapy: A Systematic Literature Review

PubMed Central

Rijnsburger, Adriana J.; Severens, Johan L.

2016-01-01

Background Neglected Tropical Diseases (NTDs) not only cause health and life expectancy loss, but can also lead to economic consequences including reduced ability to work. This article describes a systematic literature review of the effect on the economic productivity of individuals affected by one of the five worldwide most prevalent NTDs: lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths (ascariasis, trichuriasis, and hookworm infection) and trachoma. These diseases are eligible to preventive chemotherapy (PCT). Methodology/Principal Findings Eleven bibliographic databases were searched using different names of all NTDs and various keywords relating to productivity. Additional references were identified through reference lists from relevant papers. Of the 5316 unique publications found in the database searches, thirteen papers were identified for lymphatic filariasis, ten for onchocerciasis, eleven for schistosomiasis, six for soil-transmitted helminths and three for trachoma. Besides the scarcity in publications reporting the degree of productivity loss, this review revealed large variation in the estimated productivity loss related to these NTDs. Conclusions It is clear that productivity is affected by NTDs, although the actual impact depends on the type and severity of the NTD as well as on the context where the disease occurs. The largest impact on productivity loss of individuals affected by one of these diseases seems to be due to blindness from onchocerciasis and severe schistosomiasis manifestations; productivity loss due to trachoma-related blindness has never been studied directly. However, productivity loss at an individual level might differ from productivity loss at a population level because of differences in the prevalence of NTDs. Variation in estimated productivity loss between and within diseases is caused by differences in research methods and setting. Publications should provide enough information to enable

Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence, Distribution, and Disease Burden

PubMed Central

Hotez, Peter J.; Kamath, Aruna

2009-01-01

The neglected tropical diseases (NTDs) are the most common conditions affecting the poorest 500 million people living in sub-Saharan Africa (SSA), and together produce a burden of disease that may be equivalent to up to one-half of SSA's malaria disease burden and more than double that caused by tuberculosis. Approximately 85% of the NTD disease burden results from helminth infections. Hookworm infection occurs in almost half of SSA's poorest people, including 40–50 million school-aged children and 7 million pregnant women in whom it is a leading cause of anemia. Schistosomiasis is the second most prevalent NTD after hookworm (192 million cases), accounting for 93% of the world's number of cases and possibly associated with increased horizontal transmission of HIV/AIDS. Lymphatic filariasis (46–51 million cases) and onchocerciasis (37 million cases) are also widespread in SSA, each disease representing a significant cause of disability and reduction in the region's agricultural productivity. There is a dearth of information on Africa's non-helminth NTDs. The protozoan infections, human African trypanosomiasis and visceral leishmaniasis, affect almost 100,000 people, primarily in areas of conflict in SSA where they cause high mortality, and where trachoma is the most prevalent bacterial NTD (30 million cases). However, there are little or no data on some very important protozoan infections, e.g., amebiasis and toxoplasmosis; bacterial infections, e.g., typhoid fever and non-typhoidal salmonellosis, the tick-borne bacterial zoonoses, and non-tuberculosis mycobaterial infections; and arboviral infections. Thus, the overall burden of Africa's NTDs may be severely underestimated. A full assessment is an important step for disease control priorities, particularly in Nigeria and the Democratic Republic of Congo, where the greatest number of NTDs may occur. PMID:19707588

When Is Neglect, Neglect?: It Depends on Who You Ask.

PubMed

Dickerson, Kelli L; Lindner, Sonia; Scurich, Nicholas; Quas, Jodi A

2017-08-01

In order to identify victims of child neglect, social service workers rely heavily on referrals from concerned friends, neighbors, and others in the community. Little is known, however, about how lay individuals perceive child neglect and what factors influence their decision to make a referral. This study explored the effects of child, parent, and participant gender on laypersons' evaluations of child neglect. Participants read a case of neglect of a child by a custodial and absent parent and then rated the parents' culpability and intentionality and decided whether the parents' behavior met the legal definition of neglect. When evaluating the custodial parent, men but not women viewed fathers as more culpable than mothers for the neglect of their son and viewed mothers as somewhat more culpable for the neglect of their daughter. Men also perceived absent mothers as more intentionally harmful than absent fathers. Finally, both men and women were more likely to qualify parental behavior as legally neglectful when the genders of the custodial parent and child matched. Results, which suggest that gender bias may exist in laypersons' perceptions of child neglect and may influence their decisions to report, have implications for identification of and intervention for vulnerable children and families.

Child Neglect in the Military Community: Are We Neglecting the Child?

DTIC Science & Technology

1995-04-01

encompasses "a parent’s or other caretaker’s failure to provide basic physical health care, supervision, nutrition, personal hygiene, emotional nurturing...the term "child neglect" generally refers to: emotional neglect, abandonment, and the failure to provide: food, shelter, clothing, medical care...Resource Center on Child Abuse and Neglect 26-- divides child neglect into four types: physical, educational, emotional , and medical. Physical neglect

Neglected tropical diseases: prevalence and risk factors for schistosomiasis and soil-transmitted helminthiasis in a region of Minas Gerais State, Brazil.

PubMed

Couto, Luzivalda D; Tibiriça, Sandra H C; Pinheiro, Izabella O; Mitterofhe, Adalberto; Lima, Adilson C; Castro, Milton F; Gonçalves, Murilo; Silva, Marcio R; Guimarães, Ricardo J P S; Rosa, Florence M; Coimbra, Elaine S

2014-06-01

Among the neglected tropical diseases (NTDs), schistosomiasis and the three main soil-transmitted helminthiases (STHs), i.e., ascariasis, trichuriasis and hookworm infection, represent the most common infections in developing countries. In Brazil, there is a lack of epidemiological data in many parts of the country, which favors the unawareness of the real situation concerning these diseases. Due to this, we investigated the occurrence of schistosomiasis and STHs in a region of Minas Gerais State, Brazil. One stool sample was collected from 503 individuals, whose ages ranged from 0.1 to 91.2 years, and screened using both the Kato-Katz and the Formol-Ether methods. In parallel, a malacological survey was carried out in the main water bodies of the district, and Biomphalaria susceptibility assays and kernel-based techniques were also performed. No individual was found infected with Ascaris lumbricoides or hookworm. Schistosoma mansoni was the most common parasite found (1.6%). The prevalence was higher in males and the chance of acquiring the disease increased by 43.35 times with contact with a body of water. None of the Biomphalaria tenagophila and B. glabrata specimens were found naturally infected, but B. glabrata was highly susceptible to infection with Schistosoma mansoni. Using kernel-based techniques, clusters of Biomphalaria were found near the households where the infected individuals lived. Schistosomiasis was the most prevalent parasitic infection found. Our findings show that the occurrence of this disease has been underestimated by the local health care service, and highlight the importance of epidemiological surveillance in areas of low prevalence for schistosomiasis. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Neglected tropical diseases among the Association of Southeast Asian Nations (ASEAN): overview and update.

PubMed

Hotez, Peter J; Bottazzi, Maria Elena; Strych, Ulrich; Chang, Li-Yen; Lim, Yvonne A L; Goodenow, Maureen M; AbuBakar, Sazaly

2015-04-01

The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines

A Novel Electronic Data Collection System for Large-Scale Surveys of Neglected Tropical Diseases

PubMed Central

King, Jonathan D.; Buolamwini, Joy; Cromwell, Elizabeth A.; Panfel, Andrew; Teferi, Tesfaye; Zerihun, Mulat; Melak, Berhanu; Watson, Jessica; Tadesse, Zerihun; Vienneau, Danielle; Ngondi, Jeremiah; Utzinger, Jürg; Odermatt, Peter; Emerson, Paul M.

2013-01-01

Background Large cross-sectional household surveys are common for measuring indicators of neglected tropical disease control programs. As an alternative to standard paper-based data collection, we utilized novel paperless technology to collect data electronically from over 12,000 households in Ethiopia. Methodology We conducted a needs assessment to design an Android-based electronic data collection and management system. We then evaluated the system by reporting results of a pilot trial and from comparisons of two, large-scale surveys; one with traditional paper questionnaires and the other with tablet computers, including accuracy, person-time days, and costs incurred. Principle Findings The electronic data collection system met core functions in household surveys and overcame constraints identified in the needs assessment. Pilot data recorders took 264 (standard deviation (SD) 152 sec) and 260 sec (SD 122 sec) per person registered to complete household surveys using paper and tablets, respectively (P = 0.77). Data recorders felt a lack of connection with the interviewee during the first days using electronic devices, but preferred to collect data electronically in future surveys. Electronic data collection saved time by giving results immediately, obviating the need for double data entry and cross-correcting. The proportion of identified data entry errors in disease classification did not differ between the two data collection methods. Geographic coordinates collected using the tablets were more accurate than coordinates transcribed on a paper form. Costs of the equipment required for electronic data collection was approximately the same cost incurred for data entry of questionnaires, whereas repeated use of the electronic equipment may increase cost savings. Conclusions/Significance Conducting a needs assessment and pilot testing allowed the design to specifically match the functionality required for surveys. Electronic data collection using an Android

Canada's neglected tropical disease research network: who's in the core-who's on the periphery?

PubMed

Phillips, Kaye; Kohler, Jillian Clare; Pennefather, Peter; Thorsteinsdottir, Halla; Wong, Joseph

2013-01-01

This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canada's neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding. MULTIPLE METHODS WERE USED TO CONDUCT THIS STUDY, INCLUDING: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level "core-periphery" network analysis to measure and map the structure of Canada's NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canada's NTD network ("k-core measure") and the quantity and quality of research produced. Over the past sixty years (1950-2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network. The publication specialties, composition, and position of NTD researchers within Canada's NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the NTD research they generate; there is opportunity to leverage existing

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success

PubMed Central

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-01-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti’s neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a “directly observed treatment” strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained– 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH—and the significant reduction in burden of infection– 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti’s very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of “best practices” for

Implementing Preventive Chemotherapy through an Integrated National Neglected Tropical Disease Control Program in Mali

PubMed Central

Dembélé, Massitan; Bamani, Sanoussi; Dembélé, Robert; Traoré, Mamadou O.; Goita, Seydou; Traoré, Mamadou Namory; Sidibe, Abdoul Karim; Sam, Letitia; Tuinsma, Marjon; Toubali, Emily; MacArthur, Chad; Baker, Shawn K.; Zhang, Yaobi

2012-01-01

Background Mali is endemic for all five targeted major neglected tropical diseases (NTDs). As one of the five ‘fast-track’ countries supported with the United States Agency for International Development (USAID) funds, Mali started to integrate the activities of existing disease-specific national control programs on these diseases in 2007. The ultimate objectives are to eliminate lymphatic filariasis, onchocerciasis and trachoma as public health problems and to reduce morbidity caused by schistosomiasis and soil-transmitted helminthiasis through regular treatment to eligible populations, and the specific objectives were to achieve 80% program coverage and 100% geographical coverage yearly. The paper reports on the implementation of the integrated mass drug administration and the lessons learned. Methodology/Principal Findings The integrated control program was led by the Ministry of Health and coordinated by the national NTD Control Program. The drug packages were designed according to the disease endemicity in each district and delivered through various platforms to eligible populations involving the primary health care system. Treatment data were recorded and reported by the community drug distributors. After a pilot implementation of integrated drug delivery in three regions in 2007, the treatment for all five targeted NTDs was steadily scaled up to 100% geographical coverage by 2009, and program coverage has since been maintained at a high level: over 85% for lymphatic filariasis, over 90% for onchocerciasis and soil-transmitted helminthiasis, around 90% in school-age children for schistosomiasis, and 76–97% for trachoma. Around 10 million people have received one or more drug packages each year since 2009. No severe cases of adverse effects were reported. Conclusions/Significance Mali has scaled up the drug treatment to national coverage through integrated drug delivery involving the primary health care system. The successes and lessons learned in Mali

Neglected Tropical Diseases among the Association of Southeast Asian Nations (ASEAN): Overview and Update

PubMed Central

Hotez, Peter J.; Bottazzi, Maria Elena; Strych, Ulrich; Chang, Li-Yen; Lim, Yvonne A. L.; Goodenow, Maureen M.; AbuBakar, Sazaly

2015-01-01

The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines

Canada's Neglected Tropical Disease Research Network: Who's in the Core—Who's on the Periphery?

PubMed Central

Phillips, Kaye; Kohler, Jillian Clare; Pennefather, Peter; Thorsteinsdottir, Halla; Wong, Joseph

2013-01-01

Background This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canada's neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding. Methodology Multiple methods were used to conduct this study, including: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level “core-periphery” network analysis to measure and map the structure of Canada's NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canada's NTD network (“k-core measure”) and the quantity and quality of research produced. Principal Findings Over the past sixty years (1950–2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network. Conclusion/Significance The publication specialties, composition, and position of NTD researchers within Canada's NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

PubMed

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-10-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but

Distribution of isoflavones and coumestrol in neglected tropical and subtropical legumes.

PubMed

Leuner, Olga; Havlik, Jaroslav; Hummelova, Jana; Prokudina, Elena; Novy, Pavel; Kokoska, Ladislav

2013-02-01

Isoflavones and coumestrol from dietary legumes are plant constituents showing multiple beneficial effects on humans. Owing to their ability to bind with mammalian estrogenic receptors and thereby intervention in several kinds of hormone-related cancers, they have received much attention. Soybean (Glycine max) is currently the major source of isoflavonoids in human diet. However, dozens of tropical and subtropical leguminous species remain unexplored for their isoflavonoids content. We have analyzed 55 extracts from 41 tropical and subtropical legume species used either in human or animal diet by high-performance liquid chromatography for the content of soy isoflavones, biochanin A, daidzein, daidzin, formononetin, genistein, genistin, sissotrin, ononin and the coumestan coumestrol. Genistein and biochanin A were the most abundant compounds. The highest content of genistein was found in aerial parts of Andira macrothyrsa, seeds of Pachyrhizus tuberosus and aerial parts of Calopogonium mucunoides (598, 250 and 184 µg g(-1), respectively) and biochanin A in aerial parts of Cratylia argentea, C. mucunoides and flowers of A. macrothyrsa (76, 53 and 40 µg g(-1), respectively). None of the samples tested was richer overall source of soy isoflavones and coumestrol than soybean; nevertheless several species (C. mucunoides or A. macrothyrsa) may serve as a promising source of individual compounds. Copyright © 2012 Society of Chemical Industry.

Elimination of neglected tropical diseases in the South-East Asia Region of the World Health Organization.

PubMed

Narain, Jai P; Dash, A P; Parnell, B; Bhattacharya, S K; Barua, S; Bhatia, R; Savioli, L

2010-03-01

The neglected tropical diseases (NTDs), which affect the very poor, pose a major public health problem in the South-East Asia Region of the World Health Organization (WHO). Although more than a dozen NTDs affect the region, over the past five years four of them in particular - leprosy, lymphatic filariasis, visceral leishmaniasis (kala-azar) and yaws - have been targeted for elimination. These four were selected for a number of reasons. First, they affect the WHO South-East Asia Region disproportionately. For example, every year around 67% of all new leprosy cases and 60% of all new cases of visceral leishmaniasis worldwide occur in countries of the region, where as many as 850 million inhabitants are at risk of contracting lymphatic filariasis. In addition, several epidemiological, technological and historical factors that are unique to the region make each of these four diseases amenable to elimination. Safe and effective tools and interventions to achieve these targets are available and concerted efforts to scale them up, singly or in an integrated manner, are likely to lead to success. The World Health Assembly and the WHO Regional Committee, through a series of resolutions, have already expressed regional and global commitments for the elimination of these diseases as public health problems. Such action is expected to have a quick and dramatic impact on poverty reduction and to contribute to the achievement of the Millennium Development Goals. This paper reviews the policy rationale for disease control in the WHO South-East Asia Region, the progress made so far, the lessons learnt along the way, and the remaining challenges and opportunities.

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

PubMed

Macpherson, Eleanor E; Adams, Emily R; Bockarie, Moses J; Hollingsworth, T Deirdre; Kelly-Hope, Louise A; Lehane, Mike; Kovacic, Vanja; Harrison, Robert A; Paine, Mark Ji; Reimer, Lisa J; Torr, Stephen J

2015-01-01

Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs.

Spatial co-distribution of neglected tropical diseases in the East African Great Lakes region: revisiting the justification for integrated control

PubMed Central

Clements, Archie C. A.; Deville, Marie-Alice; Ndayishimiye, Onésime; Brooker, Simon; Fenwick, Alan

2010-01-01

Summary OBJECTIVE To determine spatial patterns of co-endemicity of schistosomiasis mansoni and the soil-transmitted helminths (STHs) Ascaris lumbricoides, Trichuris trichiura and hookworm in the Great Lakes region of East Africa, to help plan integrated neglected tropical disease programmes in this region. METHOD Parasitological surveys were conducted in Uganda, Tanzania, Kenya and Burundi in 28 213 children in 404 schools. Bayesian geostatistical models were used to interpolate prevalence of these infections across the study area. Interpolated prevalence maps were overlaid to determine areas of co-endemicity. RESULTS In the Great Lakes region, prevalence was 18.1% for Schistosoma mansoni, 50.0% for hookworm, 6.8% for A. lumbricoides and 6.8% for T. trichiura. Hookworm infection was ubiquitous, whereas S. mansoni, A. lumbricoides and T. trichiura were highly focal. Most areas were endemic (prevalence ≥10%) or hyperendemic (prevalence ≥50%) for one or more STHs, whereas endemic areas for schistosomiasis mansoni were restricted to foci adjacent large perennial water bodies. CONCLUSION Because of the ubiquity of hookworm, treatment programmes are required for STH throughout the region but efficient schistosomiasis control should only be targeted at limited high-risk areas. Therefore, integration of schistosomiasis with STH control is only indicated in limited foci in East Africa. PMID:20409287

Leprosy-related mortality in Brazil: a neglected condition of a neglected disease.

PubMed

Martins-Melo, Francisco Rogerlândio; Assunção-Ramos, Adriana Valéria; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Montenegro, Renan Magalhães; Wand-Del-Rey de Oliveira, Maria Leide; Heukelbach, Jorg

2015-10-01

Leprosy is a public health problem and a neglected condition of morbidity and mortality in several countries of the world. We analysed time trends and spatiotemporal patterns of leprosy-related mortality in Brazil. We performed a nationwide population-based study using secondary mortality data. We included all deaths that occurred in Brazil between 2000 and 2011, in which leprosy was mentioned in any field of death certificates. Leprosy was identified in 7732/12 491 280 deaths (0.1%). Average annual age-adjusted mortality rate was 0.43 deaths/100 000 inhabitants (95% CI 0.40-0.46). The burden of leprosy deaths was higher among males, elderly, black race/colour and in leprosy-endemic regions. Lepromatous leprosy was the most common clinical form mentioned. Mortality rates showed a significant nationwide decrease over the period (annual percent change [APC]: -2.8%; 95% CI -4.2 to -2.4). We observed decreasing mortality rates in the South, Southeast and Central-West regions, while the rates remained stable in North and Northeast regions. Spatial and spatiotemporal high-risk clusters for leprosy-related deaths were distributed mainly in highly endemic and socio-economically deprived regions. Leprosy is a neglected cause of death in Brazil since the disease is preventable, and a cost-effective treatment is available. Sustainable control measures should include appropriate management and systematic monitoring of leprosy-related complications, such as severe leprosy reactions and adverse effects to multidrug therapy. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Non-sanctioning of illegal tackles in South African youth community rugby.

PubMed

Brown, J C; Boucher, S J; Lambert, M; Viljoen, W; Readhead, C; Hendricks, S; Kraak, W J

2018-06-01

The tackle event in rugby union ('rugby') contributes to the majority of players' injuries. Referees can reduce this risk by sanctioning dangerous tackles. A study in elite adult rugby suggests that referees only sanction a minority of illegal tackles. The aim of this study was to assess if this finding was similar in youth community rugby. Observational study. Using EncodePro, 99 South African Rugby Union U18 Youth Week tournament matches were coded between 2011 and 2015. All tackles were coded by a researcher and an international referee to ensure that laws were interpreted correctly. The inter- and intra-rater reliabilities were 0.97-1.00. A regression analysis compared the non-sanctioned rates over time. In total, 12 216 tackles were coded, of which less than 1% (n=113) were 'illegal'. The majority of the 113 illegal tackles were front-on (75%), high tackles (72%) and occurred in the 2nd/4th quarters (29% each). Of the illegal tackles, only 59% were sanctioned. The proportions of illegal tackles and sanctioning of these illegal tackles to all tackles improved by 0.2% per year from 2011-2015 (p<0.05). In these youth community rugby players, 59% of illegal tackles were not sanctioned appropriately. This was better than a previous study in elite adult rugby, where only 7% of illegal tackles were penalised. Moreover, the rates of illegal tackles and non-sanctioned illegal tackles both improved over time. However, it is critical that referees consistently enforce all laws to enhance injury prevention efforts. Further studies should investigate the reasons for non-sanctioning. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Recovery of personal neglect.

PubMed

Iosa, Marco; Guariglia, Cecilia; Matano, Alessandro; Paolucci, Stefano; Pizzamiglio, Luigi

2016-12-01

Extrapersonal unilateral spatial neglect after stroke is associated to a poor rehabilitation outcome. Minor attention has been paid to the recovery of personal neglect, to its relationship with the recovery of extrapersonal neglect and of independency in activities of daily living. The present study aims at evaluating whether there is an association between recovery of extrapersonal and personal neglect. The secondary aim was to investigate if personal neglect may affect the effectiveness of neurorehabilitation in patients with subacute stroke. Observational study. Neurorehabilitation Hospital in Rome, Italy, inpatients. A sample of 49 patients with unilateral spatial neglect resulting from right ischemic cerebral infarction was enrolled in this study, divided into three subgroups according to the presence and the degree of personal neglect, and evaluated pre and postneurorehabilitation. Personal neglect was evaluated using Zoccolotti and Judica's Scale, extrapersonal neglect using Letter Cancellation Test, Barrage Test, Sentence Reading Test and Wundt-Jastrow Area Illusion Test. Barthel Index (BI), Rivermead Mobility Index, and Canadian Neurological Scale were also administered. Results showed the following: 1) recovery of personal neglect was not significantly correlated with that of extrapersonal neglect, despite both the disorders were ameliorated after a "non-specific" rehabilitation treatment; 2) personal neglect per se was not an additional negative prognostic factor in the rehabilitation findings. Our results suggested that the recoveries of the two types of neglect are independent from each other, and that the presence of personal neglect does not imply significant additional problems to the functional outcomes. Our study highlighted the need of novel tools to assess the presence and to improve the recovery of personal neglect.

Diagnosis of neglected tropical diseases among patients with persistent digestive disorders (diarrhoea and/or abdominal pain ≥14 days): Pierrea multi-country, prospective, non-experimental case-control study.

PubMed

Polman, Katja; Becker, Sören L; Alirol, Emilie; Bhatta, Nisha K; Bhattarai, Narayan R; Bottieau, Emmanuel; Bratschi, Martin W; Burza, Sakib; Coulibaly, Jean T; Doumbia, Mama N; Horié, Ninon S; Jacobs, Jan; Khanal, Basudha; Landouré, Aly; Mahendradhata, Yodi; Meheus, Filip; Mertens, Pascal; Meyanti, Fransiska; Murhandarwati, Elsa H; N'Goran, Eliézer K; Peeling, Rosanna W; Ravinetto, Raffaella; Rijal, Suman; Sacko, Moussa; Saye, Rénion; Schneeberger, Pierre H H; Schurmans, Céline; Silué, Kigbafori D; Thobari, Jarir A; Traoré, Mamadou S; van Lieshout, Lisette; van Loen, Harry; Verdonck, Kristien; von Müller, Lutz; Yansouni, Cédric P; Yao, Joel A; Yao, Patrick K; Yap, Peiling; Boelaert, Marleen; Chappuis, François; Utzinger, Jürg

2015-08-18

Diarrhoea still accounts for considerable mortality and morbidity worldwide. The highest burden is concentrated in tropical areas where populations lack access to clean water, adequate sanitation and hygiene. In contrast to acute diarrhoea (<14 days), the spectrum of pathogens that may give rise to persistent diarrhoea (≥14 days) and persistent abdominal pain is poorly understood. It is conceivable that pathogens causing neglected tropical diseases play a major role, but few studies investigated this issue. Clinical management and diagnostic work-up of persistent digestive disorders in the tropics therefore remain inadequate. Hence, important aspects regarding the pathogenesis, epidemiology, clinical symptomatology and treatment options for patients presenting with persistent diarrhoea and persistent abdominal pain should be investigated in multi-centric clinical studies. This multi-country, prospective, non-experimental case-control study will assess persistent diarrhoea (≥14 days; in individuals aged ≥1 year) and persistent abdominal pain (≥14 days; in children/adolescents aged 1-18 years) in up to 2000 symptomatic patients and 2000 matched controls. Subjects from Côte d'Ivoire, Indonesia, Mali and Nepal will be clinically examined and interviewed using a detailed case report form. Additionally, each participant will provide a stool sample that will be examined using a suite of diagnostic methods (i.e., microscopic techniques, rapid diagnostic tests, stool culture and polymerase chain reaction) for the presence of bacterial and parasitic pathogens. Treatment will be offered to all infected participants and the clinical treatment response will be recorded. Data obtained will be utilised to develop patient-centred clinical algorithms that will be validated in primary health care centres in the four study countries in subsequent studies. Our research will deepen the understanding of the importance of persistent diarrhoea and related digestive disorders in

Engineering Synergistically Active and Bioavailable Cost-effective Medicines for Neglected Tropical Diseases; The Role of Excipients.

PubMed

Serrano, Dolores R; Lalatsa, Aikaterini; Dea-Ayuela, M Auxiliadora

2017-07-19

Leishmaniasis is a neglected tropical disease responsible for the ninth largest disease burden in the world threatening 350 million people mostly in developing countries. The lack of efficacy, severe adverse effects, long duration, high cost and parenteral administration of the current therapies result in poor patient compliance and emergence of resistance. Leishmaniasis' unmet need for safer, affordable and more effective treatments is only partly addressed by today's global health product pipeline that focuses on products amenable to rapid clinical development, mainly by reformulating or repurposing existing drugs for new uses. Excipients are necessary for ensuring the stability and bioavailability of currently available antileishmaniasis drugs which in their majority are poorly soluble or have severe side-effects. Thus, selection of excipients that can ensure bioavailability and safety as well as elicit a synergistic effect against the Leishmania parasites without compromising safety will result in a more efficacious, safe and fast to market medicine. We have evaluated the in vitro activity of 30 commercially available generally regarded as safe (GRAS) excipients against different Leishmania spp., their cytotoxicity and potential use for inclusion in novel formulations. Amongst the tested excipients, the compounds with higher selectivity index were Eudragit E100 (cationic triblock copolymer of dimethylaminoethyl methacrylate, butyl methacrylate, and methyl methacrylate), CTAB (cetyltrimethylammonium bromide, cationic), lauric acid, Labrasol(non-ionic, caprylocaproyl polyoxyl- 8 glycerides) and sodium deoxycholate. An ideal excipient need to possess amphiphilic nature with ionic/polar groups and possess a short or medium fatty acid chain such as lauric (C12), capric C10) or caprylicacid (C8). Inclusion of these excipients and identification of the optimal combination of drug and excipients would lead to a more effective and safer antileishmanial therapies

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals.

PubMed

Bangert, Mathieu; Molyneux, David H; Lindsay, Steve W; Fitzpatrick, Christopher; Engels, Dirk

2017-04-04

The Sustainable Development Goals (SDGs) call for an integrated response, the kind that has defined Neglected Tropical Diseases (NTDs) efforts in the past decade.NTD interventions have the greatest relevance for SDG3, the health goal, where the focus on equity, and its commitment to reaching people in need of health services, wherever they may live and whatever their circumstances, is fundamentally aligned with the target of Universal Health Coverage. NTD interventions, however, also affect and are affected by many of the other development areas covered under the 2030 Agenda. Strategies such as mass drug administration or the programmatic integration of NTD and WASH activities (SDG6) are driven by effective global partnerships (SDG17). Intervention against the NTDs can also have an impact on poverty (SDG1) and hunger (SDG2), can improve education (SDG4), work and economic growth (SDG8), thereby reducing inequalities (SDG10). The community-led distribution of donated medicines to more than 1 billion people reinforces women's empowerment (SDG5), logistics infrastructure (SDG9) and non-discrimination against disability (SDG16). Interventions to curb mosquito-borne NTDs contribute to the goals of urban sustainability (SDG11) and resilience to climate change (SDG13), while the safe use of insecticides supports the goal of sustainable ecosystems (SDG15). Although indirectly, interventions to control water- and animal-related NTDs can facilitate the goals of small-scale fishing (SDG14) and sustainable hydroelectricity and biofuels (SDG7).NTDs proliferate in less developed areas in countries across the income spectrum, areas where large numbers of people have little or no access to adequate health care, clean water, sanitation, housing, education, transport and information. This scoping review assesses how in this context, ending the epidemic of the NTDs can impact and improve our prospects of attaining the SDGs.

Relapsing Fevers: Neglected Tick-Borne Diseases

PubMed Central

Talagrand-Reboul, Emilie; Boyer, Pierre H.; Bergström, Sven; Vial, Laurence; Boulanger, Nathalie

2018-01-01

Relapsing fever still remains a neglected disease and little is known on its reservoir, tick vector and physiopathology in the vertebrate host. The disease occurs in temperate as well as tropical countries. Relapsing fever borreliae are spirochaetes, members of the Borreliaceae family which also contain Lyme disease spirochaetes. They are mainly transmitted by Ornithodoros soft ticks, but some species are vectored by ixodid ticks. Traditionally a Borrelia species is associated with a specific vector in a particular geographical area. However, new species are regularly described, and taxonomical uncertainties deserve further investigations to better understand Borrelia vector/host adaptation. The medical importance of Borrelia miyamotoi, transmitted by Ixodes spp., has recently spawned new interest in this bacterial group. In this review, recent data on tick-host-pathogen interactions for tick-borne relapsing fevers is presented, with special focus on B. miyamotoi. PMID:29670860

46 CFR 121.300 - Ground tackle and mooring lines.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Ground tackle and mooring lines. 121.300 Section 121.300... MISCELLANEOUS SYSTEMS AND EQUIPMENT Mooring and Towing Equipment § 121.300 Ground tackle and mooring lines. A vessel must be fitted with ground tackle and mooring lines necessary for the vessel to be safely anchored...

46 CFR 121.300 - Ground tackle and mooring lines.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Ground tackle and mooring lines. 121.300 Section 121.300... MISCELLANEOUS SYSTEMS AND EQUIPMENT Mooring and Towing Equipment § 121.300 Ground tackle and mooring lines. A vessel must be fitted with ground tackle and mooring lines necessary for the vessel to be safely anchored...

Spatial neglect

PubMed Central

Li, Korina; Malhotra, Paresh A

2015-01-01

The syndrome of visuospatial neglect is a common consequence of unilateral brain injury. It is most often associated with stroke and is more severe and persistent following right hemisphere damage, with reported frequencies in the acute stage of up to 80%. Neglect is primarily a disorder of attention whereby patients characteristically fail to orientate, to report or to respond to stimuli located on the contralesional side. Neglect is usually caused by large strokes in the middle cerebral artery territory and is heterogeneous, such that most patients do not manifest every feature of the syndrome. A number of treatments may improve neglect, but there is no widely accepted universal approach to therapy. Although most patients recover spontaneously, the evidence suggests that they continue to have significant cognitive impairments, particularly relating to attention. PMID:26023203

Concerted Efforts to Control or Eliminate Neglected Tropical Diseases: How Much Health Will Be Gained?

PubMed Central

Hontelez, Jan A. C.; Bakker, Roel; Blok, David J.; Cai, Rui; Houweling, Tanja A. J.; Kulik, Margarete C.; Lenk, Edeltraud J.; Luyendijk, Marianne; Matthijsse, Suzette M.; Redekop, William K.; Wagenaar, Inge; Jacobson, Julie; Nagelkerke, Nico J. D.; Richardus, Jan H.

2016-01-01

Background The London Declaration (2012) was formulated to support and focus the control and elimination of ten neglected tropical diseases (NTDs), with targets for 2020 as formulated by the WHO Roadmap. Five NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma) are to be controlled by preventive chemotherapy (PCT), and four (Chagas’ disease, human African trypanosomiasis, leprosy and visceral leishmaniasis) by innovative and intensified disease management (IDM). Guinea worm, virtually eradicated, is not considered here. We aim to estimate the global health impact of meeting these targets in terms of averted morbidity, mortality, and disability adjusted life years (DALYs). Methods The Global Burden of Disease (GBD) 2010 study provides prevalence and burden estimates for all nine NTDs in 1990 and 2010, by country, age and sex, which were taken as the basis for our calculations. Estimates for other years were obtained by interpolating between 1990 (or the start-year of large-scale control efforts) and 2010, and further extrapolating until 2030, such that the 2020 targets were met. The NTD disease manifestations considered in the GBD study were analyzed as either reversible or irreversible. Health impacts were assessed by comparing the results of achieving the targets with the counterfactual, construed as the health burden had the 1990 (or 2010 if higher) situation continued unabated. Principle Findings/Conclusions Our calculations show that meeting the targets will lead to about 600 million averted DALYs in the period 2011–2030, nearly equally distributed between PCT and IDM-NTDs, with the health gain amongst PCT-NTDs mostly (96%) due to averted disability and amongst IDM-NTDs largely (95%) from averted mortality. These health gains include about 150 million averted irreversible disease manifestations (e.g. blindness) and 5 million averted deaths. Control of soil-transmitted helminths accounts for one third of all

The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

PubMed Central

2012-01-01

Background Neglected tropical diseases (NTDs) are a group of chronic parasitic diseases and related conditions that are the most common diseases among the 2·7 billion people globally living on less than US$2 per day. In response to the growing challenge of NTDs, Ethiopia is preparing to launch a NTD Master Plan. The purpose of this review is to underscore the burden of NTDs in Ethiopia, highlight the state of current interventions, and suggest ways forward. Results This review indicates that NTDs are significant public health problems in Ethiopia. From the analysis reported here, Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo. Ethiopia is estimated to have the highest burden of trachoma, podoconiosis and cutaneous leishmaniasis in sub-Saharan Africa (SSA), the second highest burden in terms of ascariasis, leprosy and visceral leishmaniasis, and the third highest burden of hookworm. Infections such as schistosomiasis, trichuriasis, lymphatic filariasis and rabies are also common. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. However, despite these high burdens of infection, the control of most NTDs in Ethiopia is in its infancy. In terms of NTD control achievements, Ethiopia reached the leprosy elimination target of 1 case/10,000 population in 1999. No cases of human African trypanosomiasis have been reported since 1984. Guinea worm eradication is in its final phase. The Onchocerciasis Control Program has been making steady progress since 2001. A national blindness survey was conducted in 2006 and the trachoma program has kicked off in some regions. Lymphatic Filariasis, podoconiosis and rabies mapping are underway. Conclusion Ethiopia bears a significant burden of NTDs compared to other SSA countries. To achieve success in integrated control of NTDs, integrated mapping

NTDs V.2.0: "blue marble health"--neglected tropical disease control and elimination in a shifting health policy landscape.

PubMed

Hotez, Peter J

2013-11-01

The concept of the neglected tropical diseases (NTDs) was established in the aftermath of the Millennium Development Goals. Here, we summarize the emergence of several new post-2010 global health documents and policies, and how they may alter the way we frame the world's major NTDs since they were first highlighted. These documents include a new Global Burden of Disease 2010 Study that identifies visceral leishmaniasis and food-borne trematode infections as priority diseases beyond the seven NTDs originally targeted by preventive chemotherapy, a London Declaration for access to essential medicines, and a 2013 World Health Assembly resolution on NTDs. Additional information highlights an emerging dengue fever pandemic. New United Nations resolutions on women and the non-communicable diseases (NCDs) have not yet embraced NTDs, which may actually be the most common afflictions of girls and women and represent a stealth cause of NCDs. NTDs also have important direct and collateral effects on HIV/AIDS and malaria, and there is now a robust evidence base and rationale for incorporating NTDs into the Global Fund to Fight AIDS, Tuberculosis, and Malaria. "Blue marble health" is an added concept that recognizes a paradoxical NTD disease burden among the poor living in G20 (Group of Twenty) and other wealthy countries, requiring these nations to take greater ownership for both disease control and research and development. As we advance past the year 2015, it will be essential to incorporate global NTD elimination into newly proposed Sustainable Development Goals.

Extinction risk escalates in the tropics.

PubMed

Vamosi, Jana C; Vamosi, Steven M

2008-01-01

The latitudinal biodiversity gradient remains one of the most widely recognized yet puzzling patterns in nature. Presently, the high level of extinction of tropical species, referred to as the "tropical biodiversity crisis", has the potential to erode this pattern. While the connection between species richness, extinction, and speciation has long intrigued biologists, these interactions have experienced increased poignancy due to their relevancy to where we should concentrate our conservation efforts. Natural extinction is a phenomenon thought to have its own latitudinal gradient, with lower extinction rates in the tropics being reported in beetles, birds, mammals, and bivalves. Processes that have buffered ecosystems from high extinction rates in the past may also buffer ecosystems against disturbance of anthropogenic origin. While potential parallels between historical and present-day extinction patterns have been acknowledged, they remain only superficially explored and plant extinction patterns have been particularly neglected. Studies on the disappearances of animal species have reached conflicting conclusions, with the rate of extinction appearing either higher or lower in species richness hotspots. Our global study of extinction risk in vascular plants finds disproportionately higher extinction risk in tropical countries, even when indicators of human pressure (GDP, population density, forest cover change) are taken into account. Our results are at odds with the notion that the tropics represent a museum of plant biodiversity (places of historically lowered extinction) and we discuss mechanisms that may reconcile this apparent contradiction.

Social sciences research in neglected tropical diseases 3: Investment in social science research in neglected diseases of poverty: a case study of Bill and Melinda Gates Foundation.

PubMed

Pokhrel, Subhash; Reidpath, Daniel; Allotey, Pascale

2011-01-06

The level of funding provides a good proxy for the level of commitment or prioritisation given to a particular issue. While the need for research relevant to social, economic, cultural and behavioural aspects of neglected tropical diseases (NTD) control has been acknowledged, there is limited data on the level of funding that supports NTD social science research. A case study was carried out in which the spending of a major independent funder, the Bill and Melinda Gates Foundation (BMGF) - was analysed. A total of 67 projects funded between October 1998 and November 2008 were identified from the BMGF database. With the help of keywords within the titles of 67 grantees, they were categorised as social science or non-social science research based on available definition of social science. A descriptive analysis was conducted. Of 67 projects analysed, 26 projects (39%) were social science related while 41 projects (61%) were basic science or other translational research including drug development. A total of US$ 697 million was spent to fund the projects, of which 35% ((US$ 241 million) went to social science research. Although the level of funding for social science research has generally been lower than that for non-social science research over 10 year period, social science research attracted more funding in 2004 and 2008. The evidence presented in this case study indicates that funding on NTD social science research compared to basic and translational research is not as low as it is perceived to be. However, as there is the acute need for improved delivery and utilisation of current NTD drugs/technologies, informed by research from social science approaches, funding priorities need to reflect the need to invest significantly more in NTD social science research.

Social sciences research in neglected tropical diseases 3: Investment in social science research in neglected diseases of poverty: a case study of Bill and Melinda Gates Foundation

PubMed Central

2011-01-01

Background The level of funding provides a good proxy for the level of commitment or prioritisation given to a particular issue. While the need for research relevant to social, economic, cultural and behavioural aspects of neglected tropical diseases (NTD) control has been acknowledged, there is limited data on the level of funding that supports NTD social science research. Method A case study was carried out in which the spending of a major independent funder, the Bill and Melinda Gates Foundation (BMGF) - was analysed. A total of 67 projects funded between October 1998 and November 2008 were identified from the BMGF database. With the help of keywords within the titles of 67 grantees, they were categorised as social science or non-social science research based on available definition of social science. A descriptive analysis was conducted. Results Of 67 projects analysed, 26 projects (39%) were social science related while 41 projects (61%) were basic science or other translational research including drug development. A total of US$ 697 million was spent to fund the projects, of which 35% ((US$ 241 million) went to social science research. Although the level of funding for social science research has generally been lower than that for non-social science research over 10 year period, social science research attracted more funding in 2004 and 2008. Conclusion The evidence presented in this case study indicates that funding on NTD social science research compared to basic and translational research is not as low as it is perceived to be. However, as there is the acute need for improved delivery and utilisation of current NTD drugs/technologies, informed by research from social science approaches, funding priorities need to reflect the need to invest significantly more in NTD social science research. PMID:21210999

Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges

PubMed Central

2017-01-01

Infectious diseases are a significant burden on public health and economic stability of societies all over the world. They have for centuries been among the leading causes of death and disability and presented growing challenges to health security and human progress. The threat posed by infectious diseases is further deepened by the continued emergence of new, unrecognized, and old infectious disease epidemics of global impact. Over the past three and half decades at least 30 new infectious agents affecting humans have emerged, most of which are zoonotic and their origins have been shown to correlate significantly with socioeconomic, environmental, and ecological factors. As these factors continue to increase, putting people in increased contact with the disease causing pathogens, there is concern that infectious diseases may continue to present a formidable challenge. Constant awareness and pursuance of effective strategies for controlling infectious diseases and disease emergence thus remain crucial. This review presents current updates on emerging and neglected infectious diseases and highlights the scope, dynamics, and advances in infectious disease management with particular focus on WHO top priority emerging infectious diseases (EIDs) and neglected tropical infectious diseases. PMID:28286767

Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges.

PubMed

Nii-Trebi, Nicholas Israel

2017-01-01

Infectious diseases are a significant burden on public health and economic stability of societies all over the world. They have for centuries been among the leading causes of death and disability and presented growing challenges to health security and human progress. The threat posed by infectious diseases is further deepened by the continued emergence of new, unrecognized, and old infectious disease epidemics of global impact. Over the past three and half decades at least 30 new infectious agents affecting humans have emerged, most of which are zoonotic and their origins have been shown to correlate significantly with socioeconomic, environmental, and ecological factors. As these factors continue to increase, putting people in increased contact with the disease causing pathogens, there is concern that infectious diseases may continue to present a formidable challenge. Constant awareness and pursuance of effective strategies for controlling infectious diseases and disease emergence thus remain crucial. This review presents current updates on emerging and neglected infectious diseases and highlights the scope, dynamics, and advances in infectious disease management with particular focus on WHO top priority emerging infectious diseases (EIDs) and neglected tropical infectious diseases.

Tackle and impact detection in elite Australian football using wearable microsensor technology.

PubMed

Gastin, Paul B; McLean, Owen C; Breed, Ray V P; Spittle, Michael

2014-01-01

The effectiveness of a wearable microsensor device (MinimaxX(TM) S4, Catapult Innovations, Melbourne, VIC, Australia) to automatically detect tackles and impact events in elite Australian football (AF) was assessed during four matches. Video observation was used as the criterion measure. A total of 352 tackles were observed, with 78% correctly detected as tackles by the manufacturer's software. Tackles against (i.e. tackled by an opponent) were more accurately detected than tackles made (90% v 66%). Of the 77 tackles that were not detected at all, the majority (74%) were categorised as low-intensity. In contrast, a total of 1510 "tackle" events were detected, with only 18% of these verified as tackles. A further 57% were from contested ball situations involving player contact. The remaining 25% were in general play where no contact was evident; these were significantly lower in peak Player Load™ than those involving player contact (P < 0.01). The tackle detection algorithm, developed primarily for rugby, was not suitable for tackle detection in AF. The underlying sensor data may have the potential to detect a range of events within contact sports such as AF, yet to do so is a complex task and requires sophisticated sport and event-specific algorithms.

The German government's global health strategy--a strategy also to support research and development for neglected diseases?

PubMed

Fehr, Angela; Razum, Oliver

2014-01-01

Neglected tropical infectious diseases as well as rare diseases are characterized by structural research and development (R&D) deficits. The market fails for these disease groups. Consequently, to meet public health and individual patient needs, political decision makers have to develop strategies at national and international levels to make up for this R&D deficit. The German government recently published its first global health strategy. The strategy underlines the German government's commitment to strengthening global health governance. We find, however, that the strategy lacks behind the international public health endeavors for neglected diseases. It fails to make reference to the ongoing debate on a global health agreement. Neither does it outline a comprehensive national strategy to promote R&D into neglected diseases, which would integrate existing R&D activities in Germany and link up to the international debate on sustainable, needs-based R&D and affordable access. This despite the fact that only recently, in a consensus-building process, a National Plan of Action for rare diseases was successfully developed in Germany which could serve as a blueprint for a similar course of action for neglected diseases. We recommend that, without delay, a structured process be initiated in Germany to explore all options to promote R&D for neglected diseases, including a global health agreement.

Momentum and Kinetic Energy Before the Tackle in Rugby Union

PubMed Central

Hendricks, Sharief; Karpul, David; Lambert, Mike

2014-01-01

Understanding the physical demands of a tackle in match situations is important for safe and effective training, developing equipment and research. Physical components such as momentum and kinetic energy, and it relationship to tackle outcome is not known. The aim of this study was to compare momenta between ball-carrier and tackler, level of play (elite, university and junior) and position (forwards vs. backs), and describe the relationship between ball-carrier and tackler mass, velocity and momentum and the tackle outcome. Also, report on the ball-carrier and tackler kinetic energy before contact and the estimated magnitude of impact (energy distributed between ball-carrier and tackler upon contact). Velocity over 0.5 seconds before contact was determined using a 2-dimensional scaled version of the field generated from a computer alogorithm. Body masses of players were obtained from their player profiles. Momentum and kinetic energy were subsequently calculated for 60 tackle events. Ball-carriers were heavier than the tacklers (ball-carrier 100 ± 14 kg vs. tackler 93 ± 11 kg, d = 0.52, p = 0.0041, n = 60). Ball-carriers as forwards had a significantly higher momentum than backs (forwards 563 ± 226 Kg.m.s-1 n = 31 vs. backs 438 ± 135 Kg.m.s-1, d = 0.63, p = 0.0012, n = 29). Tacklers dominated 57% of tackles and ball-carriers dominated 43% of tackles. Despite the ball-carrier having a mass advantage before contact more frequently than the tackler, momentum advantage and tackle dominance between the ball-carrier and tackler was proportionally similar. These findings may reflect a characteristic of the modern game of rugby where efficiently heavier players (particularly forwards) are tactically predetermined to carry the ball in contact. Key Points First study to quantify momentum, kinetic energy, and magnitude of impact in rugby tackles across different levels in matches without a device attached to a player. Physical components alone, of either ball-carrier or

Momentum and kinetic energy before the tackle in rugby union.

PubMed

Hendricks, Sharief; Karpul, David; Lambert, Mike

2014-09-01

Understanding the physical demands of a tackle in match situations is important for safe and effective training, developing equipment and research. Physical components such as momentum and kinetic energy, and it relationship to tackle outcome is not known. The aim of this study was to compare momenta between ball-carrier and tackler, level of play (elite, university and junior) and position (forwards vs. backs), and describe the relationship between ball-carrier and tackler mass, velocity and momentum and the tackle outcome. Also, report on the ball-carrier and tackler kinetic energy before contact and the estimated magnitude of impact (energy distributed between ball-carrier and tackler upon contact). Velocity over 0.5 seconds before contact was determined using a 2-dimensional scaled version of the field generated from a computer alogorithm. Body masses of players were obtained from their player profiles. Momentum and kinetic energy were subsequently calculated for 60 tackle events. Ball-carriers were heavier than the tacklers (ball-carrier 100 ± 14 kg vs. tackler 93 ± 11 kg, d = 0.52, p = 0.0041, n = 60). Ball-carriers as forwards had a significantly higher momentum than backs (forwards 563 ± 226 Kg(.)m(.)s(-1) n = 31 vs. backs 438 ± 135 Kg(.)m(.)s(-1), d = 0.63, p = 0.0012, n = 29). Tacklers dominated 57% of tackles and ball-carriers dominated 43% of tackles. Despite the ball-carrier having a mass advantage before contact more frequently than the tackler, momentum advantage and tackle dominance between the ball-carrier and tackler was proportionally similar. These findings may reflect a characteristic of the modern game of rugby where efficiently heavier players (particularly forwards) are tactically predetermined to carry the ball in contact. Key PointsFirst study to quantify momentum, kinetic energy, and magnitude of impact in rugby tackles across different levels in matches without a device attached to a player.Physical components alone, of either ball

Tackle characteristics and injury in a cross section of rugby union football.

PubMed

McIntosh, Andrew S; Savage, Trevor N; McCrory, Paul; Fréchède, Bertrand O; Wolfe, Rory

2010-05-01

The tackle is the game event in rugby union most associated with injury. This study's main aims were to measure tackle characteristics from video using a qualitative protocol, to assess whether the characteristics differed by level of play, and to measure the associations between tackle characteristics and injury. A cohort study was undertaken. The cohort comprised male rugby players in the following levels: younger than 15 yr, 18 yr, and 20 yr, grade, and elite (Super 12 and Wallabies). All tackle events and technique characteristics were coded in 77 game halves using a standardized qualitative protocol. Game injuries and missed-game injuries were identified and correlated with tackle events. A total of 6618 tackle events, including 81 resulting in a game injury, were observed and coded in the 77 game halves fully analyzed (145 tackle events per hour). An increase in the proportion of active shoulder tackles was observed from younger than 15 yr (13%) to elite (31%). Younger players engaged in more passive tackles and tended to stay on their feet more than experienced players. Younger than 15 yr rugby players had a significantly lower risk of tackle game injury compared with elite players. No specific tackle technique was observed to be associated with a significantly increased risk of game injury. There was a greater risk of game injury associated with two or more tacklers involved in the tackle event, and the greatest risk was associated with simultaneous contact by tacklers, after adjusting for level of play. Tackle characteristics differed between levels of play. The number of tacklers and the sequence of tackler contact with the ball carrier require consideration from an injury prevention perspective.

Addressing the Neglected Tropical Disease Podoconiosis in Northern Ethiopia: Lessons Learned from a New Community Podoconiosis Program

PubMed Central

Tomczyk, Sara; Tamiru, Abreham; Davey, Gail

2012-01-01

Background Despite its great public health importance, few control initiatives addressing podoconiosis (non-filarial elephantiasis, a geochemical neglected tropical disease) exist. In June 2010, the first podoconiosis program in Northern Ethiopia, consisting of prevention, awareness, and care and support activities, began in Debre Markos, Northern Ethiopia. This study aims to document and disseminate the lessons learned from a new community podoconiosis program in Debre Markos. Methods/Principal Findings We used a content analysis approach to examine and evaluate data from a series of sources. These sources include conducted interview transcripts, a focus group discussion transcript and secondary sources including monitoring and evaluation field reports, observation notes, and research obtained from a literature review. Themes were identified and grouped into matrix tables. Overall, sixteen program steps were identified and grouped into 6 domains: Initial preparation, training and sensitization, foundation building, treatment activity implementation, awareness, and follow-up. Emphasis is placed on the need for baseline data, effective training, local leadership, experience-sharing, mass-awareness, cross-cutting sector issues (i.e., water and waste management), and integration with government health systems. Related successes and challenges are also described, as are stakeholder roles and misconceptions and socio-cultural challenges affecting the program start-up. Many of the identified successes and challenges are relevant to the aim of the podoconiosis program to be sustainable and community-led. Conclusions/Significance Much of this information has already been used to improve the Debre Markos program. We also anticipate that the domains and steps identified will be useful in guiding new programs in other settings where podoconiosis is highly prevalent. We hope to encourage partnerships and collaboration among podoconiosis stakeholders in future growth and

A Practical Green Synthesis and Biological Evaluation of Benzimidazoles Against Two Neglected Tropical Diseases: Chagas and Leishmaniasis.

PubMed

Bandyopadhyay, Debashis; Samano, Selina; Villalobos-Rocha, Juan Carlos; Sanchez-Torres, Luvia Enid; Nogueda-Torres, Benjamin; Rivera, Gildardo; Banik, Bimal K

2017-01-01

Antimicrobial resistance is an ever-increasing problem throughout the world and has already reached severe proportions. Two very common neglected tropical diseases are Chagas' disease and leishmaniasis. Chagas' disease is a severe health problem, mainly in Latin America, causing approximately 50000 deaths a year and millions of people are infected. About 25-30% of the patients infected with Trypanosoma cruzi develop the chronic form of the disease. On the other hand, Leishmaniasis represents complex diseases with an important clinical and epidemiological diversity. It is endemic in 88 countries 72 of which are developing countries and it has been estimated that are 12 million people infected and 350 million are in areas with infection risk. On this basis, research on organic compounds that can be used against these two diseases is an important target. A very simple, green, and efficient protocol is developed in which bismuth nitrate pentahydrate is employed as a Lewis acid catalyst in aqueous media under microwave irradiation for the synthesis of various 2-aryl substituted benzimidazoles from aldehydes and o-phenylenediamine. Other salient features of this protocol include milder conditions, atom-economy, easy extraction, and no wastes. Nine 1H-benzimidazole derivatives (1-9) with substituents at positions 2 and 5 were synthesized and the structure of the compounds was elucidated by spectroscopic methods. The compounds were screened to identify whether they posses pharmacological activity against Chagas' disease and leishmaniasis. Compound 8 showed better activity than the control Nifurtimox against INC-5 Trypanosoma cruzi strain whereas compounds 3 and 9 have demonstrated potent leshmanicidal activity. A systematic green synthetic procedure and in vitro biological evaluation of nine 1H-benzimidazoles are described. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Between-Country Inequalities in the Neglected Tropical Disease Burden in 1990 and 2010, with Projections for 2020.

PubMed

Stolk, Wilma A; Kulik, Margarete C; le Rutte, Epke A; Jacobson, Julie; Richardus, Jan Hendrik; de Vlas, Sake J; Houweling, Tanja A J

2016-05-01

The World Health Organization (WHO) has set ambitious time-bound targets for the control and elimination of neglected tropical diseases (NTDs). Investing in NTDs is not only seen as good value for money, but is also advocated as a pro-poor policy since it would improve population health in the poorest populations. We studied the extent to which the disease burden from nine NTDs (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, trachoma, Chagas disease, human African trypanosomiasis, leprosy, visceral leishmaniasis) was concentrated in the poorest countries in 1990 and 2010, and how this would change by 2020 in case the WHO targets are met. Our analysis was based on 1990 and 2010 data from the Global Burden of Disease (GBD) 2010 study and on projections of the 2020 burden. Low and lower-middle income countries together accounted for 69% and 81% of the global burden in 1990 and 2010 respectively. Only the soil-transmitted helminths and Chagas disease caused a considerable burden in upper-middle income countries. The global burden from these NTDs declined by 27% between 1990 and 2010, but reduction largely came to the benefit of upper-middle income countries. Achieving the WHO targets would lead to a further 55% reduction in the global burden between 2010 and 2020 in each country income group, and 81% of the global reduction would occur in low and lower-middle income countries. The GBD 2010 data show the burden of the nine selected NTDs in DALYs is strongly concentrated in low and lower-middle income countries, which implies that the beneficial impact of NTD control eventually also largely comes to the benefit of these same countries. While the nine NTDs became increasingly concentrated in developing countries in the 1990-2010 period, this trend would be rectified if the WHO targets were met, supporting the pro-poor designation.

Recent advances in tropical medicine.

PubMed

Solomon, Anthony W; Nayagam, Shevanthi; Pasvol, Geoffrey

2009-07-01

There have been significant advances in both the classical and neglected tropical diseases, with Guinea worm looking set to be the next disease after smallpox to be eradicated. Aided by a combination of enhanced understanding of the biology of the pathogens, intensification of immunisation activities or mass drug administration, together with the development of synergies with control programmes for co-endemic tropical diseases, polio, lymphatic filariasis, trachoma and onchocerciasis all appear to be in global decline, with good prospects for eventual successful elimination. While the global incidence of new cases of leprosy continues to decrease, the focus of leprosy control efforts has shifted following more widespread recognition that cure of infection does not necessarily prevent disability. Expansion in funding for HIV/AIDS and malaria provides some grounds for optimism about the control of these diseases. However, ongoing education and access remain essential to increasing the uptake of HIV testing and decreasing transmission. Meanwhile, the rise of drug-resistant tuberculosis and malaria is concerning, and the emergence of the highly pathogenic avian influenza A and re-emergence of viruses such as chikungunya and West Nile virus, without significant recent progress in vaccine development, pose additional ongoing challenges to tropical medicine physicians worldwide.

Technical determinants of tackle and ruck performance in International rugby union.

PubMed

Hendricks, Sharief; van Niekerk, Tiffany; Sin, Drew Wade; Lambert, Mike; den Hollander, Steve; Brown, James; Maree, Willie; Treu, Paul; Till, Kevin; Jones, Ben

2018-03-01

The most frequently occurring contact events in rugby union are the tackle and ruck. The ability repeatedly to engage and win the tackle and ruck has been associated with team success. To win the tackle and ruck, players have to perform specific techniques. These techniques have not been studied at the highest level of rugby union. Therefore, the purpose of this study was to identify technical determinants of tackle and ruck performance at the highest level of rugby union. A total of 4479 tackle and 2914 ruck events were coded for the Six Nations and Championship competitions. Relative risk ratio (RR), the ratio of the probability of an outcome occurring when a characteristic was observed (versus the non-observed characteristic), was determined using multinomial logistic regression. Executing front-on tackles reduced the likelihood of offloads and tackle breaks in both competitions (Six Nations RR 3.0 Behind tackle, 95% confidence interval [95% CI]: 1.9-4.6, effect size [ES] = large, P < 0.001); Championship RR 2.9 Jersey tackle, 95% CI: 1.3-6.4, ES = moderate, P = 0.01). Fending during contact increased the chances of offloading and breaking the tackle in both competitions (Six Nations RR 4.5 Strong, 95% CI: 2.2-9.2, ES = large, P = P < 0.001; Championship RR 5.1 Moderate, 95% CI: 3.5-7.4, ES = large, P < 0.001). For the ruck, actively placing the ball increased the probability of maintaining possession (Six Nations RR 2.2, 95% CI: 1.1-4.3, ES = moderate, P = 0.03); Championship RR 4.0, 95% CI: 1.3-11.8, ES = large, P = 0.01). The techniques identified in this study should be incorporated and emphasised during training to prepare players for competition. Furthermore, these techniques need to be added to coaching manuals for the tackle and ruck.

A literature review of economic evaluations for a neglected tropical disease: human African trypanosomiasis ("sleeping sickness").

PubMed

Sutherland, C Simone; Yukich, Joshua; Goeree, Ron; Tediosi, Fabrizio

2015-02-01

key funders. These analyses would be of use, as HAT is currently being prioritized as a neglected tropical disease (NTD) to reach elimination by 2020.

Collapsed scrums and collision tackles: what is the injury risk?

PubMed

Roberts, Simon P; Trewartha, Grant; England, Mike; Stokes, Keith A

2015-04-01

To establish the propensity for specific contact events to cause injury in rugby union. Medical staff at participating English community-level rugby clubs reported any injury resulting in the absence for one match or more from the day of the injury during the 2009/2010 (n=46), 2010/2011 (n=67) and 2011/2012 (n=76) seasons. Injury severity was defined as the number of matches missed. Thirty community rugby matches were filmed and the number of contact events (tackles, collision tackles, rucks, mauls, lineouts and scrums) recorded. Of 370 (95% CI 364 to 378) contact events per match, 141 (137 to 145) were tackles, 115 (111 to 119) were rucks and 32 (30 to 33) were scrums. Tackles resulted in the greatest propensity for injury (2.3 (2.2 to 2.4) injuries/1000 events) and the greatest severity (16 (15 to 17) weeks missed/1000 events). Collision tackles (illegal tackles involving a shoulder charge) had a propensity for injury of 15 (12.4 to 18.3) injuries/1000 events and severity was 92 (75 to 112) weeks missed/1000 events, both of which were higher than any other event. Additional scrum analysis showed that only 5% of all scrums collapsed, but the propensity for injury was four times higher (2.9 (1.5 to 5.4) injuries/1000 events) and the severity was six times greater (22 (12 to 42) weeks missed/1000 events) than for non-collapsed scrums. Injury prevention in the tackle should focus on technique with strict enforcement of existing laws for illegal collision tackles. The scrum is a relatively controllable event and further attempts should be made to reduce the frequency of scrum collapse. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Functional Assessment of Region-Specific Neglect: Are There Differential Behavioural Consequences of Peripersonal versus Extrapersonal Neglect?

PubMed Central

Nijboer, T. C. W.; ten Brink, A. F.; Kouwenhoven, M.; Visser-Meily, J. M. A.

2014-01-01

Background. Region-specific types of neglect (peripersonal and extrapersonal) have been dissociated, yet, differential behavioural consequences are unknown. Objective. The aim of the current study was to investigate behavioural consequences at the level of basic activities of daily living of region-specific neglect, using the Catherine Bergego Scale (CBS). Methods. 118 stroke patients were screened within the first two weeks after admission to the rehabilitation center for inpatient rehabilitation. Results. Patients with peripersonal neglect and patients with neglect for both regions had significantly higher total score on the CBS compared to nonneglect patients. Total scores for patients with extrapersonal neglect were comparable to non-neglect patients. ADL impairments were found across activities (e.g., looking towards one side, forgetting body parts, colliding) for both patients with peripersonal neglect and patients with neglect for both regions. Patients with extrapersonal neglect were only impaired on the item on way finding. Conclusions. When diagnosing neglect, it is relevant to distinguish the type of region-specific neglect and, where needed, to adjust the rehabilitation program accordingly. As the CBS is not developed to typically measure ADL in extrapersonal neglect, it would be of importance to add other (instrumental) activities that heavily rely on processing information in farther space. PMID:24825959

Disease ecology, health and the environment: a framework to account for ecological and socio-economic drivers in the control of neglected tropical diseases.

PubMed

Garchitorena, A; Sokolow, S H; Roche, B; Ngonghala, C N; Jocque, M; Lund, A; Barry, M; Mordecai, E A; Daily, G C; Jones, J H; Andrews, J R; Bendavid, E; Luby, S P; LaBeaud, A D; Seetah, K; Guégan, J F; Bonds, M H; De Leo, G A

2017-06-05

Reducing the burden of neglected tropical diseases (NTDs) is one of the key strategic targets advanced by the Sustainable Development Goals. Despite the unprecedented effort deployed for NTD elimination in the past decade, their control, mainly through drug administration, remains particularly challenging: persistent poverty and repeated exposure to pathogens embedded in the environment limit the efficacy of strategies focused exclusively on human treatment or medical care. Here, we present a simple modelling framework to illustrate the relative role of ecological and socio-economic drivers of environmentally transmitted parasites and pathogens. Through the analysis of system dynamics, we show that periodic drug treatments that lead to the elimination of directly transmitted diseases may fail to do so in the case of human pathogens with an environmental reservoir. Control of environmentally transmitted diseases can be more effective when human treatment is complemented with interventions targeting the environmental reservoir of the pathogen. We present mechanisms through which the environment can influence the dynamics of poverty via disease feedbacks. For illustration, we present the case studies of Buruli ulcer and schistosomiasis, two devastating waterborne NTDs for which control is particularly challenging.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Author(s).

Disease ecology, health and the environment: a framework to account for ecological and socio-economic drivers in the control of neglected tropical diseases

PubMed Central

Sokolow, S. H.; Ngonghala, C. N.; Jocque, M.; Lund, A.; Barry, M.; Mordecai, E. A.; Daily, G. C.; Andrews, J. R.; Bendavid, E.; Luby, S. P.; LaBeaud, A. D.; Seetah, K.; Guégan, J. F.; De Leo, G. A.

2017-01-01

Reducing the burden of neglected tropical diseases (NTDs) is one of the key strategic targets advanced by the Sustainable Development Goals. Despite the unprecedented effort deployed for NTD elimination in the past decade, their control, mainly through drug administration, remains particularly challenging: persistent poverty and repeated exposure to pathogens embedded in the environment limit the efficacy of strategies focused exclusively on human treatment or medical care. Here, we present a simple modelling framework to illustrate the relative role of ecological and socio-economic drivers of environmentally transmitted parasites and pathogens. Through the analysis of system dynamics, we show that periodic drug treatments that lead to the elimination of directly transmitted diseases may fail to do so in the case of human pathogens with an environmental reservoir. Control of environmentally transmitted diseases can be more effective when human treatment is complemented with interventions targeting the environmental reservoir of the pathogen. We present mechanisms through which the environment can influence the dynamics of poverty via disease feedbacks. For illustration, we present the case studies of Buruli ulcer and schistosomiasis, two devastating waterborne NTDs for which control is particularly challenging. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’. PMID:28438917

Severe and Catastrophic Neck Injuries Resulting from Tackle Football

ERIC Educational Resources Information Center

Torg, Joseph S.; And Others

1977-01-01

Use of the spring-loaded blocking and tackling devices should be discontinued due to severe neck injuries resulting from their use; employment of the head and helmet as the primary assault weapon in blocking, tackling, and head butting should be condemned for the same reason. (MJB)

A business plan to help the 'global South' in its fight against neglected diseases.

PubMed

Frew, Sarah E; Liu, Victor Y; Singer, Peter A

2009-01-01

Although neglected tropical diseases (NTDs) threaten the health of those living in the developing world, innovation directed toward addressing NTDs is comparatively meager. Health biotechnology firms in rapidly growing economies in the global South are developing and selling vaccines, diagnostics, and therapeutics for these diseases to local markets. In this paper we identify a pipeline of sixty-two NTD products from seventy-eight "Southern" companies. We also propose creation of a Global Health Accelerator-a new nonprofit organization whose mission would be to support and help grow this Southern source of affordable innovation for NTDs.

Integrated Surveys of Neglected Tropical Diseases in Southern Sudan: How Much Do They Cost and Can They Be Refined?

PubMed Central

Kolaczinski, Jan H.; Hanson, Kara; Robinson, Emily; Picon, Diana; Sabasio, Anthony; Mpakateni, Martin; Lado, Mounir; Moore, Stephen; Petty, Nora; Brooker, Simon

2010-01-01

Background Increasing emphasis on integrated control of neglected tropical diseases (NTDs) requires identification of co-endemic areas. Integrated surveys for lymphatic filariasis (LF), schistosomiasis and soil-transmitted helminth (STH) infection have been recommended for this purpose. Integrated survey designs inevitably involve balancing the costs of surveys against accuracy of classifying areas for treatment, so-called implementation units (IUs). This requires an understanding of the main cost drivers and of how operating procedures may affect both cost and accuracy of surveys. Here we report a detailed cost analysis of the first round of integrated NTD surveys in Southern Sudan. Methods and Findings Financial and economic costs were estimated from financial expenditure records and interviews with survey staff using an ingredients approach. The main outcome was cost per IU surveyed. Uncertain variables were subjected to univariate sensitivity analysis and the effects of modifying standard operating procedures were explored. The average economic cost per IU surveyed was USD 40,206 or USD 9,573, depending on the size of the IU. The major cost drivers were two key categories of recurrent costs: i) survey consumables, and ii) personnel. Conclusion The cost of integrated surveys in Southern Sudan could be reduced by surveying larger administrative areas for LF. If this approach was taken, the estimated economic cost of completing LF, schistosomiasis and STH mapping in Southern Sudan would amount to USD 1.6 million. The methodological detail and costing template provided here could be used to generate cost estimates in other settings and readily compare these to the present study, and may help budget for integrated and single NTDs surveys elsewhere. PMID:20644619

Advances in neglected tropical disease vaccines: Developing relative potency and functional assays for the Na-GST-1/Alhydrogel hookworm vaccine

PubMed Central

Brelsford, Jill B.; Plieskatt, Jordan L.; Yakovleva, Anna; Jariwala, Amar; Keegan, Brian P.; Peng, Jin; Xia, Pengjun; Li, Guangzhao; Campbell, Doreen; Periago, Maria Victoria; Correa-Oliveira, Rodrigo; Bottazzi, Maria Elena; Hotez, Peter J.

2017-01-01

A new generation of vaccines for the neglected tropical diseases (NTDs) have now advanced into clinical development, with the Na-GST-1/Alhydrogel Hookworm Vaccine already being tested in Phase 1 studies in healthy adults. The current manuscript focuses on the often overlooked critical aspects of NTD vaccine product development, more specifically, vaccine stability testing programs. A key measure of vaccine stability testing is "relative potency" or the immunogenicity of the vaccine during storage. As with most NTD vaccines, the Na-GST-1/Alhydrogel Hookworm Vaccine was not developed by attenuation or inactivation of the pathogen (Necator americanus), so conventional methods for measuring relative potency are not relevant for this investigational product. Herein, we describe a novel relative potency testing program and report for the first time on the clinical lot of this NTD vaccine during its first 60 months of storage at 2–8°C. We also describe the development of a complementary functional assay that measures the ability of IgG from animals or humans immunized with Na-GST-1/Alhydrogel to neutralize this important hookworm enzyme. While 90% inhibition of the catalytic activity of Na-GST-1 was achieved in animals immunized with Na-GST-1/Alhydrogel, lower levels of inhibition were observed in immunized humans. Moreover, anti-Na-GST-1 antibodies from volunteers in non-hookworm endemic areas were better able to inhibit catalytic activity than anti-Na-GST-1 antibodies from volunteers resident in hookworm endemic areas. The results described herein provide the critical tools for the product development of NTD vaccines. PMID:28192438

Advances in neglected tropical disease vaccines: Developing relative potency and functional assays for the Na-GST-1/Alhydrogel hookworm vaccine.

PubMed

Brelsford, Jill B; Plieskatt, Jordan L; Yakovleva, Anna; Jariwala, Amar; Keegan, Brian P; Peng, Jin; Xia, Pengjun; Li, Guangzhao; Campbell, Doreen; Periago, Maria Victoria; Correa-Oliveira, Rodrigo; Bottazzi, Maria Elena; Hotez, Peter J; Diemert, David; Bethony, Jeffrey M

2017-02-01

A new generation of vaccines for the neglected tropical diseases (NTDs) have now advanced into clinical development, with the Na-GST-1/Alhydrogel Hookworm Vaccine already being tested in Phase 1 studies in healthy adults. The current manuscript focuses on the often overlooked critical aspects of NTD vaccine product development, more specifically, vaccine stability testing programs. A key measure of vaccine stability testing is "relative potency" or the immunogenicity of the vaccine during storage. As with most NTD vaccines, the Na-GST-1/Alhydrogel Hookworm Vaccine was not developed by attenuation or inactivation of the pathogen (Necator americanus), so conventional methods for measuring relative potency are not relevant for this investigational product. Herein, we describe a novel relative potency testing program and report for the first time on the clinical lot of this NTD vaccine during its first 60 months of storage at 2-8°C. We also describe the development of a complementary functional assay that measures the ability of IgG from animals or humans immunized with Na-GST-1/Alhydrogel to neutralize this important hookworm enzyme. While 90% inhibition of the catalytic activity of Na-GST-1 was achieved in animals immunized with Na-GST-1/Alhydrogel, lower levels of inhibition were observed in immunized humans. Moreover, anti-Na-GST-1 antibodies from volunteers in non-hookworm endemic areas were better able to inhibit catalytic activity than anti-Na-GST-1 antibodies from volunteers resident in hookworm endemic areas. The results described herein provide the critical tools for the product development of NTD vaccines.

46 CFR 121.300 - Ground tackle and mooring lines.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Ground tackle and mooring lines. 121.300 Section 121.300 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... MISCELLANEOUS SYSTEMS AND EQUIPMENT Mooring and Towing Equipment § 121.300 Ground tackle and mooring lines. A...

The Socioeconomic Benefit to Individuals of Achieving the 2020 Targets for Five Preventive Chemotherapy Neglected Tropical Diseases.

PubMed

Redekop, William K; Lenk, Edeltraud J; Luyendijk, Marianne; Fitzpatrick, Christopher; Niessen, Louis; Stolk, Wilma A; Tediosi, Fabrizio; Rijnsburger, Adriana J; Bakker, Roel; Hontelez, Jan A C; Richardus, Jan H; Jacobson, Julie; de Vlas, Sake J; Severens, Johan L

2017-01-01

Lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminths (STH) and trachoma represent the five most prevalent neglected tropical diseases (NTDs). They can be controlled or eliminated by means of safe and cost-effective interventions delivered through programs of Mass Drug Administration (MDA)-also named Preventive Chemotherapy (PCT). The WHO defined targets for NTD control/elimination by 2020, reinforced by the 2012 London Declaration, which, if achieved, would result in dramatic health gains. We estimated the potential economic benefit of achieving these targets, focusing specifically on productivity and out-of-pocket payments. Productivity loss was calculated by combining disease frequency with productivity loss from the disease, from the perspective of affected individuals. Productivity gain was calculated by deducting the total loss expected in the target achievement scenario from the loss in a counterfactual scenario where it was assumed the pre-intervention situation in 1990 regarding NTDs would continue unabated until 2030. Economic benefits from out-of-pocket payments (OPPs) were calculated similarly. Benefits are reported in 2005 US$ (purchasing power parity-adjusted and discounted at 3% per annum from 2010). Sensitivity analyses were used to assess the influence of changes in input parameters. The economic benefit from productivity gain was estimated to be I$251 billion in 2011-2020 and I$313 billion in 2021-2030, considerably greater than the total OPPs averted of I$0.72 billion and I$0.96 billion in the same periods. The net benefit is expected to be US$ 27.4 and US$ 42.8 for every dollar invested during the same periods. Impact varies between NTDs and regions, since it is determined by disease prevalence and extent of disease-related productivity loss. Achieving the PCT-NTD targets for 2020 will yield significant economic benefits to affected individuals. Despite large uncertainty, these benefits far exceed the investment

Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis.

PubMed

Tomczyk, Sara; Deribe, Kebede; Brooker, Simon J; Clark, Hannah; Rafique, Khizar; Knopp, Stefanie; Utzinger, Jürg; Davey, Gail

2014-01-01

The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR=0.15; 95% CI: 0.08-0.29), CLM (OR=0.24; 95% CI: 0.06-0.96), tungiasis (OR=0.42; 95% CI: 0.26-0.70), hookworm infection (OR=0.48; 95% CI: 0

Intentional gaze shift to neglected space: a compensatory strategy during recovery after unilateral spatial neglect.

PubMed

Takamura, Yusaku; Imanishi, Maho; Osaka, Madoka; Ohmatsu, Satoko; Tominaga, Takanori; Yamanaka, Kentaro; Morioka, Shu; Kawashima, Noritaka

2016-11-01

Unilateral spatial neglect is a common neurological syndrome following predominantly right hemispheric stroke. While most patients lack insight into their neglect behaviour and do not initiate compensatory behaviours in the early recovery phase, some patients recognize it and start to pay attention towards the neglected space. We aimed to characterize visual attention capacity in patients with unilateral spatial neglect with specific focus on cortical processes underlying compensatory gaze shift towards the neglected space during the recovery process. Based on the Behavioural Inattention Test score and presence or absence of experience of neglect in their daily life from stroke onset to the enrolment date, participants were divided into USN+‰‰+ (do not compensate, n = 15), USN+ (compensate, n = 10), and right hemisphere damage groups (no neglect, n = 24). The patients participated in eye pursuit-based choice reaction tasks and were asked to pursue one of five horizontally located circular objects flashed on a computer display. The task consisted of 25 trials with 4-s intervals, and the order of highlighted objects was randomly determined. From the recorded eye tracking data, eye movement onset and gaze shift were calculated. To elucidate the cortical mechanism underlying behavioural results, electroencephalagram activities were recorded in three USN+‰‰+, 13 USN+ and eight patients with right hemisphere damage. We found that while lower Behavioural Inattention Test scoring patients (USN+‰‰+) showed gaze shift to non-neglected space, some higher scoring patients (USN+) showed clear leftward gaze shift at visual stimuli onset. Moreover, we found a significant correlation between Behavioural Inattention Test score and gaze shift extent in the unilateral spatial neglect group (r = -0.62, P < 0.01). Electroencephalography data clearly demonstrated that the extent of increase in theta power in the frontal cortex strongly correlated with the leftward gaze shift

Thiamine Deficiency in Tropical Pediatrics: New Insights into a Neglected but Vital Metabolic Challenge

PubMed Central

Hiffler, Laurent; Rakotoambinina, Benjamin; Lafferty, Nadia; Martinez Garcia, Daniel

2016-01-01

In humans, thiamine is a micronutrient prone to depletion that may result in severe clinical abnormalities. This narrative review summarizes current knowledge on thiamine deficiency (TD) and bridges the gap between pathophysiology and clinical presentation by integrating thiamine metabolism at subcellular level with its function to vital organs. The broad clinical spectrum of TD is outlined, with emphasis on conditions encountered in tropical pediatric practice. In particular, TD is associated with type B lactic acidosis and classic forms of beriberi in children, but it is often unrecognized. Other severe acute conditions are associated with hypermetabolism, inducing a functional TD. The crucial role of thiamine in infant cognitive development is also highlighted in this review, along with analysis of the potential impact of TD in refeeding syndrome during severe acute malnutrition (SAM). This review aims to increase clinical awareness of TD in tropical settings where access to diagnostic tests is poor, and advocates for an early therapeutic thiamine challenge in resource-limited settings. Moreover, it provides evidence for thiamine as treatment in critical conditions requiring metabolic resuscitation, and gives rationale to the consideration of increased thiamine supplementation in therapeutic foods for malnourished children. PMID:27379239

The changing global landscape of health and disease: addressing challenges and opportunities for sustaining progress towards control and elimination of neglected tropical diseases (NTDs).

PubMed

Molyneux, David H; Dean, Laura; Adekeye, Oluwatosin; Stothard, J Russell; Theobald, Sally

2018-03-16

The drive to control neglected tropical diseases (NTDs) has had many successes but to reach defined targets new approaches are required. Over the last decade, NTD control programmes have benefitted from increased resources, and from effective partnerships and long-term pharmaceutical donations. Although the NTD agenda is broader than those diseases of parasitic aetiology there has been a massive up-scaling of the delivery of medicines to some billion people annually. Recipients are often the poorest, with the aspiration that NTD programmes are key to universal health coverage as reflected within the 2030 United Nations sustainable development goals (SDGs). To reach elimination targets, the community will need to adapt global events and changing policy environments to ensure programmes are responsive and can sustain progress towards NTD targets. Innovative thinking embedded within regional and national health systems is needed. Policy makers, managers and frontline health workers are the mediators between challenge and change at global and local levels. This paper attempts to address the challenges to end the chronic pandemic of NTDs and achieve the SDG targets. It concludes with a conceptual framework that illustrates the interactions between these key challenges and opportunities and emphasizes the health system as a critical mediator.

Building local research and development capacity for the prevention and cure of neglected diseases: the case of India.

PubMed

Kettler, H E; Modi, R

2001-01-01

This paper examines the proposal to build research and development (R&D) capabilities for dealing with neglected infectious and tropical diseases in countries where they are endemic, as a potentially cost- and time-effective way to fill the gap between the supply of and need for new medicines. With reference to the situation in India, we consider the competencies and incentives needed by companies so that their strategy can be shifted from reverse engineering of existing products to investment in R&D for new products. This requires complex reforms, of which the intellectual property rights agreement is only one. We also consider whether Indian companies capable of conducting research and development are likely to target neglected diseases. Patterns of patenting and of R&D, together with evidence from interviews we have conducted, suggest that Indian companies, like multinational corporations, are likely to target global diseases because of the prospect of much greater returns. Further studies are required on how Indian companies would respond to push and pull incentives originally designed to persuade multinational corporations to do more R&D on neglected diseases.

Tackling racism in the NHS.

PubMed

Dean, Erin

2016-11-30

Essential facts Trade union Unite has developed a policy briefing on a new toolkit to combat racism in the NHS. It can help nurses and other staff tackle racial discrimination in health, with black and minority ethnic (BME) nurses often treated unequally compared with their white colleagues.

Tocopherol in Elder Self-Neglect

NASA Technical Reports Server (NTRS)

Aung, K.; Burnett, J.; Dyer, C.; Smith, S. M.

2009-01-01

Although elder self-neglect is the most common form of elder mistreatment, its pathophysiology is not well understood. Alpha-tocopherol is a lipid soluble antioxidant required for the preservation of cell membranes. Since the association between tocopherol and cognitive impairment in older adults has been described, we explored the possibility of its role in elder self-neglect. OBJECTIVE: (1) To determine whether serum tocopherol levels are associated with elder self-neglect, and (2) to assess the association of serum tocopherol levels and cognitive function in elder self-neglect. METHODS: Serum tocopherol levels were measured in a cohort of 67 self-neglecting elders and 67 matched controls, recruited for the Consortium for Research in Elder Self-neglect of Texas. Pearson s correlation tests were performed to assess bivariate associations between serum tocopherol levels and cognitive function. RESULTS: Mean serum alpha-tocopherol levels were 10.8 +/- 4.7 ug/mL in self-neglect group and 13.0 +/- 4.9 ug/mL in control group (p = 0.006, unpaired student s t-test). None of the participants from either group had alpha-tocopherol level lower than the reference range. Mean serum gamma-tocopherol levels were 2.0 +/- 1.0 ug/mL in self-neglect group and 2.0 +/- 1.1 in control group (p=0.83). Proportion of the elders with gamma-tocopherol level lower than the reference range were 4.5% (3/66) in self-neglect group and 10.4% (7/67) in control group (p=0.32, Fisher s Exact Test). Among the self-neglecting elders, no association was found between serum alpha-tocopherol levels and the Mini-Mental State Examination (MMSE) or the Wolf-Klein Clock Drawing Test (CDT) scores (r =-0.42, p=0.75 for MMSE; r=0.08, p=0.54 for CDT). No association was found between serum gamma-tocopherol levels and the MMSE or the CDT (r=-0.12, p=0.35 for MMSE; r=0.05, p=0.68 for CDT). CONCLUSION: In our sample, neither alpha-tocopherol nor gamma-tocopherol appears to have a role in pathophysiology of elder

Tropical Aquatic Archaea Show Environment-Specific Community Composition

PubMed Central

Silveira, Cynthia B.; Cardoso, Alexander M.; Coutinho, Felipe H.; Lima, Joyce L.; Pinto, Leonardo H.; Albano, Rodolpho M.; Clementino, Maysa M.; Martins, Orlando B.; Vieira, Ricardo P.

2013-01-01

The Archaea domain is ubiquitously distributed and extremely diverse, however, environmental factors that shape archaeal community structure are not well known. Aquatic environments, including the water column and sediments harbor many new uncultured archaeal species from which metabolic and ecological roles remain elusive. Some environments are especially neglected in terms of archaeal diversity, as is the case of pristine tropical areas. Here we investigate the archaeal composition in marine and freshwater systems from Ilha Grande, a South Atlantic tropical environment. All sampled habitats showed high archaeal diversity. No OTUs were shared between freshwater, marine and mangrove sediment samples, yet these environments are interconnected and geographically close, indicating environment-specific community structuring. Group II Euryarchaeota was the main clade in marine samples, while the new putative phylum Thaumarchaeota and LDS/RCV Euryarchaeota dominated freshwaters. Group III Euryarchaeota , a rare clade, was also retrieved in reasonable abundance in marine samples. The archaeal community from mangrove sediments was composed mainly by members of mesophilic Crenarchaeota and by a distinct clade forming a sister-group to Crenarchaeota and Thaumarchaeota. Our results show strong environment-specific community structuring in tropical aquatic Archaea, as previously seen for Bacteria. PMID:24086729

The role of community participation for sustainable integrated neglected tropical diseases and water, sanitation and hygiene intervention programs: A pilot project in Tanzania.

PubMed

Madon, Shirin; Malecela, Mwele Ntuli; Mashoto, Kijakazi; Donohue, Rose; Mubyazi, Godfrey; Michael, Edwin

2018-04-01

Strategies aimed at reducing the prevalence of neglected tropical diseases (NTDs) in Tanzania including those attributed to water, sanitation and hygiene (WASH) problems have been largely top-down in nature. They have focused on strengthening the governance of NTD-WASH programs by integrating different vertical disease programs and improving the efficiency of report-generation. In this paper, we argue for community participation as an effective strategy for developing sustainable village health governance. We present the results of a pilot undertaken between November 2015 and April 2016 in which we adopted a mixed methods case study approach to implement an Enhanced Development Governance (EDG) model using existing village governance structures. Our results show that the EDG model was associated with a statistically significant reduction in the prevalence of schistosomiasis and diarrhoea, and has led to an increase in awareness of WASH interventions for sustaining gains in NTD control. We identify five key social processes enacted by the EDG model that have led to improved health benefits related to frequency of meetings and attendance, promotion of health and sanitation awareness, income-generating activities, self-organising capabilities, and interaction between village bodies. These findings hold important implications for conceptualising the role of community participation in sustaining NTD-WASH intervention programs and for sensitising institutional and policy reform. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Safeguarding children in dentistry: 2. Do paediatric dentists neglect child dental neglect?

PubMed

Harris, J C; Elcock, C; Sidebotham, P D; Welbury, R R

2009-05-09

In this second part of a two-part report, further findings of a postal questionnaire sent in March 2005 to dentists with an interest in paediatric dentistry working in varied UK settings are presented and discussed in the context of current multi-agency good practice in safeguarding and promoting the welfare of children. Using insights gained from a survey of self-reported management of children with neglected dentitions, this paper explores whether paediatric dentists neglect child dental neglect. The authors conclude that current practice already includes much that contributes to promoting children's oral health and wellbeing. However, in a society where children continue to suffer as a result of abuse and neglect, they warn that improvements are needed in communication between dentists and other health and social care professionals if children's welfare is to be safeguarded and promoted effectively and future tragedies avoided.

Community Attitudes toward Mass Drug Administration for Control and Elimination of Neglected Tropical Diseases after the 2014 Outbreak of Ebola Virus Disease in Lofa County, Liberia

PubMed Central

Bogus, Joshua; Gankpala, Lincoln; Fischer, Kerstin; Krentel, Alison; Weil, Gary J.; Fischer, Peter U.; Kollie, Karsor; Bolay, Fatorma K.

2016-01-01

The recent outbreak of Ebola virus disease (EVD) interrupted mass drug administration (MDA) programs to control and eliminate neglected tropical diseases in Liberia. MDA programs treat entire communities with medication regardless of infection status to interrupt transmission and eliminate lymphatic filariasis and onchocerciasis. Following reports of hostilities toward health workers and fear that they might be spreading EVD, it was important to determine whether attitudes toward MDA might have changed after the outbreak. We surveyed 140 community leaders from 32 villages in Lofa County, Liberia, that had previously participated in MDA and are located in an area that was an early epicenter of the EVD outbreak. Survey respondents reported a high degree of community trust in the MDA program, and 97% thought their communities were ready to resume MDA. However, respondents predicted that fewer people would comply with MDA after the EVD epidemic than before. The survey also uncovered fears in the community that EVD and MDA might be linked. Respondents suggested that MDA programs emphasize to people that the medications are identical to those previously distributed and that MDA programs have nothing to do with EVD. PMID:26666700

Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases.

PubMed

Stanton, Michelle; Molineux, Andrew; Mackenzie, Charles; Kelly-Hope, Louise

2016-01-01

As global mobile phone penetration increases, direct health information communication from hard-to-reach communities is becoming commonplace. Mobile health (mHealth) tools that enable disease control programs to benefit from this information, while simultaneously empowering community members to take control of their own health, are vital to the goal of universal health care. Our aim was to highlight the development of the Liverpool mHealth Suite (LMS), which has been designed to address this need and improve health services for neglected tropical diseases being targeted for global elimination, such as lymphatic filariasis. The LMS has two main communication approaches-short message service and mobile phone apps-to facilitate real-time mass drug administration (MDA) coverage, reporting patient numbers, managing stock levels of treatment supplies, and exchanging health information to improve the quality of care of those affected. The LMS includes the MeasureSMS-MDA tool to improve drug supplies and MDA coverage rates in real-time (currently being trialed in urban Tanzania); the MeasureSMS-Morbidity tool to map morbidity, including lymphedema and hydrocele cases (initially piloted in rural Malawi and Ghana, then extended to Ethiopia, and scaled up to large urban areas in Bangladesh and Tanzania); the LyMSS-lymphedema management supply system app to improve distribution of treatments (trialed for 6 months in Malawi with positive impacts on health workers and patients); and the HealthFront app to improve education and training (in development with field trials planned). The current success and scale-up of the LMS by many community health workers in rural and urban settings across Africa and Asia highlights the value of this simple and practical suite of tools that empowers local health care workers to contribute to local, national, and global elimination of disease.

Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence, Distribution, and Opportunities for Control

PubMed Central

Hotez, Peter J.; Savioli, Lorenzo; Fenwick, Alan

2012-01-01

The neglected tropical diseases (NTDs) are highly endemic but patchily distributed among the 20 countries and almost 400 million people of the Middle East and North Africa (MENA) region, and disproportionately affect an estimated 65 million people living on less than US$2 per day. Egypt has the largest number of people living in poverty of any MENA nation, while Yemen has the highest prevalence of people living in poverty. These two nations stand out for having suffered the highest rates of many NTDs, including the soil-transmitted nematode infections, filarial infections, schistosomiasis, fascioliasis, leprosy, and trachoma, although they should be recognized for recent measures aimed at NTD control. Leishmaniasis, especially cutaneous leishmaniasis, is endemic in Syria, Iran, Iraq, Libya, Morocco, and elsewhere in the region. Both zoonotic (Leishmania major) and anthroponotic (Leishmania tropica) forms are endemic in MENA in rural arid regions and urban regions, respectively. Other endemic zoonotic NTDs include cystic echinococcosis, fascioliasis, and brucellosis. Dengue is endemic in Saudi Arabia, where Rift Valley fever and Alkhurma hemorrhagic fever have also emerged. Great strides have been made towards elimination of several endemic NTDs, including lymphatic filariasis in Egypt and Yemen; schistosomiasis in Iran, Morocco, and Oman; and trachoma in Morocco, Algeria, Iran, Libya, Oman, Saudi Arabia, Tunisia, and the United Arab Emirates. A particularly noteworthy achievement is the long battle waged against schistosomiasis in Egypt, where prevalence has been brought down by regular praziquantel treatment. Conflict and human and animal migrations are key social determinants in preventing the control or elimination of NTDs in the MENA, while local political will, strengthened international and intersectoral cooperative efforts for surveillance, mass drug administration, and vaccination are essential for elimination. PMID:22389729

Understanding Communities of Neglectful Parents: Child Caregiving Networks and Child Neglect

ERIC Educational Resources Information Center

Roditti, Martha G.

2005-01-01

This article focuses on family social networks and the community of caregivers of neglected children. If neglect is part of family functioning, who watches over the children? Using a case study approach, this study researched 12 children and their parents. Several concepts, such as multiple caregiving and kin keepers, revealed that study children…

SPATIAL NEGLECT AND ATTENTION NETWORKS

PubMed Central

Corbetta, Maurizio; Shulman, Gordon L.

2013-01-01

Unilateral spatial neglect is a common neurological syndrome following predominantly right hemisphere injuries to ventral fronto-parietal cortex. We propose that neglect reflects deficits in the coding of saliency, control of spatial attention, and representation within an egocentric frame of reference, in conjunction with non-spatial deficits of reorienting, target detection, and arousal/vigilance. In contrast to theories that link spatial neglect to structural damage of specific brain regions, we argue that neglect is better explained by the physiological dysfunction of distributed cortical networks. The ventral lesions in right parietal, temporal, and frontal cortex that cause neglect directly impair non-spatial functions and hypoactivate the right hemisphere, inducing abnormalities in task-evoked activity and functional connectivity of a dorsal frontal-parietal network that controls spatial attention. The anatomy and right hemisphere dominance of neglect follows from the anatomy and laterality of the ventral regions that interact with the dorsal attention network. PMID:21692662

Cognitive Processes Associated with Child Neglect

ERIC Educational Resources Information Center

Hildyard, Kathryn; Wolfe, David

2007-01-01

Objective: To compare neglectful and non-neglectful mothers on information processing tasks related to child emotions, behaviors, the caregiving relationship, and recall of child-related information. Method: A natural group design was used. Neglectful mothers (N = 34) were chosen from active, chronic caseloads; non-neglectful comparison mothers (N…

Schistosoma haematobium in Guinea-Bissau: unacknowledged morbidity due to a particularly neglected parasite in a particularly neglected country.

PubMed

Botelho, Monica C; Machado, Ana; Carvalho, André; Vilaça, Manuela; Conceição, Orquídea; Rosa, Fernanda; Alves, Helena; Richter, Joachim; Bordalo, Adriano Agostinho

2016-04-01

Schistosomiasis is the major neglected tropical helminthic disease worldwide. Current knowledge on the epidemiology of schistosomiasis in Guinea-Bissau is scarce and regarding to the absence of Schistosoma haematobium (S.h.). Therefore, a pilot study was undertaken to assess the prevalence and morbidity due to S.h. infection in randomly selected 90 children and adolescents aged 6 to 15 years. Prevalence of S.h. infection was 20.00 % (18/90). Microhematuria was observed in 61.11 % (11/18) of S.h.-egg-excreting vs. 37.50 % (27/72) of non-S.h.-egg-excreting children p ≤ 0.01. Body mass index (BMI) was less than 15 kg/m(2) in 52/90 (57.78 %) of all children and adolescents, but this proportion increased to 66.67 % (12/18) in S.h.-infected children who were more frequently stunted and wasted than in non-infected children. The mean weight-for-age Z score (WAZ) was reduced in S.h. infected as compared to non-infected children (-1.48 ± 1.08 SD vs. -0.80 ± 1.11 SD; p ≤ 0.01). To our knowledge, this is the first epidemiologic report on S. haematobium infection in Guinea-Bissau since 22 years. Even in this relatively small study sample, it appears that S. haematobium, besides the well-known symptoms such as hematuria, leads to significant, albeit commonly unacknowledged morbidity such as stunting and wasting. These observations underscore the notion that this vulnerable but neglected population urgently needs to be targeted for implementation of measures for treatment and control.

Neglect Dyslexia: Frequency, Association with Other Hemispatial Neglects, and Lesion Localization

ERIC Educational Resources Information Center

Lee, Byung Hwa; Suh, Mee Kyung; Kim, Eun-Joo; Seo, Sang Won; Choi, Kyung Mook; Kim, Gyeong-Moon; Chung, Chin-Sang; Heilman, Kenneth M.; Na, Duk L.

2009-01-01

Patients with right hemisphere injury often omit or misread words on the left side of a page or the beginning letters of single words (neglect dyslexia). Our study involving a large sample of acute right hemisphere stroke investigated (1) the frequency of neglect dyslexia (ND), (2) the association between ND and other types of contralesional…

Camelid Single-Domain Antibodies As an Alternative to Overcome Challenges Related to the Prevention, Detection, and Control of Neglected Tropical Diseases.

PubMed

Fernandes, Carla F C; Pereira, Soraya Dos S; Luiz, Marcos B; Zuliani, Juliana P; Furtado, Gilvan P; Stabeli, Rodrigo G

2017-01-01

Due mainly to properties such as high affinity and antigen specificity, antibodies have become important tools for biomedical research, diagnosis, and treatment of several human diseases. When the objective is to administer them for therapy, strategies are used to reduce the heterologous protein immunogenicity and to improve pharmacokinetic and pharmacodynamic characteristics. Size minimization contributes to ameliorate these characteristics, while preserving the antigen-antibody interaction site. Since the discovery that camelids produce functional antibodies devoid of light chains, studies have proposed the use of single domains for biosensors, monitoring and treatment of tumors, therapies for inflammatory and neurodegenerative diseases, drug delivery, or passive immunotherapy. Despite an expected increase in antibody and related products in the pharmaceutical market over the next years, few research initiatives are related to the development of alternatives for helping to manage neglected tropical diseases (NTDs). In this review, we summarize developments of camelid single-domain antibodies (VHH) in the field of NTDs. Particular attention is given to VHH-derived products, i.e., VHHs fused to nanoparticles, constructed for the development of rapid diagnostic kits; fused to oligomeric matrix proteins for viral neutralization; and conjugated with proteins for the treatment of human parasites. Moreover, paratransgenesis technology using VHHs is an interesting approach to control parasite development in vectors. With enormous biotechnological versatility, facility and low cost for heterologous production, and greater ability to recognize different epitopes, VHHs have appeared as an opportunity to overcome challenges related to the prevention, detection, and control of human diseases, especially NTDs.

Camelid Single-Domain Antibodies As an Alternative to Overcome Challenges Related to the Prevention, Detection, and Control of Neglected Tropical Diseases

PubMed Central

Fernandes, Carla F. C.; Pereira, Soraya dos S.; Luiz, Marcos B.; Zuliani, Juliana P.; Furtado, Gilvan P.; Stabeli, Rodrigo G.

2017-01-01

Due mainly to properties such as high affinity and antigen specificity, antibodies have become important tools for biomedical research, diagnosis, and treatment of several human diseases. When the objective is to administer them for therapy, strategies are used to reduce the heterologous protein immunogenicity and to improve pharmacokinetic and pharmacodynamic characteristics. Size minimization contributes to ameliorate these characteristics, while preserving the antigen–antibody interaction site. Since the discovery that camelids produce functional antibodies devoid of light chains, studies have proposed the use of single domains for biosensors, monitoring and treatment of tumors, therapies for inflammatory and neurodegenerative diseases, drug delivery, or passive immunotherapy. Despite an expected increase in antibody and related products in the pharmaceutical market over the next years, few research initiatives are related to the development of alternatives for helping to manage neglected tropical diseases (NTDs). In this review, we summarize developments of camelid single-domain antibodies (VHH) in the field of NTDs. Particular attention is given to VHH-derived products, i.e., VHHs fused to nanoparticles, constructed for the development of rapid diagnostic kits; fused to oligomeric matrix proteins for viral neutralization; and conjugated with proteins for the treatment of human parasites. Moreover, paratransgenesis technology using VHHs is an interesting approach to control parasite development in vectors. With enormous biotechnological versatility, facility and low cost for heterologous production, and greater ability to recognize different epitopes, VHHs have appeared as an opportunity to overcome challenges related to the prevention, detection, and control of human diseases, especially NTDs. PMID:28649245

An investigation of shoulder forces in active shoulder tackles in rugby union football.

PubMed

Usman, Juliana; McIntosh, Andrew S; Fréchède, Bertrand

2011-11-01

In rugby union football the tackle is the most frequently executed skill and one most associated with injury, including shoulder injury to the tackler. Despite the importance of the tackle, little is known about the magnitude of shoulder forces in the tackle and influencing factors. The objectives of the study were to measure the shoulder force in the tackle, as well as the effects of shoulder padding, skill level, side of body, player size, and experimental setting on shoulder force. Experiments were conducted in laboratory and field settings using a repeated measures design. Thirty-five participants were recruited to the laboratory and 98 to the field setting. All were male aged over 18 years with rugby experience. The maximum force applied to the shoulder in an active shoulder tackle was measured with a custom built forceplate incorporated into a 45 kg tackle bag. The overall average maximum shoulder force was 1660 N in the laboratory and 1997 N in the field. This difference was significant. The shoulder force for tackling without shoulder pads was 1684 N compared to 1635 N with shoulder pads. There was no difference between the shoulder forces on the dominant and non-dominant sides. Shoulder force reduced with tackle repetition. No relationship was observed between player skill level and size. A substantial force can be applied to the shoulder and to an opponent in the tackle. This force is within the shoulder's injury tolerance range and is unaffected by shoulder pads. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Object-based neglect in number processing

PubMed Central

2013-01-01

Recent evidence suggests that neglect patients seem to have particular problems representing relatively smaller numbers corresponding to the left part of the mental number line. However, while this indicates space-based neglect for representational number space little is known about whether and - if so - how object-based neglect influences number processing. To evaluate influences of object-based neglect in numerical cognition, a group of neglect patients and two control groups had to compare two-digit numbers to an internally represented standard. Conceptualizing two-digit numbers as objects of which the left part (i.e., the tens digit should be specifically neglected) we were able to evaluate object-based neglect for number magnitude processing. Object-based neglect was indicated by a larger unit-decade compatibility effect actually reflecting impaired processing of the leftward tens digits. Additionally, faster processing of within- as compared to between-decade items provided further evidence suggesting particular difficulties in integrating tens and units into the place-value structure of the Arabic number system. In summary, the present study indicates that, in addition to the spatial representation of number magnitude, also the processing of place-value information of multi-digit numbers seems specifically impaired in neglect patients. PMID:23343126

Emotion Knowledge in Young Neglected Children

PubMed Central

Sullivan, Margaret W.; Bennett, David S.; Carpenter, Kim; Lewis, Michael

2013-01-01

Young neglected children may be at risk for emotion knowledge deficits. Children with histories of neglect or with no maltreatment were initially seen at age 4 and again 1 year later to assess their emotion knowledge. Higher IQ was associated with better emotion knowledge, but neglected children had consistently poorer emotion knowledge over time compared to non-neglected children after controlling for IQ. Because both neglected status and IQ may contribute to deficits in emotional knowledge, both should be assessed when evaluating these children to appropriately design and pace emotion knowledge interventions. PMID:18299632

Emotion knowledge in young neglected children.

PubMed

Sullivan, Margaret W; Bennett, David S; Carpenter, Kim; Lewis, Michael

2008-08-01

Young neglected children may be at risk for emotion knowledge deficits. Children with histories of neglect or with no maltreatment were initially seen at age 4 and again 1 year later to assess their emotion knowledge. Higher IQ was associated with better emotion knowledge, but neglected children had consistently poorer emotion knowledge over time compared to non-neglected children after controlling for IQ. Because both neglected status and IQ may contribute to deficits in emotional knowledge, both should be assessed when evaluating these children to appropriately design and pace emotion knowledge interventions.

Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs

PubMed Central

Jacobson, Julie; Mosher, Aryc W.; Walson, Judd L.

2016-01-01

Background While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD) programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration. Methodology We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH) teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list. Findings In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group. Conclusions Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and

Care neglect, supervisory neglect, and harsh parenting in the development of children's aggression: a replication and extension.

PubMed

Knutson, John F; DeGarmo, David; Koeppl, Gina; Reid, John B

2005-05-01

To understand the effects of neglectful parenting, poor supervision, and punitive parenting in the development of children's aggression, 218 children ages 4 to 8 years who were disadvantaged and their mothers were recruited from two states to develop a sample that was diverse with respect to degree of urbanization and ethnicity. Multimethod and multisource indices of the predictive constructs (Social Disadvantage, Denial of Care Neglect, Supervisory Neglect, and Punitive Discipline) and the criterion construct (Aggression) were used in a test of a theoretical model using structural equation modeling. The results established the role of care neglect, supervisory neglect, and punitive parenting as mediators of the role of social disadvantage in the development of children's aggression, the importance of distinguishing between two subtypes of neglect, and the need to consider the role of discipline in concert with neglect when attempting to understand the parenting in the development of aggression.

Association between Footwear Use and Neglected Tropical Diseases: A Systematic Review and Meta-Analysis

PubMed Central

Brooker, Simon J.; Clark, Hannah; Rafique, Khizar; Knopp, Stefanie; Utzinger, Jürg; Davey, Gail

2014-01-01

Background The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. Methodology We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. Principal Findings Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR = 0.15; 95% CI: 0.08–0.29), CLM (OR = 0.24; 95% CI: 0.06–0.96), tungiasis (OR = 0

Noma: Overview of a Neglected Disease and Human Rights Violation.

PubMed

Srour, M Leila; Marck, Klaas; Baratti-Mayer, Denise

2017-02-08

Noma is an orofacial gangrene affecting malnourished children and mainly observed in tropical countries, particularly sub-Saharan Africa. Epidemiological data on noma are scarce, but a current estimate of the global incidence is 30,000-40,000 cases per year, with a mortality rate of approximately 85% and a burden of disease calculated to be a loss of 1-10 million disability-adjusted life years. The etiology of noma is multifactorial with malnutrition as an ever present factor, often in combination with concomitant diseases, such as measles, malaria, and human immunodeficiency virus (HIV), and poor oral hygiene. The pathogenesis is a fast-spreading, noncontagious gangrenous infection occurring in the face, often preceded by acute necrotizing gingivitis, and stomatitis. Rare microbiological studies suggest an opportunistic infection caused by an imbalance in normal intraoral microorganisms. Prevention lies in food security, measles vaccination, prevention of malaria and HIV, including the early detection and treatment of necrotizing gingivitis and stomatitis. Early treatment with antibiotics may prevent gangrene or reduce its extent. Late treatment consists of surgical rehabilitation, which is often complex. However, access to medical care is very limited for noma patients due to the extremely poor conditions in which they live that are frequently located in remote rural areas. The authors support the United Nations Human Rights Council Resolution 19/7 adopted on March 22, 2012 "The right to food," and advocate for the inclusion of noma on the list of neglected tropical diseases to encourage more medical and institutional attention for this often lethal or very mutilating infectious gangrene. © The American Society of Tropical Medicine and Hygiene.

Group study of an "undercover" test for visuospatial neglect: invisible cancellation can reveal more neglect than standard cancellation.

PubMed

Wojciulik, E; Rorden, C; Clarke, K; Husain, M; Driver, J

2004-09-01

Visual neglect is a relatively common deficit after brain damage, particularly strokes. Cancellation tests provide standard clinical measures of neglect severity and deficits in daily life. A recent single-case study introduced a new variation on standard cancellation. Instead of making a visible mark on each target found, the patient made invisible marks (recorded with carbon paper underneath, for later scoring). Such invisible cancellation was found to reveal more neglect than cancellation with visible marks. Here we test the generality of this. Twenty three successive cases with suspected neglect each performed cancellation with visible or invisible marks. Neglect of contralesional targets was more pronounced with invisible marks. Indeed, about half of the patients only showed neglect in this version. For cases showing more neglect with invisible marks, stronger neglect of contralesional targets correlated with more revisits to ipsilesional targets for making additional invisible marks upon them. These results indicate that cancellation with invisible marks can reveal more neglect than standard cancellation with visible marks, while still providing a practical bedside test. Our observations may be consistent with recent proposals that demands on spatial working memory (required to keep track of previously found items only when marked invisibly) can exacerbate spatial neglect.

Spurring new research for neglected diseases.

PubMed

Anderson, Gerard F

2009-01-01

A very small proportion of global spending for biomedical research is for neglected diseases. However, neglected diseases account for a sizable percentage of the global burden of disease, especially in low-income countries. For-profit pharmaceutical and biotech companies are unlikely to conduct significant additional research on neglected diseases without financial incentives. This paper examines the benefits of providing a tax credit to encourage companies to conduct preclinical research on neglected diseases in the laboratory or in animals. This strategy could lead to a new generation of treatment options for the people in low-income countries who are susceptible to neglected diseases.

Neglected children, shame-proneness, and depressive symptoms.

PubMed

Bennett, David S; Sullivan, Margaret Wolan; Lewis, Michael

2010-11-01

Neglected children may be at increased risk for depressive symptoms. This study examines shame-proneness as an outcome of child neglect and as a potential explanatory variable in the relation between neglect and depressive symptoms. Participants were 111 children (52 with a Child Protective Services [CPS] allegation of neglect) seen at age 7. Neglected children reported more shame-proneness and more depressive symptoms than comparison children. Guilt-proneness, in contrast, was unrelated to neglect and depressive symptoms, indicating specificity for shame-proneness. The potential role of shame as a process variable that can help explain how some neglected children exhibit depressive symptoms is discussed.

Child dental neglect: is it a neglected area in the UK?

PubMed

Sarri, G; Marcenes, W

2012-08-01

This commentary focuses on the condition of dental neglect (DN) in children in the UK. It is divided into three sections: the first section defines DN in children and its consequences, the second section discusses who may be responsible for dental diseases in children as a result of neglect and the third section proposes a holistic approach to address DN in children in the UK.

Does player time-in-game affect tackle technique in elite level rugby union?

PubMed

Tierney, Gregory J; Denvir, Karl; Farrell, Garreth; Simms, Ciaran K

2018-02-01

It has been hypothesised that fatigue may be a major factor in tackle-related injury risk in rugby union and hence more injuries occur in the later stages of a game. The aim of this study is to identify changes in ball carrier or tackler proficiency characteristics, using elite level match video data, as player time-in-game increases. Qualitative observational cohort study. Three 2014/15 European Rugby Champions Cup games were selected for ball carrier and tackler proficiency analysis. Analysis was only conducted on players who started and remained on the field for the entire game. A separate analysis was conducted on 10 randomly selected 2014/15 European Rugby Champions Cup/Pro 12 games to assess the time distribution of tackles throughout a game. A Chi-square test and one-way way ANOVA with post-hoc testing was conducted to identify significant differences (p<0.05) for proficiency characteristics and tackle counts between quarters in the game, respectively. Player time-in-game did not affect tackle proficiency for both the ball carrier and tackler. Any results that showed statistical significance did not indicate a trend of deterioration in proficiency with increased player time-in-game. The time distribution of tackles analysis indicated that more tackles occurring in the final quarter of the game than the first (p=0.04) and second (p=<0.01). It appears that player time-in-game does not affect tackler or ball carrier tackle technique proficiency at the elite level. More tackles occurring in the final quarter of a game provides an alternative explanation to more tackle-related injuries occurring at this stage. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The Socioeconomic Benefit to Individuals of Achieving the 2020 Targets for Five Preventive Chemotherapy Neglected Tropical Diseases

PubMed Central

Luyendijk, Marianne; Fitzpatrick, Christopher; Niessen, Louis; Stolk, Wilma A.; Tediosi, Fabrizio; Rijnsburger, Adriana J.; Bakker, Roel; Hontelez, Jan A. C.; Richardus, Jan H.; Jacobson, Julie; de Vlas, Sake J.; Severens, Johan L.

2017-01-01

Background Lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminths (STH) and trachoma represent the five most prevalent neglected tropical diseases (NTDs). They can be controlled or eliminated by means of safe and cost-effective interventions delivered through programs of Mass Drug Administration (MDA)—also named Preventive Chemotherapy (PCT). The WHO defined targets for NTD control/elimination by 2020, reinforced by the 2012 London Declaration, which, if achieved, would result in dramatic health gains. We estimated the potential economic benefit of achieving these targets, focusing specifically on productivity and out-of-pocket payments. Methods Productivity loss was calculated by combining disease frequency with productivity loss from the disease, from the perspective of affected individuals. Productivity gain was calculated by deducting the total loss expected in the target achievement scenario from the loss in a counterfactual scenario where it was assumed the pre-intervention situation in 1990 regarding NTDs would continue unabated until 2030. Economic benefits from out-of-pocket payments (OPPs) were calculated similarly. Benefits are reported in 2005 US$ (purchasing power parity-adjusted and discounted at 3% per annum from 2010). Sensitivity analyses were used to assess the influence of changes in input parameters. Results The economic benefit from productivity gain was estimated to be I$251 billion in 2011–2020 and I$313 billion in 2021–2030, considerably greater than the total OPPs averted of I$0.72 billion and I$0.96 billion in the same periods. The net benefit is expected to be US$ 27.4 and US$ 42.8 for every dollar invested during the same periods. Impact varies between NTDs and regions, since it is determined by disease prevalence and extent of disease-related productivity loss. Conclusion Achieving the PCT-NTD targets for 2020 will yield significant economic benefits to affected individuals. Despite large

Building local research and development capacity for the prevention and cure of neglected diseases: the case of India.

PubMed Central

Kettler, H. E.; Modi, R.

2001-01-01

This paper examines the proposal to build research and development (R&D) capabilities for dealing with neglected infectious and tropical diseases in countries where they are endemic, as a potentially cost- and time-effective way to fill the gap between the supply of and need for new medicines. With reference to the situation in India, we consider the competencies and incentives needed by companies so that their strategy can be shifted from reverse engineering of existing products to investment in R&D for new products. This requires complex reforms, of which the intellectual property rights agreement is only one. We also consider whether Indian companies capable of conducting research and development are likely to target neglected diseases. Patterns of patenting and of R&D, together with evidence from interviews we have conducted, suggest that Indian companies, like multinational corporations, are likely to target global diseases because of the prospect of much greater returns. Further studies are required on how Indian companies would respond to push and pull incentives originally designed to persuade multinational corporations to do more R&D on neglected diseases. PMID:11545331

Measuring changes in transmission of neglected tropical diseases, malaria, and enteric pathogens from quantitative antibody levels.

PubMed

Arnold, Benjamin F; van der Laan, Mark J; Hubbard, Alan E; Steel, Cathy; Kubofcik, Joseph; Hamlin, Katy L; Moss, Delynn M; Nutman, Thomas B; Priest, Jeffrey W; Lammie, Patrick J

2017-05-01

both high- and low transmission settings, mean antibody curves revealed changes in population mean antibody levels that were masked by seroprevalence measures because changes took place above or below the seropositivity cutoff. Age-dependent antibody curves and summary means provided a robust and sensitive measure of changes in transmission, with greatest sensitivity among young children. The method generalizes to pathogens that can be measured in high-throughput, multiplex serological assays, and scales to surveillance activities that require high spatiotemporal resolution. Our results suggest quantitative antibody levels will be particularly useful to measure differences in exposure for pathogens that elicit a transient antibody response or for monitoring populations with very high- or very low transmission, when seroprevalence is less informative. The approach represents a new opportunity to conduct integrated serological surveillance for neglected tropical diseases, malaria, and other infectious diseases with well-defined antigen targets.

Children neglected: Where cumulative risk theory fails.

PubMed

O'Hara, Mandy; Legano, Lori; Homel, Peter; Walker-Descartes, Ingrid; Rojas, Mary; Laraque, Danielle

2015-07-01

Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent-child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p=0.03). The groups did not differ on the block design subtest (p=0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children. Copyright © 2015 Elsevier Ltd. All rights reserved.

TSCA Section 21 Petition Requesting EPA to Regulate Lead in Fishing Tackle

EPA Pesticide Factsheets

This petition requests EPA to promulgate regulations under section 6 of TSCA to protect the environment from fishing tackle containing lead including fishing weights, sinkers, lures, jigs, and/or other tackle.

Neglecting Neglect: Some Thoughts about Children Who Have Lacked Good Input, and Are "Undrawn" and "Unenjoyed"

ERIC Educational Resources Information Center

Music, Graham

2009-01-01

This paper looks at emotional neglect in the early years of life, and postulates some probable long-term sequelae of such neglect. It argues that there is a continuum of neglect; ranging from the severest form, as seen in institutional orphanages, to milder variations. A range of theoretical and research traditions, including developmental…

Baltimore District Tackles High Suspension Rates

ERIC Educational Resources Information Center

Maxwell, Lesli A.

2007-01-01

This article reports on how the Baltimore District tackles its high suspension rates. Driven by an increasing belief that zero-tolerance disciplinary policies are ineffective, more educators are embracing strategies that do not exclude misbehaving students from school for offenses such as insubordination, disrespect, cutting class, tardiness, and…

The Neglected Majority--Revisited

ERIC Educational Resources Information Center

Beebe, Anthony; Walleri, R. Dan

2005-01-01

Dale Parnell's "The Neglected Majority" is one of the most influential works by a community college leader in the history of the community college movement. This essay explores the impact of "The Neglected Majority" since publication in 1985 and includes an interview with Parnell that assesses his perspective of the nearly 20 years following his…

Could visual neglect induce amblyopia?

PubMed

Bier, J C; Vokaer, M; Fery, P; Garbusinski, J; Van Campenhoudt, G; Blecic, S A; Bartholomé, E J

2004-12-01

Oculomotor nerve disease is a common cause of diplopia. When strabismus is present, absence of diplopia has to induce the research of either uncovering of visual fields or monocular suppression, amblyopia or blindness. We describe the case of a 41-year-old woman presenting with right oculomotor paresis and left object-centred visual neglect due to a right fronto-parietal haemorrhage expanding to the right peri-mesencephalic cisterna caused by the rupture of a right middle cerebral artery aneurysm. She never complained of diplopia despite binocular vision and progressive recovery of strabismus, excluding uncovering of visual fields. Since all other causes were excluded in this case, we hypothesise that the absence of diplopia was due to the object-centred visual neglect. Partial internal right oculomotor paresis causes an ocular deviation in abduction; the image being perceived deviated contralaterally to the left. Thus, in our case, the neglect of the left image is equivalent to a right monocular functional blindness. However, bell cancellation test clearly worsened when assessed in left monocular vision confirming that eye patching can worsen attentional visual neglect. In conclusion, our case argues for the possibility of a functional monocular blindness induced by visual neglect. We think that in presence of strabismus, absence of diplopia should induce the search for hemispatial visual neglect when supratentorial lesions are suspected.

Elder self-neglect: research and practice.

PubMed

Dong, XinQi

2017-01-01

Elder self-neglect is a global public health and human rights issue that threatens older people's health and safety. It commonly refers to refusal or failure to provide oneself with care and protection in areas of food, water, clothing, hygiene, medication, living environments, and safety precautions. While prevalent, the status of self-neglecting individuals remains largely unclear, in particular within community-dwelling populations. By reviewing the epidemiology of elder self-neglect (definition, prevalence, risk factors, and consequences) to date, the present paper identifies key research gaps such as methodological inconsistency in case identification and measurement, and study designs that are inadequate to determine risk factors of self-neglect. More importantly, in light of the rapidly growing older population, relevant stakeholders (researchers, healthcare providers, social service providers, legal professionals, community organizations, and policymakers) must be prepared for an expected increasing number of self-neglect cases and enlarging scope of the problem. Hence, in this article, I present an overview regarding the management issues of elderly self-neglect related to the detection, assessment, reporting and referral, and decision-making capacity. Based on the current literature, the paper is aimed to explore the present knowledge and challenges, and how they can pave the way for solutions to self-neglect research, practice, and policy.

Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees.

PubMed

Miller, Bradley S; Spratt, Eve G; Himes, John H; Condon, Doreen; Summer, Andrea; Papa, Carrie E; Brady, Kathleen T

2015-01-01

The long-lasting impact of different neglectful environments on growth in children is not well studied. Three groups of children, 3-10 years old, were recruited (n=60): previously institutionalized international adoptees living in stable home environments for at least 2 years (IA; n=15), children with a history of neglect born in the USA (USN; n=17), and controls (n=28). Children underwent physical examination, anthropometry, and collection of serum for growth parameters. Mean height standard deviation scores (SDS) were different (p<0.05). Age-adjusted head circumference (HC) was significantly smaller (p<0.05) in IAs. Insulin growth factor (IGF-1), a marker of growth hormone action, was higher in US neglected children. IGF-1 adjusted for age and weight SDS were different (p<0.05) between control and US neglect groups. The degree of growth failure in height and HC in IAs was more severe than neglected US children. These findings may reflect differences between the impact of chronic and intermittent deprivation on the growth hormone system.

Dental neglect among children in Chennai.

PubMed

Gurunathan, Deepa; Shanmugaavel, Arunachalam Karthikeyan

2016-01-01

Child dental neglect is the failure of a parent or guardian to meet the child's basic oral health needs such that the child enjoys adequate function and freedom from pain and infection, where reasonable resources are available to family or caregiver. The aim of the study is to evaluate the phenomenon of dental neglect among children in Chennai and to associate dental neglect with oral health status of children aged 3-12 years. This is a cross-sectional study involving 478 pairs of parents and children. Dental neglect scale and a questionnaire were used to assess the dental neglect score among parents of the children involved in the study. Oral health status of children was clinically assessed using oral hygiene index, decayed, extracted, filled teeth (def(t)), pulp, ulcers, fistula, abscess (pufa), decayed, missing, filled teeth (DMFT), PUFA as per the World Health Organization criteria and pufa/PUFA index. Student's t-test and one-way ANOVA were used appropriately for statistical analysis using SPSS software version 20.0. A significant higher dental neglect score was reported among the parents who reside in the suburban location (P < 0.001), whose educational qualification was secondary (P < 0.001) and who have not availed any dental service for >3 years (P = 0.001). A significant higher DMFT (P = 0.003), deft (P = 0 < 0.001), pufa (P = 0.011), and debris index (P = 0.002) scores were seen in the higher dental neglect group. Child dental neglect is seen among the parents whose educational qualification was secondary, who reside in the suburban location, and who have not utilized the dental services for more than 3 years in Chennai. This dental neglect results in poorer oral health of children.

Child neglect and emotional abuse

MedlinePlus

... or neglect, call 911. Call the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD). Counseling and ... of Health and Human Services website. Children's Bureau. Child abuse and neglect. www.acf.hhs.gov/cb/focus- ...

What Is Child Abuse and Neglect?

ERIC Educational Resources Information Center

US Department of Health and Human Services, 2006

2006-01-01

Each State provides its own definitions of child abuse and neglect based on minimum standards set by Federal law. This fact sheet provides the answers to the following questions: (1) How is child abuse and neglect defined in Federal law?; and (2) What are the major types of child abuse and neglect? Additional resources are listed. (Contains 2…

Ipsilesional 'where' with contralesional 'what' neglect.

PubMed

Kwon, Jay Cheol; Ahn, Sunyoung; Kim, Sunghee; Heilman, Kenneth M

2012-01-01

Whereas contralesional spatial neglect is usually caused by right temporo-parietal lesions, ipsilesional spatial neglect is induced primarily by right frontal lesions. This report describes a 73-year-old woman with a right inferior parietal lesion who on 'where' tasks (line bisection and midline pointing) demonstrated ipsilesional neglect, but on 'what' tests (gap vs. no-gap detection cancellation and clothing tape removal) demonstrated contralesional neglect. This 'what' and 'where' directional dissociation provides evidence for independent 'what' and 'where' attentional networks; however, the reason this parietal lesion causes this contralesional vs. ipsilesional spatial attentional 'what' and 'where' dichotomy remains to be determined.

Working toward a conceptual definition of child neglect.

PubMed

Tang, Connie M

2008-01-01

The phenomenon of child neglect has been nebulous due to limited research on child neglect and the meshing of child neglect with child abuse. There are disagreements among neglect researchers about several important issues, such as whether to frame child neglect as a child's unmet needs or as omissions in parental behavior. It has therefore been difficult to develop a standard conceptual definition of child neglect. In this article, a conceptual definition of child neglect is proposed. The definition's stand on a few important issues is discussed. Finally, how the conceptual definition can guide the formulation of operational definitions for both research and practice is described.

Female genital schistosomiasis (FGS): from case reports to a call for concerted action against this neglected gynaecological disease.

PubMed

Christinet, Vanessa; Lazdins-Helds, Janis K; Stothard, J Russell; Reinhard-Rupp, Jutta

2016-06-01

In recent years, control of neglected tropical diseases has been increasingly gaining momentum and interventions against schistosomiasis are being progressively scaled-up through expansion of donated praziquantel and preventive chemotherapy campaigns. However, the public health importance of female genital schistosomiasis is not fully recognised nor its control is adequately addressed. Taking a clinical and anatomopathological perspective, we evaluated the available literature to highlight the importance of female genital schistosomiasis and its connections with two sexually transmitted infections of global importance, Human Immunodeficiency Virus (HIV) and Human Papilloma Virus. Outside the long list of clinical descriptive reports beginning in 1899, there is presently a shocking gap in epidemiological assessment and a significant underestimation of the burden of FGS remains. The scarcity of integrated approaches to address female genital schistosomiasis calls for more concerted action in its detection, treatment and prevention alongside other concomitant women's health issues, otherwise female genital schistosomiasis will remain a neglected gynaecological disease. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Using Co-authorship Networks to Map and Analyse Global Neglected Tropical Disease Research with an Affiliation to Germany

PubMed Central

Bender, Max Ernst; Edwards, Suzanne; von Philipsborn, Peter; Steinbeis, Fridolin; Keil, Thomas; Tinnemann, Peter

2015-01-01

Background Research on Neglected Tropical Diseases (NTDs) has increased in recent decades, and significant need-gaps in diagnostic and treatment tools remain. Analysing bibliometric data from published research is a powerful method for revealing research efforts, partnerships and expertise. We aim to identify and map NTD research networks in Germany and their partners abroad to enable an informed and transparent evaluation of German contributions to NTD research. Methodology/Principal Findings A SCOPUS database search for articles with German author affiliations that were published between 2002 and 2012 was conducted for kinetoplastid and helminth diseases. Open-access tools were used for data cleaning and scientometrics (OpenRefine), geocoding (OpenStreetMaps) and to create (Table2Net), visualise and analyse co-authorship networks (Gephi). From 26,833 publications from around the world that addressed 11 diseases, we identified 1,187 (4.4%) with at least one German author affiliation, and we processed 972 publications for the five most published-about diseases. Of those, we extracted 4,007 individual authors and 863 research institutions to construct co-author networks. The majority of co-authors outside Germany were from high-income countries and Brazil. Collaborations with partners on the African continent remain scattered. NTD research within Germany was distributed among 220 research institutions. We identified strong performers on an individual level by using classic parameters (number of publications, h-index) and social network analysis parameters (betweenness centrality). The research network characteristics varied strongly between diseases. Conclusions/Significance The share of NTD publications with German affiliations is approximately half of its share in other fields of medical research. This finding underlines the need to identify barriers and expand Germany’s otherwise strong research activities towards NTDs. A geospatial analysis of research

The Effects of Verbal Instruction and Shaping to Improve Tackling by High School Football Players

ERIC Educational Resources Information Center

Harrison, Antonio M.; Pyles, David A.

2013-01-01

We evaluated verbal instruction and shaping using TAG (teaching with acoustical guidance) to improve tackling by 3 high school football players. Verbal instruction and shaping improved tackling for all 3 participants. In addition, performance was maintained as participants moved more quickly through the tackling procedure.

A Systematic Approach to Capacity Strengthening of Laboratory Systems for Control of Neglected Tropical Diseases in Ghana, Kenya, Malawi and Sri Lanka

PubMed Central

Njelesani, Janet; Dacombe, Russell; Palmer, Tanith; Smith, Helen; Koudou, Benjamin; Bockarie, Moses; Bates, Imelda

2014-01-01

Background The lack of capacity in laboratory systems is a major barrier to achieving the aims of the London Declaration (2012) on neglected tropical diseases (NTDs). To counter this, capacity strengthening initiatives have been carried out in NTD laboratories worldwide. Many of these initiatives focus on individuals' skills or institutional processes and structures ignoring the crucial interactions between the laboratory and the wider national and international context. Furthermore, rigorous methods to assess these initiatives once they have been implemented are scarce. To address these gaps we developed a set of assessment and monitoring tools that can be used to determine the capacities required and achieved by laboratory systems at the individual, organizational, and national/international levels to support the control of NTDs. Methodology and principal findings We developed a set of qualitative and quantitative assessment and monitoring tools based on published evidence on optimal laboratory capacity. We implemented the tools with laboratory managers in Ghana, Malawi, Kenya, and Sri Lanka. Using the tools enabled us to identify strengths and gaps in the laboratory systems from the following perspectives: laboratory quality benchmarked against ISO 15189 standards, the potential for the laboratories to provide support to national and regional NTD control programmes, and the laboratory's position within relevant national and international networks and collaborations. Conclusion We have developed a set of mixed methods assessment and monitoring tools based on evidence derived from the components needed to strengthen the capacity of laboratory systems to control NTDs. Our tools help to systematically assess and monitor individual, organizational, and wider system level capacity of laboratory systems for NTD control and can be applied in different country contexts. PMID:24603407

Chronic neglect and aggression/delinquency: A longitudinal examination.

PubMed

Logan-Greene, Patricia; Semanchin Jones, Annette

2015-07-01

Neglect is the most common form of maltreatment in the United States, yet its impact on development remains understudied, especially for chronic neglect. Chronic neglect is also one of the most costly burdens on child welfare systems. This study examines the effects of chronic neglect, including two subtypes (Failure to Provide and Lack of Supervision) on adolescent aggression and delinquency using a diverse longitudinal sample of youth. Chronic neglect and chronic failure to provide (ages 0-12) predicted aggression/delinquency (age 14) even after controlling for the effects of other maltreatment (ages 0-12). Chronic lack of supervision, however, did not. Gender significantly moderated these effects, suggesting that males are more likely to respond to neglect by becoming aggressive/delinquent. Finally, social problems (age 12) partially mediated for boys, and fully mediated for girls, the connections between chronic neglect and aggression/delinquency, bolstering theorizing that neglect impairs social functioning broadly. Implications include the need for further research on chronic neglect, especially in providing guidance for child welfare systems. Interventions for chronically neglected youth should include social skill development. Copyright © 2015 Elsevier Ltd. All rights reserved.

Tackling scabies: novel agents for a neglected disease.

PubMed

Gopinath, Hima; Aishwarya, Manju; Karthikeyan, Kaliaperumal

2018-04-16

The scabies mite, Sarcoptes scabiei var hominis, is an obligate ectoparasite of humans. It has been a source of distress for humanity since antiquity. The troublesome mite is emerging triumphant over current acaricidal agents with reports of emerging resistance and treatment failures. Scabies in endemic areas and crusted scabies offer additional management challenges. Exploration of indigenous plants and better understanding of mite biology and pathogenesis provide opportunities for the development of novel agents for this common pest. We review the recent diverse approaches to scabies, including the use of novel plant products with a better safety profile, translating the use of moxidectin from veterinary practice to human scabies, vaccination, immunotherapy, and development of drugs that directly target mite molecules. © 2018 The International Society of Dermatology.

Measuring changes in transmission of neglected tropical diseases, malaria, and enteric pathogens from quantitative antibody levels

PubMed Central

van der Laan, Mark J.; Hubbard, Alan E.; Steel, Cathy; Kubofcik, Joseph; Hamlin, Katy L.; Moss, Delynn M.; Nutman, Thomas B.; Priest, Jeffrey W.; Lammie, Patrick J.

2017-01-01

. falciparum (Spearman’s rho = 0.75). In both high- and low transmission settings, mean antibody curves revealed changes in population mean antibody levels that were masked by seroprevalence measures because changes took place above or below the seropositivity cutoff. Conclusions/Significance Age-dependent antibody curves and summary means provided a robust and sensitive measure of changes in transmission, with greatest sensitivity among young children. The method generalizes to pathogens that can be measured in high-throughput, multiplex serological assays, and scales to surveillance activities that require high spatiotemporal resolution. Our results suggest quantitative antibody levels will be particularly useful to measure differences in exposure for pathogens that elicit a transient antibody response or for monitoring populations with very high- or very low transmission, when seroprevalence is less informative. The approach represents a new opportunity to conduct integrated serological surveillance for neglected tropical diseases, malaria, and other infectious diseases with well-defined antigen targets. PMID:28542223

Dopaminergic stimulation in unilateral neglect

PubMed Central

Geminiani, G.; Bottini, G.; Sterzi, R.

1998-01-01

OBJECTIVE—To explore the hypothesis that dopaminergic circuits play a part in the premotor components of the unilateral neglect syndrome, the effects of acute dopaminergic stimulation in patients with neglect were studied.
METHODS—Two tasks were evaluated before and after subcutaneous administration of apomorphine and placebo: a circle crossing test and a test of target exploration (a modified version of the bell test), performed both in perceptual (counting) and in perceptual-motor (pointing) conditions.
SUBJECTS—Four patients with left neglect.
RESULTS—After dopaminergic stimulation, a significant improvement was found compared with placebo administration and baseline evaluation, in the performance of the two tests. Three of the patients had a more marked improvement in the perceptual-motor condition (pointing) of the task than the perceptual condition (counting).
CONCLUSIONS—The findings suggest that dopaminergic neuronal networks may mediate, in different ways, both perceptive and premotor components of the unilateral neglect syndrome. 

 PMID:9728946

Neglecting the Left Side of a City Square but Not the Left Side of Its Clock: Prevalence and Characteristics of Representational Neglect

PubMed Central

Guariglia, Cecilia; Palermo, Liana; Piccardi, Laura; Iaria, Giuseppe; Incoccia, Chiara

2013-01-01

Representational neglect, which is characterized by the failure to report left-sided details of a mental image from memory, can occur after a right hemisphere lesion. In this study, we set out to verify the hypothesis that two distinct forms of representational neglect exist, one involving object representation and the other environmental representation. As representational neglect is considered rare, we also evaluated the prevalence and frequency of its association with perceptual neglect. We submitted a group of 96 unselected, consecutive, chronic, right brain-damaged patients to an extensive neuropsychological evaluation that included two representational neglect tests: the Familiar Square Description Test and the O'Clock Test. Representational neglect, as well as perceptual neglect, was present in about one-third of the sample. Most patients neglected the left side of imagined familiar squares but not the left side of imagined clocks. The present data show that representational neglect is not a rare disorder and also support the hypothesis that two different types of mental representations (i.e. topological and non-topological images) may be selectively damaged in representational neglect. PMID:23874416

Left neglect dyslexia: Perseveration and reading error types.

PubMed

Ronchi, Roberta; Algeri, Lorella; Chiapella, Laura; Gallucci, Marcello; Spada, Maria Simonetta; Vallar, Giuseppe

2016-08-01

Right-brain-damaged patients may show a reading disorder termed neglect dyslexia. Patients with left neglect dyslexia omit letters on the left-hand-side (the beginning, when reading left-to-right) part of the letter string, substitute them with other letters, and add letters to the left of the string. The aim of this study was to investigate the pattern of association, if any, between error types in patients with left neglect dyslexia and recurrent perseveration (a productive visuo-motor deficit characterized by addition of marks) in target cancellation. Specifically, we aimed at assessing whether different productive symptoms (relative to the reading and the visuo-motor domains) could be associated in patients with left spatial neglect. Fifty-four right-brain-damaged patients took part in the study: 50 out of the 54 patients showed left spatial neglect, with 27 of them also exhibiting left neglect dyslexia. Neglect dyslexic patients who showed perseveration produced mainly substitution neglect errors in reading. Conversely, omissions were the prevailing reading error pattern in neglect dyslexic patients without perseveration. Addition reading errors were much infrequent. Different functional pathological mechanisms may underlie omission and substitution reading errors committed by right-brain-damaged patients with left neglect dyslexia. One such mechanism, involving the defective stopping of inappropriate responses, may contribute to both recurrent perseveration in target cancellation, and substitution errors in reading. Productive pathological phenomena, together with deficits of spatial attention to events taking place on the left-hand-side of space, shape the manifestations of neglect dyslexia, and, more generally, of spatial neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.

Neglect severity after left and right brain damage.

PubMed

Suchan, Julia; Rorden, Chris; Karnath, Hans-Otto

2012-05-01

While unilateral spatial neglect after left brain damage is undoubtedly less common than spatial neglect after a right hemisphere lesion, it is also assumed to be less severe. Here we directly test this latter hypothesis using a continuous measure of neglect severity: the so-called Center of Cancellation (CoC). Rorden and Karnath (2010) recently validated this index for right brain damaged neglect patients. A first aim of the present study was to evaluate this new measure for spatial neglect after left brain damage. In a group of 48 left-sided stroke patients with and without neglect, a score greater than -0.086 on the Bells Test and greater than -0.024 on the Letter Cancellation Task turned out to indicate neglect behavior for acute left brain damaged patients. A second aim was to directly compare the severity of spatial neglect after left versus right brain injury by using the new CoC measure. While neglect is less frequent following left than right hemisphere injury, we found that when this symptom occurs it is of similar severity in acute left brain injury as in patients after acute right brain injury. Copyright © 2012 Elsevier Ltd. All rights reserved.

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

PubMed Central

2005-01-01

Background People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation. Discussion Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations. Summary The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can

Specific tackling situations affect the biomechanical demands experienced by rugby union players.

PubMed

Seminati, Elena; Cazzola, Dario; Preatoni, Ezio; Trewartha, Grant

2017-03-01

Tackling in Rugby Union is an open skill which can involve high-speed collisions and is the match event associated with the greatest proportion of injuries. This study aimed to analyse the biomechanics of rugby tackling under three conditions: from a stationary position, with dominant and non-dominant shoulder, and moving forward, with dominant shoulder. A specially devised contact simulator, a 50-kg punch bag instrumented with pressure sensors, was translated towards the tackler (n = 15) to evaluate the effect of laterality and tackling approach on the external loads absorbed by the tackler, on head and trunk motion, and on trunk muscle activities. Peak impact force was substantially higher in the stationary dominant (2.84 ± 0.74 kN) than in the stationary non-dominant condition (2.44 ± 0.64 kN), but lower than in the moving condition (3.40 ± 0.86 kN). Muscle activation started on average 300 ms before impact, with higher activation for impact-side trapezius and non-impact-side erector spinae and gluteus maximus muscles. Players' technique for non-dominant-side tackles was less compliant with current coaching recommendations in terms of cervical motion (more neck flexion and lateral bending in the stationary non-dominant condition) and players could benefit from specific coaching focus on non-dominant-side tackles.

Evaluating behavioral skills training to teach safe tackling skills to youth football players.

PubMed

Tai, Sharayah S M; Miltenberger, Raymond G

2017-10-01

With concussion rates on the rise for football players, there is a need for further research to increase skills and decrease injuries. Behavioral skills training is effective in teaching a wide variety of skills but has yet to be studied in the sports setting. We evaluated behavioral skills training to teach safer tackling techniques to six participants from a Pop Warner football team. Safer tackling techniques increased during practice and generalized to games for the two participants who had opportunities to tackle in games. © 2017 Society for the Experimental Analysis of Behavior.

Child Neglect: State of Knowledge. Final Report.

ERIC Educational Resources Information Center

Polansky, Norman A.; And Others

The discussion of child neglect considers the following topics: definition, prevalence, etiology, identification and case finding, sequelae, prevention, and treatment. The differences between child neglect and child abuse and between the legal and professional definitions of child neglect are pointed out, and an operational definition is provided.…

Tackling Noncommunicable Diseases in Africa: Caveat Lector

ERIC Educational Resources Information Center

Mensah, George A.

2016-01-01

Noncommunicable disease (NCD), principally cardiovascular diseases, cancer, chronic lung disease, and diabetes, constitutes the major cause of death worldwide. Evidence of a continuing increase in the global burden of these diseases has generated recent urgent calls for global action to tackle and reduce related death and disability. Because the…

Child abuse and neglect experts' determination of when a child being left home alone constitutes child neglect.

PubMed

Jennissen, Charles A; Evans, Erin; Oral, Resmiye; Denning, Gerene

2018-04-10

Only 14 states have laws or guidelines regarding the minimum age a child may be left home alone. These ages range from 6 to 14 years. Our objective was to identify factors that influence child neglect determination by experts with regards to parents leaving children home alone. American Academy of Pediatrics Section on Child Abuse and Neglect members (N = 523) were surveyed from July-August, 2015. Respondents were asked whether scenarios involving a child of varying age knowingly left home alone for 4 h were neglect in the presence or absence of injury to the child and the legality of the situation. Comparisons were performed using the chi-square test. One hundred ninety-three members responded (36.9%). In the scenario where there were no relevant laws and the child was uninjured, nearly 100% of the child experts determined this as being child neglect when the child was 6 years old. For 8, 10, 12, and 14 year olds, this was 88, 48, 4, and 1%, respectively. However, a significantly higher percentage of experts considered it child neglect for most ages when there was a law making the scenario illegal as compared when there was no law, and when the child was injured versus when they were not. The only demographic variable that showed a difference in child neglect determination was that females were more likely to consider higher aged children as having been neglected when there were no laws but the child was injured. The vast majority of experts (85%) stated that leaving a child home alone for 4 h should be illegal if the child is < 9 years old, and nearly one-half (44%) said it should be illegal for children < 11 years old. A number of factors affect how experts view children being left home alone as potential child neglect. Our data suggests that such cases may be evaluated differently due to variations in state laws, even though the risk to the child is the same. These results call for child safety law reform to provide greater uniformity in the

Ask the experts.

PubMed

Pecoul, Bernard; Pollastri, Michael; McKerrow, James; Bueno-Calderon, Jose Maria

2012-07-01

The Uniting to Combat Neglected Tropical Diseases partners, including the US, UK, UAE and other national governments, along with 13 pharmaceutical industry businesses, the World Bank, the Bill and Melinda Gates Foundation, and other neglected tropical disease-endemic countries, announced that they are to join together to drive research and innovation for the treatment of neglected tropical diseases. The collaboration will see neglected tropical disease-endemic countries work alongside these organizations with the goal of fueling R&D of treatments for ten neglected tropical diseases in support of WHO's 2020 goals. Isaac Bruce, Commissioning Editor, spoke to four experts in the field from academia, not-for-profit organizations and the pharmaceutical industry, and asked their opinions on the partnerships announced and what the status of neglected tropical disease research will be at the end of this decade.

Planning for the Neglected Majority

ERIC Educational Resources Information Center

Beebe, Anthony E.

2007-01-01

The "Neglected Majority" represents that 70 to 80 percent of our nation's population who, for a myriad of reasons, do not hold baccalaureate degrees. In 1985, Dale Parnell, Ed.D., described this "Neglected Majority" for the first time in one of the most influential works in the history of the community college movement. This…

Is "Object-Centred Neglect" a Homogeneous Entity?

ERIC Educational Resources Information Center

Gainotti, Guido; Ciaraffa, Francesca

2013-01-01

The nature of object-centred (allocentric) neglect and the possibility of dissociating it from egocentric (subject-centred) forms of neglect are controversial. Originally, allocentric neglect was described by and in patients who reproduced all the elements of a multi-object scene, but left unfinished the left side of one or more of them. More…

Other Safety Concerns and Self-Neglect

MedlinePlus

... Program Application Frequently Asked Questions DONATE Other Safety Concerns and Self-Neglect Other safety concerns focus on ... for additional information. When To Report Other Safety Concerns and Self-Neglect? If you witness a life- ...

Empathy and child neglect: a theoretical model.

PubMed

De Paul, Joaquín; Guibert, María

2008-11-01

To present an explanatory theory-based model of child neglect. This model does not address neglectful behaviors of parents with mental retardation, alcohol or drug abuse, or severe mental health problems. In this model parental behavior aimed to satisfy a child's need is considered a helping behavior and, as a consequence, child neglect is considered as a specific type of non-helping behavior. The central hypothesis of the theoretical model presented here suggests that neglectful parents cannot develop the helping response set to care for their children because the observation of a child's signal of need does not lead to the experience of emotions that motivate helping or because the parents experience these emotions, but specific cognitions modify the motivation to help. The present theoretical model suggests that different typologies of neglectful parents could be developed based on different reasons that parents might not to experience emotions that motivate helping behaviors. The model can be helpful to promote new empirical studies about the etiology of different groups of neglectful families.

Simulating hemispatial neglect with virtual reality.

PubMed

Baheux, Kenji; Yoshizawa, Makoto; Yoshida, Yasuko

2007-07-19

Hemispatial neglect is a cognitive disorder defined as a lack of attention for stimuli contra-lateral to the brain lesion. The assessment is traditionally done with basic pencil and paper tests and the rehabilitation programs are generally not well adapted. We propose a virtual reality system featuring an eye-tracking device for a better characterization of the neglect that will lead to new rehabilitation techniques. This paper presents a comparison of eye-gaze patterns of healthy subjects, patients and healthy simulated patients on a virtual line bisection test. The task was also executed with a reduced visual field condition hoping that fewer stimuli would limit the neglect. We found that patients and healthy simulated patients had similar eye-gaze patterns. However, while the reduced visual field condition had no effect on the healthy simulated patients, it actually had a negative impact on the patients. We discuss the reasons for these differences and how they relate to the limitations of the neglect simulation. We argue that with some improvements the technique could be used to determine the potential of new rehabilitation techniques and also help the rehabilitation staff or the patient's relatives to better understand the neglect condition.

Neglected locked vertical patellar dislocation

PubMed Central

Gupta, Rakesh Kumar; Gupta, Vinay; Sangwan, Sukhbir Singh; Kamboj, Pradeep

2012-01-01

Patellar dislocations occurring about the vertical and horizontal axis are rare and irreducible. The neglected patellar dislocation is still rarer. We describe the clinical presentation and management of a case of neglected vertical patellar dislocation in a 6 year-old boy who sustained an external rotational strain with a laterally directed force to his knee. Initially the diagnosis was missed and 2 months later open reduction was done. The increased tension generated by the rotation of the lateral extensor retinaculum kept the patella locked in the lateral gutter even with the knee in full extension. Traumatic patellar dislocation with rotation around a vertical axis has been described earlier, but no such neglected case has been reported to the best of our knowledge. PMID:23162154

Five thousand years of tropical lake sediment DNA records from Benin

NASA Astrophysics Data System (ADS)

Bremond, L.; Favier, C.; Ficetola, G. F.; Tossou, M. G.; Akouégninou, A.; Gielly, L.; Giguet-Covex, C.; Oslisly, R.; Salzmann, U.

2017-08-01

Until now, sedimentary DNA (sedDNA) studies have only focused on cold and temperate regions were DNA is relatively well preserved. Consequently, the tropics, where vegetation is hyperdiverse and natural archives are rare, have been neglected and deserve attention. In this study, we used next-generation sequencing to barcode sedDNA from Lake Sele, localized in the tropical lowlands of Benin (Africa), and compared the taxonomic diversity detected by DNA analyses with pollen assemblages. Plant sedDNA was successfully amplified from 33 of the 34 successfully extracted samples. In total, 43 taxa were identified along the 5000 years spanned by the sediment: 22 taxa were identified at the family level and 21 at the genus level. The plant diversity recovered through sedDNA from Lake Sele showed a specific local signal and limited overlapping with pollen. Introduced plants, grown and cultivated close to the water, such as sweet potato, were also well recorded by sedDNA. It appears, therefore, to be a promising approach to studying past diversity in tropical regions, and could help in tracking the introduction and history of agriculture. This is the first time this method has been used in the field of domestication and dissemination of several specific crops, and the results are very encouraging.

Clock-drawing test and unilateral spatial neglect.

PubMed

Ishiai, S; Sugishita, M; Ichikawa, T; Gono, S; Watabiki, S

1993-01-01

We investigated the ability of 25 patients with left unilateral spatial neglect to make a clock face by putting numbers inside a printed circle. Impairment seen in this clock-drawing test did not parallel neglect severity as judged by results of the line-cancellation and line-bisection tests, as well as the copying of a daisy. The score for clock drawing correlated highly with the verbal WAIS score. Most neglect patients with a verbal IQ of 87 or more could draw a clock face fairly well and used planning in placing the numbers 12, 3, 6, and 9 before the others. In clock drawing, verbal intelligence may compensate for left unilateral spatial neglect. We therefore recommend use of the line-cancellation and line-bisection tests, as well as the copying test, but do not recommend use of the clock-drawing test in the diagnosis of left unilateral spatial neglect.

Bisecting or Not Bisecting: This Is the Neglect Question. Line Bisection Performance in the Diagnosis of Neglect in Right Brain-Damaged Patients

PubMed Central

Guariglia, Paola; Matano, Alessandro; Piccardi, Laura

2014-01-01

In the present study we analysed the bisecting behaviour of 287 chronic right brain-damaged patients by taking into account the presence and severity of extrapersonal and/or personal neglect diagnosed with the hemineglect battery. We also analysed right brain-damaged patients who had (or did not have) neglect according to their line bisection performance. Our results showed that performance of the line bisection task correlates with performance of cancellation tasks, reading and perceptual tasks, but not with the presence of personal neglect. Personal neglect seems to be unrelated to line bisection behaviour. Indeed, patients affected by extrapersonal and personal neglect do not show more severe neglect in line bisection than patients with only extrapersonal neglect. Furthermore, we observed that 20.56% of the patients were considered affected or not by neglect on the line bisection task compared with the other spatial tasks of the hemineglect battery. We conclude that using a battery with multiple tests is the only way to guarantee a reliable diagnosis and effectively plan for rehabilitative training. PMID:24937472

Reporting Fatal Neglect in Child Death Review.

PubMed

Scott, Debbie

2018-01-01

Child death reviews are conducted with the aim of preventing child deaths however, definitions, inclusion criteria for the review of child deaths and reporting practices vary across Child Death Review Teams (CDRTs). This article aims to identify a common context and understanding of fatal neglect reporting by reviewing definitional issues of fatal neglect and comparing reporting practice across a number of CDRTs. Providing a consistent context for identifying and reporting neglect-related deaths may improve the understanding of the impact of fatal neglect and the risk factors associated with it and therefore, improve the potential of CDRT review to inform prevention programs, policies, and procedures.

Tackling the challenges of matching biomedical ontologies.

PubMed

Faria, Daniel; Pesquita, Catia; Mott, Isabela; Martins, Catarina; Couto, Francisco M; Cruz, Isabel F

2018-01-15

Biomedical ontologies pose several challenges to ontology matching due both to the complexity of the biomedical domain and to the characteristics of the ontologies themselves. The biomedical tracks in the Ontology Matching Evaluation Initiative (OAEI) have spurred the development of matching systems able to tackle these challenges, and benchmarked their general performance. In this study, we dissect the strategies employed by matching systems to tackle the challenges of matching biomedical ontologies and gauge the impact of the challenges themselves on matching performance, using the AgreementMakerLight (AML) system as the platform for this study. We demonstrate that the linear complexity of the hash-based searching strategy implemented by most state-of-the-art ontology matching systems is essential for matching large biomedical ontologies efficiently. We show that accounting for all lexical annotations (e.g., labels and synonyms) in biomedical ontologies leads to a substantial improvement in F-measure over using only the primary name, and that accounting for the reliability of different types of annotations generally also leads to a marked improvement. Finally, we show that cross-references are a reliable source of information and that, when using biomedical ontologies as background knowledge, it is generally more reliable to use them as mediators than to perform lexical expansion. We anticipate that translating traditional matching algorithms to the hash-based searching paradigm will be a critical direction for the future development of the field. Improving the evaluation carried out in the biomedical tracks of the OAEI will also be important, as without proper reference alignments there is only so much that can be ascertained about matching systems or strategies. Nevertheless, it is clear that, to tackle the various challenges posed by biomedical ontologies, ontology matching systems must be able to efficiently combine multiple strategies into a mature matching

Pleistocene tropical Pacific temperature sensitivity to radiative greenhouse gas forcing

NASA Astrophysics Data System (ADS)

Dyck, K. A.; Ravelo, A. C.

2011-12-01

How high will Earth's global average surface temperature ultimately rise as greenhouse gas concentrations increase in the future? One way to tackle this question is to compare contemporaneous temperature and greenhouse gas concentration data from paleoclimate records, while considering that other radiative forcing mechanisms (e.g. changes in the amount and distribution of incoming solar radiation associated with changes in the Earth's orbital configuration) also contribute to surface temperature change. Since the sensitivity of surface temperature varies with location and latitude, here we choose a central location representative of the west Pacific warm pool, far from upwelling regions or surface temperature gradients in order to minimize climate feedbacks associated with high-latitude regions or oceanic dynamics. The 'steady-state' or long-term temperature change associated with greenhouse gas radiative forcing is often labeled as equilibrium (or 'Earth system') climate sensitivity to the doubling of atmospheric greenhouse gas concentration. Climate models suggest that Earth system sensitivity does not change dramatically over times when CO2 was lower or higher than the modern atmospheric value. Thus, in our investigation of the changes in tropical SST, from the glacial to interglacial states when greenhouse gas forcing nearly doubled, we use Late Pleistocene paleoclimate records to constrain earth system sensitivity for the tropics. Here we use Mg/Ca-paleothermometry using the foraminifera G. ruber from ODP Site 871 from the past 500 kyr in the western Pacific warm pool to estimate tropical Pacific equilibrium climate sensitivity to a doubling of greenhouse gas concentrations to be ~4°C. This tropical SST sensitivity to greenhouse gas forcing is ~1-2°C higher than that predicted by climate models of past glacial periods or future warming for the tropical Pacific. Equatorial Pacific SST sensitivity may be higher than predicted by models for a number of reasons

A Legal Approach to Tackling Contract Cheating?

ERIC Educational Resources Information Center

Draper, Michael J.; Newton, Philip M.

2017-01-01

The phenomenon of contract cheating presents, potentially, a serious threat to the quality and standards of Higher Education around the world. There have been suggestions, cited below, to tackle the problem using legal means, but we find that current laws are not fit for this purpose. In this article we present a proposal for a specific new law to…

Error Types and Error Positions in Neglect Dyslexia: Comparative Analyses in Neglect Patients and Healthy Controls

ERIC Educational Resources Information Center

Weinzierl, Christiane; Kerkhoff, Georg; van Eimeren, Lucia; Keller, Ingo; Stenneken, Prisca

2012-01-01

Unilateral spatial neglect frequently involves a lateralised reading disorder, neglect dyslexia (ND). Reading of single words in ND is characterised by left-sided omissions and substitutions of letters. However, it is unclear whether the distribution of error types and positions within a word shows a unique pattern of ND when directly compared to…

How Neglect and Punitiveness Influence Emotion Knowledge

PubMed Central

Sullivan, Margaret Wolan; Carmody, Dennis P.

2010-01-01

To explore whether punitive parenting styles contribute to early-acquired emotion knowledge deficits observable in neglected children, we observed 42 preschool children’s emotion knowledge, expression recognition time, and IQ. The children’s mothers completed the Parent–Child Conflict Tactics Scales to assess the recent use of three types of discipline strategies (nonviolent, physically punitive, and psychological aggression), as well as neglectful parenting. Fifteen of the children were identified as neglected by Child Protective Services (CPS) reports; 27 children had no record of CPS involvement and served as the comparison group. There were no differences between the neglect and comparison groups in the demographic factors of gender, age, home language, minority status, or public assistance, nor on IQ. Hierarchical multiple regression modeling showed that neglect significantly predicted emotion knowledge. The addition of IQ contributed a significant amount of additional variance to the model and maintained the fit. Adding parental punitiveness in the final stage contributed little additional variance and did not significantly improve the fit. Thus, deficits in children’s emotion knowledge may be due primarily to lower IQ or neglect. IQ was unrelated to speed of emotion recognition. Punitiveness did not directly contribute to emotion knowledge deficits but appeared in exploratory analysis to be related to speed of emotion recognition. PMID:20099078

How neglect and punitiveness influence emotion knowledge.

PubMed

Sullivan, Margaret Wolan; Carmody, Dennis P; Lewis, Michael

2010-06-01

To explore whether punitive parenting styles contribute to early-acquired emotion knowledge deficits observable in neglected children, we observed 42 preschool children's emotion knowledge, expression recognition time, and IQ. The children's mothers completed the Parent-Child Conflict Tactics Scales to assess the recent use of three types of discipline strategies (nonviolent, physically punitive, and psychological aggression), as well as neglectful parenting. Fifteen of the children were identified as neglected by Child Protective Services (CPS) reports; 27 children had no record of CPS involvement and served as the comparison group. There were no differences between the neglect and comparison groups in the demographic factors of gender, age, home language, minority status, or public assistance, nor on IQ. Hierarchical multiple regression modeling showed that neglect significantly predicted emotion knowledge. The addition of IQ contributed a significant amount of additional variance to the model and maintained the fit. Adding parental punitiveness in the final stage contributed little additional variance and did not significantly improve the fit. Thus, deficits in children's emotion knowledge may be due primarily to lower IQ or neglect. IQ was unrelated to speed of emotion recognition. Punitiveness did not directly contribute to emotion knowledge deficits but appeared in exploratory analysis to be related to speed of emotion recognition.

Representational neglect for words as revealed by bisection tasks.

PubMed

Arduino, Lisa S; Marinelli, Chiara Valeria; Pasotti, Fabrizio; Ferrè, Elisa Raffaella; Bottini, Gabriella

2012-03-01

In the present study, we showed that a representational disorder for words can dissociate from both representational neglect for objects and neglect dyslexia. This study involved 14 brain-damaged patients with left unilateral spatial neglect and a group of normal subjects. Patients were divided into four groups based on presence of left neglect dyslexia and representational neglect for non-verbal material, as evaluated by the Clock Drawing test. The patients were presented with bisection tasks for words and lines. The word bisection tasks (with words of five and seven letters) comprised the following: (1) representational bisection: the experimenter pronounced a word and then asked the patient to name the letter in the middle position; (2) visual bisection: same as (1) with stimuli presented visually; and (3) motor bisection: the patient was asked to cross out the letter in the middle position. The standard line bisection task was presented using lines of different length. Consistent with the literature, long lines were bisected to the right and short lines, rendered comparable in length to the words of the word bisection test, deviated to the left (crossover effect). Both patients and controls showed the same leftward bias on words in the visual and motor bisection conditions. A significant difference emerged between the groups only in the case of the representational bisection task, whereas the group exhibiting neglect dyslexia associated with representational neglect for objects showed a significant rightward bias, while the other three patient groups and the controls showed a leftward bisection bias. Neither the presence of neglect alone nor the presence of visual neglect dyslexia was sufficient to produce a specific disorder in mental imagery. These results demonstrate a specific representational neglect for words independent of both representational neglect and neglect dyslexia. ©2011 The British Psychological Society.

Child Neglect: Developmental Issues and Outcomes.

ERIC Educational Resources Information Center

Hildyard, Kathryn L.; Wolfe, David A.

2002-01-01

This article reviews the effects of child neglect on three developmental periods: infancy/preschool, school-aged and younger adolescents, and older adolescents and adults. The severe cognitive and academic deficits, the social withdrawal and limited peer interactions, and the internalizing problems of neglected children relative to physically…

Patient neglect in healthcare institutions: a systematic review and conceptual model

PubMed Central

2013-01-01

Background Patient neglect is an issue of increasing public concern in Europe and North America, yet remains poorly understood. This is the first systematic review on the nature, frequency and causes of patient neglect as distinct from patient safety topics such as medical error. Method The Pubmed, Science Direct, and Medline databases were searched in order to identify research studies investigating patient neglect. Ten articles and four government reports met the inclusion criteria of reporting primary data on the occurrence or causes of patient neglect. Qualitative and quantitative data extraction investigated (1) the definition of patient neglect, (2) the forms of behaviour associated with neglect, (3) the reported frequency of neglect, and (4) the causes of neglect. Results Patient neglect is found to have two aspects. First, procedure neglect, which refers to failures of healthcare staff to achieve objective standards of care. Second, caring neglect, which refers to behaviours that lead patients and observers to believe that staff have uncaring attitudes. The perceived frequency of neglectful behaviour varies by observer. Patients and their family members are more likely to report neglect than healthcare staff, and nurses are more likely to report on the neglectful behaviours of other nurses than on their own behaviour. The causes of patient neglect frequently relate to organisational factors (e.g. high workloads that constrain the behaviours of healthcare staff, burnout), and the relationship between carers and patients. Conclusion A social psychology-based conceptual model is developed to explain the occurrence and nature of patient neglect. This model will facilitate investigations of i) differences between patients and healthcare staff in how they perceive neglect, ii) the association with patient neglect and health outcomes, iii) the relative importance of system and organisational factors in causing neglect, and iv) the design of interventions and

Unintentional child neglect: literature review and observational study.

PubMed

Friedman, Emily; Billick, Stephen B

2015-06-01

Child abuse is a problem that affects over six million children in the United States each year. Child neglect accounts for 78% of those cases. Despite this, the issue of child neglect is still not well understood, partially because child neglect does not have a consistent, universally accepted definition. Some researchers consider child neglect and child abuse to be one in the same, while other researchers consider them to be conceptually different. Factors that make child neglect difficult to define include: (1) Cultural differences; motives must be taken into account because parents may believe they are acting in the child's best interests based on cultural beliefs (2) the fact that the effect of child abuse is not always immediately visible; the effects of emotional neglect specifically may not be apparent until later in the child's development, and (3) the large spectrum of actions that fall under the category of child abuse. Some of the risk factors for increased child neglect and maltreatment have been identified. These risk factors include socioeconomic status, education level, family composition, and the presence of dysfunction family characteristics. Studies have found that children from poorer families and children of less educated parents are more likely to sustain fatal unintentional injuries than children of wealthier, better educated parents. Studies have also found that children living with adults unrelated to them are at increased risk for unintentional injuries and maltreatment. Dysfunctional family characteristics may even be more indicative of child neglect. Parental alcohol or drug abuse, parental personal history of neglect, and parental stress greatly increase the odds of neglect. Parental depression doubles the odds of child neglect. However, more research needs to be done to better understand these risk factors and to identify others. Having a clearer understanding of the risk factors could lead to prevention and treatment, as it would allow

Image of a line is not shrunk but neglected. Absence of crossover in unilateral spatial neglect.

PubMed

Ishiai, Sumio; Koyama, Yasumasa; Nakano, Naomi; Seki, Keiko; Nishida, Yoichiro; Hayashi, Kazuko

2004-01-01

Patients with left unilateral spatial neglect following right hemisphere lesions usually err rightward when bisecting a horizontal line. For very short lines (e.g. 25 mm), however, leftward errors or seemingly 'right' neglect is often observed. To explain this paradox of crossover in the direction of errors, rather complicated models have been introduced as to the distribution of attention. Neglect may be hypothesized to occur in representational process of a line or estimation of the midpoint on the formed image, or both. We devised a line image task using a computer display with a touch panel and approached the representational image of a line to be bisected. Three patients with typical left neglect were presented with a line and forced to see its whole extent with cueing to the left endpoint. After disappearance of the line, they pointed to the right endpoint, the left endpoint, or the subjective midpoint according to their representational image. The line image between the reproduced right and left endpoints was appropriately formed for the 200 mm lines. However, the images for the shorter 25 and 100 mm lines were longer than the physical lengths with overextension to the left side. These results proved the context effect that short lines may be perceived longer when they are presented in combination with longer lines. One of our patients had an extensive lesion that involved the frontal, temporal, and parietal lobes, and the other two had a lesion restricted to the posterior right hemisphere. The image for a fully perceived line may be represented far enough into left space even when left neglect occurs after a lesion that involves the right parietal lobe. The patients with neglect placed the subjective midpoint rightward from the centre of the stimulus line for the 100 and 200 mm lines and leftward for the 25 mm lines. This crossover of bisection errors disappeared when the displacement of the subjective midpoint was measured from the centre of the

[Tropical and travel-related dermatomycoses: Part 1: Dermatophytoses].

PubMed

Nenoff, P; Reinel, D; Krüger, C; Grob, H; Mugisha, P; Süß, A; Mayser, P

2015-06-01

Today, tropical and travel-related dermatomycoses must be increasingly anticipated to present in dermatological offices and clinics. Skin infections due to dermatophytes or other fungi may occur after a journey in countries with a high prevalence for the respective causative fungal pathogen, e.g., tinea corporis due to Trichophyton soudanense. Otherwise, more frequently, single infections and even localized outbreaks due to "exotic" or "imported" pathogens of dermatophytoses occur. These epidemics are observed in childcare facilities in Germany and in other European countries. Source of infection are immigrants from Africa and sometimes from Asian countries. Furthermore, African children, and sometimes also adults, are often only asymptomatic carriers of such anthropophilic dermatophytes. Outbreaks of dermatophyte infections with one and more affected children and also adult staff and teachers due to Trichophyton violaceum or Microsporum audouinii in kindergartens and schools are not a rarity these days. Further tropical and travel-associated dermatophytes are Trichophyton tonsurans, Trichophyton schoenleinii, and Trichophyton concentricum. Tinea capitis should be treated in a species-specific manner. Griseofulvin is the treatment of choice for infections due to Microsporum species. In contrast, tinea capitis due to Trichophyton species has to be treated by terbinafine, however, because the agent is not approved for children in Germany, only after receiving written consent of parents. Alternatives are fluconazole and itraconazole. Onset and aggravation of tinea pedis during travel has its origin in a preexisting neglected fungal infection of the feet. In the tropics, exacerbations and secondary bacterial complications of tinea pedis develop under distinctly promoting conditions.

Base Rates: Both Neglected and Intuitive

ERIC Educational Resources Information Center

Pennycook, Gordon; Trippas, Dries; Handley, Simon J.; Thompson, Valerie A.

2014-01-01

Base-rate neglect refers to the tendency for people to underweight base-rate probabilities in favor of diagnostic information. It is commonly held that base-rate neglect occurs because effortful (Type 2) reasoning is required to process base-rate information, whereas diagnostic information is accessible to fast, intuitive (Type 1) processing…

Nonverbal Behavior of Young Abused and Neglected Children.

ERIC Educational Resources Information Center

Hecht, Michael L.; And Others

A study was conducted to examine the effects of child abuse and neglect on children's nonverbal behaviors. It was hypothesized that abused and neglected children would be less active nonverbally than would control group children. Eight abused and neglected children, aged one through three years, were videotaped interacting with their caregivers in…

Parental Refusal of Childhood Vaccines and Medical Neglect Laws.

PubMed

Parasidis, Efthimios; Opel, Douglas J

2017-01-01

To examine the relation of vaccine refusal and medical neglect under child welfare laws. We used the Westlaw legal database to search court opinions from 1905 to 2016 and identified cases in which vaccine refusal was the sole or a primary reason in a neglect proceeding. We also delineated if religious or philosophical exemptions from required school immunizations were available at the time of adjudication. Our search yielded 9 cases from 5 states. Most courts (7 of 9) considered vaccine refusal to constitute neglect. In the 4 cases decided in jurisdictions that permitted religious exemptions, courts either found that vaccine refusal did not constitute neglect or considered it neglect only in the absence of a sincere religious objection to vaccination. Some states have a legal precedent for considering parental vaccine refusal as medical neglect, but this is based on a small number of cases. Each state should clarify whether, under its laws, vaccine refusal constitutes medical neglect.

Peste des petits ruminants (PPR): A neglected tropical disease in Maghreb region of North Africa and its threat to Europe.

PubMed

Baazizi, Ratiba; Mahapatra, Mana; Clarke, Brian Donald; Ait-Oudhia, Khatima; Khelef, Djamel; Parida, Satya

2017-01-01

Peste des petits ruminants (PPR) is a contagious disease listed by the World Organisation for Animal health (OIE) as being a specific hazard. It affects sheep, goats, and wild ungulates, and is prevalent throughout the developing world particularly Asia, the Middle East, and Africa. PPR has been targeted for eradication by 2030 by the Food and Agriculture Organization of the United Nations (FAO) and the OIE, after the successful eradication of the related disease, rinderpest in cattle. PPR was first reported in 1942 in the Ivory Coast in Western Africa and has since extended its range in Asia, the Middle East, and Africa posing an immediate threat of incursion into Europe, South East Asia and South Africa. Although robust vaccines are available, the use of these vaccines in a systematic and rational manner is not widespread, resulting in this devastating disease becoming an important neglected tropical disease in the developing world. We isolated and characterized the PPR virus from an outbreak in Cheraga, northern Algeria, during October 2015 by analyzing the partial N-gene sequence in comparison with other viruses from the Maghreb region. As well as sequencing the full length viral genome and performing real-time RT-PCR on clinical samples. Maximum-likelihood and Bayesian temporal and phylogeographic analyses were performed to assess the persistence and spread of PPRV circulation from Eastern Africa in the Maghreb region of North Africa. Recent PPR outbreaks in Cheraga, in the northern part of Algiers (October 2015) and North-West Morocco (June, 2015) highlight that PPRV has spread to the northern border of North Africa and may pose a threat of introduction to Europe. Phylogeographic analysis suggests that lineage IV PPRV has spread from Eastern Africa, most likely from the Sudan 2000 outbreak, into Northern Africa resulting in the 2008 Moroccan outbreak. Maximum-likelihood and Bayesian analysis shows that these North African viruses cluster closely together

Novel Insights in the Rehabilitation of Neglect

PubMed Central

Fasotti, Luciano; van Kessel, Marlies

2013-01-01

Visuospatial neglect due to right hemisphere damage, usually a stroke, is a major cause of disability, impairing the ability to perform a whole range of everyday life activities. Conventional and long-established methods for the rehabilitation of neglect like visual scanning training, optokinetic stimulation, or limb activation training have produced positive results, with varying degrees of generalization to (un)trained tasks, lasting from several minutes up to various months after training. Nevertheless, some promising novel approaches to the remediation of left visuospatial neglect have emerged in the last decade. These new therapy methods can be broadly classified into four categories. First, non-invasive brain stimulation techniques by means of transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS), after a period of mainly diagnostic utilization, are increasingly applied as neurorehabilitative tools. Second, two classes of drugs, dopaminergic and noradrenergic, have been investigated for their potential effectiveness in rehabilitating neglect. Third, prism adaptation treatment has been shown to improve several neglect symptoms consistently, sometimes during longer periods of time. Finally, virtual reality technologies hold new opportunities for the development of effective training techniques for neglect. They provide realistic, rich, and highly controllable training environments. In this paper the degree of effectiveness and the evidence gathered to support the therapeutic claims of these new approaches is reviewed and discussed. The conclusion is that for all these approaches there still is insufficient unbiased evidence to support their effectiveness. Further neglect rehabilitation research should focus on the maintenance of therapy results over time, on a more functional evaluation of treatment effects, on the design and execution of true replication studies and on the exploration of optimal combinations of treatments

Analysis of North Atlantic tropical cyclone intensify change using data mining

NASA Astrophysics Data System (ADS)

Tang, Jiang

Tropical cyclones (TC), especially when their intensity reaches hurricane scale, can become a costly natural hazard. Accurate prediction of tropical cyclone intensity is very difficult because of inadequate observations on TC structures, poor understanding of physical processes, coarse model resolution and inaccurate initial conditions, etc. This study aims to tackle two factors that account for the underperformance of current TC intensity forecasts: (1) inadequate observations of TC structures, and (2) deficient understanding of the underlying physical processes governing TC intensification. To tackle the problem of inadequate observations of TC structures, efforts have been made to extract vertical and horizontal structural parameters of latent heat release from Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) data products. A case study of Hurricane Isabel (2003) was conducted first to explore the feasibility of using the 3D TC structure information in predicting TC intensification. Afterwards, several structural parameters were extracted from 53 TRMM PR 2A25 observations on 25 North Atlantic TCs during the period of 1998 to 2003. A new generation of multi-correlation data mining algorithm (Apriori and its variations) was applied to find roles of the latent heat release structure in TC intensification. The results showed that the buildup of TC energy is indicated by the height of the convective tower, and the relative low latent heat release at the core area and around the outer band. Adverse conditions which prevent TC intensification include the following: (1) TC entering a higher latitude area where the underlying sea is relative cold, (2) TC moving too fast to absorb the thermal energy from the underlying sea, or (3) strong energy loss at the outer band. When adverse conditions and amicable conditions reached equilibrium status, tropical cyclone intensity would remain stable. The dataset from Statistical Hurricane Intensity Prediction

How Can Elispot Add Information to Improve Knowledge on Tropical Diseases?

PubMed Central

Lima-Junior, Josué da Costa; Conceição-Silva, Fátima

2017-01-01

Elispot has been used as an important tool for detecting immune cells’ products and functions and has facilitated the understanding of host-pathogen interaction. Despite the incredible diversity of possibilities, two main approaches have been developed: the immunopathogenesis and diagnosis/prognosis of infectious diseases as well as cancer research. Much has been described on the topics of allergy, autoimmune diseases, and HIV-Aids, however, Elispot can also be applied to other infectious diseases, mainly leishmaniasis, malaria, some viruses, helminths and mycosis usually classified as tropical diseases. The comprehension of the function, concentration and diversity of the immune response in the infectious disease is pointed out as crucial to the development of infection or disease in humans and animals. In this review we will describe the knowledge already obtained using Elispot as a method for accessing the profile of immune response as well as the recent advances in information about host-pathogen interaction in order to better understand the clinical outcome of a group of tropical and neglected diseases. PMID:28961208

Ecological correlates of neglect in infants and toddlers.

PubMed

Connell-Carrick, Kelli; Scannapieco, Maria

2006-03-01

Infants and toddlers are more likely to be victims of neglect than any other form of maltreatment. Infants and toddlers are at highest risk of fatality because of maltreatment and experience behavioral, social, academic, medical, and cognitive consequences of neglect during their most formative years. Within an ecological framework, this study examines the correlates of the substantiation of neglect in children 0 to 36 months of age. Using an ex post facto design and a random sample of 148 child protective services cases, bivariate analysis revealed significant differences in families who were substantiated for neglect in the areas of child characteristics, home environment, social environment, caregiver, and maltreatment situations. Multivariate analysis found children who were substantiated for neglect were exposed to greater environmental dangers and had caregivers who had poor parenting skills. Implications for practice and future research are discussed.

Seasonal Variation of Ozone in the Tropical Lower Stratosphere: Southern Tropics are Different from Northern Tropics

NASA Technical Reports Server (NTRS)

Stolarski, Richard S.; Waugh, Darryn W.; Wang, Lei,; Oman, Luke D.; Douglass, Anne R.; Newman, Paul A.

2014-01-01

We examine the seasonal behavior of ozone by using measurements from various instruments including ozonesondes, Aura Microwave Limb Sounder, and Stratospheric Aerosol and Gas Experiment II. We find that the magnitude of the annual variation in ozone, as a percentage of the mean ozone, exhibits a maximum at or slightly above the tropical tropopause. The maximum is larger in the northern tropics than in the southern tropics, and the annual maximum of ozone in the southern tropics occurs 2 months later than that in the northern tropics, in contrast to usual assumption that the tropics can be treated as a horizontally homogeneous region. The seasonal cycles of ozone and other species in this part of the lower stratosphere result from a combination of the seasonal variation of the Brewer-Dobson circulation and the seasonal variation of tropical and midlatitude mixing. In the Northern Hemisphere, the impacts of upwelling and mixing between the tropics and midlatitudes on ozone are in phase and additive. In the Southern Hemisphere, they are not in phase. We apply a tropical leaky pipe model independently to each hemisphere to examine the relative roles of upwelling and mixing in the northern and southern tropical regions. Reasonable assumptions of the seasonal variation of upwelling and mixing yield a good description of the seasonal magnitude and phase in both the southern and northern tropics. The differences in the tracers and transport between the northern and southern tropical stratospheres suggest that the paradigm of well-mixed tropics needs to be revised to consider latitudinal variations within the tropics.

Tropical Convection's Roles in Tropical Tropopause Cirrus

NASA Technical Reports Server (NTRS)

Boehm, Matthew T.; Starr, David OC.; Verlinde, Johannes; Lee, Sukyoung

2002-01-01

The results presented here show that tropical convection plays a role in each of the three primary processes involved in the in situ formation of tropopause cirrus. First, tropical convection transports moisture from the surface into the upper troposphere. Second, tropical convection excites Rossby waves that transport zonal momentum toward the ITCZ, thereby generating rising motion near the equator. This rising motion helps transport moisture from where it is detrained from convection to the cold-point tropopause. Finally, tropical convection excites vertically propagating tropical waves (e.g. Kelvin waves) that provide one source of large-scale cooling near the cold-point tropopause, leading to tropopause cirrus formation.

Development and Psychometric Evaluation of the Child Neglect Questionnaire.

PubMed

Stewart, Chris; Kirisci, Levent; Long, Abigail L; Giancola, Peter R

2015-11-01

Neglect poses a significant risk for children throughout their development and is often linked with serious consequences that reach into adulthood. The Child Neglect Questionnaire (CNQ) fills existing gaps by incorporating multiple perspectives from both parents and the child, as well as measuring the complex phenomenon of neglect multidimensionally. Furthermore, this measure addresses the need for an instrument specifically developed for late childhood (ages 10-12), as much of the extant evidence and corresponding measures focus on young children and their mothers. A panel of three psychologists, using Cicchetti's model of child neglect as a theoretical guide, began by selecting items from an existing database. Results of exploratory and confirmatory factor analyses and item response theory demonstrated the unidimensionality of physical, emotional, educational, and supervision neglect as well as a second-order construct of child neglect. Analyses controlling for risk status due to father's substance use disorder, socioeconomic status, and child's ethnicity demonstrated that father's and mother's (parental) neglect, particularly in the child's versions, had sound concurrent and predictive validity. Concurrently, at age 10-12, the child's version of both parents' neglect correlated with their parenting behaviors evaluated by other available measures. Prospectively, from 10-12 years of age to 11-13 years of age, parental neglect predicted child's drug use frequency with coexisting psychological dysregulation, psychiatric symptoms, antisocial behavior, non-normative sexual behavior, involvement with deviant peers and leisure activities thus demonstrating sound predictive validity. Also, internal consistency and inter-rater reliability were excellent. The CNQ, particularly the child's version, may thus be useful for detecting children at high risk for parental neglect. © The Author(s) 2014.

PhyloChip Tackles Coral Disease

ScienceCinema

Todd DeSantis

2017-12-09

Scientists at Berkeley Lab and the University of California, Merced are using an innovative DNA array developed at Berkeley Lab to catalog the microbes that live among coral in the tropical waters off the coast of Puerto Rico.

[Status of research and development for control of tropical diseases: hypocrisy, indifference or lack of coordination].

PubMed

Millet, P

2006-12-01

Tropical diseases neglected by the pharmaceutical industry usually involve developing countries. Neglected diseases can now be divided into two groups. The first includes the big three infections i.e., malaria, HIV/AIDS, and tuberculosis, that present strategic and political overtones. The second group includes a host of other fatal infections including worms, trypanosomiasis, and leishmaniasis. Fundamental research on neglected diseases has been highly productive, but there has been little success in transferring research findings to a pharmaceutical industry unwilling to take the risks associated with developing new drugs on its own. However several public-private initiatives have revived hopes of developing new products with growing involvement of industries in developing countries (India and Brazil) despite the high risks associated with fluctuating demand for medicines or funding shortages. To meet the need for testing new drugs, more clinical facilities and better patient recruitment will be needed in endemic countries. Although these new efforts to control neglected diseases are encouraging, there is now a need for coordination. Clinical research in developing countries must be organized in compliance with international principles of ethics. Testing must be aimed at validating fundamental data from industrialized countries. Appropriate incentives must be given to ensure that pharmaceutical companies use research findings for new product development. In this context, the time seems ripe for the establishment of an independent laboratory for technological innovation in neglected diseases. Such a facility could not only validate scientific data but also supervise the development of clinical applications from research data.

Patterns of Language Comprehension Deficit in Abused and Neglected Children.

ERIC Educational Resources Information Center

Fox, Lynn; And Others

1988-01-01

A study of the relationship between child abuse/neglect and language disability compared 30 abused, generally neglected, or severely neglected children, aged 3-8, to 10 nonabused controls. Results on language comprehension tests suggest that abused and severely neglected children show greater difficulty with language comprehension tasks than their…

The microbial perspective of organic matter turnover and nutrient cycling in tropical soils

NASA Astrophysics Data System (ADS)

Rasche, Frank

2017-04-01

A primary goal of low-input small-holder farming systems in the tropics is the appropriate management of organic matter (OM) turnover and nutrient cycling via adapted agricultural practices. These emphasize the promotion of soil organic matter (SOM) turnover and carbon (C) sequestration, nutrient use efficiency and soil microbial activity. Since soil microbial communities are acknowledged as key players in the terrestrial C and nutrient (e.g., nitrogen (N), phosphorus (P)) cycles, they may respond sensitively to agricultural management with shifts in their community structure as well as functional traits (i.e., decomposition, mineralization). This may be in particular evident for tropical, agricultural soils which show an accelerated microbial decomposition activity induced by favourable climatic and unique physico-chemical soil conditions. While modern molecular techniques advanced primarily the understanding about the microbiome and their functional traits interacting closely with SOM dynamics in temperate soils, tropical soils under agricultural use have been still neglected to a great extent. The majority of available studies revealed mainly descriptive data on the structural composition of microbial communities rather than questioning if detected structural alterations of the soil microbiome influenced key processes in N and P cycling which actually maintain ecosystem functioning and soil productivity. This talk highlights latest efforts in deploying molecular techniques to study the compositional status of soil microbial decomposer communities and their functional attributes in response to land use change and OM management in tropical agro-ecosystems.

Tropical Glaciers

NASA Astrophysics Data System (ADS)

Fountain, Andrew

The term "tropical glacier" calls to mind balmy nights and palm trees on one hand and cold, blue ice on the other. Certainly author Gabriel Garcia Marqez exploited this contrast in One Hundred Years of Solitude. We know that tropical fish live in warm, Sun-kissed waters and tropical plants provide lush, dense foliage populated by colorful tropical birds. So how do tropical glaciers fit into this scene? Like glaciers everywhere, tropical glaciers form where mass accumulation—usually winter snow—exceeds mass loss, which is generally summer melt. Thus, tropical glaciers exist at high elevations where precipitation can occur as snowfall exceeds melt and sublimation losses, such as the Rwenzori Mountains in east Africa and the Maoke Range of Irian Jaya.

Using virtual reality to rehabilitate neglect.

PubMed

Sedda, A; Borghese, N A; Ronchetti, M; Mainetti, R; Pasotti, F; Beretta, G; Bottini, G

2013-01-01

Virtual Reality (VR) platforms gained a lot of attention in the rehabilitation field due to their ability to engage patients and the opportunity they offer to use real world scenarios. As neglect is characterized by an impairment in exploring space that greatly affects daily living, VR could be a powerful tool compared to classical paper and pencil tasks and computer training. Nevertheless, available platforms are costly and obstructive. Here we describe a low cost platform for neglect rehabilitation, that using consumer equipments allows the patient to train at home in an intensive fashion. We tested the platform on IB, a chronic neglect patient, who did not benefit from classical rehabilitation. Our results show that IB improved both in terms of neglect and attention. Importantly, these ameliorations lasted at a follow up evaluation 5 months after the last treatment session and generalized to everyday life activities. VR platforms built using equipment technology and following theoretical principles on brain functioning may induce greater ameliorations in visuo-spatial deficits than classical paradigms possibly thanks to the real world scenarios in association with the "visual feedback" of the patient's own body operating in the virtual environment.

[Family Health Strategies to tackle violence involving adolescents].

PubMed

Vieira Netto, Moysés Francisco; Deslandes, Suely Ferreira

2016-05-01

The Family Health Strategy (FHS) has an acknowledged potential for the promotion of health and the prevention of violence. This is an integrative bibliographic review with the aim of evaluating the performance of FHS professionals in tackling and preventing violence involving adolescents. It is an integrative review of dissertations and theses on healthcare published from 1994 to 2014. The collection of 17 dissertations and 2 doctoral theses reveals that these studies are recent. The FHS professionals acknowledge the vulnerability of adolescents to inflicting and being subject to violence, however the FHS proves ineffective in tackling and preventing such violence. The predominance of the medical technical care model, the deficiencies in Public Health education in professional training and the lack of institutional support are seen as the main obstacles. Many of these professionals are unaware of the files for notification of violence. The existence of family violence and criminal groups were the aspects most mentioned in the territories. The social representation of adolescents as being "problematic" and the lack of ESF actions that promote an increase youth leadership and empowerment were clearly detected.

Drugs for Neglected Diseases initiative model of drug development for neglected diseases: current status and future challenges.

PubMed

Ioset, Jean-Robert; Chang, Shing

2011-09-01

The Drugs for Neglected Diseases initiative (DNDi) is a patients' needs-driven organization committed to the development of new treatments for neglected diseases. Created in 2003, DNDi has delivered four improved treatments for malaria, sleeping sickness and visceral leishmaniasis. A main DNDi challenge is to build a solid R&D portfolio for neglected diseases and to deliver preclinical candidates in a timely manner using an original model based on partnership. To address this challenge DNDi has remodeled its discovery activities from a project-based academic-bound network to a fully integrated process-oriented platform in close collaboration with pharmaceutical companies. This discovery platform relies on dedicated screening capacity and lead-optimization consortia supported by a pragmatic, structured and pharmaceutical-focused compound sourcing strategy.

A brief history of British military experiences with infectious and tropical diseases.

PubMed

Bailey, Mark S

2013-09-01

Infectious and tropical diseases have been a problem for British expeditionary forces ever since the Crusades. Outbreaks were especially common on Navy ships from the 16th to 18th centuries due to poor living conditions and travel to the tropics. However, since these occurred in small, isolated and controlled environments it meant that naval medical practitioners were able to keep detailed records and develop empirical approaches for their prevention. The first Royal Naval Hospitals were established in response to these diseases and Royal Navy doctors made valuable early contributions towards understanding them. Even larger outbreaks of infectious and tropical diseases occurred in the Army during the Napoleonic, Crimean and Boer Wars and throughout the colonial era, which strongly influenced the formation of the Army Medical Services including provision for teaching and research. The establishment of germ theory led to a golden era of discovery regarding these diseases and British Army doctors made numerous important contributions. Subsequent improvements in prevention, diagnosis and treatment reduced the mortality from infectious and tropical diseases during the World Wars, but they remained a significant problem in the non-European campaigns and also the numerous 'small wars' that followed. Even in the 21st century some of these diseases still cause outbreaks with significant morbidity and impact on deployments, but the military clinical and academic resources to deal with them are now much reduced. Preventive measures such as hygiene, sanitation, infection control, vaccination and chemoprophylaxis are invaluable, but history shows that these can become neglected over time and disrupted or overwhelmed during the early or most intense stages of military operations. This is why military specialists in infectious diseases, tropical medicine, sexual health, medical microbiology and communicable diseases control are still required.

Child Abuse and Neglect in India.

PubMed

Seth, Rajeev

2015-08-01

India is home to the largest child population in the world, with almost 41 % of the total population under 18 y of age. The health and security of the country's children is integral to any vision for its progress and development. Doctors and health care professionals are often the first point of contact for abused and neglected children. They play a key role in detecting child abuse and neglect, provide immediate and longer term care and support to children. Despite being important stakeholders, often physicians have a limited understanding on how to protect these vulnerable groups. There is an urgent need for systematic training for physicians to prevent, detect and respond to cases of child abuse and neglect in the clinical setting. The purpose of the present article is to provide an overview of child abuse and neglect from a medical assessment to a socio-legal perspective in India, in order to ensure a prompt and comprehensive multidisciplinary response to victims of child abuse and neglect. During their busy clinical practice, medical professionals can also use the telephone help line (CHILDLINE telephone 1098) to refer cases of child abuse, thus connecting them to socio-legal services. The physicians should be aware of the new legislation, Protection of Children from Sexual Offences (POCSO) Act, 2012, which requires mandatory reporting of cases of child sexual abuse, failing which they can be penalized. Moreover, doctors and allied medical professionals can help prevent child sexual abuse by delivering the message of personal space and privacy to their young patients and parents.

Child Abuse and Neglect: A Curriculum Proposal.

ERIC Educational Resources Information Center

Gladbach, Randall M.; Wheeler, Virginia R.

1986-01-01

The presence of abused and neglected children in our nation's classrooms strongly argues the case for a curriculum component in both pre-service and in-service teacher education. The objectives and content of a child abuse and neglect curriculum component and its implementation are discussed.

The Making of a Self-Neglect Severity Scale

NASA Technical Reports Server (NTRS)

Smith, Scott M.; Dyer, C. B.; Pavlik, V. N.; Kelly, P. A.; Lee, J.; Doody, R. S.; Regev, C.; Pickens, C.; Burnett, J.

2006-01-01

Research in elder self-neglect has lagged behind that of other forms of mistreatment, despite the fact that self-neglect is the most common allegation reported to Adult Protective Service agencies throughout the US. The lack of a gold-standard to measure self-neglect has hampered efforts to study this phenomenon. Researchers designed the Self-neglect Severity Scale (SSS) based on interviews with Adult Protective Service workers and a national expert panel. The SSS is based on observation and interview and is administered in the home to include an environmental assessment. It was piloted, extensively field tested and then revised. The CREST SSS was developed using survey data and consultation with experts in the field. This instrument utilizes observer ratings, interview responses, and assesses subjects physical and environmental domains. It also assesses functional status as it relates to health and safety issues. After field and pilot testing the SSS was finalized and is currently undergoing reliability and validity testing. The CREST SSS was developed as a state scale to provide a common language for describing cases of self-neglect. It is the first self-neglect severity scale available to researchers. If found to be both reliable and valid it can be used in future intervention studies.

The making of a self-neglect severity scale.

PubMed

Dyer, Carmel Bitondo; Kelly, P Adam; Pavlik, Valory N; Lee, Jessica; Doody, Rachelle S; Regev, Tziona; Pickens, Sabrina; Burnett, Jason; Smith, Scott M

2006-01-01

Research in elder self-neglect has lagged behind that of other forms of mistreatment, despite the fact that self-neglect is the most common allegation reported to Adult Protective Service agencies throughout the US. The lack of a gold standard to measure self-neglect has hampered efforts to study this phenomenon. Researchers designed the Self-Neglect Severity Scale (SSS) based on interviews with Adult Protective Service workers and a national expert panel. The SSS is based on observation and interview and is administered in the home to include an environmental assessment. It was piloted, extensively field tested and then revised. The CREST SSS was developed using survey data and consultation with experts in the field. This instrument utilizes observer ratings, interview responses, and assesses subjects' physical and environmental domains. It also assesses functional status as it relates to health and safety issues. After field and pilot testing, the SSS was finalized and is currently undergoing reliability and validity testing. The CREST SSS was developed as a state scale to provide a common language for describing cases of self-neglect. It is the first self-neglect severity scale available to researchers. If found to be both reliable and valid, it may be used in future intervention studies.

1978 Annual Review of Child Abuse and Neglect Research.

ERIC Educational Resources Information Center

Martin, Mary Porter; Klaus, Susan L.

The review of research on child abuse and neglect presents brief abstracts of studies collected by the Clearinghouse of the National Center on Child Abuse and Neglect. Material is organized into five subject areas (sample subtopics in parentheses): definition of abuse and neglect; incidence (national and selected geographic estimates);…

Complexity vs. unity in unilateral spatial neglect.

PubMed

Rode, G; Fourtassi, M; Pagliari, C; Pisella, L; Rossetti, Y

Unilateral spatial neglect constitutes a heterogeneous syndrome characterized by two main entangled components: a contralesional bias of spatial attention orientation; and impaired building and/or exploration of mental representations of space. These two components are present in different subtypes of unilateral spatial neglect (visual, auditory, somatosensory, motor, allocentric, egocentric, personal, representational and productive manifestations). Detailed anatomical and clinical analyses of these conditions and their underlying disorders show the complexity of spatial cognitive deficits and the difficulty of proposing just one explanation. This complexity is in contrast, however, to the widely acknowledged effectiveness of rehabilitation of the various symptoms and subtypes of unilateral spatial neglect, exemplified in the case of prism adaptation. These common effects are reflections of the unity of the physiotherapeutic mechanisms behind the higher brain functions related to multisensory integration and spatial representations, whereas the paradoxical aspects of unilateral spatial neglect emphasize the need for a greater understanding of spatial cognitive disorders. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Review of the factors influencing the motivation of community drug distributors towards the control and elimination of neglected tropical diseases (NTDs).

PubMed

Krentel, Alison; Gyapong, Margaret; Mallya, Shruti; Boadu, Nana Yaa; Amuyunzu-Nyamongo, Mary; Stephens, Mariana; McFarland, Deborah A

2017-12-01

Community drug distributors or neglected tropical disease (NTD) volunteers have played a crucial role in ensuring the success of mass drug administration (MDA) programs using preventive chemotherapy (PC) for lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminths. In recent years however, a noticeable decline in motivation of some of these volunteers has been perceived, potentially negatively impacting the success of these programs. Potential hypotheses for this change in motivation include the long duration of many MDA programs, the change in sociocultural environments as well as the changes to the programs over time. This literature review identifies factors that affect NTD volunteer performance and motivation, which may be used to influence and improve future programming. A systematic search was conducted to identify studies published between January 1995 and September 2016 that investigate factors pertaining to volunteer motivation and performance in NTD drug distribution programs. Searches from several databases and grey literature yielded 400 records, of which 28 articles from 10 countries met the inclusion criteria. Quality assessment of studies was performed using the Critical Appraisal Skills Programme(CASP) checklist. Data pertaining to motivation, performance, retention and satisfaction was extracted and examined for themes. Recurring themes in the literature included monetary and material incentives, intrinsic motivation, gender, cost to participate, and health systems and community support. Of these, community support and the health system were found to be particularly impactful. Very few studies were found to explicitly look at novel incentives for volunteers and very few studies have considered the out of pocket and opportunity costs that NTD volunteers bear carrying out their tasks. There is currently great interest in incorporating more attractive incentive schemes for NTD volunteers. However, our results show

Crossing institutional boundaries: mapping the policy process for improved control of endemic and neglected zoonoses in sub-Saharan Africa.

PubMed

Okello, Anna; Welburn, Susan; Smith, James

2015-07-01

The recent adoption of the World Health Assembly Resolution 66.12 for neglected tropical diseases (NTDs) in May 2013 is an important turning point for advocacy regarding a number of endemic zoonotic infections, defined by the World Health Organization as the neglected zoonotic diseases (NZDs). In addition to NTD-listed zoonoses such as rabies, echinococcosis (hydatid disease), leishmaniasis, Human African trypanosomiasis (sleeping sickness) and Taenia solium cysticercosis, the NZDs also include important bacterial zoonoses such as anthrax, bovine tuberculosis and brucellosis. To date, analysis of the processes that prioritize, develop and deliver zoonoses control programmes in many low- and middle-income countries is lacking, despite its potential to highlight significant evidence gaps and institutional constraints to the intersectoral approach required for their control. Policy process analysis was conducted via a series of semi-structured interviews with key policy actors within various ministries and institutes in Uganda and Nigeria. The study concluded that despite the rhetoric around 'linear' models of health policy development promoting consultation with a wide range of national stakeholders, the decision-making process for zoonotic disease control appears instead overtly influenced by the external political economy of trending pandemic threats, often overlooking national and regional zoonoses priorities. The inclusion of political systems remains a key factor in the zoonoses analysis matrix, enhancing our understanding of the intersectoral and transdisciplinary approaches required for their control. The authors consider policy process analysis to be a fundamental first step of any attempt to holistically strengthen human and animal health systems in a development context, particularly regarding the promotion of integrated control policies for regionally important zoonoses under the growing One Health movement. Published by Oxford University Press in

Defining Child Neglect Based on Child Protective Services Data

ERIC Educational Resources Information Center

Dubowitz, H.; Pitts, S.C.; Litrownik, A.J.; Cox, C.E.; Runyan, D.; Black, M.M.

2005-01-01

Objectives:: To compare neglect defined by Child Protective Services official codes with neglect defined by a review of CPS narrative data, and to examine the validity of the different neglect measures using children's functioning at age 8 years. Methods:: Data are from 740 children participating in a consortium of longitudinal studies on child…

Mechanisms and Factors Associated With Tackle-Related Injuries in South African Youth Rugby Union Players.

PubMed

Burger, Nicholas; Lambert, Mike Ian; Viljoen, Wayne; Brown, James Craig; Readhead, Clint; den Hollander, Steve; Hendricks, Sharief

2017-02-01

The majority of injuries in rugby union occur during tackle events. The mechanisms and causes of these injuries are well established in senior rugby union. To use information from an injury database and assess video footage of tackle-related injuries in youth rugby union matches to identify environmental factors and mechanisms that are potentially confounding to these injuries. Descriptive epidemiological study. Injury surveillance was conducted at the under-18 Craven Week rugby tournament. Tackle-related injury information was used to identify injury events in match video footage (role-matched noninjury tackle events were identified for the cohort of injured players). Events were coded using match situational variables (precontact, contact, and postcontact). Relative risk ratio (RRR; ratio of probability of an injury or noninjury outcome occurring when a characteristic was observed) was reported by use of logistic regression. In comparison with the first quarter, injury risk was greater in the third (RRR = 9.75 [95% CI, 1.71-55.64]; P = .010) and fourth quarters (RRR = 6.97 [95% CI, 1.09-44.57]; P = .040) for ball carriers and in the fourth quarter (RRR = 9.63 [95% CI, 1.94-47.79]; P = .006) for tacklers. Ball carriers were less likely to be injured when they were aware of impending contact (RRR = 0.14 [95% CI, 0.03-0.66]; P = .012) or when they executed a moderate fend (hand-off) (RRR = 0.22 [95% CI, 0.06-0.84]; P = .026). Tacklers were less likely to be injured when performing shoulder tackles (same side as leading leg) in comparison to an arm-only tackle (RRR = 0.02 [95% CI, 0.001-0.79]; P = .037). Ball carriers (RRR = 0.09 [95% CI, 0.01-0.89]; P = .040) and tacklers (RRR = 0.02 [95% CI, 0.001-0.32]; P =.006) were less likely to be injured when initial contact was made with the tackler's shoulder/arm instead of his head/neck. The relative risk of tackle-related injury was higher toward the end of matches. Incorrect technique may contribute to increased injury

Neglected post burns contracture of hand in children: Analysis of contributory socio-cultural factors and the impact of neglect on outcome.

PubMed

Gupta, Ravi Kumar; Jindal, Nipun; Kamboj, Kulbhushan

2014-12-01

No study has ever evaluated the causes and effect of neglect on the outcome of post burns contractures of hand in children. 66 hands in 61 children (mean age 12.22 years) with a mean neglect of 11.6 years (range 5-17 years) were assessed for the causes of neglect and the outcome of surgery. Average follow up was 6.6 years. The results were assessed in two groups of 5-10 years neglect as group I and >10 years neglect as group II. In a total number of 134 contracted rays in 66 hands, the surgical procedures included local Z/V-Y flap (51 rays), cross finger flap (48 rays), full thickness graft (35 rays). Additional external fixator with a distracter was used in 3 patients treated at a delay of 14, 16 and 17 years. 50 (81.96%) patients belonged to rural and slum areas. The reasons for delayed treatment included poverty - 33 patients, lack of awareness of surgical treatment - 16 patients; and indifference of parents - 12 patients. 44 (72.13%) children were illiterates. With treatment the average DASH score improved from 65.10 to 36.90 (p < .000) and from 68.14 to 45.93 (p < .000) in group I and II respectively. The results were significantly superior in group I (p < .000). The main factors for neglect in treatment of post burns contracture include poverty, lack of awareness and illiteracy. All the patients showed significant improvement in function after the surgery. Contractures with higher neglect had significantly inferior outcome.

Child neglect: Definition and identification of youth's experiences in official reports of maltreatment

PubMed Central

Mennen, Ferol E.; Kim, Kihyun; Sang, Jina; Trickett, Penelope K.

2010-01-01

Objective The purpose of this study was to describe the nature of neglect in child welfare clients, to describe these experiences, to examine its typologies, and to understand how different types of neglect co-occurred with each other and with other types of maltreatment. Methods Case record abstraction was conducted on the child welfare case records of an urban, ethnically-diverse sample of youths (n = 303) identified as maltreated by a very large public child welfare agency. We utilized the Maltreatment Case Record Abstraction Instrument (MCRAI) which was based on the work of Barnett, Manly, and Cicchetti (1993) as modified by English and LONGSCAN (1997). Thirteen items of parental behavior deemed neglectful were coded and organized into 5 subtypes of neglect (care neglect, environmental neglect, medical neglect, educational neglect, supervisory neglect) Results Neglect was present in 71.0% of the sample as compared to the 41.0% classified as neglected by CPS records. Neglect was accompanied by other types of maltreatment in 95% of the cases. Children who were neglected had more reports of maltreatment and experienced a greater number of different types of maltreatment than those who were maltreated, but not neglected. The most common type of neglect was supervisory neglect (72.5%) followed by environmental neglect (61.6%). With the exception of medical neglect, all types of neglect were significantly correlated with each other. Conclusions The abstraction resulted in rich data showing that under a one-word label of neglect, the nature of neglect that the youngsters actually experienced was quite diverse and heterogeneous in its phenomenology. Furthermore, neglect is pervasive for children in the child welfare system and official classifications underestimate its occurrence. Neglect does not happen in isolation; children who are reported as neglected are likely to experience other forms of maltreatment. Practice implications Official classifications should not be

Child neglect: definition and identification of youth's experiences in official reports of maltreatment.

PubMed

Mennen, Ferol E; Kim, Kihyun; Sang, Jina; Trickett, Penelope K

2010-09-01

The purpose of this study was to describe the nature of neglect in child welfare clients, to describe these experiences, to examine its typologies, and to understand how different types of neglect co-occurred with each other and with other types of maltreatment. Case record abstraction was conducted on the child welfare case records of an urban, ethnically-diverse sample of youths (n=303) identified as maltreated by a very large public child welfare agency. We utilized the Maltreatment Case Record Abstraction Instrument (MCRAI) which was based on the work of Barnett et al. (1993) as modified by English and LONGSCAN (1997). Thirteen items of parental behavior deemed neglectful were coded and organized into 5 subtypes of neglect (care neglect, environmental neglect, medical neglect, educational neglect, supervisory neglect). Neglect was present in 71.0% of the sample as compared to the 41.0% classified as neglected by CPS records. Neglect was accompanied by other types of maltreatment in 95% of the cases. Children who were neglected had more reports of maltreatment and experienced a greater number of different types of maltreatment than those who were maltreated, but not neglected. The most common type of neglect was supervisory neglect (72.5%) followed by environmental neglect (61.6%). With the exception of medical neglect, all types of neglect were significantly correlated with each other. The abstraction resulted in rich data showing that under a one-word label of neglect, the nature of neglect that the youngsters actually experienced was quite diverse and heterogeneous in its phenomenology. Furthermore, neglect is pervasive for children in the child welfare system and official classifications underestimate its occurrence. Neglect does not happen in isolation; children who are reported as neglected are likely to experience other forms of maltreatment. Official classifications should not be used in determining interventions for children and families. Interventions

Child Abuse and Neglect: A Shared Community Concern. Revised.

ERIC Educational Resources Information Center

National Center on Child Abuse and Neglect (DHHS/OHDS), Washington, DC.

The purpose of this publication is to help the reader understand the problems of child abuse and neglect and become familiar with prevention and intervention efforts. Introductory pages define child abuse and neglect, suggest the scope of the problem, delineate reasons for its occurrence, and explain how to recognize abuse or neglect. This section…

Local Communities and Schools Tackling Sustainability and Climate Change

ERIC Educational Resources Information Center

Flowers, Rick; Chodkiewicz, Andrew

2009-01-01

Local communities and their schools remain key sites for actions tackling issues of sustainability and climate change. A government-funded environmental education initiative, the Australian Sustainable Schools Initiative (AuSSI), working together with state based Sustainable Schools Programs (SSP), has the ability to support the development of…

45 CFR 1357.20 - Child abuse and neglect programs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Child abuse and neglect programs. 1357.20 Section... APPLICABLE TO TITLE IV-B § 1357.20 Child abuse and neglect programs. The State agency must assure that, with regard to any child abuse and neglect programs or projects funded under title IV-B of the Act, the...

2. VIEW OF BLOCK AND TACKLE FOR MOVING CEDAR LOGS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. VIEW OF BLOCK AND TACKLE FOR MOVING CEDAR LOGS FROM POND TO JACK LADDER--AN ENDLESS CHAIN CONVEYOR THAT MOVES LOGS INTO MILL - Lester Shingle Mill, 1602 North Eighteenth Street, Sweet Home, Linn County, OR

Podoconiosis in Ethiopia: From Neglect to Priority Public Health Problem

PubMed Central

Deribe, Kebede; Kebede, Biruck; Mengistu, Belete; Negussie, Henok; Sileshi, Mesfin; Tamiru, Mossie; Tomczyk, Sara; Tekola-Ayele, Fasil; Davey, Gail; Fentaye, Amha

2017-01-01

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated master plan for NTDs. An integrated lymphoedema management guideline has been developed. Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this. PMID:28878431

Podoconiosis in Ethiopia: From Neglect to Priority Public Health Problem.

PubMed

Deribe, Kebede; Kebede, Biruck; Mengistu, Belete; Negussie, Henok; Sileshi, Mesfin; Tamiru, Mossie; Tomczyk, Sara; Tekola-Ayele, Fasil; Davey, Gail; Fentaye, Amha

2017-01-01

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated master plan for NTDs. An integrated lymphoedema management guideline has been developed. Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this.

Acts of Omission: An Overview of Child Neglect

MedlinePlus

... gov/pubs/focus/acts/index.cfm Addresses the scope of the problem of child neglect as well ... This bulletin for child welfare professionals addresses the scope of the problem of child neglect as well ...

Interactions between Global Health Initiatives and country health systems: the case of a neglected tropical diseases control program in Mali.

PubMed

Cavalli, Anna; Bamba, Sory I; Traore, Mamadou N; Boelaert, Marleen; Coulibaly, Youssouf; Polman, Katja; Pirard, Marjan; Van Dormael, Monique

2010-08-17

Recently, a number of Global Health Initiatives (GHI) have been created to address single disease issues in low-income countries, such as poliomyelitis, trachoma, neonatal tetanus, etc.. Empirical evidence on the effects of such GHIs on local health systems remains scarce. This paper explores positive and negative effects of the Integrated Neglected Tropical Disease (NTD) Control Initiative, consisting in mass preventive chemotherapy for five targeted NTDs, on Mali's health system where it was first implemented in 2007. Campaign processes and interactions with the health system were assessed through participant observation in two rural districts (8 health centres each). Information was complemented by interviews with key informants, website search and literature review. Preliminary results were validated during feedback sessions with Malian authorities from national, regional and district levels. We present positive and negative effects of the NTD campaign on the health system using the WHO framework of analysis based on six interrelated elements: health service delivery, health workforce, health information system, drug procurement system, financing and governance. At point of delivery, campaign-related workload severely interfered with routine care delivery which was cut down or totally interrupted during the campaign, as nurses were absent from their health centre for campaign-related activities. Only 2 of the 16 health centres, characterized by a qualified, stable and motivated workforce, were able to keep routine services running and to use the campaign as an opportunity for quality improvement. Increased workload was compensated by allowances, which significantly improved staff income, but also contributed to divert attention away from core routine activities. While the campaign increased the availability of NTD drugs at country level, parallel systems for drug supply and evaluation requested extra efforts burdening local health systems. The campaign budget

Communicating with "Neglected" Farmers on Regulatory Programs.

ERIC Educational Resources Information Center

Animal and Plant Health Inspection Service (USDA), Washington, DC.

Workshop recommendations resulting from an Animal and Plant Health Service (APHS) Seminar on ways of reaching "neglected" farmers and enlisting their support for the APHS regulatory programs are provided. The "neglected" farmer is identified as those low-income/minority group marginal farmers who cannot be reached by ordinary means, e.g., poor…

46 CFR 184.300 - Ground tackle and mooring lines.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Ground tackle and mooring lines. 184.300 Section 184.300 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Mooring and Towing Equipment § 184.300...

PhyloChip Tackles Coral Disease

ScienceCinema

DeSantis, Todd

2017-12-13

Scientists at Berkeley Lab and the University of California, Merced are using an innovative DNA array developed at Berkeley Lab to catalog the microbes that live among coral in the tropical waters off the coast of Puerto Rico. More info: http://newscenter.lbl.gov/feature-stories/2009/02/02/coral-reefs/

Child Abuse and Neglect Fatalities: Statistics and Interventions

MedlinePlus

... and Interventions Child Abuse and Neglect Fatalities 2015: Statistics and Interventions Series Title: Numbers and Trends Author(s): ... this information. Child Abuse and Neglect Fatalities 2015: Statistics and Interventions Series: Numbers and Trends Year Published: ...

Tackling antibiotic resistance: the environmental framework.

PubMed

Berendonk, Thomas U; Manaia, Célia M; Merlin, Christophe; Fatta-Kassinos, Despo; Cytryn, Eddie; Walsh, Fiona; Bürgmann, Helmut; Sørum, Henning; Norström, Madelaine; Pons, Marie-Noëlle; Kreuzinger, Norbert; Huovinen, Pentti; Stefani, Stefania; Schwartz, Thomas; Kisand, Veljo; Baquero, Fernando; Martinez, José Luis

2015-05-01

Antibiotic resistance is a threat to human and animal health worldwide, and key measures are required to reduce the risks posed by antibiotic resistance genes that occur in the environment. These measures include the identification of critical points of control, the development of reliable surveillance and risk assessment procedures, and the implementation of technological solutions that can prevent environmental contamination with antibiotic resistant bacteria and genes. In this Opinion article, we discuss the main knowledge gaps, the future research needs and the policy and management options that should be prioritized to tackle antibiotic resistance in the environment.

Empathy and Child Neglect: A Theoretical Model

ERIC Educational Resources Information Center

De Paul, Joaquin; Guibert, Maria

2008-01-01

Objective: To present an explanatory theory-based model of child neglect. This model does not address neglectful behaviors of parents with mental retardation, alcohol or drug abuse, or severe mental health problems. In this model parental behavior aimed to satisfy a child's need is considered a helping behavior and, as a consequence, child neglect…

Today's "Neglected Majority"

ERIC Educational Resources Information Center

Risley, Rod A.

2007-01-01

In 1985, then American Association of Community Colleges (AACC) President Dale Parnell wrote of the "neglected majority," a phrase he coined for the astounding 70 percent of high school graduates who did not plan or aspire to attain baccalaureate degrees. Twenty-two years later, community college and public policy leaders still face the…

Neglect Contributing to Tertiary Hospitalization in Childhood Asthma.

ERIC Educational Resources Information Center

Boxer, Gary H.; And Others

1988-01-01

The study examined the extent to which child neglect and family dysfunction have contributed to the need for hospitalization of asthmatic children. Using a measure of global functioning, psychologic morbidity is associated with medical neglect. (Author/DB)

Considerations in identifying pediatric dental neglect and the legal obligation to report.

PubMed

Katner, David; Brown, Christopher; Fournier, Suzanne

2016-10-01

Dental health care professionals play an important role as mandated advocates when health care neglect is suspected in children; however, there is some confusion around what constitutes child neglect. The authors reviewed the dental literature for descriptors and definitions of neglect. They studied the individual state statutes to learn the protection afforded for both victims of neglect and for health care providers acting on behalf of such children. They also reviewed methods of action to address suspected neglect. The authors found confusion around what is or is not child neglect. Yet, dental professionals are tasked by the law, and by a moral code, to protect children from neglect. The authors offer a definition of neglect and suggested practice guidelines to assist the practitioner acting as a child's advocate. Clinicians can use strategies to address the problem of child neglect. A digital data treatment registry may provide additional views of a child's health status. With a better understanding of the definition of neglect, strategies can be implemented for use by the dental team to address this problem of neglect and reduce its incidence. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

25 CFR 11.424 - Neglect of children.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Neglect of children. 11.424 Section 11.424 Indians BUREAU... ORDER CODE Criminal Offenses § 11.424 Neglect of children. (a) A parent, guardian, or other person supervising the welfare of a child under 18 commits a misdemeanor if he or she knowingly endangers the child's...

25 CFR 11.424 - Neglect of children.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Neglect of children. 11.424 Section 11.424 Indians BUREAU... ORDER CODE Criminal Offenses § 11.424 Neglect of children. (a) A parent, guardian, or other person supervising the welfare of a child under 18 commits a misdemeanor if he or she knowingly endangers the child's...

25 CFR 11.424 - Neglect of children.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Neglect of children. 11.424 Section 11.424 Indians BUREAU... ORDER CODE Criminal Offenses § 11.424 Neglect of children. (a) A parent, guardian, or other person supervising the welfare of a child under 18 commits a misdemeanor if he or she knowingly endangers the child's...

25 CFR 11.424 - Neglect of children.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Neglect of children. 11.424 Section 11.424 Indians BUREAU... ORDER CODE Criminal Offenses § 11.424 Neglect of children. (a) A parent, guardian, or other person supervising the welfare of a child under 18 commits a misdemeanor if he or she knowingly endangers the child's...

25 CFR 11.424 - Neglect of children.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Neglect of children. 11.424 Section 11.424 Indians BUREAU... ORDER CODE Criminal Offenses § 11.424 Neglect of children. (a) A parent, guardian, or other person supervising the welfare of a child under 18 commits a misdemeanor if he or she knowingly endangers the child's...

Child Abuse and Neglect Curriculum in Schools.

ERIC Educational Resources Information Center

Broadhurst, Diane; And Others

The booklet presents a recommended course outline for a course in child abuse and neglect in schools of education. The course may be adapted to a semester or quarter schedule and be used whole or in part. An introduction gives a rationale for inclusion of child abuse and neglect curriculum in teacher training programs. The course is divided into…

Timing of Academic Difficulties for Neglected and Nonmaltreated Males and Females.

ERIC Educational Resources Information Center

Kendall-Tackett, Kathleen

1997-01-01

Neglected or abused/neglected children (N=420) were compared with matched, nonmal-treated children on measures of school performance. Differences between the sexes in timing of academic difficulties was found for both math and English. Grades of neglected and abused/neglected students paralleled that of nonmal-treated students but were lower at…

A Chinese patient with pusher syndrome and unilateral spatial neglect syndrome.

PubMed

Chen, Xiao-Wei; Lin, Cheng-He; Zheng, Hua; Lin, Zhen-Lan

2014-07-01

To observe clinical manifestations, behavioral characteristics, and effects of rehabilitation on a patient with pusher syndrome and unilateral spatial neglect caused by right thalamic hemorrhage. Assessment of pusher syndrome was made by the Scale for Contraversive pushing (SCP), and unilateral spatial neglect syndrome was diagnosed using line cancellation, letter and star cancellation, line bisection tests and copy and continuation of graphic sequence test. Behavioral therapy, occupational therapy, reading training and traditional Chinese medicine methods were adopted for treatment of pusher syndrome and unilateral spatial neglect. The patient showed typical pusher syndrome and unilateral spatial neglect symptoms. The pusher syndrome and unilateral spatial neglect symptoms were significantly improved following rehabilitation treatments. Pusher syndrome and unilateral spatial neglect syndrome occurred simultaneously after right thalamic hemorrhage. Early rehabilitation therapy can reduce the symptoms of pusher syndrome and unilateral spatial neglect syndrome and improve motor function.

Trauma-related symptoms in neglected preschoolers and affective quality of mother-child communication.

PubMed

Milot, Tristan; St-Laurent, Diane; Ethier, Louise S; Provost, Marc A

2010-11-01

This study (a) assessed whether child neglect is associated with posttraumatic stress disorder (PTSD) and dissociative symptoms in the preschool period and (b) examined the role of quality of mother-child affective communication in the development of trauma-related symptoms among neglected children. Participants were 33 neglected and 72 non-neglected preschoolers (mean age = 60 months). Neglected children were recruited from the Child Protection Agencies. Neglected and non-neglected children victims of other form of abuse were excluded from the study. Trauma symptoms were evaluated through mother and preschool teacher reports. Quality of mother-child affective communication was assessed in a lab visit during an unstructured task. According to teachers, neglected children displayed more PTSD and dissociative symptoms than non-neglected children. Quality of mother-child communication was lower in neglected dyads. Mother-child affective communication predicted teacher-reported child trauma symptomatology, over and above child neglect. Discussion focuses on the traumatic nature of child neglect and the underlying parent-child relational processes.

Poverty-related and neglected diseases - an economic and epidemiological analysis of poverty relatedness and neglect in research and development.

PubMed

von Philipsborn, Peter; Steinbeis, Fridolin; Bender, Max E; Regmi, Sadie; Tinnemann, Peter

2015-01-01

Economic growth in low- and middle-income countries (LMIC) has raised interest in how disease burden patterns are related to economic development. Meanwhile, poverty-related diseases are considered to be neglected in terms of research and development (R&D). Developing intuitive and meaningful metrics to measure how different diseases are related to poverty and neglected in the current R&D system. We measured how diseases are related to economic development with the income relation factor (IRF), defined by the ratio of disability-adjusted life-years (DALYs) per 100,000 inhabitants in LMIC versus that in high-income countries. We calculated the IRF for 291 diseases and injuries and 67 risk factors included in the Global Burden of Disease Study 2010. We measured neglect in R&D with the neglect factor (NF), defined by the ratio of disease burden in DALYs (as percentage of the total global disease burden) and R&D expenditure (as percentage of total global health-related R&D expenditure) for 26 diseases. The disease burden varies considerably with the level of economic development, shown by the IRF (median: 1.38; interquartile range (IQR): 0.79-6.3). Comparison of IRFs from 1990 to 2010 highlights general patterns of the global epidemiological transition. The 26 poverty-related diseases included in our analysis of neglect in R&D are responsible for 13.8% of the global disease burden, but receive only 1.34% of global health-related R&D expenditure. Within this group, the NF varies considerably (median: 19; IQR: 6-52). The IRF is an intuitive and meaningful metric to highlight shifts in global disease burden patterns. A large shortfall exists in global R&D spending for poverty-related and neglected diseases, with strong variations between diseases.

Neglected endemic mycoses.

PubMed

Queiroz-Telles, Flavio; Fahal, Ahmed Hassan; Falci, Diego R; Caceres, Diego H; Chiller, Tom; Pasqualotto, Alessandro C

2017-11-01

Fungi often infect mammalian hosts via the respiratory route, but traumatic transcutaneous implantation is also an important source of infections. Environmental exposure to spores of pathogenic fungi can result in subclinical and unrecognised syndromes, allergic manifestations, and even overt disease. After traumatic cutaneous inoculation, several fungi can cause neglected mycoses such as sporotrichosis, chromoblastomycosis, mycetoma, entomophthoramycosis, and lacaziosis. Most of these diseases have a subacute to chronic course and they can become recalcitrant to therapy and lead to physical disabilities, including inability to work, physical deformities, and amputations. For many years, paracoccidioidomycosis was considered the most prevalent endemic systemic mycosis in the Americas, but this situation might be changing with recognition of the worldwide presence of Histoplasma capsulatum. Both paracoccidioidomycosis and histoplasmosis can mimic several infectious and non-infectious medical conditions and lead to death if not recognised early and treated. Cutaneous implantation and systemic mycoses are neglected diseases that affect millions of individuals worldwide, especially in low-income countries where their management is suboptimum because challenges in diagnosis and therapeutic options are substantial issues. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tropical mathematics and the financial catastrophe of the 17th century. Thermoeconomics of Russia in the early 20th century

NASA Astrophysics Data System (ADS)

Maslov, V. P.

2010-03-01

In the paper, an example is presented concerning relationships (which cannot be neglected) between mathematics and other sciences. In particular, the relationship between the tropical mathematics and the humanitarian-economic catastrophe of 17th century (related to slavery of Africans) is considered. The notion of critical state of economy of the 19th century is introduced by using the refined Fisher equation. A correspondence principle for thermodynamics of fluids and economics of the 19th century is presented.

White matter lesional predictors of chronic visual neglect: a longitudinal study

PubMed Central

Lunven, Marine; Thiebaut De Schotten, Michel; Bourlon, Clémence; Duret, Christophe; Migliaccio, Raffaella; Rode, Gilles

2015-01-01

Chronic visual neglect prevents brain-damaged patients from returning to an independent and active life. Detecting predictors of persistent neglect as early as possible after the stroke is therefore crucial to plan the relevant interventions. Neglect signs do not only depend on focal brain lesions, but also on dysfunction of large-scale brain networks connected by white matter bundles. We explored the relationship between markers of axonal degeneration occurring after the stroke and visual neglect chronicity. A group of 45 patients with unilateral strokes in the right hemisphere underwent cognitive testing for neglect twice, first at the subacute phase (<3 months after onset) and then at the chronic phase (>1 year). For each patient, magnetic resonance imaging including diffusion sequences was performed at least 4 months after the stroke. After masking each patient’s lesion, we used tract-based spatial statistics to obtain a voxel-wise statistical analysis of the fractional anisotropy data. Twenty-seven patients had signs of visual neglect at initial testing. Only 10 of these patients had recovered from neglect at follow-up. When compared with patients without neglect, the group including all subacute neglect patients had decreased fractional anisotropy in the second (II) and third (III) branches of the right superior longitudinal fasciculus, as well as in the splenium of the corpus callosum. The subgroup of chronic patients showed reduced fractional anisotropy in a portion the splenium, the forceps major, which provides interhemispheric communication between regions of the occipital lobe and of the superior parietal lobules. The severity of neglect correlated with fractional anisotropy values in superior longitudinal fasciculus II/III for subacute patients and in its caudal portion for chronic patients. Our results confirm a key role of fronto-parietal disconnection in the emergence and chronic persistence of neglect, and demonstrate an implication of caudal

Long-term growth decline in Toona ciliata in a moist tropical forest in Bangladesh: Impact of global warming

NASA Astrophysics Data System (ADS)

Rahman, Mizanur; Islam, Rofiqul; Islam, Mahmuda

2017-04-01

Tropical forests are carbon rich ecosystems and small changes in tropical forest tree growth substantially influence the global carbon cycle. Forest monitoring studies report inconsistent growth changes in tropical forest trees over the past decades. Most of the studies highlighted changes in the forest level carbon gain, neglecting the species-specific growth changes which ultimately determine community-level responses. Tree-ring analysis can provide historical data on species-specific tree growth with annual resolution. Such studies are inadequate in Bangladesh, which is one of the most climate sensitive regions in the tropics. In this study, we investigated long-term growth rates of Toona ciliata in a moist tropical forest of Bangladesh by using tree-ring analysis. We sampled 50 trees of varying size, obtained increment cores from these trees and measured tree-ring width. Analyses of growth patterns revealed size-dependent growth increments. After correcting for the effect of tree size on tree growth (ontogenetic changes) by two different methods we found declining growth rates in T. ciliata from 1960 to 2013. Standardized ring-width index (RWI) was strongly negatively correlated with annual mean and maximum temperatures suggesting that rising temperature might cause the observed growth decline in T. ciliata. Assuming that global temperatures will rise at the current rate, the observed growth decline is assumed to continue. The analysis of stable carbon and oxygen isotopes may reveal more insight on the physiological response of this species to future climatic changes.

Combining language and space: sentence bisection in unilateral spatial neglect.

PubMed

Veronelli, Laura; Guasti, Maria T; Arduino, Lisa S; Vallar, Giuseppe

2014-10-01

In line bisection right-brain-damaged patients with left spatial neglect show a rightward deviation, with respect to the line's physical center. In word bisection ortho-phonological features of the stimulus' final (right-sided) part modulate performance of both patients and healthy participants (Veronelli, Vallar, Marinelli, Primativo, & Arduino, 2014). We investigated the role of linguistic factors in sentence bisection, in patients with and without neglect, and control participants. The effects of information in the right-sided part of the sentence (Experiment #1), and of lexical and syntactic violations (Experiment #2) were assessed. Neglect patients showed an overall rightward bias, larger than those of patients without neglect and controls. The neglect patients' bias was modulated by stimulus type, decreasing from lines, to letter strings and to all types of sentences. In sum, in visuo-manual sentence bisection a basic linguistic mechanism, such as sentence readability, brings about a more leftward appreciation of the stimulus, reducing the neglect patients' rightward bias. Copyright © 2014 Elsevier Inc. All rights reserved.

Child neglect in one-child families from Suzhou City of Mainland China

PubMed Central

2014-01-01

Background The one-child policy introduced in China in 1979 has led to far-reaching changes in socio-demographic characteristics. Under this policy regime, each household has few children. This study aims to describe the prevalence of child neglect in one-child families in China and to examine the correlates of child neglect. Methods A cross-sectional study of 2044 children aged 6 to 9 years and recruited from four primary schools in Suzhou City, China was conducted. Neglect subtypes were determined using a validated indigenous measurement scale reported by parents. Child, parental and family characteristics were obtained by questionnaires and review of social security records. Linear regression analyses were performed to estimate the associations between these factors and the subtypes of child neglect. Results The prevalence of child any neglect was 32.0% in one child families in Suzhou City, China. Supervisory (20.3%) neglect was the most prevalent type of child neglect, followed by emotional (15.2%), physical (11.1%), and educational (6.0%) neglect After simultaneous adjustment to child and family characteristics and the school factor, boys, children with physical health issues and cognitive impairment, younger and unemployed mother, were positively associated with neglect subtypes. We also found that parents with higher education and three-generation families were negatively associated with neglect. Conclusion The rates of child neglect subtypes vary across different regions in China probably due to the different policy implementation and socio-economic levels, with a lower level of physical and educational neglect and a higher level of emotional neglect in this study. The three-generation family structure was correlates of neglect which may be unique in one child families. This indicates that future intervention programs in one-child families should target these factors. PMID:24661722

Similarities in Siblings' Experiences of Neglectful Parenting Behaviors

ERIC Educational Resources Information Center

Hines, Denise A.; Kantor, Glenda Kaufman; Holt, Melissa K.

2006-01-01

Objective: Researchers and policymakers typically assume that within families, individual children are at an equivalent risk of neglectful behaviors. There is evidence that siblings experience differential parental treatment, and some research suggests that parents may maltreat their children to differing degrees. However, because neglect is…

[Certificate "Tropical and Travel Dermatology (DDA)": quality-assured medical education for dermatologists with a "migration perspective"].

PubMed

Elsner, P; Nenoff, P; Schliemann, S; Tittelbach, J; Reinel, D

2014-10-01

Under the conditions of economic pressure in the medical system and the DRG system for hospitals in Germany, so-called "uneconomic" services and fields of specialized dermatologic competence such as pediatric dermatology, trichology, occupational dermatology and tropical dermatology are increasingly being neglected. While hospitals tend to train fewer residents in these subspecialties, there is a demand for additional high-quality training opportunities that are certified by the German Dermatologic Academy (DDA). Tropical and travel-related skin diseases are more frequently observed in Germany which can be explained by the increased world-wide travel activities, but also by the international migration from developing countries into Europe. Furthermore, dermatologists trained in Germany are working more and more also internationally. Thus, they require knowledge and experience in tropical and travel-related dermatology. The certificate "Tropical and Travel Dermatology (DDA)" was developed and published in 2013 in a cooperation between the International Society for Dermatology in the Tropics in cooperation with the German Academy of Dermatology (DDA). It consists of 3 full day teaching modules (basic, additional and special seminar). The first seminar cycle in 2013/2014 showed a high demand from dermatologists in hospitals and private practices. While the basic and the special seminars were held in Germany, the additional seminar took place in cooperation with the Regional Dermatology Training Center (RDTC) in Moshi, Tanzania. Many attending dermatologists fulfilling the requirements for the new certificate have practiced in developing countries or plan to do so. In order to gain practical experience on the basis of the knowledge acquired in the qualifying seminars, the International Society for Dermatology in the Tropics supports dermatologists to find internships and work placements in dermatological units in developing countries.

Online and offline awareness deficits: Anosognosia for spatial neglect.

PubMed

Chen, Peii; Toglia, Joan

2018-04-12

Anosognosia for spatial neglect (ASN) can be offline or online. Offline ASN is general unawareness of having experienced spatial deficits. Online ASN is an awareness deficit of underestimating spatial difficulties that likely to occur in an upcoming task (anticipatory ASN) or have just occurred during the task (emergent ASN). We explored the relationships among spatial neglect, offline ASN, anticipatory ASN, and emergent ASN. Research Method/Design: Forty-four survivors of stroke answered questionnaires assessing offline and online self-awareness of spatial problems. The online questionnaire was asked immediately before and after each of 4 tests for spatial neglect, including shape cancellation, address and sentence copying, telephone dialing, and indented paragraph reading. Participants were certain they had difficulties in daily spatial tasks (offline awareness), in the task they were about to perform (anticipatory awareness) and had just performed (emergent awareness). Nonetheless, they consistently overestimated their spatial abilities, indicating ASN. Offline and online ASN appeared independent. Online ASN improved after task execution. Neglect severity was not positively correlated with offline ASN. Greater neglect severity correlated with both greater anticipatory and emergent ASN. Regardless of neglect severity, we found task-specific differences in emergent ASN but not in anticipatory ASN. Individuals with spatial neglect acknowledge their spatial difficulty (certainty of error occurrence) but may not necessarily recognize the extent of their difficulty (accuracy of error estimation). Our findings suggest that offline and online ASN are independent. A potential implication from the study is that familiar and challenging tasks may facilitate emergence of self-awareness. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Child Neglect: A Guide for Intervention. The User Manual Series.

ERIC Educational Resources Information Center

Gaudin, James M., Jr.

This manual provides a state-of-the art review of child neglect in the United States, its nature, causes, and the implications of that knowledge for preventive and remedial intervention. After an introduction, the first chapter considers the definition of neglect including types of neglect, the withholding of medically indicated treatment from…

[The battered, abused and neglected child and the Crisis Center for Children].

PubMed

Dunovský, J

1995-05-31

The syndrome of the battered, abused and neglected child is becoming manifest also in our country with increasing frequency and severity, not only because much more attention is paid to it than ever before. Our system of child care and protection is, however, by far not yet ready to resolve this serious problem in the life of children, families and society as a whole and therefore ways and means must be sought how to face it, how to recognize it, treat it and in particular how to prevent it. One of the important means how to tackle this dangerous social phenomenon is a specialized department concerned in a comprehensive way on an interdisciplinary basis, with skilled and effective clinical work with every single abused child and its family in close association with all disciplines and institutions interested in the problem as well as by conceptual work, research, training and expert opinions etc. The crisis centre for children in Prague 4-Michle wants to serve with its experience and findings as a model workplace for building special institutions within the framework of a rational, interdisciplinary network of child care and protection in this country. The results of its two-year work and the great interest in it on the part of many localities and regions justify its efforts.

Types of Neglected Tropical Diseases

MedlinePlus

... Operations Administrative Services Office of Biodefense Research & Surety Communications Government Relations Cyber Infrastructure Computational Biology Equal Employment Opportunity Ethics Global Research Office of Mission Integration and Financial ...

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

PubMed

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Neglect assessment as an application of virtual reality.

PubMed

Broeren, J; Samuelsson, H; Stibrant-Sunnerhagen, K; Blomstrand, C; Rydmark, M

2007-09-01

In this study a cancellation task in a virtual environment was applied to describe the pattern of search and the kinematics of hand movements in eight patients with right hemisphere stroke. Four of these patients had visual neglect and four had recovered clinically from initial symptoms of neglect. The performance of the patients was compared with that of a control group consisting of eight subjects with no history of neurological deficits. Patients with neglect as well as patients clinically recovered from neglect showed aberrant search performance in the virtual reality (VR) task, such as mixed search pattern, repeated target pressures and deviating hand movements. The results indicate that in patients with a right hemispheric stroke, this VR application can provide an additional tool for assessment that can identify small variations otherwise not detectable with standard paper-and-pencil tests. VR technology seems to be well suited for the assessment of visually guided manual exploration in space.

Attachment Representations in a Sample of Neglected Preschool-Age Children

ERIC Educational Resources Information Center

Venet, Michele; Bureau, Jean-Francois; Gosselin, Catherine; Capuano, France

2007-01-01

A number of studies (see Ethier, 1999) have shown that neglect has a deleterious impact on children's development. However, the effect of neglect on a child's internal representations of their family still needs to be investigated. The aim of this study was to examine the attachment patterns observed in a subsample of neglected children as…

Perceptions and Attitudes of Mothers about Child Neglect in Turkey

ERIC Educational Resources Information Center

Polat, Selda; Tasar, Aysin; Ozkan, Secil; Yeltekin, Sevinc; Cakir, Bahar Cuhac; Akbaba, Sevil; Sahin, Figen; Camurdan, Aysu Duyan; Beyazova, Ufuk

2010-01-01

The purpose of this study was to evaluate the perceptions and attitudes about child neglect of a group of mothers, in Ankara, Turkey, and to determine the factors affecting perception and attitudes of these mothers about child neglect. A questionnaire consisting of 15 scenarios about perception of child neglect and 12 behavioral descriptions about…

Social networks: a profile of the elderly who self-neglect.

PubMed

Burnett, Jason; Regev, Tziona; Pickens, Sabrina; Prati, Laura Lane; Aung, Koko; Moore, Jenny; Dyer, Carmel Bitondo

2006-01-01

Self-neglect is an independent risk factor for early mortality in older people and has been linked to depression and the occurrence of mental and physical decline. Sound social networks have been shown to slow the process of decline in the elderly, and currently little is known about the social networks associated with elder self-neglect. The aim of this study was to explore the social networks associated with elder self-neglect compared with a matched-control group. Ninety-one Adult Protective Services-validated cases of elder self-neglect were compared on formal and informal social network factors with 91controls matched for age, race, gender, and socio-economic status. Elders in the self-neglect group were significantly less likely to (1) Live with a spouse, (2) Live with others, (3) Have weekly contact with children or siblings, (4) Visit with neighbors and friends and (5) Participate in religious activities. Less adequate social resources related to family, friends, and religious affiliations are significantly associated with elder self-neglect.

Neglect Subtypes, Race, and Poverty: Individual, Family, and Service Characteristics

PubMed Central

Jonson-Reid, Melissa; Drake, Brett; Zhou, Pan

2013-01-01

Recent child maltreatment research has highlighted the very different context of poverty for Black and White children. Neglect is the most common form of maltreatment and strongly associated with poverty. Neglect is, however, not a unitary construct. We lack an understanding of whether reporting of and responding to different types of neglect may vary by poverty, race, or the intersection of the two. Administrative census, child welfare, welfare, health, and education data were used to examine how family and community poverty factors associate with various subtypes of neglect and subsequent case dispositions for Black and White children. Black children reported to child welfare reside in far poorer communities than Whites, even after taking into account family income (Aid to Families with Dependent Children [AFDC]/Temporary Aid to Needy Families [TANF]). Black children were more commonly reported and substantiated for severe and basic needs neglect. Community poverty indicators had a different relationship to report disposition for Black as compared to White children after controlling for neglect subtypes, child and family characteristics. Implications for practice and policy are discussed. PMID:23109353

Poverty-related and neglected diseases – an economic and epidemiological analysis of poverty relatedness and neglect in research and development

PubMed Central

von Philipsborn, Peter; Steinbeis, Fridolin; Bender, Max E.; Regmi, Sadie; Tinnemann, Peter

2015-01-01

Background Economic growth in low- and middle-income countries (LMIC) has raised interest in how disease burden patterns are related to economic development. Meanwhile, poverty-related diseases are considered to be neglected in terms of research and development (R&D). Objectives Developing intuitive and meaningful metrics to measure how different diseases are related to poverty and neglected in the current R&D system. Design We measured how diseases are related to economic development with the income relation factor (IRF), defined by the ratio of disability-adjusted life-years (DALYs) per 100,000 inhabitants in LMIC versus that in high-income countries. We calculated the IRF for 291 diseases and injuries and 67 risk factors included in the Global Burden of Disease Study 2010. We measured neglect in R&D with the neglect factor (NF), defined by the ratio of disease burden in DALYs (as percentage of the total global disease burden) and R&D expenditure (as percentage of total global health-related R&D expenditure) for 26 diseases. Results The disease burden varies considerably with the level of economic development, shown by the IRF (median: 1.38; interquartile range (IQR): 0.79–6.3). Comparison of IRFs from 1990 to 2010 highlights general patterns of the global epidemiological transition. The 26 poverty-related diseases included in our analysis of neglect in R&D are responsible for 13.8% of the global disease burden, but receive only 1.34% of global health-related R&D expenditure. Within this group, the NF varies considerably (median: 19; IQR: 6–52). Conclusions The IRF is an intuitive and meaningful metric to highlight shifts in global disease burden patterns. A large shortfall exists in global R&D spending for poverty-related and neglected diseases, with strong variations between diseases. PMID:25623607

A Comparison of Oral Health Status and Need for Dental Care Between Abused/Neglected Children and Nonabused/Non-Neglected Children

DTIC Science & Technology

1994-02-01

controls. The sample comprised 903 children between 5 and 13 years old; 30 were confirmed cases of child abuse and 873 served as controls. Their oral...cases of child abuse / neglect should be referred routinely for dental screening as part of their overall rehabilitation. Child abuse , Child neglect, Oral health status, Dental treatment needs.

Adolescents' experience of parental psychological caregiving and neglect: Construct development.

PubMed

Christ, Sharon L; Kwak, Yoon Young; Lu, Ting

2017-01-01

Psychological or emotional neglect is a recognized form of child maltreatment in the United States. However, neglect as a form of maltreatment and particularly psychological neglect as a subtype are understudied relative to other forms of maltreatment. One reason for this is that few measures of psychological (or emotional) neglect are available and there remains some uncertainty about how to define and measure it. In this article, we put forth a theoretical definition of psychological caregiving, including omission of care or psychological neglect of adolescents by their primary caregivers. We present an operationalization of psychological caregiving/neglect using adolescent self-reported survey items. A confirmatory latent variable modeling approach was used to measure and validate psychological caregiving/neglect in 2 adolescent (age 11 to 17) population cohorts involved with Child Protective Services (CPS) in the United States. The latent variable fits the samples well in both cohort populations indicating a valid construct, is mostly invariant across gender and age, is stable over time, and has good reliability. The measure also shows concurrent validity, associating strongly with all problem behavior domains. Questionnaire items similar to those used in this measure could be included along with other items in future studies of adolescent populations. We recommend further dialogue and development of this construct as a potential major contributing factor to the health and well-being of individuals and to advance research in the area of emotional care and neglect experiences in adolescence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Assessing Unilateral Spatial Neglect using advanced technologies: The potentiality of mobile virtual reality.

PubMed

Pallavicini, Federica; Pedroli, Elisa; Serino, Silvia; Dell'Isola, Andrea; Cipresso, Pietro; Cisari, Carlo; Riva, Giuseppe

2015-01-01

Unilateral Spatial Neglect, or neglect, is a common behavioral syndrome in patients following unilateral brain damage, such as stroke. In recent years, new technologies, such as computer-based tools and virtual reality have been used in order to solve some limitations of the traditional neglect evaluation. Within this perspective, also mobile devices such as tablets seems to be promising tools, being able to support interactive virtual environments and, at the same time, allowing to easily reproduce traditional paper-and-pencil test. In this context, the aim of our study was to investigate the potentiality of a new mobile application (Neglect App) designed and developed for tablet (iPad) for screening neglect symptoms. To address this objective, we divided a sample of 16 right-damaged patients according to the presence or absence of neglect and we administered assessment test in their traditional and Neglect App version. Results showed that the cancellation tests developed within Neglect App were equally effective to traditional paper-and-pencil tests (Line cancellation test and Star Cancellation test) in detecting neglect symptoms. Secondly, according to our results, the Neglect App Card Dealing task was more sensitive in detecting neglect symptoms than traditional functional task. Globally, results gives preliminary evidences supporting the feasibility of Neglect App for the screening of USN symptoms.

Review of the factors influencing the motivation of community drug distributors towards the control and elimination of neglected tropical diseases (NTDs)

PubMed Central

Gyapong, Margaret; Mallya, Shruti; Boadu, Nana Yaa; Amuyunzu-Nyamongo, Mary; Stephens, Mariana; McFarland, Deborah A.

2017-01-01

Background Community drug distributors or neglected tropical disease (NTD) volunteers have played a crucial role in ensuring the success of mass drug administration (MDA) programs using preventive chemotherapy (PC) for lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminths. In recent years however, a noticeable decline in motivation of some of these volunteers has been perceived, potentially negatively impacting the success of these programs. Potential hypotheses for this change in motivation include the long duration of many MDA programs, the change in sociocultural environments as well as the changes to the programs over time. This literature review identifies factors that affect NTD volunteer performance and motivation, which may be used to influence and improve future programming. Methodology/Principal findings A systematic search was conducted to identify studies published between January 1995 and September 2016 that investigate factors pertaining to volunteer motivation and performance in NTD drug distribution programs. Searches from several databases and grey literature yielded 400 records, of which 28 articles from 10 countries met the inclusion criteria. Quality assessment of studies was performed using the Critical Appraisal Skills Programme(CASP) checklist. Data pertaining to motivation, performance, retention and satisfaction was extracted and examined for themes. Recurring themes in the literature included monetary and material incentives, intrinsic motivation, gender, cost to participate, and health systems and community support. Of these, community support and the health system were found to be particularly impactful. Very few studies were found to explicitly look at novel incentives for volunteers and very few studies have considered the out of pocket and opportunity costs that NTD volunteers bear carrying out their tasks. Conclusions/Significance There is currently great interest in incorporating more

Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD.

PubMed

DE Bellis, Michael D; Hooper, Stephen R; Spratt, Eve G; Woolley, Donald P

2009-11-01

Although child neglect is the most prevalent form of child maltreatment, the neurocognitive effects of neglect are understudied. We examined IQ, reading, mathematics, and neurocognitive domains of fine-motor skills, language, visual-spatial, memory/learning, and attention/executive functions in two groups of nonsexually abused medically healthy neglected children, one with DSM-IV posttraumatic stress disorder (PTSD) and one without, and a demographically similar healthy nonmaltreated control group. Significantly lower IQ, reading, mathematics, and selected differences in complex visual attention, visual memory, language, verbal memory and learning, planning, problem solving, and speeded naming were seen in Neglect Groups. The Neglect with PTSD Group performed worse than controls on NEPSY Design Copying, NEPSY Tower, and Mathematics; and performed worse than controls and Neglect without PTSD on NEPSY Memory for Faces-Delayed. Negative correlations were seen between PTSD symptoms, PTSD severity, and maltreatment variables, and IQ, Academic Achievement, and neurocognitive domains. Neglected children demonstrated significantly lower neurocognitive outcomes and academic achievement than controls. Lower IQ, neurocognitive functions, and achievement may be associated with more PTSD symptoms (particularly re-experiencing symptoms), greater PTSD severity, and a greater number of maltreatment experiences. Trauma experiences may additionally contribute to subsequent neurodevelopmental risk in neglected children. (JINS, 2009, 15, 868-878.).

Neuropsychological Findings in Childhood Neglect and their Relationships to Pediatric PTSD

PubMed Central

De Bellis, Michael D.; Hooper, Stephen R.; Spratt, Eve G.; Woolley, Donald P.

2011-01-01

Statement of the problem Although child neglect is the most prevalent form of child maltreatment, the neurocognitive effects of neglect is understudied. Methods We examined IQ, reading, mathematics, and neurocognitive domains of fine-motor skills, language, visual-spatial, memory/learning, and attention/executive functions in two groups of non-sexually abused medically healthy neglected children, one with DSM-IV posttraumatic stress disorder (PTSD) and one without, and a demographically similar healthy non-maltreated control group. Key findings Significantly lower IQ, reading, mathematics, and selected differences in complex visual attention, visual memory, language, verbal memory and learning, planning, problem solving, and speeded naming were seen in Neglect Groups. The Neglect with PTSD Group performed worse than controls on NEPSY Design Copying, NEPSY Tower, and Mathematics; and performed worse than controls and Neglect without PTSD on NEPSY Memory for Faces-Delayed. Negative correlations were seen between PTSD symptoms, PTSD severity, and maltreatment variables, and IQ, Academic Achievement, and neurocognitive domains. Conclusions Neglected children demonstrated significantly lower neurocognitive outcomes and academic achievement than controls. Lower IQ, neurocognitive functions, and achievement may be associated with more PTSD symptoms (particularly re-experiencing symptoms), greater PTSD severity, and a greater number of maltreatment experiences. Trauma experiences may additionally contribute to subsequent neurodevelopmental risk in neglected children. PMID:19703321

A virtual reality assessment and training system for unilateral neglect.

PubMed

Kim, Kwanguk; Kim, Jaehun; Ku, Jeonghun; Kim, Deog Young; Chang, Won Hyek; Shin, Dong Ik; Lee, Jang Han; Kim, In Young; Kim, Sun I

2004-12-01

Patients with unilateral neglect have problems reporting, responding, or orienting to novel or meaningful stimuli that is presented to the side opposite to that of a brain lesion. This creates a serous problem in regards to daily living activities. However, the established methods for assessing and training of unilateral neglect patients have several deficits. Recently, virtual reality (VR) technologies have been used as an assessment and treatment tool for rehabilitation. Hence, this study designed a VR system to assess and train unilateral neglect patients. In addition, the suitability and feasibility of our VR system for unilateral neglect patients was verified.

Language Problems Among Abused and Neglected Children: A Meta-Analytic Review.

PubMed

Sylvestre, Audette; Bussières, Ève-Line; Bouchard, Caroline

2016-02-01

Research data show that exposure to abuse and neglect has detrimental effects on a child's language development. In this meta-analysis, we analyze studies (k = 23), to compare the language skills (receptive language, expressive language, pragmatics) of children who have experienced abuse and/or neglect with the language skills of children who have not experienced abuse and/or neglect and to examine whether age or type of maltreatment moderate the relationship between maltreatment and language skills. Results confirm that the language skills of children who have experienced abuse and/or neglect are delayed when compared to children who have not experienced abuse and/or neglect. Compared to older children, young children seem particularly vulnerable to abuse and neglect. No significant differences were demonstrated concerning the type of maltreatment suffered by the child. These findings support the necessity of early detection of language problems in abused and neglected children as well as early intervention in order to implement interventions that will positively stimulate their development. © The Author(s) 2015.

Tackling emerging fungal threats to animal health, food security and ecosystem resilience.

PubMed

Fisher, Matthew C; Gow, Neil A R; Gurr, Sarah J

2016-12-05

Emerging infections caused by fungi have become a widely recognized global phenomenon. Their notoriety stems from their causing plagues and famines, driving species extinctions, and the difficulty in treating human mycoses alongside the increase of their resistance to antifungal drugs. This special issue comprises a collection of articles resulting from a Royal Society discussion meeting examining why pathogenic fungi are causing more disease now than they did in the past, and how we can tackle this rapidly emerging threat to the health of plants and animals worldwide.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

Homocysteine and Cognitive Performance in Elders with Self-Neglect

NASA Technical Reports Server (NTRS)

Burnett, J.; Smith, S.M.; Aung, K.; Dyer, C.

2009-01-01

Elevated plasma homocysteine has been associated with altered cognitive performance in older adults. Elders referred to Adult Protective Services (APS) for self-neglect have been reported to have elevated plasma homocysteine levels and to suffer from cognitive impairment. This study assesses the association, if any, between plasma homocysteine and cognitive performance among elders with self-neglect. Methods: Sixty-five community-living adults, 65 years of age and older, reported to Adult Protective Services for self-neglect and 55 matched controls (matched for age, ethnicity, gender and socio-economic status) consented and participated in this study. The research team conducted in-home comprehensive geriatric assessments which included the mini-mental state exam (MMSE), the 15-item geriatric depression scale (GDS), the Wolf-Klein Clock Drawing Tests (CDT) and a comprehensive nutritional biochemistry panel, which included plasma homocysteine. Student s t tests and Pearson correlations were conducted to assess for bivariate associations. Results: Elders with self-neglect had significantly higher plasma homocysteine levels (M=12.68umol/L, sd=4.4) compared to the controls (M=10.40umol/L, sd=3.61;t=3.21, df=127, p=.002). There were no statistically significant associations between cognitive performance and plasma homocysteine in the self-neglect group, however there was a significant correlation between plasma homocysteine and the CDT among the controls (r=-.296, p=.022). Conclusion: Mean plasma homocysteine levels were significantly higher in elders with self-neglect, however, they do not appear to be related to cognitive performance, indicating that cognitive impairment in elder self-neglect involve mechanisms other than hyperhomocysteinemia. These findings warrant further investigation

Adolescent neglect, juvenile delinquency and the risk of recidivism.

PubMed

Ryan, Joseph P; Williams, Abigail B; Courtney, Mark E

2013-03-01

Victims of child abuse and neglect are at an increased risk of involvement with the juvenile justice and adult correctional systems. Yet, little is known about the continuation and trajectories of offending beyond initial contact with law enforcement. Neglect likely plays a critical role in continued offending as parental monitoring, parental rejection and family relationships are instrumental in explaining juvenile conduct problems. This study sought to determine whether neglect is associated with recidivism for moderate and high risk juvenile offenders in Washington State. Statewide risk assessments and administrative records for child welfare, juvenile justice, and adult corrections were analyzed. The sample was diverse (24 % female, 13 % African American, 8 % Hispanic, 5 % Native American) and included all moderate and high risk juvenile offenders screened by juvenile probation between 2004 and 2007 (n = 19,833). Official records from child protection were used to identify juvenile offenders with a history of child neglect and to identify juvenile offenders with an ongoing case of neglect. Event history models were developed to estimate the risk of subsequent offending. Adolescents with an ongoing case neglect were significantly more likely to continue offending as compared with youth with no official history of neglect. These findings remain even after controlling for a wide range of family, peer, academic, mental health, and substance abuse covariates. Interrupting trajectories of offending is a primary focus of juvenile justice. The findings of the current study indicate that ongoing dependency issues play a critical role in explaining the outcomes achieved for adolescents in juvenile justice settings. The implications for improved collaboration between child welfare and juvenile justice are discussed.

Task-related modulation of visual neglect in cancellation tasks

PubMed Central

Sarri, Margarita; Greenwood, Richard; Kalra, Lalit; Driver, Jon

2008-01-01

Unilateral neglect involves deficits of spatial exploration and awareness that do not always affect a fixed portion of extrapersonal space, but may vary with current stimulation and possibly with task demands. Here, we assessed any ‘top-down’, task-related influences on visual neglect, with novel experimental variants of the cancellation test. Many different versions of the cancellation test are used clinically, and can differ in the extent of neglect revealed, though the exact factors determining this are not fully understood. Few cancellation studies have isolated the influence of top-down factors, as typically the stimuli are changed also when comparing different tests. Within each of three cancellation studies here, we manipulated task factors, while keeping visual displays identical across conditions to equate purely bottom-up factors. Our results show that top-down task-demands can significantly modulate neglect as revealed by cancellation on the same displays. Varying the target/non-target discrimination required for identical displays has a significant impact. Varying the judgement required can also have an impact on neglect even when all items are targets, so that non-targets no longer need filtering out. Requiring local versus global aspects of shape to be judged for the same displays also has a substantial impact, but the nature of discrimination required by the task still matters even when local/global level is held constant (e.g. for different colour discriminations on the same stimuli). Finally, an exploratory analysis of lesions among our neglect patients suggested that top-down task-related influences on neglect, as revealed by the new cancellation experiments here, might potentially depend on right superior temporal gyrus surviving the lesion. PMID:18790703

Task-related modulation of visual neglect in cancellation tasks.

PubMed

Sarri, Margarita; Greenwood, Richard; Kalra, Lalit; Driver, Jon

2009-01-01

Unilateral neglect involves deficits of spatial exploration and awareness that do not always affect a fixed portion of extrapersonal space, but may vary with current stimulation and possibly with task demands. Here, we assessed any 'top-down', task-related influences on visual neglect, with novel experimental variants of the cancellation test. Many different versions of the cancellation test are used clinically, and can differ in the extent of neglect revealed, though the exact factors determining this are not fully understood. Few cancellation studies have isolated the influence of top-down factors, as typically the stimuli are changed also when comparing different tests. Within each of three cancellation studies here, we manipulated task factors, while keeping visual displays identical across conditions to equate purely bottom-up factors. Our results show that top-down task demands can significantly modulate neglect as revealed by cancellation on the same displays. Varying the target/non-target discrimination required for identical displays has a significant impact. Varying the judgement required can also have an impact on neglect even when all items are targets, so that non-targets no longer need filtering out. Requiring local versus global aspects of shape to be judged for the same displays also has a substantial impact, but the nature of discrimination required by the task still matters even when local/global level is held constant (e.g. for different colour discriminations on the same stimuli). Finally, an exploratory analysis of lesions among our neglect patients suggested that top-down task-related influences on neglect, as revealed by the new cancellation experiments here, might potentially depend on right superior temporal gyrus surviving the lesion.

Childhood Abuse and Neglect in Body Dysmorphic Disorder

ERIC Educational Resources Information Center

Didie, Elizabeth R.; Tortolani, Christina C.; Pope, Courtney G.; Menard, William; Fay, Christina; Phillips, Katharine A.

2006-01-01

Objective: No published studies have examined childhood abuse and neglect in body dysmorphic disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this disorder. Methods: Seventy-five subjects (69.3% female, mean age = 35.4 +/- 12.0) with DSM-IV BDD completed the Childhood Trauma…

Tackling misconceptions in geometrical optics

NASA Astrophysics Data System (ADS)

Ceuppens, S.; Deprez, J.; Dehaene, W.; De Cock, M.

2018-07-01

To improve the teaching and learning materials for a curriculum it is important to incorporate the findings from educational research. In light of this, we present creative exercises and experiments to elicit, confront and resolve misconceptions in geometrical optics. Since ray diagrams can be both the cause and the solution for many misconceptions we focus strongly on improving understanding of this tool to solve and understand optical phenomena. Through a combination of a conceptual understanding programme (CUP) and provocative exercises with ray diagrams we aim to elicit conceptual or cognitive conflict and exploit this to tackle misconceptions and increase students’ conceptual understanding through inquiry. We describe exercises for image formation by a plane mirror, image formation by a convex lens and indirect and direct observation of a real image formed by a convex lens as examples of our approach.

Biodiversity Can Help Prevent Malaria Outbreaks in Tropical Forests

PubMed Central

Laporta, Gabriel Zorello; de Prado, Paulo Inácio Knegt Lopez; Kraenkel, Roberto André; Coutinho, Renato Mendes; Sallum, Maria Anice Mureb

2013-01-01

Background Plasmodium vivax is a widely distributed, neglected parasite that can cause malaria and death in tropical areas. It is associated with an estimated 80–300 million cases of malaria worldwide. Brazilian tropical rain forests encompass host- and vector-rich communities, in which two hypothetical mechanisms could play a role in the dynamics of malaria transmission. The first mechanism is the dilution effect caused by presence of wild warm-blooded animals, which can act as dead-end hosts to Plasmodium parasites. The second is diffuse mosquito vector competition, in which vector and non-vector mosquito species compete for blood feeding upon a defensive host. Considering that the World Health Organization Malaria Eradication Research Agenda calls for novel strategies to eliminate malaria transmission locally, we used mathematical modeling to assess those two mechanisms in a pristine tropical rain forest, where the primary vector is present but malaria is absent. Methodology/Principal Findings The Ross–Macdonald model and a biodiversity-oriented model were parameterized using newly collected data and data from the literature. The basic reproduction number () estimated employing Ross–Macdonald model indicated that malaria cases occur in the study location. However, no malaria cases have been reported since 1980. In contrast, the biodiversity-oriented model corroborated the absence of malaria transmission. In addition, the diffuse competition mechanism was negatively correlated with the risk of malaria transmission, which suggests a protective effect provided by the forest ecosystem. There is a non-linear, unimodal correlation between the mechanism of dead-end transmission of parasites and the risk of malaria transmission, suggesting a protective effect only under certain circumstances (e.g., a high abundance of wild warm-blooded animals). Conclusions/Significance To achieve biological conservation and to eliminate Plasmodium parasites in human populations

Biodiversity can help prevent malaria outbreaks in tropical forests.

PubMed

Laporta, Gabriel Zorello; Lopez de Prado, Paulo Inácio Knegt; Kraenkel, Roberto André; Coutinho, Renato Mendes; Sallum, Maria Anice Mureb

2013-01-01

Plasmodium vivax is a widely distributed, neglected parasite that can cause malaria and death in tropical areas. It is associated with an estimated 80-300 million cases of malaria worldwide. Brazilian tropical rain forests encompass host- and vector-rich communities, in which two hypothetical mechanisms could play a role in the dynamics of malaria transmission. The first mechanism is the dilution effect caused by presence of wild warm-blooded animals, which can act as dead-end hosts to Plasmodium parasites. The second is diffuse mosquito vector competition, in which vector and non-vector mosquito species compete for blood feeding upon a defensive host. Considering that the World Health Organization Malaria Eradication Research Agenda calls for novel strategies to eliminate malaria transmission locally, we used mathematical modeling to assess those two mechanisms in a pristine tropical rain forest, where the primary vector is present but malaria is absent. The Ross-Macdonald model and a biodiversity-oriented model were parameterized using newly collected data and data from the literature. The basic reproduction number ([Formula: see text]) estimated employing Ross-Macdonald model indicated that malaria cases occur in the study location. However, no malaria cases have been reported since 1980. In contrast, the biodiversity-oriented model corroborated the absence of malaria transmission. In addition, the diffuse competition mechanism was negatively correlated with the risk of malaria transmission, which suggests a protective effect provided by the forest ecosystem. There is a non-linear, unimodal correlation between the mechanism of dead-end transmission of parasites and the risk of malaria transmission, suggesting a protective effect only under certain circumstances (e.g., a high abundance of wild warm-blooded animals). To achieve biological conservation and to eliminate Plasmodium parasites in human populations, the World Health Organization Malaria Eradication

78 FR 17412 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... Control of Neglected Tropical Diseases in Africa, FOA GH13-002, initial review. In accordance with Section... Neglected Tropical Diseases in Africa, FOA GH13-002, initial review.'' Contact Person for More Information...

[Neglected infectious diseases: an ongoing challenge for public health and equity in Peru].

PubMed

Cabezas-Sánchez, César

2014-04-01

Neglected Infectious Diseases (NID) affect more than one billion people worldwide, and are associated with poverty, geographic isolation of populations, social stigma, lack of precise data on estimates on both the global and local burden of disease (underreporting of the diseases), inadequate financial and political resources to effective control measures, lack of lobbying on behalf of the most vulnerable population, as well as scarce drug and diagnostic methods development. In this article we describe the relationship between NID, poverty and inequality, we propose a new concept of disease in the tropics, expanding the list of diseases that share characteristics with NID in the Peruvian context, discuss the limited availability of drugs and diagnostic tests to properly deal with these diseases, as well as highlight the contributions by the Peruvian National Institute of Health, and as final thoughts, we state that the solution for the prevention and control of NID must include an integrated approach, including the social determinants of health in the context of the fight against poverty and inequality.

Abuse and neglect experienced by aging chinese in Canada.

PubMed

Lai, Daniel W L

2011-10-01

The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.

Childhood abuse and neglect and adult intimate relationships: a prospective study.

PubMed

Colman, Rebecca A; Widom, Cathy Spatz

2004-11-01

The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on gender, age, race, and approximate family class with non-abused and non-neglected children and followed prospectively into adulthood. Between 1989 and 1995, 1,196 participants (676 abused and neglected and 520 controls) were administered a 2-hour in-person interview, including a psychiatric assessment and a variety of standardized rating scales. Male and female abuse and neglect victims reported higher rates of cohabitation, walking out, and divorce than controls. Abused and neglected females were also less likely than female controls to have positive perceptions of current romantic partners and to be sexually faithful. Although previous research on childhood maltreatment and adult intimate relationships has emphasized outcomes for female victims of childhood sexual abuse, present findings suggest that other forms of early maltreatment (physical abuse and neglect) also have a negative effect on both males' and females' ability to establish and maintain healthy intimate relationships in adulthood.

[Motor neglect of thalamic origin: report on two cases (author's transl)].

PubMed

Laplane, D; Escourolle, R; Degos, J D; Sauron, B; Massiou, H

1982-01-01

Two cases of thalamic lesions with motor neglect are presented. The syndrome of motor neglect was complete in those cases with a) underutilization of left limbs, but good utilization upon verbal orders, b) loss of placement reaction, c) weakness of movement when hand was approaching the target, d) weakness of motor reaction to nociceptive stimuli. Those cases confirm that motor neglect exists after thalamic lesions and bring pathologic clues for topographic discussion. Motor neglect seems to be a particular case of partial unilateral neglect throwing some doubt on the hypothesis of a global trouble of hemispheric activation. Prevalence of left motor neglects suggests some linkage between propositional motility and language. One may suppose that in the right hemisphere language is able to have a vicarious action when spontaneous activation is lost; at the opposite, in the left hemisphere language and motility would be too linked to let this dissociation be generally possible.

Dyadic Vulnerability and Risk Profiling for Elder Neglect

ERIC Educational Resources Information Center

Fulmer, Terry; Paveza, Gregory; VandeWeerd, Carla; Fairchild, Susan; Guadagno, Lisa; Bolton-Blatt, Marguarette; Norman, Robert

2005-01-01

Purpose: Neglect of older adults accounts for 60% to 70% of all elder-mistreatment reports made to adult protective services. The purpose of this article is to report data from research, using a risk-and-vulnerability model, that captures the independent contributions of both the elder and the caregiver as they relate to the outcome of neglect.…

The impact of tackle football injuries on the American healthcare system with a neurological focus.

PubMed

McGinity, Michael J; Grandhi, Ramesh; Michalek, Joel E; Rodriguez, Jesse S; Trevino, Aron M; McGinity, Ashley C; Seifi, Ali

2018-01-01

Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013. The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED) and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI). Patient demographics, length of hospital stay (LOS), cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed. A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days). 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2). Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion. Injuries related to tackle

The impact of tackle football injuries on the American healthcare system with a neurological focus

PubMed Central

McGinity, Michael J.; Grandhi, Ramesh; Michalek, Joel E.; Rodriguez, Jesse S.; Trevino, Aron M.; McGinity, Ashley C.

2018-01-01

Background Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. Objective Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013. Methods The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED) and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI). Patient demographics, length of hospital stay (LOS), cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed. Results A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days). 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2). Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1

Neglected Population, Neglected Right

PubMed Central

MacNaughton, Gillian; Sprague, Courtenay

2017-01-01

Abstract The laws, language, and tools of human rights have been instrumental in expanding access to lifesaving treatment for people living with HIV. Children, however, remain a neglected population, as evidenced by inadequate child-specific and child-friendly HIV treatment options. In this article, we explore the right to science, a potentially powerful but underdeveloped right in international law, and its application to research and development for pediatric HIV treatment. Drawing on reports of human rights bodies and scholars and applying the human rights typology of state obligations to respect, protect, and fulfill, we argue that states have five core obligations related to research and development for child-specific and child-friendly treatment: (1) adopting a public goods approach to science and science policy; (2) including and protecting children in research activities; (3) adopting legal and policy frameworks to support research and development through public funding and private sector incentives; (4) promoting international cooperation and assistance; and (5) ensuring the participation of marginalized communities in decision-making processes. In concluding, we make a number of recommendations for states, human rights bodies, international organizations, civil society, and private industry to further develop and implement the right to science. PMID:29302174

Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses’ assessments of oral health in preschool children

PubMed Central

2013-01-01

Background Child neglect is a pernicious child protection issue with adverse consequences that extend to adulthood. Simultaneously, though it remains prevalent, childhood dental caries is a preventable disease. Public health nurses play a pivotal role in assessing oral health in children as part of general health surveillance. However, little is known about how they assess dental neglect or what their thresholds are for initiating targeted support or instigating child protection measures. Understanding these factors is important to allow improvements to be made in care pathways. Methods We investigated public health nurses’ assessment of oral health in preschool children in relation to dental neglect and any associations they make with child neglect more broadly. A qualitative study was conducted in Scotland during 2011/12. Sixteen public health nurses were recruited purposively from one health region. Individual, semi-structured interviews were undertaken and data were analyzed inductively using a framework approach. Categories were subsequently mapped to the research questions. Results Public health nurses assess oral health through proxy measures, opportunistic observation and through discussion with parents. Dental neglect is rarely an isolated issue that leads on its own to child protection referral. It tends to be other presenting issues that initiate a response. Threshold levels for targeted support were based on two broad indicators: social issues and concerns about child (and parental) dental health. Thresholds for child protection intervention were untreated dental caries or significant dental pain. Barriers to intervention are that dental neglect may be ‘unseen’ and ‘unspoken’. The study revealed a communication gap in the care pathway for children where a significant dental problem is identified. Conclusions Public health nurses take their child protection role seriously, but rarely make a link between dental caries and child neglect. Clear

The Neglect of Virtue

ERIC Educational Resources Information Center

Sockett, Hugh

2013-01-01

This chapter argues that schooling neglects virtue through the dominant quest for right answers. This is not only intellectually disreputable in presuming the correctness of what is taught, but it undermines the development of necessary intellectual virtues, such as open-mindedness, impartiality, and accuracy in the school curriculum, and it fails…

Reaching the Neglected 95%

ERIC Educational Resources Information Center

LoSchiavo, Frank M.; Shatz, Mark A.

2009-01-01

Comments on an article by J. J. Arnett regarding the assertion that American psychology focuses too narrowly on Americans while neglecting the other 95% of the world's population. The authors' comments focus on why American psychologists have become overreliant on American samples, and they provide alternative suggestions for broadening the scope…

Correlate of self-care and self-neglect among community-dwelling older adults.

PubMed

Mardan, Homa; Hamid, TengkuAizan; Redzuan, Ma'rof; Ibrahim, Rahimah

2014-02-01

The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being.

Association Between Elder Self-Neglect and Hospice Utilization in a Community Population

PubMed Central

Dong, XinQi; Simon, Melissa A.

2012-01-01

Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically-defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8,669 participants in the Chicago Health and Aging Project, a subset of 1,438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (Mild: (HR, 2.12 (1.61-2.79); Moderate: (HR, 2.36 (1.95-2.84); Severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, −0.27, SE, 0.12, p<0.02) and shorter time from hospice admission to death (PE, −0.32, SE, 0.13, p<0.01). Elder self-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death. PMID:22770866

Carbon budget of Nyungwe Tropical Montane Rain Forest in Central Africa

NASA Astrophysics Data System (ADS)

Nyirambangutse, B.; Zibera, E.; Uwizeye, F. K.; Hansson, L.; Nsabimana, D.; Pleijel, H.; Uddling, J.; Wallin, G.

2015-12-01

African tropical rainforests host rich biodiversity and play many roles at different scales such as local, regional and global, in the functioning of the earth system. Despite that the African tropical forests are the world's second largest, it has been neglected in terms of understanding the storage and fluxes of carbon and other nutrients. The question of whether this biome is a net sink or source of atmospheric CO2 is still not answered, and little is known concerning the climate change response. Tropical montane forests are even more poorly sampled compared with their importance. Deeper understanding of these ecosystems is required to provide insights on how they might react under global change. To answer questions related to these issues for African tropical montane forests, 15 permanent 0.5 ha plots were established in 2011 in Nyungwe tropical montane rainforest gazetted as a National Park to protect its extensive floral and faunal diversity. The plots are arranged along an east-westerly transect and includes both primary and secondary forest communities. The study is connected to the global ecosystem monitoring network (GEM, http://gem.tropicalforests.ox.ac.uk/). The aim is to characterize spatial and temporal heterogeneity of carbon and nutrient dynamics processes. The role of microclimate, topography, human disturbances, and plant species to the variability of these pools and processes will be explored. We compare stocks and fluxes of carbon and nutrients of the secondary and primary forest communities. The carbon stock are determined by an inventory of height and diameter at breast height (dbh) of all trees with a dbh above 5 cm, wood density, biomass of understory vegetation, leaf area index, standing and fallen dead wood, fine root biomass and organic content of various soil layers (litter, organic and mineral soil down to 45 cm depth). The carbon fluxes are determined by measurements of photosynthesis and respiration of leaves, above and below ground

Types, Subtypes, and Severity of Substantiated Child Neglect in U.S. Army Communities.

PubMed

Cozza, Stephen J; Ortiz, Claudio D; Fullerton, Carol S; McCarroll, James E; Holmes, Allison K; Harris, April M; Wryter, Christina L; Ursano, Robert J

2015-11-01

Neglect has been linked to short-term and long-term deleterious outcomes in children, but has received little attention in the research literature. Identify types, subtypes, and severity of child neglect in a sample of substantiated cases at 4 U.S. Army installations. Describe demographic correlates of victims and offenders by type and subtype. Data were collected from archived clinical records. A stratified random sample of 100 substantiated child neglect case files were selected per site (N = 400). Data from a single child per case file were used. 5 types and 17 subtypes of neglect were represented, singly or in combination, with varying severity. Lack of Supervision was most common (n = 177, 35.3%), followed by Emotional Neglect (n = 159, 31.8%), Failure to Provide Physical Needs (n = 131, 26.2%), Moral-Legal Neglect (n = 20, 4%), and Educational Neglect (n = 13; 2.6%). Child neglect occurred mostly among young children and in young enlisted families. Current results highlight the need to focus on types, subtypes, and severity of neglect incidents that provide specific understanding of child risk to better inform policy. Further study should examine specific risk factors and their relationship to neglect types and severity outcomes. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Relationship between visuospatial neglect and kinesthetic deficits after stroke.

PubMed

Semrau, Jennifer A; Wang, Jeffery C; Herter, Troy M; Scott, Stephen H; Dukelow, Sean P

2015-05-01

After stroke, visuospatial and kinesthetic (sense of limb motion) deficits are common, occurring in approximately 30% and 60% of individuals, respectively. Although both types of deficits affect aspects of spatial processing necessary for daily function, few studies have investigated the relationship between these 2 deficits after stroke. We aimed to characterize the relationship between visuospatial and kinesthetic deficits after stroke using the Behavioral Inattention Test (BIT) and a robotic measure of kinesthetic function. Visuospatial attention (using the BIT) and kinesthesia (using robotics) were measured in 158 individuals an average of 18 days after stroke. In the kinesthetic matching task, the robot moved the participant's stroke-affected arm at a preset direction, speed, and magnitude. Participants mirror-matched the robotic movement with the less/unaffected arm as soon as they felt movement in their stroke affected arm. We found that participants with visuospatial inattention (neglect) had impaired kinesthesia 100% of the time, whereas only 59% of participants without neglect were impaired. For those without neglect, we observed that a higher percentage of participants with lower but passing BIT scores displayed impaired kinesthetic behavior (78%) compared with those participants who scored perfect or nearly perfect on the BIT (49%). The presence of visuospatial neglect after stroke is highly predictive of the presence of kinesthetic deficits. However, the presence of kinesthetic deficits does not necessarily always indicate the presence of visuospatial neglect. Our findings highlight the importance of assessment and treatment of kinesthetic deficits after stroke, especially in patients with visuospatial neglect. © The Author(s) 2014.

Psychosocial determinants of nutritional neglect in a developing country.

PubMed

Mehnaz, Aisha; Shah, Nusrat; Mala, Ashfaq; Rai, Krishan; Arif, Fehmina; Munnawar, Uzma; Raj, Rakesh; Tariq, Abida; Yasin, Shahnaz

2014-05-01

To determine the demographic features and psycho-social and economic determinants of nutritional neglect in order to suggest interventional strategies. Cross-sectional, observational study. Department of Paediatrics, Dow University of Health Sciences (DUHS) and Civil Hospital Karachi (CHK), from January 2009 to December 2010. All children suffering from nutritional neglect suggested by weight and height less than the third centile for age, and their mothers were recruited in the study through non-probability consecutive sampling. A team comprising of paediatrician, psychologist, medical social worker and social motivator interviewed the mothers and children suffering from nutritional neglect. Information about demographic, social, economic and psychological factors was obtained. The results were analyzed and described as frequency distribution and percentage. A total of 658 children suffering from nutritional neglect were inducted. Around 75% of children were below 5 years of age, 51% were females. Other determinants of nutritional neglect were, large family size (family of > 5 members (84%), young mother (60%), uneducated parents (67% father and 77% mothers being illiterate), low income (77% earning less than Rs. 7000/month), addiction (23%), tobacco smoking (50%) and non-nutritive substance use (51%). Psychological indicators identified in mothers were depression (70%), anxiety (73%), helplessness (70%), displaced aggression (50%) and insecurity (36%). Psychological factors identified in children as a secondary outcome were aggression (80%), rebellious behaviour (75%), lack of confidence (70%), lack of social interaction (70%) and paranoid tendencies (60%). Psycho-social and economic factors are important determinants of neglect. A holistic approach and intervention at multiple levels is required to address these issues.

Future research: a prospective longitudinal study of elder self-neglect.

PubMed

Dyer, Carmel Bitondo; Franzini, Luisa; Watson, Mary; Sanchez, Luis; Prati, Laura; Mitchell, Stacy; Wallace, Robert; Pickens, Sabrina

2008-11-01

In almost every U.S. jurisdiction, elder self-neglect is the most common allegation addressed by Adult Protective Service (APS) agencies. Not only is self-neglect common, but this form of mistreatment is an independent risk factor for death. A lack of understanding of the precipitating factors and root causes and of the effect on social and medical systems persists in this field. Research in this area has been limited, because the needs of these vulnerable elderly people are complex and diverse. Moreover, these factors encompass interrelated medical, psychiatric, economic, social, and functional problems. In 2004, the National Institutes of Health Interdisciplinary Roadmap Initiative provided the means for preliminary exploration of elder self-neglect through the formation of the Consortium for Research in Elder Self-neglect of Texas (CREST). The goals of CREST include to conduct pilot studies, form interdisciplinary working groups, convene a national research conference, and appoint a national external advisory board. CREST orchestrated the work of 35 interdisciplinary investigators to achieve these goals. CREST researchers have begun to characterize the population of vulnerable elderly people who were reported to APS for neglecting themselves. The pilot studies provided a snapshot of 100 elderly people who had neglected themselves. A proposed next phase could involve a prospective longitudinal study of elderly people with severe self-neglect. This study of the clinical course, the death rate, the causes of death, the occurrence of acute and chronic medical or mental illness, and the costs to the healthcare and social systems would greatly inform the field of elder mistreatment.

Near and far space neglect: task sensitivity and anatomical substrates.

PubMed

Aimola, Lina; Schindler, Igor; Simone, Anna Maria; Venneri, Annalena

2012-05-01

Most group studies which have investigated neglect for near and far space have found an increased severity of symptoms in far space compared to near space. However, the majority of these studies used relatively small samples and based their findings almost exclusively on line bisection performance. The aim of the present study was, therefore, to explore the occurrence of neglect for near and far space in a larger group of unselected right brain damaged patients and to evaluate whether neglect specific to near and far space is a task-related deficit or generalises across distance irrespective of task. In addition, a lesion overlap analysis was carried out to identify critical lesion sites associated with distance specific neglect deficits. Thirty-eight right hemisphere damaged patients carried out a line bisection and a cancellation task by using a pen in near space (40 cm) and a laser pointer in far space (320 cm). The results showed that both the number of left-sided omissions and rightward bisection errors were significantly increased in near compared to far space. Distance specific dissociations, albeit less common, were more frequently observed for cancellation than line bisection. These results suggest that space representation in neglect is more severely impaired in near than in far space. In addition, distance related dissociations in neglect may depend on task demands. Although the anatomical findings were broadly consistent with a dorsal and ventral stream dichotomy for near and far space processing, they also suggest the involvement of intermediate structures in distance related neglect phenomena. Copyright © 2012 Elsevier Ltd. All rights reserved.

Symbiosis: Rich, Exciting, Neglected Topic

ERIC Educational Resources Information Center

Rowland, Jane Thomas

1974-01-01

Argues that the topic of symbiosis has been greatly neglected and underemphasized in general-biology textbooks. Discusses many types and examples of symbiosis, and provides an extensive bibliography of the literature related to this topic. (JR)

The Impact of Neglect on Initial Adaptation to School

PubMed Central

Manly, Jody Todd; Lynch, Michael; Oshri, Assaf; Herzog, Margaret; Wortel, Sanne N.

2013-01-01

This study examined the impact of child neglect during the first four years of life on adaptation to school during kindergarten and first grade in the context of neighborhood poverty. Processes related to the development of school competencies were examined, including the mediational role of cognitive functioning and ego-resiliency in shaping children’s school outcomes. 170 low-income urban children were followed prospectively for two years (ages four to six). Results indicated that neglected children had significantly lower scores on kindergarten classroom behavior and first grade academic performance than nonneglected children. Children’s cognitive performance at age four, controlling for maternal IQ, mediated the relation between severity of neglect and children’s behavior in kindergarten as well as their academic performance in first grade. Moreover, severity of neglect was related to children’s ego-resiliency at age four. However, additional ecological adversity in the form of neighborhood poverty moderated the link between ego-resiliency and classroom behavior such that at lower levels of poverty, ego-resiliency mediated the relation between severity of neglect and school adaptation. Conversely, when neighborhood poverty was extreme, the effects of ego-resiliency were attenuated and ego-resiliency ceased to predict behavioral performance in kindergarten. The implications of these findings for prevention and intervention are discussed. PMID:23843472

Tackling Work Related Stress in a National Health Service Trust

ERIC Educational Resources Information Center

Vick, Donna; Whyatt, Hilary

2004-01-01

The challenge of tackling the problem of coping with work related stress in a National Health Service (NHS) Trust was undertaken. Ideas were developed within the context of two different action learning sets and led to actions resulting in a large therapy Taster Session event and the establishment of a centre offering alternative therapies and…

Correlate of self-care and self-neglect among community-dwelling older adults

PubMed Central

Mardan, Homa; Hamid, TengkuAizan; Redzuan, Ma’rof; Ibrahim, Rahimah

2014-01-01

Background: The prevalence of self-neglect among the elderly is expected to rise with a rapid increase in the growth of the older population. However, self-neglect in the elderly and the factors related to it are not fully understood due to the limited research in the area, lack of consensus in the definition of the concept, and limited instrumentation. The purpose of this study was to investigate the relationship between selected socio-demographic factors on self-care and self-neglect among older persons living in the community. Materials and Methods: A cross-sectional survey design with cluster sampling was adopted for the study. Data were gathered from 201 older persons aged 60 years and over in the state of Selangor, Malaysia, through face-to-face interviews in their homes with a team of trained enumerators. A new instrument was developed to measure self-neglect. Results: The internal consistency of the new instrument showed a reliability of 0.90. A significant bivariate relationship was noted between self-care and self-neglect. The socio-demographic factors were also reported between self-care and self-neglect. Conclusions: The new instrument of elder self-neglect (ESN) could be used to measure self-neglect in a community dwelling. The need to increase the self-care skills and the capacity of self-care among older adults is crucial in order to reduce self-neglect and enhance their well-being. PMID:25949256

The Abused and Neglected Child: Strategies for the Teacher.

ERIC Educational Resources Information Center

DiBrezzo, Ro; Hughes, Honore M.

1988-01-01

Training teachers to recognize and assist abused and neglected children is important because a positive relationship with a teacher can help remediate some detrimental effects. Signs of abuse and neglect, areas of needed research, and actions for educators to take in abuse cases are set forth. (MT)

Mapping the neglected space: gradients of detection revealed by virtual reality.

PubMed

Dvorkin, Assaf Y; Bogey, Ross A; Harvey, Richard L; Patton, James L

2012-02-01

Spatial neglect affects perception along different dimensions. However, there is limited availability of 3-dimensional (3D) methods that fully map out a patient's volume of deficit, although this could guide clinical management. To test whether patients with neglect exhibit simple contralesional versus complex perceptual deficits and whether deficits are best described using Cartesian (rectangular) or polar coordinates. Seventeen right-hemisphere persons with stroke (8 with a history of neglect) and 9 healthy controls were exposed to a 3D virtual environment. Targets placed in a dense array appeared one at a time in various locations. When tested using rectangular array of targets, subjects in the neglect group exhibited complex asymmetries across several dimensions in both reaction time and target detection rates. Paper-and-pencil tests only detected neglect in 4 of 8 of these patients. When tested using polar array of targets, 2 patients who initially appeared to perform poorly in both left and near space only showed a simple left-side asymmetry that depended almost entirely on the angle from the sagittal plane. A third patient exhibited left neglect irrespective of the arrangements of targets used. An idealized model with pure dependence on the polar angle demonstrated how such deficits could be misconstrued as near neglect if one uses a rectangular array. Such deficits may be poorly detected by paper-and-pencil tests and even by computerized tests that use regular screens. Assessments that incorporate 3D arrangements of targets enable precise mapping of deficient areas and detect subtle forms of neglect whose identification may be relevant to treatment strategies.

The profile and progress of neglected and abused children in long-term foster care.

PubMed

Barber, James G; Delfabbro, Paul H

2009-07-01

This study compared the profile of neglected and abused children in the Australian foster care system as well as differences between maltreatment types in relation to parental contact, reunification and psychosocial progress in care. The case files of 235 children entering foster care were examined and their social workers were administered standardised questionnaires at the point of intake. All measures were repeated for those remaining in care 1 year and then again 2 years later. Neglected children were younger than non-neglected children, more likely to have a physical or mental disability, more likely to experience multiple forms of maltreatment and less likely to pose conduct problems for carers. Neglected children were more likely than non-neglected children to experience a decline in parental contact over time, and were less likely to be reunified with their families of origin. There was minimal difference between neglected and non-neglected in their psychosocial progress while in care. Aboriginal children were more likely to be reunified than non-Aboriginal children when neglect was attributable to transient factors (parental incapacity) but the reverse was true for non-neglected children. The fact that neglected children more often require a second form of maltreatment before being removed from home suggests that children's services workers are less inclined to remove children for neglect than for other forms of maltreatment. As a consequence, those neglected children who are in care tend to come from more dysfunctional families than non-neglected children do, as evidenced by the relatively poorer parental contact and reunification results of neglected children. Neglected children differ systematically from non-neglected children and suffer relative disadvantage in relation to multiple forms of maltreatment, parental contact, and reunification. The fact that declines in parental contact among neglected children in care occurred only when indirect contact

Improving left spatial neglect through music scale playing.

PubMed

Bernardi, Nicolò Francesco; Cioffi, Maria Cristina; Ronchi, Roberta; Maravita, Angelo; Bricolo, Emanuela; Zigiotto, Luca; Perucca, Laura; Vallar, Giuseppe

2017-03-01

The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right-brain-damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right-brain-damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age-matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no-sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder. © 2015 The British Psychological Society.

Left neglect dyslexia and the effect of stimulus duration.

PubMed

Arduino, Lisa S; Vallar, Giuseppe; Burani, Cristina

2006-01-01

The present study investigated the effects of the duration of the stimulus on the reading performance of right-brain-damaged patients with left neglect dyslexia. Three Italian patients read aloud words and nonwords, under conditions of unlimited time of stimulus exposure and of timed presentation. In the untimed condition, the majority of the patients' errors involved the left side of the letter string (i.e., neglect dyslexia errors). Conversely, in the timed condition, although the overall level of performance decreased, errors were more evenly distributed across the whole letter string (i.e., visual - nonlateralized - errors). This reduction of neglect errors with a reduced time of presentation of the stimulus may reflect the read out of elements of the letter string from a preserved visual storage component, such as iconic memory. Conversely, a time-unlimited presentation of the stimulus may bring about the rightward bias that characterizes the performance of neglect patients, possibly by a capture of the patients' attention by the final (rightward) letters of the string.

The Role of Parental Distress in Moderating the Influence of Child Neglect on Maladjustment.

PubMed

Berzenski, Sara R; Bennett, David S; Marini, Victoria A; Sullivan, Margaret Wolan; Lewis, Michael

2014-11-01

Despite pervasive evidence of the harmful impact of neglect on children's adjustment, individual differences in adaptation persist. This study examines parental distress as a contextual factor that may moderate the relation between neglect and child adjustment, while considering the specificity of the relation between neglect and internalizing versus externalizing problems. In a sample of 66 children (33 with a documented child protective services history of neglect prior to age six), neglect predicted internalizing, and to a lesser extent externalizing, problems as rated by teachers at age seven. Parental distress moderated the relation between neglect and internalizing, but not externalizing, problems. Specifically, higher levels of neglect predicted more internalizing problems only among children of distressed parents. These findings indicate that parent-level variables are important to consider in evaluating the consequences of neglect, and point to the importance of considering contextual factors when identifying those children most at risk following neglect.

The Role of Empathy in Preparing Teachers to Tackle Bullying

ERIC Educational Resources Information Center

Murphy, Helena; Tubritt, John; Norman, James O'Higgins

2018-01-01

Much research on bullying behaviour in schools among students has been carried out since the 1970's, when Olweus started a large-scale project in Norway which is now generally regarded as the first scientific study on bullying. Yet, there has been little research on how teachers respond to reports of bullying and tackle bullying behaviour in…

Biased figure-ground assignment affects conscious object recognition in spatial neglect.

PubMed

Eramudugolla, Ranmalee; Driver, Jon; Mattingley, Jason B

2010-09-01

Unilateral spatial neglect is a disorder of attention and spatial representation, in which early visual processes such as figure-ground segmentation have been assumed to be largely intact. There is evidence, however, that the spatial attention bias underlying neglect can bias the segmentation of a figural region from its background. Relatively few studies have explicitly examined the effect of spatial neglect on processing the figures that result from such scene segmentation. Here, we show that a neglect patient's bias in figure-ground segmentation directly influences his conscious recognition of these figures. By varying the relative salience of figural and background regions in static, two-dimensional displays, we show that competition between elements in such displays can modulate a neglect patient's ability to recognise parsed figures in a scene. The findings provide insight into the interaction between scene segmentation, explicit object recognition, and attention.

Military tropical medicine.

PubMed

Bailey, M S; Ellis, C J

2009-03-01

Tropical diseases remain a significant threat to deployed military personnel as demonstrated by recent outbreaks amongst troops in Sierra Leone, Iraq and Afghanistan. Five cases are presented from military deployments in tropical or sub-tropical areas, which illustrate important diseases and diagnostic principles for military physicians.

Mirror Therapy in Unilateral Neglect After Stroke (MUST trial)

PubMed Central

Arora, Rajni; Kaur, Paramdeep; Sharma, Deepika; Vishwambaran, Dheeraj K.; Arima, Hisatomi

2014-01-01

Objective: We explored the effectiveness of mirror therapy (MT) in the treatment of unilateral neglect in stroke patients. Methods: This is an open, blinded endpoint, randomized controlled trial carried out from January 2011 to August 2013. We included stroke patients with thalamic and parietal lobe lesions with unilateral neglect 48 hours after stroke. Patients were randomized to the MT group or the control group (sham MT), and both the groups received limb activation. Patients received treatment for 1–2 hours a day 5 days a week for 4 weeks. The primary outcome was unilateral neglect assessed by a blinded assessor using the star cancellation test, the line bisection test, and a picture identification task at 1, 3, and 6 months. This study was registered at http://clinicaltrials.gov (NCT 01735877). Results: Forty-eight patients were randomized to MT (n = 27) or the control group (n = 21). Improvement in scores on the star cancellation test over 6 months was greater in the MT group (mean difference 23, 95% confidence interval [CI] 19–28; p < 0.0001). Similarly, improvement in the MT group was observed in the scores on the picture identification task (mean difference 3.2, 95% CI 2.4–4.0; p < 0.0001) and line bisection test (mean difference 8.6, 95% CI 2.7–14.6; p = 0.006). Conclusions: In patients with stroke, MT is a simple treatment that improves unilateral neglect. Classification of evidence: This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes, MT improves neglect. PMID:25107877

The evolution of policy and actions to tackle obesity in England.

PubMed

Jebb, S A; Aveyard, P N; Hawkes, C

2013-11-01

Tackling obesity has been a policy priority in England for more than 20 years. Two formal government strategies on obesity in 2008 and 2011 drew together a range of actions and developed new initiatives to fill perceived gaps. Today, a wide range of policies are in place, including support for breastfeeding and healthy weaning practices, nutritional standards in schools, restrictions on marketing foods high in fat, sugar and salt to children, schemes to boost participation in sport, active travel plans, and weight management services. Data from annual surveys show that the rate of increase in obesity has attenuated in recent years, but has not yet been reversed. This paper considers the actions taken and what is known about the impact of individual policies and the overarching strategy to tackle obesity in England. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

Adolescent Neglect, Juvenile Delinquency and the Risk of Recidivism

ERIC Educational Resources Information Center

Ryan, Joseph P.; Williams, Abigail B.; Courtney, Mark E.

2013-01-01

Victims of child abuse and neglect are at an increased risk of involvement with the juvenile justice and adult correctional systems. Yet, little is known about the continuation and trajectories of offending beyond initial contact with law enforcement. Neglect likely plays a critical role in continued offending as parental monitoring, parental…

Empowering Young Abused and Neglected Children through Contingency Play.

ERIC Educational Resources Information Center

Gunsberg, Andrew

1989-01-01

Argues that contingency play as an intervention strategy can ameliorate abused and neglected children's alienation from adults, reduce stress, and develop positive modes of behavior. The argument is supported by a case study of a four-year-old girl in a day treatment center for abused and neglected children. (BB)

Research advances on the multiple uses of Moringa oleifera: A sustainable alternative for socially neglected population.

PubMed

Brilhante, Raimunda Sâmia Nogueira; Sales, Jamille Alencar; Pereira, Vandbergue Santos; Castelo-Branco, Débora de Souza Collares Maia; Cordeiro, Rossana de Aguiar; de Souza Sampaio, Célia Maria; de Araújo Neto Paiva, Manoel; Santos, João Bosco Feitosa Dos; Sidrim, José Júlio Costa; Rocha, Marcos Fábio Gadelha

2017-07-01

Moringa oleifera Lam (Moringaceae) is a plant with high nutritional and medicinal value. Native to India, it is now widely distributed throughout tropical and subtropical regions of the world. Its different parts are sources of proteins, vitamins and minerals and present different pharmacological and biotechnological potential. Moreover, M. oleifera seeds are widely used in water and effluent treatment, for their coagulation, flocculation and sedimentation properties, their ability of improving water quality, by reducing organic matter and microbial load, with special applicability in intensive animal production systems, such as aquaculture. In addition, due to its high nutritional value and several medicinal properties, this tree may act as a nutritional and medical alternative for socially neglected populations. In this context, this review gathers information on M. oleifera, emphasizing its chemical constituents, nutritional, pharmacological and antimicrobial properties, applications in the treatment of water effluents, and ecological and social aspects. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Tropical sprue

MedlinePlus

... than avoiding living in or traveling to tropical climates, there is no known prevention for tropical sprue. ... Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David ...

Redrawing the line: An exploration of how lay people construct child neglect.

PubMed

Williams, Sasha Emma

2017-06-01

While there has been an increasing professional and political focus on the prevalence and harmfulness of child neglect, little has been done to explore what child neglect means outside child protection circles. This qualitative study explores lay constructions of child neglect by thematically analyzing focus group discussions between 46 self-defined 'lay' people in England. Participants viewed neglect as extremely damaging for children and as arising when children's physical, emotional, training and supervisory needs were unmet due to abnormal parental behavior. Children with unmet needs were positioned as deprived, unloved, uncontrolled and escaping. They were only positioned as neglected when failure to meet their needs was attributable to a lack of parental knowledge and skill (clueless parents), a lack of appropriate parental disposition (underinvested parents) or both (unsuitable parents). 'Normal' parents - those with the appropriate parental disposition, skills and knowledge - who failed to meet their children's needs were not seen as neglectful but rather as overburdened. As 'normal parenting' has fragmented in late modernity, society wide consensus on child neglect was felt by participants to have retreated to child protection definitions, alienating lay understandings. If child neglect really is 'everybody's business', then it is important that lay people are included in forging new definitions of and responses to meeting the needs of children. Copyright © 2017 Elsevier Ltd. All rights reserved.

Unilateral neglect: further validation of the baking tray task.

PubMed

Appelros, Peter; Karlsson, Gunnel M; Thorwalls, Annika; Tham, Kerstin; Nydevik, Ingegerd

2004-11-01

The Baking Tray Task is a comprehensible, simple-to-perform test for use in assessing unilateral neglect. The aim of this study was to validate further its use with stroke patients. The Baking Tray Task was compared with 2 versions of the Behaviour Inattention Test and a test for personal neglect. A total of 270 patients were subjected to a 3-item version of the Behaviour Inattention Test and 40 patients were subjected to an 8-item version of the Behaviour Inattention Test, besides the Baking Tray Task and the personal neglect test. The Baking Tray Task was more sensitive than the 3-item Behaviour Inattention Test, but the 8-item Behaviour Inattention Test was more sensitive than the Baking Tray Task. The best combination of any 3 tests was Baking Tray Task, Reading an article, and Figure copying; the 2 last-mentioned being a part of the 8-item Behaviour Inattention Test. Multi-item tests detect more cases of neglect than do single tests. However, it is tiresome for the patient to undergo a larger test battery than necessary. It is also time-consuming for the staff. Behavioural tests seem more appropriate when assessing neglect. The Baking Tray Task seems to be one of the most sensitive single tests, but its sensitivity can be further enhanced when it is used in combination with other tests.

Applications of NASA TROPICS Data for Tropical Cyclone Analysis, Nowcasting, and Impacts

NASA Astrophysics Data System (ADS)

Zavodsky, B.; Dunion, J. P.; Blackwell, W. J.; Braun, S. A.; Green, D. S.; Velden, C.; Adler, R. F.; Cossuth, J.; Murray, J. J.; Brennan, M. J.

2017-12-01

The National Aeronautics and Space Administration (NASA) Time-Resolved Observations of Precipitation structure and storm Intensity with a Constellation of Smallsats (TROPICS) mission is a constellation of state-of-the-science observing platforms that will measure temperature and humidity soundings and precipitation with spatial resolution comparable to current operational passive microwave sounders but with unprecedented temporal resolution. TROPICS is a cost-capped ($30M) Venture-class mission funded by the NASA Earth Science Division. The mission is comprised of a constellation of 3 unit (3U) SmallSats, each hosting a 12-channel passive microwave spectrometer based on the Micro-sized Microwave Atmospheric Satellite 2 (MicroMAS-2) developed at MIT LL. TROPICS will provide imagery near 91 and 205 GHz, temperature sounding near 118 GHz, and moisture sounding near 183 GHz. Spatial resolution at nadir will be around 27 km for temperature and 17 km for moisture and precipitation. The swath width is approximately 2000 km. TROPICS enables temporal resolution similar to geostationary orbit but at a much lower cost, demonstrating a technology that could impact the design of future Earth-observing missions. The TROPICS satellites for the mission are slated for delivery to NASA in 2019 with potential launch opportunities in 2020. The primary mission objective of TROPICS is to relate temperature, humidity, and precipitation structure to the evolution of tropical cyclone (TC) intensity. This abstract summarizes the outcomes of the 1st TROPICS Applications Workshop, held from May 8-10, 2017 at the University of Miami. At this meeting, a series of presentations and breakout discussions in the topical areas of Tropical Cyclone Dynamics, Tropical Cyclone Analysis and Nowcasting, Tropical Cyclone Modeling and Data Assimilation, and Terrestrial Impacts were convened to identify applications of the mission data and to begin to establish a community of end-users who will be able to

Hospitalization of abused and neglected children.

PubMed

Marshall, W N

1997-03-01

To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

Ursolic Acid, a Natural Pentacylcic Triterpene from Ochrosia elliptica and Its Role in The Management of Certain Neglected Tropical Diseases

PubMed Central

Labib, Rola M.; Ebada, Sherif S.; Youssef, Fadia S.; Ashour, Mohamed L.; Ross, Samir A.

2016-01-01

parasitic enzymes. SUMMARY The fresh leaves of Ochrosia elleptica Labill., family Apocyanaceae are a reliable source of ursolic acid.Ursolic acid displayed considerable antitrypanosomal and antileishmanial activities. It showed superior antitrypanosomal activity as compared to difluoromethylornithine (DFMO), potent antitrypanosomal reference drug.In silico molecular modeling studies revealed that the antileishmanial and antitrypanosomal activities of ursolic acid could be partially explained in view of its multiple inhibitory effects on vital parasitic enzymes with the highest potency exerted in the inhibition of pteridine reductase 1 and trypanothione reductase. Abbreviations used: AHT: African Human Trypanosomiasis, ATCC: American type cell culture, BuOH: n-butanol, DCM: dichloromethane, DFMO: difluoromethylornithine, EtOAc: ethyl acetate, FCS: fetal calf serum, HMBC: Heteronuclear Multiple Bond Correlation, HMQC: Heteronuclear Multiple-Quantum Correlation, HR-ESI-FTMS: High Resolution Electrospray ionozation Mass Spectrometry, MENA: Middle East and North Africa, MeOH: Methanol, MRSA: Methicillin-resistant Staphylococcus aureus, NTDs: Neglected tropical diseases, TLC: Thin layer chromatography, UA: Ursolic acid, UV: Ultra violet, WHO: World Health Organization. PMID:27867276

Polar-Tropical Coupling in the Winter Stratosphere

NASA Astrophysics Data System (ADS)

Scott, R.

2017-12-01

A distinct pattern of enhanced equatorial potential vorticitygradients during QBO westerly anomalies, enhanced subtropicalgradients during QBO easterlies, is used to motivate a new formulationof dynamical coupling between the tropics and winter polar vortexbased on remote transfer of finite amplitude wave activity defined interms of lateral potential vorticity displacements. While the weakpotential vorticity gradients in the surf zone imply laterallyevanescent Rossby waves, transfer of wave activity from the polarvortex edge to the subtropical barrier or to the QBO westerly phaseequatorial gradients arises from nonlocality of potential vorticityinversion and the large horizontal displacements of the vortex edge.Our approach goes beyond the traditional description of the effect ofQBO wind anomalies on linear wave propagation through the stratospherevia wave reflection at the zero wind line; linear wave theory isappealing but neglects the long horizontal and vertical wavelengthsinvolved and the inhomogeneous background potential vorticity. Aparticular issue of outstanding interest is whether and how therelatively shallow QBO anomalies can influence the deep verticallypropagating waves on the edge of the winter stratospheric polarvortex. Process studies with a mechanistic model with prescribed QBOand carefully controlled high-latitude wave forcing are analyzed,guided by a reexamination of meteorological reanalysis, to address howsuch a dynamical linkage may influence in particular the resonantexcitation of the winter vortex, and the occurrence ofvortex-splitting sudden warming events. We quantify the associatedtransfer of wave activity from vortex edge to the tropics, considerunder what conditions this becomes a significant source of easterlymomentum in the driving of the QBO itself, and how the structure ofthe Brewer-Dobson circulation varies in response to the location ofthe QBO westerly winds in any given winter.

Resilience among abused and neglected children grown up.

PubMed

McGloin, J M; Widom, C S

2001-01-01

Although an extensive literature has accumulated documenting the maladaptive outcomes associated with childhood victimization, a limited body of knowledge addresses resilience. This paper sought to operationalize the construct of resilience across a number of domains of functioning and time periods and to determine the extent to which abused and neglected children grown up demonstrate resilience. Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on gender, age, race, and approximate family social class with nonabused and nonneglected children and followed prospectively into young adulthood. Between 1989 and 1995. 1,196 participants (676 abused and neglected and 520 controls) were administered a 2-hr in-person interview, including a psychiatric assessment. Resilience requires meeting the criteria for success across six of eight domains of functioning: employment, homelessness, education, social activity, psychiatric disorder, substance abuse, and two domains assessing criminal behavior (official arrest and self-reports of violence). Results indicate that 22% of abused and neglected individuals meet the criteria for resilience. More females met the criteria for resilience and females were successful across a greater number of domains than males. We speculate on the meaning of these findings and discuss implications for the child maltreatment field. Limitations of the study are also acknowledged.

Representation and disconnection in imaginal neglect.

PubMed

Rode, G; Cotton, F; Revol, P; Jacquin-Courtois, S; Rossetti, Y; Bartolomeo, P

2010-08-01

Patients with neglect failure to detect, orient, or respond to stimuli from a spatially confined region, usually on their left side. Often, the presence of perceptual input increases left omissions, while sensory deprivation decreases them, possibly by removing attention-catching right-sided stimuli (Bartolomeo, 2007). However, such an influence of visual deprivation on representational neglect was not observed in patients while they were imagining a map of France (Rode et al., 2007). Therefore, these patients with imaginal neglect either failed to generate the left side of mental images (Bisiach & Luzzatti, 1978), or suffered from a co-occurrence of deficits in automatic (bottom-up) and voluntary (top-down) orienting of attention. However, in Rode et al.'s experiment visual input was not directly relevant to the task; moreover, distraction from visual input might primarily manifest itself when representation guides somatomotor actions, beyond those involved in the generation and mental exploration of an internal map (Thomas, 1999). To explore these possibilities, we asked a patient with right hemisphere damage, R.D., to explore visual and imagined versions of a map of France in three conditions: (1) 'imagine the map in your mind' (imaginal); (2) 'describe a real map' (visual); and (3) 'list the names of French towns' (propositional). For the imaginal and visual conditions, verbal and manual pointing responses were collected; the task was also given before and after mental rotation of the map by 180 degrees . R.D. mentioned more towns on the right side of the map in the imaginal and visual conditions, but showed no representational deficit in the propositional condition. The rightward inner exploration bias in the imaginal and visual conditions was similar in magnitude and was not influenced by mental rotation or response type (verbal responses or manual pointing to locations on a map), thus suggesting that the representational deficit was robust and independent of

Tropical Rainforests.

ERIC Educational Resources Information Center

Nigh, Ronald B.; Nations, James D.

1980-01-01

Presented is a summary of scientific knowledge about the rainforest environment, a tropical ecosystem in danger of extermination. Topics include the current state of tropical rainforests, the causes of rainforest destruction, and alternatives of rainforest destruction. (BT)

Economic inequality caused by feedbacks between poverty and the dynamics of a rare tropical disease: the case of Buruli ulcer in sub-Saharan Africa

PubMed Central

Garchitorena, Andrés; Ngonghala, Calistus N.; Guegan, Jean-Francois; Texier, Gaëtan; Bellanger, Martine; Bonds, Matthew; Roche, Benjamin

2015-01-01

Neglected tropical diseases (NTDs) have received increasing attention in recent years by the global heath community, as they cumulatively constitute substantial burdens of disease as well as barriers for economic development. A number of common tropical diseases such as malaria, hookworm or schistosomiasis have well-documented economic impacts. However, much less is known about the population-level impacts of diseases that are rare but associated with high disability burden, which represent a great number of tropical diseases. Using an individual-based model of Buruli ulcer (BU), we demonstrate that, through feedbacks between health and economic status, such NTDs can have a significant impact on the economic structure of human populations even at low incidence levels. While average wealth is only marginally affected by BU, the economic conditions of certain subpopulations are impacted sufficiently to create changes in measurable population-level inequality. A reduction of the disability burden caused by BU can thus maximize the economic growth of the poorest subpopulations and reduce significantly the economic inequalities introduced by the disease in endemic regions. PMID:26538592

Economic inequality caused by feedbacks between poverty and the dynamics of a rare tropical disease: the case of Buruli ulcer in sub-Saharan Africa.

PubMed

Garchitorena, Andrés; Ngonghala, Calistus N; Guegan, Jean-Francois; Texier, Gaëtan; Bellanger, Martine; Bonds, Matthew; Roche, Benjamin

2015-11-07

Neglected tropical diseases (NTDs) have received increasing attention in recent years by the global heath community, as they cumulatively constitute substantial burdens of disease as well as barriers for economic development. A number of common tropical diseases such as malaria, hookworm or schistosomiasis have well-documented economic impacts. However, much less is known about the population-level impacts of diseases that are rare but associated with high disability burden, which represent a great number of tropical diseases. Using an individual-based model of Buruli ulcer (BU), we demonstrate that, through feedbacks between health and economic status, such NTDs can have a significant impact on the economic structure of human populations even at low incidence levels. While average wealth is only marginally affected by BU, the economic conditions of certain subpopulations are impacted sufficiently to create changes in measurable population-level inequality. A reduction of the disability burden caused by BU can thus maximize the economic growth of the poorest subpopulations and reduce significantly the economic inequalities introduced by the disease in endemic regions. © 2015 The Author(s).

Behavior Problems in School-Aged Physically Abused and Neglected Children in Spain.

ERIC Educational Resources Information Center

de Paul, Joaquin; Arruabarrena, M. Ignacia

1995-01-01

This study investigated behavior problems in 66 school-aged physically abused, neglected, and control group children in the Basque Country, Spain. Abused and neglected children had higher subscale scores for social problems, delinquent behavior, and attention problems and showed lower school adjustment. Neglected children appeared more aggressive,…

Greek Teachers' Experience and Perceptions of Child Abuse/Neglect

ERIC Educational Resources Information Center

Bibou-Nakou, I.; Markos, A.

2017-01-01

The present paper focuses on teachers' experiences of child abuse/neglect cases, teachers' awareness of reporting or discounting, and their ways of responding to a hypothetical disclosure of abuse/neglect. A total of 1877 teachers in Greek public schools participated from a national teacher in-service training across the country; of them, 306…

Elder Abuse and Neglect: Considerations for Mental Health Practitioners

ERIC Educational Resources Information Center

Thompson, Heather; Priest, Ronnie

2005-01-01

Elder abuse and neglect are prevalent throughout the U.S. and are often unrecognized and untreated. It is projected that by the year 2030, the number of older adults (age 60 and older) will double, thereby increasing the likelihood that mental health practitioners will encounter instances of elder abuse and neglect. The authors address the…

Oral and Dental Aspects of Child Abuse and Neglect.

PubMed

2017-09-15

In all 50 states, health care providers (including dentists) are mandated to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this report is to review the oral and dental aspects of physical and sexual abuse and dental neglect in children and the role of pediatric care providers and dental providers in evaluating such conditions. This report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect. Oral health issues can also be associated with bullying and are commonly seen in human trafficking victims. Some medical providers may receive less education pertaining to oral health and dental injury and disease and may not detect the mouth and gum findings that are related to abuse or neglect as readily as they detect those involving other areas of the body. Therefore, pediatric care providers and dental providers are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions in children.

Association of Personality Traits with Elder Self-Neglect in a Community Dwelling Population

PubMed Central

Dong, XinQi; Simon, Melissa; Wilson, Robert; Beck, Todd; McKinell, Kelly; Evans, Denis

2010-01-01

Objective Elder self-neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder self-neglect among community-dwelling populations. The objectives of this study are: 1) to examine the association of personality traits with elder self-neglect and 2) to examine the association of personality traits with elder self-neglect severity. Methods Population-based study conducted from 1993–2005 of community-dwelling older adults (N=9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N=1,820) were identified for suspected self-neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity and information processing. Logistic and linear regressions were used to assess these associations. Results In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder self-neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater self-neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder self-neglect outcomes. Conclusion Neuroticism, extraversion, rigidity and information processing were not associated with significantly increased risk of elder self-neglect after consideration of potential confounders. PMID:21788924

Individual Differences in the Cortisol Responses of Neglected and Comparison Children

PubMed Central

Sullivan, Margaret Wolan; Bennett, David S.; Lewis, Michael

2014-01-01

Neglected children’s acute hypothalamic–pituitary–adrenal axis (HPA axis) reactivity in response to a laboratory visit was contrasted with that of a comparison group. The authors examined initial salivary cortisol response upon entering the laboratory and its trajectory following a set of tasks designed to elicit negative self-evaluation in 64 children (30 with a history of neglect and 34 demographically matched comparison children). Neglected, but not comparison, children showed higher initial cortisol responses. The cortisol response of both groups showed a decline from the sample taken at lab entry, with neglected children’s cortisol exhibiting steeper decline. The groups, however, did not differ in their mean cortisol levels at 20 and 35 min post-task. The results are interpreted in terms of the meaning of initial responses as a “baseline” and as evidence for neglected children’s heightened HPA-axis reactivity as either a reflection of differences in home levels or the consequence of stress/anxiety associated with arrival at the laboratory. PMID:22752003

Individual differences in the cortisol responses of neglected and comparison children.

PubMed

Sullivan, Margaret Wolan; Bennett, David S; Lewis, Michael

2013-02-01

Neglected children's acute hypothalamic-pituitary-adrenal axis (HPA axis) reactivity in response to a laboratory visit was contrasted with that of a comparison group. The authors examined initial salivary cortisol response upon entering the laboratory and its trajectory following a set of tasks designed to elicit negative self-evaluation in 64 children (30 with a history of neglect and 34 demographically matched comparison children). Neglected, but not comparison, children showed higher initial cortisol responses. The cortisol response of both groups showed a decline from the sample taken at lab entry, with neglected children's cortisol exhibiting steeper decline. The groups, however, did not differ in their mean cortisol levels at 20 and 35 min post-task. The results are interpreted in terms of the meaning of initial responses as a "baseline" and as evidence for neglected children's heightened HPA-axis reactivity as either a reflection of differences in home levels or the consequence of stress/anxiety associated with arrival at the laboratory.

A Profile of Elder Abuse and Neglect in Tennessee.

ERIC Educational Resources Information Center

Villas, Paul

A survey of 35 cases of reported abuse to individuals aged 60 and older in the state of Tennessee sought to determine demographic characteristics of the abused, perpetrators of elder abuse and neglect, types of abuse that occur, and any existence of relationships in elder abuse and neglect between urban and rural counties and eastern and western…

Anosognosia, neglect and quality of life of right hemisphere stroke survivors.

PubMed

Dai, C-Y; Liu, W-M; Chen, S-W; Yang, C-A; Tung, Y-C; Chou, L-W; Lin, L-C

2014-05-01

Anosognosia and neglect may coexist in stroke patients. Neglect patients often report poor quality of life (QOL), whereas patients suffering from other cognition disorders with poor insight report better QOL. This study investigates the relationship between anosognosia, neglect and QOL amongst stroke survivors. Stroke survivors who met the criteria were used as a sampling pool. Sixty stroke patients were observed in this study, amongst whom 20 patients with anosognosia and neglect (A+N+), 20 patients with neglect but not anosognosia (A-N+) and 20 patients with neither anosognosia nor neglect (A-N-) were selected from the sampling pool based on demographic characteristics matched with the A+N+ group. A questionnaire (SS-QOL) was used to collect the QOL perceived by the stroke survivors. The perceived QOL of the A+N+ group was significantly better than those of the other groups, including the subscales of self-care, mobility, work/productivity, upper extremity, mood, family role and social role. However, the A+N+ group had poor balance level and more fall incidents were reported. The A+N+ group perceived better QOL but had more falls and poorer balance than the other groups. Health providers should work with caregivers aggressively in preventing accidents. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

Dissociation in victims of childhood abuse or neglect: a meta-analytic review.

PubMed

Vonderlin, Ruben; Kleindienst, Nikolaus; Alpers, Georg W; Bohus, Martin; Lyssenko, Lisa; Schmahl, Christian

2018-04-10

Childhood abuse and neglect are associated with dissociative symptoms in adulthood. However, empirical studies show heterogeneous results depending on the type of childhood abuse or neglect and other maltreatment characteristics. In this meta-analysis, we systematically investigated the relationship between childhood interpersonal maltreatment and dissociation in 65 studies with 7352 abused or neglected individuals using the Dissociative Experience Scale (DES). We extracted DES-scores for abused and non-abused populations as well as information about type of abuse/neglect, age of onset, duration of abuse, and relationship to the perpetrator. Random-effects models were used for data synthesis, and meta-regression was used to predict DES-scores in abused populations from maltreatment characteristics. The results revealed higher dissociation in victims of childhood abuse and neglect compared with non-abused or neglected subsamples sharing relevant population features (MAbuse = 23.5, MNeglect = 18.8, MControl = 13.8) with highest scores for sexual and physical abuse. An earlier age of onset, a longer duration of abuse, and parental abuse significantly predicted higher dissociation scores. This meta-analysis underlines the importance of childhood abuse/neglect in the etiology of dissociation. The identified moderators may inform risk assessment and early intervention to prevent the development of dissociative symptoms.

Behavior problems in school-aged physically abused and neglected children in Spain.

PubMed

de Paúl, J; Arruabarrena, M I

1995-04-01

The present study investigated behavior problems in school-aged physically abused, neglected, and comparison children in the Basque Country (Spain). Data from the Teacher's Report Form of the Child Behavior Checklist was obtained on 66 children consisting of three groups (17 physically abused children, 24 physically neglected children, and 25 low-risk comparison children). The three groups were matched on seven sociodemographic variables. Overall, the abused and neglected children were higher than the comparison group on Total Behavior Problems scores. However, only neglected children obtained higher scores than the comparison group on the total score of the Externalized Scale, and only abused children scored higher than the comparison group on the total score of the Internalized Scale. Follow-up analysis indicated that both abused and neglected children had higher scores on the Social Problems, Delinquent Behavior, and Attention Problems subscales. Moreover, neglected children had higher scores on the Aggressive Behavior subscale than the comparison children, and abused children had higher scores on the Withdrawn subscale than the comparison children. The abused and neglected children also showed a lower school adjustment than the comparison group. Possible explanations of these findings are discussed and their implications for research and treatment are considered.

Treatment of the neglected Achilles tendon rupture.

PubMed

Bevilacqua, Nicholas J

2012-04-01

Achilles tendon ruptures are best managed acutely. Neglected Achilles tendon ruptures are debilitating injuries and the increased complexity of the situation must be appreciated. Surgical management is recommended, and only in the poorest surgical candidate is conservative treatment entertained. Numerous treatment algorithms and surgical techniques have been described. A V-Y advancement flap and flexor halluces longus tendon transfer have been found to be reliable and achieve good clinical outcomes for defects ranging from 2 cm to 8 cm. This article focuses on the treatment options for the neglected Achilles tendon rupture. Copyright © 2012 Elsevier Inc. All rights reserved.

Dental neglect and adverse birth outcomes: a validation and observational study.

PubMed

Acharya, S; Pentapati, K C; Bhat, P V

2013-05-01

The objectives of this study were to validate the Indian translation of the Dental Neglect Scale (DNS) among a sample of parturient Indian women and to investigate dental neglect as a possible risk indicator in adverse birth outcomes. Three hundred and sixteen parturient women were administered the DNS and the Modified Dental Beliefs Scale (MDBS) and were also clinically examined for oral health status. Information regarding socio-economic status, weeks of gestation and birth weight was also collected. A gestation period of less than 37 weeks was considered as preterm and a birth weight of less than 2500 gm as 'low birth weight'. The Indian version of the DNS was found to be reliable (Cronbach's Alpha = 0.72) and valid for assessing dental neglect among the women. Factor analysis of the DNS revealed a two-factor structure accounting for 56% variance. Dental neglect was higher among those with poorer oral health status, lower socio-economic and educational status. Multinomial logistic regression showed high dental neglect and negative dental beliefs and not poor oral health, as significant risk indicators for occurrence of adverse birth outcomes. The finding of an association of adverse birth outcomes with dental neglect and beliefs, but not with poor oral health could be due to the influence of other more important general factors which had a direct bearing on birth outcomes. There is a need for further research to assess the role of behavioural factors like dental neglect as risk indicators for adverse birth outcomes. © 2012 John Wiley & Sons A/S.

Split-brain patients neglect left personal space during right-handed gestures.

PubMed

Lausberg, Hedda; Kita, Sotaro; Zaidel, Eran; Ptito, Alain

2003-01-01

Since some patients with right hemisphere damage or with spontaneous callosal disconnection neglect the left half of space, it has been suggested that the left cerebral hemisphere predominantly attends to the right half of space. However, clinical investigations of patients having undergone surgical callosal section have not shown neglect when the hemispheres are tested separately. These observations question the validity of theoretical models that propose a left hemispheric specialisation for attending to the right half of space. The present study aims to investigate neglect and the use of space by either hand in gestural demonstrations in three split-brain patients as compared to five patients with partial callosotomy and 11 healthy subjects. Subjects were asked to demonstrate with precise gestures and without speaking the content of animated scenes with two moving objects. The results show that in the absence of primary perceptual or representational neglect, split-brain patients neglect left personal space in right-handed gestural demonstrations. Since this neglect of left personal space cannot be explained by directional or spatial akinesia, it is suggested that it originates at the conceptual level, where the spatial coordinates for right-hand gestures are planned. The present findings are at odds with the position that the separate left hemisphere possesses adequate mechanisms for acting in both halves of space and neglect results from right hemisphere suppression of this potential. Rather, the results provide support for theoretical models that consider the left hemisphere as specialised for processing the right half of space during the execution of descriptive gestures.

Postural disorders and spatial neglect in stroke patients: a strong association.

PubMed

Pérennou, Dominic

2006-01-01

In this paper we analyse the arguments for a strong association between spatial neglect and postural disorders and attempt to better understand the mechanisms which underlie that. We first provide a general overview of the available tools for a rational assessment of postural control in a clinical context. We then analyse the arguments in favour of a close relationship, although not necessarily causal, between spatial neglect and: 1) body orientation with respect to gravity (including verticality perception i.e. the visual vertical, the haptic vertical, and the postural vertical); 2) body stabilisation with respect to the base of support; 3) posturographic features of stroke patients; 4) and finally their postural disability in daily life. This second part of the paper is based both on the literature review and on results of our current research. Neglect patients show a dramatic postural disability, due both to problems in body orientation with respect to gravity and to problems in body stabilisation. It might be that these problems are partly caused by a neglect phenomenon bearing on graviceptive (somaesthetic > vestibular) and visual information serving postural control. This could correspond to a kind of postural neglect involving both the bodily and nonbodily domains of spatial neglect. The existence of distorsion(s) in the body scheme are also probably involved, especially to explain the weight-bearing asymmetry in standing, and probably an impaired multisegmental postural coordination leading to an impaired body stabilisation. The present paper explains why neglect patients show longer/worse recovery of postural-walking autonomy than other stroke patients.

Gender Differences in Unilateral Spatial Neglect within 24 Hours of Ischemic Stroke

ERIC Educational Resources Information Center

Kleinman, Jonathan T.; Gottesman, Rebecca F.; Davis, Cameron; Newhart, Melissa; Heidler-Gary, Jennifer; Hillis, Argye E.

2008-01-01

Hemispatial neglect is a common and disabling consequence of stroke. Previous reports examining the relationship between gender and the incidence of unilateral spatial neglect (USN) have included either a large numbers of patients with few neglect tests or small numbers of patients with multiple tests. To determine if USN was more common and/or…

Fatal neglect of the elderly.

PubMed

Ortmann, C; Fechner, G; Bajanowski, T; Brinkmann, B

2001-01-01

Maltreatment of the elderly is a common problem that affects more than 3% of the elderly. We report on two cases of fatal neglect. Risk factors of victims and caregivers were analysed in the context of the social history. In both cases, the victims had a dominant personality and the abusers (the sons) had been strictly controlled and formed by the parent. The victims showed typical risk factors such as living together with the abuser, isolation, dependence on care, income and money administration. Initially, the victims declined help from outside and self-neglect occurred. The unemployed perpetrators lived in social isolation and depended financially and mentally on the victims. In both cases no mental illness was present but there was a decrease of social competence. Legal medicine is predominantly involved in fatal cases in connection with external post-mortem examinations and autopsies. Also in the living, the medico-legal expert can assist in the identification of findings in elderly persons in cases of suspected abuse.

Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke.

PubMed

Sturt, Ruth; Punt, T David

2013-01-01

The impact of spatial neglect remains a substantial challenge to patients undergoing rehabilitation following stroke. Beyond the relatively well-described implications for visuospatial function, neglect is increasingly shown to have a negative impact on the wider aspects of sensori-motor performance with corresponding implications for activities including gait and balance. Caloric vestibular stimulation (CVS) administered to the contralesional ear has previously been shown to improve performance in patients with spatial neglect. Here, in Experiment One, we investigated the effect of CVS on clinical measures of spatial neglect and postural control in three groups of patients following stroke; left brain damaged patients (LBD, n = 6), right brain damaged patients without neglect (RBD-, n = 6), and right brain damaged patients with neglect (RBD+ , n = 6). While post-stimulation scores demonstrated an improvement for participants with spatial neglect, further analysis of postural scores indicated that improvement was selective for asymmetrical activities, with symmetrical activities remaining unchanged. We interpret these results with reference to the related problem of extinction which predicts that activities demanding synchronous bilateral activity (symmetrical activities) would cause greater difficulties for patients with neglect. In Experiment Two, we tested a further six RBD+ patients on the same measures following CVS to the ipsilesional (right) ear. There was no significant improvement in perceptual or postural scores. Our findings are supportive of previous studies that demonstrate improvement in perception and movement for patients with spatial neglect following contralesional CVS and suggest that these improvements may have clinical benefits.

Comparing consequences of right and left unilateral neglect in a stroke rehabilitation population.

PubMed

Wee, Joy Y M; Hopman, Wilma M

2008-11-01

This article details right and left unilateral neglect (UN) in a stroke rehabilitation population. This prospective observational cohort study documented hemipersonal neglect and hemispatial neglect in 309 of 325 stroke rehabilitation patients consecutively admitted over a 28-month period. Shoulder-hand complications, safety concerns, length of stay, discharge function, and discharge destination were documented. Of the 85 with right UN and 113 with left UN, 17.7% had expressive aphasia, and 17.7% had mixed or receptive aphasia. Hemispatial neglect was associated with hemianopsia (29.2% and 31.8% for right and left, respectively). Having both hemipersonal neglect and hemispatial neglect was related to greater safety risk (46.9% vs. 24.3%), greater incidence of shoulder-hand complications (28.3% vs. 9.9%), lower FIM scores (>10 points lower), longer length of stay (8 days), and less likelihood of discharge to home (67.3% vs. 87.4%) than subjects without UN. Results were similar for those with right and left UN. Right and left UN occur after stroke, can be detected even in the presence of aphasia, and are associated with shoulder-hand problems, lower discharge function, and lower likelihood of discharge home. Having both hemispatial neglect and hemipersonal neglect impacts people more than having either type of UN alone.

Do adult mental health services identify child abuse and neglect? A systematic review.

PubMed

Read, John; Harper, David; Tucker, Ian; Kennedy, Angela

2018-02-01

Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required. © 2017 Australian College of Mental Health Nurses Inc.

Fat-Soluble Vitamin Status in Self-Neglecting Elderly

NASA Technical Reports Server (NTRS)

Kala, G.; Oliver, S. Mathews; Kelly, P. A.; Pickens, S.; Burnett, J.; Dyer, C. B.; Smith, S. M.

2006-01-01

Elder self-neglect is a form of elder mistreatment. The systematic characterization of self-neglecting individuals is the goal of the CREST project. Reported here is the evaluation of fat-soluble vitamin status. Self-neglect (SN) subjects were recruited and consented following referral from Adult Protective Services. Control (CN) subjects were matched for age, gender, race, and socioeconomic status, as possible. We report here on 47 SN subjects (age 77 plus or minus 7, mean plus or minus SD; body weight 76 kg plus or minus 26) and 40 CN subjects (77 y plus or minus 7, 79 kg plus or minus 20). Blood samples were analyzed for indices of fat-soluble vitamin status. Plasma retinol (p less than 0.01) was lower in SN subjects. Plasma tocopherol tended (p less than 0.06) to be lower in SN subjects, while gamma-tocopherol was unchanged. SN subjects tended to have lower serum 25-OH vitamin D (p less than 0.11), and to be vitamin D deficient (26% below 23 mmol/L). Hypercalcemia occurred more often in SN subjects (23% had values above 2.56 mmol/L), as did elevated parathyroid hormone concentrations (p less than 0.05). These data demonstrate that many nutrients are affected in the self-neglecting elderly, and that long-term deficits are evident by the nature of changes in fat soluble vitamins.

Nutritional Status in Self-Neglecting Elderly

NASA Technical Reports Server (NTRS)

Oliver, S. Mathews; Kelly, P. A.; Pickens, S.; Burnett, J.; Dyer, C. B.; Smith, S. M.

2006-01-01

Elder self-neglect is the most common, and most compelling form of elder mistreatment. Individuals who cannot provide the basic needs for themselves may develop social, functional, and physical deficits. The CREST project has the goal of systematically characterizing these individuals, and the objective of the study reported here is to characterize aspects of their nutritional status. Self-neglect (SN) subjects referred from Adult Protective Services were recruited and consented. Control (CN) subjects were matched for age, gender, race, and socio-economic status when possible. Reported here are data on 47 SN subjects (age 77 +/- 7, mean +/- SD; body weight 76 kg +/- 26) and 40 CN subjects (77 +/- 7, 79 kg +/- 20). Blood samples were analyzed for indices of nutritional status. SN subjects had higher serum concentrations of homocysteine (p < 0.01) and methylmalonic acid (p < 0.05). Red blood cell folate levels were lower (p < 0.01) in the SN subjects and serum folate levels tended (p < 0.07) to be lower, also. C-reactive protein concentrations were higher than 10 mg/dL in 36% of SN subjects and 18% of CN subjects. Total cholesterol and triglyceride concentrations were similar in the two groups. These data demonstrate that the self-neglecting elderly population is at risk with respect to several markers of nutritional status.

[Neglected ipsilateral simultaneous ruptures of patellar and quadriceps tendon].

PubMed

Karahasanoğlu, İlker; Yoloğlu, Osman; Kerimoğlu, Servet; Turhan, Ahmet Uğur

2015-01-01

Neglected patellar and quadriceps tendon rupture is a rare injury, but ipsilateral simultaneous patellar and quadriceps tendon rupture was not described in the literature to our knowledge. In this article, we report a 40-year-old healthy male patient with neglected ipsilateral patellar and quadriceps tendon ruptures treated by peroneus longus tendon autograft. Patient had received some conservative and surgical treatments for patellar fracture before applying to our clinic. After our treatment using peroneus longus autograft and interference nails, patient was immobilized for six weeks in cylindrical cast. Flexion exercises and full weight bearing were started after cast removal. Patient had no complaint at postoperative second year. Patient was a neglected case. Surgical repair and early rehabilitation enabled us to achieve a satisfactory outcome.

Seroepidemiology of Human Brucellosis Among Blood Donors in Southern Ethiopia: Calling Attention to a Neglected Zoonotic Disease.

PubMed

Workalemahu, Bereket; Sewunet, Tsegaye; Astatkie, Ayalew

2017-01-11

Human brucellosis is neglected in southern Ethiopia. Although traditional food processing practices and animal husbandry which increase the risk of brucellosis are common, it has not been properly studied yet. This study was conducted to determine the seroepidemiology of brucellosis among apparently healthy individuals in southern Ethiopia. In the study, blood samples were collected to screen for serum agglutinins reactive to stained antigen of Brucella abortus Standard tube titration was performed for reactive serum to determine the titer of the agglutinin. A structured questionnaire was used to collect data on possible risk factors for brucellosis. The seroprevalence of human brucellosis in this study was found to be 10.6% (95% confidence interval = 7.0, 14.0). Possession of domestic ruminant animals, contact with ruminant animals, and husbandry practices at home were associated with seropositivity. The higher seroprevalence of human brucellosis in the study area needs attention and additional confirmatory investigation. © The American Society of Tropical Medicine and Hygiene.

Long-range transport of airborne microbes over the global tropical and subtropical ocean.

PubMed

Mayol, Eva; Arrieta, Jesús M; Jiménez, Maria A; Martínez-Asensio, Adrián; Garcias-Bonet, Neus; Dachs, Jordi; González-Gaya, Belén; Royer, Sarah-J; Benítez-Barrios, Verónica M; Fraile-Nuez, Eugenio; Duarte, Carlos M

2017-08-04

The atmosphere plays a fundamental role in the transport of microbes across the planet but it is often neglected as a microbial habitat. Although the ocean represents two thirds of the Earth's surface, there is little information on the atmospheric microbial load over the open ocean. Here we provide a global estimate of microbial loads and air-sea exchanges over the tropical and subtropical oceans based on the data collected along the Malaspina 2010 Circumnavigation Expedition. Total loads of airborne prokaryotes and eukaryotes were estimated at 2.2 × 10 21 and 2.1 × 10 21 cells, respectively. Overall 33-68% of these microorganisms could be traced to a marine origin, being transported thousands of kilometres before re-entering the ocean. Moreover, our results show a substantial load of terrestrial microbes transported over the oceans, with abundances declining exponentially with distance from land and indicate that islands may act as stepping stones facilitating the transoceanic transport of terrestrial microbes.The extent to which the ocean acts as a sink and source of airborne particles to the atmosphere is unresolved. Here, the authors report high microbial loads over the tropical Atlantic, Pacific and Indian oceans and propose islands as stepping stones for the transoceanic transport of terrestrial microbes..

Prevention of Child Abuse and Neglect in Child Care Settings

DTIC Science & Technology

1988-08-01

The purpose of this Manual is to assist child development program personnel in preventing child abuse and neglect within child care settings and in...identifying and reporting child abuse and neglect. This Manual was by the Office of the Assistant Secretary of Defense (Force Management and Personnel

Oral and Dental Aspects of Child Abuse and Neglect.

PubMed

Fisher-Owens, Susan A; Lukefahr, James L; Tate, Anupama Rao

2017-08-01

In all 50 states, health care providers (including dentists) are mandated to report suspected cases of abuse and neglect to social service or law enforcement agencies. The purpose of this report is to review the oral and dental aspects of physical and sexual abuse and dental neglect in children and the role of pediatric care providers and dental providers in evaluating such conditions. This report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, and diseases that may raise suspicion for child abuse or neglect. Oral health issues can also be associated with bullying and are commonly seen in human trafficking victims. Some medical providers may receive less education pertaining to oral health and dental injury and disease and may not detect the mouth and gum findings that are related to abuse or neglect as readily as they detect those involving other areas of the body. Therefore, pediatric care providers and dental providers are encouraged to collaborate to increase the prevention, detection, and treatment of these conditions in children. Copyright © 2017 by the American Academy of Pediatrics and American Academy of Pediatric Dentistry.

Dissociation between awareness and spatial coding: evidence from unilateral neglect.

PubMed

Treccani, Barbara; Cubelli, Roberto; Sellaro, Roberta; Umiltà, Carlo; Della Sala, Sergio

2012-04-01

Prevalent theories about consciousness propose a causal relation between lack of spatial coding and absence of conscious experience: The failure to code the position of an object is assumed to prevent this object from entering consciousness. This is consistent with influential theories of unilateral neglect following brain damage, according to which spatial coding of neglected stimuli is defective, and this would keep their processing at the nonconscious level. Contrary to this view, we report evidence showing that spatial coding and consciousness can dissociate. A patient with left neglect, who was not aware of contralesional stimuli, was able to process their color and position. However, in contrast to (ipsilesional) consciously perceived stimuli, color and position of neglected stimuli were processed separately. We propose that individual object features, including position, can be processed without attention and consciousness and that conscious perception of an object depends on the binding of its features into an integrated percept.

Hypothalamic-pituitary-adrenal axis functioning and dysfunctional attitude in depressed patients with and without childhood neglect.

PubMed

Peng, Hongjun; Long, Ying; Li, Jie; Guo, Yangbo; Wu, Huawang; Yang, YuLing; Ding, Yi; He, Jianfei; Ning, Yuping

2014-02-18

To date, the relationships between childhood neglect, hypothalamic-pituitary-adrenal (HPA) axis functioning and dysfunctional attitude in depressed patients are still obscure. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood emotional neglect and physical neglect. Twenty-eight depressed patients with childhood neglect and 30 depressed patients without childhood neglect from Guangzhou Psychiatric Hospital were compared with 29 age- and gender-matched control subjects without childhood neglect and 22 control subjects with childhood neglect. Cortisol awakening response, the difference between the cortisol concentrations at awakening and 30 minutes later, provided a measure of HPA axis functioning. The Dysfunctional Attitude Scale measured cognitive schema. HPA axis functioning was significantly increased in depressed patients with childhood neglect compared with depressed patients without childhood neglect (p < 0.001). HPA axis activity in the control group with childhood neglect was significantly higher than in the depressed group without childhood neglect (p < 0.001). Total scores of childhood neglect were positively correlated with HPA axis functioning and dysfunctional attitude scores, but not with severity of depression. We did not find correlations with HPA axis functioning and dysfunctional attitude or with the Hamilton Rating Scale for Depression scores. Childhood neglect may cause hyperactivity of the HPA axis functioning and dysfunctional attitude, but does not affect depression severity.

Assessing chronic stroke survivors with aphasia sheds light on prevalence of spatial neglect

PubMed Central

Hreha, Kimberly; Mulry, Claire; Gross, Melissa; Jedziniak, Tarah; Gramas, Natanya; Ohevshalom, Leora; Sheridan, Alisha; Szabo, Gretchen; Davison, Christina; Barrett, A. M.

2016-01-01

Background Stroke is a chronic disease. Standardized assessment is essential in order to determine areas for treatment. Individuals with aphasia are often excluded from research, because it is believed that their language impairments may impact their ability to provide informed consent. Thus, right spatial neglect could be under-diagnosed. Objective This study was developed to (1) determine the frequency of spatial neglect in chronic left-brain stroke survivors with aphasia, (2) determine the clinical utility of an aphasia-friendly consent form, and (3) determine any differences between neglect and no-neglect groups regarding activities of daily living (ADL) performance and community independence. Methods Forty-six people were consented at community center. Three were screen failures secondary to the exclusion criteria. A novel, aphasia-friendly consent form was developed to facilitate participation of individuals with aphasia. This enabled 93% or 40 out of the 43 recruited participants to be included in this study. The Behavioral Inattention Test-conventional and the Catherine Bergego Scale via Kessler Foundation Neglect Assessment Process (CBS via KF-NAP) were utilized to determine neglect. The Life Space Questionnaire was used to determine community mobility and independence. The Barthel Index (BI) was used for objective clarification of performance in ADL. Results Successful use of the consent form resulted in determination that five out of 40 (12.5%) met criteria for spatial neglect; (on the CBS via KF-NAP). The neglect group had lower scores on the Life Space, suggesting less community mobility and independence, however, it was not statistically significant (p = 0.16). Differences in BI scores were also not significant (p = .013) but the neglect group did have reduced independence. Conclusions This study demonstrates the need to administer functional neglect assessments in left-brain stroke and to include individuals with aphasia in research. PMID:27322860

Assessing chronic stroke survivors with aphasia sheds light on prevalence of spatial neglect.

PubMed

Hreha, Kimberly; Mulry, Claire; Gross, Melissa; Jedziniak, Tarah; Gramas, Natanya; Ohevshalom, Leora; Sheridan, Alisha; Szabo, Gretchen; Davison, Christina; Barrett, A M

2017-03-01

Stroke is a chronic disease. Standardized assessment is essential in order to determine areas for treatment. Individuals with aphasia are often excluded from research, because it is believed that their language impairments may impact their ability to provide informed consent. Thus, right spatial neglect could be under-diagnosed. This study was developed to (1) determine the frequency of spatial neglect in chronic left-brain stroke survivors with aphasia, (2) determine the clinical utility of an aphasia-friendly consent form, and (3) determine any differences between neglect and no-neglect groups regarding activities of daily living (ADL) performance and community independence. Forty-six people were consented at community center. Three were screen failures secondary to the exclusion criteria. A novel, aphasia-friendly consent form was developed to facilitate participation of individuals with aphasia. This enabled 93% or 40 out of the 43 recruited participants to be included in this study. The Behavioral Inattention Test-conventional and the Catherine Bergego Scale via Kessler Foundation Neglect Assessment Process (CBS via KF-NAP) were utilized to determine neglect. The Life Space Questionnaire was used to determine community mobility and independence. The Barthel Index (BI) was used for objective clarification of performance in ADL. Successful use of the consent form resulted in determination that five out of 40 (12.5%) met criteria for spatial neglect; (on the CBS via KF-NAP). The neglect group had lower scores on the Life Space, suggesting less community mobility and independence, however, it was not statistically significant (p = 0.16). Differences in BI scores were also not significant (p = .013) but the neglect group did have reduced independence. This study demonstrates the need to administer functional neglect assessments in left-brain stroke and to include individuals with aphasia in research.

Early Results of a Helmetless-Tackling Intervention to Decrease Head Impacts in Football Players

PubMed Central

Swartz, Erik E.; Broglio, Steven P.; Cook, Summer B.; Cantu, Robert C.; Ferrara, Michael S.; Guskiewicz, Kevin M.; Myers, Jay L.

2015-01-01

Objective To test a helmetless-tackling behavioral intervention for reducing head impacts in National Collegiate Athletic Association Division I football players. Design Randomized controlled clinical trial. Setting Football field. Patients or Other Participants Fifty collegiate football players (intervention = 25, control = 25). Intervention(s) The intervention group participated in a 5-minute tackling drill without their helmets and shoulder pads twice per week in the preseason and once per week through the season. During this time, the control group performed noncontact football skills. Main Outcome Measure(s) Frequency of head impacts was recorded by an impact sensor for each athlete-exposure (AE). Data were tested with a 2 × 3 (group and time) repeated-measures analysis of variance. Significant interactions and main effects (P < .05) were followed with t tests. Results Head impacts/AE decreased for the intervention group compared with the control group by the end of the season (9.99 ± 6.10 versus 13.84 ± 7.27, respectively). The intervention group had 30% fewer impacts/AE than the control group by season's end (9.99 ± 6.10 versus 14.32 ± 8.45, respectively). Conclusion A helmetless-tackling training intervention reduced head impacts in collegiate football players within 1 season. PMID:26651278

Children's Perceptions of Parental Emotional Neglect and Control and Psychopathology

ERIC Educational Resources Information Center

Young, Robert; Lennie, Susan; Minnis, Helen

2011-01-01

Background: Parental emotional neglect is linked to psychiatric disorder. This study explores the associations between children's perceptions of parental emotional neglect and future psychopathology. Methods: In a school-based longitudinal study of nearly 1,700 children aged 11-15 we explored children's perceptions of parenting, as measured by the…

Are Elementary School Teachers Prepared to Tackle Bullying? A Pilot Study

ERIC Educational Resources Information Center

Oldenburg, Beau; Bosman, Rie; Veenstra, René

2016-01-01

The aim of this pilot study was to investigate to what extent elementary school teachers were prepared to tackle bullying. Interview data from 22 Dutch elementary school teachers (M[subscript age]?=?43.3, 18 classrooms in eight schools) were combined with survey data from 373 students of these teachers (M age?=?10.7, grades 3-6, ages 8- to…

Tackling Behaviour in Your Primary School: A Practical Handbook for Teachers

ERIC Educational Resources Information Center

Reid, Ken; Morgan, Nicola S.

2012-01-01

"Tackling Behaviour in the Primary School" provides ready-made advice and support for classroom professionals and can be used, read and adapted to suit the busy everyday lives of teachers working in primary schools today. This valuable text sets the scene for managing behaviour in the primary classroom in the context of the Children Act 2004…

Organic livestock production: an emerging opportunity with new challenges for producers in tropical countries.

PubMed

Chander, M; Subrahmanyeswari, B; Mukherjee, R; Kumar, S

2011-12-01

Agrochemicals, veterinary drugs, antibiotics and improved feeds can increase the food supply while minimising production costs in various livestock production systems around the world. However, these days, quality-conscious consumers are increasingly seeking environmentally safe, chemical-residue-free healthy foods, along with product traceability and a high standard of animal welfare, which organic production methods are said to ensure. Organic production is not only a challenge for producers in developing countries, it offers new export opportunities as well. Organic agriculture is practised by 1.8 million producers in 160 countries, and production of organically grown food continues to increase steadily by 15% per year. Most tropical countries are now exporting organic agricultural products but, apart from organic beef from Brazil and Argentina, organic livestock products are yetto take off. Most trade in organic livestock products is restricted to the European Union and other developed nations. Nevertheless, tropical countries cannot afford to neglect this emerging system of animal production. Organic production is knowledge- and management-intensive. Producers must be well versed in organic production standards, principles and practices, which require a high degree of knowledge and skill. In organic production, it is not simply the final product but the whole production process that must be inspected and approved by the accredited certification bodies. Organic livestock farming is still evolving, and further research is needed to make it sustainable. In this paper, the authors review the prospects of organic animal husbandry and its possible constraints in developing and tropical countries.

Elder self-neglect and the justice system: an essay from an interdisciplinary perspective.

PubMed

Connolly, Marie-Therese

2008-11-01

Elder self-neglect is a complex issue for the legal system-one not always easily distinguished from other types of elder abuse, neglect, and exploitation. The issue inherently implicates several disciplines, and although self-neglect is not prosecuted per se, prosecutions of other types of elder abuse, neglect, and exploitation may affect self-neglect as well. In addition, other types of legal intervention, such as guardianship actions, may serve to protect vulnerable older people, but it is critical to ensure that such interventions do not inappropriately infringe on the older person's civil liberties or result in exploitation or worse. There are daunting challenges to doing work in this field-death; ageism; medical, legal, and ethical complexities; and a chronic paucity of funding. It is nevertheless imperative that researchers expand their efforts to elucidate the nature and scope of elder self-neglect; its interplay with other forms of abuse, neglect, and exploitation; and the most effective mechanisms for intervention and prevention. Such efforts, and in particular interdisciplinary approaches to these common problems, are critical to improving care for the nation's older people and assisting millions of families and practitioners.

Coping strategies and immune neglect in affective forecasting: Direct evidence and key moderators

PubMed Central

Hoerger, Michael

2012-01-01

Affective forecasting skills have important implications for decision making. However, recent research suggests that immune neglect – the tendency to overlook coping strategies that reduce future distress – may lead to affective forecasting problems. Prior evidence for immune neglect has been indirect. More direct evidence and a deeper understanding of immune neglect are vital to informing the design of future decision-support interventions. In the current study, young adults (N = 325) supplied predicted, actual, and recollected reactions to an emotionally-evocative interpersonal event, Valentine’s Day. Based on participants’ qualitative descriptions of the holiday, a team of raters reliably coded the effectiveness of their coping strategies. Supporting the immune neglect hypothesis, participants overlooked the powerful role of coping strategies when predicting their emotional reactions. Immune neglect was present not only for those experiencing the holiday negatively (non-daters) but also for those experiencing it positively (daters), suggesting that the bias may be more robust than originally theorized. Immune neglect was greater for immediate emotional reactions than more enduring reactions. Further, immune neglect was conspicuously absent from recollected emotional reactions. Implications for decision-support interventions are discussed. PMID:22375161

What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms

MedlinePlus

... is child abuse and neglect defined in Federal law? • What are the major types of child abuse ... Is Child Abuse and Neglect Defined in Federal Law? Federal legislation lays the groundwork for State laws ...

Missed cases of multiple forms of child abuse and neglect.

PubMed

Koc, Feyza; Oral, Resmiye; Butteris, Regina

2014-01-01

Child abuse and neglect is a public health problem and usually associated with family dysfunction due to multiple psychosocial, individual, and environmental factors. The diagnosis of child abuse may be difficult and require a high index of suspicion on the part of the practitioners encountering the child and the family. System-related factors may also enable abuse or prevent the early recognition of abuse. Child abuse and neglect that goes undiagnosed may give rise to chronic abuse and increased morbidity-mortality. In this report, we present two siblings who missed early diagnosis and we emphasize the importance of systems issues to allow early recognition of child abuse and neglect.

Reporting Child Abuse and Neglect: Your Responsibility and Your Protections.

ERIC Educational Resources Information Center

Beezer, Bruce

1985-01-01

Educators are reluctant to report child abuse and neglect because they are not sure how abuse and neglect are defined, they are inadequately informed about the reporting process, and they fear prosecution. Most states make failure to report illegal, and courts tend to support educators making reports in good faith. (PGD)

Deployment Family Stress: Child Neglect and Maltreatment in U.S. Army Families

DTIC Science & Technology

2013-10-01

08-2-0189 TITLE: Deployment Family Stress: Child Neglect and Maltreatment in U.S. Army Families PRINCIPAL INVESTIGATOR: Stephen...10      4 | P a g e INTRODUCTION The Deployment Family Stress: Child Neglect and Maltreatment in the U.S. Army study...was conducted to identify the effects of child neglect within and around military installations. Data for this study was collected from clinical

The Great Recession and risk for child abuse and neglect

PubMed Central

Schneider, William; Waldfogel, Jane; Brooks-Gunn, Jeanne

2016-01-01

This paper examines the association between the Great Recession and four measures of the risk for maternal child abuse and neglect: (1) maternal physical aggression; (2) maternal psychological aggression; (3) physical neglect by mothers; and (4) supervisory/exposure neglect by mothers. It draws on rich longitudinal data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of families in 20 U.S. cities (N = 3,177; 50% African American, 25% Hispanic; 22% non-Hispanic white; 3% other). The study collected information for the 9-year follow-up survey before, during, and after the Great Recession (2007-2010). Interview dates were linked to two macroeconomic measures of the Great Recession: the national Consumer Sentiment Index and the local unemployment rate. Also included are a wide range of socio-demographic controls, as well as city fixed effects and controls for prior parenting. Results indicate that the Great Recession was associated with increased risk of child abuse but decreased risk of child neglect. Households with social fathers present may have been particularly adversely affected. Results also indicate that economic uncertainty during the Great Recession, as measured by the Consumer Sentiment Index and the unemployment rate, had direct effects on the risk of abuse or neglect, which were not mediated by individual-level measures of economic hardship or poor mental health. PMID:28461713

Benchmarking the Cost per Person of Mass Treatment for Selected Neglected Tropical Diseases: An Approach Based on Literature Review and Meta-regression with Web-Based Software Application.

PubMed

Fitzpatrick, Christopher; Fleming, Fiona M; Madin-Warburton, Matthew; Schneider, Timm; Meheus, Filip; Asiedu, Kingsley; Solomon, Anthony W; Montresor, Antonio; Biswas, Gautam

2016-12-01

Advocacy around mass treatment for the elimination of selected Neglected Tropical Diseases (NTDs) has typically put the cost per person treated at less than US$ 0.50. Whilst useful for advocacy, the focus on a single number misrepresents the complexity of delivering "free" donated medicines to about a billion people across the world. We perform a literature review and meta-regression of the cost per person per round of mass treatment against NTDs. We develop a web-based software application (https://healthy.shinyapps.io/benchmark/) to calculate setting-specific unit costs against which programme budgets and expenditures or results-based pay-outs can be benchmarked. We reviewed costing studies of mass treatment for the control, elimination or eradication of lymphatic filariasis, schistosomiasis, soil-transmitted helminthiasis, onchocerciasis, trachoma and yaws. These are the main 6 NTDs for which mass treatment is recommended. We extracted financial and economic unit costs, adjusted to a standard definition and base year. We regressed unit costs on the number of people treated and other explanatory variables. Regression results were used to "predict" country-specific unit cost benchmarks. We reviewed 56 costing studies and included in the meta-regression 34 studies from 23 countries and 91 sites. Unit costs were found to be very sensitive to economies of scale, and the decision of whether or not to use local volunteers. Financial unit costs are expected to be less than 2015 US$ 0.50 in most countries for programmes that treat 100 thousand people or more. However, for smaller programmes, including those in the "last mile", or those that cannot rely on local volunteers, both economic and financial unit costs are expected to be higher. The available evidence confirms that mass treatment offers a low cost public health intervention on the path towards universal health coverage. However, more costing studies focussed on elimination are needed. Unit cost benchmarks can

Tackling the Triple-Threat Genome of Miscanthus x giganteus (2010 JGI User Meeting)

ScienceCinema

Moose, Steve

2018-02-05

Steve Moose from the University of Illinois at Urbana-Champaign and the Energy Biosciences Institute on "Tackling the Triple-Threat Genome of Miscanthus x giganteus" on March 25, 2010 at the 5th Annual DOE JGI User Meeting.

Tackling the Triple-Threat Genome of Miscanthus x giganteus (2010 JGI User Meeting)