community control
Recently Published Documents


TOTAL DOCUMENTS

508
(FIVE YEARS 87)

H-INDEX

28
(FIVE YEARS 3)

2022 ◽  
Author(s):  
Roderic Crooks ◽  

This field review explores how the benefits of access to computing for racialized and minoritized communities has become an accepted fact in policy and research, despite decades of evidence that technical fixes do not solve the kinds of complex social problems that disproportionately affect these communities. I use the digital divide framework—a 1990s policy diagnosis that argues that the growth and success of the internet would bifurcate the public into digital “haves” and “have-nots”—as a lens to look at why access to computing frequently appears as a means to achieve economic, political, and social equality for racialized and minoritized communities. First, I present a brief cultural history of computer-assisted instruction to show that widely-held assumptions about the educational utility of computing emerged from utopian narratives about scientific progress and innovation—narratives that also traded on raced and gendered assumptions about users of computers. Next, I use the advent of the digital divide framework and its eventual transformation into digital inequality research to show how those raced and gendered norms about computing and computer users continue to inform research on information and communication technologies (ICTs) used in educational contexts. This is important because the norms implicated in digital divide research are also present in other sites where technology and civic life intersect, including democratic participation, public health, and immigration, among others. I conclude by arguing that naïve or cynical deployments of computing technology can actually harm or exploit the very same racialized and minoritized communities that access is supposed to benefit. In short, access to computing in education—or in any other domain—can only meaningfully contribute to equality when minoritized and racialized communities are allowed to pursue their own collective goals.


2021 ◽  
Author(s):  
Judith Aloyo ◽  
Juliet Kiguli ◽  
Christopher Orach Garimoi ◽  
David Lagoro Kitara

Abstract Background There was an epidemic of Hepatitis E infection in Kitgum District in 2007. More than 10,422 people were infected, and over 166 deaths were registered due to the Hepatitis E virus. Kitgum District Health Management Information Systems (HMIS) showed that Hepatitis E cases continued to occur more in Mucwini than Kitgum Matidi Sub County despite instituting similar epidemic control measures in the two communities. The tenacity of the virus in Mucwini Sub County had remained unclear. Objective To assess communities’ views and perspectives on the differential prevalence of Hepatitis E in the two Sub Counties of Kitgum Matidi and Mucwini in Northern Uganda. Methods A cross-sectional study using qualitative methods was conducted. Four Focus Group discussions and six key informant interviews were conducted with village health teams, local council chairpersons, health workers, and community members. These persons were chosen purposively because of their expertise and experience in community and health services. Face-to-face interview guides were administered to obtain detailed information on factors associated with the differential occurrence of Hepatitis E in the two Sub Counties. This study was approved by a local IRB and Uganda National Council of Science and Technology (UNCS&T). Results The most significant findings from this study were the differences in prevention and control practices in the two communities. Residents of Mucwini were less compliant to infection, prevention, and control guidelines, and disagreements between local councilors and village health teams in Mucwini led to poor implementation and non-adherence to guidelines on community control of Hepatitis E. Conclusion A differentially higher prevalence of Hepatitis E in Mucwini than Kitgum Matidi Sub County resulted from poor personal and community hygiene and non-adherence to behavior change communication among residents Mucwini compared to their counterparts in Kitgum Midi. The authors recommend a more proactive approach in managing the epidemic by securing the willingness of the affected community to adopt appropriate infection prevention and control guidelines. In addition, disagreements among stakeholders should be resolved timely so that all community members adhere to control measures.


Author(s):  
Adrian Harper ◽  
Bridget Pratt

The ethics of research involving Aboriginal populations and low and middle-income country populations each developed out of a long history of exploitative research projects and partnerships. Commonalities and differences between the two fields have not yet been examined. This study undertook two independent literature searches for Aboriginal health research ethics and global health research ethics. Content analysis identified shared and differently emphasised ethical principles and concepts between the two fields. Shared ethical concepts like “benefit” and “capacity development” have been developed to guide collaborations in both Aboriginal health research and global health research. However, Aboriginal health research ethics gives much greater prominence to ethical principles that assist in decolonising research practice such as “self-determination”, “community-control”, and “community ownership”. The paper argues that global health research ethics would benefit from giving greater emphasis to these principles to guide research practice, while justice as approached in global health research ethics may inform Aboriginal health research practice. With increasing attention being drawn to the need to decolonise global health research, the lessons Aboriginal health research ethics can offer may be especially timely.


PLoS Medicine ◽  
2021 ◽  
Vol 18 (11) ◽  
pp. e1003849
Author(s):  
Myra Hardy ◽  
Josaia Samuela ◽  
Mike Kama ◽  
Meciusela Tuicakau ◽  
Lucia Romani ◽  
...  

Background Scabies is a neglected tropical disease hyperendemic to many low- and middle-income countries. Scabies can be successfully controlled using mass drug administration (MDA) using 2 doses of ivermectin-based treatment. If effective, a strategy of 1-dose ivermectin-based MDA would have substantial advantages for implementing MDA for scabies at large scale. Methods and findings We did a cluster randomised, noninferiority, open-label, 3-group unblinded study comparing the effectiveness of control strategies on community prevalence of scabies at 12 months. All residents from 35 villages on 2 Fijian islands were eligible to participate. Villages were randomised 1:1:1 to 2-dose ivermectin-based MDA (IVM-2), 1-dose ivermectin-based MDA (IVM-1), or screen and treat with topical permethrin 5% for individuals with scabies and their household contacts (SAT). All groups also received diethylcarbamazine and albendazole for lymphatic filariasis control. For IVM-2 and IVM-1, oral ivermectin was dosed at 200 μg/kg and when contraindicated substituted with permethrin. We designated a noninferiority margin of 5%. We enrolled 3,812 participants at baseline (July to November 2017) from the 35 villages with median village size of 108 (range 18 to 298). Age and sex of participants were representative of the population with 51.6% male and median age of 25 years (interquartile range 10 to 47). We enrolled 3,898 at 12 months (July to November 2018). At baseline, scabies prevalence was similar in all groups: IVM-2: 11.7% (95% confidence interval (CI) 8.5 to 16.0); IVM-1: 15.2% (95% CI 9.4 to 23.8); SAT: 13.6% (95% CI 7.9 to 22.4). At 12 months, scabies decreased substantially in all groups: IVM-2: 1.3% (95% CI 0.6 to 2.5); IVM-1: 2.7% (95% CI 1.1 to 6.5); SAT: 1.1% (95% CI 0.6 to 2.0). The risk difference in scabies prevalence at 12 months between the IVM-1 and IVM-2 groups was 1.2% (95% CI −0.2 to 2.7, p = 0.10). Limitations of the study included the method of scabies diagnosis by nonexperts, a lower baseline prevalence than anticipated, and the addition of diethylcarbamazine and albendazole to scabies treatment. Conclusions All 3 strategies substantially reduced prevalence. One-dose was noninferior to 2-dose ivermectin-based MDA, as was a screen and treat approach, for community control of scabies. Further trials comparing these approaches in varied settings are warranted to inform global scabies control strategies. Trial registration Clinitrials.gov NCT03177993 and ANZCTR N12617000738325.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 979-979
Author(s):  
Kristine Anne Karkoska ◽  
Amanda Pfeiffer ◽  
Patrick T. McGann

Abstract Introduction: The neurologic changes of sickle cell anemia (SCA) are particularly devastating and include acute stroke, silent infarctions, and cerebral hypoxemia that together result in cumulative damage and significant neurocognitive deficits. Executive functioning and attention are the most commonly reported deficits with individuals with SCA scoring on average ten points lower on measures of full scale intelligence compared to matched unaffected controls, translating to poor academic achievement and later job attainment. Hydroxyurea is the standard-of-care in patients with SCA with a growing body of evidence suggesting a role in neuroprotection. However, although encouraging, until now, the only studies have involved children who began hydroxyurea in grade school, well after the onset of SCA-related neurocognitive decline. Beginning in 2014, Cincinnati Children's Hospital Medical Center (CCHMC) began treating children with SCA as young as six months with hydroxyurea; these children have had few SCA-related complications and offer a unique population to evaluate the effects of the early introduction of hydroxyurea on neurocognition. Methods: We completed a cross-sectional analysis of the neurocognitive status of our SCA population. Children at least three years old with SCA were enrolled in two cohorts: 1) children with SCA (HbSS and HbS-B 0thalassemia genotypes) who began hydroxyurea before age five years and 2) children with SCA who did not qualify for the first cohort (either on hydroxyurea or chronic transfusions (CTT)). Unaffected controls (siblings of patients with SCA or children seen in the CCHMC primary care clinic) were matched to each patient with early hydroxyurea use by age, race, and sex. All participants completed the NIH Toolbox: Cognition Battery, a shortened neuropsychological evaluation administered using a handheld tablet in the clinical setting, requiring 15-30 minutes. The mean score is 100 and standard deviation 15. We also obtained academic history, demographic variables, and laboratory values for SCA patients. Our overall objective was to compare the neurocognitive status of children with SCA who initiated hydroxyurea before age five years to an unaffected, matched sibling and community control cohort and to historically treated patients followed at the CCHMC sickle cell clinic in order to assess whether the beneficial effects of hydroxyurea extend to neuroprotection. Results: We enrolled 29 patients into the early hydroxyurea SCA group with 24 matched unaffected controls (early hydroxyurea group: mean age 7.2 +/-3.2 years, 52% female). The SCA cohort who initiated disease modifying treatment later in life included 20 patients (mean age 16 +/-5.1 years, 70% female) (Table 1). There were no differences in age, gender, patient education, maternal education, and Area Deprivation Index (ADI, a marker of socioeconomic status) between the early hydroxyurea SCA and control cohorts (Table 1). In the SCA cohort initiating treatment later in life, 5 patients received hydroxyurea, 13 were on CTT for reasons other than for stroke prophylaxis, and 2 received no therapy. The early hydroxyurea use patients and controls scored no differently on the composite cognition score (86 +/-13 versus 88 +/-12, p = 0.6), while the early hydroxyurea patients scored significantly higher than the SCA cohort treated later in life on the composite cognition (versus 77 +/-14, p = 0.03) (Table 2). On a linear regression model, age (p = 0.004) and patient years of education (p = 0.04) were significantly correlated with the composite cognition score when considering all cohorts. When limited to only patients with SCA on hydroxyurea, age (p = 0.005) and patient education (p = 0.002) remained significant, while maternal educational attainment below high school (p = 0.07), hemoglobin (p = 0.07), and fetal hemoglobin (p = 0.07) approached significance. Conclusions: Due to challenges with social determinants of health, children with SCA are already at risk for poor academic performance with early and recurrent "silent" hypoxic events further exacerbating these challenges. If started early in life and maintained through the important early years of brain development, hydroxyurea may be neuroprotective for children with SCA. These data provide further evidence to support the universal prescription of hydroxyurea beginning in the first years of life for all children with SCA. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Author(s):  
Yohannes Hailemichael ◽  
Damen Hailemariam ◽  
Kebede Tirfessa ◽  
Sumaiyah Docrat ◽  
Atalay Alem ◽  
...  

Abstract BackgroundPoverty and mental illness are strongly associated. The aim of this study was to investigate the economic impact of implementing a district level integrated mental healthcare plan for people with severe mental disorders (SMD) and depression compared to secular trends in the general population in a rural Ethiopian setting.MethodsA community-based, controlled before-after study design was used to assess changes in household economic status and catastrophic out-of-pocket (OOP) payments in relation to expanded access to mental health care. Two household samples were recruited, each with a community control group: (1) SMD sub-study and (2) depression sub-study. In the SMD sub-study, 290 households containing a member with SMD and 289 comparison households without a person with SMD participated. In the depression sub-study, 129 households with a person with depression and 129 comparison households. The case and comparison cohorts were followed up over 12 months. Propensity score matching and multivariable regression analyses were conducted. ResultsProvision of mental healthcare in the district was associated with a greater increase in income (Birr 919.53, 95% CI: 34.49, 4573.56) but no significant changes in consumption expenditure (Birr 176.25, 95% CI: -1338.19, 1690.70) in households of people with SMD compared to secular trends in comparison households. In households of people with depression, there was no significant change in income (Birr 227.78, 95% CI: -1361.21, 1816.79) or consumption expenditure (Birr -81.20, 95% CI: -2572.57, 2410.15). The proportion of households incurring catastrophic OOP payments at the ≥10% and ≥40% thresholds were significantly reduced after the intervention in the SMD (from 20.3% to 9.0%, p=0.002, and 31.9% to 14.9%, p< 0.001) and in the depression intervention (from 19.6% to 5.3%, p=0.003, and 25.2% to 11.8%, p= 0.015). Nonetheless, households of persons with SMD or depression remained impoverished relative to comparison groups at follow-up. Households of people with SMD and depression were significantly less likely to be enrolled in community-based health insurance (CBHI) than comparison households. ConclusionsOur findings support global initiatives to scale up mental healthcare as part of universal health coverage initiatives, alongside interventions to support social inclusion and targeted financial protection for vulnerable households.


2021 ◽  
Vol 9 ◽  
Author(s):  
Janya McCalman ◽  
Crystal Sky Jongen ◽  
Sandy Campbell ◽  
Ruth Fagan ◽  
Kingsley Pearson ◽  
...  

Introduction: Consistent with the aspirations of First Nations Australians for community control of healthcare services, 123/196 (63%) of Australia's First Nations-specific primary health care services are community-controlled. Yet despite policy commitment over 30 years, the transition of government-run First Nations' primary healthcare services to First Nations community control has been slow. This paper identifies the barriers and enablers to transitioning the delivery of primary healthcare services from Queensland Health to Gurriny Yealamucka community-controlled health service in Yarrabah.Methods: Grounded theory methods were used to select 14 Gurriny and Queensland Health (QH) personnel involved in the transition for interview and to analyse these interview transcripts and 88 Gurriny organisational documents.Results: Barriers and enablers to transition were identified at three levels: those internal factors within Gurriny, external factors directly related to the government handover, and broader structural and policy factors outside the control of either Gurriny or QH. Barriers at the Gurriny organisational level were an internal lack of experience and capacity, and varying levels of community confidence; enablers were leadership stability and capacity, community mandate, relationships with partner organisations, and ability to provide service continuity. Barriers in Gurriny's relationship with QH were a lack of certainty, transparency and prioritisation of the transition process; systemic racism; difficulties obtaining and maintaining the necessary workforce; limited resources including insufficient, unstable and inappropriate funding support; and problems with information sharing; enablers were performance frameworks to keep transition progress on track. Barriers in broad policy environment were an unsupportive Queensland government policy environment; government bureaucracy; and delays, conflicts and divisions; enablers were high-level government support and commitment.Conclusions: The evaluation of Yarrabah's transition process suggests that future such transitions will require planning and commitment to a long-term, multi-faceted and complex process, encompassing the required level of authorisation and resourcing. This case example of a transition from government to community control of PHC highlighted the ongoing power issues that are faced every day by community-controlled organisations that co-exist with mainstream health systems within a colonial power structure.


Biomolecules ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1488
Author(s):  
Nikolina Atanasova ◽  
Tsvetelina Paunova-Krasteva ◽  
Stoyanka Stoitsova ◽  
Nadja Radchenkova ◽  
Ivanka Boyadzhieva ◽  
...  

The continual plastic accumulation in the environment and the hazardous consequences determine the interest in thermophiles as possible effective plastic degraders, due to their unique metabolic mechanisms and change of plastic properties at elevated temperatures. PCL is one of major biodegradable plastics with promising application to replace existing non-biodegradable polymers. Metagenomic analysis of the phylogenetic diversity in plastic contaminated area of Marikostinovo hot spring, Bulgaria revealed a higher number taxonomic groups (11) in the sample enriched without plastic (Marikostinovo community, control sample, MKC-C) than in that enriched in the presence of poly-ε-caprolactone (PCL) (MKC-P), (7). A strong domination of the phylum Proteobacteria was observed for MKC-C, while the dominant phyla in MKC-P were Deinococcus-Thermus and Firmicutes. Among the strains isolated from MKC-P, the highest esterase activity was registered for Brevibacillus thermoruber strain 7 at 55 °C. Its co-cultivation with another isolate resulted in ~10% increase in enzyme activity. During a 28-day biodegradation process, a decrease in PCL molecular weight and weight loss were established resulting in 100% degradation by MKC-P and 63.6% by strain 7. PCL degradation intermediate profiles for MKC-P and pure strain were similar. Broken plastic pieces from PCL surface and formation of a biofilm by MKC-P were observed by SEM, while the pure strain caused significant deformation of PCL probes without biofilm formation.


Sign in / Sign up

Export Citation Format

Share Document