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- Kitutu, Freddy, et al.
(författare)
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Health system effects of implementing integrated community case management (iCCM) intervention in private retail drug shops in South Western Uganda: a qualitative study
- 2017
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Ingår i: BMJ Global Health. - 2059-7908. ; 2:e000334
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Tidskriftsartikel (refereegranskat)abstract
- Background Intervening in private drug shops to improve quality of care and enhance regulatory oversight may have health system effects that need to be understood before scaling up any such interventions. We examine the processes through which a drug shop intervention culminated in positive unintended effects and other dynamic interactions within the underlying health system.Methods A multifaceted intervention consisting of drug seller training, supply of diagnostics and subsidised medicines, use of treatment algorithms, monthly supervision and community sensitisation was implemented in drug shops in South Western Uganda, to improve paediatric fever management. Focus group discussions and in-depth interviews were conducted with stakeholders (drug sellers, government officials and community health workers) at baseline, midpoint and end-line between September 2013 and September 2015. Using a health market and systems lens, transcripts from the interviews were analysed to identify health system effects associated with the apparent success of the intervention.Findings Stakeholders initially expressed caution and fears about the intervention's implications for quality, equity and interface with the regulatory framework. Over time, these stakeholders embraced the intervention. Most respondents noted that the intervention had improved drug shop standards, enabled drug shops to embrace patient record keeping, parasite-based treatment of malaria and appropriate medicine use. There was also improved supportive supervision, and better compliance to licensing and other regulatory requirements. Drug seller legitimacy was enhanced from the community and client perspective, leading to improved trust in drug shops.Conclusion The study showed how effectively using health technologies and the perceived efficacy of medicines contributed to improved legitimacy and trust in drug shops among stakeholders. The study also demonstrated that using a combination of appropriate incentives and consumer empowerment strategies can help harmonise common practices with medicine regulations and safeguard public health, especially in mixed health market contexts.
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| 2. |
- Laxminarayan, Ramanan, et al.
(författare)
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Antibiotic resistance-the need for global solutions
- 2013
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Ingår i: The Lancet - Infectious diseases. - 1473-3099 .- 1474-4457. ; 13:12, s. 1057-1098
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Tidskriftsartikel (refereegranskat)abstract
- The causes of antibiotic resistance are complex and include human behaviour at many levels of society; the consequences affect everybody in the world. Similarities with climate change are evident. Many efforts have been made to describe the many different facets of antibiotic resistance and the interventions needed to meet the challenge. However, coordinated action is largely absent, especially at the political level, both nationally and internationally. Antibiotics paved the way for unprecedented medical and societal developments, and are today indispensible in all health systems. Achievements in modern medicine, such as major surgery, organ transplantation, treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken. Here, we describe the global situation of antibiotic resistance, its major causes and consequences, and identify key areas in which action is urgently needed.
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| 3. |
- Mansouri, M., et al.
(författare)
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Excessive audio-visual stimulation leads to impaired social behavior with an effect on amygdala: Early life excessive exposure to digital devices in male rats
- 2022
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Ingår i: European Journal of Neuroscience. - : Wiley. - 0953-816X .- 1460-9568. ; 56:12, s. 6174-6186
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Tidskriftsartikel (refereegranskat)abstract
- Today, the effect of extreme early-life exposure to digital devices is suggested as a risk factor for neurodevelopmental disorders. However, the multitudes of factors that influence brain development with subsequent behavioral abnormality have not been fully elucidated. Herein, we simulated extreme early-life exposure to digital devices in rat by audio and visual stimulation and investigated its effects on autism-related behaviors and brain structural alteration. Male rat pups were exposed to excessive audio-visual stimulation (EAVS) from PND (post-natal day) 12 to PND 35, with and without maternal separation (MS). Autism related behaviors including abnormal sociability, stereotype behaviors, anxiety and locomotor dysfunction were tested at PND 42. Brain structural alternation was examined by considering amygdala, mPFC (medial prefrontal cortex) and hippocampal regions with performing 3D quantitative stereological analysis. We found that EAVS led to social behavior deficit and higher locomotion in rats which were associated with increased in number of the neurons and volume of the amygdala. We also showed that MS did not exaggerate the effect of extreme sensory stimulation on behavior and structure of brain. This study proposed EAVS in rats as an animal model of early exposure to digital devices for investigating possible neurobiological alternations underlying autistic-like behaviors with emphasis on the amygdala area.
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