ABSTRACT
Smokers are not the only ones who suffer the effects of tobacco; those around them are also harmed, particularly vulnerable groups such as pregnant women. This study aimed to describe the prevalence of secondhand smoke (SHS) among pregnant women and the factors associated with SHS exposure. This study was a cross-sectional descriptive study conducted at Central Women's Hospital in the Yangon Region in 2022. The prevalence of SHS exposure was described, and multivariate analyses were conducted to determine the associated factors. Out of 407 participants, the prevalence of SHS exposure was 65.4%. Education level, religion, smoking rules at home, visiting public places, and avoidance of SHS during pregnancy were significantly associated with SHS exposure. The findings highlighted the need for community guidance programs, policies, and interventions to establish smoke-free environments. It is also important to conduct behavioral interventions for smokers, especially to avoid SHS for pregnant women.
Subject(s)
Pregnant Women , Tobacco Smoke Pollution , Female , Humans , Pregnancy , Prenatal Care , Tobacco Smoke Pollution/prevention & control , Prevalence , Cross-Sectional Studies , MyanmarABSTRACT
INTRODUCTION: Efficient management of study drug inventory shipments is critical to keep research sites enrolling into multisite clinical treatment trials. A standard manual drug-management process used by the Tuberculosis Trials Consortium (TBTC), did not accommodate import permit approval timelines, shipment transit-times and time-zone differences. We compared a new web-based solution with the manual process, during an international 34-site clinical trial conducted by the TBTC and the AIDS Clinical Trials Group (ACTG); TBTC Study 31/ACTG A5349. MATERIAL AND METHODS: We developed and implemented a technological solution by integrating logistical and regulatory requirements for drug importation with statistical simulations that estimated stock-out times in an online Drug Management Module (DMM). We measured the average shipment-related drug stock-outs and time to drug availability, to assess the efficiency of the DMM compared to the manual approach. RESULTS: An Interrupted Time-Series (ITS) analysis showed a 15.4% [p-value = 0.03; 95% C.I. (-28.8%, -2.0%)] reduction in average shipment-related study drug stock-out after DMM implementation. The DMM streamlined the restocking process at study sites, reducing median transit-time for sites associated with a depot by 2 days [95% C.I. (-3.0, -1.0)]. Under the DMM, study drugs were available for treatment assignment on the day received, compared to one day after receipt under the manual process. DISCUSSION: The DMM provided TBTC's Data and Coordinating Center and site staff with more efficient procedures to manage and consistently maintain study drug inventory at enrolling sites. This DMM framework can improve efficiency in future multicenter clinical trials. TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (Identifier: NCT02410772) on April 8, 2015.
Subject(s)
Pharmaceutical Preparations , Tuberculosis , Humans , Information Systems , Internet , Research Design , Tuberculosis/drug therapyABSTRACT
Targeted, biocompatible, and synergistic "all in one" systems should be designed to combat the heterogeneity of cancer. In this study, we constructed a dual function nanosystem, copper sulfide nanoplatform loaded with the chemotherapeutic drug docetaxel wrapped by a conjugated polymer-peptide for targeted chemo-phototherapy. The nanoconstruct has been successfully designed with a size of 186.1⯱â¯5.2â¯nm, a polydispersity index of 0.18⯱â¯0.01, and zeta potential of -16.4⯱â¯0.1â¯mV. The enhanced uptake and near-infrared-responsive behavior of the nanosystem resulted in efficient drug release, photothermal ablation, effective cytotoxic activity, and potentiated reactive oxygen species generation. The induction of apoptotic markers, enhanced accumulation in the tumor site, and maximum tumor growth inhibition were seen during in vivo studies compared to non-targeted nanoformulations and free drug. Cumulatively, our results indicate that, with low systemic toxicity and better biocompatibility, this nanoconstruct could provide a promising strategy for treating prostate cancer.
Subject(s)
Doxorubicin/pharmacology , Drug Delivery Systems , Polymers/pharmacology , Prostatic Neoplasms/drug therapy , Animals , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Antineoplastic Agents/radiation effects , Cell Proliferation/drug effects , Copper/chemistry , Doxorubicin/chemistry , Drug Liberation/radiation effects , Humans , Hyperthermia, Induced , Male , Nanoparticles/chemistry , Peptides/chemistry , Peptides/pharmacology , Peptides, Cyclic/chemistry , Peptides, Cyclic/pharmacology , Phototherapy , Polymers/chemistry , Polymers/radiation effects , Prostatic Neoplasms/genetics , Prostatic Neoplasms/pathology , Reactive Oxygen Species/chemistry , Receptors, Somatostatin/genetics , Somatostatin/analogs & derivatives , Somatostatin/chemistry , Somatostatin/pharmacology , Sulfides/chemistryABSTRACT
The global HIV epidemic confronts pregnant women with hard reproductive choices. This paper offers a theoretically innovative and ethnographically sensitive exploration of the social processes through which 20 HIV positive women living in Northern Vietnam decide whether to continue or terminate their pregnancies. Arguing that human agency must be seen as an outcome of intersubjective engagements in shared social worlds, this paper explores how these women came to the decisions that they had to make and shows that women's choices were configured through everyday social relations, shaped through intimate engagements with husbands, parents, siblings, and in-laws. Based on the findings, it is recommended that pregnancy counseling is offered not only to the woman herself, but also, if she desires, involves members of her extended family.
