Pain Management and Its Possible Implementation Research in North Ethiopia: A before and after Study.

BACKGROUND: Though there is an effective intervention, pain after surgical intervention is undermanaged worldwide. A systematic implementation is required to increase the utilization of available evidence-based intervention to manage the inevitable pain after surgery. The aim of this research project is to develop a scalable model for managing pain after cesarean section by implementing the World Health Organization's (WHO) pain management guidelines through a combination of implementation research and quality improvement methods. METHODS: We implemented the World Health Organization (WHO) pain management guidelines using effective implementation strategies. First, we conducted a formative qualitative exploration to identify enablers and obstacles. In addition, we took base-line assessment on pain management implementation process and outcome using a checklist prepared from the guideline and an adapted American Pain Outcome assessment tool version 2010, respectively. Then, we integrated the guidelines into the existing practice by using collaborative iterative learning strategy. We analyzed the data by Statistical Packages for Social Sciences (SPSS) version 21. We compared the before and after data using chi-squared and Fischer's exact test. A change in any measurement was considered as significant at p value 0.05. RESULT: We collected data from 106 mothers before and 110 mothers after intervention implementation. We successfully integrated pain as a fifth vital sign in more than 87% (p value <0.001) of patient, and fidelity was approximately 59% (p value <0.001). In addition, we significantly improved pain outcome measures after the implementation of the intervention. Conclusion and Recommendations. A systematic approach to implement pain management guidelines was successful. We recommend the ward sustain these gains and that hospital, the region, and the nation to replicate the success.

What does popular media have to tell us about the future of seafood?

We examined ∼300 newspaper and business-oriented articles published over a 10-year period to assess trends in how seafood "sustainability" is talked about. We mapped key concepts relating to seafood sustainability as the word was used. We asked if the reports provided evidence that perceptions of problems or solutions for sustainability in seafood have changed over time. What were emergent areas of interest, and what concepts relevant to sustainable fisheries and seafood were absent in the reports? The number of reports concerning sustainability that focused on the middle of the supply chain (e.g., primary processors and importers) increased over time; certification was cited as both part of sustainability problems and a solution. We observed very little change over time in the kinds of fishery and seafood problems reported in the media sampled; themes consistently focused on environmental aspects of fisheries (social wellbeing aspects did not appear in the sample as linked with the term "sustainability"); and very few media reports on sustainable seafood cited aquaculture as a solution. We discuss the gap between what many researchers may perceive as the state-of-the-art of ideas and communication in seafood sustainability, and what appeared empirically in media during the period under study.

Wildlife Trade and Human Health in Lao PDR: An Assessment of the Zoonotic Disease Risk in Markets.

Although the majority of emerging infectious diseases can be linked to wildlife sources, most pathogen spillover events to people could likely be avoided if transmission was better understood and practices adjusted to mitigate risk. Wildlife trade can facilitate zoonotic disease transmission and represents a threat to human health and economies in Asia, highlighted by the 2003 SARS coronavirus outbreak, where a Chinese wildlife market facilitated pathogen transmission. Additionally, wildlife trade poses a serious threat to biodiversity. Therefore, the combined impacts of Asian wildlife trade, sometimes termed bush meat trade, on public health and biodiversity need assessing. From 2010 to 2013, observational data were collected in Lao PDR from markets selling wildlife, including information on volume, form, species and price of wildlife; market biosafety and visitor origin. The potential for traded wildlife to host zoonotic diseases that pose a serious threat to human health was then evaluated at seven markets identified as having high volumes of trade. At the seven markets, during 21 observational surveys, 1,937 alive or fresh dead mammals (approximately 1,009 kg) were observed for sale, including mammals from 12 taxonomic families previously documented to be capable of hosting 36 zoonotic pathogens. In these seven markets, the combination of high wildlife volumes, high risk taxa for zoonoses and poor biosafety increases the potential for pathogen presence and transmission. To examine the potential conservation impact of trade in markets, we assessed the status of 33,752 animals observed during 375 visits to 93 markets, under the Lao PDR Wildlife and Aquatic Law. We observed 6,452 animals listed by Lao PDR as near extinct or threatened with extinction. The combined risks of wildlife trade in Lao PDR to human health and biodiversity highlight the need for a multi-sector approach to effectively protect public health, economic interests and biodiversity.

Serosurveillance for foot-and-mouth disease in Mongolian gazelles (Procapra gutturosa) and livestock on the Eastern Steppe of Mongolia.

Foot-and-mouth disease (FMD) is a highly contagious, viral disease that affects most ruminant and porcine species, and periodic outbreaks on Mongolia's Eastern Steppe affect Mongolian gazelles (Procapra gutturosa) and livestock. During 2005-08, we collected sera from 36 and 57 calf and adult gazelles, respectively, and from adult domestic animals sympatric with the gazelles, including 138 sheep (Ovis aries), 140 goats (Capra aegagrus hircus), 139 Bactrian camels (Camelus bactrianus), and 138 cattle (Bos taurus). Our goal was to determine whether the prevalence of the antibody to foot-and-mouth disease virus (FMDV) in gazelles declined relative to previous estimates in the absence of FMD outbreaks. Overall, 2.0% (95% CI 0.7-3.3%, n=555) of the four livestock species were antibody-positive for nonstructural proteins of FMDV (FMDV-NS), whereas 30.3% (95% CI 26.5-34.1%, n=555) had antibodies for structural proteins (i.e., vaccination-derived antibodies). Seven of 57 free-ranging gazelle calves (7.5%, 95%CI 1.6-12.4%) were FMDV-NS positive. None of 36 adult gazelles sampled in 2008 were antibody-positive for exposure to FMDV, indicating a significant decline (χ(2)=18.99; P<0.001; df=1) in antibody prevalence among gazelles from the same area during a livestock outbreak in 2001. The episodic nature of FMD outbreaks on the Eastern Steppe, Mongolia, with evidence of FMDV exposure in gazelles only during or following concurrent outbreaks in livestock, suggests that FMDV may spill over into the gazelle population during livestock outbreaks and that successful control of FMD on the Eastern Steppe requires a focus on control in livestock populations through vaccination.

Deforming the hippocampal map.

To investigate conjoint stimulus control over place cells, Fenton et al. (J Gen Physiol 116:191-209, 2000a) recorded while rats foraged in a cylinder with 45 degrees black and white cue cards on the wall. Card centers were 135 degrees apart. In probe trials, the cards were rotated together or apart by 25 degrees . Firing field centers shifted during these trials, stretching and shrinking the cognitive map. Fenton et al. (2000b) described this deformation with an ad hoc vector field equation. We consider what sorts of neural network mechanisms might be capable of accounting for their observations. In an abstract, maximum likelihood formulation, the rat's location is estimated by a conjoint probability density function of landmark positions. In an attractor neural network model, recurrent connections produce a bump of activity over a two-dimensional array of cells; the bump's position is influenced by landmark features such as distances or bearings. If features are chosen with appropriate care, the attractor network and maximum likelihood models yield similar results, in accord with previous demonstrations that recurrent neural networks can efficiently implement maximum likelihood computations (Pouget et al. Neural Comput 10:373-401, 1998; Deneve et al. Nat Neurosci 4:826-831, 2001).