Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Msiska Z [original query] |
---|
Bringing women's voices to PMTCT CARE: adapting CARE's Community Score Card to engage women living with HIV to build quality health systems in Malawi
Laterra A , Callahan T , Msiska T , Woelk G , Chowdhary P , Gullo S , Mwale PM , Modi S , Chauwa F , Kayira D , Kalua T , Wako E . BMC Health Serv Res 2020 20 (1) 679 BACKGROUND: Coverage of prevention of mother-to-child transmission of HIV (PMTCT) services has expanded rapidly but approaches to ensure service delivery is patient-centered have not always kept pace. To better understand how the inclusion of women living with HIV in a collective, quality improvement process could address persistent gaps, we adapted a social accountability approach, CARE's Community Score Card© (CSC), to the PMTCT context. The CSC process generates perception-based score cards and facilitates regular quality improvement dialogues between service users and service providers. METHODS: Fifteen indicators were generated by PMTCT service users and providers as part of the CSC process. These indicators were scored by each population during three sequential cycles of the CSC process which culminates in a sharing of scores in a collective meeting followed by action planning. We aggregated these scores across facilities and analyzed the differences in first and last scorings to understand perceived improvements over the course of the project (z-test comparing the significance of two proportions; one-tailed p-value ≤ .05). Data were collected over 12 months from September 2017 to August 2018. RESULTS: Fourteen of the fifteen indicators improved over the course of this project, with eight showing statistically significant improvement. Out of the indicators that showed statistically significant improvement, the majority fell within the control of local communities, local health facilities, or service providers (7 out of 8) and were related to patient or user experience and support from families and community members (6 out of 8). From first to last cycle, scores from service users' and service providers' perspectives converged. At the first scoring cycle, four indicators exhibited statistically significant differences (p-value ≤ .05) between service users and service providers. At the final cycle there were no statistically significant differences between the scores of these two groups. CONCLUSIONS: By creating an opportunity for mothers living with HIV, health service providers, communities, and local government officials to jointly identify issues and implement solutions, the CSC contributed to improvements in the perceived quality of PMTCT services. The success of this model highlights the feasibility and importance of involving people living with HIV in quality improvement and assurance efforts. TRIAL REGISTRATION: Trial registration: ClincalTrials.gov NCT04372667 retrospectively registered on May 1st 2020. |
DNA double strand breaks by asbestos, silica and titanium dioxide: possible biomarker of carcinogenic potential?
Msiska Z , Pacurari M , Mishra A , Leonard SS , Castranova V , Vallyathan V . Am J Respir Cell Mol Biol 2009 43 (2) 210-9 DNA double strand breaks (DNA DSBs) are a very rapid response to DNA damage that occurs in cells subjected to radiation, exposure to toxic substances, and other environmental stresses. The inability to repair these breaks can lead to carcinogenesis. One of the earliest responses to DNA DSBs is the phosphorylation of a histone, H2AX, at serine 139, yielding a focal product (gamma-H2AX) that can be detected by a fluorescent antibody. A study was undertaken to compare the induction of DNA DSBs in normal (SAE) and cancer cells (A549) after exposure to asbestos (crocidolite), a proven carcinogen, silica a suspected carcinogen, and titanium dioxide (an inert particle, recently reported to be carcinogenic in animals). The results indicate that crocidolite induced greater DNA DSBs than silica and TiO2 regardless of cell type. DNA DSBs due to crocidolite were higher in normal cells than in cancer cells. Silica and TiO2 induced higher DNA DSBs in cancer cells than in normal cells. The production of reactive oxygen species (ROS) was found to be highest in cells exposed to crocidolite followed in potency by silica and TiO2. The generation of ROS was higher in normal cells than in cancer cells. Cell viability assay indicated that crocidolite caused the greatest cytotoxicity in both cell types. Apoptosis, measured by caspase 3/7 activity, was highest in crocidolite-exposed cells followed in potency by TiO2 and silica. The results of this study indicate that crocidolite has a greater carcinogenic potential than silica and TiO2 judged by its ability to cause sustained genomic instability in normal lung cells. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jun 03, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure