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New Delhi, India

Globally, tobacco kills more people than HIV-related conditions or AIDS, tuberculosis and malaria combined. In 1991, The World Bank, the world's largest lender, pledged that it would no longer support tobacco-related projects. It was expected that other financial investors would follow, but most did not respond to this call. As a result, several financial institutions continue to invest in tobacco and fuel an epidemic to an unprecedented scale. Using tobacco as a case in point, this review highlights the continuing investments among financial institutions which do not conform to 'socially responsible investments' and calls for monitoring and reporting such unethical practices. The paper also underscores the need to harmonise the numerous criteria, principles and voluntary codes that govern socially responsible investing and ensure that financial institutions comply with them. © The Author(s) 2012. Source

Wambui Charity K.,Academic Model Providing Access to Healthcare | Kumar A.M.V.,Qutub Institutional Area | Hinderaker S.G.,University of Bergen | Chinnakali P.,Jawaharlal Institute of Postgraduate Medical Education & Research | And 2 more authors.
Diabetes Research and Clinical Practice

Aims: Among diabetes mellitus (DM) patients with poor glycemic control enrolled into a self-monitoring of blood glucose (SMBG) program in Kenya, to assess the level of SMBG adherence, its associated factors and its relation to glycemic control (defined as HbA1c <7% and/or 2% absolute reduction relative to baseline). Methods: In this retrospective cohort study, we used routinely collected data of patients enrolled during 2012-2013. We assessed adherence to SMBG by dividing the number of glucose tests performed by the number recommended. A level of ≥80% was considered 'good adherence'. Glycemic control was considered as absolute change from baseline of 2%. Results: Of 164 patients (59% female; 76% rural), the proportions with good SMBG adherence were 34%, 17%, 15% and 10% during 0-6, 7-12, 13-18 and 19-24 months into the HGM program respectively. In multivariate analysis, male gender, urban place of residence and payment for glucostrips were associated with poor adherence during 0-12 months. The mean reduction in HbA1c compared to baseline was 1.2%, 1.1%, 0.8% and 0.7% at 6, 12, 18 and 24 months, respectively. We did not find any association between SMBG adherence and glycemic control. Conclusions: Adherence to SMBG was sub-optimal, especially among those who had to pay for glucostrips. Patient education and provision of free glucostrips are recommended to improve adherence and glycemic control. © 2015 The Authors. Source

Kochhar S.,Qutub Institutional Area | Rath B.,Charite - Medical University of Berlin | Seeber L.D.,Charite - Medical University of Berlin | Rundblad G.,Kings College London | And 2 more authors.
Expert Review of Vaccines

Vaccines offer the most cost-effective approach to controlling infectious diseases. Access to vaccines remains unequal and suboptimal, particularly in poorer developing countries. Introduction of new vaccines and long-term sustainability of immunization programs will require proactive planning from conception to implementation. International and national coordination efforts as well as local and cultural factors need to be known and accounted for. Adequate infrastructure should be in place for the monitoring of disease burden, vaccine effectiveness and vaccine safety, based on the common terminology and international consensus. This overview paper aims to raise awareness of the importance of introduction efforts for vaccines of special relevance to resource-poor countries. The target audiences are those involved in immunization programs, from planning or oversight roles to frontline providers, as well as health care professionals. © Informa UK, Ltd. Source

Chella S.,Vellore Institute of Technology | Kollu P.,University of Cambridge | Komarala E.V.P.R.,Indian Institute of Technology Bombay | Doshi S.,Indian Institute of Technology Bombay | And 8 more authors.
Applied Surface Science

Graphene manganese ferrite (MnFe2O4-G) composite was prepared by a solvothermal process. The as-prepared graphene manganese ferrite composite was tested for the adsorption of lead (Pb(II)) and cadmium (Cd(II)) ions by analytical methods under diverse experimental parameters. With respect to contact time measurements, the adsorption of Pb and Cd ions increased and reached equilibrium within 120 and 180 min at 37°C with a maximum adsorption at pH 5 and 7 respectively. The Langmuir model correlates to the experimental data showing an adsorption capacity of 100 for Pb(II) and 76.90 mg g-1 for Cd(II) ions. Thermodynamic studies revealed that the adsorption of Pb and Cd ions onto MnFe2O4-G was spontaneous, exothermic and feasible in the range of 27-47°C. Cytotoxicity behavior of graphene against bacterial cell membrane is well known. To better understand its antimicrobial mechanism, the antibacterial activity of graphene and MnFe2O4-G nanocomposite was compared. Under similar concentration and incubation conditions, nanocomposite MnFe2O4-G dispersion showed the highest antibacterial activity of 82%, as compared to graphene showing 37% cell loss. Results showed that the prepared composite possess good adsorption efficiency and thus could be considered as an excellent material for removal of toxic heavy metal ions as explained by adsorption isotherm. Hence MnFe2O4-G can be used as an adsorbent as well as an antimicrobial agent. © 2014 Elsevier B.V. All rights reserved. Source

Takarinda K.C.,AIDS and TB Unit | Harries A.D.,International Union Against Tuberculosis and Lung Disease | Harries A.D.,London School of Hygiene and Tropical Medicine | Srinath S.,Qutub Institutional Area | And 3 more authors.
BMC Public Health

Background. Zimbabwe is a Southern African country with a high HIV-TB burden and is ranked 19 th among the 22 Tuberculosis high burden countries worldwide. Recurrent TB is an important problem for TB control, yet there is limited information about treatment outcomes in relation to HIV status. This study was therefore conducted in Chitungwiza, a high density dormitory town outside the capital city, to determine in adults registered with recurrent TB how treatment outcomes were affected by type of recurrence and HIV status. Methods. Data were abstracted from the Chitungwiza district TB register for all 225 adult TB patients who had previously been on anti-TB treatment and who were registered as recurrent TB from January to December 2009. The Chi-square and Fischer's exact tests were used to establish associations between categorical variables. Multivariate relative risks for associations between the various TB treatment outcomes and HIV status, type of recurrent TB, sex and age were calculated using Poisson regression with robust error variance. Results. Of 225 registered TB patients with recurrent TB, 159 (71%) were HIV tested, 135 (85%) were HIV-positive and 20 (15%) were known to be on antiretroviral treatment (ART). More females were HIV-tested (75/90, 83%) compared with males (84/135, 62%). There were 103 (46%) with relapse TB, 32 (14%) with treatment after default, and 90 (40%) with "retreatment other" TB. There was one failure patient. HIV-testing and HIV-positivity were similar between patients with different types of TB. Overall, treatment success was 73% with transfer-outs at 14% being the most common adverse outcome. TB treatment outcomes did not differ by HIV status. However those with relapse TB had better treatment success compared to "retreatment other" TB patients, (adjusted RR 0.81; 95% CI 0.68 - 0.97, p = 0.02). Conclusions. No differences in treatment outcomes by HIV status were established in patients with recurrent TB. Important lessons from this study include increasing HIV testing uptake, a better understanding of what constitutes "retreatment other" TB, improved follow-up of true outcomes in patients who transfer-out and better recording practices related to HIV care and treatment especially for ART. © 2012 Takarinda et al; licensee BioMed Central Ltd. Source

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