Integration of health solutions into government systems: a tool for assessing readiness.

Government partnerships are essential for many health solutions to sustain impact at scale, particularly in low-resource settings where strengthening health systems is critical for Universal Health Coverage. Many non-governmental organizations (NGOs) and funders ultimately want solutions to be integrated into public health systems by transitioning solution ownership, management and/or operation to government. However, NGOs and their government partners have limited guidance on how to effectively determine when a solution is ready to transition in a way that will maintain impact long term.

Clinical spectrum of previously undiagnosed pediatric cardiac disease.

Unlabelled: Previously undiagnosed pediatric cardiac disease represents a clinical challenge for the emergency physician. The clinical presentation of these disorders can mimic other conditions of the respiratory, gastrointestinal and neurologic systems at a time when the need for early identification and treatment is at a premium. A high index of suspicion and superb clinical acumen is required to make a timely diagnosis and initiate optimal care.

The potential effects of introducing microneedle patch vaccines into routine vaccine supply chains.

Background: Microneedle patch (MNP) technology is designed to simplify the process of vaccine administration; however, depending on its characteristics, MNP technology may provide additional benefits beyond the point-of-use, particularly for vaccine supply chains.

Methods: Using the HERMES modeling software, we examined replacing four routine vaccines - Measles-containing vaccine (MCV), Tetanus toxoid (TT), Rotavirus (Rota) and Pentavalent (Penta) - with MNP versions in the routine vaccine supply chains of Benin, Bihar (India), and Mozambique.

Results: Replacing MCV with an MNP (5 cm-per-dose, 2-month thermostability, current single-dose price-per-dose) improved MCV availability by 13%, 1% and 6% in Benin, Bihar and Mozambique, respectively, and total vaccine availability by 1% in Benin and Mozambique, while increasing the total cost per dose administered by $0.

Re-designing the Mozambique vaccine supply chain to improve access to vaccines.

Introduction: Populations and routine childhood vaccine regimens have changed substantially since supply chains were designed in the 1980s, and introducing new vaccines during the "Decade of Vaccine" may exacerbate existing bottlenecks, further inhibiting the flow of all vaccines.

Methods: Working with the Mozambique Ministry of Health, our team implemented a new process that integrated HERMES computational simulation modeling and on-the-ground implementers to evaluate and improve the Mozambique vaccine supply chain using a system-re-design that integrated new supply chain structures, information technology, equipment, personnel, and policies.

Results: The alternative system design raised vaccine availability (from 66% to 93% in Gaza; from 76% to 84% in Cabo Delgado) and reduced the logistics cost per dose administered (from $0.

Engagement of Men in Antenatal Care Services: Increased HIV Testing and Treatment Uptake in a Community Participatory Action Program in Mozambique.

Uptake of HIV testing and antiretroviral therapy (ART) services during antenatal care (ANC) in rural Mozambique is disappointing. To nurture supportive male engagement in ANC services, we partnered with traditional birth attendants and trained a new type of male-to-male community health agent, "Male Champions", who focused on counseling male partners to create new, male-friendly community norms around engagement in spousal/partner pregnancies. We assessed ANC service uptake using a pre-post intervention design.

Barriers to Male Involvement in Antenatal Care in Rural Mozambique.

Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods.

Consensus on context-specific strategies for reducing the stigma of human immunodeficiency virus/acquired immunodeficiency syndrome in Zambézia Province, Mozambique.

Stigma has been implicated in poor outcomes of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) care. Reducing stigma is important for HIV prevention and long-term treatment success. Although stigma reduction interventions are conducted in Mozambique, little is known about the current nature of stigma and the efficacy and effectiveness of stigma reduction initiatives.

The movement of oil under non-breaking waves.

The combined effects of wave kinematics, turbulent diffusion, and buoyancy on the transport of oil droplets at sea were investigated in this work using random walk techniques in a Monte Carlo framework. Six hundred oil particles were placed at the water surface and tracked for 500 wave periods. A dimensionless formulation was presented that allowed reporting distances in terms of the wave length and times in terms of the wave period.

Computerized content analysis of writings of Mahatma Gandhi.

Three brief excerpts from the autobiographical writings of Mohandas K. Gandhi were analyzed for neuropsychobiological content using the PCAD 2000 computer program. The computer software produces scores on 13 scales such as anxiety, hostility, cognitive impairment, and depression; compares the assigned scores with norms derived from 5-minute speech samples taken from normal, medically and psychiatrically healthy adults and children; and suggests DSM-IV diagnostic categories for consideration.

Computerized content analysis of speech plus speech recognition in the measurement of neuropsychiatric dimensions.

The Psychiatric Content Analysis and Diagnosis (PCAD) program performs automated content analysis of machine-readable transcriptions of speech samples to measure the magnitude of neuropsychiatric states and traits. Technological advances provided by computerized speech recognition may offer a possible alternative to labor-intensive manual transcription for preparation of samples for PCAD processing. To test this hypothesis, 25 digitally recorded verbal samples were transcribed both manually and by a commercially available speech recognition software package, and the transcriptions scored by PCAD.

Computerized neuropsychiatric assessment of geriatric subjects by content analysis of brief samples of their speech.

The life expectancy of people living in the United States is increasing. Are very elderly individuals compromised mentally and physically in comparison to much younger persons? The purpose of this study was to test the efficacy of a computerized program applicable to the content analysis of 5-minute speech samples obtained from a group of individuals 90 years of age and older and to compare the results with those previously obtained in younger people with respect to their mental capacities in terms of a set of diverse neuropsychiatric dimensions. After obtaining informed consent from 26 elderly people, recorded verbal samples were elicited from each individual in response to purposely ambiguous instructions to talk for 5 minutes about any interesting or dramatic personal life experiences.

Physical characteristics of the axial interosseous ligament of the human sacroiliac joint.

Background Context: Although the sacroiliac joint has occupied a place in medical literature since at least the eighteenth century, its role in normal function and dysfunction of the back and hip remains controversial. The controversy persists, because there is still no suitable method to study the role of stability and mobility at the sacroiliac joints in vivo. One cost-effective approach to understanding such complex, deeply placed structures is biomechanical modeling.

Computerized content analysis of conversational interactions.

The emotional impact of illness sustained by patients, their families, and friends is increasingly recognized as an important dimension of clinical evaluation and intervention. This study first attempted to extend a computerized technique of measuring the magnitude of mental events from a content analysis of speech initially designed for use on single verbal samples or verbal texts to the analysis of conversational interactions. The study then applied this method of extended measurement to conversations concerning seriously ill surgical patients.

The effects of anticancer chemotherapeutic drugs on cognitive function and other neuropsychiatric dimensions in breast cancer patients.

This preliminary study aimed to apply a novel computerized measure derived from the content analysis of 5-min speech samples from patients with breast cancer to measure cognitive impairment and other neuropsychiatric dimensions during the course of anticancer chemotherapeutic treatment. Since such patients are often administered other pharmacological agents to alleviate their symptoms in addition to anticancer chemotherapeutic agents, another aim was to try to distinguish the mental effects of the anticancer drugs from the effects of any other drugs administered. Before and during the course of their anticancer chemotherapy, 12 breast cancer patients gave 5-min verbal samples, elicited by purposely ambiguous instructions, to talk about any personal life experiences.

Computer detection of cognitive impairment and associated neuropsychiatric dimensions from the content analysis of verbal samples.

This is a report of a study testing the capacity of a computerized measure of the content analysis of five minute verbal samples to detect and measure cognitive impairment and comorbid neuropsychiatric dimensions in 117 drug-abusing inpatients. The cognitive impairment scores obtained from the computerized procedure correlated significantly with independent scores from the Trails B and Stroop Color and Word test as well as with ANAM (Automated Neuropsychiatric Assessment Metric) neuropsychological tests, including the Matching to Sample Efficiency and Accuracy, the Code Substitution Efficiency, the Continuous Performance Task Efficiency and Accuracy, the Code Substitution Delayed Recall Accuracy, and the Simple Reaction Time Efficiency. When the computerized verbal-content-analysis-derived cognitive impairment scores were combined with scores of selected other ANAM measures, more and higher intercorrelations occurred with Trails A, Trails B, the Stroop Color and Word test, and the Wisconsin Card Sort test.

Computerized content analysis of some adolescent writings of Napoleon Bonaparte: a test of the validity of the method.

The aim of this study was to test the validity of a computer software program previously demonstrated to be capable of making DSM-IV neuropsychiatric diagnoses from the content analysis of speech or verbal texts. In this report, the computer program was applied to three personal writings of Napoleon Bonaparte when he was 12 to 16 years of age. The accuracy of the neuropsychiatric evaluations derived from the computerized content analysis of these writings of Napoleon was independently corroborated by two biographers who have described pertinent details concerning his life situations, moods, and other emotional reactions during this adolescent period of his life.

Computerized measurement of cognitive impairment and associated neuropsychiatric dimensions.

This study aimed to cross-validate the capacity of a computer software program to detect and measure, using a measurement method applied to the content and form analysis of 5-minute speech samples, cognitive impairment and associated comorbid neuropsychiatric psychobiological dimensions in drug-abusing patients. At the University of California-Irvine (UCI) Neuropsychiatric Center, 28 drug-abusing inpatients using illegal drugs were clinically evaluated. Their scores for cognitive impairment derived by the computerized content analysis method were compared with scores derived from selected tests from the Halstead-Reitan Neuropsychological Test Battery, the computerized Automated Neuropsychological Assessment Metric Battery (ANAM), the Alzheimer's Disease Assessment Scale-Cognitive Portion, the Stroop Color and Word Test, the Symbol Digit Modalities Test, and the Controlled Oral Word Association Test.

Stuttering: neuropsychiatric features measured by content analysis of speech and the effect of risperidone on stuttering severity.

Positron-emission tomographic (PET) studies and genetic research of stuttering have recently revealed underlying cerebral neurobiologic contributing factors in this disorder. We aimed to assess whether cognitive impairment and other neuropsychiatric dimensions could be detected through computerized content analysis of short samples of speech from stutterers, and whether administration of risperidone in a double-blind placebo-controlled study could decrease the severity of stuttering, as well as any of the neuropsychiatric features of these stutterers. A group of 21 stutterers with the developmental form of stuttering, an onset before age of 6 years, aged 20 to 74 years, and who were otherwise free of major medical or psychiatric problems, initially gave a 5-minute tape-recorded speech sample in response to purposely ambiguous instructions to talk about any interesting or dramatic life experiences.

The relationship between dissociated vertical divergence (DVD) and head tilts.

Introduction: Dissociated vertical divergence (DVD) has been associated with manifest head tilts. Also, DVD has been described as demonstrating a characteristic response to forced head tilt by increasing the size of the DVD on contralateral tilt.

Methods: A series of 116 consecutive patients with DVD associated with infantile esotropia were examined according to a predetermined protocol between 1989 and 1994.

"Biospheric medicine" as viewed from the two-year first closure of Biosphere 2.

Biosphere 2 is a 3.15-acre, 7-million ft. enclosed ecological space near Tucson, AZ.

Computerized measurement of the content analysis of natural language for use in biomedical and neuropsychiatric research.

Over several decades, the senior author, with various colleagues, has developed an objective method of measuring the magnitude of commonly useful and pertinent neuropsychiatric and neuropsychological dimensions from the content and form analysis of verbal behavior and natural language. Extensive reliability and validation studies using this method have been published involving English, German, Spanish and many other languages, and which confirm that these Content Analysis Scales can be reliably scored cross-culturally and have construct validity. The validated measures include the Anxiety Scale (and six subscales), the Hostility Outward Scale (and two subscales), the Hostility In Scale, the Ambivalent Hostility Scale, the Social Alienation-Personal Disorganization Scale, the Cognitive Impairment Scale, the Depression Scale (and seven subscales), and the Hope Scale.