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Background: The efficacy and safety of a novel isoxazoline compound, sarolaner (Simparica®, Zoetis) and spinosad (Comfortis®, Elanco) as a positive control were evaluated for the treatment and control of natural flea infestations on dogs in two randomised, blinded, multi-centric clinical trials conducted in 11 veterinary clinics in northeastern and southeastern states of Australia. Methods: A total of 162 client-owned dogs (80 in northern study and 82 in southern study) from 105 households were enrolled. Each household was randomly allocated to receive either sarolaner (Simparica®, Zoetis) or spinosad (Comfortis®, Elanco). Dogs were dosed on Days 0, 30 and 60 and physical examinations and flea counts were conducted on Days 0, 14, 30, 60 and 90. Efficacy assessments were based on the percentage reduction in live flea counts post-treatment compared to Day 0. Results: In the northern study, at enrolment, primary dogs had flea counts ranging from 5 to 772. At the first efficacy assessment on Day 14, sarolaner resulted in 99.3% mean reduction in live flea counts relative to Day 0, compared to 94. 6% in the spinosad group. On Day 30, the sarolaner-treated group had mean efficacy of 99.2% compared to 95.7% in the spinosad-treated group, and on days 60 and 90, both groups had mean efficacies of ≥ 98.8%. In the southern study, at enrolment, primary dogs had flea counts ranging from 5 to 156. Both sarolaner and spinosad resulted in ≥ 96. 7% mean reduction in live flea counts on Day 14. On Day 30, the sarolaner-treated group had mean efficacy of 99.5% compared to 89.7% in the spinosad-treated group, and on days 60 and 90, both groups had mean efficacies of ≥ 98. 6%. No treatment-related adverse events were observed in either study. Conclusions: A single monthly dose of sarolaner (Simparica®) administered orally at 2-4 mg/kg for three consecutive months was well tolerated and provided excellent efficacy against natural infestations of fleas under a range of Australian field conditions including different climatic and housing conditions. Similar efficacy was observed with spinosad (Comfortis®) after the second and third monthly treatments. [ABSTRACT FROM AUTHOR]

Background: Health-related within-country inequalities continue to be a matter of great interest and concern to both policy makers and researchers. This study aims to assess the level and the distribution of child mortality outcomes in the Philippines across geographical and socioeconomic indicators. Methodology: Data on 159,130 children ever borne were analysed from five waves of the Philippine Demographic and Health Survey. Direct estimation was used to construct under-five and neonatal mortality rates for the period 1980–2013. Rate differences and ratios, and where possible, slope and relative indices of inequality were calculated to measure disparities on absolute and relative scales. Stratification was undertaken by levels of rural/urban location, island groups and household wealth. Findings: National under-five and neonatal mortality rates have shown considerable albeit differential reductions since 1980. Recently released data suggests that neonatal mortality has declined following a period of stagnation. Declines in under-five mortality have been accompanied by decreases in wealth and geography-related absolute inequalities. However, relative inequalities for the same markers have remained stable over time. For neonates, mixed evidence suggests that absolute and relative inequalities have remained stable or may have risen. Conclusion: In addition to continued reductions in under-five mortality, new data suggests that the Philippines have achieved success in addressing the commonly observed stagnated trend in neonatal mortality. This success has been driven by economic improvement since 2006 as well as efforts to implement a nationwide universal health care campaign. Yet, such patterns, nonetheless, accorded with persistent inequalities, particularly on a relative scale. A continued focus on addressing universal coverage, the influence of decentralisation and armed conflict, and issues along the continuum of care is advocated. [ABSTRACT FROM AUTHOR]

Results from worm egg counts (WECs) of cattle from across Australia over an 11 year period have been analysed to provide contemporary data on WEC and worm genus distribution in Australian cattle. A sampling kit consisted of ten sample containers. Faecal samples were collected into each sampling kit from groups of cattle and WEC and larval cultures were conducted using standard procedures. A submission form was completed for each kit with data requested including date of sampling, property address, age, average estimated weight and production type of cattle, last drench used and date of drenching. Regional analysis was done by postcode region and postcode regions were grouped into bioclimatic regions. A total of 5069 submissions were received from 2002 to the end of 2012 representing over 50,000 individual faecal samples. Seventy-seven percent of cattle sampled were no more than 2 years of age with the remainder representing a range of age groups. Samples were collected from all of the significant cattle producing regions of Australia. There was a tendency for higher geometric mean WEC in cattle in northern Australia and in high rainfall areas along the east coast of Australia. Geometric mean WEC for bioclimatic regions varied seasonally with a peak in autumn in regions with summer dominant rainfall, but little seasonal variation in regions with winter dominant rainfall patterns. Worm genera cultured varied throughout Australia with Cooperia spp. being most prevalent across the country, followed by Haemonchus spp. and Oesophagostomum spp. in summer rainfall dominant regions and Ostertagia spp. and Trichostrongylus spp. in winter rainfall regions. In the coastal, tablelands, and temperate rangelands regions of NSW, Haemonchus spp. were as prevalent as Cooperia spp. during autumn months and levels of Haemonchus spp. found in south-western Western Australia were higher than previously documented. These data provide an up-to-date summary of internal parasites in Australian cattle. Regional differences in WEC between northern and southern Australia are evident and should be further explored. These data suggest that there has been a move to Cooperia spp. being the predominant worm genus in Australian cattle, with increasing levels of Haemonchus spp. being evident in southern temperate regions of Australia. [ABSTRACT FROM AUTHOR]

Significant disparities in reproductive, maternal, newborn, and child health (RMNCH) outcomes and intervention coverage exist between the Mountains and other ecoregions of Nepal. Delivery of essential health services to remote mountainous areas is challenging and access is a known barrier to utilization. However, the contribution of demand-side barriers is poorly understood. Consequently, policies and programs cannot strategically target constraints to increase coverage. This systematic review identifies demand-side barriers to utilization of RMNCH services in the Mountain districts of Nepal. Research was drawn from MEDLINE, Web of Science, Scopus, Google Scholar, Eldis, and unpublished literature. Beyond inaccessibility, utilization is undermined by costs of care-seeking, traditional attitudes and practices, low status of women, limited health knowledge, dissatisfaction with service quality, and low and inequitable care by community health workers. The intensity and repercussions of these barriers are of greater magnitude in the Mountains where delayed care-seeking combines with long distances for critical health consequences. [ABSTRACT FROM PUBLISHER]

Background Few previous studies have examined non-wealth-based inequalities in child mortality within developing countries. This study estimates changes in under-5-year-olds and neonatal mortality in Nepal across a range of subnational levels, which allows us to assess the degree of equity in Nepal’s progress towards Millennium Development Goal 4.Methods Direct estimates of under-5-year-olds and neonatal death rates were generated for 1990–2005using three Demographic and Health Surveys and two Living Standards Surveys by the following levels:national, rural/urban location, ecological region,development region, ethnicity and wealth. Absolute and relative inequalities were measured by rate differences and rate ratios, respectively. Additionally, wealth-related inequality was calculated using slope and relative indexes of inequality and concentration indices.Results Estimates suggest that while most rates of under-5-year-olds and neonatal mortality have declined across the different equity markers, leading to a downward trend in absolute inequalities, relative inequalities appear to have remained stable over time.The decline in absolute inequalities is strongest for under-5-year-olds’ mortality, with no statisticallysignificant trend in either relative or absolute inequalities found for neonatal mortality. A possible increase in inequalities, at least in relative terms, was found across development regions, where death rates remain high in the mid-western region.Conclusions By 2015, our estimates suggest that more than 65% of deaths of under-5-year-olds will occur in the neonatal period, with stable trends in neonatal mortality inequalities. These findings along with the fact that health outcomes for neonates are more highly dependent on health systems, suggest further equitable reductions in under-5-year-olds mortality will require broad health-system strengthening, with a focus on the improvement of healthcare services provided for mothers and newborns. Other inequities suggest continued special attention for vulnerable subpopulations is warranted, particularly to overcome social exclusion and financial barriers to care in urban areas. [ABSTRACT FROM AUTHOR]

During process development testing of the ARES I composite interstage, large regions of node disbonds were observed in the aluminum honeycomb core. The sandwich panels were composed of carbon fiber/epoxy face sheets and one-eighth inch cell size aluminum core co-cured in an autoclave. Node disbonds were initially observed after cure with ultrasonic inspection and subsequently confirmed with X-ray inspection and cross sectioning. A stress analysis was performed on the residual thermal stresses resulting from post-cure cool down. Analysis indicated that the thermal stresses in the aluminum core are a function of foil thickness of the aluminum core. Thermal stresses are relieved through disbonding of the adhesive node. The node disbonds were shown to significantly reduce the shear capability of the sandwich structure. Funding was provided by the ARES I Upper Stage Project. [ABSTRACT FROM AUTHOR]

Introduction: The Millennium Development Goals prompted renewed international efforts to reduce under-five mortality and measure national progress. However, scant evidence exists about the distribution of child mortality at low sub-national levels, which in diverse and decentralized countries like India are required to inform policy-making. This study estimates changes in child mortality across a range of markers of inequalities in Orissa and Madhya Pradesh, two of India's largest, poorest, and most disadvantaged states. Methods: Estimates of under-five and neonatal mortality rates were computed using seven datasets from three available sources - sample registration system, summary birth histories in surveys, and complete birth histories. Inequalities were gauged by comparison of mortality rates within four sub-state populations defined by the following characteristics: rural-urban location, ethnicity, wealth, and district. Results: Trend estimates suggest that progress has been made in mortality rates at the state levels. However, reduction rates have been modest, particularly for neonatal mortality. Different mortality rates are observed across all the equity markers, although there is a pattern of convergence between rural and urban areas, largely due to inadequate progress in urban settings. Inter-district disparities and differences between socioeconomic groups are also evident. Conclusions: Although child mortality rates continue to decline at the national level, our evidence shows that considerable disparities persist. While progress in reducing under-five and neonatal mortality rates in urban areas appears to be levelling off, polices targeting rural populations and scheduled caste and tribe groups appear to have achieved some success in reducing mortality differentials. The results of this study thus add weight to recent government initiatives targeting these groups. Equitable progress, particularly for neonatal mortality, requires continuing efforts to strengthen health systems and overcome barriers to identify and reach vulnerable groups. [ABSTRACT FROM AUTHOR]