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Background: Low- and middle- income countries account for three-fourths of the global non- communicable disease related mortality. In response to the increasing number of non- communicable disease diagnoses in Kenya, the government released a national strategy for non- communicable disease in 2015. The purpose of this study was to assess facility-based care of diabetes, hypertension, and heart failure across western Kenya. Methods: A 71-question cross-sectional survey was administered among facilitybased healthcare workers in Siaya County, western Kenya, between October 2015 and January 2016. All Level 4 and 5 facilities, as well as a cohort of lower-level facilities were surveyed. Results: Of the 21 health facilities surveyed, six (31.6%) had specific noncommunicable disease clinics. Eleven of the 21 (52.4%) facilities had glucometers, and providers indicated that even these glucometers were often not functional. Three of the 21 facilities (14.3%) had a diabetic registry, one a functioning electrocardiogram machine, and one other a congestive heart failure registry. Conclusions: Facilities at every level were lacking equipment and medications expected by the Kenya's Essential Package of Health Services. Improvement for follow up and referral services could be achieved through the development of comprehensive non-communicable disease registries. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness and safety of an ultra-low-cost uterine balloon tamponade package (ESM-UBT™) for facility-based management of uncontrolled postpartum haemorrhage (PPH) in Kenya, Sierra Leone, Senegal, and Nepal.Design: Prospective multi-centre case series.Setting: Facilities in resource-scarce areas of Kenya, Sierra Leone, Nepal, and Senegal.Population: Women with uncontrolled postpartum haemorrhage in 307 facilities across the four countries.Methods: A standardised ESM-UBT package was implemented in 307 facilities over 29 months (1 September 2012 to 1 February 2015). Data were collected via a multi-pronged approach including data card completion, chart reviews, and provider interviews. Beginning in August 2014, women who had previously undergone UBT placement were sought and queried regarding potential complications associated with UBT use.Main Outcome Measures: All-cause survival, survival from PPH, and post-UBT use complications (surgery, hospitalisation, antibiotics for pelvic infection) associated with UBT use.Results: 201 UBTs were placed for uncontrolled vaginal haemorrhage refractory to all other interventions. In all, 38% (71/188) of women were either unconscious or confused at the time of UBT insertion. All-cause survival was 95% (190/201). However, 98% (160/163) of women survived uncontrolled PPH if delivery occurred at an ESM-UBT online facility. One (1/151) potential UBT-associated complication (postpartum endometritis) was identified and two improvised UBTs were placed in women with a ruptured uterus.Conclusions: These pilot data suggest that the ESM-UBT package is a clinically promising and safe method to arrest uncontrolled postpartum haemorrhage and save women's lives. The UBT was successfully placed by all levels of facility-based providers. Future studies are needed to further evaluate the effectiveness of ESM-UBT in low-resource settings.Tweetable Abstract: Evidence for ESM-UBT as a clinically promising and safe method to arrest uncontrolled PPH and save women's lives. [ABSTRACT FROM AUTHOR]

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Objective: To develop an evidence-based maternal, newborn and child emergency training package for community-based frontline health workers (FHWs) in post-conflict South Sudan. Methods: In partnership with the new Republic of South Sudan, a multimodal needs assessment was conducted through purposive sampling, involving key informant interviews, focus group discussions, provider knowledge assessments and facility surveys. Data were analyzed using traditional qualitative techniques and compared with existing training programmes and curricula. These findings informed the development and implementation of the novel training approach. Results: The needs assessment involved 33 FHWs, eight diverse health facilities in Eastern Equatoria, and stakeholders within 18 governmental and non-governmental organizations. Significant consensus emerged regarding the need for greater capacity among previously untrained FHWs. A maternal, newborn and child health training package was developed that included: (1) a participatory training course taught through a 'training of trainers' approach; (2) nine different pictorial action-based checklists covering basic management and referral of maternal, newborn and child emergencies; and (3) essential setting-appropriate equipment. Conclusion: A novel maternal, newborn and child survival package was developed for previously untrained and illiterate FHWs in South Sudan. It is hoped that this approach will build community-based capacity in resource-limited settings while greater capacity is being developed for facility-based deliveries by skilled birth attendants. [ABSTRACT FROM AUTHOR]

We provide a detailed study of the phenomenology of orbifold compactifications of the heterotic string within the context of supergravity effective theories. Our investigation focuses on those models where the soft Lagrangian is dominated by loop contributions to the various soft supersymmetry breaking parameters. Such models typically predict non-universal soft masses and are thus significantly different from minimal supergravity and other universal models. We consider the pattern of masses that are governed by these soft terms and investigate the implications of certain indirect constraints on supersymmetric models, such as flavor-changing neutral currents, the anomalous magnetic moment of the muon and the density of thermal relic neutralinos. We also comment on the possible discovery of these models at the LHC. These string-motivated models show a novel behavior that interpolates between the phenomenology of unified supergravity models and models dominated by the superconformal anomaly. [ABSTRACT FROM AUTHOR]