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Background: Fiji faces a growing burden of diseases and a significant emigration of health workers, heightening the role of community health workers (CHWs) in healthcare delivery. Effective training is crucial for CHWs to enhance their capacity and service quality. This study evaluates CHW training in Fiji, aiming to identify areas for improvement., Methods: A qualitative study was conducted, encompassing a review of national policies on CHW training, six focus group discussions, and interviews with CHWs and their supervisors across Fijian subdivisions. This study was collaboratively designed with Fiji's Ministry of Health and Medical Services (MOHMS). Data was transcribed, coded, and thematically analysed using the Community Health Workers Assessment and Improvement Matrix (CHW-AIM)., Findings: While CHW training policies in Fiji are well-established, discrepancies exist between the policy and its implementation. Challenges include inconsistent training for new recruits, limited resources, and variability in training content and frequency of training across divisions, especially concerning noncommunicable disease (NCD) training., Interpretation: To enhance the CHW training program in Fiji, a restructuring and standardisation of both pre-service and in-service training is necessary, tailored to the needs of each division. Investment in ongoing capacity building, alongside the development and revision of training guidelines, particularly for managing NCD complications in the community, is crucial. Implementing these changes will enable CHWs in Fiji to be better equipped for providing essential community-based care., (© 2024. The Author(s).)

The Mango I and II RNA aptamers have been widely used in vivo and in vitro as genetically encodable fluorogenic markers that undergo large increases in fluorescence upon binding to their ligand, TO1-Biotin. However, while studying nucleic acid sequences, it is often desirable to have trans -acting probes that induce fluorescence upon binding to a target sequence. Here, we rationally design three types of light-up RNA Mango Beacons based on a minimized Mango core that induces fluorescence upon binding to a target RNA strand. Our first design is bimolecular in nature and uses a DNA inhibition strand to prevent folding of the Mango aptamer core until binding to a target RNA. Our second design is unimolecular in nature, and features hybridization arms flanking the core that inhibit G-quadruplex folding until refolding is triggered by binding to a target RNA strand. Our third design builds upon this structure, and incorporates a self-inhibiting domain into one of the flanking arms that deliberately binds to, and precludes folding of, the aptamer core until a target is bound. This design separates G-quadruplex folding inhibition and RNA target hybridization into separate modules, enabling a more universal unimolecular beacon design. All three Mango Beacons feature high contrasts and low costs when compared to conventional molecular beacons, with excellent potential for in vitro and in vivo applications., (© 2024 Abdolahzadeh et al.; Published by Cold Spring Harbor Laboratory Press for the RNA Society.)

Within biofilms, gradients of electron acceptors such as oxygen stimulate the formation of physiological subpopulations. This heterogeneity can enable cross-feeding and promote drug resilience, features of the multicellular lifestyle that make biofilm-based infections difficult to treat. The pathogenic bacterium Pseudomonas aeruginosa produces pigments called phenazines that can support metabolic activity in hypoxic/anoxic biofilm subzones, but these compounds also include methylated derivatives that are toxic to their producer under some conditions. In this study, we uncover roles for the global regulators RpoS and Hfq/Crc in controlling the beneficial and detrimental effects of methylated phenazines in biofilms. Our results indicate that RpoS controls phenazine methylation by modulating activity of the carbon catabolite repression pathway, in which the Hfq/Crc complex inhibits translation of the phenazine methyltransferase PhzM. We find that RpoS indirectly inhibits expression of CrcZ, a small RNA that binds to and sequesters Hfq/Crc, specifically in the oxic subzone of P. aeruginosa biofilms. Deletion of rpoS or crc therefore leads to overproduction of methylated phenazines, which we show leads to increased metabolic activity-an apparent beneficial effect-in hypoxic/anoxic subpopulations within biofilms. However, we also find that under specific conditions, biofilms lacking RpoS and/or Crc show increased sensitivity to phenazines indicating that the increased metabolic activity in these mutants comes at a cost. Together, these results suggest that complex regulation of PhzM allows P. aeruginosa to simultaneously exploit the benefits and limit the toxic effects of methylated phenazines.

Background: Following reports of new scientific research there are frequently discussions in the media about the effectiveness of antidepressants., Aim: To find out whether recently published meta-analyses about the effectiveness of antidepressants have consequences for clinical practice., Method: Two recent meta-analyses which investigated the effectiveness of antidepressants are discussed. results The two studies were conducted along similar lines using similar methods. Both meta-analyses concluded that antidepressants are effective in the more serious type of depressive disorders. They are less effective in mild depressive disorders., Conclusion: On the basis of these two meta-analyses it was concluded that antidepressants should be prescribed solely for patients with severe depressive disorders.

This paper sets out in detail how the Singapore Anglican Welfare Council (SAWC) has worked from its charter vision to a number of interlocking strategies and programs in the rehabilitation of those with psychiatric disabilities in Singapore. While the pathway toward a holistic and integrated model of rehabilitation may seem, in the body of this paper, to be almost rational-comprehensive in formulation, it has emerged from ongoing diagnosis and assessment of societal needs, and of the needs of those with psychiatric disabilities. It began simply from a compassionate vision but enlarged significantly as the writer continued in a doctor of business and administration program, to sharpen perceptions, purpose change within, and to collaborate with other agencies, both government and private. To facilitate the journey through this paper, the writer speaks of various continua of education and training, of growing the needed employment opportunities for the disabled, and of offering graduated housing and living skills opportunities. In reality, each initiative generated another and fed off one another. But the goal of all the activities described in this paper seems to have emerged as offering a graduated independence to those with psychiatric disabilities at their own choice and pace. They have taught the writer to listen, consult and to act in concert with them.

Objective: To determine norms for assessing Health-related Quality of Life (HRQOL) in Singapore using the Short Form 36 Health Survey (SF-36)., Materials and Methods: Mean SF-36 scores were calculated for 24 population subgroups (categorised by age, gender, ethnicity and questionnaire language) and for subjects with self-reported co-morbid conditions using data from a community-based survey in Singapore., Results: The English and Chinese SF-36 was completed by 4122 and 1381 subjects, respectively, 58% (n = 3188) of whom had self-reported co-morbid conditions. SF-36 scores varied in subgroups differing in age, gender and ethnicity. In general, subjects with self-reported co-morbid conditions had lower SF-36 scores than those without these conditions, the magnitude of which exceeded 20 points in several instances. A method for calculation of SF-36 scores adjusted for age, gender, ethnicity and questionnaire language is described., Conclusion: We present norms for English and Chinese SF-36 versions in Singapore and describe potential uses for these data in assessing HRQOL in Singapore.

Objective: To examine the relationship between ethnicity and major organ involvement at and after diagnosis in community-based cohorts of Caucasian and Chinese systemic lupus erythematosus (SLE) patients resident in Rochester, Minnesota, and Singapore, respectively., Methods: Clinical manifestations at and after diagnosis were compared in Caucasian and Chinese SLE patients. The association between ethnicity and disease manifestations at and after diagnosis was determined using logistic regression and Cox proportional hazards models, respectively, adjusting for the influence of demographic, socioeconomic, disease-related, and therapy-related factors., Results: At diagnosis, Caucasian SLE patients were 3 times more likely than Chinese SLE patients to have serositis (odds ratio [OR] 3.11, 95% confidence interval [CI] 1.01-9.71), nearly 7 times more likely to have a hematologic disorder (OR 6.95, 95% CI 2.20-21.97), and far less likely to have a malar rash (OR 0.19, 95% CI 0.07-0.54) or positive antinuclear antibodies (OR 0.11, 95% CI 0.03-0.52). Ethnicity was not associated with the prevalence of proteinuria or central nervous system (CSN) and other major organ involvement at diagnosis. After diagnosis, there was a trend toward less development of proteinuria and other major organ involvement in Caucasians (relative risk [RR] 0.47, 95% CI 0.19-1.15, and RR 0.22, 95% CI 0.05-1.04, respectively)., Conclusion: Chinese SLE patients are far less likely to have serositis or a hematologic disorder at diagnosis and may be more likely to develop proteinuria or CNS or other major organ involvement over the course of the disease, compared with Caucasian SLE patients. This may contribute to the increased mortality seen in Chinese SLE patients.