Exploring Managers’ Perspectives on MNCH Program in Pakistan: A Qualitative Study

Background

Pakistan’s Maternal, Newborn and Child Health (MNCH) Program is faced with multiple challenges in service delivery, financial and logistic management, training and deployment of human resources, and integration within the existing health system. There is a lack of evidence on managerial aspects of the MNCH program management and implementation.

Methods and Findings

This study used qualitative methods to explore the challenges national, provincial and district program managers have faced in implementing a community midwifery program in province of Punjab while also exploring future directions for the program under a devolved health system. While the program had been designed in earnest, the planning lacked critical elements of involving relevant stakeholders in design and implementation, socio-demographic context and capacity of the existing health system. Financial limitations, weak leadership and lack of a political commitment to the problem of maternal health have also had an impact on program implementation.

Conclusions

Our study results suggest that there is a need to re-structure the program while ensuring sustainability and collaboration within the health sector to increase uptake of skilled birth attendance and improve maternal health care in Pakistan.     

Bacteriostatic stimulus of meropenem on allelochemical-metabolizing Burkholderia sp. LS-044 mitigates ferulic acid autotoxicity in rice (Oryza sativa ssp. japonica cv. Tainung 71)

Plant and Soil - To screen plant-associated Burkholderia strains for plant probiotic traits including allelochemical metabolism and understand their role on rice allelopathy using a...     

Ginseng and Ginkgo Biloba Effects on Cognition as Modulated by Cardiovascular Reactivity: A Randomised Trial

Background

There is some evidence to suggest that ginseng and Ginkgo biloba can improve cognitive performance, however, very little is known about the mechanisms associated with such improvement. Here, we tested whether cardiovascular reactivity to a task is associated with cognitive improvement.

Methodology/Principal findings

Using a double-blind, placebo controlled, crossover design, participants (N = 24) received two doses of Panax Ginseng (500, 1000 mg) or Ginkgo Biloba (120, 240 mg) (N = 24), and underwent a series of cognitive tests while systolic, diastolic, and heart rate readings were taken. Ginkgo Biloba improved aspects of executive functioning (Stroop and Berg tasks) in females but not in males. Ginseng had no effect on cognition. Ginkgo biloba in females reversed the initial (i.e. placebo) increase in cardiovascular reactivity (systolic and diastolic readings increased compared to baseline) to cognitive tasks. This effect (reversal) was most notable after those tasks (Stroop and Iowa) that elicited the greatest cardiovascular reactivity during placebo. In males, although ginkgo also decreased cardiovascular readings, it did so from an initial (placebo) blunted response (i.e. decrease or no change from baseline) to cognitive tasks. Ginseng, on the contrary, increased cardiovascular readings compared to placebo.

Conclusions/Significance

These results suggest that cardiovascular reactivity may be a mechanism by which ginkgo but not ginseng, in females is associated with certain forms of cognitive improvement.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02386852","term_id":"NCT02386852"}}NCT02386852     

Siansivirga zeaxanthinifaciens gen. nov., sp. nov., a novel zeaxanthin-producing member of the family Flavobacteriaceae isolated from coastal seawater of Taiwan

A strictly aerobic, Gram-negative, rod-shaped bacterium (strain CC-SAMT-1(T)) showing gliding motility was isolated from coastal seawater of China Sea, Taiwan. Strain CC-SAMT-1(T) synthesizes all-trans-zeaxanthin (6.5 ± 0.5 mg g(-1) dry biomass) as a predominant xanthophyll carotenoid. As determined by 16S rRNA gene analysis, strain CC-SAMT-1(T) shared very high sequence similarity to the members of the genera Mariniflexile (96.1-95.3%) and Gaetbulibacter (96.0-95.9%); however, it formed a distinct phyletic lineage distantly associated with Mariniflexile species. Polar lipid profile constitutes phosphatidylethanolamine, four unidentified aminolipids, four unidentified lipids, and an unidentified glycolipid. Strain CC-SAMT-1(T) contains excessive unidentified aminolipid lipid (AL2-4) and glycolipid contents, and therefore clearly distinct from Mariniflexile species. Major fatty acids (> 5% of total fatty acids) were iso-C(15:0) (14.8%), iso-C(17:0) 3-OH (11.8%), iso-C(15:1) G (10.6%), anteiso-C(15:0) (9.7%), C(16:0) (8.1%), iso-C(16:0) 3-OH (7.9%), iso-C(15:0) 3-OH (7.5%), and summed feature 3 (containing C(16:1) ω6c and/or C(16:1) ω7c) (7.5%). Menaquinone-6 (MK-6) was major respiratory quinone. DNA G+C content was 33.7 mol%. Based on polyphasic taxonomy, strain CC-SAMT-1(T) represents a novel genus and species in the family Flavobacteriaceae for which the name Siansivirga zeaxanthinifaciens gen. nov., sp. nov. is proposed. The type strain is CC-SAMT-1(T) (= BCRC 80315(T) = JCM 17682(T)).