A survey of the tuberculosis physician workforce in the country of Georgia

SETTING

A well-trained and sufficient tuberculosis (TB) workforce is essential for disease control, especially in an era of newly implemented diagnostics and medications. However, there are few reports on the status of the TB workforce in many endemic countries.

OBJECTIVE

To evaluate the demographics, salary, career satisfaction, and attitudes towards the field of TB among the physician TB workforce in the country of Georgia.

DESIGN

A cross-sectional study of physicians in the current Georgian National TB Programme (NTP) using an anonymous 31-item questionnaire.

RESULTS

Among 184 NTP physicians countrywide, 142 (77%) were contacted and 138 (75%) completed questionnaires. The median age was 56 years (interquartile range 50-64); most (81%) were female. The monthly salary from TB work was USD205 for 50% of respondents. Nearly half (47%) received an additional salary from another source. Many physicians (65%) indicated that they were satisfied with their work, but over half (55%) were unsatisfied with reimbursement. While most physicians (78%) were concerned about the lack of interest in TB, only 36% would recommend a career in TB care.

CONCLUSION

While the current TB workforce in Georgia finds their work fulfilling, an ageing workforce, low salaries and perceived lack of interest in the field are a matter of concern for future TB control.

Synthesis and characterization of functional elastomeric poly(ester amide) co-polymers

A new family of random co-poly(ester amides)s (co-PEAs) having reactive pendant functional carboxylic acid groups were synthesized by co-polycondensation of di-p-toluenesulfonic acid salts of bis-(L-alpha-amino acid (L-leucine and/or L-phenylalanine)) alpha,omega-alkylene diesters with active diesters of dicarboxylic acids using di-p-toluenesulfonic acid salt of L-lysine benzyl ester as a co-monomer. The lateral benzyl ester groups in the L-lysine segment of co-PEAs were subsequently transformed into free COOH groups by catalytic hydrogenolysis using Pd black as a catalyst. The co-PEA-based polyacids obtained, as well as the original co-PEA having lateral benzyl ester groups were characterized by standard methods. In vitro biodegradation studies in the presence of hydrolases like alpha-chymotrypsin and lipase showed significant enzymatic-catalyzed biodegradation of these co-PEAs. These co-PEA-based polyacids were used for covalent attachment of iminoxyl radicals (4-amino-TEMPO) and in vitro biodegradation of 4-aminoTEMPO attached polymer was studied along with releasing kinetic of iminoxyl radical.

Biodegradation of amino-acid-based poly(ester amide)s: in vitro weight loss and preliminary in vivo studies

A systematic in vitro biodegradation study of regular poly(ester amide)s (PEAs) composed of naturally occurring hydrophobic alpha-amino acids, fatty diols and dicarboxylic acids using gravimetric (weight loss) method was carried out in the presence of hydrolases like alpha-chymotrypsin, lipase and a complex of proteases of Papaya. The last enzyme was used for modeling the catalytic action of nonspecific proteases. It was found that the PEAs, in the presence of enzyme solutions, were biodegraded by surface chemical erosion mechanism, according to the first-order kinetics. Spontaneous immobilization (adsorption) of the enzymes onto the PEAs surfaces was observed. The surface immobilized enzyme can also catalyze the chemical erosion of the PEAs. The enzymes could also be impregnated into the PEAs to make PEAs biochemically biodegraded, i.e. 'self-destructive', at a target rate. A comparison of in vitro biodegradation data of the PEAs with polylactide (PDLLA) showed that PEAs exhibited a far more tendency toward enzyme catalyzed biodegradation than PDLLA. A preliminary in vivo biodegradation study of selected PEA films in rats with and without lipase-impregnation showed that those PEAs were completely absorbed within 1-2 months post-implantation (for the lipase-impregnated ones) and 3-6 months (for the lipase-free ones). These findings prompt us to suggest that these new PEAs may have a great potential for designing drug sustained/controlled release devices, as well as implantable surgical devices.