The Case for Space Sexology

Space poses significant challenges for human intimacy and sexuality. Life in space habitats during long-term travel, exploration, or settlement may: detrimentally impact the sexual and reproductive functions of astronauts, restrict privacy and access to intimate partners, impose hygiene protocols and abstinence policies, and heighten risks of interpersonal conflicts and sexual violence. Together, this may jeopardize the health and well-being of space inhabitants, crew performance, and mission success. Yet, little attention has been given to the sexological issues of human life in space. This situation is untenable considering our upcoming space missions and expansion. It is time for space organizations to embrace a new discipline, space sexology: the scientific study of extraterrestrial intimacy and sexuality. To make this case, we draw attention to the lack of research on space intimacy and sexuality; discuss the risks and benefits of extraterrestrial eroticism; and propose an initial biopsychosocial framework to envision a broad, collaborative scientific agenda on space sexology. We also underline key anticipated challenges faced by this innovative field and suggest paths to solutions. We conclude that space programs and exploration require a new perspective - one that holistically addresses the intimate and sexual needs of humans - in our pursuit of a spacefaring civilization.

Perceived outcomes and SWOT analysis of a virtual community of practice in Burkina Faso

Background

In Burkina Faso, maternity is a risk. Global Affairs Canada funded the initiative PASME-2 with World University Service of Canada, Laval University and Farm Radio International to improve maternal outcomes. A preventative program was co-developed in phases. Phase 3 received funding from Social Sciences and Humanities Research Council in partnership with the Centre for International Cooperation in Health and Development (CCISD) and TIESS, a liaison and transfer expert in Québec, to support local teams towards sustainable practice changes. This research aimed at documenting the partnership experience, digital literacy, perceived direct and indirect outcomes.

Methods

A participative co-design approach, allowed the engagement of several stakeholders in the process. Two active phases where 16 health professionals engaged actively in the VCoP, according to the final agreed-upon Constitutional Chart, are presented. The phases pilot-tested two different technology tools.

Results

16 interviews post-phase 1 and 16 interviews post-phase 2 were conducted. Implementation issues as perceived by users are discussed and include: feasibility, challenges, needs, animation, relevance to care, communication and sharing, use and perspectives. Perceived outcomes focus on professional preventative practice changes, skills, family outcomes, challenges to practice integration, knowledge and practice exchanges.

Conclusions

The phases of experimentation demonstrate that strategies can be put in place to counter the digital literacy challenges and to engage users in new ways of communicating, sharing on the platform about health practices and taking valuable time to do it. Overcoming technology constraints is essential especially in lower resource settings. The most practical life experiences and cases lead to more engagement and innovations. Support from management and upper directorate is significant.

Key messages

Partnership from several stakeholders is key to implementing a VCoP. Experimenting and sharing solutions is influenced by the capacitating environment that the VCoP can provide with recognition from administration and as a professional development activity.

Co-designing a virtual community of practice (VCoP) for maternal and child health in Burkina Faso

Background

In Burkina Faso, maternity is a risk. Global Affairs Canada funded the initiative PASME-2 with World University Service of Canada, Laval University and Farm Radio International to improve maternal outcomes. A preventative program was co-developed. Phase 1 included to train the Health Ministry training coordinators. Phase 2 related to the training of nearly 100 health professionals. Phase 3 received funding from Social Sciences and Humanities Research Council in partnership with the Centre for International Cooperation in Health and Development and TIESS, a liaison and transfer expert in Québec, to support local teams towards sustainable practice changes.

Results

On the first objective, to describe the co-development of this living lab are presented. We share our perspective of the co-designing challenges, tools, and solutions. We will demonstrate the VCoP platform and environment. Method. A participative co-design approach, allowed the engagement of several stakeholders in the process. Results. Four workshops were organised. Seventeen maternal and child care health professionals took part in the initial 8-month development phase.

Results

Four steps of the six phases of Gusche innovation design are presented with associated products and results. Implementation challenges, critical decisions, role of face-to-face meetings, technology factors, digital literacy and solutions are presented.

Conclusions

Implementing a technology innovation in low income setting with limited access to the web and to technologies is a challenge. Its advantages are greater: access to evidenced-base care, facilitating professional development, creating a safe space and leading to emerging problem-solving collective solutions. Conceived as a capacitating environment (Sen) and supporting strength-based (Gottlieb) care through partnership, this VCoP becomes a driver of action to maintain preventative health competence and to share experiences and ways of knowing.

Key messages

The digital space crosses the borders and can contribute to human development and expansion of safe, evidenced-based and culturally appropriate professional practices. Working in partnerships, interprofessional and intersectoral, with public and community groups can create synergies that will unfold in greater health equity.

Community-based health agents practices in Burkina Faso

Background

It is estimated that around 25% of the world's infant mortality is in West Africa where undernutrition accounts for more than 50% of the underlying causes of under-5 mortality. Malnutrition rates have decreased slightly, especially compared to the targets set for 2025. Since Alma-Ata's declaration in 1978, community participation in primary health care has been one way of reducing health inequalities. WHO recommended the integration of community health workers (CHW) into the health system and their inclusion in the human resources planning strategy. We observed a decline of programs involving CHW in the 1990s, then a definite revaluation since the 1990s and specifically, since 2012. They provide health education, as well as referral for a range of services, and provide support and assistance to communities and families through preventive health, easier access to curative health services as well as social services. The specific objectives of this project include: to describe the roles and functions of CHW in Burkina Faso, to identify the workers' needs, to explore the changes in the system and to identify the conditions related to their deployment.

Methods

A qualitative case study allowed to describe the processes and also facilitated the discovery of key elements related to the experiences of community agents, considering the elements of complexity and context.

Results

Our results include activities in promotional services, preventive services, curative services and health data management. In addition, we will shed light on their feelings and experiences related to integration into the system, on the strategies they use, on the advantages that bring their role as community workers, their concerns and finally, we will share their perception of their impact. Some recommendations are proposed in regards to training and supervision.

Key messages

CHW are major players in health systems by creating a bridge between health and social service providers and communities with reduced access. CHW contributes to social justice by facilitating access, promoting recognition and creating empowering processes through increased participation.

Potent and systematic RNAi mediated silencing with single oligonucleotide compounds

RNA interference (RNAi) has been established as an important tool for functional genomics studies and has great promise as a therapeutic intervention for human diseases. In mammalian cells, RNAi is conventionally induced by 19-27-bp RNA duplexes generated by hybridization of two complementary oligonucleotide strands (oligos). Here we describe a novel class of RNAi molecules composed of a single 25-28-nucleotide (nt) oligo. The oligo has a 16-nt mRNA targeting region, followed by an additional 8-10 nt to enable self-dimerization into a partially complementary duplex. Analysis of numerous diverse structures demonstrates that molecules composed of two short helices separated by a loop can efficiently enter and activate the RNA-induced silencing complex (RISC). This finding enables the design of highly effective single-oligo compounds for any mRNA target.

Modified dsRNAs that are not processed by Dicer maintain potency and are incorporated into the RISC

Chemical modification of RNA duplexes can provide practical advantages for RNA interference (RNAi) triggering molecules including increased stability, safety and specificity. The impact of nucleotide modifications on Dicer processing, RISC loading and RNAi-mediated mRNA cleavage was investigated with duplexes >or=25 bp in length. It is known that dsRNAs >or=25 bp are processed by Dicer to create classic 19-bp siRNAs with 3'-end overhangs. We demonstrate that the presence of minimal modification configurations on longer RNA duplexes can block Dicer processing and result in the loading of the full-length guide strand into RISC with resultant mRNA cleavage at a defined site. These longer, modified duplexes can be highly potent gene silencers, with EC50s in the picomolar concentration range, demonstrating that Dicer processing is not required for incorporation into RISC or potent target silencing.

Delivery to Macrophages and Efficacy of Orally Administered RNAi Compounds (42.27)

Data will be presented on a method for RNAi compound delivery utilizing RNA encapsulated in beta-glucan shells. When orally administered to mice, these encapsulated nucleic acids traverse the intestinal epithelia by an M cell transcytosis mechanism and are then endocytosed by macrophages. Macrophages containing RNAi compounds migrate to sites of inflammation, and the targeted RNA is specifically inhibited by RNA interference. This formulation presents some unique advantages for therapeutic RNAi including oral mode of administration, low dose (ug/kg/day) and specific delivery to immune cells possibly affording safety advantages for some targets. This novel mode of RNA administration can be used to down-regulate target genes involved in multiple inflammatory disease indications.

The difluoromethylene group as a replacement for the labile oxygen in steroid sulfates: a new approach to steroid sulfatase inhibitors

Several estrone sulfate and estradiol sulfate analogues, in which the sulfate group was replaced with an alpha,alpha-difluoromethylenesulfonate group or an alpha,alpha-difluoromethylenetetrazole group, were examined as inhibitors of steroid sulfatase (STS). These compounds were 4.5-10.5 times more potent than their non-fluorinated analogues. Moreover, the presence of the fluorines changed the mode of inhibition from mixed to competitive. The inhibitor bearing the alpha,alpha-difluoromethylenetetrazole group exhibited an affinity for STS approaching that of the natural STS substrate, estrone sulfate. Possible reasons for the enhanced affinity of the fluorinated compounds compared to their non-fluorinated counterparts are discussed.

Discrepancies between meta-analyses and subsequent large randomized, controlled trials

BACKGROUND

Meta-analyses are now widely used to provide evidence to support clinical strategies. However, large randomized, controlled trials are considered the gold standard in evaluating the efficacy of clinical interventions.

METHODS

We compared the results of large randomized, controlled trials (involving 1000 patients or more) that were published in four journals (the New England Journal of Medicine, the Lancet, the Annals of Internal Medicine, and the Journal of the American Medical Association) with the results of meta-analyses published earlier on the same topics. Regarding the principal and secondary outcomes, we judged whether the findings of the randomized trials agreed with those of the corresponding meta-analyses, and we determined whether the study results were positive (indicating that treatment improved the outcome) or negative (indicating that the outcome with treatment was the same or worse than without it) at the conventional level of statistical significance (P<0.05).

RESULTS

We identified 12 large randomized, controlled trials and 19 meta-analyses addressing the same questions. For a total of 40 primary and secondary outcomes, agreement between the meta-analyses and the large clinical trials was only fair (kappa= 0.35; 95 percent confidence interval, 0.06 to 0.64). The positive predictive value of the meta-analyses was 68 percent, and the negative predictive value 67 percent. However, the difference in point estimates between the randomized trials and the meta-analyses was statistically significant for only 5 of the 40 comparisons (12 percent). Furthermore, in each case of disagreement a statistically significant effect of treatment was found by one method, whereas no statistically significant effect was found by the other.

CONCLUSIONS

The outcomes of the 12 large randomized, controlled trials that we studied were not predicted accurately 35 percent of the time by the meta-analyses published previously on the same topics.

Prenatal peer counseling: an answer to the persistent difficulties with prenatal care for low-income women

Our intention in this article is to provide the reader with the theoretical framework of prenatal peer counseling. A second article describing a prenatal peer program that is functional in the province of Quebec will be presented subsequently with its outcomes and recommendations. However, before planning the implementation of such a program or even assessing its effectiveness, one must understand how peer counseling can be used as an assistive strategy and why it is perceived to be a community approach worth considering with pregnant women from poor socioeconomic backgrounds. This approach addresses most problems encountered when prenatal programs fail to meet the specific needs of these women. Principles of the therapeutic community and its derivatives are put forward to lay the theoretical foundation of prenatal peer counseling. The studies reviewed show that psychosocial variables associated with pregnancy outcome and poverty such as anxiety, social support, and self-esteem can be positively influenced through a prenatal peer counseling program. We strongly recommend that nurses working with low-income families consider prenatal peer counseling as an empowering strategy for mothers within a given community.

[First case of human toxocariasis (?) with adult worms in the circulatory system, detected by the presence of embryonated eggs in hemolysis concentration]

Ascarids's eggs were found by blood concentration in a Cameroonese patient with hypereosinophilia. Eggs, similar to those of Toxocara canis or cati, were present in 6 blood concentrations carried out during 7 weeks. These eggs (70-75 x 100-112 microns) contained embryos and hatching of 437-504 microns long larvae was sometimes observed. The presence of adult worms in a well oxygenated localization (e.g.; the left ventricle) was supposed. A pleural effusion was also observed but the low number of eosinophils in the pleural fluid (3%) eliminated the responsibility of the parasite. The treatment by thiabendazole for an associated strongyloidosis was well tolerated but inefficient. On the contrary, the treatment by diethylcarbamazine, well tolerated, induced the disparition of the circulating eggs. This result was confirmed by 6 blood concentrations carried out during 6 months.

Growth of poliovirus using alginate entrapped-anchorage dependant Vero cells

Obligatory anchorage dependant Vero cells were successfully grown in gelatinous-like macrocarriers made of calcium alginate. Entrapped single cells were immobilized within the polymerized alginate matrix divide to form large spherical clumps of cells. A cell density of 17 x 10(6) cells/ml of alginate with over 95% viability was obtained after 14 days in spinner flasks. When subjected to poliovirus type I infection, spherical masses of Vero cells progressively showed extensive cytopathic effect but remained entrapped in the alginate matrix of the macrocarriers. Virus was released into a cellular debris free-like supernatant and reached a peak titer of 10(8.0) TCID50/ml after 72 hours.

[The role of mefloquine in the prevention of malaria]

The use of Méfloquine in the prophylactic treatment of malaria has, up to now, been hampered by the standpoint adopted by the WHO, the Conseil Supérieur d'Hygiène and some specialists, for whom Méfloquine should be administered only for short stays in areas of strong chloroquine-resistance. This policy, which prevents many travellers and overseas residents from benefitting from one of the most effective prophylactic treatments on the market today, thereby indirectly causing a number of pernicious cases of malaria, is based on the unfounded, unproved premise that wide use of this drug would foster the development of méfloquine-resistance or on side-effects, which are in fact rarely of any consequence and always curable. The efficacity of this drug should ensure that it is used for the basic prophylactic treatment of malaria in chloroquine-resistant areas, whatever the degree of this resistance and the length of stay involved, on condition that care is taken as to the tolerance of this drug in the early stages of treatment.

Growth of a murine coronavirus in a microcarrier cell culture system

The growth of the murine coronavirus MHV-A59 on murine DBT cells adapted to dextran-made Cytodex 1 microcarriers was studied in comparison with cells grown on plastic dishes. With a microcarrier concentration of 5 g/l in spinner flasks, a density of 3 x 10(6) cells/ml was reached in 7 days. Under these conditions, cells supported virus growth to the same extent as when they were grown on the plastic substratum. This was shown by a similar development of virus-induced syncytia, the release of an equivalent number of infectious progeny virions per cell, similar recoveries observed after concentration and purification and an identical appearance of the purified virus under the electron microscope. On the other hand, the technical convenience of microcarriers and the ease of scale-up emphasize their potential for the growth of coronaviruses.

[Study of specific immunoglobulins (total, IgG, IgM, IgA, IgE) in indirect immunofluorescence and ELISA in 40 patients with trichinosis followed over a 9-month period]

The evolution of the classes of specific immunoglobulins (IgG, IgM, IgA, IgE) of 40 cases of human trichinosis was followed over a nine month period by means of an indirect immunofluorescence test (IF) and ELISA. Specific IgG and IgM appear between 4 and 6 weeks after infection and were still demonstrable after 9 months (respectively in 87.5% and 38.5% of the patients with IF, in 85% and 87.5% with ELISA). Specific IgA were mainly seen on the 2nd month and specific IgE were detected in 37.5% of the patients on the 4th month. In this outbreak, specific antibodies seem to appear later than in a second outbreak observed a few weeks later.

Two outbreaks of trichinosis caused by horsemeat in France in 1985

Two outbreaks of trichinosis occurred in France in August and October of 1985 and 1,073 cases in all were identified. In the first outbreak, two localities were involved: the town of Melun and the 14th district of Paris. To determine the origin of the contamination, three case-control studies were carried out: among patients' families, among the populations of these two areas, and among the inmates in the prison of Melun. In the second outbreak, cases again occurred in Paris but in a different district (the 12th), in the city's suburbs, and in other towns scattered throughout France. Although no parasites were found in any of the meat examined in either outbreak, results of the study indicate that infection was due to horsemeat consumption and led to the incrimination of two carcasses, one imported from a slaughterhouse in the United States and the other from West Germany. These findings led the French Ministry of Agriculture to order the inspection for trichinosis of all meat from horses slaughtered both in France and in countries exporting horsemeat to France.

Optical fiber probe to measure local void fraction profiles

A fiber optic probe for measuring the local void fraction in a two-phase (air-water) flow has been developed. The liquid-gas and gas-liquid interfaces are detected by the normal reflections of IR laser light at the tip of a multimode fiber. The probe and its associated electronic circuitry were calibrated by using the averaged void fraction measured by a quick closing valve system. The void profiles obtained by this method were compared with those obtained by a conductivity local probe. The proposed optical system shows a better sensitivity at high void fractions.

Investigation of power oscillations along tapered monomode fibers

An abruptly tapered fiber can be essentially divided into three different regions: one beating region in its central, quasi-cylindrical part, lying between two coupling regions, where the slopes are large. In this paper we report two experiments which help to visualize and analyze the beating region. We show that, in this region, there are principally two modes present, HE(11) and HE(12), both excited with large amplitudes.

Liquid-crystal-clad tapered fibers

The capability of changing the optical output of a tapered single-mode fiber by using a liquid crystal as an electrelectrooptical medium is shown.

[Comparison of immune response in patients with bilharziasis (S. mansoni) from Africa south of the Sahara and Antilles]

Retrospective study has been conducted in the parasitic and tropical diseases department of the hospital Cochin, based on observations made between 1966 and 1985 on antibody rates in sera of 709 bilharziasis patients (S. mansoni). This study shows a great difference of immunologic reaction between the group of patients from French West Indies (458 patients) and the one of the group of patients from Africa South of Sahara (189 patients). Such an observation leads the authors to suppose a difference between strains of schistosomes from Black Africa and French West Indies.

[Drug resistance of Plasmodium falciparum and Plasmodium vivax strains in Cambodia (Cardamone Massif). Morphological characteristics of Plasmodium vivax]

The authors report some failures of chemoprophylaxis and curative treatment of Plasmodium falciparum and Plasmodium vivax malaria. These infections were contracted in the area of the cambodian-thaï border by 8 Europeans treated by various regimens and 34 Cambodians treated by quinine. In the latter group, the quinine failure rate in Plasmodium falciparum infections was about 47% (RII or RIII?) and 17,5% in Plasmodium vivax. Total cure of vivax malaria with usual doses of Primaquine among the Europeans, failed in 3 out of the 6 treated patients. Morphological particularities (abnormal pigment, lack of Schüffner dots) were noticed in these Primaquine resistant vivax strains. A possible relation is considered between Primaquine resistance and these morphological particularities.