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Health technology assessment (HTA) is an area that remains less implemented in low- and lower middle-income countries. The aim of the study is to understand the perceptions of stakeholders in Uganda toward HTA and its role in decision making, in order to inform its potential implementation in the country.
The study takes a cross-sectional mixed methods approach, utilizing an adapted version of the International Decision Support Initiative questionnaire with both semi-structured and open-ended questions. We interviewed thirty key informants from different stakeholder institutions in Uganda that support policy and decision making in the health sector.
All participants perceived HTA as an important tool for decision making. Allocative efficiency was regarded as the most important use of HTA receiving the highest average score (8.8 out of 10), followed by quality of healthcare (7.8/10), transparency (7.6/10), budget control (7.5/10), and equity (6.5/10). There was concern that some of the uses of HTA may not be achieved in reality if there was political interference during the HTA process. The study participants identified development partners as the most likely potential users of HTA (66.7 percent of participants), followed by Ministry of Health (43.3 percent).
Interviewed stakeholders in Uganda viewed the role of HTA positively, suggesting that there exists a promising environment for the establishment and operationalization of HTA as a tool for decision making within the health sector. However, sustainable development and application of HTA in Uganda will require adequate capacity both to undertake HTAs and to support their use and uptake.
The COVID-19 pandemic is a global traumatic experience for citizens, especially during sensitive time windows of heightened plasticity such as pregnancy and neonatal life. Pandemic-related stress experienced by mothers during pregnancy may act as an early risk factor for infants’ regulatory capacity development by altering maternal psychosocial well-being (e.g., increased anxiety, reduced social support) and caregiving environment (e.g., greater parenting stress, impaired mother–infant bonding). The aim of the present longitudinal study was to assess the consequences of pandemic-related prenatal stress on infants’ regulatory capacity. A sample of 163 mother–infant dyads was enrolled at eight maternity units in northern Italy. They provided complete data about prenatal stress, perceived social support, postnatal anxiety symptoms, parenting stress, mother–infant bonding, and infants’ regulatory capacity at 3 months of age. Women who experienced emotional stress and received partial social support during pregnancy reported higher anxious symptoms. Moreover, maternal postnatal anxiety was indirectly linked to the infants’ regulatory capacity at 3 months, mediated by parenting stress and mother–infant bonding. Dedicated preventive interventions should be delivered to mothers and should be focused on protecting the mother–infant dyad from the detrimental effects of pandemic-related stress during the COVID-19 healthcare emergency.
The downstream box (DB) has been proposed to enhance
translation of several mRNAs and to be a key element controlling
the expression of cold-shocked mRNAs. However, the proposal
that the DB exerts its effects through a base pairing interaction
with the complementary anti-downstream box (antiDB) sequence
(nt 1469–1483) located in the penultimate stem (helix
44) of 16S rRNA remains controversial. The existence of
this interaction during initiation of protein synthesis
under cold-shock conditions has been investigated in the
present work using an Escherichia coli strain
whose ribosomes lack the potential to base pair with mRNA
because of a 12 bp inversion of the antiDB sequence in
helix 44. Our results show that this strain is capable
of cold acclimation, withstands cold shock, and its ribosomes
translate mRNAs that contain or lack DB sequences with
similar efficiency, comparable to that of the wild type.
The structure of helix 44 in 30S ribosomal subunits from
cells grown at 37 °C and from cells subjected to cold
shock was also analyzed by binding a 32P-labeled
oligonucleotide complementary to the antiDB region and
by chemical probing with DMS and kethoxal. Both approaches
clearly indicate that this region is in a double-stranded
conformation and therefore not available for base pairing
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