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Biomedical subjects

Alex Mercer

Publications and source records attributed to Alex Mercer.

8 recordsLinked to original sources
PubMed2007

Sexual risk behavior of married men and women in Bangladesh associated with husbands' work migration and living apart.

OBJECTIVES: This study aimed to ascertain the prevalence of sexual risk behavior among married men and women who had, or had not, lived apart from their spouse as a result of the husbands' work migration. METHODS: A cross-sectional survey was conducted among a random sample of 1,175 married women and 703 married men in 2 rural areas of Bangladesh. RESULTS: Extramarital sex was reported by 64.2% (95% confidence interval [CI] = 58.7-69.7) of 296 men and 8.6% (95% CI = 7.6-9.6) of 779 women who had lived apart from their spouse, 2 to 3 times higher than the proportions among those who had not lived apart (P <0.05). The proportions of men who reported sex with a female sex worker (50.7%; 95% CI = 45.0-56.4) or with another male (5.4%; 95% CI = 2.8-8.0), while living away, were double the proportions reporting they had done so before living away or among men who had not lived away (P <0.05). Only 2 men had ever used had a condom during sex with another male, and less than one third of men had used a condom during sex with a sex worker or during marital sex. CONCLUSIONS: The sexual risk behavior of married men living away from home may put themselves and their wives at risk for HIV infection and other sexually transmitted diseases.

Adolescent↗
PubMed2006

Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme.

Neonatal deaths account for about half of all deaths among children under 5 years of age in Bangladesh, making prevention a major priority. This paper reports on a study of neonatal deaths in 12 areas of Bangladesh served by a large NGO programme, which had high coverage of reproductive health outreach services and relatively low neonatal mortality in recent years. The study aimed to identify the main factors associated with neonatal mortality in these areas, with a view to developing appropriate strategies for prevention. A case-control design was adopted for collection of data from mothers whose children, born alive in 2003, died within 28 days postpartum (142 cases), or did not (617 controls). Crude and adjusted odds ratios (AOR) were calculated as estimates of relative risk for neonatal death, using 'neighbourhood' controls (241) and 'non-neighbourhood' controls (376). A similar proportion of case and control mothers had received NGO health education and maternal health services. The main risk factors for neonatal death among 122 singleton babies, based on the two sets of controls, were: complications during delivery [AOR, 2.6 (95% CI: 1.5-4.5) and 3.1 (95% CI: 1.8-5.3)], prematurity [AOR, 7.2 (95% CI: 3.6-14.4) and 8.3 (95% CI: 4.2-16.5)], care for a sick neonate from an unlicensed 'traditional healer' [AOR, 2.9 (95% CI 0.9-9.5 and 5.9 (95% CI: 1.3-26.3)], or care not sought at all [AOR, 23.3 (95% CI: 3.9-137.4)]. The strongest predictor of neonatal death was having a previous sibling not vaccinated against measles [AOR, 5.9 (95% CI: 2.2-15.5) and 12.0 (95% CI: 4.5-31.7)]. The findings of this study indicate the need for identification of babies at high risk and early postpartum interventions (40.2% of the deaths occurred within 24 hours of delivery). Relevant strategies include special counselling during pregnancy for mothers with risk characteristics, training birth attendants in resuscitation, immediate postnatal check-up in the home for high-risk babies identified at delivery, advice for mothers on appropriate care-seeking for sick babies, improving the capacity of sub-district hospitals for emergency obstetric and newborn care, and promotion of institutional deliveries.

Adult↗
PubMed2006

Validating neonatal mortality and use of NGO reproductive health outreach services in rural Bangladesh.

Although the neonatal mortality rate (NMR) in Bangladesh remained steady between 1995-99 and 1999-2003 (41-42 deaths per 1,000 live births), evidence from the management information system (MIS) of a large nongovernmental organization (NGO) program indicates that the NMR declined by about 50 percent between 1996 and 2002 in the area served. This study aims to validate the recording of neonatal deaths among the cohort of children registered as born in 2003 and to assess the evidence of a decline in the NMR. It also measures the coverage of reproductive health outreach services, focusing on 12 of the 27 NGOs that have provided services in the same areas since 1996. Field-workers' registers, verbal autopsy reports, and immunization records were checked to confirm infants' survival. Interviews were conducted with 142 mothers of children who died within 28 days postpartum and with a random sample of 109 women with registered stillbirths. Out of 11,253 registered live births in 2003, 210 neonatal deaths were found, compared with 194 deaths that were reported in the MIS for 2003. The corrected NMR was 19 deaths per 1,000 live births, and it was in the range of 15-29 deaths per 1,000 live births in 11 of the NGO areas. Because underreporting of neonatal deaths was probably higher in 1996 when the MIS-reported NMR was 39 deaths per 1,000 live births, the decline in the NMR is likely to have been genuine.

Bangladesh↗
PubMed2005

Epidermal growth factor (EGF) withdrawal masks gene expression differences in the study of pituitary adenylate cyclase-activating polypeptide (PACAP) activation of primary neural stem cell proliferation.

BACKGROUND: The recently discovered adult neural stem cells, which maintain continuous generation of new neuronal and glial cells throughout adulthood, are a promising and expandable source of cells for use in cell replacement therapies within the central nervous system. These cells could either be induced to proliferate and differentiate endogenously, or expanded and differentiated in culture before being transplanted into the damaged site of the brain. In order to achieve these goals effective strategies to isolate, expand and differentiate neural stem cells into the desired specific phenotypes must be developed. However, little is known as yet about the factors and mechanisms influencing these processes. It has recently been reported that pituitary adenylate cyclase-activating polypeptide (PACAP) promotes neural stem cell proliferation both in vivo and in vitro. RESULTS: We used cDNA microarrays with the aim of analysing the transcriptional changes underlying PACAP induced proliferation of neural stem cells. The primary neural stem/progenitor cells used were neurospheres, generated from the lateral ventricle wall of the adult mouse brain. The results were compared to both differentiation and proliferation controls, which revealed an unexpected and significant differential expression relating to withdrawal of epidermal growth factor (EGF) from the neurosphere growth medium. The effect of EGF removal was so pronounced that it masked the changes in gene expression patterns produced by the addition of PACAP. CONCLUSION: Experimental models aiming at transcriptional analysis of induced proliferation in primary neural stem cells need to take into consideration the significant effect on transcription caused by removal of EGF. Alternatively, EGF-free culture conditions need to be developed.

Animals↗
PubMed2005

Transcriptome analysis in primary neural stem cells using a tag cDNA amplification method.

BACKGROUND: Neural stem cells (NSCs) can be isolated from the adult mammalian brain and expanded in culture, in the form of cellular aggregates called neurospheres. Neurospheres provide an in vitro model for studying NSC behaviour and give information on the factors and mechanisms that govern their proliferation and differentiation. They are also a promising source for cell replacement therapies of the central nervous system. Neurospheres are complex structures consisting of several cell types of varying degrees of differentiation. One way of characterising neurospheres is to analyse their gene expression profiles. The value of such studies is however uncertain since they are heterogeneous structures and different populations of neurospheres may vary significantly in their gene expression. RESULTS: To address this issue, we have used cDNA microarrays and a recently reported tag cDNA amplification method to analyse the gene expression profiles of neurospheres originating from separate isolations of the lateral ventricle wall of adult mice and passaged to varying degrees. Separate isolations as well as consecutive passages yield a high variability in gene expression while parallel cultures yield the lowest variability. CONCLUSIONS: We demonstrate a low technical amplification variability using the employed amplification strategy and conclude that neurospheres from the same isolation and passage are sufficiently similar to be used for comparative gene expression analysis.

Animals↗
PubMed2005

Use of family planning services in the transition to a static clinic system in Bangladesh: 1998-2002.

CONTEXT: In rural Bangladesh, family planning services--previously provided through household visits and satellite clinics--were transferred to static community clinics under the government's sectoral program for 1998-2003, but the next sectoral program reversed the change without a formal evaluation. It is important to assess changes in utilization and coverage to inform further development of the service delivery system. METHODS: Longitudinal data on use of family planning services and contraceptive methods were collected quarterly in 1998-2002 from married women in about 11,000 households in two rural surveillance areas--Abhoynagar and Mirsarai. Cross-sectional surveys were conducted among women and service providers in 2003 to gather detailed information about the transition to static clinics and women's response to the changes. Quarterly time series graphs of selected indicators were plotted for areas served by community clinics. RESULTS: In a time of considerable change in service delivery and sources of contraceptive supply, contraceptive prevalence remained constant in Abhoynagar and increased in Mirsarai. Community clinics quickly became the source of supplies for one-third of contraceptive users in Abhoynagar and one-fifth in Mirsarai. In wards where community clinics became operational (mostly in 2001-2002), three-quarters of women had used one at some time. CONCLUSIONS: Despite cultural constraints on mobility, women do not appear to have become dependent on home delivery of contraceptives.

Adolescent↗
PubMed2004

PACAP promotes neural stem cell proliferation in adult mouse brain.

In recent years, it has become evident that neural stem cells in the adult mammalian brain continuously generate new neurons, mainly in the hippocampus and olfactory bulb. Although different growth factors have been shown to stimulate neurogenesis in the adult brain, very little is known about the role of neuropeptides in this process. Pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide with pleiotropic effects acting through three receptors to which it has high affinity, namely, PACAP receptor 1 (PAC1), vasoactive intestinal peptide (VIP) receptor 1, and VIP receptor 2. We show that PAC1 is expressed in the neurogenic regions of the adult mouse brain, namely the ventricular zone of the lateral ventricle and the hippocampal dentate gyrus. Cultured neural stem cells isolated from the lateral ventricle wall of adult mice express PAC1 and proliferate in vitro in response to two PAC1 agonists, PACAP and Maxadilan, but not VIP at physiologic concentrations, indicating PAC1 as a mediator of neural stem cell proliferation. Pharmacologic and biochemical characterization of PACAP-induced neural stem cell proliferation revealed the protein kinase C pathway as the principal signaling pathway, whereas addition of epidermal growth factor synergistically enhanced the proliferating effect of PACAP. Further in vitro characterization of the effect of PACAP on neural stem cells showed PACAP capable of stimulating ex novo in vitro formation of multipotent neurospheres with the capacity to generate both neuronal and glial cells. Finally, intracerebroventricular infusion of PACAP increases cell proliferation in the ventricular zone of the lateral ventricle and the dentate gyrus of the hippocampus. We conclude that PACAP, through PAC1, is a potent mediator of adult neural stem cell proliferation.

Adenosine Triphosphate↗