214 research outputs found

    Improving Sanitation at Scale: Lessons From TSSM Implementation in East Java, Indonesia

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    Low-quality or nonexistent sanitation affects health and hinders economic development, especially in the world's poorest countries. To address this issue, the Water and Sanitation Program, a partnership administered by the World Bank and funded by the Bill & Melinda Gates Foundation, launched a global initiative in 2006 at selected sites in India, Indonesia, and Tanzania. In Indonesia, the program was known as the Total Sanitation and Sanitation Marketing initiative, which moved beyond simply building sanitation "hardware" and relied, instead, on providing training and technical assistance to promote collective action to eliminate open defecation and to strengthen demand for and supply of sanitation products and services

    Polyarteritis nodosa presenting as a bladder outlet obstruction

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    Polyarteritis nodosa (PAN) of the urinary tract is rare. An unusual case of systemic PAN involving the bladder neck is described. A 27-year-old man, with known diastolic hypertension diagnosed 2 years earlier, was admitted with chronic urinary obstruction complicated by hydronephrosis. He had symptoms of myalgia and weight loss, was afebrile but had an elevated erythrocyte sedimentation rate and acute-on-chronic renal impairment. All virological and serological tests including hepatitis B and anti-neutrophil cytoplasmic antibody were negative. A computed tomography scan of the brain revealed small-vessel disease. A bladder neck mass was visualised on cystoscopy. Histological examination of this demonstrated a medium-sized necrotising vasculitis with small-vessel fibrinoid necrosis suggestive of PAN. At least six of the American College of Rheumatology criteria for PAN were met. The patient was treated with pulses of intravenous cyclophosphamide and oral corticosteroids with a good clinical response

    Impact of transthoracic echocardiography at district hospital level

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    Background. The use of and demand for echocardiography (ECHO) has increased worldwide. In developed countries, this has not translated into improved access outside tertiary centres. Previous studies have favoured the appropriate use of ECHO over its clinical impact, limiting generalisability to resource-constrained settings. Objectives. To assess the impact of an ECHO service at district hospital level in Cape Town, South Africa. Methods. A prospective, cross-sectional study was performed. A total of 210 consecutive patients, referred to the ECHO clinic over a 5-month period, were recruited. Transthoracic ECHO was evaluated in terms of its indication, new information provided, correlation with the referring doctor’s diagnosis and subsequent management plan. Impact included the escalation and de-escalation of treatment, as well as usefulness without a change in management. Results. The results show that 83.8% of the patients’ management was impacted on by echocardiography. Valvular lesions were the main indication. The most frequent contribution was information provided towards the diagnosis of heart failure and assessment after myocardial infarction. Of the echocardiograms, 56.2% confirmed the referring doctor’s diagnosis, yet were still associated with a significant impact. The rational prescription of medication had the major impetus, followed by de-escalation of therapy and screening patients to determine referral to a tertiary facility. Conclusion. ECHO has a positive impact on patient management outside tertiary settings, where the definition of impact appears to be different. The value of a normal study, screening prior to upstream referral and usefulness irrespective of change have been established. This should alert policy makers against restriction of access to ECHO and promote training of personnel in its use.

    myExperiment: a repository and social network for the sharing of bioinformatics workflows

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    myExperiment (http://www.myexperiment.org) is an online research environment that supports the social sharing of bioinformatics workflows. These workflows are procedures consisting of a series of computational tasks using web services, which may be performed on data from its retrieval, integration and analysis, to the visualization of the results. As a public repository of workflows, myExperiment allows anybody to discover those that are relevant to their research, which can then be reused and repurposed to their specific requirements. Conversely, developers can submit their workflows to myExperiment and enable them to be shared in a secure manner. Since its release in 2007, myExperiment currently has over 3500 registered users and contains more than 1000 workflows. The social aspect to the sharing of these workflows is facilitated by registered users forming virtual communities bound together by a common interest or research project. Contributors of workflows can build their reputation within these communities by receiving feedback and credit from individuals who reuse their work. Further documentation about myExperiment including its REST web service is available from http://wiki.myexperiment.org. Feedback and requests for support can be sent to [email protected]

    Longitudinal Predictors of Child Sexual Abuse in a Large Community-Based Sample of South African Youth

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    Sexual abuse has severe negative impacts on children's lives, but little is known about risk factors for sexual abuse victimization in sub-Saharan Africa. This study examined prospective predictors of contact sexual abuse in a random community-based sample of children aged 10 to 17 years (N = 3,515, 56.6% female) in South Africa. Self-report questionnaires using validated scales were completed at baseline and at 1-year follow-up (96.8% retention rate). Cross-sectional and longitudinal associations between hypothesized factors and sexual abuse were examined. For girls, previous sexual abuse (odds ratio [OR] = 3.44, 95% confidence interval [CI] = [2.03, 5.60]), baseline school dropout (OR = 2.76, 95% CI = [1.00, 6.19]), and physical assault in the community (OR = 2.17, 95% CI = [1.29, 3.48]) predicted sexual abuse at follow-up. Peer social support (OR = 0.84, 95% CI = [0.74, 0.98]) acted as a protective factor. Previous contact sexual abuse was the strongest predictor of subsequent sexual abuse victimization. In addition, peer support moderated the relationship between baseline assault and subsequent sexual abuse. For boys, no longitudinal predictors for sexual abuse victimization were identified. These results indicate that the most vulnerable girls-those not in school and with a history of victimization-are at higher risk for sexual abuse victimization. High levels of peer support reduced the risk of sexual abuse victimization and acted as a moderator for those who had experienced physical assault within the community. Interventions to reduce school drop-out rates and revictimization may help prevent contact sexual abuse of girls in South Africa

    Low-Energy Physics in Neutrino LArTPCs

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    In this white paper, we outline some of the scientific opportunities and challenges related to detection and reconstruction of low-energy (less than 100 MeV) signatures in liquid argon time-projection chamber (LArTPC) detectors. Key takeaways are summarized as follows. 1) LArTPCs have unique sensitivity to a range of physics and astrophysics signatures via detection of event features at and below the few tens of MeV range. 2) Low-energy signatures are an integral part of GeV-scale accelerator neutrino interaction final states, and their reconstruction can enhance the oscillation physics sensitivities of LArTPC experiments. 3) BSM signals from accelerator and natural sources also generate diverse signatures in the low-energy range, and reconstruction of these signatures can increase the breadth of BSM scenarios accessible in LArTPC-based searches. 4) Neutrino interaction cross sections and other nuclear physics processes in argon relevant to sub-hundred-MeV LArTPC signatures are poorly understood. Improved theory and experimental measurements are needed. Pion decay-at-rest sources and charged particle and neutron test beams are ideal facilities for experimentally improving this understanding. 5) There are specific calibration needs in the low-energy range, as well as specific needs for control and understanding of radiological and cosmogenic backgrounds. 6) Novel ideas for future LArTPC technology that enhance low-energy capabilities should be explored. These include novel charge enhancement and readout systems, enhanced photon detection, low radioactivity argon, and xenon doping. 7) Low-energy signatures, whether steady-state or part of a supernova burst or larger GeV-scale event topology, have specific triggering, DAQ and reconstruction requirements that must be addressed outside the scope of conventional GeV-scale data collection and analysis pathways

    Low exposure long-baseline neutrino oscillation sensitivity of the DUNE experiment

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    The Deep Underground Neutrino Experiment (DUNE) will produce world-leading neutrino oscillation measurements over the lifetime of the experiment. In this work, we explore DUNE's sensitivity to observe charge-parity violation (CPV) in the neutrino sector, and to resolve the mass ordering, for exposures of up to 100 kiloton-megawatt-years (kt-MW-yr). The analysis includes detailed uncertainties on the flux prediction, the neutrino interaction model, and detector effects. We demonstrate that DUNE will be able to unambiguously resolve the neutrino mass ordering at a 3σ\sigma (5σ\sigma) level, with a 66 (100) kt-MW-yr far detector exposure, and has the ability to make strong statements at significantly shorter exposures depending on the true value of other oscillation parameters. We also show that DUNE has the potential to make a robust measurement of CPV at a 3σ\sigma level with a 100 kt-MW-yr exposure for the maximally CP-violating values \delta_{\rm CP}} = \pm\pi/2. Additionally, the dependence of DUNE's sensitivity on the exposure taken in neutrino-enhanced and antineutrino-enhanced running is discussed. An equal fraction of exposure taken in each beam mode is found to be close to optimal when considered over the entire space of interest
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