Rapid assessment for prioritisation of trachoma control at community level in one district of the Kaolack Region, Senegal.

The objective of this study was to use a modified Lot Quality Assurance Sampling methodology to classify communities according to prevalence of active trachoma and to estimate the prevalence of trachoma and trichiasis in Nioro department, Kaolack Region, Senegal. A survey was conducted using two-stage cluster sampling to select 50 children aged 2-5 years in each of 33 clusters. In total 1,648 children were examined for active trachoma. Information on trachoma risk factors was collected through interviews with the mother or the household head of the child. Adults (>40 years) with trichiasis were identified through case finding. Nineteen clusters had a low prevalence of active trachoma in children aged 2-5 years (40%). The prevalence of active trachoma in children aged 2-5 years was 17.4% (95% CI 12.9-21.8%). Multivariate-adjusted predictors of active trachoma were: age, facial cleanliness, hygiene practices and keeping cattle in the household. The prevalence of trichiasis in adults aged over 40 years was 1.77% (95% CI 1.24-2.51), equating to 985 adults (95% CI 765-1250) with trichiasis in Nioro department. In conclusion, a survey using rapid methodology showed that trachoma is a problem of public significance in Nioro department, Senegal

Is metacognition a causal moderator of the relationship between catastrophic misinterpretation and health anxiety? A prospective study

Psychological theories have identified a range of variables contributing to health anxiety, including, dysfunctional illness beliefs, catastrophic misinterpretation, somatosensoryamplification and neuroticism. More recently, metacognitive beliefs have been proposed as important in health anxiety. This study aimed to test the potential causal role of metacognitive beliefs in health anxiety. A prospective design was employed and participants (n=105) completed a battery of questionnaire at two time points (6 months apart). Results demonstrated that cognitive, personality and metacognitive variables were bi-variate prospective correlates of health anxiety. Hierarchical regression analysis revealed that only metacognitive beliefs emerged as independent and significant prospective predictors of health anxiety. Moderation analysis demonstrated that metacognitive beliefs prospectively moderated the relationship between catastrophic misinterpretation and health anxiety. Follow-up regression analysis incorporating the interaction term (metacognition x misinterpretation) showed that the term explained additional variance in health anxiety. The results confirm that metacognition is a predictor of health anxiety and it is more substantive than misinterpretations of symptoms, somatosensory amplification, neuroticism, and illness beliefs. These results may have major implications for current cognitive models and for the treatment of health anxiety

On trial: agricultural biotechnology in Africa

Increasing agricultural productivity and adapting farming to climate change are central to Africa’s development prospects. There are important opportunities to enhance yields and increase resilience through the adoption of improved crop varieties. In some cases, biotechnology, and in particular genetic modification (GM), offers advantages over conventional plant-breeding approaches. Accordingly there are a various projects under way to develop new GM varieties for African farmers, ranging from drought-resistant maize to varieties of cassava, banana, sorghum, cowpea and sweet potato with resistance to pests and disease. In addition to government funds, these projects have also attracted the support of influential donor agencies and philanthropic foundations. However, despite the expenditure of considerable resources, the potential of GM in Africa is not being realized. So far no GM trait developed for African farmers has been put to use. Multiple barriers inhibit the development and adoption of pro-poor GM varieties in Africa. On the demand side, farmers may be reluctant to adopt GM varieties owing to a lack of export opportunities and distrust of the technology among local consumers. Farmers may also be concerned about exploitation by transnational seed companies (despite the fact that development of new GM technologies in Africa is dominated by the public sector). On the supply side, donor funding struggles to match the long timescales of research and development, while incentives among research scientists may be poorly aligned with farmer outcomes. Non-existent, poorly functioning or overly punitive regulatory regimes discourage investment. The most important barriers – such as regulatory constraints, consumer distrust and weak farmer demand – must be understood in the context of wider social and political dynamics surrounding GM, typified by misinformation, polarized public discourse, and dysfunctional and opportunistic politics. The result is most GM projects becoming ‘stuck’ at the field trial stage without ever progressing to release. This ‘convenient deadlock’ of continual field trials allows governments to manage political risks by effectively balancing the demands of pro-GM and anti-GM lobbies – proponents of GM have a pipeline of technologies, while opponents are appeased by the failure of any to gain approval. The disabling socio-political environment for GM development in Africa greatly reduces the efficacy of investment in this technology. This has two important implications. First, technology development needs to be located within a wider project of transformation that engages key actors – most notably politicians, policy-makers and farmers – as stakeholders from the outset, and includes strategies to address multiple demand- and supply-side barriers. Second, successful adoption is more likely in countries with less disabling political conditions, characterized by lower levels of consumer distrust and opposition, genuine farmer demand and demonstrable commitment from government. Focusing efforts and resources on a small number of ‘best bet’ countries will also allow donors and technology providers to support more ambitious, transformational projects led by national governments

Design and characterization of a research electrohydraulic lithotripter patterned after the Dornier HM3

An electrohydraulic lithotripter has been designed that mimics the behavior of the Dornier HM3 extracorporeal shock wave lithotripter. The key mechanical and electrical properties of a clinical HM3 were measured and a design implemented to replicate these parameters. Three research lithotripters have been constructed on this design and are being used in a multi-institutional, multidisciplinary research program to determine the physical mechanisms of stone fragmentation and tissue damage in shock wave lithotripsy. The acoustic fields of the three research lithotripters and of two clinical Dornier HM3 lithotripters were measured with a PVDF membrane hydrophone. The peak positive pressure, peak negative pressure, pulse duration, and shock rise time of the focal waveforms were compared. Peak positive pressures varied from 25 MPa at a voltage setting of 12 kV to 40 MPa at 24 kV. The magnitude of the peak negative pressure varied from -7 to -12 MPa over the same voltage range. The spatial variations of the peak positive pressure and peak negative pressure were also compared. The focal region, as defined by the full width half maximum of the peak positive pressure, was 60 mm long in the axial direction and 10 mm wide in the lateral direction. The performance of the research lithotripters was found to be consistent at clinical firing rates (up to 3 Hz). The results indicated that pressure fields in the research lithotripters are equivalent to those generated by a clinical HM3 lithotripter

An outbreak of acute haemorrhagic conjunctivitis associated with coxsackievirus A24 variant in The Gambia, West Africa.

OBJECTIVE: An outbreak of acute haemorrhagic conjunctivitis occurred in The Gambia, West Africa in 2011. Affected individuals presented with conjunctival haemorrhages, swelling and ocular discharge. In an effort to identify a causative agent of the disease, ocular swabs were taken from patients during the acute and convalescent phases. Total RNA was extracted from all samples and reverse-transcriptase PCR performed using primers specific for all enteroviruses. Resulting amplicons were sequenced and data compared to known sequences using the BLAST algorithm. RESULTS: Forty-eight swabs were included in the analysis. Of these, 21 acute and 9 convalescent swabs (65% of the total) gave positive PCR results. Sequence analysis of the resulting amplicons indicated 99% sequence identity with coxsackievirus A24 variant identified during independent outbreaks of acute haemorrhagic conjunctivitis around the world and suggest the Gambian outbreak was due to this virus

The prevalence and risk factors for acute respiratory infections in children aged 0-59 months in rural Malawi: A cross-sectional study.

BACKGROUND: Acute Respiratory Infections (ARI) are a leading cause of childhood mortality and morbidity. Malawi has high childhood mortality but limited data on the prevalence of disease in the community. METHODS: A cross-sectional study of children aged 0-59 months. Health passports were examined for ARI diagnoses in the preceding 12 months. Children were physically examined for malnutrition or current ARI. RESULTS: 828 children participated. The annual prevalence of ARI was 32.6% (95% CI 29.3-36.0%). Having a sibling with ARI (OR 1.44, P = .01), increasing household density (OR 2.17, P = .02) and acute malnutrition (OR 1.69, P = .01) were predictors of infection in the last year. The point prevalence of ARI was 8.3% (95% CI 6.8-10.4%). Risk factors for current ARI were acute-on-chronic malnutrition (OR 3.06, P = .02), increasing household density (OR1.19, P = .05) and having a sibling with ARI (OR 2.30, P = .02). CONCLUSION: This study provides novel data on the high prevalence of ARI in Malawi. This baseline data can be used in the monitoring and planning of future interventions in this population

Clustering in 18O - absolute determination of branching ratios via high-resolution particle spectroscopy

The determination of absolute branching ratios for high-energy states in light nuclei is an important and useful tool for probing the underlying nuclear structure of individual resonances: for example, in establishing the tendency of an excited state towards α -cluster structure. Difficulty arises in measuring these branching ratios due to similarities in available decay channels, such as ( 18 O, n ) and ( 18 O, 2 n ), as well as differences in geometric efficiencies due to population of bound excited levels in daughter nuclei. Methods are presented using Monte Carlo techniques to overcome these issues

Students’ perceptions on their use of an EHR: pilot questionnaire study

Introduction Many clinical education programmes have not incorporated the use of the electronic health record (EHR) into their curriculum. It is important to incorporate technologies that will be used in real-world settings to better prepare students for clinical practice. Objectives To undertake a review of literature to identify a training evaluation framework; to conduct a self-completion survey, pretraining and post-training, to determine students’ perceptions on the benefit of using EHR training system. Setting Nursing School, University, North West England, UK; University Ethic Committee Approval Received. Participants Registered nurses undertaking a validated return to practice course; 24 participants for the first cohort who completed pretraining questionnaire and 23 for the second post-training cohort. Results The statistical results show that the students perceived that the training improved their capability in employing digital systems with statistically significant difference in the assessed preproficiency and post proficiency in the use of digital clinical systems (premedians and post medians are 2 and 5 on 10-point Likert scale, p=0.041). There was also an indication of an improvement in the knowledge of EHR systems although not statistically significant. Most students perceived it increased their knowledge on digital systems. Conclusion Students perceived an increase in proficiency with the EHR. There was evidence of improvement in confidence in the use of the EHR, but this confidence would be enhanced by additional use of the system. Some desire to increase confidence further and to develop knowledge of digital systems was expressed