Challenging empowerment: AIDS-affected southern African children and the need for a multi-level relational approach

Critics of empowerment have highlighted the concept's mutability, focus on individual transformation, one-dimensionality and challenges of operationalisation. Relating these critiques to children's empowerment raises new challenges. Drawing on scholarship on children's subjecthood and exercise of power, alongside empirical research with children affected by AIDS, I argue that empowerment envisaged as individual self-transformation and increased capacity to act independently offers little basis for progressive change. Rather it is essential to adopt a relational approach that recognises the need to transform power relationships at multiple levels. This analysis has implications for our wider understanding of empowerment in the 21st century. © The Author(s) 2013.This research was funded by DFID

Search for astronomical neutrinos from blazar TXS 0506+056 in super-kamiokande

We report a search for astronomical neutrinos in the energy region from several GeV to TeV in the direction of the blazar TXS 0506+056 using the Super-Kamiokande detector following the detection of a 100 TeV neutrinos from the same location by the IceCube collaboration. Using Super-Kamiokande neutrino data across several data samples observed from 1996 April to 2018 February we have searched for both a total excess above known backgrounds across the entire period as well as localized excesses on smaller timescales in that interval. No significant excess nor significant variation in the observed event rate are found in the blazar direction. Upper limits are placed on the electron- and muon-neutrino fluxes at the 90% confidence level as 6.0 × 10−7 and 4.5 × 10−7–9.3 × 10−10 [erg cm−2 s−1], respectively

Genital ulcer severity score and genital health quality of life in Behçet's disease

Background: Behçet's Disease (BD) is a chronic auto-inflammatory, multisystem relapsing/remitting disorder of unknown aetiology. Oro-genital ulceration is a key feature of the disease and has a major impact on the patients' quality of life. Other clinical manifestations include ocular inflammation, rheumatologic and skin involvement, while CNS and vascular complications can lead to considerable morbidity. The availability of a valid monitoring tool for BD activity is crucial in evaluating the impact of the disease on daily life activity. The aims of this study were to validate a novel tool for monitoring genital ulceration severity in BD and to assess the impact of genital ulcers on the Genital Health Quality of Life (GHQoL). Methods: Genital Ulcer Severity Score (GUSS) was developed using six genital ulcer characteristics: number, size, duration, ulcer-free period, pain and site. A total of 207 BD patients were examined, (137 females: mean age∈±∈SD: 39.83∈±∈13.42 and 70 males: mean age∈±∈SD: 39.98∈±∈11.95) from the multidisciplinary Behçet's Centre of Excellence at Barts Health NHS Trust. GUSS was used in conjunction with Behçet's Disease Current Activity Form (BDCAF). Results: The over-all score of GUSS showed a strong correlation with all genital ulcer characteristics, and the strongest correlation was with the pain domain (r∈=∈0.936; P∈2: 0.600; P∈<∈0.0001). Conclusions: This study established the practicality of GUSS as a severity monitoring tool for BD genital ulcers and validated its use in 207 patients. Genital ulcers of BD have a considerable impact on the patients GHQoL

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The effect of olive pomace biochar on some characteristics of Vertisols

The aim of this study was to investigate the effect of olive pomace biochar (OB) application on the mechanical, physical and chemical properties of Vertisols. For this study, soil samples classified as Vertisol in & Ccedil;anakkale, where internal drainage and surface ponding are major problems, were used. The OB was produced at 450 degrees C and then mixed with 0% (control), 3%, 6% and 9% of the soil by weight. Various soil parameters, including the Atterberg limits (liquid limit [LL], plastic limit [PL], plasticity index [PI], shrinkage limit [SL]), saturated hydraulic conductivity (K-sat), field capacity (FC), total carbon (TC) and total nitrogen (TN), were determined. The values of all the soil parameters increased, except for the PI. Moreover, the K-sat value increased by 127% and 136% with 6% and 9% OB application, respectively, compared to that of the control. Additionally, the FC, TN and TC levels in the soils increased in response to biochar application. In conclusion, OB application has a positive effect on the specific properties of Vertisol and can improve its physical properties

A tectonic-rules-based mantle reference frame since 1 billion years ago – implications for supercontinent cycles and plate–mantle system evolution

Understanding the long-term evolution of Earth's plate–mantle system is reliant on absolute plate motion models in a mantle reference frame, but such models are both difficult to construct and controversial. We present a tectonic-rules-based optimization approach to construct a plate motion model in a mantle reference frame covering the last billion years and use it as a constraint for mantle flow models. Our plate motion model results in net lithospheric rotation consistently below 0.25∘ Myr−1, in agreement with mantle flow models, while trench motions are confined to a relatively narrow range of −2 to +2 cm yr−1 since 320 Ma, during Pangea stability and dispersal. In contrast, the period from 600 to 320 Ma, nicknamed the “zippy tricentenary” here, displays twice the trench motion scatter compared to more recent times, reflecting a predominance of short and highly mobile subduction zones. Our model supports an orthoversion evolution from Rodinia to Pangea with Pangea offset approximately 90∘ eastwards relative to Rodinia – this is the opposite sense of motion compared to a previous orthoversion hypothesis based on paleomagnetic data. In our coupled plate–mantle model a broad network of basal mantle ridges forms between 1000 and 600 Ma, reflecting widely distributed subduction zones. Between 600 and 500 Ma a short-lived degree-2 basal mantle structure forms in response to a band of subduction zones confined to low latitudes, generating extensive antipodal lower mantle upwellings centred at the poles. Subsequently, the northern basal structure migrates southward and evolves into a Pacific-centred upwelling, while the southern structure is dissected by subducting slabs, disintegrating into a network of ridges between 500 and 400 Ma. From 400 to 200 Ma, a stable Pacific-centred degree-1 convective planform emerges. It lacks an antipodal counterpart due to the closure of the Iapetus and Rheic oceans between Laurussia and Gondwana as well as due to coeval subduction between Baltica and Laurentia and around Siberia, populating the mantle with slabs until 320 Ma when Pangea is assembled. A basal degree-2 structure forms subsequent to Pangea breakup, after the influence of previously subducted slabs in the African hemisphere on the lowermost mantle structure has faded away. This succession of mantle states is distinct from previously proposed mantle convection models. We show that the history of plume-related volcanism is consistent with deep plumes associated with evolving basal mantle structures. This Solid Earth Evolution Model for the last 1000 million years (SEEM1000) forms the foundation for a multitude of spatio-temporal data analysis approaches

The influence of sea ice cover and Atlantic water advection on annual particle export north of Svalbard

The Arctic Ocean north of Svalbard has recently experienced large sea ice losses and the increasing prominence of Atlantic water (AW) advection. To investigate the impact of these ongoing changes on annual particle export, two moorings with sequential sediment traps were deployed in ice‐free and seasonally ice‐covered waters on the shelf north (NSv) and east (ESv) of Svalbard, collecting sinking particles nearly continuously from October 2017 to October 2018. Vertical export of particulate organic carbon (POC), total particulate matter (TPM), planktonic protists, chlorophyll a, and zooplankton fecal pellets were measured, and swimmers were quantified and identified. Combined with sensor data from the moorings, these time‐series measurements provided a first assessment of the factors influencing particle export in this region of the Arctic Ocean. Higher annual TPM and POC fluxes at the ice‐free NSv site were primarily driven by the advection of AW, higher grazing by large copepods, and a wind‐induced mixing event during winter. Higher diatom fluxes were observed during spring in the presence of sea ice at the ESv site. Along with sea ice cover, regional differences in AW advection and the seasonal presence of grazers played a prominent role in the biological carbon pump along the continental shelf off Svalbard