Microenterprise development coupled with nutrition education can help increase caregivers’ incomes and household accessibility to animal source foods

Low income and lack of knowledge about child nutrition have been identified as key constraints to the use of Animal Source Foods (ASF) in the diets of young Ghanaian children. To improve ASF consumption among children in Ghana, the Enhancing Child Nutrition through Animal Source Food Management (ENAM) project introduced an intervention that combined women’s microenterprise development activities with nutrition education on the importance of ASF in children’s diets. The present study assessed the effects of the intervention on the participants’ enterprise performance, their contribution to key household and child-related expenditures as well as their households’ purchases of ASF. Additionally, household ASF consumption was assessed in monetary terms (measured in Ghana cedis (GH¢):1GH¢ = US$ 0.92).A structured questionnaire was used to interview 80 caregivers who participated in the ENAM project activities in four intervention communities and 80 non-participant caregivers in four control communities. Information solicited included household characteristics, profits from microenterprises and contributions to household food and non-food expenditures. Significantly more participant caregivers expanded (P=0.004) and diversified (P=0.004) their enterprises and, as a result, tended to have higher average enterprise profits (GH¢19.3 ± 2.2 vs. GH¢12.2 ± 1.9; P=0.08) and significantly higher savings (GH¢62.9 ± 2.2 vs. GH¢26.3 ± 1.9; P<0.05) than non-participant caregivers. In addition, the intervention was associated with significantly higher percentage of monetary contributions by caregivers towards children’s health expenses (P<0.05), school expenses (P<0.01) as well as expenses on clothing and footwear (P<0.01). Caregivers’ mean percentage contribution to household food expenses also tended to be higher (P<0.1) for participants (50.8 ± 3.5%) then for non-participants (41.8 ± 4.1%). Participant households also tended to spend more money (P<0.10) and consumed significantly more amounts (in monetary value) of ASF (P<0.01) than non-participant households. Being a participant in the ENAM project’s microenterprise development and nutrition education activities was associated with higher enterprise profits, savings deposits, contributions to householdand children-related expenditures, and ASF consumption at the household level

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

Electrodiagnostic subtyping in Guillain–Barr\ue9 syndrome patients in the International Guillain–Barr\ue9 Outcome Study

\ua9 2024 The Authors. European Journal of Neurology published by John Wiley &amp; Sons Ltd on behalf of European Academy of Neurology.Background and purpose: Various electrodiagnostic criteria have been developed in Guillain–Barr\ue9 syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. Methods: From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Results: Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. Conclusions and discussion: This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted

Productivity and Competitiveness Of Sorghum Production in Northern Ghana; A Policy Analysis Matrix Approach

A major element of low productivity at the farm level of smallholder farmers is high production costs which result in low competitiveness of the produce. Low produce prices, especially during harvests, also result in low returns to farmers. To help mitigate this problem in sorghum farming, the study sought to analyze the productivity and competitiveness of sorghum production in northern Ghana with particular reference to varieties produced for the brewery industry. A Policy Analysis Matrix (PAM) approach was used in the analysis. The PAM results showed that sorghum production in the study areas yielded profitable returns to land and management at social prices but not at private prices mainly because of low yields. The results also indicated differences in profitability for different areas. To make sorghum production sustainable, profit levels of farmers are critical. It is therefore recommended that the cost of production and output levels of farmers be taken into consideration in negotiating prices for farmers to at least break even.Keywords: Sorghum, Profitability, Competitiveness, Investment Potential, Poverty Reduction

Microenterprise Development Coupled With Nutrition Education Can Help Increase Caregivers&Apos; Incomes And Household Accessibility To Animal Source Foods

Low income and lack of knowledge about child nutrition have been identified as key constraints to the use of Animal Source Foods (ASF) in the diets of young Ghanaian children. To improve ASF consumption among children in Ghana, the Enhancing Child Nutrition through Animal Source Food Management (ENAM) project introduced an intervention that combined women&apos;s microenterprise development activities with nutrition education on the importance of ASF in children&apos;s diets. The present study assessed the effects of the intervention on the participants&apos; enterprise performance, their contribution to key household and child-related expenditures as well as their households&apos; purchases of ASF. Additionally, household ASF consumption was assessed in monetary terms (measured in Ghana cedis (GH¢):1GH¢ = US$ 0.92).A structured questionnaire was used to interview 80 caregivers who participated in the ENAM project activities in four intervention communities and 80 non-participant caregivers in four control communities. Information solicited included household characteristics, profits from microenterprises and contributions to household food and non-food expenditures. Significantly more participant caregivers expanded (P=0.004) and diversified (P=0.004) their enterprises and, as a result, tended to have higher average enterprise profits (GH¢19.3 ± 2.2 vs. GH¢12.2 ± 1.9; P=0.08) and significantly higher savings (GH¢62.9 ± 2.2 vs. GH¢26.3 ± 1.9; P<0.05) than non-participant caregivers. In addition, the intervention was associated with significantly higher percentage of monetary contributions by caregivers towards children&apos;s health expenses (P<0.05), school expenses (P<0.01) as well as expenses on clothing and footwear (P<0.01). Caregivers&apos; mean percentage contribution to household food expenses also tended to be higher (P<0.1) for participants (50.8 ± 3.5%) then for non-participants (41.8 ± 4.1%). Participant households also tended to spend more money (P<0.10) and consumed significantly more amounts (in monetary value) of ASF (P<0.01) than non-participant households. Being a participant in the ENAM project&apos;s microenterprise development and nutrition education activities was associated with higher enterprise profits, savings deposits, contributions to household- and children-related expenditures, and ASF consumption at the household level

Vestibulo-perceptual influences upon the vestibulo-spinal reflex

The vestibular system facilitates gaze and postural stability via the vestibulo-ocular (VOR) and vestibulo-spinal reflexes, respectively. Cortical and perceptual mechanisms can modulate long-duration VOR responses, but little is known about whether high-order neural phenomena can modulate short-latency vestibulo-spinal responses. Here, we investigate this by assessing click-evoked cervical vestibular myogenic-evoked potentials (VEMPS) during visual roll motion that elicited an illusionary sensation of self-motion (i.e. vection). We observed that during vection, the amplitude of the VEMPs was enhanced when compared to baseline measures. This modulation in VEMP amplitude was positively correlated with the subjective reports of vection strength. That is, those subjects reporting greater subjective vection scores exhibited a greater increase in VEMP amplitude. Control experiments showed that simple arousal (cold-induced discomfort) also increased VEMP amplitude but that, unlike vection, it did not modulate VEMP amplitude linearly. In agreement, small-field visual roll motion that did not induce vection failed to increase VEMP amplitude. Taken together, our results demonstrate that vection can modify the response of vestibulo-collic reflexes. Even short-latency brainstem vestibulo-spinal reflexes are influenced by high-order mechanisms, illustrating the functional importance of perceptual mechanisms in human postural control. As VEMPs are inhibitory responses, we argue that the findings may represent a mechanism whereby high-order CNS mechanisms reduce activity levels in vestibulo-collic reflexes, necessary for instance when voluntary head movements need to be performed