Food Security: Let them Eat Information

Insufficient information to predict famine was widely seen to be a central reason for the failure of national governments and the international donor community to prevent famines in Africa in the mid 1980s. Since then, there have been substantial improvements in the development of purpose-built information systems to predict famine. Many new famine early warning systems (EWS) have been set up, but the goal of famine prevention remains elusive. At least in the Sahel and Horn of Africa, the information now provided is not being used adequately to trigger timely and appropriate response.European Research Council (ERC

Formative evaluation of a training intervention for community health workers in South Africa : a before and after study

Background Community Health Workers (CHWs) have a crucial role in improving health in their communities and their role is being expanded in many parts of the world. However, the effectiveness of CHWs is limited by poor training and the education of CHWs has received little scientific attention. Methods Our study was carried out in two districts of KwaZulu-Natal, South Africa. We developed and piloted an inexpensive (two day) training intervention covering national government priorities: HIV/AIDS, sexually transmitted disease and Tuberculosis; and Women’s Sexual and Reproductive Health and Rights. Sixty-four CHWs consented to participate in the main study which measured knowledge gains using a modified Solomon design of four different testing schedules to distinguish between the effects of the intervention, testing and any interaction between intervention and testing. We also measured confidence, satisfaction and costs. Results Following the training intervention, improvements in knowledge scores were seen across topics and across districts. These changes in knowledge were statistically significant (p<0.001) and of large magnitude (over 45 percentage points or four standard deviations). However, the CHWs assigned to the test-test-train schedule in one district showed high gains in knowledge prior to receiving the training. All CHWs reported high levels of satisfaction with the training and marked improvements in their confidence in advising clients. The training cost around US$48 per CHW per day and has the potential to be cost-effective if the large gains in knowledge are translated into improved field-based performance and thus health outcomes. Conclusion Training CHWs can result in large improvements in knowledge with a short intervention. However, improvements seen in other studies could be due to test ‘reactivity’. Further work is needed to measure the generalisability of our results, retention of knowledge and the extent to which improved knowledge is translated into improved practice

Behavioural interventions for people living with adult-onset primary dystonia : a systematic review

Background: Primary dystonia is a chronic neurological movement disorder that causes abnormal muscle movements. Pain and emotional distress may accompany these physical symptoms. Behavioural interventions are used to help people with long term conditions improve their quality of life. Little is known about behavioural interventions applied to Dystonia. We report a systematic review of studies reporting current evidence of behavioural interventions for people with primary dystonia. Methods: We did systematic searches of Medline, PsycINFO, AHMED and CINAHL. We assessed the methodological quality of included studies using a risk of bias tool. Any disagreements were resolved by liaising with an independent rater. Physiological outcomes such as dystonia severity and psychological outcomes such as sleep and depression were selected on the basis that primary dystonia causes motor and non-motor symptoms. No time limit was placed on the searches. A narrative synthesis of the results is presented. Results: Of 1798 titles and abstracts screened, 14 full articles were retrieved and inclusion and exclusion criteria applied. Of these a final nine were eligible for the review (N = 73). Only two were Randomised Controlled Trials (RCTs). Using the Movement Disorders Society (MDS) dystonia classification, that was published after this work started, all of the included studies were of idiopathic adult onset focal dystonia without associated features. These included: blepharospasm (eye dystonia) (N = 1), cervical dystonia (neck dystonia) (N = 2), writer’s cramp (hand dystonia) (N = 3) and the yips (N = 3). No studies reported on dystonia that affects two or more body regions. Studies reported good adherence and response rates to treatment. Physiological and psychological improvements were noted in all studies at weekly, monthly and yearly follow-ups. Caution should be taken when interpreting the results because of the scarcity of RCTs identified, use of small sample sizes, and inappropriate statistical methods. Conclusion: We identified few studies; mainly of poor methodological quality that all studied a focal dystonia. It is not possible to draw firm conclusions. Nevertheless, the data suggests that a combined behavioural therapy approach including relaxation practice for people with idiopathic adult onset focal dystonia merits further investigation

Detecção de Trypanosoma cruzi em tecido e sangue murinos por PCR convencional e em tempo real

El objetivo del presente trabajo fue comparar la detección de ADN de Trypanosoma cruzi mediante PCR en tiempo real (qPCR) y PCR convencional en sangre periférica (n=25) y músculo esquelético (n=20) de ratones tratados con drogas tripanomicidas luego de 6 meses post-tratamiento. En las muestras de sangre se detectaron un total de 7 positivas por qPCR, mientras que por PCR convencional sólo se detectaron 2. En músculo esquelético, 15 muestras fueron positivas por qPCR y 3 por PCR convencional. Los resultados obtenidos demuestran que la fuerza de concordancia es débil entre las técnicas de PCR utilizadas para la detección de ADN de T. cruzi (k=0,37; 49% positivas por qPCR vs. 11% por PCR convencional, p=0,0001). En las muestras de sangre, los valores diagnósticos de qPCR con respecto a la PCR convencional fueron: 100% sensibilidad; 78% especificidad; 30% VPP; 100% VPN; 4,6 RVP; 0 RVN. Para las muestras de músculo esquelético se obtuvieron los siguientes valores diagnósticos de qPCR: 100% sensibilidad; 29% especificidad; 20% VPP; 100% VPN; 1,4 RVP; 0 RVN. Ambas técnicas fueron igualmente sensibles en el rango de mediana-alta concentración, pero qPCR fue más efectiva para detectar bajas cargas parasitarias, en particular en las muestras de tejido.The aim of this work was to compare detection of Trypanosoma cruzi DNA by real time (qPCR) and conventional PCR in peripheral blood (n=25), and skeletal muscle (n=20) of mice treated with trypanocidal compounds after 6 months post-treatment. A total of 7 blood samples were positive by qPCR; whereas, by conventional PCR only 2 were detected. In skeletal muscle, 15 samples were regarded positive by qPCR and 3 by conventional PCR. These results showed a weak concordance strength among PCR techniques employed to detect T. cruzi DNA in the studied samples (k=0.37; 49% positives by qPCR vs. 11% by conventional PCR, p=0.0001). In blood samples, qPCR diagnostic values in comparison with conventional PCR were: 100% sensibility; 78% specificity; 30% PPV; 100% NPV; 4.6 PVR; 0 NVR. For skeletal muscle samples, qPCR diagnostic values were: 100% sensibility; 29% specificity; 20% PPV; 100% NPV; 1.4 PVR; 0 NVR. Both techniques were equally sensitive in the medium-high concentration range, but qPCR was more effective to detect low parasitic burden, particularly in skeletal muscle samples.O objetivo deste estudo foi comparar a detecção de DNA de Trypanosoma cruzi por PCR em tempo real (qPCR) e PCR convencional no sangue periférico (N=25) e músculo esquelético (N= 20) de camundongos tratados com medicamentos tripanomicidas depois de 6 meses de pós-tratamento. Nas amostras de sangue foi detectado um total de sete positivas por qPCR; enquanto que apenas foram encontradas 2 por PCR convencional. No músculo esquelético, 15 amostras foram positivas por qPCR e 3 por PCR convencional. Os resultados mostram que a força de concordância é fraca entre as técnicas de PCR utilizadas para a detecção de DNA de T. cruzi (k=0,37, 49% positivas por qPCR vs. 11% para a PCR convencional, p=0,0001). Nas amostras de sangue, os valores diagnósticos de qPCR em relação a PCR convencional foram de 100% sensibilidade; 78% de especificidade; 30% de VPP; 100% VPN; 4,6 RVP; 0 RVN. Para as amostras de músculo esquelético, os seguintes valores diagnósticos de qPCR foram obtidos: 100% sensibilidade; 29% de especificidade; 20% de VPP; 100% VPN; 1,4 RVP; 0 RVN. Ambas as técnicas são igualmente sensíveis na faixa de concentração média-alta, mas qPCR foi mais eficaz na detecção de baixas cargas parasitárias, especialmente em amostras de tecido.Fil: Davies, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Patología Experimental; ArgentinaFil: Poma, Hugo Ramiro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Investigación Para la Industria Química (i); ArgentinaFil: Cardozo, Rubén Marino. Provincia de Salta. Ministerio de Salud Publica; ArgentinaFil: Mora, Maria Celia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Patología Experimental; ArgentinaFil: Ramos, Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Patología Experimental; ArgentinaFil: Rajal, Verónica Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Investigación Para la Industria Química (i); ArgentinaFil: Basombrio, Miguel Angel Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Patología Experimental; Argentin

Adaptive Kronrod-Patterson integration of non-linear finite-element matrices

Efficient simulation of unsaturated moisture flow in porous media is of great importance in many engineering fields. The highly non-linear character of unsaturated flow typically gives sharp moving moisture fronts during wetting and drying of materials with strong local moisture permeability and capacity variations as result. It is shown that these strong variations conflict with the common preference for low-order numerical integration in finite element simulations of unsaturated moisture flow: inaccurate numerical integration leads to errors that are often far more important than errors from inappropriate discretization. In response, this article develops adaptive integration, based on nested Kronrod–Patterson–Gauss integration schemes: basically, the integration order is adapted to the locally observed grade of non-linearity. Adaptive integration is developed based on a standard infiltration problem, and it is demonstrated that serious reductions in the numbers of required integration points and discretization nodes can be obtained, thus significantly increasing computational efficiency. The multi-dimensional applicability is exemplified with two-dimensional wetting and drying applications. While developed for finite element unsaturated moisture transfer simulation, adaptive integration is similarly applicable for other non-linear problems and other discretization methods, and whereas perhaps outperformed by mesh-adaptive techniques, adaptive integration requires much less implementation and computation. Both techniques can moreover be easily combined.status: publishe