Epidemiology of coinfection with soil transmitted helminths and Plasmodium falciparum among school children in Bumula District in western Kenya.

BACKGROUND: Many school children living in Africa are infected with plasmodia and helminth species and are consequently at risk of coinfection. However, the epidemiology of such coinfection and the implications of coinfection for children's health remain poorly understood. This study describes the epidemiology of Ascaris lumbricoides-Plasmodium and hookworm-Plasmodium coinfection among school children living in western Kenya and investigates the associated risk factors. METHODS: As part of a randomized trial, a baseline cross-sectional survey was conducted among school children aged 5-18 years in 23 schools in Bumula District. Single stool samples were collected to screen for helminth infections using the Kato-Katz technique and malaria parasitaemia was determined from a finger prick blood sample. Demographic and anthropometric data were also collected. RESULTS: Overall, 46.4% of the children were infected with Plasmodium falciparum while 27.6% of the children were infected with at least one soil transmitted helminth (STH) species, with hookworm being the most common (16.8%) followed by A. lumbricoides (15.3%). Overall 14.3% of the children had STH-Plasmodium coinfection, with hookworm-Plasmodium (9.0%) coinfection being the most common. Geographical variation in the prevalence of coinfection occurred between schools. In multivariable logistic regression analysis, hookworm was positively associated with P. falciparum infection. In stratified analysis, hookworm infection was associated with increased odds of P. falciparum infection among both boys (P < 0.001) and girls (P = 0.01), whereas there was no association between A. lumbricoides and P. falciparum. CONCLUSION: These findings demonstrate STH infections are still prevalent, despite the ongoing national deworming programme in Kenya, and that malaria parasitaemia is widespread, such that coinfection occurs among a proportion of children. A subsequent trial will allow us to investigate the implications of coinfection for the risk of clinical malaria

Effect of Repeated Anthelminthic Treatment on Malaria in School Children in Kenya: A Randomized, Open-Label, Equivalence Trial.

BACKGROUND: School children living in the tropics are often concurrently infected with plasmodium and helminth parasites. It has been hypothesized that immune responses evoked by helminths may modify malaria-specific immune responses and increase the risk of malaria. METHODS: We performed a randomized, open-label, equivalence trial among 2436 school children in western Kenya. Eligible children were randomized to receive either 4 repeated doses or a single dose of albendazole and were followed up during 13 months to assess the incidence of clinical malaria. Secondary outcomes were Plasmodium prevalence and density, assessed by repeat cross-sectional surveys over 15 months. Analysis was conducted on an intention-to-treat basis with a prespecified equivalence range of 20%. RESULTS: During 13 months of follow-up, the incidence rate of malaria was 0.27 episodes/person-year in the repeated treatment group and 0.26 episodes/person-year in the annual treatment group (incidence difference, 0.01; 95% confidence interval, -.03 to .06). The prevalence and density of malaria parasitemia did not differ by treatment group at any of the cross-sectional surveys. CONCLUSIONS: Our findings suggest that repeated deworming does not alter risks of clinical malaria or malaria parasitemia among school children and that school-based deworming in Africa may have no adverse consequences for malaria. CLINICAL TRIALS REGISTRATION: NCT01658774

PLUTONIUM FEED IMPURITY TESTING IN A LANTHANIDE BOROSILICATE (LABS) GLASS

A vitrification technology utilizing a lanthanide borosilicate (LaBS) glass is a viable option for dispositioning excess weapons-useable plutonium that is not suitable for processing into mixed oxide (MOX) fuel. A significant effort to develop a glass formulation and vitrification process to immobilize plutonium was completed in the mid-1990s. The LaBS glass formulation was found to be capable of immobilizing in excess of 10 wt % Pu and to be tolerant of a range of impurities. A more detailed study is now needed to quantify the ability of the glass to accommodate the anticipated impurities associated with the Pu feeds now slated for disposition. The database of Pu feeds was reviewed to identify impurity species and concentration ranges for these impurities. Based on this review, a statistically designed test matrix of glass compositions was developed to evaluate the ability of the LaBS glass to accommodate the impurities. Sixty surrogate LaBS glass compositions were prepared in accordance with the statistically designed test matrix. The heterogeneity (e.g. degree of crystallinity) and durability (as measured by the Product Consistency Test - Method A (PCT-A)) of the glasses were used to assess the effects of impurities on glass quality

EVALUATION OF IMPURITY EXTREMES IN A PLUTONIUM-LOADED BOROSILICATE GLASS

A vitrification technology utilizing a lanthanide borosilicate (LaBS) glass appears to be a viable option for the disposition of excess weapons-useable plutonium that is not suitable for processing into mixed oxide (MOX) fuel. A significant effort to develop a glass formulation and vitrification process to immobilize plutonium was completed in the mid-1990s. The LaBS glass formulation was found to be capable of immobilizing in excess of 10 wt % Pu and to be tolerant of a range of impurities. To confirm the results of previous testing with surrogate Pu feeds containing impurities, four glass compositions were selected for fabrication with actual plutonium oxide and impurities. The four compositions represented extremes in impurity type and concentration. The homogeneity and durability of these four compositions were measured. The homogeneity of the glasses was evaluated using x-ray diffraction (XRD) and scanning electron microscopy coupled with energy dispersive spectroscopy (SEM/EDS). The XRD results indicated that the glasses were amorphous with no evidence of crystalline species in the glass. The SEM/EDS analyses did show the presence of some undissolved PuO{sub 2} material. The EDS spectra indicated that some of the PuO{sub 2} crystals also contained hafnium oxide. The SEM/EDS analyses showed that there were no heterogeneities in the glass due to the feed impurities. The durability of the glasses was measured using the Product Consistency Test (PCT). The PCT results indicated that the durability of Pu impurity glasses was comparable with Pu glasses without impurities and significantly more durable than the Environmental Assessment (EA) glass used as the benchmark for repository disposition of high-level waste (HLW) glasses

VARIABILITY STUDY TO DETERMINE THE SOLUBILITY OF IMPURITIES IN PLUTONIUM-BEARING, LANTHANIDE BOROSILICATE GLASS

This study focuses on the development of a compositional envelope that describes the retention of various impurities in lanthanide borosilicate (LaBS) glass for vitrification and immobilization of excess, defense-related plutonium. A limited amount of impurity data for the various plutonium sources is available and projections were made through analysis of the available information. These projections were used to define types and concentrations of impurities in the LaBS glass compositions to be fabricated and tested. Sixty surrogate glass compositions were developed through a statistically designed approach to cover the anticipated ranges of concentrations for several impurity species expected in the plutonium feeds. An additional four glass compositions containing actual plutonium oxide were selected based on their targeted concentrations of metals and anions. The glasses were fabricated and characterized in the laboratory and shielded cells facility to determine the degree of retention of the impurity components, the impact of the impurities on the durability of each glass, and the degree of crystallization that occurred, both upon quenching and slow cooling. Overall, the LaBS glass system appears to be very tolerant of most of the impurity types and concentrations projected in the plutonium waste stream. For the surrogate glasses, the measured CuO, Ga{sub 2}O{sub 3}, Na{sub 2}O, NiO, and Ta{sub 2}O{sub 5} concentrations fell very close to their target values across the ranges of concentrations targeted in this study for each of these components. The measured CaO and PbO concentrations were consistently higher than the targeted values. The measured Cr{sub 2}O{sub 3} and Fe{sub 2}O{sub 3} concentrations were very close to the targets except for the one highest targeted value for each of these components. A solubility limit may have been approached in this glass system for K{sub 2}O and MgO. The measured Cl{sup -}, F{sup -}, SeO{sub 2} and SO{sub 4}{sup 2-} concentrations were well below their target values for all of the study glasses. This is likely due to volatilization of these species during melting of the glass batch. Note that the degree of volatilization that occurred in this crucible-scale study may differ from the full-scale melter. The measured HfO{sub 2} concentrations were below their target values for all of the surrogate glasses. It is likely that for HfO{sub 2}, the solubility limit in the glass was exceeded and some of the HfO{sub 2} batch material remained in the bottom of the crucibles after pouring the glasses. X-ray diffraction and scanning electron microscopy (SEM) results indicated that some crystalline HfO2 remained in some of the surrogate glasses with the lowest concentration of impurities. No other crystalline phases were identified. The Product Consistency Test (PCT) results showed that all 60 of the surrogate glass compositions tested were very durable, regardless of thermal history, with the highest normalized release for boron being 0.041 g/L. The pH of the leachate solutions was generally lower than that of conventional waste glasses due to the lack of alkali in the LaBS glass, which likely impacted the PCT results. The normalized release rates for the elements measured were generally too small to attempt to correlate the results with the compositions of the test glasses. The Toxicity Characteristic Leaching Procedure results showed that no hazardous metals were leached from the surrogate glasses in any measurable concentration. A plutonium-containing crystalline phase with a cross-shaped morphology was identified via SEM in the glasses fabricated with plutonium oxide. This phase was identified in a previous study of plutonium-bearing LaBS glasses and may provide an opportunity to intentionally crystallize some of the plutonium oxide into a highly insoluble form with an intrinsic neutron absorber. Additional work is necessary to better characterize the influence that this phase has on durability of the glass. The PCT results for the plutonium-containing LaBS glasses with impurities were similar to previous tests conducted on PuO{sub 2}-containing glasses without impurities added. The highest normalized release for boron was 0.02 g/L, which bounded the highest normalized release for plutonium of 0.01 g/L

'To live and die [for] Dixie': Irish civilians and the Confederate States of America

Around 20,000 Irishmen served in the Confederate army in the Civil War. As a result, they left behind, in various Southern towns and cities, large numbers of friends, family, and community leaders. As with native-born Confederates, Irish civilian support was crucial to Irish participation in the Confederate military effort. Also, Irish civilians served in various supporting roles: in factories and hospitals, on railroads and diplomatic missions, and as boosters for the cause. They also, however, suffered in bombardments, sieges, and the blockade. Usually poorer than their native neighbours, they could not afford to become 'refugees' and move away from the centres of conflict. This essay, based on research from manuscript collections, contemporary newspapers, British Consular records, and Federal military records, will examine the role of Irish civilians in the Confederacy, and assess the role this activity had on their integration into Southern communities. It will also look at Irish civilians in the defeat of the Confederacy, particularly when they came under Union occupation. Initial research shows that Irish civilians were not as upset as other whites in the South about Union victory. They welcomed a return to normalcy, and often 'collaborated' with Union authorities. Also, Irish desertion rates in the Confederate army were particularly high, and I will attempt to gauge whether Irish civilians played a role in this. All of the research in this paper will thus be put in the context of the Drew Gilpin Faust/Gary Gallagher debate on the influence of the Confederate homefront on military performance. By studying the Irish civilian experience one can assess how strong the Confederate national experiment was. Was it a nation without a nationalism

Fanny Copeland and the geographical imagination

Raised in Scotland, married and divorced in the English south, an adopted Slovene, Fanny Copeland (1872 – 1970) occupied the intersection of a number of complex spatial and temporal conjunctures. A Slavophile, she played a part in the formation of what subsequently became the Kingdom of Yugoslavia that emerged from the First World War. Living in Ljubljana, she facilitated the first ‘foreign visit’ (in 1932) of the newly formed Le Play Society (a precursor of the Institute of British Geographers) and guided its studies of Solčava (a then ‘remote’ Alpine valley system) which, led by Dudley Stamp and commended by Halford Mackinder, were subsequently hailed as a model for regional studies elsewhere. Arrested by the Gestapo and interned in Italy during the Second World War, she eventually returned to a socialist Yugoslavia, a celebrated figure. An accomplished musician, linguist, and mountaineer, she became an authority on (and populist for) the Julian Alps and was instrumental in the establishment of the Triglav National Park. Copeland’s role as participant observer (and protagonist) enriches our understanding of the particularities of her time and place and illuminates some inter-war relationships within G/geography, inside and outside the academy, suggesting their relative autonomy in the production of geographical knowledge

Radial shortening following a fracture of the proximal radius: Degree of shortening and short-term outcome in 22 proximal radial fractures

Background and purpose: The Essex-Lopresti lesion is thought to be rare, with a varying degree of disruption to forearm stability probable. We describe the range of radial shortening that occurs following a fracture of the proximal radius, as well as the short-term outcome in these patients. Patients and methods Over an 18-month period, we prospectively assessed all patients with a radiographically confirmed proximal radial fracture. Patients noted to have ipsilateral wrist pain at initial presentation underwent bilateral radiography to determine whether there was disruption of the distal radio-ulnar joint suggestive of an Essex-Lopresti lesion. Outcome was assessed after a mean of 6 (1.5-12) months using clinical and radiographic results, including the Mayo elbow score (MES) and the short musculoskeletal function assessment (SMFA) questionnaire. One patient with a Mason type-I fracture was lost to follow-up after initial presentation. Results 60 patients had ipsilateral wrist pain at the initial assessment of 237 proximal radial fractures. Radial shortening of ≥ 2mm (range: 2-4mm) was seen in 22 patients (mean age 48 (19-79) years, 16 females). The most frequent mechanism of injury was a fall from standing height (10/22). 21 fractures were classified as being Mason type-I or type-II, all of which were managed nonoperatively. One Mason type-III fracture underwent acute radial head replacement. Functional outcome was assessed in 21 patients. We found an excellent or good MES in 18 of the 20 patients with a Mason type-I or type-II injury. Interpretation The incidence of the Essex-Lopresti lesion type is possibly under-reported as there is a spectrum of injuries, and subtle disruptions often go unidentified. A full assessment of all patients with a proximal radial fracture is required in order to identify these injuries, and the index of suspicion is raised as the complexity of the fracture increases.</p

Shades of empire: police photography in German South-West Africa

This article looks at a photographic album produced by the German police in colonial Namibia just before World War I. Late 19th- and early 20th-century police photography has often been interpreted as a form of visual production that epitomized power and regimes of surveillance imposed by the state apparatuses on the poor, the criminal and the Other. On the other hand police and prison institutions became favored sites where photography could be put at the service of the emergent sciences of the human body—physiognomy, anthropometry and anthropology. While the conjuncture of institutionalized colonial state power and the production of scientific knowledge remain important for this Namibian case study, the article explores a slightly different set of questions. Echoing recent scholarship on visuality and materiality the photographic album is treated as an archival object and visual narrative that was at the same time constituted by and constitutive of material and discursive practices within early 20th-century police and prison institutions in the German colony. By shifting attention away from image content and visual codification alone toward the question of visual practice the article traces the ways in which the photo album, with its ambivalent, unstable and uncontained narrative, became historically active and meaningful. Therein the photographs were less informed by an abstract theory of anthropological and racial classification but rather entrenched with historically contingent processes of colonial state constitution, socioeconomic and racial stratification, and the institutional integration of photography as a medium and a technology into colonial policing. The photo album provides a textured sense of how fragmented and contested these processes remained throughout the German colonial period, but also how photography could offer a means of transcending the limits and frailties brought by the realities on the ground.International Bibliography of Social Science