Empowering Women through SHGs – Evidence from a Case Study of SHGs in Imphal East District, Manipur

In recent years, traditional literature implies that women are empowered when they can exercise choices and are aware of alternatives, microfinance being one of the most important catalysts. However, doubts about the long term viability of SHGs as a model for supply of micro credit to low income groups of women have risen, as for SHGs-Bank linkage model to remain viable as long as long term key support and maintenance services must be provided to individual community group-level bodies, and their costs recovered. It is found that even though women have experienced an increase in income and consumption, they have very little control over resources, assets and do not participate equally in major household decisions. However, they have significant influence on the choices that their children make. The paper made an empirical study of SHGs in Imphal East, Manipur as a case for illustration. The study shows that microfinance and SHG is very closely related and is considered as two sides of the same coin. This study attempts to understand the impact of microfinance on women empowerment through a case study in study of SHGs in Imphal East, Manipur as a case for illustration. The success and failures of SHGs to achieve the goal of socio-economic empowerment of women have been evaluated and lessons and evidences learnt have been incorporated in the paper. The study has covered the specific constraints and challenges of SHGs, and policy prescriptions to address the specific problems are suggested

La schistosomose urinaire dans le massif saharien de l'Aïr (République du Niger)

Dans deux villages de l'Aïr (République du Niger), les auteurs ont trouvé une prévalence globale de #Schistosoma haematobium$de 24,1$ est l'hôte intermédiaire des schistosomes. Le rôle de ce mollusque dans la transmission de la schistosomose urinaire à Timia n'a pas été mis en évidence. Cemio de #Bulinus senegalensis$ présent dans les deux localités reste encore à préciser. (Résumé d'auteur

Ageing, urban marginality, and health in Ghana

The world’s population is rapidly ageing. Global estimates for the next three decades indicate a two-fold increase in the population of older adults aged ≥60 years. Nearly 80% of this growth will occur in low and middle-income countries in Asia and sub-Saharan Africa, where population health is already under threat from poverty, degraded environments, and deficient healthcare systems. Although the world’s poorest region, sub-Saharan Africa, ironically, will witness the fastest growth in older populations, rising by 64% over the next 15 years. Indications are that the majority of this population will live in resource-poor settings, characterized by deficient housing and neighbourhood conditions. Yet, very little research has systematically examined the health and wellbeing of older adults in such settings. Drawing on the ecological theory of ageing, the present study explores the living conditions and quality of life of elderly slum dwellers in Ghana, a sub-Saharan African country with a growing population of older adults. Data collection was undertaken in two phases in two environmentally contrasting neighbourhoods in Accra, Ghana. In Phase 1, we carried out a cross-sectional survey of older adults in a slum community (n = 302) and a non-slum neighbourhood (n = 301), using the World Health Organization quality of life assessment tool (WHOQoL-BREF). The survey data were complemented in Phase 2 with qualitative interviews involving a sample of community dwelling older adults (N = 30), health service providers (N = 5), community leaders (N = 2), and policymakers (N = 5). Preliminary analysis of the survey data revealed statistically significant differences in the social and environment domains of quality of life, while the qualitative data identified multiple health barriers and facilitators in the two neighbourhoods. Insights from the research are expected to inform health and social interventions for older slum dwellers in Ghana

Cribado de la actividad hipoglucémica in vitro de Murraya koenigii y Catharanthus roseu

Objective: The study aimed to verify the hypoglycemic effect of Murraya koenigii (M. koenigii) and Catharanthus roseus (C. roseus) by using various in-vitro techniques. Method: The extracts were studied for their effects on glucose adsorption capacity, in-vitro glucose diffusion, in-vitro amylolysis kinetics and glucose transport across the yeast cells. Results: It was observed that the extracts of M. koenigii and C. roseus adsorbed glucose and the adsorption of glucose increased remarkably with an increase in glucose concentration. There were no significant (p≤0.05) differences between their adsorption capacities. In the amylolysis kinetic experimental model the rate of glucose diffusion was found to be increased with time from 30 to 180 min and both the plant extracts exhibited significant inhibitory effects on the movement of glucose into external solution across the dialysis membrane as compared to control. The extracts also promoted glucose uptake by the yeast cells and the enhancement of glucose uptake was dependent on both the sample and glucose concentration. The extract of M. koenigii exhibited significantly higher (p≤0.05) activity than the extract of C. roseus at all concentrations used in the study. Our report suggests the mechanism(s) for the hypoglycemic effect of M. koenigii and C. roseus. Conclusion: The said effect was observed to be mediated by inhibiting alpha amylase, inhibiting glucose diffusion by adsorbing glucose and by increasing glucose transport across the cell membranes as revealed by in-vitro model of yeast cells. However, these effects need to be affirmed by using different in vivo models and clinical trials.Objetivo: El estudio tuvo como objetivo verificar el efecto hipoglucémico de Murraya koenigii (M. koenigii) y Catharanthus roseus (C. roseus) mediante el uso de diversas técnicas in vitro. Método: Los extractos se estudiaron por sus efectos sobre la capacidad de adsorción de glucosa, la difusión de glucosa in vitro, la cinética de amilolisis in vitro y el transporte de glucosa a través de las células de levadura. Resultados: se observó que los extractos de M. koenigii y C. roseus adsorbieron glucosa y la adsorción de glucosa aumentó notablemente con un aumento en la concentración de glucosa. No hubo diferencias significativas (p≤0.05) entre sus capacidades de adsorción. En el modelo experimental cinético de amilolisis, se encontró que la velocidad de difusión de glucosa aumentaba con el tiempo de 30 a 180 min y ambos extractos de planta exhibían efectos inhibitorios significativos sobre el movimiento de la glucosa hacia la solución externa a través de la membrana de diálisis en comparación con el control. Los extractos también promovieron la absorción de glucosa por las células de levadura y la mejora de la captación de glucosa dependió tanto de la muestra como de la concentración de glucosa. El extracto de M. koenigii exhibió una actividad significativamente mayor (p≤0.05) que el extracto de C. roseus en todas las concentraciones utilizadas en el estudio. Nuestro informe sugiere el mecanismo (s) para el efecto hipoglucemiante de M. koenigii y C. roseus. Conclusión: Se observó que dicho efecto estaba mediado por la inhibición de la alfa amilasa, la inhibición de la difusión de glucosa por la adsorción de glucosa y el aumento del transporte de glucosa a través de las membranas celulares según lo revelado por el modelo in vitro de células de levadura. Sin embargo, estos efectos deben ser afirmados mediante el uso de diferentes modelos in vivo y ensayos clínicos

Sustainability determinants of an intervention to identify clinical deterioration and improve childhood cancer survival in Latin American hospitals: The INSPIRE study protocol

BACKGROUND: More than 90% of children with cancer live in low-resourced settings, where survival is only 20%. Sustainable evidence-based (EB) interventions yielding ongoing beneficial patient outcomes are critical to improve childhood cancer survival. A better understanding of factors promoting intervention sustainability in these settings is urgently needed. The aim of this study is to provide an empirical understanding of how clinical capacity for sustainability, or the resources needed to sustain an intervention, impacts the sustainment of Pediatric Early Warning System (PEWS), an EB intervention that improves pediatric oncology outcomes in low-resource hospitals by detecting clinical deterioration and preventing the need for more intense treatment. METHODS: We will conduct a prospective, longitudinal study of approximately 100 resource-variable hospitals implementing and sustaining PEWS participating in Proyecto EVAT, a quality improvement collaborative of Latin American pediatric oncology centers. Aim 1: We will evaluate how clinical capacity for sustainability changes over time through 5 to 9 prospective measurements of capacity via survey of clinical staff using PEWS (approximately n = 13 per center) during the phases of PEWS adoption, implementation, and sustainability using the Clinical Sustainability Assessment Tool (CSAT). Aim 2: We will determine the relationship between capacity and a) PEWS sustainment and b) clinical deterioration mortality among pediatric oncology patients at centers sustaining PEWS for 2 to 10 years using chart review and an existing patient outcomes registry. Aim 3: We will develop novel strategies to promote sustainability by gaining a deeper understanding of perceived challenges to building capacity and PEWS sustainment. In combination with quantitative outcomes, we will conduct 24 focus groups with staff (doctors, nurses, and administrators) from hospitals with both high (n = 4) and low capacity (n = 4). We will then use implementation mapping to generate theoretically driven, empirically-supported sustainability strategies. DISCUSSION: This study will advance implementation science by providing a theoretically driven, foundational understanding of factors that predict sustainability among a large, diverse cohort of hospitals. We will then use this knowledge to develop sustainability evidence-informed strategies that optimize capacity and promote long-term sustainment of PEWS and improvements in patient outcomes, thus promoting equity in childhood cancer care globally

Influence of cranial radiotherapy on outcome in children with acute lymphoblastic leukemia treated with contemporary therapy

Purpose We sought to determine whether cranial radiotherapy (CRT) is necessary to prevent relapse in any subgroup of children with acute lymphoblastic leukemia (ALL). Patients and Methods We obtained aggregate data on relapse and survival outcomes for 16,623 patients age 1 to 18 years old with newly diagnosed ALL treated between 1996 and 2007 by 10 cooperative study groups from around the world. The proportion of patients eligible for prophylactic CRT varied from 0%to 33% by trial and was not related to the proportion eligible for allogeneic stem-cell transplantation in first complete remission. Using a random effects model, with CRT as a dichotomous covariate, we performed a single-arm metaanalysis to compare event-free survival and cumulative incidence of isolated or any CNS relapse and isolated bone marrow relapse in high-risk subgroups of patients who either did or did not receive CRT. Results Although there was significant heterogeneity in all outcome end points according to trial, CRT was associated with a reduced risk of relapse only in the small subgroup of patients with overt CNS disease at diagnosis, who had a significantly lower risk of isolated CNS relapse (4% with CRT v 17% without CRT; P = .02) and a trend toward lower risk of any CNS relapse (7% with CRT v 17% without CRT; P = .09). However, this group had a relatively high rate of events regardless of whether or not they received CRT (32% [95% CI, 26% to 39%] v 34% [95% CI, 19% to 54%]; P = .8). Conclusion CRT does not have an impact on the risk of relapse in children with ALL treated on contemporary protocols

IoT-enabled water distribution systems - a comparative technological review

Water distribution systems are one of the critical infrastructures and major assets of the water utility in a nation. The infrastructure of the distribution systems consists of resources, treatment plants, reservoirs, distribution lines, and consumers. A sustainable water distribution network management has to take care of accessibility, quality, quantity, and reliability of water. As water is becoming a depleting resource for the coming decades, the regulation and accounting of the water in terms of the above four parameters is a critical task. There have been many efforts towards the establishment of a monitoring and controlling framework, capable of automating various stages of the water distribution processes. The current trending technologies such as Information and Communication Technologies (ICT), Internet of Things (IoT), and Artificial Intelligence (AI) have the potential to track this spatially varying network to collect, process, and analyze the water distribution network attributes and events. In this work, we investigate the role and scope of the IoT technologies in different stages of the water distribution systems. Our survey covers the state-of-the-art monitoring and control systems for the water distribution networks, and the status of IoT architectures for water distribution networks. We explore the existing water distribution systems, providing the necessary background information on the current status. This work also presents an IoT Architecture for Intelligent Water Networks - IoTA4IWNet, for real-time monitoring and control of water distribution networks. We believe that to build a robust water distribution network, these components need to be designed and implemented effectively