587 research outputs found

    First-year experience of chemotherapy for advanced retinoblastoma in Tanzania: disease profile, outcomes, and challenges in 2008.

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    PURPOSE: To examine the profile of retinoblastoma in a national tertiary referral center in Tanzania and to report first-year outcomes of its treatment using chemotherapy. METHODS: All patients with retinoblastoma referred in 2008 were included. Disease was classified on clinical grounds as ocular, orbital, or metastatic. Those with ocular and orbital disease received chemotherapy. Remission was the main outcome measure and defined as absence of disease at the end of treatment. RESULTS: In 2008, 37 patients (20 males and 17 females) with retinoblastoma were referred to Ocean Road Cancer Institute. The mean delay from the first sign of disease to presentation at hospital was 10.4 ± 8.7 months. Disease was ocular in 32% (12 of 37), orbital in 57% (21 of 37), and metastatic in 11% (4 of 37). Of those with ocular disease, 67% (8 of 12) completed chemotherapy and all (8 of 8) achieved remission. In contrast, 48% (10 of 21) with orbital disease completed chemotherapy and only 50% (5 of 10) achieved remission. The difference in outcome between the groups was statistically significant (P = .001, Fisher exact test). CONCLUSION: The profile of retinoblastoma in Tanzania is skewed toward severe invasive disease. Despite the introduction of chemotherapy, further improvements in mortality and morbidity can only be achieved through emphasis on early detection

    Does intra-party democracy affect levels of trust in parties?:the cases of Belgium and Israel

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    Previous research has shown a steady decline of citizen's political trus and growing skepticism towards key institutions of representative democr acy. Political parties, which perform the crucial role of linking citizens to the political system, are in the eye of the storm: citizens are generally more distrusting towards parties than other social and political institutions. The relevant literature mentions that parties often implement intra-party democratization to remedy party distrust. This article examines whether democratic candidate selection processes actually affect party trust among voters. The analysis is based on the cases of Belgium and Israel, where politicians made a strong case for intra-party democracy in recent history. The results indicate that, while inclusive selectorates indeed increase trust levels, decentralization decreases trust towards parties in both countries

    Macroeconomic costs of the unmet burden of surgical disease in Sierra Leone: a retrospective economic analysis.

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    OBJECTIVES: The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US12.3trillionfromgrossdomesticproduct(GDP)duetotheunmetburdenofsurgicaldisease.However,nocountryspecificdatacurrentlyexist.WeaimedtoestimatethecoststotheSierraLeoneeconomyfromdeathanddisabilitywhichmayhavebeenavertedbysurgicalcare.DESIGN:Weusedestimatesoftotal,metandunmetneedfromtwomainsourcesaclusterrandomised,crosssectional,countrywidesurveyandaretrospective,nationwidestudyonsurgeryinSierraLeone.Wecalculatedestimateddisabilityadjustedlifeyearsfrommorbidityandmortalityfortheestimatedunmetburdenandmodelledthelikelyeconomicimpactusingthreedifferentmethodsgrossnationalincomepercapita,lifetimeearningsforegoneandvalueofastatisticallife.RESULTS:In2012,estimated,discountedlifetimelossestotheSierraLeoneeconomyfromtheunmetburdenofsurgicaldiseasewasbetweenUS12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care. DESIGN: We used estimates of total, met and unmet need from two main sources-a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone. We calculated estimated disability-adjusted life years from morbidity and mortality for the estimated unmet burden and modelled the likely economic impact using three different methods-gross national income per capita, lifetime earnings foregone and value of a statistical life. RESULTS: In 2012, estimated, discounted lifetime losses to the Sierra Leone economy from the unmet burden of surgical disease was between US1.1 and US3.8billion,dependingontheeconomicmethodused.Theselifetimelossesequatetobetween233.8 billion, depending on the economic method used. These lifetime losses equate to between 23% and 100% of the annual GDP for Sierra Leone. 80% of economic losses were due to mortality. The incremental losses averted by scale up of surgical provision to the Lancet Commission target of 80% were calculated to be between US360 million and US$2.9 billion. CONCLUSION: There is a large economic loss from the unmet need for surgical care in Sierra Leone. There is an immediate need for massive investment to counteract ongoing economic losses

    Water Quality as Affected by Pesticides in Rice Production

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    Studies were conducted to determine the environmental persistence of the rice pesticides triclopyr, 2,4-D, benomyl and quinclorac. Triclopyr half-lives ranged from \u3c7 d to \u3e100 d depending on depth within the soil profile and clay content. Triclopyr persistence increased as depth within the profile increased and clay content increased. The benomyl metabolite MBC was present at greater than 50% of the initial amount after 9 months in the field. In simulated carryover field studies quinclorac exhibited the greatest potential for injury to subsequent rotational crops. Cotton and soybean growth was reduced when planted at four weeks after quinclorac application. The adsorption of triclopyr to three soils was measured by the batch equilibrium technique. Freundlich isotherms were linear and resulted in Kf values of 1.60, 1.41, and 2.75 for Crowley silt loam soil from depths of 0, 0.2, and 0.6 m, respectively, within soil profile. Soil thin-layer chromatography of triclopyr resulted in Rf values of 0.42, 0.69, and 0.40 for the Crowley silt loam soil from 0, 0.2, and 0.6 m depths. In controlled temperature and water potential degradation studies, triclopyr and 2,4-D degraded more rapidly at 3 0 C than at 15 C. The degradation rates of the two herbicides responded oppositely to water potential. 2,4-D degraded more rapidly under anaerobic conditions, whereas triclopyr degraded more rapidly under aerobic conditions

    Efficacy of a combination of imidacloprid 10%/moxidectin 2.5% spot-on (Advocate® for dogs) in the prevention of canine spirocercosis (Spirocerca lupi)

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    The nematode Spirocerca lupi is a major canine parasite in warm regions of the world, classically causing parasitic nodules in the esophagus, aortic aneurysms, and spondylitis. This study evaluated the preventive efficacy of monthly treatment with imidacloprid 10%/moxidectin 2.5% spot-on (Advocate® for dogs) administered over a period of 9 months in young dogs naturally exposed to S. lupi on Réunion island. One hundred and twelve puppies, aged from 2.0 to 4.0 months and with a negative spirocerca fecal examination at inclusion, completed the study. They were randomly allocated to two groups. Group A puppies (n = 58) received nine spot-on treatments with Advocate® at the minimum dose of 2.5 mg moxidectin/kg bw at monthly intervals. Control group B puppies (n = 54) received no treatment for S. lupi. During the study, regular clinical and fecal examinations were performed, as was final upper gastrointestinal endoscopy. Endoscopy showed that 19 dogs from group B had spirocerca nodules, corresponding to a prevalence of 35.2% in dogs aged 12 to 14 months. In contrast, only one dog from group A had a nodule, corresponding to a preventive efficacy of 94.7% (p < 0.0001). None of the 378 fecal examinations were positive for spirocerca. This study confirms a high prevalence of canine spirocercosis on Réunion and shows that infestation occurs in very young puppies. Furthermore, it demonstrates that monthly spot-on administration of a combination of imidacloprid 10%/moxidectin 2.5% (Advocate® for dogs) in puppies starting at the age of 2 to 4 months achieves effective and safe prevention of canine spirocercosis

    Paradoxical effects of Worrisome Thoughts Suppression: the influence of depressive mood

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    Thought suppression increases the persistence of unwanted idiosyncratic worries thoughts when individuals try to suppress them. The failure of suppression may contribute to the development and maintenance of emotional disorders. Depressive people seem particulary prone to engage in unsuccessful mental control strategies such as thought suppression. Worry has been reported to be elevated in depressed individuals and a dysphoric mood may also contribute for the failure of suppression. No studies examine, however, the suppression of worisome thoughts in individuals with depressive symptoms. To investigate the suppression effects of worrisome thoughts, 46 participants were selected according to the cut-off score of a depressive symptomatology scale and they were divided in two groups (subclinical and nonclinical group). All the individuals took part in an experimental paradigm of thought suppression. The results of the mixed factorial analysis of variance revealed an increased frequency of worrisome thoughts during the suppression phase on depending of the depressive symptoms. These findings confirm that depressive mood can reduce the success of suppression.info:eu-repo/semantics/publishedVersio

    Investigation of attentional bias in obsessive compulsive disorder with and without depression in visual search

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    Copyright: © 2013 Morein-Zamir et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedWhether Obsessive Compulsive Disorder (OCD) is associated with an increased attentional bias to emotive stimuli remains controversial. Additionally, it is unclear whether comorbid depression modulates abnormal emotional processing in OCD. This study examined attentional bias to OC-relevant scenes using a visual search task. Controls, non-depressed and depressed OCD patients searched for their personally selected positive images amongst their negative distractors, and vice versa. Whilst the OCD groups were slower than healthy individuals in rating the images, there were no group differences in the magnitude of negative bias to concern-related scenes. A second experiment employing a common set of images replicated the results on an additional sample of OCD patients. Although there was a larger bias to negative OC-related images without pre-exposure overall, no group differences in attentional bias were observed. However, OCD patients subsequently rated the images more slowly and more negatively, again suggesting post-attentional processing abnormalities. The results argue against a robust attentional bias in OCD patients, regardless of their depression status and speak to generalized difficulties disengaging from negative valence stimuli. Rather, post-attentional processing abnormalities may account for differences in emotional processing in OCD.Peer reviewedFinal Published versio

    A National Survey of Musculoskeletal Impairment in Rwanda: Prevalence, Causes and Service Implications

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    BACKGROUND: Accurate information on the prevalence and causes of musculoskeletal impairment (MSI) is lacking in low income countries. We present a new survey methodology that is based on sound epidemiological principles and is linked to the World Health Organisation's International Classification of Functioning. METHODS: Clusters were selected with probability proportionate to size. Households were selected within clusters through compact segment sampling. 105 clusters of 80 people (all ages) were included. All participants were screened for MSI by a physiotherapist and medical assistant. Possible cases plus a random sample of 10% of non-MSI cases were examined further to ascertain diagnosis, aetiology, quality of life, and treatment needs. FINDINGS: 6757 of 8368 enumerated individuals (80.8%) were screened. There were 352 cases, giving an overall prevalence for MSI of 5.2%. (95% CI 4.5-5.9) The prevalence of MSI increased with age and was similar in men and women. Extrapolating these estimates, there are approximately 488,000 MSI diagnoses in Rwanda. Only 8.2% of MSI cases were severe, while the majority were moderate (43.7%) or mild (46.3%). Diagnostic categories comprised 11.5% congenital, 31.3% trauma, 3.8% infection, 9.0% neurological, and 44.4% non-traumatic non infective acquired. The most common individual diagnoses were joint disease (13.3%), angular limb deformity (9.7%) and fracture mal- and non-union (7.2%). 96% of all cases required further treatment. INTERPRETATION: This survey demonstrates a large burden of MSI in Rwanda, which is mostly untreated. The survey methodology will be useful in other low income countries, to assist with planning services and monitoring trends
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