An injury awareness education program on outcomes of juvenile justice offenders in Western Australia: an economic analysis

Background: Injury is a major cause of mortality and morbidity of young people and the cost-effectiveness of many injury prevention programs remains uncertain. This study aimed to analyze the costs and benefits of an injury awareness education program, the P.A.R.T.Y. (Prevent Alcohol and Risk-related Trauma in Youth) program, for juvenile justice offenders in Western Australia. Methods: Costs and benefits analysis based on effectiveness data from a linked-data cohort study on 225 juvenile justice offenders who were referred to the education program and 3434 who were not referred to the program between 2006 and 2011. Results: During the study period, there were 8869 hospitalizations and 113 deaths due to violence or traffic-related injuries among those aged between 14 and 21 in Western Australia. The mean length of hospital stay was 4.6 days, a total of 320 patients (3.6%) needed an intensive care admission with an average length of stay of 6 days. The annual cost saved due to serious injury was $3,765 and the annual net cost of running this program was$33,735. The estimated cost per offence prevented, cost per serious injury avoided, and cost per undiscounted and discounted life year gained were $3,124,$42,169, $8,268 and$17,910, respectively. Increasing the frequency of the program from once per month to once per week would increase its cost-effectiveness substantially. Conclusions: The P.A.R.T.Y. injury education program involving real-life trauma scenarios was cost-effective in reducing subsequent risk of committing violence or traffic-related offences, injuries, and death for juvenile justice offenders in Western Australia

Effects of flow alteration on Apple-ring Acacia (Faidherbia albida) stands, Middle Zambezi floodplains, Zimbabwe

The impounding of the Zambezi River by Kariba dam has regulated the river discharge of the Middle Zambezi river. This has been implicated in the failure of regeneration of Faidherbia albida in the downstream flood plain. This study aimed (1) to assess the effect of the altered flow regime of the river on the establishment and growth of F. albida on the Middle Zambezi floodplain and islands and (2) to test the potential of dendrochronology in detecting the age and long-term growth rates of F. albida in response to flow regime. Results indicated an uneven age distribution of F. albida stands on relatively ‘new islands’, dominated by young trees, while the floodplain and the ‘old island’ exhibited an even-aged stand but with a lack of regeneration, and a dying-off of older trees. The lack of F. albida establishment on the floodplain was linked to the decreased occurrence of flooding events, associated with a decrease in alluvial deposits, soil moisture and groundwater recharge. These effects may be enhanced by impact from browsers on regeneration of trees. Tree-ring analyses revealed the presence of distinct annual growth rings in F. albida and the applicability of dendrochronology for estimating F. albida population dynamics. The trees on the ‘new islands’ are younger and grow faster than those on the floodplain. Lack of competition and possible favourable moisture conditions suggest beneficial conditions for establishment and growth of the trees on the islands

Security in 5G-enabled Internet of Things communication: issues, challenges, and future research roadmap

5G mobile communication systems promote the mobile network to not only interconnect people, but also interconnect and control the machine and other devices. 5G-enabled Internet of Things (IoT) communication environment supports a wide-variety of applications, such as remote surgery, self-driving car, virtual reality, flying IoT drones, security and surveillance and many more. These applications help and assist the routine works of the community. In such communication environment, all the devices and users communicate through the Internet. Therefore, this communication agonizes from different types of security and privacy issues. It is also vulnerable to different types of possible attacks (for example, replay, impersonation, password reckoning, physical device stealing, session key computation, privileged-insider, malware, man-in-the-middle, malicious routing, and so on). It is then very crucial to protect the infrastructure of 5G-enabled IoT communication environment against these attacks. This necessitates the researchers working in this domain to propose various types of security protocols under different types of categories, like key management, user authentication/device authentication, access control/user access control and intrusion detection. In this survey paper, the details of various system models (i.e., network model and threat model) required for 5G-enabled IoT communication environment are provided. The details of security requirements and attacks possible in this communication environment are further added. The different types of security protocols are also provided. The analysis and comparison of the existing security protocols in 5G-enabled IoT communication environment are conducted. Some of the future research challenges and directions in the security of 5G-enabled IoT environment are displayed. The motivation of this work is to bring the details of different types of security protocols in 5G-enabled IoT under one roof so that the future researchers will be benefited with the conducted work

Effectiveness of participatory women’s groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India: a pragmatic cluster non-randomised controlled trial

INTRODUCTION: The WHO recommends community mobilisation with women’s groups practising participatory learning and action (PLA) to improve neonatal survival in high-mortality settings. This intervention has not been evaluated at scale with government frontline workers. METHODS: We did a pragmatic cluster non-randomised controlled trial of women’s groups practising PLA scaled up by government front-line workers in Jharkhand, eastern India. Groups prioritised maternal and newborn health problems, identified strategies to address them, implemented the strategies and evaluated progress. Intervention coverage and quality were tracked state-wide. Births and deaths to women of reproductive age were monitored in six of Jharkhand’s 24 districts: three purposively allocated to an early intervention start (2017) and three to a delayed start (2019). We monitored vital events prospectively in 100 purposively selected units of 10 000 population each, during baseline (1 March 2017–31 August 2017) and evaluation periods (1 September 2017–31 August 2019). The primary outcome was neonatal mortality. RESULTS: We identified 51 949 deliveries and conducted interviews for 48 589 (93.5%). At baseline, neonatal mortality rates (NMR) were 36.9 per 1000 livebirths in the early arm and 39.2 in the delayed arm. Over 24 months of intervention, the NMR was 29.1 in the early arm and 39.2 in the delayed arm, corresponding to a 24% reduction in neonatal mortality (adjusted OR (AOR) 0.76, 95% CI 0.59 to 0.98), including 26% among the most deprived (AOR 0.74, 95% CI 0.57 to 0.95). Twenty of Jharkhand’s 24 districts achieved adequate meeting coverage and quality. In these 20 districts, the intervention saved an estimated 11 803 newborn lives (min: 1026–max: 20 527) over 42 months, and cost 41 international dollars per life year saved. CONCLUSION: Participatory women’s groups scaled up by the Indian public health system reduced neonatal mortality equitably in a largely rural state and were highly cost-effective, warranting scale-up in other high-mortality rural settings. TRIAL REGISTRATION: ISRCTN99422435

The Internet of Things as Smart City Enabler:The Cases of Palo Alto, Nice and Stockholm

Part 5: Smart Cities and Smart HomesInternational audienceDue to rapid urbanization, city populations are rapidly increasing all over the world creating new problems and challenges. Solving some of these problems requires innovative approaches; one increasingly popular approach is to transform cities to Smart Cities. Smart Cities implement innovative approaches based on IoT technologies and convert many services to digital services. These services are implemented within the different components of a Smart City, helping city administrators to improve the life of the citizens, addressing different service, security and administrative challenges. The objective of this paper is to explore and determine how three well-known cities - Nice, Palo Alto and Stockholm - implemented the Smart City concept. The study indicates that a successful implementation of a Smart City model requires addressing a number of critical challenges: citizen involvement, business collaboration and strong leadership prove to be key success factors in the Smart City development process

Effect of an Injury Awareness Education Program on Risk-Taking Behaviors and Injuries in Juvenile Justice Offenders: A Retrospective Cohort Study

Background Risk-taking behavior is a leading cause of injury and death amongst young people. Methodology and Principal Findings This was a retrospective cohort study on the effectiveness of a 1-day youth injury awareness education program (Prevent Alcohol and Risk-related Trauma in Youth, P.A.R.T.Y.) program in reducing risk taking behaviors and injuries of juvenille justice offenders in Western Australia. Of the 3659 juvenile justice offenders convicted by the court magistrates between 2006 and 2010, 225 were referred to the P.A.R.T.Y. education program. In a before and after survey of these 225 participants, a significant proportion of them stated that they were more receptive to modifying their risk-taking behavior (21% before vs. 57% after). Using data from the Western Australia Police and Department of Health, the incidence of subsequent offences and injuries of all juvenile justice offenders was assessed. The incidence of subsequent traffic or violence-related offences was significantly lower for those who had attended the program compared to those who did not (3.6% vs. 26.8%; absolute risk reduction [ARR] = 23.2%, 95% confidence interval [CI] 19.9%–25.8%; number needed to benefit = 4.3, 95%CI 3.9–5.1; p = 0.001), as were injuries leading to hospitalization (0% vs. 1.6% including 0.2% fatality; ARR = 1.6%, 95%CI 1.2%–2.1%) and alcohol or drug-related offences (0% vs. 2.4%; ARR 2.4%, 95%CI 1.9%–2.9%). In the multivariate analysis, only P.A.R.T.Y. education program attendance (odds ratio [OR] 0.10, 95%CI 0.05–0.21) and a higher socioeconomic background (OR 0.97 per decile increment in Index of Relative Socioeconomic Advantage and Disadvantage, 95%CI 0.93–0.99) were associated with a lower risk of subsequent traffic or violence-related offences. Significance Participation in an injury education program involving real-life trauma scenarios was associated with a reduced subsequent risk of committing violence- or traffic-related offences, injuries, and death for juvenille justice offenders

Acquiring allophonic structure and phonetic detail in a bilingual community: The production of laterals by Sylheti-English bilingual children

Aims and objectives In this study, we consider the acquisition of allophonic contrast and phonetic detail in lateral consonants by second-generation Sylheti-English bilingual children in London, UK. Design/methodology/approach Acoustic analysis was conducted on productions of /l/ by Sylheti bilingual children, Sylheti monolingual adults and English monolingual children. Data and analysis Tokens of /l/ were elicited across initial, medial and final word positions from 14 bilingual Sylheti-English children, 10 monolingual English children, and 4 monolingual Sylheti adults. Acoustic measurements of F2–F1 were analysed using Bayesian linear mixed-effects modelling. Findings and conclusions Our results show that bilingual children produce monolingual-like positional patterns in Sylheti, producing very clear laterals in all positions. In contrast, bilinguals produce monolingual-like positional allophony in English, but they differ in phonetic detail, with bilinguals producing much clearer laterals than monolingual children across all positions. Originality This study is the first to examine the development of allophonic contrast and phonetic detail in both of a bilingual’s languages in a contact scenario. This provides new insights into how contact varieties adopt aspects of structure and detail from each language. We also report valuable data from Sylheti-English bilinguals, who are an understudied community. Significance/limitations Our study highlights the value of considering structural and detailed aspects of cross-linguistic sound systems, whereby one aspect may show monolingual-like patterns and another aspect may show distinctive patterns. We propose that the results in this study represent the development of a new sound system out of language contact, with second-generation bilingual children producing a hybrid system that combines influences from both heritage and host languages

Integrated multisectoral strategy to improve girls' and women's nutrition before conception, during pregnancy and after birth in India (Swabhimaan): protocol for a prospective, non-randomised controlled evaluation

INTRODUCTION: Swabhimaan is a community-based programme to improve adolescent girls’ and women’s nutrition in the rural areas of three Indian states—Bihar, Chhattisgarh and Odisha with high prevalence of undernutrition. METHODS AND ANALYSIS: Swabhimaan has a nested prospective, non-randomised controlled evaluation. Since 2017, five intervention sites receive community-led interventions through national government’s livelihood mission supported women’s self-help group federations and five control sites will initiate these activities 36 months later, in 2020. Community-led activities aim to improve coverage of 18 interventions including adequacy of food consumed, prevention of micronutrient deficiencies, access to basic health services and special care of nutritionally ‘at risk’ girls and women, improving hygiene and access to water and sanitation services and access to family planning services. The evaluation includes baseline (2016–2017), midline (2018–2019) and endline (2020–2021) surveys covering 6638 adolescent girls, 2992 pregnant women and 8755 mothers of children under 2. The final impact analysis will be by intention to treat, comparing primary and secondary outcomes in five intervention areas and five control areas. The primary outcomes are: (1) a 15% reduction in the proportion of adolescent girls with a body mass index (BMI) <18.5 kg/m2; (2) a 15% reduction in the proportion of mothers of children under two with a BMI <18.5 kg/m2 and (3) and a 0.4 cm improvement in mean mid-upper arm circumference among pregnant women. ETHICS AND DISSEMINATION: All procedures involving human subjects were approved by the Institutional Ethics Committee of the All India Institute of Medical Sciences, Bihar, Chhattisgarh and Odisha and in compliance with guidelines laid down in the Declaration of Helsinki. Evidence will inform maternal and preconception nutrition policy at national and state level. TRIAL REGISTRATION NUMBER: 58261b2f46876 and CTRI/2016/11/007482; Pre-results

Effects of participatory learning and action with women's groups, counselling through home visits and crèches on undernutrition among children under three years in eastern India: a quasi-experimental study

BACKGROUND: India faces a high burden of child undernutrition. We evaluated the effects of two community strategies to reduce undernutrition among children under 3 years in rural Jharkhand and Odisha, eastern India: (1) monthly Participatory Learning and Action (PLA) meetings with women's groups followed by home visits; (2) crèches for children aged 6 months to 3 years combined with monthly PLA meetings and home visits. METHODS: We tested these strategies in a non-randomised, controlled study with baseline and endline cross-sectional surveys. We purposively selected five blocks of Jharkhand and Odisha, and divided each block into three areas. Area 1 served as control. In Area 2, trained local female workers facilitated PLA meetings and offered counselling to mothers of children under three at home. In Area 3, workers facilitated PLA meetings, did home visits, and crèches with food and growth monitoring were opened for children aged 6 months to 3 years. We did a census across all study areas and randomly sampled 4668 children under three and their mothers for interview and anthropometry at baseline and endline. The evaluation's primary outcome was wasting among children under three in areas 2 and 3 compared with area 1, adjusted for baseline differences between areas. Other outcomes included underweight, stunting, preventive and care-seeking practices for children. RESULTS: We interviewed 83% (3868/4668) of mothers of children under three sampled at baseline, and 76% (3563/4668) at endline. In area 2 (PLA and home visits), wasting among children under three was reduced by 34% (adjusted Odds Ratio [aOR]: 0.66, 95%: 0.51-0.88) and underweight by 25% (aOR: 0.75, 95% CI: 0.59-0.95), with no change in stunting (aOR: 1.23, 95% CI: 0.96-1.57). In area 3, (PLA, home visits, crèches), wasting was reduced by 27% (aOR: 0.73, 95% CI: 0.55-0.97), underweight by 40% (aOR: 0.60, 95% CI: 0.47-0.75), and stunting by 27% (aOR: 0.73, 95% CI: 0.57-0.93). CONCLUSIONS: Crèches, PLA meetings and home visits reduced undernutrition among children under three in rural eastern India. These interventions could be scaled up through government plans to strengthen home visits and community mobilisation with Accredited Social Health Activists, and through efforts to promote crèches. TRIAL REGISTRATION: The evaluation was registered retrospectively with Current Controlled Trials as ISCRTN89911047 on 30/01/2019