The relationship between parental education and children's schooling in a time of economic turmoil: The case of East Zimbabwe, 2001 to 2011.

Using data collected from 1998 to 2011 in a general population cohort study in eastern Zimbabwe, we describe education trends and the relationship between parental education and children's schooling during the Zimbabwean economic collapse of the 2000s. During this period, the previously-rising trend in education stalled, with girls suffering disproportionately; however, female enrolment increased as the economy began to recover. Throughout the period, children with more educated parents continued to have better outcomes such that, at the population level, an underlying increase in the proportion of children with more educated parents may have helped to maintain the upwards education trend

Doing the ‘Dirty Work’ of the Green Economy: resource recovery and migrant labour in the EU

Europe has set out its plans to foster a ‘green economy’, focused around recycling, by 2020. This pan-European recycling economy, it is argued, will have the triple virtues of: first, stopping wastes being ‘dumped’ on poor countries; second, reusing them and thus decoupling economic prosperity from demands on global resources; and third, creating a wave of employment in recycling industries. European resource recovery is represented in academic and practitioner literatures as ‘clean and green’. Underpinned by a technical and physical materialism, it highlights the clean-up of Europe’s waste management and the high-tech character of resource recovery. Analysis shows this representation to mask the cultural and physical associations between recycling work and waste work, and thus to obscure that resource recovery is mostly ‘dirty’ work. Through an empirical analysis of three sectors of resource recovery (‘dry recyclables’, textiles and ships) in Northern member states, we show that resource recovery is a new form of dirty work, located in secondary labour markets and reliant on itinerant and migrant labour, often from accession states. We show therefore that, when wastes stay put within the EU, labour moves to process them. At the micro scale of localities and workplaces, the reluctance of local labour to work in this new sector is shown to connect with embodied knowledge of old manufacturing industries and a sense of spatial injustice. Alongside that, the positioning of migrant workers is shown to rely on stereotypical assumptions that create a hierarchy, connecting reputational qualities of labour with the stigmas of different dirty jobs – a hierarchy upon which those workers at the apex can play

Early surgery versus initial conservative treatment in patients with traumatic intracerebral haemorrhage [STITCH(Trauma)] : the first randomized trial

Acknowledgements This project was funded by the NIHR Health Technology Assessment programme (project number 07/37/16). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.Peer reviewedPublisher PD

Update on the Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II):Statistical analysis plan

<p>Abstract</p> <p>Background</p> <p>Previous studies had suggested that the outcome for patients with spontaneous lobar intracerebral haemorrhage (ICH) and no intraventricular haemorrhage (IVH) might be improved with early evacuation of the haematoma. The Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II) set out to establish whether a policy of earlier surgical evacuation of the haematoma in selected patients with spontaneous lobar ICH would improve outcome compared to a policy of initial conservative treatment. It is an international, multi-centre, prospective randomised parallel group trial of early surgery in patients with spontaneous lobar ICH. Outcome is measured at six months via a postal questionnaire.</p> <p>Results</p> <p>Recruitment to the study began on 27 November 2006 and closed on 15 August 2012 by which time 601 patients had been recruited. The protocol was published in <it>Trials</it> (<url>http://www.trialsjournal.com/content/12/1/124/</url>). This update presents the analysis plan for the study without reference to the unblinded data. The trial data will not be unblinded until after follow-up is completed in early 2013. The main trial results will be presented in spring 2013 with the aim to publish in a peer-reviewed journal at the same time.</p> <p>Conclusion</p> <p>The data from the trial will provide evidence on the benefits and risks of early surgery in patients with lobar ICH.</p> <p>Trial registration</p> <p>ISRCTN: ISRCTN22153967</p

Parental obligations, care and HIV treatment: How care for others motivates self-care in Zimbabwe

This article examines how parental obligations of care intersect with HIV treatment-seeking behaviours and retention. It draws on qualitative data from eastern Zimbabwe, produced from 65 interviews. Drawing on theories of practice and care ethics, our analysis revealed that norms of parental obligation and care acted as key motivators for ongoing engagement with HIV services and treatment. Parents' attentiveness to the future needs of their children ( caring about), and sense of obligation ( taking care of) and improved ability to care ( caregiving) following treatment initiation, emerged as central to understanding their drive for self-care and engagement with HIV services

Protein expression in the obligate hydrocarbon‐degrading psychrophile Oleispira antarctica RB‐8 during alkane degradation and cold tolerance

In cold marine environments, the obligate hydrocarbon‐degrading psychrophile Oleispira antarctica RB‐8, which utilizes aliphatic alkanes almost exclusively as substrates, dominates microbial communities following oil spills. In this study, LC–MS/MS shotgun proteomics was used to identify changes in the proteome induced during growth on n‐alkanes and in cold temperatures. Specifically, proteins with significantly higher relative abundance during growth on tetradecane (n‐C14) at 16°C and 4°C have been quantified. During growth on n‐C14, O. antarctica expressed a complete pathway for the terminal oxidation of n‐alkanes including two alkane monooxygenases, two alcohol dehydrogenases, two aldehyde dehydrogenases, a fatty‐acid‐CoA ligase, a fatty acid desaturase and associated oxidoreductases. Increased biosynthesis of these proteins ranged from 3‐ to 21‐fold compared with growth on a non‐hydrocarbon control. This study also highlights mechanisms O. antarctica may utilize to provide it with ecological competitiveness at low temperatures. This was evidenced by an increase in spectral counts for proteins involved in flagella structure/output to overcome higher viscosity, flagella rotation to accumulate cells and proline metabolism to counteract oxidative stress, during growth at 4°C compared with 16°C. Such species‐specific understanding of the physiology during hydrocarbon degradation can be important for parameterizing models that predict the fate of marine oil spills

Co-producing energy futures: impacts of participatory modelling

This transdisciplinary research case study sought to disrupt the usual ways public participation shapes future energy systems. An interdisciplinary group of academics and a self-assembling public of a North English town co-produced ‘bottom-up’ visions for a future local energy system by emphasizing local values, aspirations and desires around energy futures. The effects of participatory modelling are considered as part of a community visioning process on participants’ social learning and social capital. This paper examines both the within-process dynamics related to models and the impact of the outside process, political use of the models by the participants. Both a numerical model (to explore local electricity generation and demand) and a physical scale model of the town were developed to explore various aspects of participants’ visions. The case study shows that collaborative visioning of local energy systems can enhance social learning and social capital of communities. However, the effect of participatory modelling on these benefits is less clear. Tensions arise between ‘inspiring’ and ‘empowering’ role of visions. It is argued that the situatedness of the visioning processes needs to be recognized and integrated within broader aspects of governance and power relations

Spatial patterns of HIV prevalence and Service Use in East Zimbabwe: implications for future targeting of interventions

Introduction: Focusing resources for HIV control on geographic areas of greatest need in countries with generalised epidemics has been recommended to increase cost-effectiveness. However, socio-economic inequalities between areas of high and low prevalence could raise equity concerns and have been largely overlooked. We describe spatial patterns in HIV prevalence in east Zimbabwe and test for inequalities in accessibility and uptake of HIV services prior to the introduction of spatially-targeted programmes. Methods: 8092 participants in an open-cohort study were geo-located to 110 locations. HIV prevalence and HIV testing and counselling (HTC) uptake were mapped with ordinary kriging. Clusters of high or low HIV prevalence were detected with Kulldorff statistics, and the socio-economic characteristics and sexual risk behaviours of their populations, and levels of local HIV service availability (measured in travel distance) and uptake were compared. Kulldorff statistics were also determined for HTC, antiretroviral therapy (ART), and voluntary medical male circumcision (VMMC) uptake. Results: One large and one small high HIV prevalence cluster (relative risk [RR]=1.78, 95% confidence interval [CI]=1.53–2.07; RR=2.50, 95% CI=2.08–3.01) and one low-prevalence cluster (RR=0.70, 95% CI=0.60–0.82) were detected. The larger high-prevalence cluster was urban with a wealthier population and more high-risk sexual behaviour than outside the cluster. Despite better access to HIV services, there was lower HTC uptake in the high-prevalence cluster (odds ratio [OR] of HTC in past 3 years: OR=0.80, 95% CI=0.66–0.97). The low-prevalence cluster was predominantly rural with a poorer population and longer travel distances to HIV services; however, uptake of HIV services was not reduced. Conclusions: High-prevalence clusters can be identified to which HIV control resources could be targeted. To date, poorer access to HIV services in the poorer low-prevalence areas has not resulted in lower service uptake, while there is significantly lower uptake of HTC in the high-prevalence cluster where health service access is better. Given the high levels of risky sexual behaviour and lower uptake of HTC services, targeting high-prevalence clusters may be cost-effective in this setting. If spatial targeting is introduced, inequalities in HIV service uptake may be avoided through mobile service provision for lower prevalence areas

Surgical trial in traumatic intracerebral hemorrhage (STITCH(Trauma)) : study protocol for a randomized controlled trial

Peer reviewedPublisher PD

Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998–2003

BACKGROUND: AIDS is the main driver of young widowhood in southern Africa. METHODS: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal population-based cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission. RESULTS: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period. CONCLUSIONS: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network