Survey of rehabilitation support for children 0-15 years in a rural part of Kenya

Abstract Purpose: Information regarding the nature, availability and distribution of rehabilitation services for children with disabilities across developing countries is scarce, and data that do exist are of variable quality. If planning and development are to progress, information about service provision is vital. The aim was to establish the scope and nature of rehabilitation support available to children with disabilities (0-15 years) and their families in rural Kenya. Method: A comprehensive sample comprising service provision in the health and special education sectors was established. Non-governmental and community-based organisations were also included. A survey of rehabilitation services was conducted through examination of service-related documentation and key informant interviews with the heads of services. Results: Rehabilitation comprised hospital-based occupational therapy, physiotherapy and orthopaedic technology; and seven special education establishments plus an education assessment resource centre. There was one non-government organisation and one community-based organisation relevant to children with disabilities. Activities focused on assessment, diagnosis and raising community awareness. Provision was challenged by inadequate staffing, resources and transport. Government funding was supplemented variously by donations and self-sufficiency initiatives. Rehabilitation approaches appeared to be informed by professional background of practitioner, rather than the needs of child. Service documentation revealed use of inconsistent recording methods. Conclusions: The data highlight the challenges of rehabilitation, demanding greater investment in personnel and their training, more material resources, improved access to the community and better recording mechanisms. Implications for Rehabilitation There needs to be greater investment in rehabilitation provision in developing countries. Consideration of community-based initiatives is required to support better access for all. In order to argue the case for improved resources, better skills and mechanisms for recording, monitoring and evaluating practice are needed

Phenotypic redshifts with self-organizing maps: A novel method to characterize redshift distributions of source galaxies for weak lensing

Wide-field imaging surveys such as the Dark Energy Survey (DES) rely on coarse measurements of spectral energy distributions in a few filters to estimate the redshift distribution of source galaxies. In this regime, sample variance, shot noise, and selection effects limit the attainable accuracy of redshift calibration and thus of cosmological constraints. We present a new method to combine wide-field, few-filter measurements with catalogs from deep fields with additional filters and sufficiently low photometric noise to break degeneracies in photometric redshifts. The multi-band deep field is used as an intermediary between wide-field observations and accurate redshifts, greatly reducing sample variance, shot noise, and selection effects. Our implementation of the method uses self-organizing maps to group galaxies into phenotypes based on their observed fluxes, and is tested using a mock DES catalog created from N-body simulations. It yields a typical uncertainty on the mean redshift in each of five tomographic bins for an idealized simulation of the DES Year 3 weak-lensing tomographic analysis of $\sigma_{\Delta z} = 0.007$, which is a 60% improvement compared to the Year 1 analysis. Although the implementation of the method is tailored to DES, its formalism can be applied to other large photometric surveys with a similar observing strategy.Comment: 24 pages, 11 figures; matches version accepted to MNRA

Spatial heterogeneity of habitat suitability for Rift Valley fever occurrence in Tanzania: an ecological niche modelling approach

Despite the long history of Rift Valley fever (RVF) in Tanzania, extent of its suitable habitat in the country remains unclear. In this study we investigated potential effects of temperature, precipitation, elevation, soil type, livestock density, rainfall pattern, proximity to wild animals, protected areas and forest on the habitat suitability for RVF occurrence in Tanzania. Presence-only records of 193 RVF outbreak locations from 1930 to 2007 together with potential predictor variables were used to model and map the suitable habitats for RVF occurrence using ecological niche modelling. Ground-truthing of the model outputs was conducted by comparing the levels of RVF virus specific antibodies in cattle, sheep and goats sampled from locations in Tanzania that presented different predicted habitat suitability values. Habitat suitability values for RVF occurrence were higher in the northern and central-eastern regions of Tanzania than the rest of the regions in the country. Soil type and precipitation of the wettest quarter contributed equally to habitat suitability (32.4% each), followed by livestock density (25.9%) and rainfall pattern (9.3%). Ground-truthing of model outputs revealed that the odds of an animal being seropositive for RVFV when sampled from areas predicted to be most suitable for RVF occurrence were twice the odds of an animal sampled from areas least suitable for RVF occurrence (95% CI: 1.43, 2.76, p < 0.001). The regions in the northern and central-eastern Tanzania were more suitable for RVF occurrence than the rest of the regions in the country. The modelled suitable habitat is characterised by impermeable soils, moderate precipitation in the wettest quarter, high livestock density and a bimodal rainfall pattern. The findings of this study should provide guidance for the design of appropriate RVF surveillance, prevention and control strategies which target areas with these characteristics

The Impact of Changing Medicaid Enrollments on New Mexico's Immunization Program

Background: Immunizations are an important component to pediatric primary care. New Mexico is a relatively poor and rural state which has sometimes struggled to achieve and maintain its childhood immunization rates. We evaluated New Mexico’s immunization rates between 1996 and 2006. Specifically, we examined the increase in immunization rates between 2002 and 2004, and how this increase may have been associated with Medicaid enrollment levels, as opposed to changes in government policies concerning immunization practices. Methods and Findings: This study examines trends in childhood immunization coverage rates relative to Medicaid enrollment among those receiving Temporary Assistance for Needy Families (TANF) in New Mexico. Information on health policy changes and immunization coverage was obtained from state governmental sources and the National Immunization Survey. We found statistically significant correlations varying from 0.86 to 0.93 between immunization rates and Medicaid enrollment. Conclusions: New Mexico’s improvement and subsequent deterioration in immunization rates corresponded with changing Medicaid coverage, rather than the state’s efforts to change immunization practices. Maintaining high Medicaid enrollmen

Restricted by borders: trade-offs in transboundary conservation planning for large river systems

Effective conservation of freshwater biodiversity requires accounting for connectivity and the propagation of threats along river networks. With this in mind, the selection of areas to conserve freshwater biodiversity is challenging when rivers cross multiple jurisdictional boundaries. We used systematic conservation planning to identify priority conservation areas for freshwater fish conservation in Hungary (Central Europe). We evaluated the importance of transboundary rivers to achieve conservation goals by systematically deleting some rivers from the prioritization procedure in Marxan and assessing the trade-offs between complexity of conservation recommendations (e.g., conservation areas located exclusively within Hungary vs. transboundary) and cost (area required). We found that including the segments of the largest transboundary rivers (i.e. Danube, Tisza) in the area selection procedure yielded smaller total area compared with the scenarios which considered only smaller national and transboundary rivers. However, analyses which did not consider these large river segments still showed that fish diversity in Hungary can be effectively protected within the country’s borders in a relatively small total area (less than 20 % of the country’s size). Since the protection of large river segments is an unfeasible task, we suggest that transboundary cooperation should focus on the protection of highland riverine habitats (especially Dráva and Ipoly Rivers) and their valuable fish fauna, in addition to the protection of smaller national rivers and streams. Our approach highlights the necessity of examining different options for selecting priority areas for conservation in countries where transboundary river systems form the major part of water resources.Full Tex

Gene Activation Using FLP Recombinase in C. elegans

The FLP enzyme catalyzes recombination between specific target sequences in DNA. Here we use FLP to temporally and spatially control gene expression in the nematode C. elegans. Transcription is blocked by the presence of an “off cassette” between the promoter and the coding region of the desired product. The “off cassette” is composed of a transcriptional terminator flanked by FLP recognition targets (FRT). This sequence can be excised by FLP recombinase to bring together the promoter and the coding region. We have introduced two fluorescent reporters into the system: a red reporter for promoter activity prior to FLP expression and a green reporter for expression of the gene of interest after FLP expression. The constructs are designed using the multisite Gateway system, so that promoters and coding regions can be quickly mixed and matched. We demonstrate that heat-shock-driven FLP recombinase adds temporal control on top of tissue specific expression provided by the transgene promoter. In addition, the temporal switch is permanent, rather than acute, as is usually the case for heat-shock driven transgenes. Finally, FLP expression can be driven by a tissue specific promoter to provide expression in a subset of cells that can only be addressed as the intersection of two available promoters. As a test of the system, we have driven the light chain of tetanus toxin, a protease that cleaves the synaptic vesicle protein synaptobrevin. We show that we can use this to inactivate synaptic transmission in all neurons or a subset of neurons in a FLP-dependent manner

On the relative bias of void tracers in the Dark Energy Survey

Luminous tracers of large-scale structure are not entirely representative of the distribution of mass in our Universe. As they arise from the highest peaks in the matter density field, the spatial distribution of luminous objects is biased towards those peaks. On large scales, where density fluctuations are mild, this bias simply amounts to a constant offset in the clustering amplitude of the tracer, known as linear bias. In this work we focus on the relative bias between galaxies and galaxy clusters that are located inside and in the vicinity of cosmic voids, extended regions of relatively low density in the large-scale structure of the Universe. With the help of mock data we verify that the relation between galaxy and cluster overdensity around voids remains linear. Hence, the void-centric density profiles of different tracers can be linked by a single multiplicative constant. This amounts to the same value as the relative linear bias between tracers for the largest voids in the sample. For voids of small sizes, which typically arise in higher density regions, this constant has a higher value, possibly showing an environmental dependence similar to that observed for the linear bias itself. We confirm our findings by analysing data obtained during the first year of observations by the Dark Energy Survey. As a side product, we present the first catalogue of three-dimensional voids extracted from a photometric survey with a controlled photo-z uncertainty. Our results will be relevant in forthcoming analyses that attempt to use voids as cosmological probes