The impact and cost-effectiveness of the Amref Health Africa-Smile Train Cleft Lip and Palate Surgical Repair Programme in Eastern and Central Africa

Introduction: Cleft lip with or without cleft palate (CLP) is a congenital malformation that causes significant morbidity in low and middle income countries. Amref Health Africa has partnered with Smile Train to provide CLP surgeries since 2006. Methods: We analyzed anonymized data of 37,274 CLP patients from the Smile Train database operated on in eastern and central Africa between 2006 and 2014. Cases were analyzed by age, gender, country and surgery type. The impact of cleft surgery was determined by measuring averted Disability-Adjusted Life Years (DALYs) and delayed averted DALYs. We used mean Smile Train costs to calculate cost-effectiveness. We calculated economic benefit using the human capital approach and Value of Statistical Life (VSL) methods. Results: The median age at time of primary surgery was 5.4 years. A total of 207,879 DALYs were averted at a total estimated cost of US$13 million. Mean averted DALYs per patient were 5.6, and mean cost per averted DALY was$62.8. Total delayed burden of disease from late age at surgery was 36,352 DALYs. Surgical correction resulted in $292 million in economic gain using the human capital approach and$2.4 billion using VSL methods. Conclusion: Cleft surgery is a cost-effective intervention to reduce disability and increase economic productivity in eastern and central Africa. Dedicated programs that provide essential CLP surgery can produce substantial clinical and economic benefits.Key words: Burden of disease, cleft lip and palate, reconstructive surgery,   cost-effectiveness, economic benefit, cost-benefi

Traditional Music as a Sustainable Social Technology for Community Health Promotion in Africa: “Singing and Dancing for Health” in Rura Northern Ghana

Music is a social technology of enormous potential for improving communityhealth. This paper reports on a series of applied ethnomusicological interventions, enacted as a participatory action research project in northern Ghana, for health promotion. Initial interventions, performed by local professional urban artists, proved effective. But as they were not sustainable, we followed up by training village-based amateur youth groups, rooted in the local community, to perform a similar repertoire. These methods can be transposed to other societies maintaining participatory musical traditions, leading to improved community health whenever behavior is a primary determinant, as is so often the case (WHO 2002)

An Interactive Traction Motors Design and Selection Software

Use of electric motors in vehicle traction, in fact, predates the internal combustion engines (ICEs). Electric vehicles powered by dc motors were known as far back as 1890. Compared with vehicles powered by ICEs, the main drawback of the early electric vehicles was, and still is, their limited range and long recharging time. To overcome this, in recent years, developments have been focused on hybrid electrical vehicles (HEVs) combining two sources of energy: an ICE of a conventional vehicle and an electric motor (or motors). Such a hybrid vehicle enables the driver (or the vehicle computerised energy management system) to decide which source of power is appropriate for a particular journey.Drive Trains for HEVs are of course more complex than both conventional ICEs and totally electric vehicles. Design of HEVs, therefore, encompasses several technologies and the vehicle designer cannot be expected to be an expert in all related fields. In particular, it is recognised that vehicle designers may not be familiar with electric drive systems. The work reported here aims to provide a design tool to enable decisions to be made on type and feasibility of traction motors to meet specific traction requirements.In the first part of the software described in this thesis normalized curves, giving theoretically available force density values for different cooling arrangements, are utilised, after adopting piecewise linear approximations, to provide the vehicle designer with a quick answer to whether or not drive requirements can be met within a specified space envelope. Once the requirements are deemed feasible, the user can progress to the second part of the programme in which detailed design work for a selected drive topology is carried out. Thereafter, the user can export drive details into a number of commercially available CAE packages to perform further investigations (e.g. dynamic performance). Due to time constraints, only induction motor systems are fully developed in the reported work. However, the design of the software allows for modules relating to conventional dc, reluctance and brushless dc drives to be added at a later stage

Antioxidant properties of leaves essential oil and hydroalcoholic extract Vitex pseudo-negundo

Background : Antioxidants are compounds that protect the body against damage caused by oxidative stress that induce by free radicals. The aim of present work is to compare the various antioxidative activities of leaves hydroalcholic extract and essential oil of Vitex pseudo-negundo. Materials and Methods: In this experimental study, leaves hydroalcholic extract and essential oil of Vitex pseudo-negundo were prepared and then radical scavenging activity of samples was assessed by using Diphenylpicrylhydrazyl (DPPH). Total antioxidant capacity samples was assessed by method of phosphomolybdat. The amount of total phenol and flavonoid samples was assessed by Folin-Ciocalteu and Zhishen methods Results: The results showed that total antioxidant capacity Leaves hydroalcholic extract and essential oil of Vitex pseudo-negundo is (1.76±0.25 2.12±0.60), phenol content (133.11±3.00 22.00±2.00), and flavonoid content (18.00±1.00 5.50±4.00). In the DPPH scavenging assay, the IC50 (the concentration required to scavenge 50% of radical) values of leaves hydroalcholic extract and essential oil and Butylated hydroxytoluene (BHT) as refernce were (224.75±4.52 133.00±3 3.88±1μg/ml), respectively. Conclusion: This study showed that Vitex pseudo-negundo extract is an source easily accessible of natural antioxidants and it may be suitable for use in food and pharmaceutical applications

Impact of different Eucalypt species on forest soil properties in Guilan province

The aim of this study was to investigate the positive or negative effects of eucalypt plantation on different soil properties. For this reason, an eucalypt trial consisting of six species: E. camaldulensis, E. macarthurii, E. maidenii, E. rubida, E. saligna, E. viminalis which were planted in 1983 in Sheikh-Neshin state of Shafarud Company in Guilan province under experimental design of Randomized Complete Blocks with four replications at 2×2 m spacing and total number of 100 seedlings at each plot, was used for this research. Soil samples were taken from each plot, including four control ones by auger up to 60 cm. depth (totally 28 samples). Soil morphology was studied by digging three soil profiles at the eucalypt site and two adjacent parcels, including poplar plantation and the oak forest. Soil samples were taken from four soil horizons of each profile (totally 12 samples). Results showed that the species have differed significantly in respect to only few soil properties, including silt percentage, litter dry weight, bulk density, penetration resistance, pH and phosphorous amount. The soil profiles at the eucalypt site and the two adjacent sites of poplar plantation and oak forest consisted of four horizons, including A, AC, B and C. Root development at eucalypt, poplar and oak sites limited to 100, 85 and 150 cm soil depth, respectively. Overall, eucalypt plantation was able to improve soil structure and porosity, particularly at topsoil. Although there was intensive livestock traffic in the eucalypt site, but soil compaction was significantly less than the control plots and there was not significant difference between the eucalypt species in response to penetration resistance. Eucalypt plantation after 22 years reduced soil pH, but it was less than one unit

Performing arts as a social technology for community health promotion in northern Ghana

Objective: We present first-phase results of a performing arts public health intervention, ‘Singing and Dancing for Health,’ aiming to promote healthier behaviors in Ghana’s impoverished Northern Region. We hypothesize that live music and dance drama provide a powerful technology to overcome barriers such as illiteracy, lack of adequate media access, inadequate health resources, and entrenched sociocultural attitudes. Our research objective is to evaluate this claim. Methods: In this first phase, we evaluated the effectiveness of arts interventions in improving knowledge and behaviors associated with reduced incidence of malaria and cholera, focusing on basic information and simple practices, such as proper hand washing. Working with the Youth Home Cultural Group, we codeveloped two ‘dance dramas’ delivering health messages through dialog, lyrics, and drama, using music and dance to attract spectators, focus attention, infuse emotion, and socialize impact. We also designed knowledge, attitude, and behavior surveys as measurement instruments. Using purposive sampling, we selected three contrasting test villages in the vicinity, contrasting in size and demographics. With cooperation of chiefs, elders, elected officials, and Ghana Health Service officers, we conducted a baseline survey in each village. Next, we performed the interventions, and subsequently conducted follow-up surveys. Using a more qualitative approach, we also tracked a select subgroup, conducted focus group studies, and collected testimonials. Surveys were coded and data were analyzed by Epi Info. Results: Both quantitative and qualitative methods indicated that those who attended the dance drama performances were likelier than those who did not attend to list the causal, preventive, and transmission factors of malaria and cholera. Also, the same attendees were likelier than nonattendees to list some activities they do to prevent malaria, cholera, and other sanitation-related diseases, proving that dance dramas were highly effective both in raising awareness and in transforming behaviors. Conclusions: As a result of this study, we suggest that where improvements in community health depend primarily on behavioral change, music and associated performing arts – dancing, singing, and drama – presented by a professional troupe offer a powerful social technology for bringing them about. This article is a status report on the results of the project so far. Future research will indicate whether local community–based groups are able to provide equal or better outcomes at lower cost, without outside support, thus providing the capacity for sustainable, localized health promotion

Introducing the most adapted exotic Poplar clones in Chaharmahal-Bakhtiari

This study was performed in order to find the superior poplar clones with high wood production in Research Station of Poplus and fast growing trees in Boldaji, Chaharmahal-Bakhtiari province. We first, selected 12 exotic clones from Populus euramericana andPopulus deltoides species. Then, the clones were planted in a completed randomized blocks design with 3 blocks and 9 replicates. The experiment started at 1999. Dbh, height and crown width of trees were measured within 8 years and total volume as well as dbh, height and volume increment of all clones were calculated. Results showed that the volume increment of clones Populus euramericana I-154, Populus euramericana costanzo, Populus euramericana I-214, Populus euramericana vernirubensis and Populus euramericana 262 were 13.2, 12.83, 12.54, 12.11 and 11.65 m³/h/year, respectively; which were significantly higher than other clones. As a result, these clones are introduced as the most promising clones in term of wood production. In compare to regions with longer growth seasons, the wood production by mentioned clones seems lower, however, it should be mentioned that this wood production has been achieved only within 5.5 months of growing season in Boldaji. It seems that using year scale for the age of poplar trees could be substitute by month scale

Targeting the adaptive immune system: new strategies in the treatment of atherosclerosis

Atherosclerosis is a lipid-driven chronic inflammatory disease of the arterial wall. Current treatment of atherosclerosis is focused on limiting its risk factors, such as hyperlipidemia or hypertension. However, treatments that target the inflammatory nature of atherosclerosis are still under development. Discovery of novel targets involved in the inflammation of the arterial wall creates opportunities to design new therapeutics that successfully modulate atherosclerosis. Here, we review drug targets that have proven to play pivotal roles in the adaptive immune system in atherosclerosis, and we discuss their potential as novel therapeutic