A Socio-Spatial Survey of Water Issues in Makondo Parish, Uganda

This report details some of the key findings of a sociological survey that was undertaken in rural Makondo Parish, Lwengo District in Uganda. The cross-sectional survey was carried out between September and November 2011 and covered all the 15 villages in the Parish. The broad aim of the survey was to assess the livelihoods, health, gender and water governance issues in Makondo Parish. Prior to the survey, several preliminary visits were made to the study area, which were then followed by a rigorous literature review on rural water governance, health and livelihoods in Uganda and globally so as to identify the major themes and variables. These themes were then used to develop a quantitative or structured questionnaire. The questionnaire was structured under the following headings: household and interviewer identification; respondents’ characteristics; household livelihoods and well-being, particularly poverty indicators like main source of income, money earned, dwelling type, and number of meals eaten; knowledge of the importance of safe water; access to safe water, such as type of water sources used, access to improved water sources, transportation of water; health issues like water-related diseases suffered, cost to the household of these diseases, steps taken to mitigate against the diseases; knowledge of hand-pump functionality; household water use and management, such as satisfaction with use, conflicts if any and decision-making on use; perceptions of safe water services and systems such as rating of safe water service delivery and why; knowledge of community-based water management systems and capacity building for sustainable utilisation of safe water. The final version was translated into Luganda, the local vernacular so as not to distort the meaning of the questions. This exercise was carried out by the Makerere University Institute of Languages, and the Luganda version was then used to train the Community Health Workers on how to administer and record standardised interviews, such as mastering the intended meaning of each and every question in the questionnaire, the expected data, recording and editing among others. The CHWs were also trained on how to use a GPS (Global Positioning System) unit so as to capture the necessary data for mapping the household locations. After training the CHWs, the questionnaire was piloted in one of the villages in a neighbouring Parish (called Nanywa) and again revised. The actual field work or data collection started with Misaana village in the North-Eastern part of Makondo Parish, then moved on to Luyiiyi-Kate, Luyiiyi-Protazio and ended with Kiguluka, the last village in the Parish on 14th November 2011. It took between three to four days on average to complete the survey in each village, and the first day of work in each village involved meeting the Village Chairpersons, explaining to then about the WIL Project, objectives of the survey and seeking their support in locating selected households for interviews. After every two-three days of data collection, meetings were held with the interviewers/CHWs to share fieldwork experiences as well as edit field questionnaires. A total of six hundred and six (606) households selected proportionately across the 15 villages in Makondo Parish were covered in the survey. Despite several challenges that were met during the survey, such as failure by interviewers/CHWs to complete their assigned households in time; heavy rains that made driving on the village roads quite difficult especially in Kiteredde, Kiyumbakimu and Kiguluka villages, the survey was a success and data collection ended quite successfully, as the originally targeted sample was attained

A review of potential techniques to reduce the environmental impact of demersal trawls

Concern over the possible effects of trawls on the seabed has existed almost as long as the fishing method itself, with early concerns being voiced by fishermen themselves as far back as the 14th century. With the advance in technological developments of trawling gears (i.e. weight and size), particularly over the latter part of this century, the increase in the number of fishing vessels, engine power etc., these concerns are increasingly gaining international public and political importance. This review is divided into two sections. Section 1 gives an overview of the physical and biological effects of bottom trawling and section 2 gives an overview of potential gear modifications.Funder: Marine Institut

The clinical impact of Lumacaftor-Ivacaftor on structural lung disease and lung function in children aged 6-11 with cystic fibrosis in a real-world setting

BACKGROUND: Data from clinical trials of lumacaftor-ivacaftor (LUM-IVA) demonstrate improvements in lung clearance index (LCI) but not in FEV1 in children with Cystic Fibrosis (CF) aged 6-11 years and homozygous for the Phe508del mutation. It is not known whether LUM/IVA use in children can impact the progression of structural lung disease. We sought to determine the real-world impact of LUM/IVA on lung structure and function in children aged 6-11 years. METHODS: This real-world observational cohort study was conducted across four paediatric sites in Ireland over 24-months using spirometry-controlled CT scores and LCI as primary outcome measures. Children commencing LUM-/IVA as part of routine care were included. CT scans were manually scored with the PRAGMA CF scoring system and analysed using the automated bronchus-artery (BA) method. Secondary outcome measures included rate of change of ppFEV1, nutritional indices and exacerbations requiring hospitalisation. RESULTS: Seventy-one participants were recruited to the study, 31 of whom had spirometry-controlled CT performed at baseline, and after one year and two years of LUM/IVA treatment. At two years there was a reduction from baseline in trapped air scores (0.13 to 0.07, p = 0.016), but an increase from baseline in the % bronchiectasis score (0.84 to 1.23, p = 0.007). There was no change in overall % disease score (2.78 to 2.25, p = 0.138). Airway lumen to pulmonary artery ratios (AlumenA ratio) were abnormal at baseline and worsened over the course of the study. In 28 participants, the mean annual change from baseline LCI2.5 (-0.055 (-0.61 to 0.50), p = 0.85) measurements over two years were not significant. Improvements from baseline in weight (0.10 (0.06 to 0.15, p < 0.0001), height (0.05 (0.02 to 0.09), p = 0.002) and BMI (0.09 (0.03 to 0.15) p = 0.005) z-scores were seen with LUM/IVA treatment. The mean annual change from baseline ppFEV1 (-2.45 (-4.44 to 2.54), p = 0.66) measurements over two years were not significant. CONCLUSION: In a real-world setting, the use of LUM/IVA over two years in children with CF aged 6-11 resulted in improvements in air trapping on CT but worsening in bronchiectasis scores. Our results suggest that LUM/IVA use in this age group improves air trapping but does not prevent progression of bronchiectasis over two years of treatment

L-Carnitine and extendin-4 improve outcomes following moderate brain contusion injury

© 2018, The Author(s). There is a need for pharmaceutical agents that can reduce neuronal loss and improve functional deficits following traumatic brain injury (TBI). Previous research suggests that oxidative stress and mitochondrial dysfunction play a major role in neuronal damage after TBI. Therefore, this study aimed to investigate two drugs known to have antioxidant effects, L-carnitine and exendin-4, in rats with moderate contusive TBI. L-carnitine (1.5 mM in drinking water) or exendin-4 (15 µg/kg/day, ip) were given immediately after the injury for 2 weeks. Neurological function and brain histology were examined (24 h and 6 weeks post injury). The rats with TBI showed slight sensory, motor and memory functional deficits at 24 h, but recovered by 6 weeks. Both treatments improved sensory and motor functions at 24 h, while only exendin-4 improved memory. Both treatments reduced cortical contusion at 24 h and 6 weeks, however neither affected gliosis and inflammatory cell activation. Oxidative stress was alleviated and mitochondrial reactive oxygen species was reduced by both treatments, however only mitochondrial functional marker protein transporter translocase of outer membrane 20 was increased at 24 h post injury. In conclusion, L-carnitine and exendin-4 treatments immediately after TBI can improve neurological functional outcome and tissue integrity by reducing oxidative stress

Irish SARS-CoV-2 convalescent serological status of children following acute pneumonia during Ireland’s first wave

A global epidemic caused by a novel coronavirus (SARS-CoV-2) in China in December 2019 has spread worldwide¹. We hypothesised that due to low levels of viral shedding in children's upper airways, many children with COVID-19 related respiratory illness admitted to the hospital might be negative on nasopharyngeal PCR testing. Evidence suggests that SARS-CoV-2 antibodies can be detected typically 9-14 days after onset of symptoms but may take up to 3 months2. Therefore, convalescent serological evidence of SARS-CoV-2, as an alternative means to determine the rate of COVID-19 infection, was assessed

Tomosynthesis in pulmonary cystic fibrosis with comparison to radiography and computed tomography: a pictorial review

The purpose of this pictorial review is to illustrate chest imaging findings of cystic fibrosis (CF) using tomosynthesis (digital tomography), in comparison to radiography and computed tomography (CT). CF is a chronic systemic disease where imaging has long been used for monitoring chest status. CT exposes the patient to a substantially higher radiation dose than radiography, rendering it unsuitable for the often needed repeated examinations of these patients. Tomosynthesis has recently appeared as an interesting low dose alternative to CT, with an effective dose of approximately 0.08 mSv for children and 0.12 mSv for adults. Tomosynthesis is performed on the same X-ray system as radiography, adding only about 1 min to the normal examination time. Typical pulmonary changes in CF such as mucus plugging, bronchial wall thickening, and bronchiectases are shown in significantly better detail with tomosynthesis than with traditional radiography. In addition, the cost for a tomosynthesis examination is low compared to CT. To reduce the radiation burden of patients with CF it is important to consider low dose alternatives to CT, especially in the paediatric population. Tomosynthesis has a lower radiation dose than CT and gives a superior visualisation of pulmonary CF changes compared to radiography. It is important to further determine the role of tomosynthesis for monitoring disease progression in CF