Tuberculin Testing In African Children

A CAJM article on tuberculosis testing among Zimbabwean black African children.In African countries tuberculosis remains one of the major health problems. Tuberculin testing is widely used as a screening test for its detection and B.C.G. vaccination is one of the means for its control. The present investigation was undertaken in order to determine in one area of Rhodesia the extent of B.C.G. vaccination, and also toy means of the Heaf Test to compare tuberculosis in the vaccinated and the un-vaccinated and the degree to which tuberculin sensitivity as measured by this test and in this particular population is modified by malnutrition

Local Production of Pharmaceuticals in Africa and Access to Essential Medicines: 'Urban bias' in Access to Imported Medicines in Tanzania and its Policy Implications.

\ud International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap. This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing. Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias': that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector. The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other.\u

'The stories we tell ourselves to make ourselves come true': feminist rewriting in the Canongate Myths Series

In 2005, Canongate, an Edinburgh-based publisher, launched the first volumes in the Canongate Myths series, a project which commissioned renowned authors to retell ancient mythologies for contemporary audiences. Securing novellas from authors including Su Tong, Philip Pullman, A.S. Byatt and thirteen others, the project explores what is understood by myth today and how mythology remains relevant for a twenty-first century audience. It also asked female writers to engage directly with ancient mythologies which have perpetuated misogynistic narratives for millennia, encouraging those writers to self-consciously consider representations of gender contained within their selected source myths. This thesis uses the female-authored Greco-Roman mythologies in the series, from Margaret Atwood, Jeanette Winterson, Ali Smith and Salley Vickers, as a unique corpus in which to locate arguments regarding the efficacy and effect of a ‘feminist’ approach to rewriting mythology. Critical opinion has been split regarding whether a ‘feminist rewriting’ is, in fact, attainable, with some detractors asserting that any revision necessarily replicates the language and structure of the original. Yet by looking at the individual retellings and at the project as a whole, this project will argue that when viewed as a collaborative, ongoing process, engagements with ancient mythologies may in time yield results which are beneficial for representations of femininity and may, in turn, help to destabilise the masculinised model of the subject. The thesis contends that mythology can act as a framework through which female authors can evaluate the gendered implications of the personal, public and meta aspects of mythmaking and storytelling more generally, by considering the time and context-bound production of both the source myths - from Homer to Ovid, Sophocles to Freud - as well as the revisions themselves. The Canongate Myths series also serves as a distinct source for considering the character of rewriting within a post-postmodern literary landscape. With all four texts indicating a preoccupation with questions of ‘truth’, ‘reality’, and ‘authenticity’, the Myths series contributes to ongoing critical discussions regarding the shifting critical climate of twenty-first century literature. In particular, the texts selected from the series suggest an ongoing relationship with modernism and its engagements with mythology; the thesis helps to advance current discussions pertaining to contemporary literature’s relationship with its modernist past. These references, and each myth’s presentation of a distinct theoretical perspective, indicates that despite Lyotard’s assertions, we have not yet seen the death of all metanarratives. These self-consciously constructed novellas show that questions around metanarratives of patriarchy and mythology are ongoing and that feminist rewriting continues to have a relevant role to play in their dismantling or recalibration

Raw and Count Data Comparability of Hip-Worn ActiGraph GT3X+ and Link Accelerometers

To enable inter- and intrastudy comparisons it is important to ascertain comparability among accelerometer models. Purpose: The purpose of this study was to compare raw and count data between hip-worn ActiGraph GT3X+ and GT9X Link accelerometers. Methods: Adults (n = 26 (n = 15 women); age, 49.1 T 20.0 yr) wore GT3X+ and Link accelerometers over the right hip for an 80-min protocol involving 12–21 sedentary, household, and ambulatory/exercise activities lasting 2–15 min each. For each accelerometer, mean and variance of the raw (60 Hz) data for each axis and vector magnitude (VM) were extracted in 30-s epochs. A machine learning model (Montoye 2015) was used to predict energy expenditure in METs from the raw data. Raw data were also processed into activity counts in 30-s epochs for each axis and VM, with Freedson 1998 and 2011 count-based regression models used to predictMETs. Time spent in sedentary, light, moderate, and vigorous intensities was derived from predicted METs from each model. Correlations were calculated to compare raw and count data between accelerometers, and percent agreement was used to compare epoch-by-epoch activity intensity. Results: For raw data, correlations for mean acceleration were 0.96 T 0.05, 0.89 T 0.16, 0.71 T 0.33, and 0.80 T 0.28, and those for variance were 0.98 T 0.02, 0.98 T 0.03, 0.91 T 0.06, and 1.00 T 0.00 in the X, Y, and Z axes and VM, respectively. For count data, corresponding correlations were 1.00 T 0.01, 0.98 T 0.02, 0.96 T 0.04, and 1.00 T 0.00, respectively. Freedson 1998 and 2011 count-based models had significantly higher percent agreement for activity intensity (95.1% T 5.6% and 95.5% T 4.0%) compared with theMontoye 2015 raw data model (61.5% T 27.6%; P G 0.001). Conclusions: Count data were more highly comparable than raw data between accelerometers. Data filtering and/or more robust raw data models are needed to improve raw data comparability between ActiGraph GT3X+ and Link accelerometers

Cognitive bias modification for social anxiety in adults who stutter: a feasibility study of a randomised controlled trial

Objective: To determine the feasibility and acceptability of a computerised treatment for social anxiety disorder for adults who stutter including identification of recruitment, retention and completion rates, large cost drivers and selection of most appropriate outcome measure(s) to inform the design of a future definitive trial. Design: Two-group parallel design (treatment vs placebo), double-blinded feasibility study. Participants: 31 adults who stutter. Intervention: Attention training via an online probe detection task in which the stimuli were images of faces displaying neutral and disgusted expressions. Main outcome measures Psychological measures: Structured Clinical Interview Global Assessment of Functioning score; Liebowitz Social Anxiety Scale; Social Phobia and Anxiety Inventory; State-Trait Anxiety Inventory; Unhelpful Thoughts and Beliefs about Stuttering. Speech fluency: percent syllables stuttered. Economic evaluation: resource use questionnaire; EuroQol three-dimension questionnaire. Acceptability: Likert Scale questionnaire of experience of trial, acceptability of the intervention and randomisation procedure. Results: Feasibility of recruitment strategy was demonstrated. Participant feedback indicated that the intervention and definitive trial, including randomisation, would be acceptable to adults who stutter. Of the 31 participants who were randomised, 25 provided data at all three data collection points. Conclusions: The feasibility study informed components of the intervention. Modifications to the design are needed before a definitive trial can be undertaken. Trial registration number I SRCTN55065978

A Consensus Method for Estimating Physical Activity Levels in Adults Using Accelerometry

Identifying the best analytical approach for capturing moderate-to-vigorous physical activity (MVPA) using accelerometry is complex but inconsistent approaches employed in research and surveillance limits comparability. We illustrate the use of a consensus method that pools estimates from multiple approaches for characterising MVPA using accelerometry. Participants (n = 30) wore an accelerometer on their right hip during two laboratory visits. Ten individual classification methods estimated minutes of MVPA, including cut-point, two-regression, and machine learning approaches, using open-source count and raw inputs and several epoch lengths. Results were averaged to derive the consensus estimate. Mean MVPA ranged from 33.9–50.4 min across individual methods, but only one (38.9 min) was statistically equivalent to the criterion of direct observation (38.2 min). The consensus estimate (39.2 min) was equivalent to the criterion (even after removal of the one individual method that was equivalent to the criterion), had a smaller mean absolute error (4.2 min) compared to individual methods (4.9–12.3 min), and enabled the estimation of participant-level variance (mean standard deviation: 7.7 min). The consensus method allows for addition/removal of methods depending on data availability or field progression and may improve accuracy and comparability of device-based MVPA estimates while limiting variability due to convergence between estimate

Gratitude, resignation and the desire for dignity: lived experience of food charity recipients and their recommendations for improvement, Perth, Western Australia

ObjectiveThe present study explored recipients’ perceptions of food charity and their suggested improvements in inner-city Perth, Western Australia.DesignIn-depth interviews were conducted with charitable food service (CFS) recipients. Transcripts were thematically analysed using a phenomenological approach.SettingInterviews were conducted at two CFS in inner-city Perth.SubjectsFourteen adults.ResultsThe recipients’ journeys to a reliance on CFS were varied and multifactorial, with poverty, medical issues and homelessness common. The length of time recipients had relied on food charity ranged from 8 months to over 40 years. Most were ‘grateful yet resigned’, appreciative of any food and resigned to the poor quality, monotony and their unmet individual preferences. They wanted healthier food, more variety and better quality. Accessing services was described as a ‘full-time job’ fraught with unreliable information and transport difficulties. They called for improved information and assistance with transport. ‘Eroded dignity’ resulted from being fed without any choice and queuing for food in public places, often in a volatile environment. ‘Food memories and inclusion’ reflected a desire for commensality. Recipients suggested services offer choice and promote independence, focusing on their needs both physical and social.ConclusionsAlthough grateful, long-term CFS recipients described what constitutes a voluntary failure. Their service improvement recommendations can help meet their nutritional and social needs. A successful CFS provides a food service that prioritises nutritious, good-quality food and individual need, while promoting dignity and social inclusion, challenging in the current Australian context

Border crossings in the African travel narratives of Ibn Battuta, Richard Burton and Paul Theroux

This article compares the representation of African borders in the 14th-century travelogue of Ibn Battuta, the 19th-century travel narrative of Richard Burton and the 21st-century travel writing of Paul Theroux. It examines the mutually constitutive relationship between conceptions of literal territorial boundaries and the figurative boundaries of the subject that ventures across borders in Africa. The border is seen as a liminal zone which paradoxically separates and joins spaces. Accounts of border crossings in travel writing from different periods suggest the historicity and cultural specificity of conceptions of geographical borders, and the way they index the “boundaries” of the subjects who cross them. Tracing the transformations in these conceptions of literal and metaphorical borders allows one to chart the emergence of the dominant contemporary idea of “Africa” as the inscrutable, savage continent

The Effects of Hydrogen Peroxide on the Circadian Rhythms of Microcystis aeruginosa

Background: The cyanobacterium Microcystis aeruginosa is one of the principal bloom-forming cyanobacteria present in a wide range of freshwater ecosystems. M. aeruginosa produces cyanotoxins, which can harm human and animal health. Many metabolic pathways in M. aeruginosa, including photosynthesis and microcystin synthesis, are controlled by its circadian rhythms. However, whether xenobiotics affect the cyanobacterial circadian system and change its growth, physiology and biochemistry is unknown. We used real-time PCR to study the effect of hydrogen peroxide (H2O2) on the expression of clock genes and some circadian genes in M. aeruginosa during the light/dark (LD) cycle. Results: The results revealed that H 2O 2 changes the expression patterns of clock genes (kaiA, kaiB, kaiC and sasA) and significantly decreases the transcript levels of kaiB, kaiC and sasA. H2O2 treatment also decreased the transcription of circadian genes, such as photosynthesis-related genes (psaB, psbD1 and rbcL) and microcystin-related genes (mcyA, mcyD and mcyH), and changed their circadian expression patterns. Moreover, the physiological functions of M. aeruginosa, including its growth and microcystin synthesis, were greatly influenced by H 2O 2 treatment during LD. These results indicate that changes in the cyanobacterial circadian system can affect its physiological and metabolic pathways. Conclusion: Our findings show that a xenobiotic can change the circadian expression patterns of its clock genes t