Cost-effectiveness of community-based screening and treatment of moderate acute malnutrition in Mali.

IntroductionModerate acute malnutrition (MAM) causes substantial child morbidity and mortality, accounting for 4.4% of deaths and 6.0% of disability-adjusted life years (DALY) lost among children under 5 each year. There is growing consensus on the need to provide appropriate treatment of MAM, both to reduce associated morbidity and mortality and to halt its progression to severe acute malnutrition. We estimated health outcomes, costs and cost-effectiveness of four dietary supplements for MAM treatment in children 6-35 months of age in Mali.MethodsWe conducted a cluster-randomised MAM treatment trial to describe nutritional outcomes of four dietary supplements for the management of MAM: ready-to-use supplementary foods (RUSF; PlumpySup); a specially formulated corn-soy blend (CSB) containing dehulled soybean flour, maize flour, dried skimmed milk, soy oil and a micronutrient pre-mix (CSB++; Super Cereal Plus); Misola, a locally produced, micronutrient-fortified, cereal-legume blend (MI); and locally milled flour (LMF), a mixture of millet, beans, oil and sugar, with a separate micronutrient powder. We used a decision tree model to estimate long-term outcomes and calculated incremental cost-effectiveness ratios (ICERs) comparing the health and economic outcomes of each strategy.ResultsCompared to no MAM treatment, MAM treatment with RUSF, CSB++, MI and LMF reduced the risk of death by 15.4%, 12.7%, 11.9% and 10.3%, respectively. The ICER was US$9821 per death averted (2015 USD) and US$347 per DALY averted for RUSF compared with no MAM treatment.ConclusionMAM treatment with RUSF is cost-effective across a wide range of willingness-to-pay thresholds.Trial registrationNCT01015950

Photometric Observations of the Eta Carinae 2009.0 Spectroscopic Event

We have observed Eta Carinae over 34 nights between 4th January 2009 and 27th March 2009 covering the estimated timeframe for a predicted spectroscopic event related to a suspected binary system concealed within the homunculus nebula. A photometric minimum feature was confirmed to be periodic and comparison to a previous event indicated that the period to within our error at 2022.6 +/-1.0 d. Using the E-region standard star system, the apparent V magnitudes determined for the local comparison stars were HD303308 8.14+/-0.02, HD 93205 7.77 +/-0.03 and HD93162 8.22 +/-0.05. The latter star was found to be dimmer than previously reported.Comment: 5 pages,4 figures, 1 tabl

“I see my culture starting to disappear”: Anishinaabe perspectives on the socioecological impacts of climate change and future research needs

Climate change disproportionately affects Indigenous Peoples because of strong connections between environmental, cultural, and spiritual well-being. While much of the global discourse surrounding climate change is founded in Western science, the holistic, place-based knowledge of Indigenous Peoples offers a complementary way of understanding and mitigating climate change impacts. The goal of this research was to elevate Anishinaabe concerns, observations, and perspectives about climate change impacts and future research needs. We organized a workshop called “Connecting Guardians in a Changing World” where participants shared concerns about animal and plant life cycles, water cycles and water quality, and impacts to ways of life, including reduced capacity to perform cultural practices and erosion of their knowledge. Participants highlighted the challenge of prioritizing a single impact of climate change, emphasizing that impacts to the environment and ways of life are interconnected. Participants also expressed the need for research and policy that move beyond interdisciplinarity to include intercultural philosophy and research that better reflects Indigenous worldviews and incorporates Indigenous methodologies. Moving forward, meaningful partnerships and opportunities for knowledge sharing should be prioritized in climate change discourse to ensure solutions are generated together, with all of the tools and knowledge available

{BOAO Photometric Survey of Galactic Open Clusters. II. Physical Parameters of 12 Open Clusters

We have initiated a long-term project, the BOAO photometric survey of open clusters, to enlarge our understanding of galactic structure using UBVI CCD photometry of open clusters which have been little studied before. This is the second paper of the project in which we present the photometry of 12 open clusters. We have determined the cluster parameters by fitting the Padova isochrones to the color-magnitude diagrams of the clusters. All the clusters except for Be 0 and NGC 1348 are found to be intermediate-age to old (0.2 - 4.0 Gyrs) open clusters with a mean metallicity of [Fe/H] = 0.0.Comment: 11 page

Autophagy regulates Notch degradation and modulates stem cell development and neurogenesis.

Autophagy is a conserved, intracellular, lysosomal degradation pathway. While mechanistic aspects of this pathway are increasingly well defined, it remains unclear how autophagy modulation impacts normal physiology. It is, however, becoming clear that autophagy may play a key role in regulating developmental pathways. Here we describe for the first time how autophagy impacts stem cell differentiation by degrading Notch1. We define a novel route whereby this plasma membrane-resident receptor is degraded by autophagy, via uptake into ATG16L1-positive autophagosome-precursor vesicles. We extend our findings using a physiologically relevant mouse model with a hypomorphic mutation in Atg16L1, a crucial autophagy gene, which shows developmental retention of early-stage cells in various tissues where the differentiation of stem cells is retarded and thus reveal how modest changes in autophagy can impact stem cell fate. This may have relevance for diverse disease conditions, like Alzheimer's Disease or Crohn's Disease, associated with altered autophagy.Friedrich-Ebert-Stiftung, NIH grants AI109725 and AI08488

Judgements of Solomon: anxieties and defences of social workers involved in care proceedings

Evidence from focus group discussions with social workers in child care and child protection was collected for a research project exploring decision-making in care proceedings and seeking a better understanding of the causes of delay in the process. Here this material is used to examine social workers’ feelings about their work and to explore the anxieties they expressed. Isabel Menzies’s work on containing anxiety in institutions is used to provide a conceptual framework for thinking about the ways in which individuals’ unconscious defences against anxiety may affect the structure, policies and practices of the organization in which they work. It is suggested that this dimension needs to be taken into account in understanding difficulties which arise in putting policy into practice