Developing a gender and mobility policy assessment tool: south africa as a pilot country

Meaningfully addressing women's mobility needs is essential for enhancing women’s access to transport options, access to economic opportunities and services, and boosting economic development in general in a country. Transportation must consider the views and needs of the 50% of the population that are women, whether these women are transport workers, transport users, or transport decision-makers. South Africa is no exception. Transport that is not fit for purpose matters for all residents, but it matters differently for women. In South Africa, lack of access to transport and mobility resources entrenches existing gender inequity and hinders women’s development. While inadequate access to health, restricted social engagement, and poor education, are among other outcomes of transport poverty experienced by both men and women, women already start at lower levels in all these poverty dimensions. This paper reports on a novel mobility gender policy and gap analysis and its first test application in South Africa, and includes an overview of the method, main findings, and recommended actions. To ensure replicability outside the pilot country, the assessment relies mostly on desk research, including existing literature and online data and information, complemented by stakeholder engagement. The assessment was developed at the request of the Sustainable Mobility for All (SuM4All) partnership, with financial support from the World Bank Group and Michelin Corporate Foundation. This work informs a broader sustainable mobility diagnostic being carried out in South Africa by the World Bank, at the request of the Development Bank of Southern Africa (DBSA).Papers presented at the 40th International Southern African Transport Conference on 04 -08 July 202

Outcomes in endoscopic sinus surgery: olfaction, nose scale and quality of life in a prospective cohort study

OBJECTIVES: To determine the efficacy of endoscopic sinus surgery (ESS) on olfactory function in chronic rhinosinusitis patients with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP) and to compare the nasal obstruction and symptom evaluation (NOSE) scale before and after surgery. DESIGN: A prospective cohort study. SETTING: Royal National Throat and Nose and Ear Hospital, London UK. PARTICIPANTS: One hundred and thirteen patients with CRS; 60 CRSwNP and 53 CRSsNP. OUTCOME ASSESSMENTS: Olfaction was measured using both the University of Pennsylvania Smell Investigation Test (UPSIT) and the ‘sense of smell’ visual analogue scale (VAS). The NOSE scale, the sinonasal outcome test (SNOT 22) and the Lund–Kennedy (LK) surgeon reported scores were also measured pre- and postoperatively at 6 months. RESULTS: The UPSIT psychophysical measurement significantly improved following ESS in the CRSwNP subgroup as did the patients perceived VAS sense of smell. However, in the CRSsNP subgroup, the improved VAS and UPSIT measurements were not significant. The NOSE, SNOT 22 and LK scores all improved significantly. The olfactory improvement as measured by the UPSIT correlated to the SNOT-22, but a correlation between the NOSE score and UPSIT was not found. CONCLUSIONS: Endoscopic sinus surgery significantly improved the patient's perceived and measured sense of smell in the CRSwNP subgroup which is the most surgically responsive CRS subgroup. Additionally, improved olfaction in the CRSwNP subgroup is most likely to improve the patient's quality of life. Endoscopic sinus surgery significantly improved the NOSE scale in both CRS subgroups at 6 months following surgery

Economic evaluation of nutrition-sensitive agricultural interventions to increase maternal and child dietary diversity and nutritional status in rural Odisha, India

BACKGROUND: Economic evaluations of nutrition-sensitive agriculture (NSA) interventions are scarce, limiting assessment of their potential affordability and scalability. OBJECTIVE: We conducted cost-consequence analyses of three participatory video-based interventions of fortnightly women's group meetings using: 1) NSA videos; 2) NSA and nutrition-specific videos; or 3) NSA videos with a nutrition-specific Participatory Learning and Action (PLA) cycle. METHODS: Interventions were tested in a 32-month, four-arm cluster-randomized controlled trial, UPAVAN, in Keonjhar district, Odisha, India. Impacts were evaluated in children aged 0-23 months and their mothers. We estimated program costs using data collected prospectively from expenditure records of implementing and technical partners, and societal costs using expenditure assessment of households with a child aged 0-23 months and key informant interviews. Costs were adjusted for inflation, discounted, and converted to 2019 US${\$}$. RESULTS: Total program costs of each intervention ranged from US${\$}$272,121 to US${\$}$386,907. Program costs per pregnant woman or mother of a child aged 0-23 months were US${\$}$62 for NSA videos, US${\$}$84 for NSA and nutrition-specific videos, and US${\$}$78 for NSA videos with PLA (societal costs: US${\$}$125, US${\$}$143, and US${\$}$122 respectively). Substantial shares of total costs constituted developing and delivering the videos and PLA (52-69%) and quality assurance (25-41%). Relative to control, children's minimum dietary diversity was higher in the intervention incorporating nutrition-specific videos (adjusted relative risk [95% CI] 1.19 [1.03, 1.37]) and PLA (1.27 [1.11, 1.46]). Relative to control, mothers' minimum dietary diversity was higher in NSA video (1.21 [1.01, 1.45]), and NSA with PLA (1.30 [1.10, 1.53]) interventions. CONCLUSION: NSA videos with PLA can increase both maternal and child dietary diversity and has the lowest cost per unit increase in diet diversity. Building on investments made in developing UPAVAN, cost-efficiency at scale could be increased with less intensive monitoring, reduced start-up costs, and integration within existing government programs.Trial registration: ISRCTN65922679

Olfactory function following open rhinoplasty: A 6-month follow-up study

<p>Abstract</p> <p>Background</p> <p>Patients undergoing any type of nasal surgery may experience degrees of postoperative olfactory dysfunction. We sought to investigate "when" the olfactory function recovers to its preoperative levels.</p> <p>Methods</p> <p>In this cohort design, 40 of 65 esthetic open rhinoplasty candidates with equal gender distribution, who met the inclusion criteria, were assessed for their olfactory function using the Smell Identification Test (SIT) with 40 familiar odors in sniffing bottles. All the patients were evaluated for the SIT scores preoperatively and postoperatively (at week 1, week 6, and month 6).</p> <p>Results</p> <p>At postoperative week one, 87.5% of the patients had anosmia, and the rest exhibited at least moderate levels of hyposmia. The anosmia, which was the dominant pattern at postoperative week 1, resolved and converted to various levels of hyposmia, so that no one at postoperative week 6 showed any such complain. At postoperative week six, 85% of the subjects experienced degrees of hyposmia, almost all being mild to moderate. At postoperative six month, the olfactory function had already reverted to the preoperative levels: no anosmia or moderate to severe hyposmia. A repeated ANOVA was indicative of significant differences in the olfactory function at the different time points. According to our post hoc Benfronney, the preoperative scores had a significant difference with those at postoperative week 1, week 6, but not with the ones at month 6.</p> <p>Conclusion</p> <p>Esthetic open rhinoplasty may be accompanied by some degrees of postoperative olfactory dysfunction. Patients need a time interval of 6 weeks to 6 months to fully recover their baseline olfactory function.</p