Over-diagnosis of malaria is not a lost cause.

BACKGROUND: Recent studies have highlighted the over-diagnosis of malaria in clinical settings in Africa. This study assessed the impact of a training programme implemented as part of an intervention trial on diagnostic behaviour of clinicians in a rural district hospital in a low-moderate malaria transmission setting. METHODS: From the beginning of 2005, a randomized controlled trial (RCT) of intermittent preventive treatment for malaria in infants (IPTi) has been conducted at the study hospital. As part of the RCT, the study team offered laboratory quality assurance, and supervision and training of paediatric ward staff using information on malaria epidemiology in the community. Data on clinical and blood slide confirmed cases of malaria from 2001 to 2005 were extracted from the hospital records. RESULTS: The proportion of blood slides positive for malaria parasites had decreased from 21% in 2001 to 7% in 2005 (p < .01). The proportion of outpatient and inpatient cases diagnosed as malaria ranged between 34% and 28% from 2001 to 2004 and this decreased substantially to 17% after the introduction of the package of training and support in 2005 (p < .01). There was no clear trend in the ratio of blood slide examined versus total diagnosis of malaria. CONCLUSION: It may be possible to change the diagnostic behaviour of clinicians by rigorous training using local malaria epidemiology data and supportive supervision

Observations on Cluster Strike Patterns in Laos

Cluster strike footprints are being surveyed and subsequently cleared in Laos. Little information is available regarding the nature of cluster munition strike patterns. If more evidence from different types of strike footprints is collected, analyzed and distributed, operators will be better prepared for future survey and clearance task

World War II Coastal Minefields in the United Kingdom

While not widely appreciated today, there were once 1,997 minefields in the United Kingdom containing between 338,500–350,000 landmines. If you were to walk today on a beach suitable for amphibious landing on either the south or east coasts of the United Kingdom, chances are that you would be walking on a former 1940s minefield. This article briefly explores the story of the United Kingdom’s coastal minefields, from their hasty installation through their costly clearance. Many of the lessons from this period remain relevant today, as countries seek to apply land release principles to reduce the risk of explosive contamination to tolerable levels

The Collaborative ORDnance Data Repository (CORD): 2018 Upgrades

The Collaborative ORDnance Data Repository (CORD) has been in existence since 2015. It is a database of over 5,000 entries detailing a wide range of explosive ordnance. The database is used extensively as a means of identifying munitions by those working in the field of humanitarian mine action, but also by others. Users range from mine clearance operators in Sri Lanka, police bomb disposal teams in Florida or Abu Dhabi, human rights advocates in Washington, D.C., to journalists in London. CORD is not intended as a detailed database. It is intended as a simple online ordnance identification guide with limited detail, accessible to all

UPDATES IN THE MANAGEMENT OF NEUROBLASTOMA

Through international collaboration we are at the start of a new age in the management of this enigmatic tumour. Tumours are now grouped at diagnosis using the International Neuroblastoma Risk Grouping (INRG), which uses information from tumour tissue reflecting tumour biology, as well as radiology to define Image-defined risk factors (IDRF). Tumours in high risk groups receive maximal therapy in an attempt to try and improve outcomes which are still poor. Intermediate risk tumours, which have better outcomes due to better response to current therapy, are treated aggressively with combination therapies with proven therapeutic effects, but with increasing attention to the minimising adverse treatment effects. The treatment of low risk tumours is now vastly reduced, acknowledging the excellent outcome in these children using minimal therapy. It has become apparent that the consequences of therapy in these children can easily be worse than those from the tumour itself. For very low risk tumours trials are exploring the outcomes without any treatment. INRG allows more precise comparison of results between different international groups, and provides a template into which new prognostic variables can be introduced, and their value assessed. In many centres multi-array analysis is studying the genetic profile of each tumour; perhaps this will allow increasing individualisation of treatment programmes in the near future. Key words: Neuroblastoma, International Neuroblastoma Risk Grouping, Image defined risk factors.

Social Simulation That 'Peers into Peer Review'

This article suggests to view peer review as a social interaction problem and shows reasons for social simulators to investigate it. Although essential for science, peer review is largely understudied and current attempts to reform it are not supported by scientific evidence. We suggest that there is room for social simulation to fill this gap by spotlighting social mechanisms behind peer review at the microscope and understanding their implications for the science system. In particular, social simulation could help to understand why voluntary peer review works at all, explore the relevance of social sanctions and reputational motives to increase the commitment of agents involved, cast light on the economic cost of this institution for the science system and understand the influence of signals and social networks in determining biases in the reviewing process. Finally, social simulation could help to test policy scenarios to maximise the efficacy and efficiency of various peer review schemes under specific circumstances and for everyone involved.Peer Review, Social Simulation, Social Norms, Selection Biases, Science Policy