Collaboration for Small-Scale Fisheries Reform. Lessons in Collective Impact for Systemic Change

As a worldwide collaboration of NGOs, businesses, funders, and governments, 50in10 aimed to help its partners take promising tools and approaches in small-scale fisheries restoration to the next level by testing, strengthening, and replicating them. In January 2016, 50in10 brought together three dozen 50in10 network members and stakeholders in Belize City to learn from one another, explore financing models, innovate new approaches, and discuss how network members could continue to replicate successes. The framework of the 50in10 Theory of Change—a collective impact approach in which community empowerment, policy reform, credible science, and market demand work together—as well as collaborative learning guided the convening. Participants prioritized sustainable financing, community engagement, scientific data, and enforcement and compliance as key areas in which innovation is needed to overcome obstacles to reform, and developed ideas for how to address these challenges

Low-Intensity Continuous Ultrasound for the Symptomatic Treatment of Upper Shoulder and Neck Pain: A Randomized, Double-Blind Placebo-Controlled Clinical Trial

Purpose: Low-intensity continuous ultrasound (LICUS) is an emerging high-dosimetry ultrasound-based therapy for accelerated tissue healing and the treatment of myofascial pain. In this study, LICUS treatment is clinically evaluated for chronic upper neck and shoulder pain in a randomized, multi-site, double-blind, placebo-controlled study. Patients and Methods: CONSORT guidelines were followed in conducting and reporting the clinical trial. Thirty-three participants with upper trapezius myofascial pain were randomized for treatment with active (n=25) or placebo (n=8) devices. Investigators and subjects were blinded to treatment groups. Participants self-reported pain daily, rating from 0– 10 on the numeric rating scale. If pain rating was more significant than or equal to 3, the LICUS (3MHz, 0.132W/cm 2, 1.3W, 4 hours) was self-applied for total energy dosimetry of 18,720 Joules per treatment. During the 4-week study, daily pain rating was recorded. If LICUS treatment was delivered, pain before, during, and after treatment were recorded as well as the global rate of change (GROC). Independent t-tests were used to assess change from baseline and differences between treatment groups. ClinicalTrials.gov: NCT02135094. Results: There was a 100% completion rate for participants enrolled in the study and no significant differences between the groups regarding demographic variables or baseline outcome measures. Participants treated with active therapy observed a significant mean pain reduction from baseline of 2.61 points for active (p\u3c 0.001), compared to 1.58 points decrease from baseline for placebo (p=0.087), resulting in a 1.03 points significant decrease in the active group over placebo (p=0.003). The total GROC was significantly higher in the active group at 2.84 points compared to the placebo group at 0.46 points (p\u3c 0.001). Conclusion: Low-intensity continuous ultrasound treatment significantly reduced pain in patients with upper trapezius myofascial pain of the neck and shoulder. LICUS treatment showed a clinically meaningful improvement in the GROC scores for patients. The results from this clinical trial indicate that the LICUS treatment of 18,720 Joules can effectively be used to treat clinical pain related to upper trapezius myofascial pain. Further research could investigate varying dosimetry to improve efficacy and/or reduce the dose

Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study.

BACKGROUND: Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3-5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. METHODS: A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. RESULTS: The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs' scope of work. CONCLUSIONS: Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention's effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources

Food insecurity, diet quality and body composition:data from the Healthy Life Trajectories Initiative (HeLTI) pilot survey in urban Soweto, South Africa

Objective: To determine whether food security, diet diversity and diet quality are associated with anthropometric measurements and body composition among women of reproductive age. The association between food security and anaemia prevalence was also tested. Design: Secondary analysis of cross-sectional data from the Healthy Life Trajectories Initiative (HeLTI) study. Food security and dietary data were collected by an interviewer-administered questionnaire. Hb levels were measured using a HemoCue, and anaemia was classified as an altitude-adjusted haemoglobin level &lt; 12·5 g/dl. Body size and composition were assessed using anthropometry and dual-energy x-ray absorptiometry. Setting: The urban township of Soweto, Johannesburg, South Africa. Participants: Non-pregnant women aged 18-25 years (n 1534). Results: Almost half of the women were overweight or obese (44 %), and 9 % were underweight. Almost a third of women were anaemic (30 %). The prevalence rates of anaemia and food insecurity were similar across BMI categories. Food insecure women had the least diverse diets, and food security was negatively associated with diet quality (food security category v. diet quality score: B = -0·35, 95 % CI -0·70, -0·01, P = 0·049). Significant univariate associations were observed between food security and total lean mass. However, there were no associations between food security and body size or composition variables in multivariate models. Conclusions: Our data indicate that food security is an important determinant of diet quality in this urban-poor, highly transitioned setting. Interventions to improve maternal and child nutrition should recognise both food security and the food environment as critical elements within their developmental phases.</p

Experimental evaluation of the wake characteristics of cross flow turbine arrays

One key factor in the exploitation of tidal energy is the study of interactions of turbines when working in tidal turbine farms. The Momentum Reversal and Lift (MRL) turbine is a novel cross flow turbine. The three blades rotate around a common central horizontal axis which is parallel to their own axis and perpendicular to the flow. The novelty of the MRL turbine is that it relies on the combination of both lift and momentum reversal (drag) for energy extraction. Scaled MRL turbine models of 0.164 m in diameter were used to characterise the flow in three different tidal array settings. Detailed maps of axial velocity profiles and velocity deficits downstream of the turbine are presented, enabling the visualisation of characteristic flow patterns. The results show that the MRL generates lower velocity deficits and turbulence intensities in the near wake than those associated with horizontal axis turbines. The downstream wake was not completely symmetrical which was related to the geometry of the device but also due to the flow developed in the flume. Amongst the three array configurations studied, a fence of turbines with the lowest separation provided the highest power output

Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women

Background Relationships between mental health and multiple health behaviours have not been explored in young South African women experiencing social constraints. The aim of this study was to identify associations between mental health indicators and risk factors with physical activity, sedentary behaviour, and sleep, amongst young women living in Soweto, a predominantly low-income, urban South African setting. Methods For this cross-sectional study, baseline measurements for participants (n = 1719, 18.0–25.9 years old) recruited for the Healthy Life Trajectories Initiative were used including: physical activity, sedentary behaviour (sitting, screen and television time), sleep (duration and quality), depression and anxiety indicators, emotional health, adverse childhood experiences, alcohol-use risk; social vulnerability, self-efficacy, and social support. Results Multiple regression analyses showed that depression (β = 0.161, p < 0.001), anxiety (β = 0.126, p = 0.001), adverse childhood experiences (β = 0.076, p = 0.014), and alcohol-use risk (β = 0.089, p = 0.002) were associated with poor quality sleep. Alcohol-use risk was associated with more screen time (β = 0.105, p < 0.001) and television time (β = 0.075, p < 0.016). Social vulnerability was associated with lower sitting time (β = − 0.187, p < 0001) and screen time (β = − 0.014, p < 0.001). Higher self-efficacy was associated with more moderate- to vigorous-intensity physical activity (β = 0.07, p = 0.036), better-quality sleep (β = − 0.069, p = 0.020) and less television time (β = − 0.079, p = 0.012). Having no family support was associated with more sitting time (β = 0.075, p = 0.022). Binomial logistic regression analyses supported these findings regarding sleep quality, with anxiety and depression risk doubling the risk of poor-quality sleep (OR = 2.425, p < 0.001, OR = 2.036, p = 0.003 respectively). Conclusions These findings contribute to our understanding of how mental health indicators and risk factors can be barriers to health behaviours of young women in Soweto, and that self-efficacy and social support can be protective for certain of these behaviours for these women. Our results highlight the uniqueness of this setting regarding associations between mental health and behaviours associated with non-communicable diseases risk

The Effect of Learning to Drum on Behaviour and Brain Function in Autistic Adolescents

There is an acknowledged need for improved service provision in the context of autism spectrum disorders. Previous studies have demonstrated the positive role drum training can play in improving behavioral outcomes for children and adolescents with emotional and behavioral difficulties. However, to date, none of these studies has explored how these behavioral changes translate at the neural level. Our study provides strong evidence that drumming not only reduces hyperactivity and inattention in autistic adolescents but also strengthens functional connectivity in brain regions responsible for inhibitory control and action outcome monitoring

Impacts of conversion of tropical peat swamp forest to oil palm plantation on peat organic chemistry, physical properties and carbon stocks

Ecosystem services provided by tropical peat swamp forests, such as carbon (C) storage and water regulation, are under threat due to encroachment and replacement of these natural forests by drainage-based agriculture, commonly oil palm plantation. This study aims to quantify how the chemical and physical properties of peat change during land conversion to oil palm. This will be addressed by comparing four separate stages of conversion; namely, secondary peat swamp forests, recently deeply drained secondary forests, cleared and recently planted oil palm, and mature oil palm plantation in North Selangor, Malaysia. Results indicate accelerated peat decomposition in surface peats of mature oil palm plantations due to the lowered water table and altered litter inputs associated with this land-use change. Surface organic matter content and peat C stocks at secondary forest sites were higher than at mature oil palm sites (e.g. C stocks were 975 ± 151 and 497 ± 157 Mg ha− 1 at secondary forest and mature oil palm sites, respectively). Land conversion altered peat physical properties such as shear strength, bulk density and porosity, with mirrored changes above and below the water table. Our findings suggest close links between the organic matter and C content and peat physical properties through the entire depth of the peat profile. We have demonstrated that conversion from secondary peat swamp forest to mature oil palm plantation may seriously compromise C storage and, through its impact on peat physical properties, the water holding capacity in these peatlands