The Chars Livelihoods Programme in Bangladesh: Factors that Enable, Constrain and Sustain Graduation

The Chars Livelihoods Programme (CLP) in Bangladesh aims to lift households out of extreme poverty by providing a comprehensive package of support. As with other poverty reduction programmes in Bangladesh, CLP's success is partly judged using the concept of graduation. Defining graduation and how to actually measure it has generated significant debate. This article, prepared by members of the team responsible for implementing the programme, explains how CLP's thinking in terms of defining and measuring graduation has evolved over time. The programme finally arrived at an agreed set of graduation criteria and a measurement methodology in early 2014. This article presents graduation rates. It goes on to outline the factors that constrain and enable graduation and offers a set of conclusions and lessons learned, including the need to ensure alignment between programme design, operations and graduation criteria; and ensuring that sustainability of impacts/graduation is monitored and evaluated

Detecting the redshifted 21cm forest during reionization

The 21cm forest -- HI absorption features in the spectra of high-redshift radio sources -- can potentially provide a unique probe of the largely neutral intergalactic medium (IGM) during the epoch of reionization. We present simulations of the 21cm forest due to the large scale structure of the reionization-era IGM, including a prescription for x-ray heating and the percolation of photoionization bubbles. We show that, if detected with future instruments such as the Square Kilometer Array (SKA), the 21cm forest can provide a significant constraint on the thermal history of the IGM. Detection will be aided by consideration of the sudden increase in signal variance at the onset of 21cm absorption. If radio foregrounds and the intrinsic source spectra are well understood, the flux decrement over wide bandwidths can also improve detection prospects. Our analysis accounts for the possibility of narrow absorption lines from intervening dense regions, but, unlike previous studies, our results do not depend on their properties. Assuming x-ray heating corresponding to a local stellar population, we estimate that a statistically significant detection of 21cm absorption could be made by SKA in less than a year of observing against a Cygnus A-type source at $z \sim 9$, as opposed to nearly a decade for a significant detection of the detailed forest features. We discuss observational challenges due to uncertainties regarding the abundance of background sources and the strength of the 21cm absorption signal.Comment: Submitted to MNRAS. Revised version includes updated and extended calculations, some corrections and added reference

Constraining reionization using 21 cm observations in combination with CMB and Lyman-alpha forest data

In this paper, we explore the constraints on the reionization history that are provided by current observations of the Lyman-alpha forest and the CMB. Rather than using a particular semi-analytic model, we take the novel approach of parametrizing the ionizing sources with arbitrary functions, and perform likelihood analyses to constrain possible reionization histories. We find model independent conclusions that reionization is likely to be mostly complete by z=8 and that the IGM was 50% ionized at z=9-10. Upcoming low-frequency observations of the redshifted 21 cm line of neutral hydrogen are expected to place significantly better constraints on the hydrogen neutral fraction at 6<z<12. We use our constraints on the reionization history to predict the likely amplitude of the 21 cm power spectrum and show that observations with the highest signal-to-noise ratio will most likely be made at frequencies corresponding to z=9-10. This result provides an important guide to the upcoming 21 cm observations. Finally, we assess the impact that measurement of the neutral fraction will have on our knowledge of reionization and the early source population. Our results show that a single measurement of the neutral fraction mid-way through the reionization era will significantly enhance our knowledge of the entire reionization history.Comment: 15 pages, 16 figures, submitted to MNRA

Probing the extragalactic fast transient sky at minute timescales with DECam

Searches for optical transients are usually performed with a cadence of days to weeks, optimised for supernova discovery. The optical fast transient sky is still largely unexplored, with only a few surveys to date having placed meaningful constraints on the detection of extragalactic transients evolving at sub-hour timescales. Here, we present the results of deep searches for dim, minute-timescale extragalactic fast transients using the Dark Energy Camera, a core facility of our all-wavelength and all-messenger Deeper, Wider, Faster programme. We used continuous 20s exposures to systematically probe timescales down to 1.17 minutes at magnitude limits $g > 23$ (AB), detecting hundreds of transient and variable sources. Nine candidates passed our strict criteria on duration and non-stellarity, all of which could be classified as flare stars based on deep multi-band imaging. Searches for fast radio burst and gamma-ray counterparts during simultaneous multi-facility observations yielded no counterparts to the optical transients. Also, no long-term variability was detected with pre-imaging and follow-up observations using the SkyMapper optical telescope. We place upper limits for minute-timescale fast optical transient rates for a range of depths and timescales. Finally, we demonstrate that optical $g$-band light curve behaviour alone cannot discriminate between confirmed extragalactic fast transients such as prompt GRB flashes and Galactic stellar flares.Comment: Published in MNRA

Objective analysis of contact lens fit

Purpose: To assess the validity and repeatability of objective compared to subjective contact lens fit analysis. Methods: Thirty-five subjects (aged 22.0. ±. 3.0 years) wore two different soft contact lens designs. Four lens fit variables: centration, horizontal lag, post-blink movement in up-gaze and push-up recovery speed were assessed subjectively (four observers) and objectively from slit-lamp biomicroscopy captured images and video. The analysis was repeated a week later. Results: The average of the four experienced observers was compared to objective measures, but centration, movement on blink, lag and push-up recovery speed all varied significantly between them (p 0.05). The 95% confidence interval of subjective repeatability was better than objective assessment (±0.128. mm versus ±0.168. mm, p = 0.417), but utilised only 78% of the objective range. Vertical centration assessed objectively showed a slight inferior decentration (0.371. ±. 0.381. mm) with good inter- and intrasession repeatability (p > 0.05). Movement-on-blink was lower estimated subjectively than measured objectively (0.269. ±. 0.179. mm versus 0.352. ±. 0.355. mm; p = 0.035), but had better repeatability (±0.124. mm versus ±0.314. mm 95% confidence interval) unless correcting for the smaller range (47%). Horizontal lag was lower estimated subjectively (0.562. ±. 0.259. mm) than measured objectively (0.708. ±. 0.374. mm, p <. 0.001), had poorer repeatability (±0.132. mm versus ±0.089. mm 95% confidence interval) and had a smaller range (63%). Subjective categorisation of push-up speed of recovery showed reasonable differentiation relative to objective measurement (p <. 0.001). Conclusions: The objective image analysis allows an accurate, reliable and repeatable assessment of soft contact lens fit characteristics, being a useful tool for research and optimisation of lens fit in clinical practice

Thermal constraints on the reionisation of hydrogen by population-II stellar sources

Measurements of the intergalactic medium (IGM) temperature provide a potentially powerful constraint on the reionisation history due to the thermal imprint left by the photo-ionisation of neutral hydrogen. However, until recently IGM temperature measurements were limited to redshifts 2 < z < 4.8, restricting the ability of these data to probe the reionisation history at z > 6. In this work, we use recent measurements of the IGM temperature in the near-zones of seven quasars at z ~ 5.8 - 6.4, combined with a semi-numerical model for inhomogeneous reionisation, to establish new constraints on the redshift at which hydrogen reionisation completed. We calibrate the model to reproduce observational constraints on the electron scattering optical depth and the HI photo-ionisation rate, and compute the resulting spatially inhomogeneous temperature distribution at z ~ 6 for a variety of reionisation scenarios. Under standard assumptions for the ionising spectra of population-II sources, the near-zone temperature measurements constrain the redshift by which hydrogen reionisation was complete to be z > 7.9 (6.5) at 68 (95) per cent confidence. We conclude that future temperature measurements around other high redshift quasars will significantly increase the power of this technique, enabling these results to be tightened and generalised.Comment: 15 pages, 8 figures, accepted for publication in MNRA

Effectiveness of 0.05% oxymetazoline (Vicks Sinex Micromist) nasal spray in the treatment of objective nasal congestion demonstrated to 12h post-administration by magnetic resonance imaging

Introduction: This study aimed to assess the qualitative and quantitative utility of MRI imaging to illustrate the magnitude and duration of the effect of a standard 100 μg dose of oxymetazoline in a commercially available formulation that also contains aromatic oils. Methods: This was a randomized, open label, single dose, parallel group study in 21 adult male and female subjects who reported moderate to severe nasal congestion due to acute upper respiratory tract infection or hay fever. MRI scans were acquired using a 3T Philips Achieva scanner with a 16 channel head receive coil. High resolution MRI scans of the nasal turbinates were obtained immediately prior to dosing (baseline) and at approximately 1, 8, 10, 11, and 12 hours after dosing. The efficacy variables of primary interest were inferior turbinate total volume at 8 and 12 hours post-dosing. The secondary efficacy variables analysed were inferior turbinate total volume at 1, 10, and 11 hours post-dosing, middle turbinate total volume at 1, 8, 10, 11, and 12 hours post-dosing. Results: Changes from baseline volumes measured for the inferior and middle turbinates of subjects receiving the oxymetazoline formulation showed significant (P<0.05) decreases at all times up to and including 12 hours post-administration. No significant decreases from baseline were detected in subjects receiving a sham ‘spray’ (untreated control - spray bottles with no spray solution). Statistical ANCOVA results of inferior and middle turbinate volume indicated significant differences (P<0.05) at all measurement points up to and including 12 hours post-administration between the oxymetazoline treatment group and the untreated control with the only exception the middle turbinate volume at 10 hours (P=0.0896). The significant changes were likely to be clinically relevant though this was not measured in the study. No AEs were reported during this study and no other safety evaluations were made. Conclusions: This study showed that MRI assessment of nasal congestion in human volunteers is a robust, repeatable and viable measurement technique. The application of a 100 µg Vicks Sinex Micromist® nasal decongestant (0.05% oxymetazoline solution) delivered a highly significant reduction in inferior and middle turbinate volumes compared with the application of a control, measurable by the MRI method up to and including a 12 hour post-dose scan

Developing an intervention to facilitate family communication about inherited genetic conditions, and training genetic counsellors in its delivery.

Many families experience difficulty in talking about an inherited genetic condition that affects one or more of them. There have now been a number of studies identifying the issues in detail, however few have developed interventions to assist families. The SPRinG collaborative have used the UK Medical Research Council's guidance on Developing and Evaluating Complex Interventions, to work with families and genetic counsellors (GCs) to co-design a psycho-educational intervention to facilitate family communication and promote better coping and adaptation to living with an inherited genetic condition for parents and their children (<18 years). The intervention is modelled on multi-family discussion groups (MFDGs) used in psychiatric settings. The MFDG was developed and tested over three phases. First focus groups with parents, young people, children and health professionals discussed whether MFDG was acceptable and proposed a suitable design. Using evidence and focus group data, the intervention and a training manual were developed and three GCs were trained in its delivery. Finally, a prototype MFDG was led by a family therapist and co-facilitated by the three GCs. Data analysis showed that families attending the focus groups and intervention thought MFDG highly beneficial, and the pilot sessions had a significant impact on their family' functioning. We also demonstrated that it is possible to train GCs to deliver the MFDG intervention. Further studies are now required to test the feasibility of undertaking a definitive randomised controlled trial to evaluate its effectiveness in improving family outcomes before implementing into genetic counselling practice.The National Institute of Health Research funded the study but any views expressed do not necessarily reflect those of the Authority. Funded by NIHR reference number: RP-DG-1211-10015

Clinical Practice Recommendations for the Management and Prevention of Cisplatin-Induced Hearing Loss Using Pharmacogenetic Markers

Currently no pharmacogenomics-based criteria exist to guide clinicians in identifying individuals who are at risk of hearing loss from cisplatin-based chemotherapy. This review summarizes findings from pharmacogenomic studies that report genetic polymorphisms associated with cisplatin-induced hearing loss and aims to (1) provide up-to-date information on new developments in the field, (2) provide recommendations for the use of pharmacogenetic testing in the prevention, assessment, and management of cisplatin-induced hearing loss in children and adults, and (3) identify knowledge gaps to direct and prioritize future research. These practice recommendations for pharmacogenetic testing in the context of cisplatin-induced hearing loss reflect a review and evaluation of recent literature, and are designed to assist clinicians in providing optimal clinical care for patients receiving cisplatin-based chemotherapy