Child Support Grant access and receipt among 12-week-old infants in an urban township setting in South Africa

BACKGROUND: Cash transfers (CTs) are increasingly used as a strategy to alleviate poverty and improve child health outcomes in low- and middle-income countries. The Child Support Grant (CSG) is the largest CT programme in South Africa, and on the continent, targeting poor children from birth until the age of 18 with a monthly sum of R300 (USD30). Evidence on the CSG shows that early receipt of the grant is associated with improved child health outcomes. Since its implementation, one of the major concerns about the grant has been take-up rates, particularly for younger children. This paper reports results on take-up rates for 12-week-old infants residing in an urban township in South Africa. METHODS: This is a descriptive study utilising data from a community-based, cluster-randomised trial which evaluated a programme providing pregnancy and post-natal home visits by community health workers to 3,494 mothers in Umlazi township, South Africa. RESULTS: At the 12-week visit, half (52%) of the mothers who had enrolled in the study had applied for the CSG on behalf of their children, while 85% of the mothers who had not applied were still planning to apply. Only 38% (1,327) of all children had received the CSG. CONCLUSIONS: In this study, many mothers had not applied for the CSG in the first few months after delivery, and only a third of children had accessed the grant. Further research is needed to understand what the current barriers are that prevent mothers from applying for this important form of social protection in the early months after delivery

Morphological effects of vegetation on the tidal-fluvial transition in Holocene estuaries

Vegetation enhances bank stability and sedimentation to such an extent that it can modify river patterns, but how these processes manifest themselves in full-scale estuarine settings is poorly understood. On the one hand, tidal flats accrete faster in the presence of vegetation, reducing the flood storage and ebb dominance over time. On the other hand flow-focusing effects of a tidal floodplain elevated by mud and vegetation could lead to channel concentration and incision. Here we study isolated and combined effects of mud and tidal marsh vegetation on estuary dimensions. A 2-D hydromorphodynamic estuary model was developed, which was coupled to a vegetation model and used to simulate 100 years of morphological development. Vegetation settlement, growth and mortality were determined by the hydromorphodynamics. Eco-engineering effects of vegetation on the physical system are here limited to hydraulic resistance, which affects erosion and sedimentation pattern through the flow field. We investigated how vegetation, combined with mud, affects the average elevation of tidal flats and controls the system-scale planform. Modelling with vegetation only results in a pattern with the largest vegetation extent in the mixed-energy zone of the estuary, which is generally shallower. Here vegetation can cover more than 50 % of the estuary width while it remains below 10 %–20 % in the outer, tide-dominated zone. This modelled distribution of vegetation along the estuary shows general agreement with trends in natural estuaries observed by aerial image analysis. Without mud, the modelled vegetation has a limited effect on morphology, again peaking in the mixed-energy zone. Numerical modelling with mud only shows that the presence of mud leads to stabilisation and accretion of the intertidal area and a slight infill of the mixed-energy zone. Combined modelling of mud and vegetation leads to mutual enhancement with mud causing new colonisation areas and vegetation stabilising the mud. This occurs in particular in a zone previously described as the bedload convergence zone. While vegetation focusses the flow into the channels such that mud sedimentation in intertidal side channels is prevented on a timescale of decades, the filling of intertidal area and the resulting reduction in tidal prism may cause the infilling of estuaries over centuries

Flight performance in the altricial zebra finch: developmental effects and reproductive consequences

The environmental conditions animals experience during development can have sustained effects on morphology, physiology, and behavior. Exposure to elevated levels of stress hormones (glucocorticoids, GCs) during development is one such condition that can have long-term effects on animal phenotype. Many of the phenotypic effects of GC exposure during development (developmental stress) appear negative. However, there is increasing evidence that developmental stress can induce adaptive phenotypic changes. This hypothesis can be tested by examining the effect of developmental stress on fitness-related traits. In birds, flight performance is an ideal metric to assess the fitness consequences of developmental stress. As fledglings, mastering takeoff is crucial to avoid bodily damage and escape predation. As adults, takeoff can contribute to mating and foraging success as well as escape and, thus, can affect both reproductive success and survival. We examined the effects of developmental stress on flight performance across life-history stages in zebra finches (Taeniopygia guttata). Specifically, we examined the effects of oral administration of corticosterone (CORT, the dominant avian glucocorticoid) during development on ground-reaction forces and velocity during takeoff. Additionally, we tested for associations between flight performance and reproductive success in adult male zebra finches. Developmental stress had no effect on flight performance at all ages. In contrast, brood size (an unmanipulated variable) had sustained, negative effects on takeoff performance across life-history stages with birds from small broods performing better than birds from large broods. Flight performance at 100 days posthatching predicted future reproductive success in males; the best fliers had significantly higher reproductive success. Our results demonstrate that some environmental factors experienced during development (e.g. clutch size) have stronger, more sustained effects than others (e.g. GC exposure). Additionally, our data provide the first link between flight performance and a direct measure of reproductive success

Communication training for general practitioners aimed at improving antibiotic prescribing:A controlled before-after study in multicultural Dutch cities

Introduction: Suboptimal doctor-patient communication drives inappropriate prescribing of antibiotics. We evaluated a communication intervention for general practitioners (GPs) in multicultural Dutch cities to improve antibiotic prescribing for respiratory tract infections (RTI).Methods: This was a non-randomized controlled before-after study. The study period was pre-intervention November 2019 – April 2020 and post-intervention November 2021 – April 2022. The intervention consisted of a live training (organized between September and November 2021), an E-learning, and patient material on antibiotics and antibiotic resistance in multiple languages. The primary outcome was the absolute number of prescribed antibiotic courses indicated for RTIs per GP; the secondary outcome was all prescribed antibiotics per GP. We compared the post-intervention differences in the mean number of prescribed antibiotics between the intervention (N = 25) and the control group (N = 110) by using an analysis of covariance (ANCOVA) test, while adjusting for the pre-intervention number of prescribed antibiotics. Additionally, intervention GPs rated the training and their knowledge and skills before the intervention and 3 months thereafter.Results: There was no statistically significant difference in the mean number of prescribed antibiotics for RTI between the intervention and the control group, nor for mean number of overall prescribed antibiotics. The intervention GPs rated the usefulness of the training for daily practice a 7.3 (on a scale from 1–10) and there was a statistically significant difference between pre- and post-intervention on four out of nine items related to knowledge and skills.Discussion:There was no change in GPs prescription behavior between the intervention and control group. However, GPs found the intervention useful and showed some improvement on self-rated knowledge and communication skills

Communication training for general practitioners aimed at improving antibiotic prescribing:A controlled before-after study in multicultural Dutch cities

Introduction: Suboptimal doctor-patient communication drives inappropriate prescribing of antibiotics. We evaluated a communication intervention for general practitioners (GPs) in multicultural Dutch cities to improve antibiotic prescribing for respiratory tract infections (RTI).Methods: This was a non-randomized controlled before-after study. The study period was pre-intervention November 2019 – April 2020 and post-intervention November 2021 – April 2022. The intervention consisted of a live training (organized between September and November 2021), an E-learning, and patient material on antibiotics and antibiotic resistance in multiple languages. The primary outcome was the absolute number of prescribed antibiotic courses indicated for RTIs per GP; the secondary outcome was all prescribed antibiotics per GP. We compared the post-intervention differences in the mean number of prescribed antibiotics between the intervention (N = 25) and the control group (N = 110) by using an analysis of covariance (ANCOVA) test, while adjusting for the pre-intervention number of prescribed antibiotics. Additionally, intervention GPs rated the training and their knowledge and skills before the intervention and 3 months thereafter.Results: There was no statistically significant difference in the mean number of prescribed antibiotics for RTI between the intervention and the control group, nor for mean number of overall prescribed antibiotics. The intervention GPs rated the usefulness of the training for daily practice a 7.3 (on a scale from 1–10) and there was a statistically significant difference between pre- and post-intervention on four out of nine items related to knowledge and skills.Discussion:There was no change in GPs prescription behavior between the intervention and control group. However, GPs found the intervention useful and showed some improvement on self-rated knowledge and communication skills

Sandy contourite drift in the late Miocene Rifian Corridor (Morocco):Reconstruction of depositional environments in a foreland-basin seaway

The Rifian Corridor was a seaway between the Atlantic Ocean and the Mediterranean Sea during the late Miocene. The seaway progressively closed, leading to the Messinian Salinity Crisis in the Mediterranean Sea. Despite the key palaeogeographic importance of the Rifian Corridor, patterns of sediment transport within the seaway have not been thoroughly studied. In this study, we investigated the upper Miocene sedimentation and bottom current pathways in the South Rifian Corridor. The planktic and benthic foraminifera of the upper Tortonian and lower Messinian successions allow us to constrain the age and palaeo-environment of deposition. Encased in silty marls deposited at 150–300 m depth, there are (i) 5 to 50 m thick, mainly clastic sandstone bodies with unidirectional cross-bedding; and (ii) 50 cm thick, mainly clastic, tabular sandstone beds with bioturbation, mottled silt, lack of clear base or top, and bi-gradational sequences. Furthermore, seismic facies representing elongated mounded drifts and associated moat are present at the western mouth of the seaway. We interpret these facies as contourites: the products of a westward sedimentary drift in the South Rifian Corridor. The contourites are found only on the northern margin of the seaway, thus suggesting a geostrophic current flowing westward along slope and then northward. This geostrophic current may have been modulated by tides. By comparing these fossil examples with the modern Gulf of Cadiz, we interpret these current-dominated deposits as evidence of late Miocene Mediterranean overflow into the Atlantic Ocean, through the Rifian Corridor. This overflow may have affected late Miocene ocean circulation and climate, and the overflow deposits may represent one of the first examples of mainly clastic contourites exposed on land