Leaving no-one behind? Social inequalities and contrasting development impacts in rural Rwanda

Two polar viewpoints have emerged regarding Rwanda’s post-genocide development: (1) that economic development has improved the wellbeing of Rwandans and (2) that repressive policies have negatively impacted many. Assessing the impacts and inclusiveness of policies through trends among different social groups is timely in the context of the Sustainable Development Goals’ pledge to ‘leave no-one behind’. This study examines rural Rwandans’ perspectives on the changes affecting them. A multidimensional wellbeing approach was applied through mixed-method research involving 115 rural households in two locations in western Rwanda, in 2011–12. Findings reveal that the household-level impact was heavily influenced by socio-economic power and socio-ethnic grouping. Negative impacts, including restricted freedom and loss of material and cultural resources are disproportionately felt by the poorest. The indigenous Batwa suffer particularly detrimental impacts. The findings suggest that strategies deemed successful in making progress towards the Millennium Development Goals in Rwanda need, as a minimal measure, to be supported by social protection programs that specifically target the landless, vulnerable and cultural minorities. However, to align Rwanda’s development policies with the ambitions of the Sustainable Development Goals (SDGs), a dramatic strategic shift is required to ‘leave no-one behind’ and avoid the reproduction of poverty and exacerbation of inequality

Ebola Virus Disease in Pregnancy: Clinical, Histopathologic, and Immunohistochemical Findings.

Here we describe clinicopathologic features of Ebola virus disease in pregnancy. One woman infected with Sudan virus in Gulu, Uganda, in 2000 had a stillbirth and survived, and another woman infected with Bundibugyo virus had a live birth with maternal and infant death in Isiro, the Democratic Republic of the Congo in 2012. Ebolavirus antigen was seen in the syncytiotrophoblast and placental maternal mononuclear cells by immunohistochemical analysis, and no antigen was seen in fetal placental stromal cells or fetal organs. In the Gulu case, ebolavirus antigen localized to malarial parasite pigment-laden macrophages. These data suggest that trophoblast infection may be a mechanism of transplacental ebolavirus transmission

Statistics versus livelihoods: questioning Rwanda’s pathway out of poverty

Recent statistics indicate that poverty in Rwanda decreased impressively between 2006 and 2014. This seems to confirm Rwanda’s developmental progress. This article however argues for a more cautious interpretation of household survey data. The authors contrast macro-level statistical analysis with in-depth field research on livelihood conditions. Macro-economic numbers provide interesting information, however differentiated evidence is required to understand how poverty ‘works’ in everyday life. On the basis of the Rwandan case study, the authors conclude that because of the high political stakes of data collection and analysis, and given that relations of power influence the production of knowledge on poverty, cross-checking is crucial

Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome.</p> <p>Methods/Design</p> <p>This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization.</p> <p>The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks.</p> <p>Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants' adherence to the protocol, use of additional treatments for the shoulder, direct and indirect costs, and sick leave due to shoulder complaints will be recorded in a shoulder log-book.</p> <p>Discussion</p> <p>To our knowledge this is the first trial comparing individualized physiotherapy based on a defined decision making process to a standardized exercise protocol. Using high-quality methodologies, this trial will add evidence to the limited body of knowledge about the effect of physiotherapy in patients with SIS.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN86900354</p

Steps toward determination of the size and structure of the broad-line region in active galactic nuclei. IV - Intensity variations of the optical emission lines of NGC 5548

Measurements of optical emission-line flux variations based on spectra of the Seyfert galaxy NGC 5548 obtained between December 1988 and October 1989 are reported. All of the measured optical emission lines, H-alpha, H-beta, H-gamma, He I 5876, and He II 4686, exhibit the same qualitative behavior as the UV and optical continua, but with short time delays, or lags, which are different for the various lines. Cross-correlation analysis is applied to measure the lags between the various lines and the continuum. Similar lags are found with respect to the UV continuum for H-alpha and H-beta, 17 and 19 d, respectively. The lag for H-gamma is shorter (13 d), only somewhat larger than the lag measured for Ly-alpha (about 10 d). The helium lines respond to continuum variations more rapidly than the hydrogen lines, with lags of about 7 d for He II 4686 and 11 d for He I 5876.Astronom