Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh

BACKGROUND: Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases. METHODOLOGY/PRINCIPAL FINDINGS: A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh). Poverty data (household per capita expenditure--PCE, asset ownership and self-rated wealth) were collected from cases aged ≥50 years who were visually impaired due to cataract (visual acuity<6/24 in the better eye) and age-sex matched controls with normal vision. Cases were offered free/subsidised cataract surgery. Approximately one year later participants were re-interviewed about poverty. 466 cases and 436 controls were examined at both baseline and follow-up (Follow up rate: 78% for cases, 81% for controls), of which 263 cases had undergone cataract surgery ("operated cases"). At baseline, operated cases were poorer compared to controls in terms of PCE (Kenya: $22 versus £35 p = 0.02, Bangladesh:$16 vs $24 p = 0.004, Philippines:$24 vs 32 p = 0.0007), assets and self-rated wealth. By follow-up PCE had increased significantly among operated cases in each of the three settings to the level of controls (Kenya: $30 versus £36 p = 0.49, Bangladesh:$23 vs $23 p = 0.20, Philippines:$45 vs $36 p = 0.68). There were smaller increases in self-rated wealth and no changes in assets. Changes in PCE were apparent in different socio-demographic and ocular groups. The largest PCE increases were apparent among the cases that were poorest at baseline. CONCLUSIONS/SIGNIFICANCE: This study showed that cataract surgery can contribute to poverty alleviation, particularly among the most vulnerable members of society. This study highlights the need for increased provision of cataract surgery to poor people and shows that a focus on blindness may help to alleviate poverty and achieve the Millennium Development Goals

Aligning OCL with Domain-Specific Languages to Support Instance-Level Model Queries

The Object Constraint Language (OCL) provides a set of powerful facilities for navigating and querying models in the MOF metamodelling architecture. Currently, OCL queries can be expressed only in the context of MOF metamodels and UML models. This adds an additional burden to the development and use of Domain Specific Languages, which can also benefit from an instance-level querying mechanism. In an effort to address this issue, we report on ongoing work on defining a rigorous approach for aligning the OCL querying and navigation facilities with arbitrary Domain Specific Languages to support instance-level queries. We present a case-study that demonstrates the usefulness and practicality of this approach

[Accepted Manuscript] Field testing a draft version of the UNICEF/Washington Group Module on child functioning and disability. Background, methodology and preliminary findings from Cameroon and India

Background Global child disability data are generally non-comparable, comprising different tools, methodologies and disability definitions. UNICEF and The Washington Group on Disability Statistics (WG) have developed a new tool on child functioning and disability to address this need. Aims The aim of this paper is to describe the development of the new module, and to present an independent field test of the draft module in two contrasting settings. Methods UNICEF and the WG developed a parent-reported survey module to identify children aged 2�17 years with functional difficulties in population-based surveys through: review of existing documentation, consultation with experts and cognitive testing. A field test of the draft module was undertaken in Cameroon and India within a population-based survey. Functional limitation in each of 14 domains was scored on a scale comprising �no difficulty�, �some difficulty�, �a lot of difficulty� and �cannot do�. Results In all, 1713 children in Cameroon and 1101 children in India were assessed. Sixty-four percent of children in Cameroon and 35% of children in India were reported to have at least some difficulty in one or more domain. The proportion reported to have either �a lot of difficulty� or �cannot do� was 9% in Cameroon and 4% in India. There were no significant differences in reported functional difficulties by sex but children aged 2�4 were reported to have fewer functional difficulties of any kind compared with older children in both countries. Conclusion Comparable estimates were generated between the two countries, providing an initial overview of the tool's outputs. The continued development of this standardised questionnaire for the collection of robust and reliable data on child disability is essential

Dynamic optimisation of preventative and corrective maintenance schedules for a large scale urban drainage system

Gully pots or storm drains are located at the side of roads to provide drainage for surface water. We consider gully pot maintenance as a risk-driven maintenance problem. We explore policies for preventative and corrective maintenance actions, and build optimised routes for maintenance vehicles. Our solutions take the risk impact of gully pot failure and its failure behaviour into account, in the presence of factors such as location, season and current status. The aim is to determine a maintenance policy that can automatically adjust its scheduling strategy in line with changes in the local environment, to minimise the surface flooding risk due to clogged gully pots. We introduce a rolling planning strategy, solved by a hyper-heuristic method. Results show the behaviour and strength of the automated adjustment in a range of real-world scenarios

Absorption in the fractional quantum Hall regime: trion dichroism and spin polarization

We present measurements of optical interband absorption in the fractional quantum Hall regime in a GaAs quantum well in the range 0 < nu < 1. We investigate the mechanism of singlet trion absorption, and show that its circular dichroism can be used as a probe of the spin polarization of the ground state of the two-dimensional electron system (2DES). We find that at nu = 1/3 the 2DES is fully spin-polarized. Increasing the filling factor results in a gradual depolarization, with a sharp minimum in the dichroism near nu = 2/3. We find that in the range 0.5 < nu < 0.85 the 2DES remains partially polarized for the broad range of magnetic fields from 2.75 to 11 Tesla. This is consistent with the presence of a mixture of polarized and depolarized regions.Comment: 4 pages, 4 figures (Fig 4 is in color

Prevention of Pediatric Respiratory Syncytial Virus Lower Respiratory Tract Illness: Perspectives for the Next Decade

The landscape of infant bronchiolitis and viral pneumonia may be altered by preventive interventions against respiratory syncytial virus under evaluation today. Pediatric wards in 2018 in developing countries may differ from those attended by future generation pediatricians who may not witness the packed emergency rooms, lack of available beds, or emergency situations that all physicians caring for children with RSV experience every year. In this review, we describe and discuss different prevention strategies under evaluation to protect pediatric patients. Then, we outline a number of potential challenges, benefits, and concerns that may result from successful interventions after licensure

Using argument notation to engineer biological simulations with increased confidence

The application of computational and mathematical modelling to explore the mechanics of biological systems is becoming prevalent. To significantly impact biological research, notably in developing novel therapeutics, it is critical that the model adequately represents the captured system. Confidence in adopting in silico approaches can be improved by applying a structured argumentation approach, alongside model development and results analysis. We propose an approach based on argumentation from safety-critical systems engineering, where a system is subjected to a stringent analysis of compliance against identified criteria. We show its use in examining the biological information upon which a model is based, identifying model strengths, highlighting areas requiring additional biological experimentation and providing documentation to support model publication. We demonstrate our use of structured argumentation in the development of a model of lymphoid tissue formation, specifically Peyer's Patches. The argumentation structure is captured using Artoo (www.york.ac.uk/ycil/software/artoo), our Web-based tool for constructing fitness-for-purpose arguments, using a notation based on the safety-critical goal structuring notation. We show how argumentation helps in making the design and structured analysis of a model transparent, capturing the reasoning behind the inclusion or exclusion of each biological feature and recording assumptions, as well as pointing to evidence supporting model-derived conclusions