Effects of intervention with the SAFE strategy on trachoma across Ethiopia.

BACKGROUND/AIMS: The impact of the SAFE strategy (surgery, antibiotics, face washing, environmental hygiene), recommended to eliminate blinding trachoma, is not well explored. We determined the operational effectiveness of the whole SAFE intervention package. METHODS: Analytical cross-sectional trachoma surveys were conducted in four program areas across Ethiopia before and after 3 years of intervention with the SAFE strategy. A total of 8358 children 1-9 years, 4684 people above 14 and 3572 households were assessed in the follow-up evaluations using methodologies recommended by the WHO. Effects were measured by comparing follow-up proportions with baseline estimates of four key indicators. RESULTS: Coverage was 36% for trichiasis surgery, 59% for antibiotic and 57% for health-promotion services. Prevalence of trachoma trichiasis (TT) decreased from 4.6% (95% CI: 3.6% to 5.8%) down to 2.9% (CI: 2.1% to 3.9%). Prevalence of trachoma inflammation-follicular (TF) dropped from 36.7% (33.9% to 39.6%) to 18.4% (CI: 15.4% to 21.8%). The proportion of unclean faces and households not using latrines fell from 72.8% (68.9% to 76.4%) and 74.5% (69.9% to 78.7%) down to 47.0% (CI: 43% to 51%) and 51.7% (47.2% to 56.2%), respectively. All the reductions related with antibiotic (TF), face washing (clean face) and environmental (latrine) components were statistically significant except for Surgery (TT). CONCLUSIONS: Considerable decline in the magnitude of trachoma and its risk factors was observed in areas where the SAFE strategy was implemented. The coverage of services should be maintained or improved in order to eliminate blinding trachoma by the year 2020

Oral contraceptives and cervical cancer--further findings from the Oxford Family Planning Association contraceptive study.

In 1983, we reported results from the Oxford Family Planning Association contraceptive study regarding the association between oral contraceptives (OCs) and cervical neoplasia, after a 10 year follow-up of a cohort of 17,000 women. Further findings from this study are reported here after an additional 12 years of follow-up. A nested case--control design was used in which cases were all women diagnosed under 45 years of age with invasive carcinoma (n = 33), carcinoma in situ (n = 121) or dysplasia (n = 159). Controls were randomly selected from among cohort members and matched to cases on exact year of birth and clinic attended at recruitment to study. Conditional logistic regression analysis was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) associated with various aspects of OC use relative to never users adjusted for social class, smoking, age at first birth and ever use of diaphragm or condom. Ever users of OCs had a slightly elevated OR for all types of cervical neoplasia combined (OR = 1.40, 95% CI 1.00-1.96). Odds ratios were highest for invasive carcinoma (OR = 4.44, 95% CI 1.04-31.6), intermediate for carcinoma in situ (OR = 1.73, 95% CI 1.00-3.00) and lowest for dysplasia (OR = 1.07, 95% CI 0.69-1.66). The elevated risk associated with OC use appeared to be largely confined to current or recent (last use in the past 2 years) long-term users of OCs. Among current or recent users, ORs for all types of cervical neoplasia combined were 3.34 (95% CI 1.96-5.67) for 49-72 months of use, 1.69 (95% CI 0.97-2.95) for 73-96 months and 2.04 (95% CI 1.34-3.11) for 97 or more months. These results suggest a possible effect of OC use on later stages of cervical carcinogenesis, although residual confounding due to sexual factors or human papillomavirus (HPV) infection cannot be ruled out

Photonic mode density effects on single-molecule fluorescence blinking

We investigated the influence of the photonic mode density (PMD) on the triplet dynamics of individual chromophores on a dielectric interface by comparing their response in the presence and absence of a nearby gold film. Lifetimes of the excited singlet state were evaluated in ordet to measure directly the PMD at the molecules position. Triplet state lifetimes were simultaneously determined by statistical analysis of the detection time of the fluorescence photons. The observed singlet decay rates are in agreement with the predicted PMD for molecules with different orientations. The triplet decay rate is modified in a fashion correlated to the singlet decay rate. These results show that PMD engineering can lead to an important suppression of the fluorescence, introducing a novel aspect of the physical mechanism to enhance fluorescence intensity in PMD-enhancing systems such as plasmonic devices

The Cyprus Women’s Health Research (COHERE) initiative: normative data from the SF-36v2 questionnaire for reproductive aged women from the Eastern Mediterranean

Purpose: Describe the health-related quality of life for a representative cohort of women aged 18–55 in Northern Cyprus. Methods: We utilised the SF-36-Health-Survey-version-2 (SF-36v2) questionnaire as part of the COHERE Initiative study to calculate the eight physical and mental subscale scores, as well as the two overall summary measures for physical and mental health, where we present results using Cyprus-specific scoring as well as scores based on the test developers’ algorithms. We examined associations between sociodemographic characteristics for both scores. Results: A total of 7089 women fully completed the SF-36v2 questionnaire (mean age = 36.9), which was reliable and valid in this population. We observed better physical health in ages 18–25 compared to 46–55 (53.32 vs. 46.72 (p < 0.001)) and better mental health in women aged 46–55 compared to 18–25 (52.07 vs. 47.95 (p < 0.001)). Women in employment had better physical and mental health compared to those who were unemployed (physical: 50.25 vs 49.95, p < 0.001 and mental: 50.25 vs 49.24, p = 0.083) and scores increased as educational attainment increased (physical: 47.55 for primary to 51.58 for postgraduate, mental: 48.88 to 50.59, p < 0.001). Turkish Cypriot women had higher scores than Turkish women (physical: 50.42 vs 49.30, mental: 50.43 vs 49.10, p < 0.001). Conclusion: These are the first population normative values published from a large representative sample of women between 18 and 55 years from the Eastern Mediterranean region. We found better physical health in younger women and better mental health in older women. Turkish Cypriot women and non-migrant women had better mental health, and HRQOL was highest in those in paid employment and those with a higher educational achievement

Two-nucleon knockout contributions to the 12^{12}C(e,e′p)(e,e'p) reaction in the dip and {Δ\Delta}(1232) regions

The contributions from $^{12}$C$(e,e'pn)$ and $^{12}$C$(e,e'pp)$ to the semi-exclusive $^{12}$C$(e,e'p)$ cross section have been calculated in an unfactorized model for two-nucleon emission. We assume direct two-nucleon knockout after virtual photon coupling with the two-body pion-exchange currents in the target nucleus. Results are presented at several kinematical conditions in the dip and $\Delta$(1232) regions. The calculated two-nucleon knockout strength is observed to account for a large fraction of the measured $(e,e'p)$ strength above the two-nucleon emission threshold.Comment: 12 Revtex pages, 4 postscript figures (available upon request), University of Gent preprint SSF94-02-0

Fluvial archives of NW African climate and tectonic evolution, Atlas Mountains, central Morocco

The Atlas mountains in Morocco are a natural laboratory at the junction between the Atlantic Ocean (passive margin), the Mediterranean (subduction) and the African Craton. Here, interactions between the mantle and lithosphere, crustal compression and uplift have been recorded in river terraces, alluvial fans, drainage patterns, river long profiles, and in wedge-top & foreland sediments. Limited work on terraces in one of the catchments crossing the south Atlas thrust front has shown rates of incision are low and have been sustained since the Pleistocene. Dating of terraces using Optically Stimulated Luminescence, together with field sedimentology, links the formation of terraces in the Dades River to 100 ka climate cycles. Studies of tributary fans and fan sediments in terraces suggest coupling of hillslopes, tributaries and trunk streams vary across glacial-interglacial cycles and is geologically controlled. River long profiles extracted across the southern Atlas Mountains contain knickzones (areas of increased steepness), resulting from tectonically driven uplift. We will use newly acquired high resolution DEM data together with field mapping and Optically Stimulated Luminescence dating to constrain river terrace formation in High Atlas catchments draining into the Ouarzazate foreland basin. These data will be used to constrain further, the regional tectonic and climatic controls on river terrace formation. Integrating the terrace records with the other fluvial archives will enable challenging questions on tectonic surface processes, source-to-sink sedimentology and intra-plate tectonics to be tackled

WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity

BACKGROUND: Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. METHODS: We identified data available from Medline (1966 to 2004), Embase (1980 to 2004), PsycINFO (1887 to 2003), LILACS (1982 to 2004), Science Citation index, CINAHL (January 1980 to 2004) and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid) if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate >80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. RESULTS: There were 178 studies (459975 participants) in 148 articles. Of these, 106 studies were (124259 participants) on dysmenorrhoea, 54 (35973 participants) on dyspareunia and 18 (301756 participants) on noncyclical pain. There were only 19/95 (20%) less developed and 1/45 (2.2%) least developed countries with relevant data in contrast to 22/43 (51.2%) developed countries. Meta-regression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5%) high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. CONCLUSION: There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where valid data were available, a high disease burden of all types of pelvic pain was found

Catchment changes in response to tectonics and climate: using river terraces and DEM data in the southern High Atlas Mountains (Morocco)

Tectonics and climate drive the generation and transport of sediment in mountain rivers as these evolve over time. On a glacial-interglacial scale, in particular catchment reorganisation and catchment incision dynamics control these processes, and affect fan deposition in sedimentary basins. The Atlas Mountains in Morocco exhibit ongoing catchment reorganisation and an abundance of river terraces recording glacial fluvial aggradation and interglacial-glacial incisional periods, opening up insight into the processes behind catchment evolution over geological timescales. Topography and river profiles across drainage divides are similar in a stable divide, and if they are unequal they indicate active catchment reorganisation. When reorganisation occurs, it results in irregularities in river long profiles and changes in river valley erosion. River strath terraces are formed by transition between valley widening and downcutting of terraces in response to local divergence of sediment-transport capacity 3. Consequently, they record changes in catchments due to river capture, climate and tectonics. The presence of river terraces enables catchment processes over time to be investigated. A combination of remote sensing and field mapping and logging was completed in May 2018. River terraces have been mapped with newly released high resolution DEM data in the southern High Atlas in Morocco, and additional surveying was done in the field. Geomorphological indices suggest river catchment capture is a key control on the development of drainage networks. River long profiles suggest tectonic controls have also influenced landscape development over the last few million years. Logging of terrace sediments together with high-resolution sampling for OSL dating enables these catchment-wide effects to be compared with paleo-hydrological and sediment transport characteristics of the fluvial system. The combination of geomorphological DEM and sedimentological field data enables us to explore drivers of catchment change, and will contribute to the wider understanding of fluvial system response to climate and tectonic controls, and to its transport into the sedimentary record