Predicting critical power in elite cyclists: questioning validity of the 3-min All-out test

Purpose: New applications of the critical power concept, such as the modelling of intermittent work capabilities, are exciting prospects for elite cycling. However, accurate calculation of the required parameters is traditionally time invasive and somewhat impractical. An alternative single test protocol (3-min All-out) has recently been proposed, but validation in an elite population is lacking. The traditional approach for parameter establishment, but with fewer tests, could also prove an acceptable compromise. Methods: Six senior Australian endurance track cycling representatives completed six efforts to exhaustion on two separate days over a three week period. These included 1, 4, 6, 8 and 10 minute self-paced efforts, plus the 3-min All-out protocol. Traditional work versus time calculations of CP and W’ using the five self-paced efforts were compared to calculations from the 3-min All-out protocol. The impact of using just two or three self-paced efforts for traditional CP and W’ estimation were also explored using thresholds of agreement (8W, 2.0kJ respectively). Results: CP estimated from the 3-min All-out approach was significantly higher than from the traditional approach (402±33W, 351±27W, p<0.001), whilst W’ was lower (15.5±3.0kJ, 24.3±4.0kJ, p=0.02). Five different combinations of two or three self-paced efforts led to CP estimates within the threshold of agreement, with only one combination deemed accurate for W’. Conclusions: In elite cyclists the 3-min All-out approach is not suitable to estimate CP when compared to the traditional method. However, reducing the number of tests used in the traditional method lessens testing burden whilst maintaining appropriate parameter accuracy.Jason C Bartram, Dominic Thewlis, David T Martin, Kevin I Norto

Sustainability of community-led total sanitation outcomes: Evidence from Ethiopia and Ghana

We conducted a study to evaluate the sustainability of community-led total sanitation (CLTS) outcomes in Ethiopia and Ghana. Plan International, with local actors, implemented four CLTS interventions from 2012 to 2014: health extension worker-facilitated CLTS and teacher-facilitated CLTS in Ethiopia, and NGO-facilitated CLTS with and without training for natural leaders in Ghana. We previously evaluated these interventions using survey data collected immediately after implementation ended, and concluded that in Ethiopia health extension workers were more effective facilitators than teachers, and that in Ghana training natural leaders improved CLTS outcomes. For this study, we resurveyed 3831 households one year after implementation ended, and analyzed latrine use and quality to assess post-intervention changes in sanitation outcomes, to determine if our original conclusions were robust. In one of four interventions evaluated (health extension worker-facilitated CLTS in Ethiopia), there was an 8 percentage point increase in open defecation in the year after implementation ended, challenging our prior conclusion on their effectiveness. For the other three interventions, the initial decreases in open defecation of 8–24 percentage points were sustained, with no significant changes occurring in the year after implementation. On average, latrines in Ethiopia were lower quality than those in Ghana. In the year following implementation, forty-five percent of households in Ethiopia repaired or rebuilt latrines that had become unusable, while only 6% did in Ghana possibly due to higher latrine quality. Across all four interventions and three survey rounds, most latrines remained unimproved. Regardless of the intervention, households in villages higher latrine use were more likely to have sustained latrine use, which together with the high latrine repair rates indicates a potential social norm. There are few studies that revisit villages after an initial evaluation to assess sustainability of sanitation outcomes. This study provides new evidence that CLTS outcomes can be sustained in the presence of training provided to local actors, and strengthens previous recommendations that CLTS is not appropriate in all settings and should be combined with efforts to address barriers households face to building higher quality latrines

The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia

Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs

Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya

Training and capacity building are long established critical components of global water, sanitation, and hygiene (WaSH) policies, strategies, and programs. Expanding capacity building support for WaSH in developing countries is one of the targets of the Sustainable Development Goals. There are many training evaluation methods and tools available. However, training evaluations in WaSH have been infrequent, have often not utilized these methods and tools, and have lacked rigor. We developed a conceptual framework for evaluating training in WaSH by reviewing and adapting concepts from literature. Our framework includes three target outcomes: learning, individual performance, and improved programming; and two sets of influences: trainee and context factors. We applied the framework to evaluate a seven-month community-led total sanitation (CLTS) management training program delivered to 42 government officials in Kenya from September 2013 to May 2014. Trainees were given a pre-training questionnaire and were interviewed at two weeks and seven months after initial training. We qualitatively analyzed the data using our conceptual framework. The training program resulted in trainees learning the CLTS process and new skills, and improving their individual performance through application of advocacy, partnership, and supervision soft skills. The link from trainees' performance to improved programming was constrained by resource limitations and pre-existing rigidity of trainees’ organizations. Training-over-time enhanced outcomes and enabled trainees to overcome constraints in their work. Training in soft skills is relevant to managing public health programs beyond WaSH. We make recommendations on how training programs can be targeted and adapted to improve outcomes. Our conceptual framework can be used as a tool both for planning and evaluating training programs in WaSH

Adapting Translational Research Methods to Water, Sanitation, and Hygiene

Translational research applies scientific techniques to achieve practical outcomes, connecting pure research and pure practice. Many translational research types have arisen since the mid-1900s, reflecting the need to better integrate scientific advancement with policy and practice. Water, sanitation, and hygiene (WaSH) development efforts have aimed to reduce morbidity and mortality and improve service delivery; thus, associated research has a strong orientation toward applied studies that use diverse methods to support decision-making. Drawing from knowledge that emerged to support other professional fields, such as manufacturing and clinical healthcare, we characterize different types of translational research and clarify nomenclature and principles. We describe study approaches relevant to translational research questions, and offer overarching recommendations, specific examples, and resources for further study as practical advice to professionals who seek to apply translational methods to WaSH problems. To enhance collective outcomes, professionals should mindfully align projects within the translational spectrum. We further recommend overarching good practices such as documenting intervention adaptations, overtly considering contextual factors, and better distinguishing efficacy from effectiveness research by replicating studies in different contexts. By consciously improving the compatibility and linkages between WaSH science and practice, this guide can accelerate urgently needed progress toward global development goals

Influence of Context on Item Parameters in Forced-Choice Personality Assessments

A fundamental assumption in computerized adaptive testing (CAT) is that item parameters are invariant with respect to context – items surrounding the administered item. This assumption, however, may not hold in forced-choice (FC) assessments, where explicit comparisons are made between items included in the same block. We empirically examined the influence of context on item parameters by comparing parameter estimates from two FC instruments. The first instrument was compiled of blocks of three items, whereas in the second, the context was manipulated by adding one item to each block, resulting in blocks of four. The item parameter estimates were highly similar. However, a small number of significant deviations were observed, confirming the importance of context when designing adaptive FC assessments. Two patterns of such deviations were identified, and methods to reduce their occurrences in a FC CAT setting were proposed. It was shown that with a small proportion of violations of the parameter invariance assumption, score estimation remained stable

γδβ-thalassaemias 1 and 2 are the result of a 100 kpb deletion in the human β-globin cluster.

The DNA spanning two large deletions in the human beta-globin gene cluster (gamma beta-thalassaemia 1 and 2) has been cloned by cosmid cloning and chromosomal walking. The entire region was mapped and analyzed for the presence of repetitive sequences. The results show that the affected loci have lost almost 100 kb of DNA in a deletion event not involving homologous or repetitive sequences

8-HQA adjusts the number and diversity of bacteria in the gut microbiome of Spodoptera littoralis

Quinolinic carboxylic acids are known for their metal ion chelating properties in insects, plants and bacteria. The larval stages of the lepidopteran pest, Spodoptera littoralis, produce 8-hydroxyquinoline-2-carboxylic acid (8-HQA) in high concentrations from tryptophan in the diet. At the same time, the larval midgut is known to harbor a bacterial population. The motivation behind the work was to investigate whether 8-HQA is controlling the bacterial community in the gut by regulating the concentration of metal ions. Knocking out the gene for kynurenine 3-monooxygenase (KMO) in the insect using CRISPR/Cas9 eliminated production of 8-HQA and significantly increased bacterial numbers and diversity in the larval midgut. Adding 8-HQA to the diet of knockout larvae caused a dose-dependent reduction of bacterial numbers with minimal effects on diversity. Enterococcus mundtii dominates the community in all treatments, probably due to its highly efficient iron uptake system and production of the colicin, mundticin. Thus host factors and bacterial properties interact to determine patterns of diversity and abundance in the insect midgut

Domestic water and sanitation as water security: monitoring, concepts and strategy

Domestic water and sanitation provide examples of a situation where long-term, target-driven efforts have been launched with the objective of reducing the proportion of people who are water-insecure, most recently through the millennium development goals (MDGs) framework. Impacts of these efforts have been monitored by an increasingly evidence-based system, and plans for the next period of international policy, which are likely to aim at universal coverage with basic water and sanitation, are being currently developed. As distinct from many other domains to which the concept of water security is applied, domestic or personal water security requires a perspective that incorporates the reciprocal notions of provision and risk, as the current status of domestic water and sanitation security is dominated by deficiency This paper reviews the interaction of science and technology with policies, practice and monitoring, and explores how far domestic water can helpfully fit into the proposed concept of water security, how that is best defined, and how far the human right to water affects the situation. It is considered that they fit well together in terms both of practical planning of targets and indicators and as a conceptual framework to help development. The focus needs to be broad, to extend beyond households, to emphasize maintenance as well as construction and to increase equity of access. International and subnational monitoring need to interact, and monitoring results need to be meaningful to service providers as well as users