MAISHA Cluster Randomised Trial - Couples Survey Data

The MAISHA study (component A) is a mixed-methods evaluation, including a cluster randomised trial (CRT), of a small group based social empowerment intervention to prevent intimate partner violence (IPV) against women in Mwanza city, Tanzania. The trial was conducted among women already participating in a group-based microfinance scheme, with the microfinance group being the unit of randomisation and (in the intervention arm) the unit of intervention delivery. The CRT involved two surveys of trial participants (all female): the baseline survey was conducted prior to randomisation, and the follow-up survey conducted 29 months later. The surveys collected data on demographics, childhood experiences of abuse, health, attitudes and norms relating to gender and IPV, relationships, IPV experiences and responses, children, and respondents' interactions with their communities. At follow-up, where women granted permission, male partners were also invited to take part in the male partners survey which covered similar themes to those in the women's survey. This dataset was used in the primary analysis of the male partners survey data. It comprises 1,049 records (each pertaining to one woman and, where applicable, her male partner), and contains a subset of variables from the women's baseline survey, women's follow-up survey and male partner's survey. NB: A second trial of the same MAISHA intervention was conducted among women not receiving microfinance (MAISHA component B). Data pertaining to that trial are not included in this record

Using clinical databases to evaluate healthcare interventions.

OBJECTIVES: The aim of this study was to test the feasibility of conducting rigorous, nonrandomized studies (NRSs) of healthcare interventions using existing clinical databases in terms of the following: recruiting a large representative sample of hospitals, identifying eligible cases, matching cases to controls to achieve similar baseline characteristics, making meaningful comparisons of outcomes, and carrying out subgroup analyses. METHODS: Data were extracted from the Intensive Care National Audit & Research Centre's Case Mix Programme Database to investigate the impact of management with a pulmonary artery catheter (PAC) in intensive care unit (ICU) patients. Participating ICUs were invited to collect additional data for the analysis. Patients managed with a PAC were matched to control patients on their propensity score. Hospital mortality was then compared between the two groups. RESULTS: Of 117 eligible ICUs, 68 (58 percent) agreed to participate, of which 57 (84 percent) collected additional data. Although a slightly higher proportion of larger ICUs in university hospitals participated, the patient case-mix was similar to that in nonparticipating ICUs. Almost all patients managed with a PAC (98 percent) were successfully matched to patients managed without a PAC. The two groups were similar for baseline characteristics. However, hospital mortality was worse for PAC patients than for non-PAC patients (odds ratio, 1.28; 95 percent confidence interval, 1.06-1.55). Subgroup analysis suggested that the impact of management with a PAC was modified by severity of illness. CONCLUSIONS: Rigorous NRSs are feasible if they are based on data from high-quality clinical databases. However, the reliability of estimated treatment effects from such studies requires further investigation

Long-term decline and geographical variation in the numbers of moulting Common Eiders Somateria mollissima in Shetland

The 1977 survey was funded and led by the Nature Conservancy Council. Surveys from 1980 to 2019 were funded by the Sullom Voe Association and led by the Shetland Oil Terminal Environmental Advisory Group (SOTEAG).Capsule: Numbers of moulting Common Eiders Somateria mollissima counted in Shetland during surveys from 1977 to 2019 decreased from approximately 14,500 to an estimated 3600 individuals, a 75% population decline. Aims: To report results of extensive surveys of Eiders across Shetland during the annual complete moult period, review historical surveys, and evaluate long-term population changes and the possible underlying causes for change. Methods: Extensive areas of coastal Shetland were surveyed for Eiders during the annual moult period from July to September, every one to five years from 1977 to 2019. Spatial sampling was variable between surveys from 1977 to 1993 but more systematic and standardised during all surveys from 1996 to 2019. Overall population change, changes in numbers of birds within areas categorised as either exposed or sheltered coast, and change in the proportion of adult males to females/juveniles were assessed. Results: Surveys from 1977 to 1993 indicated a 55% decrease, from approximately 14,500–6500 individuals, and surveys from 1996 to 2019 showed a 45% decrease, from an estimated 6700–3600 individuals, indicating an overall population decrease of approximately 75% from 1977 to 2019. From 1996 to 2019, Eider numbers decreased in areas of exposed coast by approximately 90% but increased by at least 70% in the more sparsely populated sheltered areas, and the overall proportion of adult males to females/juveniles reduced by one-third. Conclusion: From 1977 to 2019, a substantial decline of approximately 75% occurred in the Shetland Eider population at the time of moult. Shetland Eiders are not S. m. mollissima but morphologically and genetically akin to S. m. faeroeensis, the Faroese subspecies, the rarest subspecies worldwide, so this decline is of high conservation concern. Causes of the decline largely remain unknown, but ecological datasets on Shetland Eiders are few and detailed studies, including remote tracking of individuals’ movements throughout the year, would be worthwhile.Publisher PDFPeer reviewe

Antimicrobial graft copolymer gels

In view of the growing worldwide rise in microbial resistance, there is considerable interest in designing new antimicrobial copolymers. The aim of the current study was to investigate the relationship between antimicrobial activity and copolymer composition/ architecture to gain a better understanding of their mechanism of action. Specifically, the antibacterial activity of several copolymers based on 2- (methacryloyloxy)ethyl phosphorylcholine [MPC] and 2-hydroxypropyl methacrylate (HPMA) toward Staphylococcus aureus was examined. Both block and graft copolymers were synthesized using either atom transfer radical polymerization or reversible addition−fragmentation chain transfer polymerization and characterized via 1H NMR, gel permeation chromatography, rheology, and surface tensiometry. Antimicrobial activity was assessed using a range of well-known assays, including direct contact, live/dead staining, and the release of lactate dehydrogenase (LDH), while transmission electron microscopy was used to study the morphology of the bacteria before and after the addition of various copolymers. As expected, PMPC homopolymer was biocompatible but possessed no discernible antimicrobial activity. PMPC-based graft copolymers comprising PHPMA side chains (i.e. PMPC-g-PHPMA) significantly reduced both bacterial growth and viability. In contrast, a PMPC−PHPMA diblock copolymer comprising a PMPC stabilizer block and a hydrophobic core-forming PHPMA block did not exhibit any antimicrobial activity, although it did form a biocompatible worm gel. Surface tensiometry studies and LDH release assays suggest that the PMPC-g-PHPMA graft copolymer exhibits surfactantlike activity. Thus, the observed antimicrobial activity is likely to be the result of the weakly hydrophobic PHPMA chains penetrating (and hence rupturing) the bacterial membrane

Curcumin-based photosensitization inactivates Aspergillus flavus and reduces aflatoxin B1 in maize kernels

Different methods have been applied in controlling contamination of foods and feeds by the carcinogenic fungal toxin, aflatoxin, but nevertheless the problem remains pervasive in developing countries. Curcumin is a natural polyphenolic compound from the spice turmeric (Curcuma longa L.) that has been identified as an efficient photosensitiser for inactivation of Aspergillus flavus conidia. Curcumin mediated photoinactivation of A. flavus has revealed the potential of this technology to be an effective method for reducing population density of the aflatoxin-producing fungus in foods. This study demonstrates the influence of pH and temperature on efficiency of photoinactivation of the fungus and how treating spore-contaminated maize kernels affects aflatoxin production. The results show the efficiency of curcumin mediated photoinactivation of fungal conidia and hyphae were not affected by temperatures between 15 and 35 °C or pH range of 1.5–9.0. The production of aflatoxin B was significantly lower (p < 0.05), with an average of 82.4 μg/kg as compared to up to 305.9 μg/kg observed in untreated maize kept under similar conditions. The results of this study indicate that curcumin mediated photosensitization can potentially be applied under simple environmental conditions to achieve significant reduction of post-harvest contamination of aflatoxin B in maize

Optimizing the construction of outcome measures for impact evaluations of intimate partner violence prevention interventions

Most impact evaluations of intimate partner violence (IPV) prevention interventions use binary measures of "any" versus "no" physical and/or sexual IPV as their primary outcome measure, missing opportunities to capture nuance. In this study, we reanalyzed secondary data from six randomized controlled trials conducted in low- and middle-income countries-Bandebereho (Rwanda), Becoming One (Uganda), Indashyikirwa (Rwanda), MAISHA CRT01, MAISHA CRT02 (Tanzania), Stepping Stones Creating Futures (South Africa), and Unite for a Better Life (Ethiopia), to assess how different conceptualizations and coding of IPV variables can influence interpretations of the impact of an intervention. We compared the standard outcome measures to new measures that reflect the severity and intensity of violence and whether interventions prevent new cases of IPV or reduce or stop ongoing violence. Results indicate that traditional binary indicators masked some of the more subtle intervention effects, and the use of the new indicators allowed for a better understanding of the impacts of the interventions. Conclusions on whether a program is perceived "to work" are highly influenced by the IPV outcomes that the investigators choose to report, and how they are measured and coded. Lack of attention to outcome choice and measurement could lead to prematurely abandoning strategies useful for violence reduction or missing essential insights into how programs may or may not affect IPV. While these results must be interpreted cautiously, given differences in intervention types, the underlying prevalence of violence, sociodemographic factors, sample sizes, and other contextual differences across the trial sites, they can help us move toward a new approach to reporting multiple outcomes that allow us to unpack the "impact" of an intervention by assessing intervention effect by the severity of violence and type of prevention, whether primary and secondary