Exploring the experiences of caregivers raising children living with disability

According to the World Health Organisation, more than a billion people are living with a disability, with the vast majority being in low- and middle-income countries. In low-income communities, caregivers of children with a disability face multiple challenges related to poverty and lack of resources, which make it difficult for them to raise their child. This study explored the experiences of caregivers raising children with disabilities in South Africa. The aim of the study was to understand the experiences and needs of the caregivers of children with disabilities, through gathering sufficient primary and secondary data to reach a deep and broad understanding of the phenomenon. Twenty primary caregivers of children living with disability from the two disadvantaged communities – Khayelitsha and Gugulethu, both Cape Town townships participated in the research. The caregivers were all the biological mother of the child and living with the child at home. This research took the form of a qualitative exploratory study, (which is the research method that will be used in as a form of research method which we will be used in the paper) allowed for obtaining data in a flexible manner and to engage with the participants within their natural setting. Due to the COVID-19 pandemic in-depth telephonic interviews were conducted with the participants. A semi-structured interview schedule was used to facilitate the discussion, which was recorded using an audio recorder. The findings revealed that caregivers experienced different challenges in caring for a child with a disability. This led to them feeling isolated in their role, which was reinforced by a lack of community resources and social welfare support services; a lack of services delivery from government social services including social work intervention for caregivers of CWD left them often feeling hopeless. In these circumstances, it is recommended that the Department of Social Development incorporate systematic efforts to provide services to caregivers of children with disabilities. In addition, training should be provided to social workers to acquire skills on how to work with families of CWD. Disability should further be incorporated in the curriculum as part of social work studies

Student sense of belonging and its impacts on help seeking behaviour

Entering higher education can be an alienating experience leading to institutional and systemic drop out. Academic help-seeking behaviour as a self-regulated learning strategy is one way to counteract this. But help-seeking can be enabled or hindered by several factors including a student’s sense of belonging. In this study we attempted to understand how issues of belonging impact on student help-seeking behaviour and, if they are positively related, how institutions of higher education might promote a greater sense of belonging. We collected a total of 818 student submissions from students in an academic recovery programme. Our thematic analysis of these submissions revealed that students did feel a lack of belonging leading to help-seeking hesitancy. We also captured students’ voices to understand what conditions would enable a greater sense of belonging and we make recommendations on how institutions may work to create these conditions for students and thereby empower their help-seeking behaviour

HIV Pre-Exposure Prophylaxis (PrEP)—A Quantitative Ethics Appraisal

Background: There is now strong evidence that preventive oral antiretroviral therapy can moderately reduce likelihood of HIV infection. This concept is called HIV pre-exposure prophylaxis (PrEP). Premature closures of some previous PrEP clinical trials, secondary to ethical concerns, did not stop research. We aimed to appraise the extent of ethics considerations reporting in PrEP study documents. Methods: We conducted a systematic quantitative ethics appraisal, grounded in PrEP literature and using eight principles proposed by Ezechiel Emanuel. We developed an a priori checklist of 101 evidence-based ethics items. We obtained protocols for eleven of nineteen clinical controlled studies identified. Two reviewers independently appraised study documents against the checklist. Ethics appraisal was synthesized using adjusted percentages of items reported. Results: On average, 58 % of the 101 ethics items were mentioned or addressed in documents, with variations noted both across studies and across principles. Considerations pertaining to social value were least reported (43 % of checklist items, on average) whereas considerations related to informed consent and favorable risk-benefit ratio were most reported (75 % of checklist items, on average). Discussion: Some PrEP studies reportedly address more ethics considerations than others but, overall, ethics considerations reporting could be much improved. While this review does not allow us to comment on the actual execution of HIV PrE

MODELLIZZAZIONE E RIMOZIONE DI RUMORE GROUND ROLL DA DATI SISMICI

Il progetto di tesi consiste nella modellizzazione e rimozione di rumore ground roll da dati sismici ed è stato realizzato in collaborazione con l'unità di acquisizione ed elaborazioni sismiche dell'azienda Eni S.p.A a Milano. Il metodo sismico a riflessione assume normalmente che solo le onde riflesse che subiscono una sola riflessione (detto in gergo Primarie) abbiano raccolto informazione dal sottosuolo. In realtà il dato registrato contiene anche il cosiddetto rumore ground roll, che corrisponde alla registrazione di onde che si propagano solo in superficie. In questo lavoro ci siamo interessati ad un problema specifico dell'elaborazione dei dati sismici terrestri che riguarda la attenuazione di questo rumore. Abbiamo cercato di verificare un modo innovativo basato su una modellizzazione del fenomeno, a differenza dell'approccio classico puramente basato solo su tecniche che non utilizzano modelli specificamente legati alla natura del segnale elaborato. Generalmente il segnale utile portatore dell’informazione è modellizzato come essendo adattativamento perturbato. Il lavoro consiste nel mettere a punto un metodo di elaborazione del segnale che elimina al meglio possibile il rumore perturbatore, tale che il rapporto segnale rumore (SNR) venga significamente migliorato. Ammettiamo che a priori l'utente possa acquisire o misurare il segnale legato alla sorgente del rumore che è il rumore osservato, che può essere di tipo scalare o vettoriale. Questo rumore osservato è in linea di principio scorrelato dal segnale utile ma è correlato con il rumore perturbatore. Questo lavoro propone il metodo della sottrazione adattativa che si implementa mediante un filtro chiamato filtro adattativo, per il fatto di adattarsi alle caratteristiche locali dei segnali da elaborare, molto diffuso nell'elaborazione dei dati sismici basato su una soluzione alla Wiener del criterio del minimo errore quadratico. Tale metodo consiste nell'identificare, e poi ricostruire, un filtro che è stato eccitato dal rumore osservato fornendo una stima del rumore perturbatore. Questo rumore stimato sarà sottratto al segnale osservato fornendo così la stima del segnale utile. Il metodo della sottrazione adattativa trova un'applicazione di interesse pratico nell'elaborazione di dati ottenuti da acquisizioni terrestri e marine affette da disturbi additivi di natura specifica noti in gergo come, rispettivamente, ground roll e multiple, che saranno sottratti utilizzando un modello di rumore che si ha a disposizione. L'efficacia di tale metodo della sottrazione adattativa è stata verificata sia sui dati sismici sintetici modellizzati che sui dati sismici reali. Abbiamo applicato il metodo della sottrazione adattativa in norma 2 e affrontato diversi problemi che si presentano nell'applicazione di tale metodo tra cui la scelta della lunghezza del filtro adattativo, la correzione dell'instabilità del risultato della sottrazione adattativa mediante la decomposizione dei valori singolari (SVD), ed anche la qualità della predizione del rumore ground roll. Le elaborazioni e le simulazioni svolte nel corso di questo lavoro sono state realizzate mediante gli algoritmi scritti su linguaggio di programmazione Matlab. Per alcune elaborazioni sono state utilizzate anche il software ProMAX e mediante un modello geologico reale abbiamo anche realizzato alcune simulazioni usando il software OASES. Il progetto è stato integralmente scritto su LaTeX

Variations des apports de litière et d'éléments minéraux dans les plantations de limba (Terminalia superba) au Congo

Variations in Litter Production and Nutrient Supply in Plantations of Limba (Terminalia superba) in Congo. A study was carried out in a chronosequence of Terminalia superba (7, 12 and 48 years) and a nearby natural forest. The results show that the peaks of litterfall take place in rainy season contrary to the majority of the forest formations of the humid tropical zone. The return of nutrients to the soil via the leaf litter is higher in plantations than in forest. The calcium released from the leaf litter was up to 175 kg.ha-1.year1. The values obtained indicate a moderate nutrient use efficiency by Terminalia superba

Le comité d’éthique de la recherche au Cameroun : la décentralisation comme solution?

En 1987, le Cameroun s’est doté d’un Comité d’éthique de la recherche (cer). Mais ce n’est qu’en 2005 que l’attention du public a été attirée sur les défis fonctionnels de ce comité, alors qu’un essai clinique controversé testait un antirétroviral pour la prévention du vih, à Douala. Cependant, peu d’écrits discutent de la structure du cer et de son adéquation par rapport aux contextes géographique et académique du pays. Basé sur une revue de la littérature et de documents administratifs locaux, cet article est une réflexion sur l’éthique de la recherche au Cameroun, avec un accent particulier sur la structure et le fonctionnement de son cer. Il est proposé qu’un modèle de cer mixte, incluant un bureau national et des comités régionaux, qui théoriquement serait mieux adapté au contexte du local.In 1987, Cameroon created a National Ethics Committee (nec). But it is only in 2005 that the public attention was drawn on this committee’s functional challenges, as a controversial clinical trial was testing an antiretroviral for hiv prevention, in Douala. However, few literature reports discuss the nec structure and its adequacy in the geographic and academic contexts of that country. Based on a review of the literature and of local administrative documents, this article is an essay on the ethics of research in Cameroon, with a focus on the structure and the operations of its nec. It is proposed that a mixed nec model, including a national office and regional committees, could theoretically be a better option for Cameroon.En 1987 Camerún creó un Comité Nacional de Ética (cne), pero sólo en el 2005, la atención del público se enfoco en los desafíos funcionales de este comité al poner en funcionamiento el controvertido ensayo clínico con el fin de probar un medicamento antirretroviral para la prevención del vih en Douala. Sin embargo, solo pocos reportes literarios han hablado de la estructura del cne y su adecuación en los contextos geográficos y académicos de este país. Basado en la revisión de la literatura y de los documentos administrativos locales, este artículo es un ensayo sobre la ética de la investigación en Camerún, con un enfoque en la estructura y las operaciones de su cne. Se ha propuesto un modelo mixto del cne que incluya una oficina nacional y comités regionales, pudiendo esto, ser teóricamente la mejor opción para Camerún

Checking whether there is an increased risk of post-transplant lymphoproliferative disorder and other cancers with specific modern immunosuppression regimens in renal transplantation: Protocol for a network meta-analysis of randomized and observational studies

BACKGROUND: Patients undergoing renal transplant procedures require multi-agent immunosuppressive regimens both short term (induction phase) and long term (maintenance phase) to minimize the risk of organ rejection. There are several drug classes and agents for immunosuppression. Use of these agents may increase the risk of different harms including not only infections, but also malignancies including post-transplant lymphoproliferative disorder. There is a need to identify which regimens minimize the risk of such outcomes. The objective of this systematic review and network meta-analysis of randomized and observational studies is to explore whether certain modern regimens of immunosuppression used to prevent organ rejection in renal transplant patients are associated with an increased risk of post-transplant lymphoproliferative disorder and other malignancies. METHODS/DESIGN: ‘Modern’ regimens were defined to be those evaluated in controlled studies beginning in 1990 or later. An electronic literature search of Medline, Embase and the Cochrane Central Register of Controlled Trials has been designed by an experienced information specialist and peer reviewed by a second information specialist. Study selection and data collection will be performed by two reviewers. The outcomes of interest will include post-transplant lymphoproliferative disorder and other incident forms of malignancy occurring in adult renal transplant patients. Network meta-analyses of data from randomized and observational studies will be performed where judged appropriate based on a review of the clinical and methodological features of included studies. A sequential approach to meta-analysis will be used to combine data from different designs. DISCUSSION: Our systematic review will include both single-agent and multi-agent modern pharmacotherapy regimens in patients undergoing renal transplantation. It will synthesize malignancy outcomes. Our work will also add to the development of methods for network meta-analysis across study designs to assess treatment safety. TRIAL REGISTRATION: PROSPERO Registration Number: CRD4201300695

Improved Dynamic Lexicographic Ordering for Multi-Objective Optimisation

There is a variety of methods for ranking objectives in multiobjective optimization and some are difficult to define because they require information a priori (e.g. establishing weights in a weighted approach or setting the ordering in a lexicographic approach). In manyobjective optimization problems, those methods may exhibit poor diversification and intensification performance. We propose the Dynamic Lexicographic Approach (DLA). In this ranking method, the priorities are not fixed, but they change throughout the search process. As a result, the search process is less liable to get stuck in local optima and therefore, DLA offers a wider exploration in the objective space. In this work, DLA is compared to Pareto dominance and lexicographic ordering as ranking methods within a Discrete Particle Swarm Optimization algorithm tackling the Vehicle Routing Problem with Time Windows

Reviewing HIV‐Related Research in Emerging Economies: The Role of Government Reviewing Agencies

Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi‐structured, in‐depth telephone interviews with 15 researchers, Research Ethics Committees (RECs ) personnel, and a government agency member involved in multinational HIV Prevention Trials Network (HPTN ) research in emerging economies. Ministries of Health (MOH ) or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can lack resources, be poorly organized, have inconsistent review processes and limited expertise, and use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country's population. The MOH /governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply‐rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration