245 research outputs found

    Tshiluba Language Structures

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    This poster provides a preliminary description of the linguistic features of Tshiluba (also known as Luba-Kasai), a major language spoken in the south-central, Kasai region of the Democratic Republic of Congo (DRC) and by several refugee families in the Boise area. Tshiluba is characterized as an Atlantic-Congo, Narrow Bantu, Central language (L31) within the Niger-Congo language family and, although it is spoken by over 6 million people and enjoys national language status in DRC, it has not received extensive recent attention in the linguistic literature. Over the course of a semester, our group has met with native speakers of Tshiluba to document the phonological, morphological, and syntactic features of the language as well as several semantic domains of interest. The analysis of these features, along with recordings made by our group, serves the greater linguistic community by providing theoretical linguists with new language data to support their research. It will also serve the Tshiluba community in the diaspora by providing documentation and archived recordings of this language for future generations to access. One goal in the community is to encourage the development of teaching materials to support others interested in learning the language

    Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

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    Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648

    Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension:Randomised controlled trial

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    Objective The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting 76 general practices in the United Kingdom. Participants 622 people with treated but poorly controlled hypertension (&gt;140/90 mm Hg) and access to the internet. Interventions Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of -3.4 mm Hg (95% confidence interval -6.1 to -0.8 mm Hg) and a mean difference in diastolic blood pressure of -0.5 mm Hg (-1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration ISRCTN13790648.</p

    Little perpetrators, witness-bearers and the young and the brave: towards a post-transitional aesthetics

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    The aesthetic choices characterizing work produced during the transition to democracy have been well documented. We are currently well into the second decade after the 1994 election - what then of the period referred to as the 'second transition'? Have trends consolidated, hardened, shifted, or have new 'post-transitional' trends emerged? What can be expected of the future 'born free' generation of writers and readers, since terms such as restlessness, dissonance and disjuncture are frequently used to describe the experience of constitutional democracy as it co-exists with the emerging new apartheid of poverty? Furthermore, what value is there in identifying post-transitional aesthetic trends?DHE

    The impact of polio eradication on routine immunization and primary health care: a mixed-methods study.

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    BACKGROUND: After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC). METHODS: Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review. RESULTS: Our quantitative analysis did not find compelling evidence of widespread and significant effects of polio eradication campaigns, either positive or negative, on measures of RI and maternal healthcare. Our qualitative analysis revealed context-specific positive impacts of polio eradication activities in many of our case studies, particularly disease surveillance and cold chain strengthening. These impacts were dependent on the initiative of policy makers. Negative impacts, including service interruption and public dissatisfaction, were observed primarily in districts with many campaigns per year. CONCLUSIONS: Polio eradication activities can provide support for RI and PHC, but many opportunities to do so remain missed. Increased commitment to scaling up best practices could lead to significant positive impacts

    Interdisciplinary progress in approaches to address social-ecological and ecocultural systems

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    SUMMARYThe emergent human cultures have shaped, and in turn been shaped by, local ecosystems. Yet humanity's intense modification of the environment has resulted in dramatic worldwide declines in natural and cultural capital. Social-ecological systems are becoming more vulnerable through the disruption of livelihoods, governance, institutions, resources and cultural traditions. This paper reviews the environmental sub-disciplines that have emerged to seek solutions for conservation and maintenance of the resilience of social-ecological systems. It shows that a central component is engagement with the knowledges of people within their contexts. Local knowledges of nature (traditional, indigenous, local ecological knowledge and ecoliteracy) are used by place-based cultures to guide actions towards nature. The importance of new engagements between different knowledges is now becoming more widely recognized by scientific institutions. Yet there still exist many false dualisms (for example local knowledge versus science) which tend to emphasize a superiority of one over the other. Ecocultures retain or strive to regain their connections with the environment, and thus improve their own resilience. Revitalization projects offer ways to connect knowledge with action to produce optimal outcomes for both nature and culture, suggesting that systems can be redesigned by emphasis on incorporation of local and traditional knowledge systems.</jats:p

    The politics and aesthetics of commemoration: national days in southern Africa

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    The contributions to the special section in this issue study recent independence celebrations and other national days in South Africa, Namibia, Zimbabwe, Madagascar and the Democratic Republic of Congo. They explore the role of national days in state-making and nation-building, and examine the performativity of nationalism and the role of performances in national festivities. Placing the case studies in a broader, comparative perspective, the introduction first discusses the role of the state in national celebrations, highlighting three themes: firstly, the political power-play and contested politics of memory involved in the creation of a country’s festive calendar; secondly, the relationship between state control of national days and civic or popular participation or contestation; and thirdly, the complex relationship between regional and ethnic loyalties and national identifications. It then turns to the role of performance and aesthetics in the making of nations in general, and in national celebrations in particular. Finally, we look at the different formats and meanings of national days in the region and address the question whether there is anything specific about national days in southern Africa as compared to other parts of the continent or national celebrations world-wide.Web of Scienc

    Gamma-Secretase Represents a Therapeutic Target for the Treatment of Invasive Glioma Mediated by the p75 Neurotrophin Receptor

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    The multifunctional signaling protein p75 neurotrophin receptor (p75NTR) is a central regulator and major contributor to the highly invasive nature of malignant gliomas. Here, we show that neurotrophin-dependent regulated intramembrane proteolysis (RIP) of p75NTR is required for p75NTR-mediated glioma invasion, and identify a previously unnamed process for targeted glioma therapy. Expression of cleavage-resistant chimeras of p75NTR or treatment of animals bearing p75NTR-positive intracranial tumors with clinically applicable γ-secretase inhibitors resulted in dramatically decreased glioma invasion and prolonged survival. Importantly, proteolytic processing of p75NTR was observed in p75NTR-positive patient tumor specimens and brain tumor initiating cells. This work highlights the importance of p75NTR as a therapeutic target, suggesting that γ-secretase inhibitors may have direct clinical application for the treatment of malignant glioma

    Are Women Who Work in Bars, Guesthouses and Similar Facilities a Suitable Study Population for Vaginal Microbicide Trials in Africa?

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    BACKGROUND: A feasibility study was conducted to investigate whether an occupational at-risk cohort of women in Mwanza, Tanzania are a suitable study population for future phase III vaginal microbicide trials. METHODOLOGY/PRINCIPAL FINDINGS: 1573 women aged 16-54 y working in traditional and modern bars, restaurants, hotels, guesthouses or as local food-handlers were enrolled at community-based reproductive health clinics, provided specimens for HIV/STI and pregnancy testing, and asked to attend three-monthly clinical follow-up visits for 12-months. HIV positive and negative women were eligible to enter the feasibility study and to receive free reproductive health services at any time. HIV prevalence at baseline was 26.5% (417/1573). HIV incidence among 1156 sero-negative women attending at baseline was 2.9/100PYs. Among 1020 HIV sero-negative, non-pregnant women, HIV incidence was 2.0/100PYs, HSV-2 incidence 12.7/100PYs and pregnancy rate 17.8/100PYs. Retention at three-months was 76.3% (778/1020). Among 771 HIV sero-negative, non-pregnant women attending at three-months, subsequent follow-up at 6, 9 and 12-months was 83.7%, 79.6%, and 72.1% respectively. Older women, those who had not moved home or changed their place of work in the last year, and women working in traditional bars or as local food handlers had the highest re-attendance. CONCLUSIONS/SIGNIFICANCE: Women working in food outlets and recreational facilities in Tanzania and other parts of Africa may be a suitable study population for microbicide and other HIV prevention trials. Effective locally-appropriate strategies to address high pregnancy rates and early losses to follow-up are essential to minimise risk to clinical trials in these settings
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