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There has been poor performance in national and international mathematics assessments among African students compared to the rest of the planet. Such consistent underperformance is attributed to factors like teaching approaches. The present study reviewed and meta-analysed African research of the last 20 years on the influence of mathematics teaching approaches on students' performance with the intent to identify effective approaches that can improve performance in mathematics. The results of a random-effects meta-analysis showed that mathematics teaching approaches have an overall large significant effect (diPPC 1.39) on students' performance. Specifically, the teaching approach that used concrete manipulatives showed a larger significant effect size (diPPC 2.736) than any other type of teaching approach. Moreover, using metaregression analysis, the study revealed that assessing students' mathematics performance using open-question tests had a large effect size than using multiple-choice tests. Hence, it is recommended that mathematics teachers in African educational institutions and teacher education institutions rethink mathematics teaching approaches along with the assessment format. [ABSTRACT FROM AUTHOR]

In spite of recognition that lesbian, gay, bisexual, and queer+ (LGBQ+) young adults face challenges associated with their sexual identities, research on inequality in education has only recently begun examining their academic experiences and outcomes in college. Prior work has mainly focused on social and extracurricular experiences during college or academic outcomes among LGBQ+ students in K‐12 settings. In this article, we review the growing body of social science literature on LGBQ+ college students' academic outcomes. A strength of our review is our integration of research on individual, interpersonal, and institutional characteristics and experiences that influence LGBQ+ student outcomes. In reviewing the literature, we identify a number of methodological and theoretical limitations, such as a lack of precision and consistency in defining and conceptualizing LGBQ+ identities and experiences and limited attention to intersections with race, class, and gender. We offer some solutions to these limitations and present a theoretical framework that promises to add clarity and further reliability to future research on LGBQ+ college student outcomes. We conclude by suggesting directions for future research. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition is prevalent in hospitalized surgical patients and has been shown to significantly alter outcomes including length of hospital stay, complications, and mortality. Different tools for nutrition assessment were developed and are being used. The aim of this study was to characterize the nutritional status of acute care surgery patients, determine risk factors for malnutrition, and describe outcomes in patients with malnutrition. Methods: This was a prospective, descriptive study of malnutrition in acute care surgery patients at CHUK. Over a 6-month time period, we collected data on demographics, diagnosis, operation, and patient outcomes. We assessed the incidence of malnutrition using the American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines and Subjective Global Assessment (SGA). We reported frequencies and percentages for categorical variables and median and interquartile range (IQR) for continuous variables. Results: We analyzed data for 279 acute care surgery patients. Most (n = 209, 73%) patients were male. The median duration of symptoms was 5 days (IQR 2, 14). The most common diagnoses were trauma (n = 83, 30%), intestinal obstruction (n = 76, 27%), and peritonitis (n = 49, 18%). Most (n = 210, 73%) patients underwent operation. The median length of hospital stay was 6 days (IQR 4, 11). Using ASPEN guidelines, 99 (35%) patients had evidence of malnutrition on hospital admission and 76 (27%) had evidence of malnutrition using SGA. After 1 week of hospital stay, 48 (41%) patients had evidence of malnutrition. Overall mortality was 3%, with higher mortality seen in patients with malnutrition (8% vs. 0.6%, p = 0.001). The length of hospital stay was longer in patients with malnutrition on hospital admission (6 days vs. 5 days, p = 0.044). Conclusions: Acute care surgical patients present to the hospital at high-risk for malnutrition. Efforts are needed to ensure that surgical patients receive adequate nutrition support to improve patient outcomes and minimize complications. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis and infection by soil-transmitted helminths are some of the world's most prevalent neglected tropical diseases. Infection by more than one parasite (co-infection) is common and can contribute to clinical morbidity in children. Geostatistical analyses of parasite infection data are key for developing mass drug administration strategies, yet most methods ignore co-infections when estimating risk. Infection status for multiple parasites can act as a useful proxy for data-poor individual-level or environmental risk factors while avoiding regression dilution bias. Conditional random fields (CRF) is a multivariate graphical network method that opens new doors in parasite risk mapping by (i) predicting co-infections with high accuracy; (ii) isolating associations among parasites; and (iii) quantifying how these associations change across landscapes. Methods: We built a spatial CRF to estimate infection risks for Ascaris lumbricoides, Trichuris trichiura, hookworms (Ancylostoma duodenale and Necator americanus) and Schistosoma mansoni using data from a national survey of Rwandan schoolchildren. We used an ensemble learning approach to generate spatial predictions by simulating from the CRF's posterior distribution with a multivariate boosted regression tree that captured non-linear relationships between predictors and covariance in infection risks. This CRF ensemble was compared against single parasite gradient boosted machines to assess each model's performance and prediction uncertainty. Results: Parasite co-infections were common, with 19.57% of children infected with at least two parasites. The CRF ensemble achieved higher predictive power than single-parasite models by improving estimates of co-infection prevalence at the individual level and classifying schools into World Health Organization treatment categories with greater accuracy. The CRF uncovered important environmental and demographic predictors of parasite infection probabilities. Yet even after capturing demographic and environmental risk factors, the presences or absences of other parasites were strong predictors of individual-level infection risk. Spatial predictions delineated high-risk regions in need of anthelminthic treatment interventions, including areas with higher than expected co-infection prevalence. Conclusions: Monitoring studies routinely screen for multiple parasites, yet statistical models generally ignore this multivariate data when assessing risk factors and designing treatment guidelines. Multivariate approaches can be instrumental in the global effort to reduce and eventually eliminate neglected helminth infections in developing countries. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis is a neglected tropical disease caused by Schistosoma parasites. Intervention relies on identifying high-risk regions, yet rapid Schistosoma diagnostics (Kato-Katz stool assays (KK) and circulating cathodic antigen urine assays (CCA)) yield different prevalence estimates. We mapped S. mansoni prevalence and delineated at-risk regions using a survey of schoolchildren in Rwanda, where Schistosoma mansoni is an endemic parasite. We asked if different diagnostics resulted in disparities in projected infection risk. Methods: Infection data was obtained from a 2014 Rwandan school-based survey that used KK and CCA diagnostics. Across 386 schools screened by CCA (N = 19,217). To allow for uncertainty when interpreting ambiguous CCA trace readings, which accounted for 28.8% of total test results, we generated two presence-absence datasets: CCA trace as positive and CCA trace as negative. Samples (N = 9,175) from 185 schools were also screened by KK. We included land surface temperature (LST) and the Normalized Difference Vegetation and Normalized Difference Water Indices (NDVI, NDWI) as predictors in geostatistical regressions. Findings: Across 8,647 children tested by both methods, prevalence was 35.93% for CCA trace as positive, 7.21% for CCA trace as negative and 1.95% for KK. LST was identified as a risk factor using KK, whereas NDVI was a risk factor for CCA models. Models predicted high endemicity in Northern and Western regions of Rwanda, though the CCA trace as positive model identified additional high-risk areas that were overlooked by the other methods. Estimates of current burden for children at highest risk (boys aged 5–9 years) varied by an order of magnitude, with 671,856 boys projected to be infected by CCA trace as positive and only 60,453 projected by CCA trace as negative results. Conclusions: Our findings show that people in Rwanda’s Northern, Western and capital regions are at high risk of S. mansoni infection. However, variation in identification of environmental risk factors and delineation of at-risk regions using different diagnostics likely provides confusing messages to disease intervention managers. Further research and statistical analyses, such as latent class analysis, can be used to improve CCA result classification and assess its use in guiding treatment regimes. [ABSTRACT FROM AUTHOR]

Purpose Minimal turnaround time for pathology results is crucial for highest-quality patient care in all settings, especially in low- and middle-income countries, where rural populations may have limited access to health care. Methods We retrospectively determined the turnaround times (TATs) for anatomic pathology specimens, comparing three different modes of operation that occurred throughout the development and implementation of our pathology laboratory at the Butaro Cancer Center of Excellence in Rwanda. Before opening this laboratory, TAT was measured in months because of inconsistent laboratory operations and a paucity of in-country pathologists. Results We analyzed 2,514 individual patient samples across the three modes of study. Diagnostic mode 1 (samples sent out of the country for analysis) had the highest median TAT, with an overall time of 30 days (interquartile range [IQR], 22 to 43 days). For diagnostic mode 2 (static image telepathology), the median TAT was 14 days (IQR, 7 to 27 days), and for diagnostic mode 3 (onsite expert diagnosis), it was 5 days (IQR, 2 to 9 days). Conclusion Our results demonstrate that telepathology is a significant improvement over external expert review and can greatly assist sites in improving their TATs until pathologists are on site. [ABSTRACT FROM AUTHOR]

Purpose: Minimal turnaround time for pathology results is crucial for highest-quality patient care in all settings, especially in low- and middle-income countries, where rural populations may have limited access to health care. Methods: We retrospectively determined the turnaround times (TATs) for anatomic pathology specimens, comparing three different modes of operation that occurred throughout the development and implementation of our pathology laboratory at the Butaro Cancer Center of Excellence in Rwanda. Before opening this laboratory, TAT was measured in months because of inconsistent laboratory operations and a paucity of in-country pathologists. Results: We analyzed 2,514 individual patient samples across the three modes of study. Diagnostic mode 1 (samples sent out of the country for analysis) had the highest median TAT, with an overall time of 30 days (interquartile range [IQR], 22 to 43 days). For diagnostic mode 2 (static image telepathology), the median TAT was 14 days (IQR, 7 to 27 days), and for diagnostic mode 3 (onsite expert diagnosis), it was 5 days (IQR, 2 to 9 days). Conclusion: Our results demonstrate that telepathology is a significant improvement over external expert review and can greatly assist sites in improving their TATs until pathologists are on site. [ABSTRACT FROM AUTHOR]

Theories suggest curricular tracking is linked to racial/ethnic inequality. However, prior studies largely examine cognitive outcomes like standardized test scores and neglect behavioral outcomes. They also overlook potential racial/ethnic differences within curricular tracks. This study asks the following questions: (a) Is curricular tracking associated with young women’s social and behavioral outcomes during the transition to adulthood (dropping out of high school, teen motherhood, and poverty)? and (b) Are there racial/ethnic differences in these associations? Using National Longitudinal Survey of Youth data and logistic regression, results show that all women reduce risks of negative outcomes in the college and vocational tracks compared with the general track. However, college track coursework buffers White women from dropping out and teen motherhood (but not poverty) significantly more than it does Black and Latina women. Thus, racial gaps are greatest within the college track rather than lower tracks, suggesting that the college track may be a site for opportunity hoarding among Whites. [ABSTRACT FROM AUTHOR]

Background: Plasmodium infection and malaria in school children are increasingly recognized as a relevant public health problem, but data on actual prevalence and health consequences are insufficient. The present study from highland southern Rwanda aimed at estimating infection prevalence among children attending school, at identifying associated factors and at assessing the clinical consequences of these infections. Methods: In a survey including 12 schools in the Huye district of Rwanda, 1089 children aged 6-10 years were clinically and anthropometrically examined, malaria parasites were diagnosed by microscopy and PCR, haemoglobin concentrations were measured, and socio-economic and behavioural parameters as well as medical histories were obtained. Results: Upon examination, the vast majority of children was asymptomatic (fever 2.7%). Plasmodium infection was detected in 22.4% (Plasmodium falciparum, 18.8%); 41% of these were submicroscopic. Independent predictors of infection included low altitude, higher age, preceding antimalarial treatment, and absence of electricity or a bicycle in the household. Plasmodium infection was associated with anaemia (mean haemoglobin difference of -1.2 g/dL; 95% CI, -0.8 to -1.5 g/dL), fever, underweight, clinically assessed malnutrition and histories of fever, tiredness, weakness, poor appetite, abdominal pain, and vomiting. With the exception of underweight, these conditions were also increased at submicroscopic infection. Conclusion: Malaria infection is frequent among children attending school in southern highland Rwanda. Although seemingly asymptomatic in the vast majority of cases, infection is associated with a number of non-specific symptoms in the children's histories, in addition to the impact on anaemia. This argues for improved malaria surveillance and control activities among school children. [ABSTRACT FROM AUTHOR]

Background Early work on school readiness focused on academic skills. Recent research highlights the value of also including both children's social and behavioural competencies and family support. Aims Reflecting this broader approach, this study aimed to develop a new and brief questionnaire for teachers: The Brief Early Skills and Support Index ( BESSI). Sample The main sample, recruited from the north-west of England, included 1,456 children (49% male), aged 2.5 to 5.5 years. A second sample consisting of 258 children (44% male) aged 3 to 5.5 years was recruited to assess the test-retest reliability of the BESSI across a 1-month interval. Methods Following development and pilot work with early years teachers, a streamlined (30 items) version of the BESSI was sent to 98 teachers and nursery staff, who rated the children in their class. Results The best-fitting model included four latent factors: Three child factors (Behavioural Adjustment, Language and Cognition, and Daily Living Skills) and one Family Support factor. The three child factors exhibited measurement invariance across gender. All four factors showed good internal consistency and test-retest reliability. Structural equation modelling showed that (1) boys had more problems than girls on all three child factors; (2) older children showed better Language and Cognition and Daily Living Skills than younger children; and (3) children eligible for free school meals (an index of financial hardship) had more problems on all four latent factors. Family Support latent scores predicted all three child latent factors and accounted for their correlation with financial hardship. Conclusions The BESSI is a promising brief teacher-report screening tool that appears suitable for children aged 2.5 to 5.5 and provides a broader perspective upon school readiness than previous measures. [ABSTRACT FROM AUTHOR]

Background: Podoconiosis is one of the major causes of lymphoedema in the tropics. Nonetheless, currently there are no endemicity classifications or elimination targets to monitor the effects of interventions. This study aimed at establishing case definitions and indicators that can be used to assess endemicity, elimination and clinical outcomes of podoconiosis. Methods: This paper describes the result of a Delphi technique used among 28 experts. A questionnaire outlining possible case definitions, endemicity classifications, elimination targets and clinical outcomes was developed. The questionnaire was distributed to experts working on podoconiosis and other neglected tropical diseases in two rounds. The experts rated the importance of case definitions, endemic classifications, elimination targets and the clinical outcome measures. Median and mode were used to describe the central tendency of expert responses. The coefficient of variation was used to describe the dispersals of expert responses. Results: Consensus on definitions and indicators for assessing endemicity, elimination and clinical outcomes of podoconiosis directed at policy makers and health workers was achieved following the two rounds of Delphi approach among the experts. Conclusions: Based on the two Delphi rounds we discuss potential indicators and endemicity classification of this disabling disease, and the ongoing challenges to its elimination in countries with the highest prevalence. Consensus will help to increase effectiveness of podoconiosis elimination efforts and ensure comparability of outcome data. [ABSTRACT FROM AUTHOR]

Many scholars highlight the benefits of high educational expectations. The study of adolescent women’s sexual risk-taking focuses on college expectations and high achievement for buffering young women from negative outcomes. But one’s expectations and level of college preparation could be mismatched, which may have negative effects. Congruent expectations and achievement are likely to be most beneficial, while inflated expectations (high expectations and low test scores) and deflated expectations (low expectations and high test scores) are expected to be associated with higher risks. College preparatory versus lower coursework in high school may also moderate or mediate these effects. This study used National Educational Longitudinal Study (NELS:88) data with event history and logistic regression analyses to examine how expectations, achievement, and college-preparatory math coursework interact to affect adolescent women’s risk of unprotected first sex. Results show that the effects of expectations are conditional on achievement and coursework: Inflated or deflated expectations (relative to test scores) are associated with the highest risks of unprotected sex, as are low expectations among women in non-college-preparatory math. Theoretically, this has implications for understanding “rationality” in the relationship between educational factors and adolescent women’s sexual risk-taking, as well as for reconsidering the notion that high educational expectations always benefit youth. [ABSTRACT FROM AUTHOR]

Background: To control malaria, the Rwandan government and its partners distributed insecticide-treated nets (ITN) and made artemisinin-based combination therapy (ACT) widely available from 2005 onwards. The impact of these interventions on malaria cases, admissions and deaths was assessed using data from district hospitals and household surveys. Methods: District records of ITN and ACT distribution were reviewed. Malaria and non-malaria indictors in 30 district hospitals were ascertained from surveillance records. Trends in cases, admissions and deaths for 2000 to 2010 were assessed by segmented log-linear regression, adjusting the effect size for time trends during the pre-intervention period, 2000-2005. Changes were estimated by comparing trends in post-intervention (2006-2010) with that of pre-intervention (2000-2005) period. All-cause deaths in children under-five in household surveys of 2005 and 2010 were also reviewed to corroborate with the trends of deaths observed in hospitals. Results: The proportion of the population potentially protected by ITN increased from nearly zero in 2005 to 38% in 2006, and 76% in 2010; no major health facility stock-outs of ACT were recorded following their introduction in 2006. In district hospitals, after falling during 2006-2008, confirmed malaria cases increased in 2009 coinciding with decreased potential ITN coverage and declined again in 2010 following an ITN distribution campaign. For all age groups, from the pre-intervention period, microscopically confirmed cases declined by 72%, (95% Confidence Interval [CI], 12-91%) in 2010, slide positivity rate declined 58%, (CI, 47%-68%), malaria inpatient cases declined 76% (CI, 49%-88%); and malaria deaths declined 47% (CI, 47%-81%). In children below five years of age, malaria inpatients decreased 82% (CI, 61%-92%) and malaria hospital deaths decreased 77% (CI, 40%-91%). Concurrently, outpatient cases, admissions and deaths due to non-malaria diseases in all age groups either increased or remained unchanged. Rainfall and temperature remained favourable for malaria transmission. The annual all-cause mortality in children under-five in household surveys declined from 152 per 1,000 live births during 2001-2005, to 76 per 1,000 live births in 2006-2010 (55% decline). The five-year cumulative number of all-cause deaths in hospital declined 28% (8,051 to 5,801) during the same period. Conclusions: A greater than 50% decline in confirmed malaria cases, admissions and deaths at district hospitals in Rwanda since 2005 followed a marked increase in ITN coverage and use of ACT. The decline occurred among both children under-five and in those five years and above, while hospital utilization increased and suitable conditions for malaria transmission persisted. Declines in malaria indicators in children under 5 years were more striking than in the older age groups. The resurgence in cases associated with decreased ITN coverage in 2009 highlights the need for sustained high levels of anti-malarial interventions in Rwanda and other malaria endemic countries. [ABSTRACT FROM AUTHOR]

Studies of teacher satisfaction suggest that satisfaction is related to both the racial composition and the organizational structure of the schools in which teachers work. In this article, the authors draw from theories of race and organizations to examine simultaneously the effects of school type (traditional public vs. charter) and racial mismatch on teacher satisfaction and subsequent turnover. In doing so, they examine the organizational differences between traditional public and charter schools that contribute to systematic differences in satisfaction and turnover across these school types. Using 1999-2000 Schools and Staffing Survey data, the authors find that charter school teachers are more satisfied than are public school teachers because of greater autonomy. Charter school teachers, however, are more likely to leave teaching than are traditional teachers. The authors also show that teaching in racially mismatched schools results in lower levels of satisfaction for white teachers and that being in a charter school reduces this negative effect. [ABSTRACT FROM PUBLISHER]

The first case is about a man of 60 years old suffering of hypereosinophilic syndrome (HES) developed since 1998. He presented chronic cough, insomnia, and negative parasitical test. We observed hypereosinophilia and fibroblastic hyperplasia at the bone marrow biopsy. Initially, hydroxyurea and α-interferon treatment failed. We proposed to him imatinib mesylate in May 2003. The FIP1L1-PDGFRA gene was detected. The second case is about a man of 34 years old seen in March 2002. First investigation concluded to CML. Progressively, eosinophil cells increased, and complications occurred as oedema syndrome, dyspnoea, and parietal chronic endocarditic fibrosis associated with pericarditis. In addition, a bowel obstruction happened and was cured by surgery. Bcr-abl fusion was negative, and FIP1L1-PDGFRA gene was detected after and imatinib mesylate was given. Actually, endocarditic fibrosis decreased. The two patients are in haematological and cytogenetic remission. We concluded that clonal HES is present in Africa, and imatinib mesylate is effective. [ABSTRACT FROM AUTHOR]

The hematological reference values are very important for diagnostic orientation and treatment decision. The aim of this study was to establish hematological reference values for healthy adults in Togo. A total of 2571 voluntary blood donors participated to this study. Only 1349 subjects negative for HIV, HBV, HCV, malaria, and without hemoglobin abnormalities in electrophoresis and hypochromia on blood smear, were definitively retained for the study. Median hemoglobin level was higher in males than females (15.1 g/dL versus 13.0 g/dL, p = 0.000).Median total WBC (4.2 x 109/L) and absolute neutrophil counts (1.6 x 109/L) were similar by gender. The median lymphocyte counts in males and females were, respectively, 2.1 x 109/L and 2.2 x 109/L (p = 0.11). The median platelet count was lower in males than females (236 x 109/L versus 247 x 109/L, p = 0.004). Our median values for RBC parameters differ from those of African countries probably because of our inclusion criteria which eliminate most cases with iron deficiency and/or thalassemia. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to determine the test characteristics for two different ultrasound (US) measures of severe dehydration in children (aorta to inferior vena cava [IVC] ratio and IVC inspiratory collapse) and one clinical measure of severe dehydration (the World Health Organization [WHO] dehydration scale). Methods: The authors enrolled a prospective cohort of children presenting with diarrhea and/or vomiting to three rural Rwandan hospitals. Children were assessed clinically using the WHO scale and then underwent US of the IVC by a second clinician. All children were weighed on admission and then fluid-resuscitated according to standard hospital protocols. A percent weight change between admission and discharge of greater than 10% was considered the criterion standard for severe dehydration. Receiver operating characteristic (ROC) curves were created for each of the three tests of severe dehydration compared to the criterion standard. Results: Children ranged in age from 1 month to 10 years; 29% of the children had severe dehydration according to the criterion standard. Of the three different measures of dehydration tested, only US assessment of the aorta/IVC ratio had an area under the ROC curve statistically different from the reference line. At its best cut-point, the aorta/IVC ratio had a sensitivity of 93% and specificity of 59%, compared with 93% and 35% for IVC inspiratory collapse and 73% and 43% for the WHO scale. Conclusions: Ultrasound of the aorta/IVC ratio can be used to identify severe dehydration in children presenting with acute diarrhea and may be helpful in guiding clinical management. ACADEMIC EMERGENCY MEDICINE 2010; 17:1035-1041 © 2010 by the Society for Academic Emergency Medicine [ABSTRACT FROM AUTHOR]

While reading online forums and frequently asked questions (FAQs) pertaining to network security, inevitably one of the questions asked is “Is my network secure'” The typical answer is that one can never be completely certain that all security measures have been taken to protect a network from intruders. While this may be true, there are ways to increase the confidence of network administrators with regards to protecting the data and resources entrusted to them. This paper will present a strategy that, if implemented, will improve confidence that all necessary precautions in establishing a secure network have been taken. [ABSTRACT FROM AUTHOR]

Background: The efficacy of amodiaquine (AQ), sulphadoxine-pyrimethamine (SP) and the combination of SP+AQ in the treatment of Cameroonian children with clinical malaria was investigated. The prevalence of molecular markers for resistance to these drugs was studied to set the baseline for surveillance of their evolution with time. Methods: Seven hundred and sixty children aged 6-59 months with uncomplicated falciparum malaria were studied in three ecologically different regions of Cameroon - Mutengene (littoral equatorial forest), Yaoundé (forestsavannah mosaic) and Garoua (guinea-savannah). Study children were randomized to receive either AQ, SP or the combination AQ+SP. Clinical outcome was classified according to WHO criteria, as either early treatment failure (ETF), late clinical failure (LCF), late parasitological failure (LPF) or adequate clinical and parasitological response (ACPR). The occurrence of mutations in pfcrt, pfmdr1, dhfr and dhps genes was studied by either RFLP or dot blot techniques and the prevalence of these mutations related to parasitological and therapeutic failures. Results: After correction for the occurrence of re-infection by PCR, ACPRs on day 28 for AQ, SP and AQ+SP were 71.2%, 70.1% and 80.9%, in Garoua, 79.2%, 62.5%, and 81.9% in Mutengene, and 80.3%, 67.5% and 76.2% in Yaoundé respectively. High levels of Pfcrt 76T (87.11%) and Pfmdr1 86Y mutations (73.83%) were associated with quinoline resistance in the south compared to the north, 31.67% (76T) and 22.08% (86Y). There was a significant variation (p < 0.001) of the prevalence of the SGK haplotype between Garoua in the north (8.33%), Yaoundé (36.29%) in the savannah-forest mosaic and Mutengene (66.41%) in the South of Cameroon and a weak relation between SGK haplotype and SP failure. The 540E mutation on the dhps gene was extremely rare (0.3%) and occurred only in Mutengene while the pfmdr1 1034K and 1040D mutations were not detected in any of the three sites. Conclusion: In this study the prevalence of molecular markers for quinoline and anti-folate resistances showed high levels and differed between the south and north of Cameroon. AQ, SP and AQ+SP treatments were well tolerated but with low levels of efficacy that suggested alternative treatments were needed in Cameroon since 2005. [ABSTRACT FROM AUTHOR]

Background: Over the last decade, utilization of ultrasound technology by non-radiologist physicians has grown. Recent advances in affordability, durability, and portability have brought ultrasound to the forefront as a sustainable and high impact technology for use in developing world clinical settings as well. However, ultrasound's impact on patient management plans, program sustainability, and which ultrasound applications are useful in this setting has not been well studied. Methods: Ultrasound services were introduced at two rural Rwandan district hospitals affiliated with Partners in Health, a US nongovernmental organization. Data sheets for each ultrasound scan performed during routine clinical care were collected and analyzed to determine patient demographics, which ultrasound applications were most frequently used, and whether the use of the ultrasound changed patient management plans. Ultrasound scans performed by the local physicians during the post-training period were reviewed for accuracy of interpretation and image quality by an ultrasound fellowship trained emergency medicine physician from the United States who was blinded to the original interpretation. Results: Adult women appeared to benefit most from the presence of ultrasound services. Of the 345 scans performed during the study period, obstetrical scanning was the most frequently used application. Evaluation of gestational age, fetal head position, and placental positioning were the most common findings. However, other applications used included abdominal, cardiac, renal, pleural, procedural guidance, and vascular ultrasounds. Ultrasound changed patient management plans in 43% of total patients scanned. The most common change was to plan a surgical procedure. The ultrasound program appears sustainable; local staff performed 245 ultrasound scans in the 11 weeks after the departure of the ultrasound instructor. Post-training scan review showed the concordance rate of interpretation between the Rwandese physicians and the ultrasound-trained quality review physicians was 96%. Conclusion: We suggest ultrasound is a useful modality that particularly benefits women's health and obstetrical care in the developing world. Ultrasound services significantly impact patient management plans especially with regards to potential surgical interventions. After an initial training period, it appears that an ultrasound program led by local health care providers is sustainable and lead to accurate diagnoses in a rural international setting. [ABSTRACT FROM AUTHOR]

The pollen of nine endemic taxa of the Gonospermum Less., Lugoa DC. and Tanacetum L. complex and of T. parthenium L. (introduced species from the Canary Islands) was studied using light and scanning electron microscopy with the aim of extending the knowledge of their morphology and to investigate whether pollen morphology may help clarifying the controversial taxonomy of these taxa. Twenty six populations in the Canary Islands (Spain) were studied and the following parameters were measured: polar axis (P), equatorial diameter (E), polar exine thickness (Ex1), length (L) and thickness (A) of the spines in the meridional optical section, exine thickness at the centre of the mesocolpium in the interapertural area (Ex2) and distance between spines (De) in the equatorial optical section. The studies show that the pollen of the three genera is very similar regarding shape, apertures, and ornamentation, but may be distinguished by size and exine thickness. [ABSTRACT FROM AUTHOR]

We standardized an indirect ELISA for measurement of serum antibody levels to four individual treponemal recombinant proteins that have been commonly used in a number of commercial EIAs, mostly as a mixture of antigens. When tested with 127 syphilis-negative and 37 secondary syphilis sera, ELISA O.D.s obtained for each of the four antigens clearly distinguished between these two groups of samples. Sensitivity and specificity of 100% was obtained with the current set of samples. Further evaluations with sera from different stages of syphilis can help to define the applications of this ELISA test for each of the four antigens studied. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Against a background of a lack of systematic epidemiological research in Ireland in the area, this study set out to determine prevalence rates of psychiatric disorders, suicidal ideation and intent, and parasuicide in a population of Irish adolescents aged 12–15 years in a defined geographical area. Method: All 12–15-year olds attending eight secondary schools were eligible for inclusion. A two-stage procedure was used involving a screening and an interview phase. Those scoring in the clinical range on the screening measures were interviewed, along with a comparison group matched for gender, school and school year. Results: 19.4% of the 723 screened were identified as being ‘at risk’. This ‘at risk’ group was interviewed along with a comparison sample. 15.6% of the total study population met the criteria for a current psychiatric disorder, including 4.5% with an affective disorder, 3.7% with an anxiety disorder and 3.7% with ADHD. Significant past suicidal ideation was experienced by 1.9%, and 1.5% had a history of parasuicide. Binge drinking was associated with both affective and behaviour disorders. Conclusions: Rates of psychiatric disorders and suicidal behaviours are similar in young Irish adolescents to those in other Western cultures. Mental health promotion should be given priority in schools. [Copyright &y& Elsevier]

The pollen content of 31 honey samples from 19 different apiaries of El Hierro (Canary Islands) were subject to qualitative and quantitative melissopalynological analysis. The quantitative analysis demonstrated that 13% of the honey belonged to Maurizio Class I ( Erica arborea L.), two of Chamaecytisus proliferus (L. f.) Link‐type (“tagasaste”), one of Fabaceae (Genisteae sp.) and one of Lamiaceae Origanum vulgare L. ssp. virens (Hoffmanns. & Link) Ietsw.‐type (thyme: Micromeria hyssopifolia Webb & Berthel.). Honeydew elements were practically absent. Sixty‐nine pollen types were identified belonging to 42 families. The number of pollen types range between 18 and 39 (mean of 27.42). Foeniculum vulgare Mill.‐type pollen is present in all the samples. Galactites tomentosa Moench‐type, Echium plantagineum L., Echium L. sp., Bituminaria bituminosa (L.) C. H. Stirt., Chamaecytisus proliferus ‐type and Origanum vulgare ssp. virens ‐type pollen were found in 96.8% of the samples. The sensorial analysis indicated that honey types are generally of good quality, because 62% were evaluated as very high (16%), high (23%), and good (23%). [ABSTRACT FROM AUTHOR]

Suicide rates in young Irish males have risen markedly in the past 10 years, and suicide is now the leading cause of death in young men in the 15–24-year-old age range.This is the first large-scale study in Ireland that set out to identify young people at risk of psychiatric disorders, including depressive disorders, and suicidal ideation. Seven hundred and twenty three school-going adolescents aged 12–15 years were screened using the Children''s Depression Inventory and the Strengths and Difficulties Questionnaire. 19.4% were identified as being ‘at risk’ of having a mental health disorder. Of this ‘at risk’ group, 12.1% expressed possible suicidal intent and 45.7% expressed suicidal ideation. Of the 583 adolescents identified as being ‘not at risk’, 13% expressed suicidal ideation while none expressed suicidal intent. Being ‘at risk’ was not related to gender or to socio-economic status. Those living with two parents were significantly more likely to be in the ‘not at risk’ group. Girls attending co-educational schools were twice as likely to be in ‘at risk’ group compared with those attending all girls schools, while school type was not a risk factor for boys.This study shows that, as in other western countries, there are large numbers of young Irish people at risk of mental health disorders and suicidal ideation in the community, and raises the question of the importance of mental health promotion in our education system. [Copyright &y& Elsevier]

OBJECTIVES/HYPOTHESIS Occult papillary thyroid carcinoma has a reported prevalence of 1% to 35% based on autopsy studies. Cervical lymphatic metastases from papillary thyroid carcinoma have been associated with a higher likelihood of recurrence with a questionable impact on survival. Without clinically evident disease in the thyroid or cervical nodes, management of these patients presents a treatment dilemma. We propose an individualized treatment plan for patients in whom metastatic papillary thyroid carcinoma is incidentally detected during neck exploration for other purposes.STUDY DESIGN Retrospective review and discussion of the literature.METHODS The clinical course of two patients with incidentally discovered metastatic papillary thyroid carcinoma to the cervical lymph nodes is described. Both patients had previously received head and neck irradiation in childhood and required free flap reconstruction of extensive skull base defects following extirpation of meningiomas.RESULTS Neck dissection specimens from levels I and II obtained during exposure of recipient vessels for microvascular tissue transfer revealed papillary thyroid carcinoma in both cases. The patients subsequently underwent total thyroidectomy, neck dissection, and postoperative radioactive iodine ablation of residual thyroid tissue. After 1 year of follow-up, both patients were without evidence of recurrent disease.CONCLUSIONS An individualized approach is justified to treat metastatic papillary thyroid carcinoma incidentally discovered during other procedures. The case reports underscore the importance of pathological analysis of surgical specimens obtained during head and neck reconstruction. [ABSTRACT FROM AUTHOR]

To explain whether high school graduates enroll in college, human capital theory suggests that youths act as "adolescent econometricians," assessing the added value of education in terms of their expected income returns to schooling. Although there is some truth to this explanation, the application of the theory is often limited because researchers have ignored important racial, class, and gender differences in economic and educational arenas. This study used data from High School and Beyond to examine whether economic conditions similarly influence the postsecondary enrollment of adolescents from distinct groups. The results indicate that the effect of income returns varies systematically by race, class, gender, and cognitive skills; the college enrollment of white men from lower socioeconomic origins with lower cognitive skills is the most consistent with human capital predictions. Thus, membership in different, groups in the stratification hierarchy importantly alters the calculations and decisions made by "adolescent econometricians." [ABSTRACT FROM AUTHOR]

Examines the role of dry mass per unit of leaf area and ash content for carbon isotope discrimination in durum wheat flag leaves and grains. Depletion of the plant dry matter; Determination of the wheat genotypes; Measurement of the grain yield.

This study assesses the effects of high school educational experiences on the risk of incarceration for young men aged 19-36 using event history analysis and National Longitudinal Survey of Youth data. High school education serves as a defining moment in an individual's life course. Young men who enroll in secondary occupational course work significantly reduce their likelihood of incarceration both overall and net of differences in the adult labor market. High school student/teacher ratios and student composition also significantly affect an individual's risk of incarceration. [ABSTRACT FROM AUTHOR]

Background: HBV, HCV, HDV and HIV are blood borne and can be transmitted from mother-to-child. Reports of HBV infection rates show up to 11.9% in Cameroon while for HCV, the rate is less than 2%. More so, as pregnant women get enrolled in the HIV PMTCT Programme and stay in the care continuum, selection of HIV-1 drug resistant strains is evident. We sought to determine the seroprevalence of HBV, HCV, HDV and HIV among pregnant women, assess their knowledge, attitudes and practices on transmission and prevention of HBV infection, and determine HIV drug resistance profile of breastfeeding women.Methods: A serosurvey of HBV, HCV, HDV and HIV was carried out among 1005 pregnant women in Yaounde, Cameroon. In 40 HIV-infected breastfeeding women enrolled in the PMTCT Programme, HIV-1 genotypes and HIV-1 resistance to NRTIs, NNRTIs and PIs, were determined by phylogeny and the Stanford University HIV Drug Resistance interpretation tool, respectively.Results: Among the pregnant women, the rates of HIV-1, HBV, HCV and HDV infections were 8.5, 6.4, 0.8 and 4.0%, respectively. About 5.9% of the women knew their HBV status before pregnancy unlike 63.7% who knew their HIV status. Although 83.3% reported that vaccination against HBV infection is a method of prevention, and 47.1% knew that HBV could be transmitted from mother-to-child, only 2.5% had received the Hepatitis B vaccine. Of the 40 women on antiretroviral therapy (ART), 9 had at least one major resistance-associated mutation (RAM, 22.5%) to NRTI, NNRTI or PI. Of these M184 V (12.5%), K70R (10.0%), K103 N (12.5%), Y181C (10.0%), M46 L (2.5%) and L90 M (2.5%) were most frequently identified, suggesting resistance to lamivudine, nevirapine, efavirenz and zidovudine. Eighty four percent were infected with HIV-1 recombinant strains with CRF02_AG predominating (50%).Conclusions: The rates of HBV and HIV-1 infections point to the need for early diagnosis of these viruses during pregnancy and referral to care services in order to minimize the risk of MTCT. Furthermore, our results would be useful for evaluating the HIV PMTCT Programme and Treatment Guidelines for Cameroon. [ABSTRACT FROM AUTHOR]