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Copyright of Conservation Biology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While the importance of professional support following very preterm delivery (VP) is established, the parental experience of support still warrants deeper understanding. Evaluation of a Dutch one-year post-discharge responsive parenting intervention following VP suggested that parents with lower educational levels benefitted less from the program. This idiographic phenomenological study investigated the lived experiences of two mothers with differing educational backgrounds receiving professional support during hospitalization and post-discharge. In-depth interviews with the mothers were analyzed using Interpretative Phenomenological Analysis. We formulate three impressions: (1) How the mothers made sense of their experiences resonated with the findings of research on class differences in parenting. (2) The mothers valued professionals who struck a personalized balance between supporting their maternal agency and attending to their vulnerability and needs for help and perspective. (3) The mothers experienced greater trust in professionals who could suspend pre-conceived assumptions and take their personal characteristics into consideration. Practice suggestions are extrapolated for social work professionals. The study has relevance to educational diversity and recommends an overarching sensitivity to positionality in professional work with parents. [ABSTRACT FROM AUTHOR]

Aim: To evaluate parental mental health monitoring during follow-up care for very preterm (VPT) infants, describe symptoms of anxiety and depression and risk factors for mothers and fathers at 1 and 12 months of corrected age.Methods: Parents completed the Hospital Anxiety and Depression Scale (HADS). Psychological symptoms and risk factors were analysed within and between mothers and fathers.Results: In 4 years, the monitoring reached 1260 (48%) families. Of these, 693 mothers and 340 fathers (300 couples) completed the HADS twice. At 1 month, 22% and 15% of the mothers and 10% and 9% of the fathers, respectively, reported elevated symptoms of anxiety and depression. At 12 months, these rates were significantly reduced to 14% and 9% for mothers and 5% and 4% for fathers respectively. Within couples, anxiety and depression were positively associated. At 12 months, in 20% of the couples, one or both parents reported elevated symptoms. Risk factors were length of hospital stay, migration background, educational level and employment status.Conclusion: The mental health of parents of VPT infants improved, but elevated symptoms were still observed in 17% of included families after one year. Acknowledging and remediating parental mental health remain essential during follow-up care. [ABSTRACT FROM AUTHOR]

Background: Endoxifen is the most important active metabolite of tamoxifen. Several retrospective studies have suggested a minimal or threshold endoxifen systemic concentration of 14-16 nM is required for a lower recurrence rate. The aim of this study was to investigate the feasibility of reaching a predefined endoxifen level of ≥ 16 nM (5.97 ng/mL) over time using therapeutic drug monitoring (TDM).Methods: This prospective open-label intervention study enrolled patients who started treatment with a standard dose of tamoxifen 20 mg once daily for early breast cancer. An outpatient visit was combined with a TDM sample at 3, 4.5, and 6 months after initiation of the tamoxifen treatment. The tamoxifen dose was escalated to a maximum of 40 mg if patients had an endoxifen concentration < 16 nM. The primary endpoint of the study was the percentage of patients with an endoxifen level ≥ 16 nM at 6 months after the start of therapy compared with historical data, in other words, 80% of patients with endoxifen levels ≥ 16 nM with standard therapy.Results: In total, 145 patients were included. After 6 months, 89% of the patients had endoxifen levels ≥ 16 nM, compared with a literature-based 80% of patients with endoxifen levels ≥ 16 nM at baseline (95% confidence interval 82-94; P = 0.007). In patients with an affected CYP2D6 allele, it was not always feasible to reach the predefined endoxifen level of ≥ 16 nM. No increase in tamoxifen-related adverse events was reported after dose escalation.Conclusion: This study demonstrated that it is feasible to increase the percentage of patients with endoxifen levels ≥ 16 nM using TDM. TDM is a safe strategy that offers the possibility of nearly halving the number of patients with endoxifen levels < 16 nM. [ABSTRACT FROM AUTHOR]

Background: Cancer and its treatment can severely affect sexual health. It is unknown how this may relate to the feelings of closeness between patients and their partners. Aim: To assess the association between sexual health and closeness in the relationship in couples coping with advanced cancer. Design: This study was part of a prospective multicentre longitudinal observational cohort study on experienced quality of care and quality of life in patients with advanced cancer and their relatives (eQuiPe). Setting/participants: Baseline data regarding sexual health and closeness in people with advanced cancer and their partners. Results: Out of the 566 dyads, 14 were same-sex couples. Especially male partners showed an interest in sex, but more than half of all patients and partners were not sexually active. Approximately one third experienced sexual dysfunction to be a problem but did not seek specialized support (<10%). There was a positive association between own sexual satisfaction and feelings of closeness in the relationship, which was stronger for partners compared to patients (p < 0.001). Sexual satisfaction of the other person was also related to own feelings of closeness (p = 0.003). Conclusions: Couples coping with advanced cancer clearly face challenges regarding sexual health but are not likely to seek specialized support. When discussing sexual health, it is crucial that health care professionals pay attention to the aspects of sexual health that may contribute to feeling close to each other and suggest specialized care if necessary. Trial registration: The eQuiPe study is registered as NTR6584 in the Netherlands Trial Register. [ABSTRACT FROM AUTHOR]

Can behavioural interventions achieve energy savings in non-residential settings where users do not face the financial consequences of their behaviour? Our paper addresses this question by using high-frequency data, leveraging social comparison and responsibility assignment in a large provincial government office building with 24 floors, a total of 1008 occupants. Floors were divided into two treatments arms and a control group. Both treatment groups received regular emails encouraging recipients to turn off appliances and lights before leaving the office and weekly ranked energy consumption results by floors. Additionally, weekly "energy advocates" were assigned to each floor in treatment group two. Floors assigned to the control group received no intervention. Findings show that floors that participated only in the inter-floor competitions reduced energy consumption by 8%, 95% CI [− 0.41, − 0.02] while those additionally assigned floor-wise "energy advocates" reduced energy consumption by 13%, 95% CI [− 0.62, − 0.05] with a substantial reduction in energy use occurring after working hours. Results, however, show no statistical difference in energy consumption between treatment groups one and two. We further investigate the intervention effect for the monthly cumulative post-intervention period. Additional qualitative interviews were conducted to enable a better understanding of our results. [ABSTRACT FROM AUTHOR]

We calculate the first distributional statistics for municipal water use with 14.9 million monthly billing records for a half million households in Cape Town, South Africa, from 2014 to 2018. These years span a historic drought and a multi‐faceted package of conservation programs that achieved a 50% citywide drop in consumption. We find that the top 10% of households consumed 31% of water before the drought, with the Gini coefficient showing clear seasonal peaks driven by outdoor water use. Matching billing records to fine‐grained census data from 2011, we find that the correlation between income and water use in the winter was 0.08 but rose to 0.36 during outdoor watering seasons. This correlation declines before switching signs by the end of the drought. The city's increasing block tariff implied that the top 10% of users generate 50%–60% of utility revenues. Although before the drought these top users were more likely to be high income, the composition of top water users changed during the drought. Average income of top users during the drought was 35% lower than the average income of top users before the drought. Our results suggest that Cape Town's policy of providing a free allowance of 10.5 kL (m3) per month to qualify indigent households helped protect many, but not all, from multiple steep tariff increases. Key Points: We calculate the first distributional statistics for municipal water supply deliveries and show how they can inform policyDuring Cape Town's historic drought, we showed that the correlation between income and water changed from positive to negativeThe city's policy of providing a free allowance to indigent households helped protect many, but not all, from steep tariff increases [ABSTRACT FROM AUTHOR]

Copyright of Infant Mental Health Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pervasive threats of climate change and land degradation have compounded the inherent low farm productivity problem in sub‐Saharan Africa. Though sustainable agricultural intensification practices have been shown to improve the resilience of farm production in the face of these emerging threats, they suffer low adoption rates typical of any technology adoption in these regions. Recent evidence points to an emergence of large traders in smallholder grain markets of countries in sub‐Saharan Africa. Given their big financial and operational capacities, the hypothesis is that they can drive the elusive transformation in agri‐food systems by enhancing sustainable production and marketing for smallholder farmers. This study tests this hypothesis using a decade‐long large‐panel dataset from Kenya. A dynamic random effects Probit model and a control function approach are used to evaluate the dynamism in adopting sustainable agricultural inputs and the effect of large grain traders in enhancing the adoption of these inputs at the farm level. Results indicate that sales to large grain traders lead to higher adoption of inorganic fertilizer and improved seed, key agricultural intensification inputs. Land ownership is also shown to be a key success factor for entry into large‐grain‐trader markets. Lastly, the adoption of improved seed and organic manure is persistent across time, indicating state dependence in using these inputs. These results suggest that strategies to foster engagements between large grain traders and farmers can enhance the uptake of sustainable intensification inputs. Such strategies should be accompanied by efforts to improve access to these markets by resource‐poor farmers who are primarily smallholders. [ABSTRACT FROM AUTHOR]

Background: Many cancer patients use additional herbs or supplements in combination with their anti-cancer therapy. Green tea—active ingredient epigallocatechin-3-gallate (EGCG)—is one of the most commonly used dietary supplements among breast cancer patients. EGCG may alter the metabolism of tamoxifen. Therefore, the aim of this study was to investigate the influence of green tea supplements on the pharmacokinetics of endoxifen; the most relevant active metabolite of tamoxifen. Methods: In this single-center, randomized cross-over trial, effects of green tea capsules on endoxifen levels were evaluated. Patients treated with tamoxifen for at least 3 months were eligible for this study. After inclusion, patients were consecutively treated with tamoxifen monotherapy for 28 days and in combination with green tea supplements (1 g twice daily; containing 300 mg EGCG) for 14 days (or vice versa). Blood samples were collected on the last day of monotherapy or combination therapy. Area under the curve (AUC0–24h), maximum concentration (Cmax) and minimum concentration (Ctrough) were obtained from individual plasma concentration–time curves. Results: No difference was found in geometric mean endoxifen AUC0–24h in the period with green tea versus tamoxifen monotherapy (− 0.4%; 95% CI − 8.6 to 8.5%; p = 0.92). Furthermore, no differences in Cmax (− 2.8%; − 10.6 to 5.6%; p = 0.47) nor Ctrough (1.2%; − 7.3 to 10.5%; p = 0.77) were found. Moreover, no severe toxicity was reported during the whole study period. Conclusions: This study demonstrated the absence of a pharmacokinetic interaction between green tea supplements and tamoxifen. Therefore, the use of green tea by patients with tamoxifen does not have to be discouraged. [ABSTRACT FROM AUTHOR]

Until recently, women have not been seen as having the potential for entrepreneurial success. Yet women's engagement in the energy sector could substantially improve energy access for those most underserved. This article examines the role of women as energy entrepreneurs from the perspective of gender inequality within the energy industry. Data from Nuru Energy, a social business focused on providing solar lighting to the ultra-poor, provide insights on how the inclusion of women sales agents can increase sales and how strategic modifications to the social business model can further support female-led businesses. Observational data from over 1,000 rural enterprises show that women, on average, sold significantly more units than men. Women operating in solo firms and leading groupbased teams consistently outsold men-led solo and group-based enterprises. Findings further suggest that, when operating in groups, women tend to outperform men even more than when operating sole proprietorships. [ABSTRACT FROM AUTHOR]

The transdermal fentanyl patch is widely used to treat cancer-related pain despite its wide inter- and intrapatient variability in pharmacokinetics. The aim of this study was to investigate whether smoking and body size (i.e. body mass index) influence fentanyl exposure in patients with cancer. These are factors that typically change during treatment and disease trajectories. We performed an explorative cohort study in patients with cancer using transdermal fentanyl patches (Durogesic®), by taking a blood sample for pharmacokinetic analysis one day after applying a patch in patients with a stable fentanyl dose. A total of 88 patients were evaluable. Although no statistically significant difference was found, the plasma concentrations of non-smokers was 28% (95% CI [-14%; +89-%]) higher than those of smokers normalizing for a dose of 25μg/min. Patients with a low BMI (< 20 kg/m2) had almost similar (10% (95% CI [-39%; +97%]) higher) plasma concentrations compared to patients with a high BMI (> 25 kg/m2). A wider variation in fentanyl plasma concentrations was found in this study than anticipated. Due to this variation, studies in larger patient cohorts are needed to further investigate the effect of smoking on plasma concentration of fentanyl and thereby clarify the clinical significance of our findings. [ABSTRACT FROM AUTHOR]

South Africa, a main food exporter in SADC, is characterised by a dual agricultural economy consisting of a well-developed commercial sector and smallholder, often subsistence, farming. Using the Ricardian cross-sectional framework, we examine the impact of climate change on a nationwide sample of crop, horticulture, livestock and mixed commercial farming systems. We find that a simultaneous decrease in precipitation and an increase in temperature will reduce productivity; and that an increase in temperature alone negatively affects farm output more than a decrease in precipitation. One of the most robust findings is the difference in the extent to which different commercial production systems will be impacted. That is, the results indicate that the strongest impact will be amongst specialised commercial crop farming system. In contrast, mixed farming systems appear to be the least vulnerable. This finding is consistent with studies on small-holder farms in sub-Saharan Africa. Hence, it appears that despite the likely benefits derived from economies of scale, commercial farms are, somewhat, equally vulnerable to climate change. Further, a province-wise assessment revealed that areas that already face disadvantageous climatic conditions will become even less productive. Overall, the findings suggest that practicing mixed farming methods will strengthen the resilience of commercial farms to climate change and that access to extensions-insurance and irrigation-is likely to reduce the risks. [ABSTRACT FROM AUTHOR]

In this article we present results from the Cape Area Panel Study investigating how income comparisons affect the subjective well-being of young adults and parents. The article builds on previous research in this area by studying whether an individual's subjective well-being depends on the comparisons they make, not only to those around them, i.e., external comparisons, but to themselves across different time periods, i.e., internal comparisons. In the comparisons, we use both objective and subjective measures of relative income. Overall, we find strong evidence to suggest that income comparisons, both relative to neighbours and relative to oneself, affect subjective well-being. Another interesting observation is that, depending on the comparator, young adults and parents differ in their perceptions of their own well-being. Furthermore, and as expected, we found that objective, as well as subjective, measures of well-being influence well-being, but that this is more prevalent in external than internal comparisons. [ABSTRACT FROM AUTHOR]

International and domestic efforts to reduce greenhouse gas emissions require a coordinated effort from heterogeneous actors. In this context, using a public good game with a climate change framing, the experiment reported here examines whether groups of heterogeneous individuals can meet a collective emission-reduction target through individual contributions. In terms of the framing, participants differ in terms of their marginal costs of abatement. The experiment consists of two games: a counterfactual baseline scenario examining the scope for voluntary cooperation and a communication game examining the role of stakeholder participation in facilitating cooperation. During the communication game, subjects are able to communicate with one another in order to coordinate contribution strategies. The results suggest that relying on the voluntary cooperation of individuals will not be sufficient to meet the mitigation target. Furthermore, while communication plays a role in promoting cooperation, even when heterogeneity is present, the non-binding nature of communication results in significant levels of free-riding. In particular, with the introduction of communication, two dominant contribution norms of free-riding and perfect-cooperation emerge. This outcome emphasizes the importance of sanctioning opportunities in ensuring compliance with mitigation obligations. [ABSTRACT FROM AUTHOR]

This paper examines the impact of agriculture-related shocks on consumption patterns of rural farming households using 3 years of data from South Africa. We make two key observations. First, agriculture-related shocks reduce households' consumption. Second, natural resources and informal social capital somewhat counteract this reduction and sustain dietary requirements. In general, our findings suggest the promotion of informal social capital and natural resources as they are cheaper and more accessible coping strategies, in comparison to, for example, insurance, which remains unaffordable in most rural parts of sub-Saharan Africa. However, a lingering concern centres on the sustainability of these less conventional adaptation strategies. [ABSTRACT FROM AUTHOR]

Post-discharge preventive intervention programmes with involvement of the parent may support the resilience and developmental outcomes of infants born very preterm. Randomized controlled trials of home-based family-centred intervention programmes in very preterm infants that aimed to improve cognitive outcome, at least at age two, were selected and updated on the basis of a recent systematic review to compare their content and effect over time to form the basis of a narrative review. Six programmes were included in this narrative review. Four of the six programmes led to improved child cognitive and/or motor development. Two programmes, which focused primarily on responsive parenting and development, demonstrated improved cognitive outcome up till 5 years after completion of the programme. The programmes that also focused on maternal anxiety remediation led to improved maternal mental well-being, along with improved child behaviour, in one study - even at 3 years after completion of the programme. The magnitude of the effects was modest. Family-centred preventive intervention programmes that aim at improvement of child development should be continued after discharge home to improve the preterm child's resilience. Programmes may be most effective when they support the evolvement of a responsive parent-infant relationship over time, as well as the parent's well-being. [ABSTRACT FROM AUTHOR]

Aim: To compare attention skills of children with a very low birth weight (VLBW) with children with a normal birth weight (NBW) when entering primary school, and explore the association of attention skills with school career 2 years later.Methods: Participants were 151 children with VLBW and 41 with NBW. Attention was assessed at 3 years and 8 months of corrected age (CA) and school career at 5½ years of CA. Children performed two tests, parents completed three questionnaires, and an assessor systematically observed children's attention.Results: Children with VLBW had significantly lower mean scores on five of the six measures. Significantly more children with VLBW had scores in the clinical range on the Child Behavior Checklist completed by the parents (13% versus 0%) and scores representing dysfunction on assessor observations (19% versus 2%). At 5½ years of age, 36% of the children with VLBW followed special education or had grade retention. Dysfunctional attention as observed by the assessor was most strongly associated with need for learning support at 5½ years of age.Conclusions: At preschool age, children with VLBW have attention difficulties. Attentive behavior at preschool age is a predictor of school career 2 years later. [ABSTRACT FROM PUBLISHER]

Even though antiretroviral treatment is becoming more efficient and available, new HIV infections still occur, and this is particularly evident in the sub-Saharan Africa region. Heterosexual intercourse is still the main mode of HIV transmission in the region, and multiple and concurrent sex partners are arguably crucial for the spread of the epidemic. It is therefore problematic that sexual risk-taking, in terms of multiple and concurrent sex partners, persists in spite of HIV awareness and knowledge. This study examines the role of social norms on multiple and concurrent sex partnerships using longitudinal data of young adults residing in the metropolitan communities of Cape Town in South Africa. Overall, our results show that the social norms related to multiple and concurrent sex partners, in the community, have a positive and significant influence on young adults' choice of sex partners. This effect appears to be stronger amongst male young adults, than female young adults. [ABSTRACT FROM AUTHOR]

This paper examines the impact of climate change on poor households across South Africa who practise subsistence farming to supplement their household income and dietary requirements. We consider three production systems: specialized crops, livestock and mixed crop-livestock farming. In general, we find specialized crop farmers to be the most vulnerable, while mixed crop-livestock farmers appear to be least vulnerable, suggesting that crop-livestock diversification is a potential coping strategy among poor subsistence farming households. We observe qualitatively similar results when we use self-reported food adequacy as the outcome. Furthermore, predicted impact shows that the climatic changes will be mildly harmful at first but will grow over time and lead to a 151 per cent loss in net revenue by the year 2080. Interestingly, we observe that crop farmers receive higher revenue when land is owned by the household, while on the other hand, livestock farmers earn more revenue when the land is communal. [ABSTRACT FROM PUBLISHER]

Copyright of Tijdschrift Voor Kindergeneeskunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To elucidate the relation between motor impairment and other developmental deficits in very preterm-born children without disabling cerebral palsy and term-born comparison children at 5 years of (corrected) age.Method: In a prospective cohort study, 165 children (81 very preterm-born and 84 term-born)were assessed with the Movement Assessment Battery for Children - 2nd edition, Touwen’s neurological examination, the Wechsler Preschool and Primary Scale of Intelligence, processing speed and visuomotor coordination tasks of the Amsterdam Neuropsychological Tasks, and the Strengths and Difficulties Questionnaire.Results: Motor impairment (≤15th centile) occurred in 32% of the very preterm-born children compared with 11% of their term-born peers (p=0.001). Of the very preterm-born children with motor impairment, 58% had complex minor neurological dysfunctions, 54% had low IQ, 69% had slow processing speed, 58% had visuomotor coordination problems, and 27%, 50%,and 46% had conduct, emotional, and hyperactivity problems respectively. Neurological outcome (odds ratio [OR]=41.7, 95% confidence intervals [CI] 7.5–232.5) and Full-scale IQ(OR=7.3, 95% CI 1.9–27.3) were significantly and independently associated with motor impairment. Processing speed (OR=4.6, 95% CI 1.8–11.6) and attention (OR=3.2, 95% CI1.3–7.9) were additional variables associated with impaired manual dexterity. These four developmental deficits mediated the relation between preterm birth and motor impairment.Interpretation: Complex minor neurological dysfunctions, low IQ, slow processing speed,and hyperactivity/inattention should be taken into account when very preterm-born children are referred for motor impairment. [ABSTRACT FROM AUTHOR]

Aim To elucidate the relation between motor impairment and other developmental deficits in very preterm-born children without disabling cerebral palsy and term-born comparison children at 5 years of (corrected) age. Method In a prospective cohort study, 165 children (81 very preterm-born and 84 term-born) were assessed with the Movement Assessment Battery for Children - 2nd edition, Touwen's neurological examination, the Wechsler Preschool and Primary Scale of Intelligence, processing speed and visuomotor coordination tasks of the Amsterdam Neuropsychological Tasks, and the Strengths and Difficulties Questionnaire. Results Motor impairment (≤15th centile) occurred in 32% of the very preterm-born children compared with 11% of their term-born peers ( p=0.001). Of the very preterm-born children with motor impairment, 58% had complex minor neurological dysfunctions, 54% had low IQ, 69% had slow processing speed, 58% had visuomotor coordination problems, and 27%, 50%, and 46% had conduct, emotional, and hyperactivity problems respectively. Neurological outcome (odds ratio [ OR]=41.7, 95% confidence intervals [ CI] 7.5-232.5) and Full-scale IQ ( OR=7.3, 95% CI 1.9-27.3) were significantly and independently associated with motor impairment. Processing speed ( OR=4.6, 95% CI 1.8-11.6) and attention ( OR=3.2, 95% CI 1.3-7.9) were additional variables associated with impaired manual dexterity. These four developmental deficits mediated the relation between preterm birth and motor impairment. Interpretation Complex minor neurological dysfunctions, low IQ, slow processing speed, and hyperactivity/inattention should be taken into account when very preterm-born children are referred for motor impairment. [ABSTRACT FROM AUTHOR]

Background. Infants with very low birth weight (VLBW) are at increased risk for motor deficits, which may be reduced by early intervention programs. For detection of motor deficits and to monitor intervention, different assessment tools are available. It is important to choose tools that are sensitive to evaluate the efficacy of intervention on motor outcome. Objective. The purpose of this study was to compare the Alberta Infant Motor Scale (AIMS) and the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development-Dutch Second Edition (BSID-II-NL) in their ability to evaluate effects of an early intervention, provided by pediatric physical therapists, on motor development in infants with VLBW at 12 months corrected age (CA). Design. This was a secondary study in which data collected from a randomized controlled trial (RCT) were used. Methods. At 12 months CA, 116 of 176 infants with VLBW participating in an RCT on the effect of the Infant Behavioral Assessment and Intervention Program were assessed with both the AIMS and the PDI. Intervention effects on the AIMS and PDI were compared. Results. Corrected for baseline differences, significant intervention effects were found for AIMS and PDI scores. The highest effect size was for the AIMS subscale sit. A significant reduction of abnormal motor development in the intervention group was found only with the AIMS. Limitations. No Dutch norms are available for the AIMS. Conclusions. The responsiveness of the AIMS to detect intervention effects was better than that of the PDI. Therefore, caution is recommended in monitoring infants with VLBW only with the PDI, and the use of both the AIMS and the Bayley Scales of Infant Development is advised when evaluating intervention effects on motor development at 12 months CA. [ABSTRACT FROM AUTHOR]

Severe fatigue and low quality of life are reported by a majority of adult patients with hereditary motor and sensory neuropathy 1A. In children with hereditary motor and sensory neuropathy 1A, the prevalence and impact of fatigue have not been studied yet. In this questionnaire survey, 55 Dutch children (response rate 77%) with genetically confirmed hereditary motor and sensory neuropathy 1A participated (mean age 15 years [standard deviation 2.1]). Prevalence of severe fatigue (based on a cut-off score of the Checklist Individual Strength) was 24%, in contrast to 14% in a Dutch school-based population (P < .05). Almost all quality-of-life scores (measured with the Child Health Questionnaire–Child Form 87) were significantly worse than population norms (P < .05). Fatigue severity was associated significantly (P < .01) with all quality-of-life scores (–0.4 < r < –0.7). In conclusion, severe fatigue and diminished quality of life are more frequent among children with hereditary motor and sensory neuropathy 1A compared to healthy peers. The strong association between fatigue severity and quality of life suggests a negative impact of fatigue on quality of life in these children. [ABSTRACT FROM AUTHOR]

Policy makers in many countries have perceived plastic-bag litter as a problem, and have used a variety of regulatory tools to address it. South Africa's current legislation on plastic-bags came into effect on 7 May 2003. It increased the thickness of the plastic used, charged a small levy and required that bags be sold rather than distributed gratis. These regulations sharply reduced consumption of plastic bags in the short term, but unlike the Irish and Danish levies have failed to curb their use meaningfully in the long run. It is suggested that the initial sharp fall in use of bags was a result of loss aversion rooted in an endowment effect (the bags having long been a free good). Once consumers became accustomed to paying for bags, demand slowly rose to its historic levels. [ABSTRACT FROM AUTHOR]

This paper explores the collective action problem as it relates to climate change and develops two models that capture the mitigation-adaptation trade-off. The first model presents climate change as a disaster that will occur with certainty, and where both mitigation and adaptation reduce the size of the loss associated with the disaster (the so-called deterministic model). The second model presents climate change as an uncertain event, where mitigation affects the probability of disaster while adaptation again reduces the size of the loss (this is the so-called stochastic model). Comparing the two models in a one-shot public goods experiment with students, we find no significant differences in subjects' choice to mitigate. The experiments also reveal a relatively low rate of mitigation for both models compared with earlier studies. [ABSTRACT FROM AUTHOR]

Climate change represents a serious threat to the economic growth potential in low income countries. Instead of investing in growth, they may be drawn into strife and conflict. Climate change and the global politics to deal with it, could however also present a number of interesting opportunities for developing countries. Such opportunities may arise in sustainable forestry, new forms of solar, wind or bioenergy and related industries, agriculture or in the programs for abatement and mitigation that are likely to be created. It is an important priority for low-income countries to develop local knowledge and understanding concerning climate change in order to better prepare for both the costs and challenges posed by climate change, as well as to defend their national interests and participate in international negotiations. Creating academic capacity is however a long and painstaking process. We discuss a number of existing initiatives but conclude that more is needed, particularly at the higher level of PhD studies. [ABSTRACT FROM AUTHOR]

This paper investigates the use of charges and standards in dealing with a common externality, plastic litter from shopping bags in Botswana. The country passed a plastic bag legislation (effective 2007) to curb the plastic bag demand. Uniquely, the act does not stipulate the amount that the retailers had to charge for plastic bags, they, independently from one another, set different prices. We assessed the environmental effectiveness and efficiency of the plastic bag legislation by analysing consumers' sensitivity to the improvement of the plastic bag and related price charges. The introduction of the plastic bag legislation led to a significant decline in the consumption of plastic bags per 1,000 Botswana pulas of shopping. The partial success of the charges levied in Botswana was due to the constantly high prices of the bags. [ABSTRACT FROM AUTHOR]

We estimate the risk attitudes of a large sample of individuals from various fishing communities along the west coast of South Africa. Female fishers and rights holders are found to be more risk averse than their male counterparts, while rights holders are found to be less risk averse relative to subjects without fishing rights. Risk attitudes are found to be correlated with compliance with fisheries regulations. In particular, a greater degree of risk aversion translates into a reduction in compliance. Furthermore, in the case of gender, female fishers and rights holders are more likely to comply with fisheries regulations. [ABSTRACT FROM AUTHOR]

Health-related quality of life is an important patient-reported outcome used in intervention trials and for monitoring the consequences of health status on physical, mental, and social domains. Parkinson's disease is a complex disorder that strongly affects patients' quality of life. Several health-related quality of life tools have been used in Parkinson's disease. A Movement Disorder Society Task Force was commissioned to rate the psychometric quality of available health-related quality of life scales as applied to Parkinson's disease. Following the methodology adopted by previous work of the Movement Disorder Society Task Force, a review of generic and specific health-related quality of life scales applied in studies on Parkinson's disease was completed. Considering the scales from 3 perspectives-use in Parkinson's disease, use by multiple research groups, and clinimetric properties-a final classification as 'recommended,' 'suggested,' or 'listed' was applied to each reviewed instrument. Four generic scales (EuroQoL, Nottingham Health Profile, 36-Item Short-Form Health Survey, and Sickness Impact Profile) and 5 specific scales (39-Item Parkinson's Disease Questionnaire, Parkinson's Disease Questionnaire Short Form, Parkinson's Disease Quality of Life Questionnaire, Parkinson's Impact Scale, and Scales for Outcomes in Parkinson's Disease-Psychosocial) reached the level of 'recommended.' The 39-item Parkinson's Disease Questionnaire is the most thoroughly tested and applied questionnaire. Three other generic measures (Quality of Life Questionnaire 15D, Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, and World Health Organization Quality of Life Assessment Short Version) and the specific Parkinson's Disease Quality of Life Scale are 'suggested.' With a little additional effort in completing the stipulated requirements, they could reach the 'recommended' level. At present there is a wide variety of health-related quality of life measures for application in the Parkinson's disease setting, and the task force does not recommend the development of a new scale. Selection of the most appropriate instrument for a particular objective requires consideration of the characteristics of each scale and the goals of the assessment. © 2011 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The SCOPA-Cognition is a reliable and valid test to evaluate cognitive functioning in Parkinson's disease and is widely used in clinical and research settings. Recently, the Movement Disorder Society introduced criteria for Parkinson's disease dementia. The objective of the present study was to use these criteria to determine SCOPA-Cognition cutoffs for maximum accuracy, screening, and diagnosing of Parkinson's disease dementia. A total of 282 patients with Parkinson's disease were assessed with the SCOPA-Cognition and the Movement Disorder Society's Parkinson's disease dementia criteria. From the 275 patients with a complete assessment of the dementia criteria, 12% (n = 32) fulfilled the criteria. Data from 268 patients with complete assessments of both the dementia criteria and the SCOPA-Cognition were used to determine cutoffs for maximum accuracy, screening, and diagnosing of Parkinson's disease dementia. The area under the curve was 0.91 (95% confidence interval, 0.85-0.97), showing a strong association between the dementia criteria and the SCOPA-Cognition. The cutoff for maximum accuracy was 22/23, based on the highest sum of sensitivity (0.80) and specificity (0.87), with positive and negative predictive values of 0.43 and 0.97, respectively. The optimal screening cutoff was 24/25, and the optimal diagnostic cutoff was 17/18. Using the recently published Parkinson's disease dementia criteria as a reference, the current study presents SCOPA-Cognition cutoffs for maximum accuracy, screening, and diagnosing of Parkinson's disease dementia. The availability of SCOPA-Cognition cutoffs for Parkinson's disease dementia may contribute to the scale's usefulness and promote its further use in both clinical and research settings. © 2011 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This paper analysed differences in the choice of health-care facility by ill individuals in human immunodeficiency virus (HIV)- and acquired immune deficiency syndrome (AIDS)-affected households in the Free State province of South Africa. Secondary education, access to medical aid and household income were significant determinants of choice as were severity and type of illness, and type of health care required. Ill persons with HIV- and AIDS-related illnesses are significantly more likely to opt for public health care, although the strength of this preference declines as household income increases. Those with severe and particularly severe HIV- and AIDS-related illness, in turn, are significantly more likely to opt for private health care, especially at higher levels of income. The public health care sector therefore is likely to remain the backbone of health-care provision to those infected with and affected by HIV and AIDS, highlighting the need for equitable access to efficient, quality public health services. [ABSTRACT FROM AUTHOR]

To identify patterns of motor disturbances in Parkinson's disease (PD) and evaluate their relation with other PD domains. A cohort of 399 PD patients was randomly divided into two samples. Factors within the motor section of the SPES/SCOPA were identified by exploratory factor analysis on data from the first sample and next tested by confirmatory factor analysis in the second sample. Relations with other PD domains were evaluated by regression analyses. A four factor model was found to be valid. This included a tremor, a bradykinetic-rigid, and two axial factors. One axial factor ('rise', 'gait', 'postural instability') was associated with age and cognition, while the other axial factor ('freezing', 'speech', 'swallowing') was related to dopaminergic medication and complications of therapy. Both other factors showed no relevant associations with demographic and clinical characteristics. The identification of motor factors and their relation with other domains of the disease may help to elucidate the mechanisms responsible for these associations and provide an objective base for further research on subtypes in PD. © 2009 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate psychiatric symptoms in Parkinson's disease (PD) patients and to assess their relation with other clinical aspects of PD. Psychotic symptoms (PS) and compulsive symptoms (CS) as well as other nonmotor and motor features were evaluated in 353 PD patients. Psychotic and compulsive symptom scores did not correlate significantly. PS occurred in 65% of patients, with item frequencies ranging from 10% (paranoid ideation) to 55% (altered dream phenomena). Regression analysis showed that autonomic impairment accounted for 20% of the 32% explained variance of PS, whereas cognitive problems, depression, daytime sleepiness, and dopamine agonist (DA) dose explained the rest. CS occurred in 19%, with item frequencies of 10% for both sexual preoccupation and compulsive shopping/gambling. Patients with more severe CS (score ≥ 2 on one or both items) were significantly more often men, had a younger age at onset, a higher DA dose and experienced more motor fluctuations compared to the other patients. PS and CS are common but unrelated psychiatric symptoms in PD. The relations found between PS and cognitive problems, depression, daytime sleepiness, and autonomic impairment suggests a resemblance with Dementia with Lewy Bodies. The prominent association between PS and autonomic impairment may be explained by a shared underlying mechanism. Our results confirm previous reports on the profile of patients developing CS, and mechanisms underlying motor fluctuations may also play a role in the development of CS in PD. © 2009 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Early onset Parkinson's disease (EOPD) has been associated with mutations in the Parkin, DJ-1, PINK1, LRRK2, and SNCA genes. The aim of this study is to assess the contribution of these genes in a Dutch EOPD cohort and the phenotypic characteristics of the mutation carriers. A total of 187 unrelated Dutch EOPD patients (age at onset ≤ 50 years) were phenotyped and screened for mutations in all exons of Parkin, DJ-1, and PINK1 by direct sequencing and gene dosage analysis. Additionally, analysis of the A30P mutation and exon dosage of SNCA and sequencing of exons 19,31,35,38,41, and 48 of LRRK2 was performed. Pathogenic variations could explain disease in 4% (7 of 187) of the patients including five patients carrying homozygous or compound heterozygous mutations in Parkin, one with a novel homozygous deletion in DJ-1 (P158Del) and one with a heterozygous mutation in LRRK2 (T2356I). We found seven novel mutations. The phenotypic characteristics of mutation carriers varied widely, comparable to the variability seen in sporadic EOPD. Parkin is the most frequently mutated gene in this EOPD cohort, followed by DJ-1, PINK1 and LRRK2. The low overall mutation frequency indicates that the extrapolation of mutation frequencies from other populations should be applied with caution. © 2008 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the characteristics of odor discrimination and odor identification deficits in a large population of patients with Parkinson's disease (PD) and to determine which of these olfactory tests best distinguishes between patients with PD and control subjects. Olfactory performance was assessed in 404 patients with PD and 150 controls, using the odor identification and discrimination parts of the Sniffin' Sticks battery. Mean identification and discrimination scores in patients with PD were significantly lower than in controls. Linear regression analysis using a 95% confidence interval revealed that, relative to the performance of controls, 65.0% of patients with PD had an impairment in odor identification, whereas 42.1% of patients were impaired on the odor discrimination task. ROC curves revealed a higher sensitivity and specificity for odor identification than for odor discrimination in separating patients from controls. In patients with PD, odor discrimination performance decreased with increasing disease duration, whereas odor identification was not correlated with disease stage or duration. In PD, odor identification is more frequently impaired than odor discrimination and allows a better discrimination between patients and controls. Although an odor identification deficit is generally believed to be independent of disease progression, the impairment in odor discrimination appears to increase with disease duration. © 2008 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This study evaluated the comparative validity and usefulness of the Parkinson's Disease Sleep Scale (PDSS) and the Scales for Outcomes in PD-Sleep Scale (SCOPA-S), two disease-specific rating scales for assessing sleep disorders in Parkinson's disease (PD). Hoehn and Yahr staging (HY), SCOPA-Motor, Mini-Mental State Examination, Clinical Impression of Severity Index for PD, Hospital Anxiety and Depression Scale, EuroQoL, and SCOPA-Psychosocial, in addition to PDSS and SCOPA-S (night-time sleep (NS) and daytime sleepiness (DS) subscales), were applied to 187 consecutive PD patients. PDSS and SCOPA-S proved similar in acceptability, scaling assumptions, precision, and internal consistency (Cronbach's α = 0.82-0.84). Factor analysis revealed five separate factors for PDSS (67% of the variance) and one factor for each SCOPA-S subscale (60% of the variance for NS and 57% for DS). Correlation coefficient between PDSS and SCOPA-S NS was −0.60. Sleep scales correlated moderately with mood, low-to-moderate with HRQoL, and low with the rest of measures. PDSS and SCOPA-S DS discriminated between patients grouped by HY severity levels and disease duration. Cutoff points of 82/83 for PDSS and 6/7 for SCOPA-S NS were drawn to identify PD patients with sleep problems. Depression/anxiety scores explained 26% for PDSS and 22% for SCOPA-S NS scores. Both scales provide valid, reliable, and useful means to evaluate sleep disorders in PD. PDSS may be used to obtain a profile about potential causes of 'bad sleep,' but is barely useful to assess DS, whereas SCOPA-S assesses nocturnal sleep disorders and daytime somnolence at a similar extent, without exploring the potential causes. © 2008 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Our objective is to evaluate nighttime sleep problems (NSP) and daytime sleepiness (DS) in patients with Parkinson's disease (PD) compared to controls, and to assess relations with demographic, disease-related, and clinical characteristics in patients. NSP and DS were evaluated with the SCOPA-SLEEP questionnaire in PD patients and controls. In patients, other disease-related and clinical characteristics were also evaluated. Four hundred twenty PD patients [mean (SD) age 61.1 (11.5) years] and 150 controls [mean (SD) age 60.9 (9.9) years] participated in the study. Compared to controls, a significantly greater proportion of patients had excessive DS (EDS) (43 vs. 10%), excessive NSP (ENSP) (27 vs. 9%), or used sleep medication (17 vs. 12%). Difficulties with falling asleep were similar in both groups. In both patients and controls, women experienced more NSP than men. In patients, depressive symptoms accounted for 21% of NSP variance and was the major contributor to the total explained variance (30%). Furthermore, NSP were related to dopamine-agonist and levodopa dose, whereas DS was related to age, dopamine-agonist dose, and disease severity. NSP and DS occur frequently in PD, with EDS being reported more commonly than ENSP. No strong relations were found between DS and demographic or clinical variables. The strong relation between NSP and depressive symptoms in PD calls for future studies to explore the nature of this relation. © 2007 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a clinimetric sound scale that addresses both psychotic and compulsive complications in Parkinson's disease (PD). The SCales for Outcomes in PArkinson's disease-Psychiatric Complications (SCOPA-PC) was developed by modifying the items of the Parkinson Psychosis Rating Scale (PPRS) and including an item on compulsive behavior in PD. To evaluate the validity of the SCOPA-PC, 106 PD patients were assessed. A subsample of 43 patients was assessed for interrater and test-retest reliability. Construct validity was evaluated using the Neuropsychiatric Inventory (NPI) and the South Oaks Gambling Scale (SOGS). Interrater and test-retest reliability for the total score was 0.95 and 0.91 (intraclass correlation coefficient), respectively. For the items, the interrater reliability ranged from 0.62 to 0.96 (weighted kappa) and the test-retest reliability ranged from 0.54 to 0.88 (weighted kappa). Cronbach's alpha was 0.68. The correlation between the SCOPA-PC total score and the NPI was 0.41. The correlation between SCOPA-PC items and NPI items that addressed similar constructs ranged from 0.34 to 0.68, whereas the correlation between the item on compulsive behavior and the SOGS was 0.49. In conclusion, the SCOPA-PC is a reliable, valid, and easily-administered semistructured questionnaire for both psychotic and compulsive complications in PD. © 2007 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This paper analyses the impact of income inequality on public good provision in an experimental setting. A sample of secondary school students were recruited to participate in a simple linear public goods game where income heterogeneity was introduced by providing participants with unequal token endowments. The results show that endowment heterogeneity does not have any significant impact on contributions to the public good, and that consistent with models of reciprocity, low and high endowment players contribute the same fraction of their endowment to the public pool. Moreover, individuals appear to adjust their contributions in order to maintain a fair share rule. [ABSTRACT FROM AUTHOR]

In May 2003 South Africa introduced legislation intended to decrease plastic bag litter. It combined standards and price-based economic tools in an attempt to reduce the public's demand for plastic bags. This paper analyses the short term effects of the legislation on bag demand. It also provides a background to these regulations and a theoretical overview. The assessment uses bag consumption data from four retailers, each representing a different consumer market. These are analysed, and respective price elasticities calculated. The results suggest that plastic bag demand is relatively price inelastic and imply that instruments utilising price alone, would have limited efficacy. However, the combination of standards and pricing successfully curbed plastic bag use in the short run. Further analysis suggests that the effectiveness of the legislation may be declining over time. [ABSTRACT FROM AUTHOR]

It is often contended that rural development works most effectively when beneficiary communities are active project participants, and not the passive recipients of assistance. This paper analyses participatory development through the lens of public goods theory. South Africa's Community Water Supply & Sanitation Programme is discussed as a case study. Conclusions from our game-theoretic analysis are used to make suggestions for South African development policy. [ABSTRACT FROM AUTHOR]

We evaluated the validity, reliability, and potential responsiveness of the Beck Depression Inventory (BDI) in patients with Parkinson's disease (PD). In part 1 of the study, 92 patients with PD underwent a structured clinical interview for DSM major depression and based on this patients were considered depressed (PD-D) or nondepressed (PD-ND). Subsequently, patients filled in the BDI. In part 2, a postal survey consisting the BDI was performed in 185 PD patients and 112 controls. Test-retest reliability was assessed in 60 PD patients. The factor analysis revealed a cognitive-affective and a somatic factor. Cronbachs α for the BDI was 0.88. Mean BDI indicated significant differences ( P < 0.001) between the PD and control group, between the PD-ND and PD-D group, and between PD-ND and control group. In part 1, the receiver operating characteristic curves showed that the area under the curve for the total BDI was 0.88. A cutoff was calculated for the BDI (14/15) that had the highest sum of sensitivity (0.71) and specificity (0.90). In part 2, the test-retest reliability for the BDI total score was 0.89 (intraclass correlation coefficient). The smallest real difference was 3.3 for the total BDI. The BDI is a valid, reliable, and potential responsive instrument to assess the severity of depression in PD. However, an adjusted cutoff is recommended. © 2006 Movement Disorder Society [ABSTRACT FROM AUTHOR]

We developed a questionnaire to assess autonomic symptoms in patients with Parkinson's disease (PD) and evaluated its reliability and validity. Based on the results of a postal survey in 46 PD patients, 21 multiple system atrophy patients, and 8 movement disorders specialists, items were included according to their frequency, burden, and clinical relevance. The questionnaire was evaluated in 140 PD patients and 100 controls, and test-retest reliability was established in a sample of 55 PD patients. The SCOPA-AUT consists of 25 items assessing the following regions: gastrointestinal (7), urinary (6), cardiovascular (3), thermoregulatory (4), pupillomotor (1), and sexual (2 items for men and 2 items for women) dysfunction. Test-retest reliability was good. Autonomic problems increased significantly with increasing disease severity for all autonomic regions, except sexual dysfunction. We conclude that SCOPA-AUT is a reliable and valid questionnaire that evaluates autonomic dysfunction in PD. © 2004 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Unfortunately, the original version of the article was published with incorrect copyright as "© Springer Science + Business Media, LLC, part of Springer Nature 2020". [ABSTRACT FROM AUTHOR]