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Sample records for malawi developmental assessment

  1. Public participation in Malawi's environmental impact assessment ...

    African Journals Online (AJOL)

    Since the adoption of the Environmental Management Act of 1996, Malawi has been using environmental impact assessment (EIA) as a tool for predicting and assessing the impact of development projects on the environment. This study assessed the extent of public participation in Malawi's EIA process. Desktop study of ...

  2. Malawi : Country Procurement Assessment Report, Volume 3. Executive Summary

    OpenAIRE

    World Bank

    2004-01-01

    The Malawi Country Procurement Assessment Report is a joint undertaking between the Malawi Government and the World Bank to analyze the country procurement system and recommend appropriate actions to improve the efficiency, economy and transparency of the system. This report is divided into (a) an Executive Summary, (b) Main Report on Findings and Recommendations, and (c) Annexes. Since th...

  3. Malawi : Country Procurement Assessment Report, Volume 2. Details and Annexes

    OpenAIRE

    World Bank

    2004-01-01

    The Malawi Country Procurement Assessment Report is a joint undertaking between the Malawi Government and the World Bank to analyze the country procurement system and recommend appropriate actions to improve the efficiency, economy and transparency of the system. This report is divided into (a) an Executive Summary, (b) Main Report on Findings and Recommendations, and (c) Annexes. Since th...

  4. Developmental and behavioural problems in children with severe acute malnutrition in Malawi: A cross–sectional study

    Science.gov (United States)

    van den Heuvel, Meta; Voskuijl, Wieger; Chidzalo, Kate; Kerac, Marko; Reijneveld, Sijmen A; Bandsma, Robert; Gladstone, Melissa

    2017-01-01

    Background Early childhood development provides an important foundation for the development of human capital. Although there is a clear relation between stunting and child development outcomes, less information is available about the developmental and behavioural outcomes of children with severe acute malnutrition (SAM). Particularly an important research gap exists in Sub–Saharan Africa where there is a high prevalence of SAM and a high rate of co–occurring HIV (human immune deficiency virus) infection. Our first objective was to assess the prevalence and severity of developmental and behavioural disorders on a cohort of children admitted to an inpatient nutritional rehabilitation centre in Malawi. Our second objective was to compare the developmental and behavioural profiles of children with the two main phenotypes of SAM: kwashiorkor and marasmus. Methods This was a cross–sectional observational study including all children hospitalized with complicated SAM in Blantyre, Malawi over an 8–month period from February to October 2015. At discharge, children were assessed with the well-validated Malawi Developmental Assessment Tool (MDAT) for gross motor, fine motor, language and social development. In children ≥24 months, emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ). Results 150 children (55% boys) with SAM were recruited; mean age of 27.2 months (standard deviation 17.9), 27 children (18%) had pre–existing neurodisabilities (ND) and 34 (23%) had a co–occurring human immune deficiency virus (HIV) infection. All children with SAM experienced profound delays in the gross and fine motor, language and social domains. Linear regression analysis demonstrated that children with kwashiorkor scored 0.75 standard deviations lower (95% confidence interval –1.43 to –0.07) on language MDAT domain than children with marasmus when adjusted for covariates. The prosocial behaviour score of the SDQ was low

  5. Malawi : Country Procurement Assessment Report, Volume 1. Main Findings and Recommendations

    OpenAIRE

    World Bank

    2004-01-01

    The Malawi Country Procurement Assessment Report is a joint undertaking between the Malawi Government and the World Bank to analyze the country procurement system and recommend appropriate actions to improve the efficiency, economy and transparency of the system. This report is divided into (a) an Executive Summary, (b) Main Report on Findings and Recommendations, and (c) Annexes. Since th...

  6. Post-neonatal mortality, morbidity, and developmental outcome after ultrasound-dated preterm birth in rural Malawi: a community-based cohort study.

    Science.gov (United States)

    Gladstone, Melissa; White, Sarah; Kafulafula, George; Neilson, James P; van den Broek, Nynke

    2011-11-01

    Preterm birth is considered to be associated with an estimated 27% of neonatal deaths, the majority in resource-poor countries where rates of prematurity are high. There is no information on medium term outcomes after accurately determined preterm birth in such settings. This community-based stratified cohort study conducted between May-December 2006 in Southern Malawi followed up 840 post-neonatal infants born to mothers who had received antenatal antibiotic prophylaxis/placebo in an attempt to reduce rates of preterm birth (APPLe trial ISRCTN84023116). Gestational age at delivery was based on ultrasound measurement of fetal bi-parietal diameter in early-mid pregnancy. 247 infants born before 37 wk gestation and 593 term infants were assessed at 12, 18, or 24 months. We assessed survival (death), morbidity (reported by carer, admissions, out-patient attendance), growth (weight and height), and development (Ten Question Questionnaire [TQQ] and Malawi Developmental Assessment Tool [MDAT]). Preterm infants were at significantly greater risk of death (hazard ratio 1.79, 95% CI 1.09-2.95). Surviving preterm infants were more likely to be underweight (weight-for-age z score; prates of developmental delay on the MDAT at 18 months (p = 0.009), with gestational age at delivery (p = 0.01) increasing this likelihood. Morbidity-visits to a health centre (93%) and admissions to hospital (22%)-was similar for both groups. During the first 2 years of life, infants who are born preterm in resource poor countries, continue to be at a disadvantage in terms of mortality, growth, and development. In addition to interventions in the immediate neonatal period, a refocus on early childhood is needed to improve outcomes for infants born preterm in low-income settings.

  7. Post-neonatal mortality, morbidity, and developmental outcome after ultrasound-dated preterm birth in rural Malawi: a community-based cohort study.

    Directory of Open Access Journals (Sweden)

    Melissa Gladstone

    2011-11-01

    Full Text Available Preterm birth is considered to be associated with an estimated 27% of neonatal deaths, the majority in resource-poor countries where rates of prematurity are high. There is no information on medium term outcomes after accurately determined preterm birth in such settings.This community-based stratified cohort study conducted between May-December 2006 in Southern Malawi followed up 840 post-neonatal infants born to mothers who had received antenatal antibiotic prophylaxis/placebo in an attempt to reduce rates of preterm birth (APPLe trial ISRCTN84023116. Gestational age at delivery was based on ultrasound measurement of fetal bi-parietal diameter in early-mid pregnancy. 247 infants born before 37 wk gestation and 593 term infants were assessed at 12, 18, or 24 months. We assessed survival (death, morbidity (reported by carer, admissions, out-patient attendance, growth (weight and height, and development (Ten Question Questionnaire [TQQ] and Malawi Developmental Assessment Tool [MDAT]. Preterm infants were at significantly greater risk of death (hazard ratio 1.79, 95% CI 1.09-2.95. Surviving preterm infants were more likely to be underweight (weight-for-age z score; p<0.001 or wasted (weight-for-length z score; p<0.01 with no effect of gestational age at delivery. Preterm infants more often screened positively for disability on the Ten Question Questionnaire (p = 0.002. They also had higher rates of developmental delay on the MDAT at 18 months (p = 0.009, with gestational age at delivery (p = 0.01 increasing this likelihood. Morbidity-visits to a health centre (93% and admissions to hospital (22%-was similar for both groups.During the first 2 years of life, infants who are born preterm in resource poor countries, continue to be at a disadvantage in terms of mortality, growth, and development. In addition to interventions in the immediate neonatal period, a refocus on early childhood is needed to improve outcomes for infants born preterm

  8. Utilizing NASA Earth Observations to Assess Landslide Characteristics and Devlelop Susceptibility and Exposure Maps in Malawi

    Science.gov (United States)

    Klug, M.; Cissell, J.; Grossman, M.

    2017-12-01

    Malawi has become increasingly prone to landslides in the past few decades. This can be attributed to the terrain, types of soil and vegetation, increased human interference, and heavy flooding after long periods of drought. In addition to the floods and droughts, landslides cause extra stress to farmlands, thus exacerbating the current food security crisis in the country. It can be difficult to pinpoint just how many people are affected by landslides in Malawi because landslides often occur in rural areas or are grouped with other disasters, such as floods or earthquakes. This project created a Landslide Susceptibility Map to assess landslide-prone areas in Malawi using variables such as slope, distance to roads, distance to streams, soil type, and precipitation. These variables were derived using imagery from Landsat 8 Operational Land Imager (OLI), Shuttle Radar Topography Mission Version 3 (SRTM-v3), Global Precipitation Measurement (GPM), and Tropical Rainfall Measuring Mission (TRMM) satellites. Furthermore, this project created a Landslide Exposure Map to estimate how much of the local population lives in susceptible areas by intersecting population data with the Landslide Susceptibility Map. Additionally, an assessment of GPM and TRMM precipitation measurements was generated to better understand the reliability of both measurements for landslide monitoring. Finally, this project updated NASA SERVIR's Global Landslide Catalog (GLC) for Malawi by using WorldView data from Google Earth and Landsat 8 OLI. These end products were used by NASA SERVIR and the Regional Centre for Mapping of Resources for Development (RCMRD) for aiding in disaster management throughout Malawi.

  9. Hydrochemical assessment of groundwater used for irrigation in Rumphi and Karonga districts, Northern Malawi

    Science.gov (United States)

    Wanda, Elijah M. M.; Gulula, Lewis C.; Phiri, Ambrose

    Irrigation water quality is an essential component of sustainable agriculture. Irrigation water quality concerns have often been neglected over concerns of quantity in most irrigation projects in Malawi. In this study, a hydrochemical assessment of groundwater was carried out to characterize, classify groundwater and evaluate its suitability for irrigation use in Karonga and Rumphi districts, Northern Malawi. Groundwater samples were collected during wet (January-April 2011) and dry (July-September 2011) seasons from 107 shallow wells and boreholes drilled for rural water supply using standard sampling procedures. The water samples were analysed for pH, major ions, total dissolved solids and electrical conductivity (EC), using standard methods. Multivariate chemometric (such as Kruskal Wallis test), hydrographical methods (i.e. Piper diagram) and PHREEQC geochemical modelling program were used to characterise the groundwater quality. Electrical conductivity, percentage sodium ion (% Na+), residual sodium carbonate (RSC), total dissolved solids (TDS), sodium adsorption ratio (SAR), Kelly’s ratio (KR) and permeability index (PI) were used to evaluate the suitability of water for irrigation. It was established that groundwater is neutral to alkaline and mostly freshwater (TDS management is suggested for sustainable development of the water resources for better plant growth, long-term as well as maintaining human health in the study area.

  10. Childhood disability in Malawi: a population based assessment using the key informant method.

    Science.gov (United States)

    Tataryn, Myroslava; Polack, Sarah; Chokotho, Linda; Mulwafu, Wakisa; Kayange, Petros; Banks, Lena Morgon; Noe, Christiane; Lavy, Chris; Kuper, Hannah

    2017-11-28

    Epidemiological data on childhood disability are lacking in Low and Middle Income countries (LMICs) such as Malawi, hampering effective service planning and advocacy. The Key Informant Method (KIM) is an innovative, cost-effective method for generating population data on the prevalence and causes of impairment in children. The aim of this study was to use the Key Informant Method to estimate the prevalence of moderate/severe, hearing, vision and physical impairments, intellectual impairments and epilepsy in children in two districts in Malawi and to estimate the associated need for rehabilitation and other services. Five hundred key informants (KIs) were trained to identify children in their communities who may have the impairment types included in this study. Identified children were invited to attend a screening camp where they underwent assessment by medical professionals for moderate/severe hearing, vision and physical impairments, intellectual impairments and epilepsy. Approximately 15,000 children were identified by KIs as potentially having an impairment of whom 7220 (48%) attended a screening camp. The estimated prevalence of impairments/epilepsy was 17.3/1000 children (95% CI: 16.9-17.7). Physical impairment (39%) was the commonest impairment type followed by hearing impairment (27%), intellectual impairment (26%), epilepsy (22%) and vision impairment (4%). Approximately 2100 children per million population could benefit from physiotherapy and occupational therapy and 300 per million are in need of a wheelchair. An estimated 1800 children per million population have hearing impairment caused by conditions that could be prevented or treated through basic primary ear care. Corneal opacity was the leading cause of vision impairment. Only 50% of children with suspected epilepsy were receiving medication. The majority (73%) of children were attending school, but attendance varied by impairment type and was lowest among children with multiple impairments (38

  11. Assessing the Developmental Neurotoxicity of 27 ...

    Science.gov (United States)

    Assessing the Developmental Neurotoxicity of 27 Organophosphorus Pesticides Using a Zebrafish Behavioral Assay, Waalkes, M., Hunter, D.L., Jarema, K., Mundy, W., and S. Padilla. The U.S. Environmental Protection Agency is evaluating methods to screen and prioritize organophosphorus pesticides for developmental neurotoxicity. As such, we are exploring a behavioral testing paradigm that can assess the effects of sublethal and subteratogenic concentrations of developmental neurotoxicants on zebrafish (Danio rerio). This in vivo assay quantifies the locomotor response to light stimuli under tandem light and dark conditions in a 96-well plate using a video tracking system on 6 day post fertilization zebrafish larvae. Each of twenty-seven organophosphorus pesticides was tested for their developmental neurotoxic potential by exposing zebrafish embryos/larvae to the pesticide at several concentrations (≤ 100 μM nominal concentration) during the first five days of development, followed by 24 hours of depuration and then behavioral testing. Approximately 22% of the chemicals (Acephate, Dichlorvos, Diazoxon, Bensulide,Tribufos, Tebupirimfos) did not produce any behavioral changes after developmental exposure, while many (Malaoxon Fosthiazate, Dimethoate, Dicrotophos, Ethoprop, Malathion, Naled, Diazinon, Methamidophos, Terbufos, Trichlorfon, Phorate, Pirimiphos-methyl, Profenofos, Z-Tetrachlorvinphos, Chlorpyrifos, Coumaphos, Phosmet, Omethoate) produced changes in swi

  12. Impact of modelling scale on probabilistic flood risk assessment: the Malawi case

    Directory of Open Access Journals (Sweden)

    Rudari Roberto

    2016-01-01

    Full Text Available In the early months of 2015, destructive floods hit Malawi, causing deaths and economic losses. Flood risk assessment outcomes can be used to increase scientific-supported awareness of risk. The recent increase in availability of high resolution data such as TanDEM-X at 12m resolution makes possible the use of detailed physical based flood hazard models in risk assessment. Nonetheless the scale of hazard modelling still remains an issue, which requires a compromise between level of detail and computational efforts. This work presents two different approaches on hazard modelling. Both methods rely on 32-years of numeric weather re-analysis and rainfall-runoff transformation through a fully distributed WFLOW-type hydrological model. The first method, applied at national scale, uses fast post-processing routines, which estimate flood water depth at a resolution of about 1×1km. The second method applies a full 2D hydraulic model to propagate water discharge into the flood plains and best suites for small areas where assets are concentrated. At the 12m resolution, three hot spots with a model area of approximately 10×10 km are analysed. Flood hazard maps obtained with both approaches are combined with flood impact models at the same resolution to generate indicators for flood risk. A quantitative comparison of the two approaches is presented in order to show the effects of modelling scale on both hazard and impact losses.

  13. Developmental and behavioural problems in children with severe acute malnutrition in Malawi : A cross-sectional study

    NARCIS (Netherlands)

    van den Heuvel, Meta; Voskuijl, Wieger; Chidzalo, Kate; Kerac, Marko; Reijneveld, Sijmen A; Bandsma, Robert; Gladstone, Melissa

    2017-01-01

    Background: Early childhood development provides an important foundation for the development of human capital. Although there is a clear relation between stunting and child development outcomes, less information is available about the developmental and behavioural outcomes of children with severe

  14. Developmental and behavioural problems in children with severe acute malnutrition in Malawi: A cross-sectional study

    NARCIS (Netherlands)

    van den Heuvel, Meta; Voskuijl, Wieger; Chidzalo, Kate; Kerac, Marko; Reijneveld, Sijmen A.; Bandsma, Robert; Gladstone, Melissa

    2017-01-01

    Background Early childhood development provides an important foundation for the development of human capital. Although there is a clear relation between stunting and child development outcomes, less information is available about the developmental and behavioural outcomes of children with severe

  15. An assessment of the effects of the 2002 food crisis on children's health in Malawi

    NARCIS (Netherlands)

    R. Hartwig (Renate); M. Grimm (Michael)

    2012-01-01

    textabstractThe food crisis encountered in 2002 in Malawi was arguably one of the worst in the recent history of the country. The World Food Programme estimated that between 2.1 and 3.2 million people were threatened by starvation. Despite this assumed severity, not much research on the actual

  16. Assessing the validity of sexual behaviour reports in a whole population survey in rural Malawi.

    Directory of Open Access Journals (Sweden)

    Judith R Glynn

    Full Text Available Sexual behaviour surveys are widely used, but under-reporting of particular risk behaviours is common, especially by women. Surveys in whole populations provide an unusual opportunity to understand the extent and nature of such under-reporting.All consenting individuals aged between 15 and 59 within a demographic surveillance site in northern Malawi were interviewed about their sexual behaviour. Validity of responses was assessed by analysis of probing questions; by comparison of results with in-depth interviews and with Herpes simplex type-2 (HSV-2 seropositivity; by comparing reports to same sex and opposite sex interviewers; and by quantifying the partnerships within the local community reported by men and by women, adjusted for response rates.6,796 women and 5,253 men (83% and 72% of those eligible consented and took part in sexual behaviour interviews. Probing questions and HSV-2 antibody tests in those who denied sexual activity identified under-reporting for both men and women. Reports varied little by sex or age of the interviewer. The number of marital partnerships reported was comparable for men and women, but men reported about 4 times as many non-marital partnerships. The discrepancy in reporting of non-marital partnerships was most marked for married women (men reported about 7 times as many non-marital partnerships with married women as were reported by married women themselves, but was only apparent in younger married women.We have shown that the under-reporting of non-marital partnerships by women was strongly age-dependent. The extent of under-reporting of sexual activity by young men was surprisingly high. The results emphasise the importance of triangulation, including biomarkers, and the advantages of considering a whole population.

  17. Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania.

    Science.gov (United States)

    Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

    2017-12-01

    Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn-related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential

  18. A metric-based assessment of flood risk and vulnerability of rural communities in the Lower Shire Valley, Malawi

    Science.gov (United States)

    Adeloye, A. J.; Mwale, F. D.; Dulanya, Z.

    2015-06-01

    In response to the increasing frequency and economic damages of natural disasters globally, disaster risk management has evolved to incorporate risk assessments that are multi-dimensional, integrated and metric-based. This is to support knowledge-based decision making and hence sustainable risk reduction. In Malawi and most of Sub-Saharan Africa (SSA), however, flood risk studies remain focussed on understanding causation, impacts, perceptions and coping and adaptation measures. Using the IPCC Framework, this study has quantified and profiled risk to flooding of rural, subsistent communities in the Lower Shire Valley, Malawi. Flood risk was obtained by integrating hazard and vulnerability. Flood hazard was characterised in terms of flood depth and inundation area obtained through hydraulic modelling in the valley with Lisflood-FP, while the vulnerability was indexed through analysis of exposure, susceptibility and capacity that were linked to social, economic, environmental and physical perspectives. Data on these were collected through structured interviews of the communities. The implementation of the entire analysis within GIS enabled the visualisation of spatial variability in flood risk in the valley. The results show predominantly medium levels in hazardousness, vulnerability and risk. The vulnerability is dominated by a high to very high susceptibility. Economic and physical capacities tend to be predominantly low but social capacity is significantly high, resulting in overall medium levels of capacity-induced vulnerability. Exposure manifests as medium. The vulnerability and risk showed marginal spatial variability. The paper concludes with recommendations on how these outcomes could inform policy interventions in the Valley.

  19. Communication-Based Assessment of Developmental Age for Young Children with Developmental Disabilities

    Science.gov (United States)

    DeVeney, Shari L.; Hoffman, Lesa; Cress, Cynthia J.

    2012-01-01

    Purpose: In this study, the authors compared a multiple-domain strategy for assessing developmental age of young children with developmental disabilities who were at risk for long-term reliance on augmentative and alternative communication (AAC) with a communication-based strategy composed of receptive language and communication indices that may…

  20. An Assessment of Peri-Urban Groundwater Quality from Shallow Dug Wells, Mzuzu, Malawi

    Science.gov (United States)

    Holm, R.; Felsot, A.

    2012-12-01

    Throughout Malawi, governmental, non-governmental, religious and civic organizations are targeting the human need for water. Diarrheal diseases, often associated with unsafe drinking water, are a leading cause of mortality in children under five in Malawi with over 6,000 deaths per year (World Health Organization, 2010). From January to March 2012, a field study was undertaken in Malawi to study water quality and develop a public health risk communication strategy. The region studied, Area 1B, represents a comparatively new peri-urban area on the edge of Mzuzu city. Area 1B is serviced by a piped municipal water supply, but many shallow dug wells are also used for household water. Groundwater samples were collected from 30 shallow dug well sites and analyzed for nitrate, total coliform, Escherichia coli, total hardness, total alkalinity and pH. In addition to water quality analyses, a structured household questionnaire was administered to address water use, sanitation, health, consumption patterns, and socioeconomics. Results showed that more than half of the groundwater samples would be considered of unacceptable quality based on World Health Organization (WHO) standards for E. coli contamination. Low levels of nitrate were found in groundwater, but only one well exceeded WHO standards. The structured questionnaire revealed that some residents were still consuming groundwater despite the access to safer municipal water. In general, the widespread E. coli contamination was not statistically correlated with well depth, latrine proximity, or surface features. Similarly, nitrate concentrations were not significantly correlated with proximity to latrines. On the other hand, nitrate was correlated with well depth, which is expected given the high potential for leaching of anionic highly water soluble compounds. E. coli was significantly correlated with nitrate concentration. Projects targeting the need for clean water need to recognize that households with access to a

  1. Formalization of Informal Waste Pickers’ Cooperatives in Blantyre, Malawi: A Feasibility Assessment

    Directory of Open Access Journals (Sweden)

    Cidrick Kasinja

    2018-04-01

    Full Text Available Poor road networks, inadequate financial resources and low levels of political will mean that many developing countries, especially their unplanned settlements, struggle with solid waste management. Recently, Informal Waste Pickers (IWPs have been incorporated into waste management cooperatives by formalizing their operations as a strategy to improve the quality and efficiency of waste management in such areas. This study was conducted in Zingwangwa, an unplanned settlement in Blantyre, Malawi, to understand whether the formalization of IWPs into cooperatives could be effective and/or accepted as a way of managing Municipal Solid Waste in unplanned urban settlements in Malawi. Thirty-four IWPs in Zingwangwa were identified and interviewed using a structured questionnaire; personnel from the Blantyre City Council and middlemen were interviewed as key informants. We determined that IWPs experience challenges in all dimensions of their lives: low material prices with exploitative price fluctuations, negative public perception and a lack of transportation are a few of their struggles. Furthermore, a fear of decreased income, conflicts during proceeds sharing, free riding behaviors and an attachment to their independence mean that IWPs are unlikely to form a cooperative on their own though some would be willing to join if a third party initiated the formalization process.

  2. Mathematical Modeling to Assess the Drivers of the Recent Emergence of Typhoid Fever in Blantyre, Malawi.

    Science.gov (United States)

    Pitzer, Virginia E; Feasey, Nicholas A; Msefula, Chisomo; Mallewa, Jane; Kennedy, Neil; Dube, Queen; Denis, Brigitte; Gordon, Melita A; Heyderman, Robert S

    2015-11-01

    Multiyear epidemics of Salmonella enterica serovar Typhi have been reported from countries across eastern and southern Africa in recent years. In Blantyre, Malawi, a dramatic increase in typhoid fever cases has recently occurred, and may be linked to the emergence of the H58 haplotype. Strains belonging to the H58 haplotype often exhibit multidrug resistance and may have a fitness advantage relative to other Salmonella Typhi strains. To explore hypotheses for the increased number of typhoid fever cases in Blantyre, we fit a mathematical model to culture-confirmed cases of Salmonella enterica infections at Queen Elizabeth Central Hospital, Blantyre. We explored 4 hypotheses: (1) an increase in the basic reproductive number (R0) in response to increasing population density; (2) a decrease in the incidence of cross-immunizing infection with Salmonella Enteritidis; (3) an increase in the duration of infectiousness due to failure to respond to first-line antibiotics; and (4) an increase in the transmission rate following the emergence of the H58 haplotype. Increasing population density or decreasing cross-immunity could not fully explain the observed pattern of typhoid emergence in Blantyre, whereas models allowing for an increase in the duration of infectiousness and/or the transmission rate of typhoid following the emergence of the H58 haplotype provided a good fit to the data. Our results suggest that an increase in the transmissibility of typhoid due to the emergence of drug resistance associated with the H58 haplotype may help to explain recent outbreaks of typhoid in Malawi and similar settings in Africa. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  3. An analysis of Malawi\\'s publication productivity | Gondwe | Malawi ...

    African Journals Online (AJOL)

    Methods: The MEDLINE/PubMed database, a registry of articles from over 5,000 scientific journals was searched for articles originating from Malawi between 1996 – 2006 by typing Malawi in the author affiliation search field. A review of abstracts was performed to determine health field and origin of first author – Malawian ...

  4. Assessment of the Developmental Toxicity of Epidermal Growth ...

    African Journals Online (AJOL)

    developmental toxicity, using the embryonic stem cell test (EST), as well as ascertain how EGF ... differentiation of embryonic stem cells, EST was used to assess changes in different blastodermic ..... However, as an extraneous drug, it is worth.

  5. Assessment of drinking water quality and rural household water treatment in Balaka District, Malawi

    Science.gov (United States)

    Mkwate, Raphael C.; Chidya, Russel C. G.; Wanda, Elijah M. M.

    2017-08-01

    Access to drinking water from unsafe sources is widespread amongst communities in rural areas such as Balaka District in Malawi. This situation puts many individuals and communities at risk of waterborne diseases despite some households adopting household water treatment to improve the quality of the water. However, there still remains data gaps regarding the quality of drinking water from such sources and the household water treatment methods used to improve public health. This study was, therefore, conducted to help bridge the knowledge gap by evaluating drinking water quality and adoption rate of household water treatment and storage (HWTS) practices in Nkaya, Balaka District. Water samples were collected from eleven systematically selected sites and analyzed for physico-chemical and microbiological parameters: pH, TDS, electrical conductivity (EC), turbidity, F-, Cl-, NO3-, Na, K, Fe, Faecal Coliform (FC) and Faecal Streptococcus (FS) bacteria using standard methods. The mean results were compared to the World Health Organization (WHO) and Malawi Bureau of Standards (MBS) (MS 733:2005) to ascertain the water quality for drinking purposes. A total of 204 randomly selected households were interviewed to determine their access to drinking water, water quality perception and HWTS among others. The majority of households (72%, n = 83) in Njerenje accessed water from shallow wells and rivers whilst in Phimbi boreholes were commonly used. Several households (>95%, n = 204) were observed to be practicing HWST techniques by boiling or chlorination and water storage in closed containers. The levels of pH (7.10-7.64), F- (0.89-1.46 mg/L), Cl- (5.45-89.84 mg/L), NO3- (0-0.16 mg/L), Na (20-490 mg/L), K (2.40-14 mg/L) and Fe (0.10-0.40 mg/L) for most sites were within the standard limits. The EC (358-2220 μS/cm), turbidity (0.54-14.60 NTU), FC (0-56 cfu/100 mL) and FS (0-120 cfu/100 mL) - mainly in shallow wells, were found to be above the WHO and MBS water quality

  6. Malawi - Infrastructure Development and Power Sector Reform

    Data.gov (United States)

    Millennium Challenge Corporation — Social Impact was contracted by MCC to develop and conduct an evaluation of the Malawi Compact. Specifically, SI has been tasked to “assess the program design and...

  7. Measuring couple relationship quality in a rural African population: Validation of a Couple Functionality Assessment Tool in Malawi.

    Directory of Open Access Journals (Sweden)

    Allison Ruark

    Full Text Available Available data suggest that individual and family well-being are linked to the quality of women's and men's couple relationships, but few tools exist to assess couple relationship functioning in low- and middle-income countries. In response to this gap, Catholic Relief Services has developed a Couple Functionality Assessment Tool (CFAT to capture valid and reliable data on various domains of relationship quality. This tool is designed to be used by interventions which aim to improve couple and family well-being as a means of measuring the effectiveness of these interventions, particularly related to couple relationship quality. We carried out a validation study of the CFAT among 401 married and cohabiting adults (203 women and 198 men in rural Chikhwawa District, Malawi. Using psychometric scales, the CFAT addressed six domains of couple relationship quality (intimacy, partner support, sexual satisfaction, gender roles, decision-making, and communication and conflict management, and included questions on intimate partner violence. We used exploratory factor analysis to assess scale performance of each domain and produce a shortened Relationship Quality Index (RQI composed of items from five relationship quality domains. This article reports the performance of the RQI. Internal reliability and validity of the RQI were found to be good. Regression analyses examined the relationship of the RQI to outcomes important to health and development: intra-household cooperation, positive health behaviors, intimate partner violence, and gender-equitable norms. We found many significant correlations between RQI scores and these couple- and family-level development issues. There is a need to further validate the tool with use in other populations as well as to continue to explore whether the observed linkages between couple functionality and development outcomes are causal relationships.

  8. Assessment of laboratory test utilization for HIV/AIDS care in urban ART clinics of Lilongwe, Malawi.

    Science.gov (United States)

    Palchaudhuri, Sonali; Tweya, Hannock; Hosseinipour, Mina

    2014-06-01

    The 2011 Malawi HIV guidelines promote CD4 monitoring for pre-ART assessment and considering HIVRNA monitoring for ART response assessment, while some clinics used CD4 for both. We assessed clinical ordering practices as compared to guidelines, and determined whether the samples were successfully and promptly processed. We conducted a retrospective review of all patients seen in from August 2010 through July 2011,, in two urban HIV-care clinics that utilized 6-monthly CD4 monitoring regardless of ART status. We calculated the percentage of patients on whom clinicians ordered CD4 or HIVRNA analysis. For all samples sent, we determined rates of successful lab-processing, and mean time to returned results. Of 20581 patients seen, 8029 (39%) had at least one blood draw for CD4 count. Among pre-ART patients, 2668/2844 (93.8%) had CD4 counts performed for eligibility. Of all CD4 samples sent, 8082/9207 (89%) samples were successfully processed. Of those, mean time to processing was 1.6 days (s.d 1.5) but mean time to results being available to clinician was 9.3 days (s.d. 3.7). Regarding HIVRNA, 172 patients of 17737 on ART had a blood draw and only 118/213 (55%) samples were successfully processed. Mean processing time was 39.5 days (s.d. 21.7); mean time to results being available to clinician was 43.1 days (s.d. 25.1). During the one-year evaluated, there were multiple lapses in processing HIVRNA samples for up to 2 months. Clinicians underutilize CD4 and HIVRNA as monitoring tools in HIV care. Laboratory processing failures and turnaround times are unacceptably high for viral load analysis. Alternative strategies need to be considered in order to meet laboratory monitoring needs.

  9. Applying Evolutionary Genetics to Developmental Toxicology and Risk Assessment

    Science.gov (United States)

    Leung, Maxwell C. K.; Procter, Andrew C.; Goldstone, Jared V.; Foox, Jonathan; DeSalle, Robert; Mattingly, Carolyn J.; Siddall, Mark E.; Timme-Laragy, Alicia R.

    2018-01-01

    Evolutionary thinking continues to challenge our views on health and disease. Yet, there is a communication gap between evolutionary biologists and toxicologists in recognizing the connections among developmental pathways, high-throughput screening, and birth defects in humans. To increase our capability in identifying potential developmental toxicants in humans, we propose to apply evolutionary genetics to improve the experimental design and data interpretation with various in vitro and whole-organism models. We review five molecular systems of stress response and update 18 consensual cell-cell signaling pathways that are the hallmark for early development, organogenesis, and differentiation; and revisit the principles of teratology in light of recent advances in high-throughput screening, big data techniques, and systems toxicology. Multiscale systems modeling plays an integral role in the evolutionary approach to cross-species extrapolation. Phylogenetic analysis and comparative bioinformatics are both valuable tools in identifying and validating the molecular initiating events that account for adverse developmental outcomes in humans. The discordance of susceptibility between test species and humans (ontogeny) reflects their differences in evolutionary history (phylogeny). This synthesis not only can lead to novel applications in developmental toxicity and risk assessment, but also can pave the way for applying an evo-devo perspective to the study of developmental origins of health and disease. PMID:28267574

  10. Classroom Assessment in Malawi: Teachersâ Perceptions and Practices in Mathematics

    OpenAIRE

    Susuwele-Banda, William John

    2005-01-01

    This study investigated teachersâ perceptions of classroom assessment in mathematics and their current classroom assessments practices. Specifically, the study sought to gain an understanding of the extent to which teachers use different classroom assessment methods and tools to understand and to support both the learning and teaching processes. The following three questions guided the study: 1) How do primary school teachers perceive classroom assessment in mathematics? 2) What kinds of a...

  11. Lost opportunities to identify and treat HIV-positive patients: results from a baseline assessment of provider-initiated HIV testing and counselling (PITC) in Malawi.

    Science.gov (United States)

    Ahmed, Saeed; Schwarz, Monica; Flick, Robert J; Rees, Chris A; Harawa, Mwelura; Simon, Katie; Robison, Jeff A; Kazembe, Peter N; Kim, Maria H

    2016-04-01

    To assess implementation of provider-initiated testing and counselling (PITC) for HIV in Malawi. A review of PITC practices within 118 departments in 12 Ministry of Health (MoH) facilities across Malawi was conducted. Information on PITC practices was collected via a health facility survey. Data describing patient visits and HIV tests were abstracted from routinely collected programme data. Reported PITC practices were highly variable. Most providers practiced symptom-based PITC. Antenatal clinics and maternity wards reported widespread use of routine opt-out PITC. In 2014, there was approximately 1 HIV test for every 15 clinic visits. HIV status was ascertained in 94.3% (5293/5615) of patients at tuberculosis clinics, 92.6% (30,675/33,142) of patients at antenatal clinics and 49.4% (6871/13,914) of patients at sexually transmitted infection clinics. Reported challenges to delivering PITC included test kit shortages (71/71 providers), insufficient physical space (58/71) and inadequate number of HIV counsellors (32/71) while providers from inpatient units cited the inability to test on weekends. Various models of PITC currently exist at MoH facilities in Malawi. Only antenatal and maternity clinics demonstrated high rates of routine opt-out PITC. The low ratio of facility visits to HIV tests suggests missed opportunities for HIV testing. However, the high proportion of patients at TB and antenatal clinics with known HIV status suggests that routine PITC is feasible. These results underscore the need to develop clear, standardised PITC policy and protocols, and to address obstacles of limited health commodities, infrastructure and human resources. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  12. Archives: Malawi Medical Journal

    African Journals Online (AJOL)

    Items 1 - 50 of 72 ... Archives: Malawi Medical Journal. Journal Home > Archives: Malawi Medical Journal. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 50 of 72 Items, 1 2 > >> ...

  13. Health spending, illicit financial flows and tax incentives in Malawi ...

    African Journals Online (AJOL)

    Health spending, illicit financial flows and tax incentives in Malawi. B O'Hare, M Curtis. Abstract. This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax ...

  14. A method to assess soil erosion from smallholder farmers' fields: a case study from Malawi.

    Science.gov (United States)

    Mohamoud, Yusuf M

    2013-09-01

    Soil erosion by water is a major threat to sustainable food production systems in Africa. This study presents a qualitative soil erosion assessment method that links the number of broken ridges (NBRS) observed on a smallholder farmer's field after a rain event to factors of soil erosion (e.g., rainfall intensity, slope steepness, crop canopy height, and conservation practice) and to soil loss data measured from a runoff plot and receiving small streams. The assessment method consists of a rapid survey of smallholder farmers combined with field monitoring. Results show an indirect relationship between NBRS and factors of soil erosion. Results also show a direct relationship between NBRS and suspended sediment concentrations measured from an experimental runoff plot and receiving streams that drain the sub-watersheds where farmers' fields are located. Given the limited human and financial resources available to soil erosion research in developing countries, monitoring NBRS is a simple, cost-effective, and reliable erosion assessment method for regions where smallholder farmers practice contour ridging.

  15. Association between neurological assessment and developmental outcome in preterm toddlers

    Directory of Open Access Journals (Sweden)

    Jana Kodrič

    2011-01-01

    Full Text Available There has been an increase in prevalence of low severity dysfunctions such as minor neurological dysfunction and cognitive deficits which consequently lead to school and behavior problems. The study presents the outcomes of a small group of preterm children with different medical complications at birth on follow-up at toddler age. In the neonatal period and at three months corrected age the neurological examination by the Amiel-Tison neurological assessment and the assessment of general movements was done. Both measures were compared with the criterion measure Bayley Scales of Infant Development - II. Results of the preterm group were compared with results of the normative group. According to results for both methods of neurological examination, children were classified into different categories meaning optimal or different degrees of non-optimal neurological results. The results of the children from different categories of neurological functioning were compared with the criterion measure. Children from the preterm group attained lower results on the developmental test compared to normative data. Children from groups with the lowest birth weight and gestational age attained the lowest results. These findings suggest that children from less optimal or non-optimal categories according to both methods of neurological examination attained lower developmental scores. The difference between groups was higher on the mental scale than on the motor scale of the developmental test.

  16. Developmental Assessment with Young Children: A Systematic Review of Battelle Studies

    Science.gov (United States)

    Cunha, Ana C. B.; Berkovits, Michelle D.; Albuquerque, Karolina A.

    2018-01-01

    Developmental assessment scales are important tools for determining developmental delays and planning preventive interventions. One broad assessment scale used to evaluate child development is the Battelle Developmental Inventories (BDIs). The BDI-2 has a standardized version in English with good psychometric properties and a translated version in…

  17. Biomarkers to assess potential developmental immunotoxicity in children

    International Nuclear Information System (INIS)

    Luster, Michael I.; Johnson, Victor J.; Yucesoy, Berran; Simeonova, Petia P.

    2005-01-01

    Clinical tests are readily available for assessing severe loss of immune function in children with diseases such as AIDS or primary immunodeficiency. However tests that could reliably identify subtle immune changes, as might be expected to result from exposure to developmental immunotoxic agents, are not readily available. A number of tests are described which we believe have potential applicability for epidemiological studies involving developmental immunotoxicity. Several of the tests, such as T cell receptor rearrangement excision circles (TRECs) and cytokine measurements, while highly relevant from a biological standpoint, may be precluded from use at the current time, for either technical issues or insufficient validation. Immunophenotyping and measurement of serum immunoglobulin levels, on the other hand, are well validated. Yet they may require extraordinary care in experimental design and technical performance in order to obtain data that would consistently detect subtle changes, as these tests are not generally considered highly sensitive. Quantification of the immune response to childhood vaccine, while up to the present used sparingly, may represent an excellent indicator for developmental immunotoxicity when conducted under appropriate conditions

  18. Assessing infection control practices to protect health care workers and patients in Malawi from nosocomial transmission of Mycobacterium tuberculosis.

    Science.gov (United States)

    Flick, Robert J; Munthali, Adamson; Simon, Katherine; Hosseinipour, Mina; Kim, Maria H; Mlauzi, Lameck; Kazembe, Peter N; Ahmed, Saeed

    2017-01-01

    Transmission of Mycobacterium tuberculosis (TB) in health settings threatens health care workers and people living with HIV in sub-Saharan Africa. Nosocomial transmission is reduced with implementation of infection control (IC) guidelines. The objective of this study is to describe implementation of TB IC measures in Malawi. We conducted a cross-sectional study utilizing anonymous health worker questionnaires, semi-structured interviews with facility managers, and direct observations at 17 facilities in central Malawi. Of 592 health care workers surveyed, 34% reported that all patients entering the facility were screened for cough and only 8% correctly named the four most common signs and symptoms of TB in adults. Of 33 managers interviewed, 7 (21%) and 1 (3%) provided the correct TB screening questions for use in adults and children, respectively. Of 592 health workers, only 2.4% had been screened for TB in the previous year. Most (90%) reported knowing their HIV status, 53% were tested at their facility of employment, and half reported they would feel comfortable receiving ART or TB treatment at their facility of employment. We conclude that screening is infrequently conducted and knowledge gaps may undercut its effectiveness. Further, health care workers do not routinely access TB and HIV diagnostic and treatment services at their facility of employment.

  19. TRWG developmental pathway for biospecimen-based assessment modalities

    Energy Technology Data Exchange (ETDEWEB)

    Translational Research Working Group; Srivastava, Sudhir; Gray, Joe W.; Reid, Brian J.; Grad, Oren; Greenwood, Addison; Hawk, Ernest T.

    2008-09-03

    The Translational Research Working Group (TRWG) was created as a national initiative to evaluate the current status of NCI's investment in translational research and envision its future. The TRWG conceptualized translational research as a set of six developmental processes or pathways focused on various clinical goals. One of those pathways describes the development of biospecimen-based assays that utilize biomarkers for the detection, diagnosis, prognosis, and assessment of response to cancer treatment. The biospecimen-based assessment modality (BM) pathway was conceived not as comprehensive description of the corresponding real-world processes, but rather as a tool designed to facilitate movement of a candidate assay through the translational process to the point where it can be handed off for definitive clinical testing. This paper introduces the pathway in the context of prior work and discusses key challenges associated with the biomarker development process in light of the pathway.

  20. Assessing hopping developmental level in childhood using wearable inertial sensor devices.

    Science.gov (United States)

    Masci, Ilaria; Vannozzi, Giuseppe; Getchell, Nancy; Cappozzo, Aurelio

    2012-07-01

    Assessing movement skills is a fundamental issue in motor development. Current process-oriented assessments, such as developmental sequences, are based on subjective judgments; if paired with quantitative assessments, a better understanding of movement performance and developmental change could be obtained. Our purpose was to examine the use of inertial sensors to evaluate developmental differences in hopping over distance. Forty children executed the task wearing the inertial sensor and relevant time durations and 3D accelerations were obtained. Subjects were also categorized in different developmental levels according to the hopping developmental sequence. Results indicated that some time and kinematic parameters changed with some developmental levels, possibly as a function of anthropometry and previous motor experience. We concluded that, since inertial sensors were suitable in describing hopping performance and sensitive to developmental changes, this technology is promising as an in-field and user-independent motor development assessment tool.

  1. Assessment of water, sanitation and hygiene interventions in response to an outbreak of typhoid fever in Neno District, Malawi.

    Science.gov (United States)

    Bennett, Sarah D; Lowther, Sara A; Chingoli, Felix; Chilima, Benson; Kabuluzi, Storn; Ayers, Tracy L; Warne, Thomas A; Mintz, Eric

    2018-01-01

    On May 2, 2009 an outbreak of typhoid fever began in rural villages along the Malawi-Mozambique border resulting in 748 illnesses and 44 deaths by September 2010. Despite numerous interventions, including distribution of WaterGuard (WG) for in-home water treatment and education on its use, cases of typhoid fever continued. To inform response activities during the ongoing Typhoid outbreak information on knowledge, attitudes, and practices surrounding typhoid fever, safe water, and hygiene were necessary to plan future outbreak interventions. In September 2010, a survey was administered to female heads in randomly selected households in 17 villages in Neno District, Malawi. Stored household drinking water was tested for free chlorine residual (FCR) levels using the N,N diethyl-p-phenylene diamine colorimetric method (HACH Company, Loveland, CO, USA). Attendance at community-wide educational meetings was reported by 56% of household respondents. Respondents reported that typhoid fever is caused by poor hygiene (77%), drinking unsafe water (49%), and consuming unsafe food (25%), and that treating drinking water can prevent it (68%). WaterGuard, a chlorination solution for drinking water treatment, was observed in 112 (56%) households, among which 34% reported treating drinking water. FCR levels were adequate (FCR ≥ 0.2 mg/L) in 29 (76%) of the 38 households who reported treatment of stored water and had stored water available for testing and an observed bottle of WaterGuard in the home. Soap was observed in 154 (77%) households, among which 51% reported using soap for hand washing. Educational interventions did not reach almost one-half of target households and knowledge remains low. Despite distribution and promotion of WaterGuard and soap during the outbreak response, usage was low. Future interventions should focus on improving water, sanitation and hygiene knowledge, practices, and infrastructure. Typhoid vaccination should be considered.

  2. Lessons from Neno, Malawi

    African Journals Online (AJOL)

    The NCD screening models were integrated into existing platforms, utilising regular mass screening events in the ... feasible to introduce NCD screening into a public system, but screening may have ... been advocated.10 However, limited data exist in Malawi on ..... system of drugs and equipment forecasting, procurement,.

  3. Country Presentation Malawi

    International Nuclear Information System (INIS)

    Kamperewera, A.M; Chiumbuzo, T.M.; Bonongwe, A.

    2010-01-01

    Discusses incidents and developments in illicit trafficking, unauthorized activities involving nuclear materials in Malawi, government systems for prevention and detection of nuclear material trafficking and response to unauthorized activities involving nuclear materials and systems put in place for nuclear trafficking information management and coordination.

  4. Democratization in Malawi

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.

    2013-01-01

    a political conditionality approach. Few countries have felt the weight of conditionality as much as Malawi did in the 1990s. Here, donors were able to use aid sanctions to successfully encourage democratization, while strengthening the demands of domestic opposition forces. This paper argues that three...

  5. Malawi: a christian theological

    African Journals Online (AJOL)

    groups of people: smallholder farmers, female-headed households, estate workers ... poverty in Malawi and these are: low agricultural production, low income, low education .... A agreed to pay tax for anyone who worked for two months and also ..... efficient, environmentally sustainable and socially equitable land tenure.

  6. IDRC in Malawi

    International Development Research Centre (IDRC) Digital Library (Canada)

    As 85% of Malawi's popu- lation are agricultural smallholders, IDRC has focused much of its support on farming systems. Early efforts improved crop production and processing methods. For example, researchers developed a low-cost wooden tool to shell groundnuts, saving farmers time and money. Hand pump designs ...

  7. Malawi's Mental Health Service

    African Journals Online (AJOL)

    ual, the child running off into the bush, the adoles- cent who almost unnoticed begins to lose concentration and fail at his studies. ... Malawi Medical Journal. .... topic. In this way the specialist service comes out to the district, rather than all those ...

  8. From Clinical-Developmental Theory to Assessment: The Holistic Student Assessment Tool

    Directory of Open Access Journals (Sweden)

    Gil Noam

    2012-12-01

    Full Text Available A description and test of the Holistic Student Assessment Tool (HSA, an assessment tool to measure children’s and adolescents’ resiliencies in relation to externalizing and internalizing problem behaviors. The HSA is based on the authors’ research-based clinical-developmental Clover Leaf Model of resilience and psychopathology, and is one of the first attempts at closing the gap between risk and resilience approaches in developmental assessment. The HSA was tested in a cross-sectional sample of 423 children and adolescents.The results lend support to the HSA as a valid measure of children’s and adolescents’ resiliencies. Furthermore, the resilience scales mostly exhibited the theoretically expected convergent and divergent relationships with the psychopathology scales. In addition, we show how the resilience scales predict adolescents’ externalizing and internalizing symptoms. We contend that evidence-based intervention to address youth aggression needs to be based on sounddevelopmental assessment.

  9. Assessment of the Developmental Toxicity of Epidermal Growth ...

    African Journals Online (AJOL)

    Purpose: To determine whether epidermal growth factor (EGF) is involved in reproductive developmental toxicity, using the embryonic stem cell test (EST), as well as ascertain how EGF influences embryonic development. Methods: To predict developmental toxicity on the basis of reducing cell viability and inhibition of ...

  10. Referral Systems to Integrate Health and Economic Strengthening Services for People with HIV: A Qualitative Assessment in Malawi.

    Science.gov (United States)

    Sears, Clinton; Andersson, Zach; Cann, Meredith

    2016-12-23

    Supporting the diverse needs of people living with HIV (PLHIV) can help reduce the individual and structural barriers they face in adhering to antiretroviral treatment (ART). The Livelihoods and Food Security Technical Assistance II (LIFT) project sought to improve adherence in Malawi by establishing 2 referral systems linking community-based economic strengthening and livelihoods services to clinical health facilities. One referral system in Balaka district, started in October 2013, connected clients to more than 20 types of services while the other simplified approach in Kasungu and Lilongwe districts, started in July 2014, connected PLHIV attending HIV and nutrition support facilities directly to community savings groups. From June to July 2015, LIFT visited referral sites in Balaka, Kasungu, and Lilongwe districts to collect qualitative data on referral utility, the perceived association of referrals with client and household health and vulnerability, and the added value of the referral system as perceived by network member providers. We interviewed a random sample of 152 adult clients (60 from Balaka, 57 from Kasungu, and 35 from Lilongwe) who had completed their referral. We also conducted 2 focus group discussions per district with network providers. Clients in all 3 districts indicated their ability to save money had improved after receiving a referral, although the percentage was higher among clients in the simplified Kasungu and Lilongwe model than the more complex Balaka model (85.6% vs. 56.0%, respectively). Nearly 70% of all clients interviewed had HIV infection; 72.7% of PLHIV in Balaka and 95.7% of PLHIV in Kasungu and Lilongwe credited referrals for helping them stay on their ART. After the referral, 76.0% of clients in Balaka and 92.3% of clients in Kasungu and Lilongwe indicated they would be willing to spend their savings on health costs. The more diverse referral network and use of an mHealth app to manage data in Balaka hindered provider uptake

  11. Nonorganic Failure to Thrive: Developmental Outcomes and Psychosocial Assessment and Intervention Issues.

    Science.gov (United States)

    Heffer, Robert W.; Kelley, Mary L.

    1994-01-01

    This review describes Nonorganic Failure to Thrive, presents developmental outcomes, and discusses psychosocial assessment and intervention issues relevant to this developmental disability of early childhood, focusing on child-specific variables, situational and family variables, parent-child interaction variables, and biopsychosocial formulation…

  12. Cross-Cultural Adaptation of a Developmental Assessment for Arabic-Speaking Children with Visual Impairment

    Science.gov (United States)

    Macrine, Sheila L.; Heji, Hayat; Sabri, Amel; Dalton, Sara

    2015-01-01

    Developmental screening has become an established component of child health programs in many developed countries. The research objective of this project was to translate and adapt a developmental assessment (Oregon Project Skills Inventory) for use with young children with visual impairments who speak Arabic. The study was prompted by the lack of…

  13. Who benefits from public spending on health care in Malawi? An ...

    African Journals Online (AJOL)

    A principal objective of the Malawi government is to provide public health services that reach poor men and women. This paper assesses to what extent the Government has been successful in achieving this. Malawi was also found to be more successful than other countries in Africa at providing health services that reach ...

  14. Deforestation in Mwanza District, Malawi, from 1981 to 1992 as determined from Landsat MSS imagery

    Science.gov (United States)

    Andrew T. Hudak; Carol A. Wessman

    2000-01-01

    Malawi is critically short of fuelwood, the primary energy source for its poverty-stricken populace. Deforestation from 1981 to 1992 in Mwanza District in southern Malawi was assessed using Normalized Difference Vegetation Index (NDVI) values calculated from multitemporal Landsat Multispectral Scanner (MSS) images. A control site, where vegetation change was assumed to...

  15. From kitchen to classroom: Assessing the impact of cleaner burning biomass-fuelled cookstoves on primary school attendance in Karonga district, northern Malawi.

    Science.gov (United States)

    Kelly, Christine A; Crampin, Amelia C; Mortimer, Kevin; Dube, Albert; Malava, Jullita; Johnston, Deborah; Unterhalter, Elaine; Glynn, Judith R

    2018-01-01

    Household air pollution from burning solid fuels is responsible for an estimated 2.9 million premature deaths worldwide each year and 4.5% of global disability-adjusted life years, while cooking and fuel collection pose a considerable time burden, particularly for women and children. Cleaner burning biomass-fuelled cookstoves have the potential to lower exposure to household air pollution as well as reduce fuelwood demand by increasing the combustion efficiency of cooking fires, which may in turn yield ancillary benefits in other domains. The present paper capitalises on opportunities offered by the Cooking and Pneumonia Study (CAPS), the largest randomised trial of biomass-fuelled cookstoves on health outcomes conducted to date, the design of which allows for the evaluation of additional outcomes at scale. This mixed methods study assesses the impact of cookstoves on primary school absenteeism in Karonga district, northern Malawi, in particular by conferring health and time and resource gains on young people aged 5-18. The analysis combines quantitative data from 6168 primary school students with in-depth interviews and focus group discussions carried out among 48 students in the same catchment area in 2016. Negative binomial regression models find no evidence that the cookstoves affected primary school absenteeism overall [IRR 0.92 (0.71-1.18), p = 0.51]. Qualitative analysis suggests that the cookstoves did not sufficiently improve household health to influence school attendance, while the time and resource burdens associated with cooking activities-although reduced in intervention households-were considered to be compatible with school attendance in both trial arms. More research is needed to assess whether the cookstoves influenced educational outcomes not captured by the attendance measure available, such as timely arrival to school or hours spent on homework.

  16. Developmental assessment of RELAP5/MOD3 using the semiscale natural circulation tests

    International Nuclear Information System (INIS)

    Carlson, K.E.

    1990-01-01

    A code development effort creating RELAP5/MOD3 from RELAP5/MOD2 has been completed. Upon completion, a developmental assessment task was performed. One of the problems used for the developmental assessment was the Semiscale Natural Circulation Test. Calculated results from RELAP5/MOD3 are compared to measured data and previously calculated results from RELAP5/MOD2. 10 refs., 6 figs., 1 tab

  17. Developmental changes in brain connectivity assessed using the sleep EEG.

    OpenAIRE

    Tarokh L; Carskadon M A; Achermann P

    2010-01-01

    Adolescence represents a time of significant cortical restructuring. Current theories posit that during this period connections between frequently utilized neural networks are strengthened while underutilized synaptic connections are discarded. The aim of the present study was to examine the developmental evolution of connectivity between brain regions using the sleep EEG. All night sleep EEG recordings in two longitudinal cohorts (children and teens) followed at 1.5 3 year intervals and one ...

  18. the Malawi National NCDI Povert

    African Journals Online (AJOL)

    elderly, or urban populations.2 Furthermore, the interventions aimed around NCDIs ... disability-adjusted life years (DALYs) in Malawi are from the big 4 categories ... chronic NCDs, as well as health promotion, are currently being scaled up ...

  19. Malawi Journal of Science and Technology

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... The Malawi Journal of Science and Technology (MJST), the research journal of the Faculty of Science, Chancellor College in Malawi is ...

  20. Validating an Online Assessment of Developmental Spelling in Grades Five through Eight

    Science.gov (United States)

    Gehsmann, Kristin; Spichtig, Alexandra; Tousley, Elias

    2017-01-01

    Assessments of developmental spelling, also called spelling inventories, are commonly used to understand students' orthographic knowledge (i.e., knowledge of how written words work) and to determine their stages of spelling and reading development. The information generated by these assessments is used to inform teachers' grouping practices and…

  1. Specialization training in Malawi: a qualitative study on the perspectives of medical students graduating from the University of Malawi College of Medicine.

    Science.gov (United States)

    Sawatsky, Adam P; Parekh, Natasha; Muula, Adamson S; Bui, Thuy

    2014-01-06

    There is a critical shortage of healthcare workers in sub-Saharan Africa, and Malawi has one of the lowest physician densities in the region. One of the reasons for this shortage is inadequate retention of medical school graduates, partly due to the desire for specialization training. The University of Malawi College of Medicine has developed specialty training programs, but medical school graduates continue to report a desire to leave the country for specialization training. To understand this desire, we studied medical students' perspectives on specialization training in Malawi. We conducted semi-structured interviews of medical students in the final year of their degree program. We developed an interview guide through an iterative process, and recorded and transcribed all interviews for analysis. Two independent coders coded the manuscripts and assessed inter-coder reliability, and the authors used an "editing approach" to qualitative analysis to identify and categorize themes relating to the research aim. The University of Pittsburgh Institutional Review Board and the University of Malawi College of Medicine Research and Ethics Committee approved this study and authors obtained written informed consent from all participants. We interviewed 21 medical students. All students reported a desire for specialization training, with 12 (57%) students interested in specialties not currently offered in Malawi. Students discussed reasons for pursuing specialization training, impressions of specialization training in Malawi, reasons for staying or leaving Malawi to pursue specialization training and recommendations to improve training. Graduating medical students in Malawi have mixed views of specialization training in their own country and still desire to leave Malawi to pursue further training. Training institutions in sub-Saharan Africa need to understand the needs of the country's healthcare workforce and the needs of their graduating medical students to be able to

  2. Safety assessment in primary Mycobacterium tuberculosis smear microscopy centres in Blantyre Malawi: a facility based cross sectional survey.

    Science.gov (United States)

    Majamanda, J; Ndhlovu, P; Shawa, I T

    2013-12-01

    Tuberculosis (TB) is caused by Mycobacterium tuberculosis and is transmitted mainly through aerosolization of infected sputum which puts laboratory workers at risk in spite of the laboratory workers' risk of infection being at 3 to 9 times higher than the general public. Laboratory safety should therefore be prioritized and optimized to provide sufficient safety to laboratory workers. To assess the safety for the laboratory workers in TB primary microscopy centres in Blantyre urban. TB primary microscopy centers in Blantyre urban were assessed in aspects of equipment availability, facility layout, and work practice, using a standardized WHO/AFRO ISO 15189 checklist for the developing countries which sets the minimum safety score at ≥80%. Each center was graded according to the score it earned upon assessment. Only one (1) microscopy center out nine (9) reached the minimum safety requirement. Four (4) centers were awarded 1 star level, four (4) centers were awarded 2 star level and only one (1) center was awarded 3 star level. In Blantyre urban, 89% of the Tuberculosis microscopy centers are failing to provide the minimum safety to the laboratory workers. Government and other stake holders should be committed in addressing the safety challenges of TB microscopy centres in the country to ensure safety for the laboratory workers. It is recommended that the study be conducted at the regional or national level for both public and private laboratories in order to have a general picture of safety in Tb microscopy centres possibly across the country.

  3. Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study

    OpenAIRE

    VanDenHeuvel, A.; Fitzgerald, M.; Greiner, Birgit A.; Perry, Ivan J.

    2007-01-01

    VanDenHeuvel A, Fitzgerald M, Greiner B, Perry IJ. Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study. Ir Med J. 2007;100(8):565-7. The objectives of this study were to assess the feasibility of administering the CHecklist for Autism in Toddlers (CHAT) at the 18-month developmental check, estimate the prevalence of screening positive for autism at the first and second administrations of the CHAT and estimate the prevalence of diagnos...

  4. Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

    Science.gov (United States)

    White, Susan W.; Smith, Laura A.; Schry, Amie R.

    2014-01-01

    Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment…

  5. Neurobehavioral assessment of children and adolescents attending a developmental disabilities clinic.

    Science.gov (United States)

    Brasić, James Robert; Barnett, Jacqueline Y; Kowalik, S; Tsaltas, Margaret Owen; Ahmad, Raheela

    2004-12-01

    Although the risk of the eventual development of tardive dyskinesia and other persistent adverse effects of neuroleptics is high, among adults with mental retardation and other developmental disabilities, neuroleptics may ameliorate dyskinesias, aggression, and inattention. The effects of traditional neuroleptics on a comparable population of children and adolescents with mental retardation and other developmental disabilities are unknown. The objective of this study was to develop an assessment battery to describe the effects of traditional neuroleptics on the behavior and movements of a small sample of children and adolescents with mental retardation and other developmental disabilities. 13 children and adolescents aged 6 to 16 years attending a developmental disabilities clinic were evaluated utilizing a Movement Assessment Battery to measure behavior and motions. Five subjects took traditional neuroleptic medications. Trained raters can reliably assess the movements and behaviors of children and adolescents with multiple handicaps. Children and adolescents with developmental disabilities may be vulnerable to experience functional impairment and akathisia, tics, and other dyskinesias when administered traditional neuroleptic medications.

  6. Quantitative assessment of developmental levels in overarm throwing using wearable inertial sensing technology.

    Science.gov (United States)

    Grimpampi, Eleni; Masci, Ilaria; Pesce, Caterina; Vannozzi, Giuseppe

    2016-09-01

    Motor proficiency in childhood has been recently recognised as a public health determinant, having a potential impact on the physical activity level and possible sedentary behaviour of the child later in life. Among fundamental motor skills, ballistic skills assessment based on in-field quantitative observations is progressively needed in the motor development community. The aim of this study was to propose an in-field quantitative approach to identify different developmental levels in overarm throwing. Fifty-eight children aged 5-10 years performed an overarm throwing task while wearing three inertial sensors located at the wrist, trunk and pelvis level and were then categorised using a developmental sequence of overarm throwing. A set of biomechanical parameters were defined and analysed using multivariate statistics to evaluate whether they can be used as developmental indicators. Trunk and pelvis angular velocities and time durations before the ball release showed increasing/decreasing trends with increasing developmental level. Significant differences between developmental level pairs were observed for selected biomechanical parameters. The results support the suitability and feasibility of objective developmental measures in ecological learning contexts, suggesting their potential supportiveness to motor learning experiences in educational and youth sports training settings.

  7. How much do patients in Blantyre, Malawi know about antibiotics ...

    African Journals Online (AJOL)

    Introduction This qualitative and quantitative exploratory study was conducted to assess patients'/customers' knowledge, beliefs and practices about antibiotics and other prescription only medication (POM) in 10 community pharmacies in Blantyre, Malawi. Method 5 out of 10 pharmacies were selected by simple random ...

  8. Malawi Medical Journal - Vol 26, No 2 (2014)

    African Journals Online (AJOL)

    Assessment of laboratory test utilization for HIV/AIDS care in urban ART clinics of Lilongwe, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. S Palchaudhuri, H Tweya, M Hosseinipour, 42-44 ...

  9. Case studies of nurseries in Malawi

    DEFF Research Database (Denmark)

    Namoto, M.; Likoswe, M.G.

    This study of 42 case studies of nurseries was made as part of a major sample survey of 360 nurseries in 6 districts in Malawi. The purpose of the study was to let the small nurseries in the country explain in their own words how they source seed, how and for whom they produce seedlings......, and to explain about their problems and opportunities in the nursery business. The assessment was made within the framework of Improved Seed Supply for Agroforestry in African Countries (ISSAAC), a Danida supported programme implemented in cooperation between Forest & Landscape Denmark and World Agroforestry...

  10. Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach

    Directory of Open Access Journals (Sweden)

    Makaula Peter

    2012-09-01

    Full Text Available Abstract Background Primary Health Care (PHC is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi and community-directed interventions (CDI are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated with PHC. The CDI approach has successfully been used to improve the delivery of interventions in areas that have previously used CDTi. However, little is known about the added value of community participation in areas without prior experience with CDTi. This study aimed at assessing PHC in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. We examined health service providers’ and beneficiaries’ perceptions on existing PHC practices, and their perspectives on official priorities and strategies to strengthen PHC. Methods We conducted 27 key informant interviews with health officials and partners at national, district and health centre levels; 32 focus group discussions with community members and in-depth interviews with 32 community members and 32 community leaders. Additionally, official PHC related documents were reviewed. Results The findings show that there is a functional PHC system in place in the two study districts, though its implementation is faced with various challenges related to accessibility of services and shortage of resources. Health service providers and consumers shared perceptions on the importance of intensifying community participation to strengthen PHC, particularly within the areas of provision of insecticide treated bed nets, home case management for

  11. Assessment of Malawi's success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation.

    Science.gov (United States)

    Doherty, Tanya; Zembe, Wanga; Ngandu, Nobubelo; Kinney, Mary; Manda, Samuel; Besada, Donela; Jackson, Debra; Daniels, Karen; Rohde, Sarah; van Damme, Wim; Kerber, Kate; Daviaud, Emmanuelle; Rudan, Igor; Muniz, Maria; Oliphant, Nicholas P; Zamasiya, Texas; Rohde, Jon; Sanders, David

    2015-12-01

    Malawi is estimated to have achieved its Millennium Development Goal (MDG) 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI) programme of support (2007-2013). We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST) was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI) 189 to 249) in the period 1991-1995 to 119 deaths (95% CI 105 to 132) in the period 2006-2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24%) and increased household coverage of insecticide-treated bednets (19%). These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub-Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community-based delivery platform, can lead to significant reductions in child mortality.

  12. Initial Steps in Creating a Developmentally Valid Tool for Observing/Assessing Rope Jumping

    Science.gov (United States)

    Roberton, Mary Ann; Thompson, Gregory; Langendorfer, Stephen J.

    2017-01-01

    Background: Valid motor development sequences show the various behaviors that children display as they progress toward competence in specific motor skills. Teachers can use these sequences to observe informally or formally assess their students. While longitudinal study is ultimately required to validate developmental sequences, there are earlier,…

  13. CAPs-IDD: Characteristics of Assessment Instruments for Psychiatric Disorders in Persons with Intellectual Developmental Disorders

    Science.gov (United States)

    Zeilinger, E. L.; Nader, I. W.; Brehmer-Rinderer, B.; Koller, I.; Weber, G.

    2013-01-01

    Background: Assessment of psychiatric disorders in persons with an intellectual developmental disorder (IDD) can be performed with a variety of greatly differing instruments. This makes the choice of an instrument best suited for the intended purpose challenging. In this study, we developed a comprehensive set of characteristics for the evaluation…

  14. Dual Rubrics and the Process of Writing: Assessment and Best Practices in a Developmental English Course

    Science.gov (United States)

    Pireh, Diane Flanegan

    2014-01-01

    This article presents strategies for using two types of essay-writing rubrics in a developmental English class of students transitioning into college-level writing. One checklist rubric is student-facing, designed to serve as a guide for students throughout the writing process and as a self-assessment tool. The other checklist rubric is…

  15. Stoves or sugar? Willingness to adopt improved cookstoves in Malawi

    International Nuclear Information System (INIS)

    Jagger, Pamela; Jumbe, Charles

    2016-01-01

    Malawi has set a target of adoption of two million improved cookstoves (ICS) by 2020. Meeting this objective requires knowledge about determinants of adoption, particularly in rural areas where the cost of traditional cooking technologies and fuels are non-monetary, and where people have limited capacity to purchase an ICS. We conducted a discrete choice experiment with 383 households in rural Malawi asking them if they would chose a locally made ICS or a package of sugar and salt of roughly equal value. Six months later, we assessed adoption and stove use patterns. Sixty-six percent of households chose the ICS. We find that having a larger share of crop residues in household fuel supply, awareness of the environmental impacts of woodfuel reliance, time the primary cook devotes to collecting fuelwood, and peer effects at the village-level increase the odds of choosing the ICS. Having a large labor supply for fuelwood collection and experience with a non-traditional cooking technology decreased the odds of choosing the ICS. In a rapid assessment six months after stoves were distributed, we found 80% of households were still using the ICS, but not exclusively. Our findings suggest considerable potential for wide-scale adoption of low cost ICS in Malawi. - Highlights: •There is demand for locally produced improved cookstoves in rural Malawi. •Environmental awareness, labor availability, and peer effects influence adoption. •Sustained and exclusive use of improved cookstoves requires training and follow-up.

  16. Assessing Variations in Developmental Outcomes Among Teenage Offspring of Teen Mothers: Maternal Life Course Correlates.

    Science.gov (United States)

    Lee, Jungeun Olivia; Gilchrist, Lewayne D; Beadnell, Blair A; Lohr, Mary Jane; Yuan, Chaoyue; Hartigan, Lacey A; Morrison, Diane M

    2017-09-01

    This study investigated potential heterogeneity in development among offspring (age 17) of teen mothers and maternal life course as correlates of variation. Using latent class analysis, subgroups of developmental outcomes were identified. Maternal standing in two life course realms (i.e., socioeconomic and domestic) was considered as a potential explanation for heterogeneity in offspring's development. Offspring reported on measures assessing their psychological, academic, and behavioral development. Teen mothers reported on measures of life course realms. Three subgroups of developmental outcomes were identified: on track (52%), at risk (37%), and troubled (11%). Findings suggest that economic hardship and number of pregnancies among teen mothers distinguish developmental patterns among teenage offspring, whereas teen mothers' educational attainment and marital status do not. © 2016 The Authors. Journal of Research on Adolescence © 2016 Society for Research on Adolescence.

  17. Developmental assessment of the SCDAP/RELAP5 code

    International Nuclear Information System (INIS)

    Harvego, E.A.; Slefken, L.J.; Coryell, E.W.

    1997-01-01

    The development and assessment of the late-phase damage progression models in the current version (designated MOD3.2) of the SCDAP/RELAP5 code are described. The SCDAP/RELAP5 code is being developed at the Idaho National Engineering and Environmental Laboratory under the primary sponsorship of the US Nuclear Regulatory Commission (NRC) to provide best-estimate transient simulations of light water reactor coolant systems (RCS) during severe accident conditions. Recent modeling improvements made to the MOD3.2 version of the code include (1) molten pool formation and heat up, including the transient start-up of natural circulation heat transfer, (2) in-core molten pool thermal-mechanical crust failure, (3) the melting and relocation of upper plenum structures, and (4) improvements in the modeling of lower plenum debris behavior and the potential for failure of the lower head. Finally, to eliminate abrupt transitions between core damage states and provide more realistic predictions of late phase accident progression phenomena, a transition smoothing methodology was developed and implemented that results in the calculation of a gradual transition from an intact core geometry through the different core damage states leading to molten pool formation. A wide range of experiments and modeling tools were used to assess the capabilities of MOD3.2. The results of the SCDAP/RELAP5/MOD3.2 assessment indicate that modeling improvements have significantly enhanced the code capabilities and performance in several areas compared to the earlier code version. New models for transition smoothing between core damage states, and modeling improvements/additions for cladding oxide failure, molten pool behavior, and molten pool crust failure have significantly improved the code usability for a wide range of applications and have significantly improved the prediction of hydrogen production, molten pool melt mass and core melt relocation time

  18. ARMY DEVELOPMENTAL ASSESSMENT CENTER: A DEMONSTRATION FOR THE NOMINATIVE COMMAND SERGEANT MAJOR POSITION

    Science.gov (United States)

    2015-12-16

    Drasgow, 2012). The TAPAS was developed to assess up to 21 sub-dimensions of the Big Five personality factors and several additional personality...differences and developmental activities: Getting more bang for your buck from DPACs. Paper presented at the 31st International Congress on Assessment...Prediction for Personnel Decisions. Hillsdale, NJ: Erlbaum. Haaland, S., & Christiansen, N. D. (2002). Implications of trait-activation theory for

  19. Community Project Funding in Malawi under the Malawi Social ...

    African Journals Online (AJOL)

    This paper gives an overview of the kind of community development projects that the Malawi Social Action Fund (MASAF) has supported since its inception in July 1996. The MASAF has tended to subscribe to a demand-driven approach in its evaluation of projects, thereby introducing an element of competition in commu ...

  20. Anaemia in pregnancy in Malawi - A Review | Munasinghe | Malawi ...

    African Journals Online (AJOL)

    No Abstract. Malawi Medical Journal Vol. 18 (4) 2006: pp. 160-175. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v18i4.10920 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  1. The Resistable Rise of Surgical Sepsis in Malawi | Lavy | Malawi ...

    African Journals Online (AJOL)

    The Resistable Rise of Surgical Sepsis in Malawi. C Lavy, C Schmidt, E Kalau, J Phuka. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about ...

  2. MARS CODE MANAUAL VOLUME IV - Developmental Assessment Report

    International Nuclear Information System (INIS)

    Chung, Bub Dong; Jeong, Jae Jun; Hwang, Moon Kyu; Lee, Won Jae; Lee, Young Jin; Lee, Seung Wook; Kim, Kyung Doo; Bae, Sung Won

    2010-02-01

    Korea Advanced Energy Research Institute (KAERI) conceived and started the development of MARS code with the main objective of producing a state-of-the-art realistic thermal hydraulic systems analysis code with multi-dimensional analysis capability. MARS achieves this objective by very tightly integrating the one dimensional RELAP5/MOD3 with the multi-dimensional COBRA-TF codes. The method of integration of the two codes is based on the dynamic link library techniques, and the system pressure equation matrices of both codes are implicitly integrated and solved simultaneously. In addition, the Equation-Of-State (EOS) for the light water was unified by replacing the EOS of COBRA-TF by that of the RELAP5. This assessment manual provides a complete list of code assessment results of the MARS code for various conceptual problem, separate effect test and integral effect test. From these validation procedures, the soundness and accuracy of the MARS code has been confirmed. The overall structure of the input is modeled on the structure of the RELAP5 and as such the layout of the manual is very similar to that of the RELAP. This similitude to RELAP5 input is intentional as this input scheme will allow minimum modification between the inputs of RELAP5 and MARS3.1. MARS3.1 development team would like to express its appreciation to the RELAP5 Development Team and the USNRC for making this manual possible

  3. Developmental assessment, cultural context, gender, and schooling in Zambia.

    Science.gov (United States)

    Serpell, Robert; Jere-Folotiya, Jacqueline

    2008-04-01

    Multiple perspectives on the assessment of children's development at the school-community interface in rural areas of Zambia are discussed in the light of several empirical studies conducted between 1974 and 2005. A longitudinal trace study of a cohort of 46 young people born into a rural, Chewa community in Katete District found that girls' scores in early childhood on a battery of ecoculturally grounded cognitive tests correlated less well than they did for boys with two educational outcomes: number of grades of schooling completed, and adult literacy scores. Conversely, ratings of the children on indigenous conceptions of intelligence by adults familiar with the children in the context of their home village lives predicted the same outcomes better for girls than for boys. A separate, linked experiment compared the performance of 76 Katete school children with that of 84 school children in the capital city of Lusaka on the US standardized Draw-a-Person Test (DPT) and the Panga Munthu Test (PMT), an expanded version of one of the tests developed for the Zambian trace study. Analysis of the correlations among scores on these two tests, age, and teacher ratings suggests that aptitudes evident in the home and school domains are less well integrated for rural girls than for urban boys, and that for a low-income, rural population, the PMT taps the domain of home cognition better than school cognition, while the converse is true of the DPT. Implications for educational assessment in Zambia are discussed, and supportive documentation is cited from two ongoing programs of test development. The authors conclude that if educational testing is to support the process of enhancing educational equity across gender, family socioeconomic status, and residential location, its focus should be broadened to include other dimensions of psychological development such as multilingual and personal-social competencies.

  4. Screening for autistic spectrum disorder at the 18-month developmental assessment: a population-based study.

    Science.gov (United States)

    VanDenHeuvel, A; Fitzgerald, M; Greiner, B; Perry, I J

    2007-09-01

    The objectives of this study were to assess the feasibility of administering the CHecklist for Autism in Toddlers (CHAT) at the 18-month developmental check, estimate the prevalence of screening positive for autism at the first and second administrations of the CHAT and estimate the prevalence of diagnosed cases of autism. A cross-sectional study design was utilised and data was collected at child developmental screening clinics in counties Cork and Kerry. The sample group consisted of infants attending the routine 18-month developmental assessment, who were broadly representative of infants in the catchment area. The main outcome measure was a medium or high-risk score following two administrations of the CHAT screening instrument and a positive diagnosis of autism after clinical assessment. The CHAT was administered to 2117 infants (79% of those approached) of whom 29 were scored at medium or high risk at first screening, resulting in a prevalence rate of 137 per 10,000 (95% CI: 87-187). A total of 7 of the 29 first screen positive infants were positive (medium or high risk) at second screening, 12 were low risk and 10 parents refused to participate. On subsequent clinical assessment of the 7 infants screening positive on first and second assessment and assessment of 5 of the 10 infants whose parents declined second screening, 7 children received a diagnosis of autism. Thus the overall prevalence of clinically diagnosed autism following this screening exercise was 33.1 per 10,000 (95% CI: 13.3 to 68.0). The CHAT instrument is a useful tool to help identify childhood autism among infants. Routine use of this instrument at 18-month developmental assessment merits consideration.

  5. Analysis of Effectiveness of Modern Information and Communication Technologies on Maize Marketing Efficiency in Lilongwe and Dedza Districts and Selected Markets of Malawi

    OpenAIRE

    Tione, Sarah Ephridah

    2011-01-01

    Government of Malawi has been promoting initiatives like Malawi Agriculture Commodity Exchange (MACE) that aim at reducing information asymmetry among market players especially smallholder farmers. Using co-integration error correction models, the study assessed effectiveness of modern ICT based market interventions on improving maize marketing efficiency in Malawi. Considering that efficient markets are integrated markets when price difference is only a factor of transaction costs, TAR model...

  6. Assessing stakeholder perceptions of the acceptability and feasibility of national scale-up for a dual HIV/syphilis rapid diagnostic test in Malawi.

    Science.gov (United States)

    Maddox, Brandy L Peterson; Wright, Shauntā S; Namadingo, Hazel; Bowen, Virginia B; Chipungu, Geoffrey A; Kamb, Mary L

    2017-12-01

    The WHO recommends pregnant women receive both HIV and syphilis testing at their first antenatal care visit, as untreated maternal infections can lead to severe, adverse pregnancy outcomes. One strategy for increasing testing for both HIV and syphilis is the use of point-of-care (rapid) diagnostic tests that are simple, proven effective and inexpensive. In Malawi, pregnant women routinely receive HIV testing, but only 10% are tested for syphilis at their first antenatal care visit. This evaluation explores stakeholder perceptions of a novel, dual HIV/syphilis rapid diagnostic test and potential barriers to national scale-up of the dual test in Malawi. During June and July 2015, we conducted 15 semistructured interviews with 25 healthcare workers, laboratorians, Ministry of Health leaders and partner agency representatives working in prevention of mother-to-child transmission in Malawi. We asked stakeholders about the importance of a dual rapid diagnostic test, concerns using and procuring the dual test and recommendations for national expansion. Stakeholders viewed the test favourably, citing the importance of a dual rapid test in preventing missed opportunities for syphilis diagnosis and treatment, improving infant outcomes and increasing syphilis testing coverage. Primary technical concerns were about the additional procedural steps needed to perform the test, the possibility that testers may not adhere to required waiting times before interpreting results and difficulty reading and interpreting test results. Stakeholders thought national scale-up would require demonstration of cost-savings, uniform coordination, revisions to testing guidelines and algorithms, training of testers and a reliable supply chain. Stakeholders largely support implementation of a dual HIV/syphilis rapid diagnostic test as a feasible alternative to current antenatal testing. Scale-up will require addressing perceived barriers; negotiating changes to existing algorithms and guidelines

  7. Schistosomiasis in Lake Malawi villages

    DEFF Research Database (Denmark)

    Madsen, Henry; Bloch, Paul; Makaula, Peter

    2011-01-01

    Historically, open shorelines of Lake Malawi were free from schistosome, Schistosoma haematobium, transmission, but this changed in the mid-1980s, possibly as a result of over-fishing reducing density of molluscivore fishes. Very little information is available on schistosome infections among...

  8. Preliminary Validation of a Parent-Child Relational Framework for Teaching Developmental Assessment to Pediatric Residents.

    Science.gov (United States)

    Regalado, Michael; Schneiderman, Janet U; Duan, Lei; Ragusa, Gisele

    A parent-child relational framework was used as a method to train pediatric residents in basic knowledge and observation skills for the assessment of child development. Components of the training framework and its preliminary validation as an alternative to milestone-based approaches are described. Pediatric residents were trained during a 4-week clinical rotation to use a semistructured interview and observe parent-child behavior during health visits using clinical criteria for historical information and observed behavior that reflect developmental change in the parent-child relationship. Clinical impressions of concern versus no concern for developmental delay were derived from parent-child relational criteria and the physical examination. A chart review yielded 330 preterm infants evaluated using this methodology at 4 and 15 months corrected age who also had standardized developmental testing at 6 and 18 months corrected age. Sensitivities and specificities were computed to examine the validity of the clinical assessment compared with standardized testing. A subset of residents who completed 50 or more assessments during the rotation was timed at the end of 4 weeks. Parent-child behavioral markers elicited from the history and/or observed during the health visit correlated highly with standardized developmental assessment. Sensitivities and specificities were 0.72/0.98 and 0.87/0.96 at 4 to 6 and 15 to 18 months, respectively. Residents completed their assessments parent-child relational framework is a potentially efficient and effective approach to training residents in the clinical knowledge and skills of child development assessment. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  9. Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi.

    Science.gov (United States)

    Nyondo, Alinane Linda; Muula, Adamson Sinjani; Chimwaza, Angela Faith

    2013-12-16

    Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT. The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face-to-face key informant interviews (KIIs) with healthcare workers and four focus group discussions (FGDs) with 18 men and 17 pregnant women attending ANC at SLHC. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analyzed using thematic content analysis. Three major themes with several subcategories emerged. Theme 1 was a gatekeeping strategy with two subcategories: (1) healthcare workers refusing service provision to women accessing antenatal clinic without their partners and (2) women refusing ANC attention in the absence of a partner. Theme 2 comprised extending invitations and had six subcategories: (1) word of mouth, (2) card invites, (3) woman's health passport book invites, (4) telephonic invites, (5) use of influential people, and (6) home visits. Theme 3 was information education and communication, such as health education forums and advertisements. Of all the strategies, an invitation card addressed to the male partner was most preferred by study participants. There are several strategies by which men may be involved in PMTCT. Healthcare workers should offer a pregnant woman all strategies available for MI for her to select the appropriate one. Further research and consultations with men should continue to achieve higher levels

  10. Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi

    Directory of Open Access Journals (Sweden)

    Alinane Linda Nyondo

    2013-12-01

    Full Text Available Background: Despite the documented benefits of prevention of mother-to-child transmission (PMTCT of human immunodeficiency virus (HIV services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT. Objective: The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC services in Blantyre, Malawi. Study design: An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC in Blantyre, Malawi. It consisted of six face-to-face key informant interviews (KIIs with healthcare workers and four focus group discussions (FGDs with 18 men and 17 pregnant women attending ANC at SLHC. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analyzed using thematic content analysis. Results: Three major themes with several subcategories emerged. Theme 1 was a gatekeeping strategy with two subcategories: (1 healthcare workers refusing service provision to women accessing antenatal clinic without their partners and (2 women refusing ANC attention in the absence of a partner. Theme 2 comprised extending invitations and had six subcategories: (1 word of mouth, (2 card invites, (3 woman's health passport book invites, (4 telephonic invites, (5 use of influential people, and (6 home visits. Theme 3 was information education and communication, such as health education forums and advertisements. Of all the strategies, an invitation card addressed to the male partner was most preferred by study participants. Conclusions: There are several strategies by which men may be involved in PMTCT. Healthcare workers should offer a pregnant woman all strategies available for MI for her to select the appropriate one. Further research and

  11. Thinking outside the boxes: Using current reading models to assess and treat developmental surface dyslexia.

    Science.gov (United States)

    Law, Caroline; Cupples, Linda

    2017-03-01

    Improving the reading performance of children with developmental surface dyslexia has proved challenging, with limited generalisation of reading skills typically reported after intervention. The aim of this study was to provide tailored, theoretically motivated intervention to two children with developmental surface dyslexia. Our objectives were to improve their reading performance, and to evaluate the utility of current reading models in therapeutic practice. Detailed reading and cognitive profiles for two male children with developmental surface dyslexia were compared to the results obtained by age-matched control groups. The specific area of single-word reading difficulty for each child was identified within the dual route model (DRM) of reading, following which a theoretically motivated intervention programme was devised. Both children showed significant improvements in single-word reading ability after training, with generalisation effects observed for untrained words. However, the assessment and intervention results also differed for each child, reinforcing the view that the causes and consequences of developmental dyslexia, even within subtypes, are not homogeneous. Overall, the results of the interventions corresponded more closely with the DRM than other current reading models, in that real word reading improved in the absence of enhanced nonword reading for both children.

  12. Development and Psychometric Properties of A Screening Tool for Assessing Developmental Coordination Disorder in Adults

    OpenAIRE

    Clark, Carol J.

    2013-01-01

    Background: Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder affecting motor coordination. Evidence suggests this disorder persists into adulthood and may be associated with biomechanical dysfunction and pain. We report on the development and initial validation of a questionnaire to assess for DCD in adults. Methods: An initial item pool (13 items) was derived from the American Psychiatric Association criteria and World Health Organisation definition for DCD. An expe...

  13. [Review of assessment methods used to evaluate feeding for children with pervasive developmental disorder].

    Science.gov (United States)

    Nadon, G; Ehrmann Feldman, D; Gisel, E

    2008-08-01

    Current evaluations used by occupational therapists to assess and treat feeding problems derive mainly from the domain of dysphagia. The purpose of this article is to familiarize the reader with tools used, in research, for children with pervasive developmental disorders (PDD) and to determine if any of these meet the needs of occupational therapists. The following data bases were searched: Medline, CINAHL, HAPI and PsyINFO, using the terms pervasive developmental disorder, autism, Asperger syndrome, pervasive developmental disorder not otherwise specified, eating behavior, eating disorder, food preference, food selectivity, feeding disorders, picky eater and child. All articles published between 1980 and 2006 (n=27) were reviewed. A total of 20 studies met our selection criteria. Assessment methods are compared using the Disability Creation Model (DCP). The DCP is the Quebec alternative to the International Classification of Functioning, Disability and Health (ICF). None of the evaluation tools reviewed met all factors that may influence eating in children with PDD. Implications for research and practice in occupational therapy are discussed.

  14. RELAP5/MOD2 Overview and Developmental. Assessment Results from TMl-1 Plant Transient Analysis

    International Nuclear Information System (INIS)

    Lin, J. C.; Tsai, C. C.; Ransom, V. H.; Johnsen, G. W.

    2013-01-01

    RELAP5/MOD2 is a new version of the RELAP5 thermal-hydraulic computer code containing improved modeling features that provide a generic capability for pressurized water reactor transient simulation. The objective of this paper is to provide code users with an overview of the code and to report developmental assessment results obtained from a Three Mile Island Unit One plant transient analysis. The assessment shows that the injection of highly sub-cooled water into a high-pressure primary coolant system does not cause unphysical results or pose a problem for RELAP5/MOD2. (author)

  15. Reproductive/developmental toxicity and immunotoxicity assessment in the nonhuman primate model

    International Nuclear Information System (INIS)

    Buse, Eberhard; Habermann, Gunnar; Osterburg, Ingrid; Korte, Rainhart; Weinbauer, Gerhard F.

    2003-01-01

    Nonhuman primates are being used increasingly as a non-rodent animal model during preclinical toxicology and safety assessment on the basis of proven similarity and comparability between nonhuman primates and humans. The validity of the nonhuman primate models applies to many aspects of toxicological testing and holds particularly true for the evaluation of reproductive toxicology and developmental toxicology. More recently, the advent of humanized antibodies and vaccines imposed further demand on nonhuman primate models since many immunotherapeutics do not interact with rodent receptors but frequently only cross-react with primate tissue. In this paper we discuss the suitability of primate models for reproductive, developmental and immunotoxicology testing, and present our initial data on the development of lymphatic organs and immune system in a nonhuman primate model

  16. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-03-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  17. Traditional birth attendants in Malawi

    Directory of Open Access Journals (Sweden)

    J. J. M. Smit

    1994-05-01

    Full Text Available Traditional Birth Attendants (TBAs and traditional healers form an important link in the chain of health personnel providing primary health care in Malawi. In spite of the establishment of hospitals and health centres, it is to these traditional healers and TBAs that the majority of people turn in times of sickness and child-birth. Approximately 60 percent of all deliveries in Malawi occur in the villages. It is therefore important that due regard be paid to the activities of these traditional practitioners in order to ensure the achievement of the goal - "Health for all by the year 2000". The training of TBAs is seen as part of the Maternal and Child Health Services in the country.

  18. Characterization of the solar climate in Malawi using NASA's surface ...

    African Journals Online (AJOL)

    user

    Characterization of the solar climate in Malawi using. NASA's surface meteorology and solar energy. (SSE) model. Senganimalunje, T. C.1 and Tenthani, C. M. 2*. 1Malawi Bureau of Standards, Metrology Services Department, Box 946, Blantyre, Malawi. 2Physics and Biochemical Sciences Department, Malawi Polytechnic, ...

  19. Perspectives on Theological Education in Malawi

    Science.gov (United States)

    Matemba, Yonah Hisbon

    2011-01-01

    This article gives an overview of (Christian) Theological Education (CTE) in Malawi. To place the discussion in its appropriate context, information about Malawi is given including the impact of Christianity on the country. The article then describes historical aspects of CTE and highlights some of its inherent shortcomings, before shifting to…

  20. Traditional healers and pulmonary tuberculosis in Malawi

    NARCIS (Netherlands)

    Brouwer, J. A.; Boeree, M. J.; Kager, P.; Varkevisser, C. M.; Harries, A. D.

    1998-01-01

    Queen Elizabeth Central Hospital (QECH) and Blantyre district, Malawi. To investigate the use that tuberculosis (TB) patients in Malawi make of traditional healers and traditional medicine. A questionnaire study was carried out on 89 smear-positive pulmonary TB patients admitted to QECH. Seven

  1. [Prospective assessment of children with pervasive developmental disorder after 2 years of day-hospital treatment].

    Science.gov (United States)

    Poinso, F; Dubois, B; Chatel, C; Viellard, M; Bastard-Rosset, D; Girardot, A-M; Grandgeorge, P; De Martino, S; Sokolowsky, M; Salle-Collemiche, X; Da Fonseca, D

    2013-01-01

    The treatment of children with pervasive developmental disorders (PDD) has not been systematically assessed in French day-care units. In this prospective study, 11 children with a diagnosis of PDD were followed up for 2years in a day-care unit in the Marseille university hospital. The treatment they received is based on an initial assessment by the "Centre Ressources Autisme" (CRA PACA) and further included a continued observation of the child and an assessment of the child's abilities and needs. This treatment used various therapeutic approaches 10h weekly and also included parental counseling and coordinated work with schools. Treatment in our day-care unit can be categorized as eclectic, non-intensive therapy. It is based on methods such as TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), Floor Time Play, speech and language therapy, developmental therapy, and psychotherapy. International studies on intensive behavioral therapies suggest that this treatment is superior to non-behavioral and/or non-intensive treatment. They suggest its efficiency is due both to the nature of the treatment (behavioral) and to its intensity (more than 25h a week). In this study, the CRA diagnosed children using the ADI and ADOS. The 11 children (mean age, 3years 5months) were tested twice, with the Vineland and CARS scales. The first assessment was on admission to the day hospital and the second was 2years later. The results showed developmental progress with a mean increase of 13.5 months at the Vineland Scale, and a decrease of the autism severity score on the CARS. The treatment presented here proves to be efficient; if compared to similar results in international studies, we obtained better results than their eclectic intensive or non-intensive treatment comparison group. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  2. Developmental assessment of the multidimensional component in RELAP5 for Savannah River Site thermal hydraulic analysis

    International Nuclear Information System (INIS)

    Hanson, R.G.; Johnson, E.C.; Carlson, K.E.; Chou, C.Y.; Davis, C.B.; Martin, R.P.; Riemke, R.A.; Wagner, R.J.

    1992-07-01

    This report documents ten developmental assessment problems which were used to test the multidimensional component in RELAP5/MOD2.5, Version 3w. The problems chosen were a rigid body rotation problem, a pure radial symmetric flow problem, an r-θ symmetric flow problem, a fall problem, a rest problem, a basic one-dimensional flow test problem, a gravity wave problem, a tank draining problem, a flow through the center problem, and coverage analysis using PIXIE. The multidimensional code calculations are compared to analytical solutions and one-dimensional code calculations. The discussion section of each problem contains information relative to the code's ability to simulate these problems

  3. Description of a developmental criterion-referenced assessment for promoting competence in internal medicine residents.

    Science.gov (United States)

    Varney, Andrew; Todd, Christine; Hingle, Susan; Clark, Michael

    2009-09-01

    End-of- rotation global evaluations can be subjective, produce inflated grades, lack interrater reliability, and offer information that lacks value. This article outlines the generation of a unique developmental criterion-referenced assessment that applies adult learning theory and the learner, manager, teacher model, and represents an innovative application to the American Board of Internal Medicine (ABIM) 9-point scale. We describe the process used by Southern Illinois University School of Medicine to develop rotation-specific, criterion-based evaluation anchors that evolved into an effective faculty development exercise. The intervention gave faculty a clearer understanding of the 6 Accreditation Council for Graduate Medical Education competencies, each rotation's educational goals, and how rotation design affects meaningful work-based assessment. We also describe easily attainable successes in evaluation design and pitfalls that other institutions may be able to avoid. Shifting the evaluation emphasis on the residents' development of competence has made the expectations of rotation faculty more transparent, has facilitated conversations between program director and residents, and has improved the specificity of the tool for feedback. Our findings showed the new approach reduced grade inflation compared with the ABIM end-of-rotation global evaluation form. We offer the new developmental criterion-referenced assessment as a unique application of the competences to the ABIM 9-point scale as a transferable model for improving the validity and reliability of resident evaluations across graduate medical education programs.

  4. Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

    LENUS (Irish Health Repository)

    Shahdadpuri, R

    2012-02-01

    The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

  5. Fetal functional brain age assessed from universal developmental indices obtained from neuro-vegetative activity patterns.

    Directory of Open Access Journals (Sweden)

    Dirk Hoyer

    Full Text Available Fetal brain development involves the development of the neuro-vegetative (autonomic control that is mediated by the autonomic nervous system (ANS. Disturbances of the fetal brain development have implications for diseases in later postnatal life. In that context, the fetal functional brain age can be altered. Universal principles of developmental biology applied to patterns of autonomic control may allow a functional age assessment. The work aims at the development of a fetal autonomic brain age score (fABAS based on heart rate patterns. We analysed n = 113 recordings in quiet sleep, n = 286 in active sleep, and n = 29 in active awakeness from normals. We estimated fABAS from magnetocardiographic recordings (21.4-40.3 weeks of gestation preclassified in quiet sleep (n = 113, 63 females and active sleep (n = 286, 145 females state by cross-validated multivariate linear regression models in a cross-sectional study. According to universal system developmental principles, we included indices that address increasing fluctuation range, increasing complexity, and pattern formation (skewness, power spectral ratio VLF/LF, pNN5. The resulting models constituted fABAS. fABAS explained 66/63% (coefficient of determination R(2 of training and validation set of the variance by age in quiet, while 51/50% in active sleep. By means of a logistic regression model using fluctuation range and fetal age, quiet and active sleep were automatically reclassified (94.3/93.1% correct classifications. We did not find relevant gender differences. We conclude that functional brain age can be assessed based on universal developmental indices obtained from autonomic control patterns. fABAS reflect normal complex functional brain maturation. The presented normative data are supplemented by an explorative study of 19 fetuses compromised by intrauterine growth restriction. We observed a shift in the state distribution towards active awakeness. The lower WGA

  6. Assessment of learning, memory and attention in developmental neurotoxicity regulatory studies: Introduction.

    Science.gov (United States)

    Makris, Susan L; Vorhees, Charles V

    2015-01-01

    There are a variety of chemicals, including pharmaceuticals, that alter neurobehavior following developmental exposure and guidelines for the conduct of studies to detect such effects by statute in the United States and Europe. Guidelines for Developmental Neurotoxicity Testing (DNT) studies issued by the U.S. Environmental Protection Agency (EPA) under prevailing law and European Organization for Economic Cooperation and Development (OECD) recommendations to member countries provide that such studies include a series of neurobehavioral and neuropathological assessments. Among these are assessment of cognitive function, specifically learning and memory. After reviewing 69 DNT studies submitted to the EPA, tests of learning and memory were noted to have detected the lowest observed adverse effect level (LOAELs) less frequently than behavioral tests of locomotor activity and acoustic/auditory startle, but slightly more than for the developmental Functional Observational Battery (devFOB; which is less extensive than the full FOB), but the reasons for the lower LOAEL detection rate for learning and memory assessment could not be determined. A major concern identified in the review, however, was the adequacy of the methods employed in these studies rather than on the importance of learning and memory to the proper assessment of brain function. Accordingly, a symposium was conducted to consider how the guidelines for tests of learning and memory might be improved. Four laboratories with established histories investigating the effects of chemical exposures during development on learning, memory, and attention, were invited to review the topic and offer recommendations, both theoretical and practical, on approaches to improve the assessment of these vital CNS functions. Reviewers were asked to recommend methods that are grounded in functional importance to CNS integrity, well-validated, reliable, and amenable to the context of regulatory studies as well as to basic

  7. Health spending, illicit financial flows and tax incentives in Malawi.

    Science.gov (United States)

    O'Hare, B; Curtis, M

    2014-12-01

    This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

  8. Young Women's Political Participation in Malawi | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC's Democratic Governance, Women's Rights and Gender Equality initiative is ... They continue to be underrepresented in positions of power. ... social, economic, cultural and political situation of rural women in Malawi affects the political ...

  9. Malawi | IDRC - International Development Research Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    Our support has aided the fight against poverty and malnutrition in Malawi. ... find ways to address degraded soils, food insecurity, and child malnutrition. ... explore urban-rural interdependence and the impact of climate change on food supply ...

  10. Exchange rate policy and devaluation in Malawi:

    OpenAIRE

    Pauw, Karl; Dorosh, Paul A.; Mazunda, John

    2013-01-01

    This study demonstrates why devaluation was ultimately necessary in Malawi and also what its eventual impact might be in terms of prices, income distribution, and domestic production. Our approach is to use a computable general equilibrium (CGE) model to evaluate the economywide impacts of foreign exchange shortages in Malawi under two alternative exchange rate regimes. The foreign exchange shortages are modeled by simulating the effect of actual shocks, including tobacco price declines and r...

  11. Applying cognitive developmental psychology to middle school physics learning: The rule assessment method

    Science.gov (United States)

    Hallinen, Nicole R.; Chi, Min; Chin, Doris B.; Prempeh, Joe; Blair, Kristen P.; Schwartz, Daniel L.

    2013-01-01

    Cognitive developmental psychology often describes children's growing qualitative understanding of the physical world. Physics educators may be able to use the relevant methods to advantage for characterizing changes in students' qualitative reasoning. Siegler developed the "rule assessment" method for characterizing levels of qualitative understanding for two factor situations (e.g., volume and mass for density). The method assigns children to rule levels that correspond to the degree they notice and coordinate the two factors. Here, we provide a brief tutorial plus a demonstration of how we have used this method to evaluate instructional outcomes with middle-school students who learned about torque, projectile motion, and collisions using different instructional methods with simulations.

  12. A Field Study of Participant Reactions to a Developmental Assessment Centre: Testing an organisational justice model

    Directory of Open Access Journals (Sweden)

    Michael M Harris

    2008-06-01

    Full Text Available Although assessment centres are being increasingly employed for developmental purposes, there has been a dearth of research regarding them. We investigated an organisational justice theory model suggested by Cohen-Charash and Spector (2001 in this relatively novel context. The model included antecedents (e.g., perceived validity, organisational justice perceptions (i.e., distributive justice and procedural justice, and one outcome (i.e., feedback utility perceptions. Most of our hypotheses were supported, suggesting much evidence for this model. The predicted effect for perceived fakability was not supported. Contrary to our hypothesis, distributive justice perceptions were at least as important as procedural justice perceptions in predicting feedback utility perceptions. A direct test of the effect of context on organisational justice theory is recommended.

  13. Assessment of attention and inhibitory control in rodent developmental neurotoxicity studies.

    Science.gov (United States)

    Driscoll, Lori L; Strupp, Barbara J

    2015-01-01

    In designing screens to assess potential neurotoxicants, the paramount goal is that the selected assessment tools detect dysfunction if it exists. This goal is particularly challenging in the case of cognitive assessments. Cognition is not a unitary phenomenon, and indeed there is growing evidence that different aspects of cognitive functioning are subserved by distinct neural systems. As a result, if a particular neurotoxicant selectively damages certain neural systems but not others, it can impair some cognitive, sensory, or affective functions, but leave many others intact. Accordingly, studies with human subjects use batteries of cognitive tests, cognizant of the fact that no one test is capable of detecting all forms of cognitive dysfunction. In contrast, assessment of cognitive functioning in non-human animal developmental neurotoxicity (DNT) studies typically consists of a single, presumably representative, "learning and memory" task that is expected to detect all potential effects on cognitive functioning. Streamlining the cognitive assessment in these studies saves time and money, but these shortcuts can have serious consequences if the aspect of cognitive functioning that is impaired is not tapped by the single selected task. In particular, executive functioning - a constellation of cognitive functions which enables the organism to focus on multiple streams of information simultaneously, and revise plans as necessary - is poorly assessed in most animal DNT studies. The failure to adequately assess these functions - which include attention, working memory, inhibitory control, and planning - is particularly worrisome in light of evidence that the neural systems that subserve these functions may be uniquely vulnerable to early developmental insults. We illustrate the importance of tapping these areas of functioning in DNT studies by describing the pattern of effects produced by early developmental Pb exposure. Rats exposed to lead (Pb) early in development

  14. Linear Growth and Child Development in Burkina Faso, Ghana, and Malawi.

    Science.gov (United States)

    Prado, Elizabeth L; Abbeddou, Souheila; Adu-Afarwuah, Seth; Arimond, Mary; Ashorn, Per; Ashorn, Ulla; Brown, Kenneth H; Hess, Sonja Y; Lartey, Anna; Maleta, Kenneth; Ocansey, Eugenia; Ouédraogo, Jean-Bosco; Phuka, John; Somé, Jérôme W; Vosti, Steve A; Yakes Jimenez, Elizabeth; Dewey, Kathryn G

    2016-08-01

    We aimed to produce quantitative estimates of the associations between 4 domains of child development and linear growth during 3 periods: before birth, early infancy, and later infancy. We also aimed to determine whether several factors attenuated these associations. In 3700 children in Burkina Faso, Ghana, and Malawi, growth was measured several times from birth to age 18 months. At 18 months, language, motor, socioemotional, and executive function development were assessed. In Burkina Faso (n = 1111), personal-social development was assessed rather than the latter 2 domains. Linear growth was significantly associated with language, motor, and personal-social development but not socioemotional development or executive function. For language, the pooled adjusted estimate of the association with length-for-age z score (LAZ) at 6 months was 0.13 ± 0.02 SD, and with ΔLAZ from 6 to 18 months it was 0.11 ± 0.03 SD. For motor, these estimates were 0.16 ± 0.02 SD and 0.22 ± 0.03 SD, respectively. In 1412 children measured at birth, estimates of the association with LAZ at birth were similar (0.07-0.16 SD for language and 0.09-0.18 SD for motor development). These associations were weaker or absent in certain subsets of children with high levels of developmental stimulation or mothers who received nutritional supplementation. Growth faltering during any period from before birth to 18 months is associated with poor development of language and motor skills. Interventions to provide developmental stimulation or maternal supplementation may protect children who are faltering in growth from poor language and motor development. Copyright © 2016 by the American Academy of Pediatrics.

  15. On-the-job training of clinical officers in Malawi | Jiskoot | Malawi ...

    African Journals Online (AJOL)

    Although Malawi started a Medical College in 1991 to train medical doctors, it continues to face a chronic shortage of medical staff. Malawi Medical Journal Vol. 20 (3) 2008: pp. 74-77. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  16. Soil and Terrain Database for Malawi (ver. 1.0) (SOTER_Malawi)

    NARCIS (Netherlands)

    Kempen, B.

    2014-01-01

    The Soil and Terrain database for Malawi (version 1.0), at scale 1:1 million, was compiled based on the soil map of Malawi at scale 1:250,000 (compiled by the Land Resources Evaluation Project) that was complemented with soil boundary information from the provisional soil map at scale 1:1 million.

  17. Socio-economic inequity in HIV testing in Malawi

    Directory of Open Access Journals (Sweden)

    Sung Wook Kim

    2016-10-01

    Full Text Available Background: Human immunodeficiency virus (HIV is a significant contributor to Malawi's burden of disease. Despite a number of studies describing socio-economic differences in HIV prevalence, there is a paucity of evidence on socio-economic inequity in HIV testing in Malawi. Objective: To assess horizontal inequity (HI in HIV testing in Malawi. Design: Data from the Demographic and Health Surveys (DHSs 2004 and 2010 in Malawi are used for the analysis. The sample size for DHS 2004 was 14,571 (women =11,362 and men=3,209, and for DHS 2010 it was 29,830 (women=22,716 and men=7,114. The concentration index is used to quantify the amount of socio-economic-related inequality in HIV testing. The inequality is a primary method in this study. Corrected need, a further adjustment of the standard decomposition index, was calculated. Standard HI was compared with corrected need-adjusted inequity. Variables used to measure health need include symptoms of sexually transmitted infections. Non-need variables include wealth, education, literacy and marital status. Results: Between 2004 and 2010, the proportion of the population ever tested for HIV increased from 15 to 75% among women and from 16 to 54% among men. The need for HIV testing among men was concentrated among the relatively wealthy in 2004, but the need was more equitably distributed in 2010. Standard HI was 0.152 in 2004 and 0.008 in 2010 among women, and 0.186 in 2004 and 0.04 in 2010 among men. Rural–urban inequity also fell in this period, but HIV testing remained pro-rich among rural men (HI 0.041. The main social contributors to inequity in HIV testing were wealth in 2004 and education in 2010. Conclusions: Inequity in HIV testing in Malawi decreased between 2004 and 2010. This may be due to the increased support to HIV testing by global donors over this period.

  18. Rapid Population Growth and its Implication for Malawi

    African Journals Online (AJOL)

    "Environment and Development" was held in Brazil ... income and employment, health and education, ... Fertility is extremely high in Malawi, with the ..... school fees, biased parent/teacher attitudes and ..... Malawi: 'Country profile 1991-92.

  19. All projects related to malawi | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Malawi has high rates of maternal mortality despite concerted efforts to increase the rate of births at health facilities. Topic: MATERNAL AND CHILD ... Malawi has the highest preterm delivery rate in the world. Topic: MATERNAL AND CHILD ...

  20. Information management in Malawi's prevention of Mother-to-Child ...

    African Journals Online (AJOL)

    Information Management in Malawi's PMTCT program 306. © 2017 The College of ..... system in Malawi: issues, innovations and results. Oxf Univ Press ... Role of Information and Knowledge Managers: Managers Perspectives. In Barcelona ...

  1. [Impact of passing items above the ceiling on the assessment results of Peabody developmental motor scales].

    Science.gov (United States)

    Zhao, Gai; Bian, Yang; Li, Ming

    2013-12-18

    To analyze the impact of passing items above the roof level in the gross motor subtest of Peabody development motor scales (PDMS-2) on its assessment results. In the subtests of PDMS-2, 124 children from 1.2 to 71 months were administered. Except for the original scoring method, a new scoring method which includes passing items above the ceiling were developed. The standard scores and quotients of the two scoring methods were compared using the independent-samples t test. Only one child could pass the items above the ceiling in the stationary subtest, 19 children in the locomotion subtest, and 17 children in the visual-motor integration subtest. When the scores of these passing items were included in the raw scores, the total raw scores got the added points of 1-12, the standard scores added 0-1 points and the motor quotients added 0-3 points. The diagnostic classification was changed only in two children. There was no significant difference between those two methods about motor quotients or standard scores in the specific subtest (P>0.05). The passing items above a ceiling of PDMS-2 isn't a rare situation. It usually takes place in the locomotion subtest and visual-motor integration subtest. Including these passing items into the scoring system will not make significant difference in the standard scores of the subtests or the developmental motor quotients (DMQ), which supports the original setting of a ceiling established by upassing 3 items in a row. However, putting the passing items above the ceiling into the raw score will improve tracking of children's developmental trajectory and intervention effects.

  2. Management of HIV associated Kaposi's Sarcoma in Malawi ...

    African Journals Online (AJOL)

    Kaposi's sarcoma is a common malignancy in Malawi and is often managed with single agent vincristine. This article outlines feasible combination chemotherapy for Kaposi's sarcoma in Malawi which should be made more widely available. Malawi Medical Journal Vol. 20 (4) 2008: pp. 129-132.

  3. Malawi Economic Monitor, November 2017 : Land for Inclusive Development

    OpenAIRE

    Kandoole, Priscilla; Record, Richard; Deininger, Klaus; Kalemba, Sunganani; Stylianou, Eleni; Chilima, Efrem; Kufeyani, Linly

    2017-01-01

    The Malawi Economic Monitor (MEM) provides an analysis of economic and structural development issues in Malawi. The aim of the publication is to foster better-informed policy analysis and debate regarding the key challenges that Malawi faces in its endeavor to achieve high rates of stable, inclusive, and sustainable economic growth. Malawi’s economy is primarily based on agriculture and he...

  4. Parameter-Based Assessment of Disturbed and Intact Components of Visual Attention in Children with Developmental Dyslexia

    Science.gov (United States)

    Bogon, Johanna; Finke, Kathrin; Schulte-Körne, Gerd; Müller, Hermann J.; Schneider, Werner X.; Stenneken, Prisca

    2014-01-01

    People with developmental dyslexia (DD) have been shown to be impaired in tasks that require the processing of multiple visual elements in parallel. It has been suggested that this deficit originates from disturbed visual attentional functions. The parameter-based assessment of visual attention based on Bundesen's (1990) theory of visual…

  5. Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult)

    Science.gov (United States)

    Mandy, William; Clarke, Kiri; McKenner, Michele; Strydom, Andre; Crabtree, Jason; Lai, Meng-Chuan; Allison, Carrie; Baron-Cohen, Simon; Skuse, David

    2018-01-01

    We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29)…

  6. Application of Psychoanalytic, Cognitive, Psychosocial and Other Theories in the Developmentally Integrated Assessment and Treatment of Emotionally Disturbed Children.

    Science.gov (United States)

    Grass, Linda; Kreger, Robert

    The authors describe their efforts to produce a global assessment scale for young emotionally disturbed children derived from an integrated synthesis of developmenta theories. Charts outline developmental stages, zones, modes, and dominant traits or characteristics of five major theorists (S. Freud, E. Erikson, A. Maslow, J. Piaget, and F.…

  7. An Analysis of HIV Risky Behaviors of College Students in Malawi: A ...

    African Journals Online (AJOL)

    zeleza

    Professor, Department of Agricultural Communication, Education & .... In Malawi, sex and condom use is seen largely as the responsibility of the male, ... largely successful (Kaiser Family Foundation, 2008). ... x To assess perceived awareness of HIV & AIDS, condom usage and role of religion on self- ... Literature Review.

  8. Adaptive developmental assessment of young children with cognitive and/or functional impairments

    NARCIS (Netherlands)

    Visser, L.; Ruiter, S.A.J.; Timmerman, M.E.; Van der Meulen, B.F.; Ruijssenaars, A.J.J.M.

    2011-01-01

    The instrument being developed aims to give additional and more refined information about the developmental course of a child with a cognitive and / or functional impairment than is possible with existing tests. It will help tune interventions to the developmental course and potentials of a child.

  9. Developmental delay

    Science.gov (United States)

    Nutrition support is essential for the care of the child with developmental delay. After a thorough evaluation, an individualized intervention plan that accounts for the child’s nutrition status, feeding ability, and medical condition may be determined. Nutrition assessments may be performed at leas...

  10. TVA-based assessment of visual attentional functions in developmental dyslexia

    Science.gov (United States)

    Bogon, Johanna; Finke, Kathrin; Stenneken, Prisca

    2014-01-01

    There is an ongoing debate whether an impairment of visual attentional functions constitutes an additional or even an isolated deficit of developmental dyslexia (DD). Especially performance in tasks that require the processing of multiple visual elements in parallel has been reported to be impaired in DD. We review studies that used parameter-based assessment for identifying and quantifying impaired aspect(s) of visual attention that underlie this multi-element processing deficit in DD. These studies used the mathematical framework provided by the “theory of visual attention” (Bundesen, 1990) to derive quantitative measures of general attentional resources and attentional weighting aspects on the basis of behavioral performance in whole- and partial-report tasks. Based on parameter estimates in children and adults with DD, the reviewed studies support a slowed perceptual processing speed as an underlying primary deficit in DD. Moreover, a reduction in visual short term memory storage capacity seems to present a modulating component, contributing to difficulties in written language processing. Furthermore, comparing the spatial distributions of attentional weights in children and adults suggests that having limited reading and writing skills might impair the development of a slight leftward bias, that is typical for unimpaired adult readers. PMID:25360129

  11. TVA-based assessment of visual attentional functions in developmental dyslexia

    Directory of Open Access Journals (Sweden)

    Johanna eBogon

    2014-10-01

    Full Text Available There is an ongoing debate whether an impairment of visual attentional functions constitutes an additional or even an isolated deficit of developmental dyslexia (DD. Especially performance in tasks that require the processing of multiple visual elements in parallel has been reported to be impaired in DD. We review studies that used parameter-based assessment for identifying and quantifying impaired aspect(s of visual attention that underlie this multi-element-processing deficit in DD. These studies used the mathematical framework provided by the ‘theory of visual attention’ (TVA; Bundesen, 1990 to derive quantitative measures of general attentional resources and attentional weighting aspects on the basis of behavioral performance in whole- and partial-report tasks. Based on parameter estimates in children and adults with DD, the reviewed studies support a slowed perceptual processing speed as an underlying primary deficit in DD. Moreover, a reduction in visual short term memory storage capacity seems to present a modulating component, contributing to difficulties in written language processing. Furthermore, comparing the spatial distributions of attentional weights in children and adults suggest that having limited reading and writing skills might impair the development of a slight leftward bias, that is typical for unimpaired adult readers.

  12. Developmental trajectories of cerebrovascular reactivity in healthy children and young adults assessed with magnetic resonance imaging.

    Science.gov (United States)

    Leung, Jackie; Kosinski, Przemyslaw D; Croal, Paula L; Kassner, Andrea

    2016-05-15

    Cerebrovascular reactivity (CVR) reflects the vasodilatory reserve of cerebral resistance vessels. Normal development in children is associated with significant changes in blood pressure, cerebral blood flow (CBF) and cerebral oxygen metabolism. Therefore, it stands to reason that CVR will also undergo changes during this period. The study acquired magnetic resonance imaging measures of CVR and CBF in healthy children and young adults to trace their changes with age. We found that CVR changes in two phases, increasing with age until the mid-teens, followed by a decrease. Baseline CBF declined steadily with age. We conclude that CVR varies with age during childhood, which prompts future CVR studies involving children to take into account the effect of development. Cerebrovascular reactivity (CVR) reflects the vasculature's ability to accommodate changes in blood flow demand thereby serving as a critical imaging tool for mapping vascular reserve. Normal development is associated with extensive physiological changes in blood pressure, cerebral blood flow and cerebral metabolic rate of oxygen, all of which can affect CVR. Moreover, the evolution of these physiological parameters is most prominent during childhood. Therefore, the aim of this study was to use non-invasive magnetic resonance imaging (MRI) to characterize the developmental trajectories of CVR in healthy children and young adults, and relate them to changes in cerebral blood flow (CBF). Thirty-four healthy subjects (17 males, 17 females; age 9-30 years) underwent CVR assessment using blood oxygen level-dependent MRI in combination with a computer controlled CO2 stimulus. In addition, baseline CBF was measured with a pulsed arterial spin labelling sequence. CVR exhibited a gradual increase with age in both grey and white matter up to 14.7 years. After this break point, a negative correlation with age was detected. Baseline CBF maintained a consistent negative linear correlation across the entire age range

  13. Applying a developmental approach to quality of life assessment in children and adolescents with psychological disorders: challenges and guidelines.

    Science.gov (United States)

    Carona, Carlos; Silva, Neuza; Moreira, Helena

    2015-02-01

    Research on the quality of life (QL) of children/adolescents with psychological disorders has flourished over the last few decades. Given the developmental challenges of QL measurements in pediatric populations, the aim of this study was to ascertain the extent to which a developmental approach to QL assessment has been applied to pedopsychiatric QL research. A systematic literature search was conducted in three electronic databases (PubMed, PsycINFO, SocINDEX) from 1994 to May 2014. Quantitative studies were included if they assessed the self- or proxy-reported QL of children/adolescents with a psychological disorder. Data were extracted for study design, participants, QL instruments and informants, and statistical approach to age-related specificities. The systematic review revealed widespread utilization of developmentally appropriate QL instruments but less frequent use of both self and proxy reports and an inconsistent approach to age group specificities. Methodological guidelines are discussed to improve the developmental validity of QL research for children/adolescents with mental disorders.

  14. Village registers for vital registration in rural Malawi.

    Science.gov (United States)

    Singogo, E; Kanike, E; van Lettow, M; Cataldo, F; Zachariah, R; Bissell, K; Harries, A D

    2013-08-01

    Paper-based village registers were introduced 5 years ago in Malawi as a tool to measure vital statistics of births and deaths at the population level. However, usage, completeness and accuracy of their content have never been formally evaluated. In Traditional Authority Mwambo, Zomba district, Malawi, we assessed 280 of the 325 village registers with respect to (i) characteristics of village headmen who used village registers, (ii) use and content of village registers, and (iii) whether village registers provided accurate information on births and deaths. All village headpersons used registers. There were 185 (66%) registers that were regarded as 95% completed, and according to the registers, there were 115 840 people living in the villages in the catchment area. In 2011, there were 1753 births recorded in village registers, while 6397 births were recorded in health centre registers in the same catchment area. For the same year, 199 deaths were recorded in village registers, giving crude death rates per 100 000 population of 189 for males and 153 for females. These could not be compared with death rates in health centre registers due to poor and inconsistent recording in these registers, but they were compared with death rates obtained from the 2010 Malawi Demographic Health Survey that reported 880 and 840 per 100 000 for males and females, respectively. In conclusion, this study shows that village registers are a potential source for vital statistics. However, considerable inputs are needed to improve accuracy of births and deaths, and there are no functional systems for the collation and analysis of data at the traditional authority level. Innovative ways to address these challenges are discussed, including the use of solar-powered electronic village registers and mobile phones, connected with each other and the health facilities and the District Commissioner's office through the cellular network and wireless coverage. © 2013 John Wiley & Sons Ltd.

  15. Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

    Science.gov (United States)

    Zafar, Shamsa; Jean-Baptiste, Rachel; Rahman, Atif; Neilson, James P; van den Broek, Nynke R

    2015-01-01

    For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective) and psychological morbidities in two different low-income countries. Cross sectional study with assessment of morbidity in early pregnancy (34%), late pregnancy (35%) and the postnatal period (31%) among 3459 women from two rural communities in Pakistan (1727) and Malawi (1732). Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity. One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective). Both infective (Pakistan) and non-infective morbidity (Pakistan and Malawi) was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon (Pakistan 2.6% in Malawi had an Edinburgh Postnatal Depression Score (EPDS) > 9. Complications during a previous pregnancy, infective morbidity (p <0.001), intra or postpartum haemorrhage (p <0.02) were associated with psychological morbidity in both settings. Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

  16. Positively essential: traditional birth attendants in Malawi.

    Science.gov (United States)

    Stronge, Shirley

    2011-06-01

    One of the biggest challenges for healthcare professionals working in developing countries is the lack of trained personnel to carry out much needed health care provision. Shirley Stronge worked as a nurse/midwife tutor in a rural area in the north of Malawi. Millennium Development Goals four and five have focused our attention on the care required by mothers and newborns. Shirley has chosen to reflect on the role of Traditional Birth Attendants in the north of Malawi and their positive impact on maternity services in this area.

  17. Design of an impact evaluation using a mixed methods model--an explanatory assessment of the effects of results-based financing mechanisms on maternal healthcare services in Malawi.

    Science.gov (United States)

    Brenner, Stephan; Muula, Adamson S; Robyn, Paul Jacob; Bärnighausen, Till; Sarker, Malabika; Mathanga, Don P; Bossert, Thomas; De Allegri, Manuela

    2014-04-22

    In this article we present a study design to evaluate the causal impact of providing supply-side performance-based financing incentives in combination with a demand-side cash transfer component on equitable access to and quality of maternal and neonatal healthcare services. This intervention is introduced to selected emergency obstetric care facilities and catchment area populations in four districts in Malawi. We here describe and discuss our study protocol with regard to the research aims, the local implementation context, and our rationale for selecting a mixed methods explanatory design with a quasi-experimental quantitative component. The quantitative research component consists of a controlled pre- and post-test design with multiple post-test measurements. This allows us to quantitatively measure 'equitable access to healthcare services' at the community level and 'healthcare quality' at the health facility level. Guided by a theoretical framework of causal relationships, we determined a number of input, process, and output indicators to evaluate both intended and unintended effects of the intervention. Overall causal impact estimates will result from a difference-in-difference analysis comparing selected indicators across intervention and control facilities/catchment populations over time.To further explain heterogeneity of quantitatively observed effects and to understand the experiential dimensions of financial incentives on clients and providers, we designed a qualitative component in line with the overall explanatory mixed methods approach. This component consists of in-depth interviews and focus group discussions with providers, service user, non-users, and policy stakeholders. In this explanatory design comprehensive understanding of expected and unexpected effects of the intervention on both access and quality will emerge through careful triangulation at two levels: across multiple quantitative elements and across quantitative and qualitative elements

  18. When will community management conserve biodiversity? Evidence from Malawi

    Directory of Open Access Journals (Sweden)

    Joy E. Hecht

    2008-12-01

    Full Text Available Both development practitioners and conservation organizations are focused on community ownership and management of natural resources as a way to create incentives for the conservation of biodiversity. This has led to the implementation of a number of large community-based conservation projects in sub-Saharan Africa, in countries including Namibia, Zimbabwe, Malawi, Zambia, and Rwanda. While the concept is logical, and valuation studies may suggest that conservation is more valuable than other uses of the resources in some areas, there has been little detailed analysis of the financial costs and benefits to the communities, to determine whether they would actually have an incentive to conserve if they had more extensive legal rights to the resources. This paper assesses the conditions under which this approach may be viable, based on a valuation study of the resources of Mount Mulanje in southern Malawi.Les spécialistes du développement et les organisations de conservation s’intéressent à la propriété et à la gestion communautaire des ressources naturelles comme moyen de créer des mesures d’incitation en faveur de la conservation de la biodiversité. Cette approche a conduit à la mise en œuvre d’un certain nombre de grands projets de conservation communautaires en Afrique subsaharienne, notamment en Namibie, au Zimbabwe, au Malawi, en Zambie et au Rwanda. Même si cette approche est logique et si les études d’évaluation semblent suggérer que, dans certaines régions, la conservation est plus utile que l’exploitation des ressources, il existe peu d’analyses détaillées sur les coûts et les avantages financiers que cela engendrerait pour les communautés, analyses qui permettraient de déterminer si le développement des droits légaux des communautés sur ces ressources les inciterait à les conserver. Ce rapport évalue les conditions de viabilité de cette approche sur la base d’une étude d’évaluation des

  19. Can the Movement Assessment Battery for Children-Test Be the "Gold Standard" for the Motor Assessment of Children with Developmental Coordination Disorder?

    Science.gov (United States)

    Venetsanou, Fotini; Kambas, Antonis; Ellinoudis, Theodoros; Fatouros, Ioannis; Giannakidou, Dimitra; Kourtessis, Thomas

    2011-01-01

    Developmental Coordination Disorder (DCD) is an important risk factor in the development of children that can have a significant academic and social impact. This reinforces the need for its timely identification using appropriate assessment methods and accurate screening tests. The commonly used standardized motor test for the DCD identification…

  20. Physical attractiveness and women's HIV risk in rural Malawi.

    Science.gov (United States)

    Frye, Margaret; Chae, Sophia

    2017-01-01

    Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country's severe AIDS epidemic. We use interviewers' ratings of respondents' attractiveness, along with HIV test results and women's assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15-35. Results show that women who are rated by interviewers as 'much less' or 'less' attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women's own assessments of their HIV risk: Among women who tested negative, those perceived as 'much less' or 'less' attractive than average report themselves to be at greater risk of HIV infection. These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.

  1. Developmental toxicity assessment of common excipients using a stem cell-based in vitro morphogenesis model.

    Science.gov (United States)

    Yuan, Chloe J; Marikawa, Yusuke

    2017-11-01

    Various chemical compounds can inflict developmental toxicity when sufficiently high concentrations are exposed to embryos at the critical stages of development. Excipients, such as coloring agents and preservatives, are pharmacologically inactive ingredients that are included in various medications, foods, and cosmetics. However, concentrations that may adversely affect embryo development are largely unknown for most excipients. Here, the lowest observed adverse effect level (LOAEL) to inflict developmental toxicity was assessed for three coloring agents (allura red, brilliant blue, and tartrazine) and three preservatives (butylated hydroxyanisole, metabisulfite, and methylparaben). Adverse impact of a compound exposure was determined using the stem cell-based in vitro morphogenesis model, in which three-dimensional cell aggregates, or embryoid bodies (EBs), recapitulate embryonic processes of body axis elongation and patterning. LOAEL to impair EB morphogenesis was 200 μM for methylparaben, 400 μM for butylated hydroxyanisole, 600 μM for allura red and brilliant blue, and 1000 μM for metabisulfite. Gene expression analyses of excipient-treated EBs revealed that butylated hydroxyanisole and methylparaben significantly altered profiles of developmental regulators involved in axial elongation and patterning of the body. The present study may provide a novel in vitro approach to investigate potential developmental toxicity of common excipients with mechanistic insights. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Health assessment of gasoline and fuel oxygenate vapors: developmental toxicity in rats.

    Science.gov (United States)

    Roberts, Linda G; Gray, Thomas M; Trimmer, Gary W; Parker, Robert M; Murray, F Jay; Schreiner, Ceinwen A; Clark, Charles R

    2014-11-01

    Gasoline-vapor condensate (BGVC) or condensed vapors from gasoline blended with methyl t-butyl ether (G/MTBE), ethyl t-butyl ether (G/ETBE), t-amyl methyl ether (G/TAME) diisopropyl ether (G/DIPE), ethanol (G/EtOH), or t-butyl alcohol (G/TBA) were evaluated for developmental toxicity in Sprague-Dawley rats exposed via inhalation on gestation days (GD) 5-20 for 6h/day at levels of 0 (control filtered air), 2000, 10,000, and 20,000mg/m(3). These exposure durations and levels substantially exceed typical consumer exposure during refueling (<1-7mg/m(3), 5min). Dose responsive maternal effects were reduced maternal body weight and/or weight change, and/or reduced food consumption. No significant malformations were seen in any study. Developmental effects occurred at 20,000mg/m(3) of G/TAME (reduced fetal body weight, increased incidence of stunted fetuses), G/TBA (reduced fetal body weight, increased skeletal variants) and G/DIPE (reduced fetal weight) resulting in developmental NOAEL of 10,000mg/m(3) for these materials. Developmental NOAELs for other materials were 20,000mg/m(3) as no developmental toxicity was induced in those studies. Developmental NOAELs were equal to or greater than the concurrent maternal NOAELs which ranged from 2000 to 20,000mg/m(3). There were no clear cut differences in developmental toxicity between vapors of gasoline and gasoline blended with the ether or alcohol oxygenates. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. AN ASSESSMENT OF THE ATTITUDES AND OUTCOMES OF STUDENTS ENROLLED IN DEVELOPMENTAL BASIC MATHEMATICS CLASSES AT PRINCE GEORGE'S COMMUNITY COLLEGE

    OpenAIRE

    Bassette, Lorraine Pratt

    2004-01-01

    The purposes of this study were to assess the effect of the initial and exiting attitudes toward mathematics and academic outcomes of students placed in the Developmental Mathematics Basic Arithmetic course at a community college in Maryland. Major research questions included were: (1) What is the difference, if any, between the pretest and posttest attitudes toward mathematics of students placed in Basic Arithmetic as measured by the Aiken Mathematics Attitude Survey? (...

  4. Cranial acetabular retroversion is common in developmental dysplasia of the hip as assessed by the weight bearing position

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mikkelsen, Lone Rømer; Jacobsen, Steffen

    2010-01-01

    The appearance of acetabular version differs between the supine and weight bearing positions in developmental dysplasia of the hip. Weight bearing radiographic evaluation has been recommended to ensure the best coherence between symptoms, functional appearance, and hip deformities. Previous...... prevalence estimates of acetabular retroversion in dysplastic hips have been established in radiographs recorded with the patient supine and with inclusion only if pelvic tilt met standardized criteria. We assessed the prevalence and the extent of acetabular retroversion in dysplastic hip joints in weight...

  5. Prevalence and risk factors for trachoma in central and southern Malawi.

    Directory of Open Access Journals (Sweden)

    Khumbo Kalua

    Full Text Available BACKGROUND: Trachoma, one of the neglected tropical diseases is suspected to be endemic in Malawi. OBJECTIVES: To determine the prevalence of trachoma and associated risk factors in central and southern Malawi. METHODOLOGY/PRINCIPAL FINDINGS: A population based survey conducted in randomly selected clusters in Chikwawa district (population 438,895, southern Malawi and Mchinji district (population 456,558, central Malawi. Children aged 1-9 years and adults aged 15 and above were assessed for clinical signs of trachoma. In total, 1010 households in Chikwawa and 1016 households in Mchinji districts were enumerated within 108 clusters (54 clusters in each district. A total of 6,792 persons were examined for ocular signs of trachoma. The prevalence of trachomatous inflammation, follicular (TF among children aged 1-9 years was 13.6% (CI 11.6-15.6 in Chikwawa and 21.7% (CI 19.5-23.9 in Mchinji districts respectively. The prevalence of trachoma trichiasis (TT in women and men aged 15 years and above was 0.6% (CI 0.2-0.9 in Chikwawa and 0.3% (CI 0.04-0.6 in Mchinji respectively. The presence of a dirty face was significantly associated with trachoma follicular (TF in both Chikwawa and Mchinji districts (P10%, and warrants the trachoma SAFE control strategy to be undertaken in Chikwawa and Mchinji districts.

  6. Baseline axle load survey in Malawi - 2014

    CSIR Research Space (South Africa)

    Roux, M

    2015-07-01

    Full Text Available of 50.4%. The average overloaded mass on the 1 356 overloaded vehicles was 4 264 kg, representing an average degree of overloading of 26.1%. Weigh data from 4 of the 5 permanent weighbridges in Malawi were also analysed to compare the extent and degree...

  7. Bat records from Malawi (Mammalia, Chiroptera)

    NARCIS (Netherlands)

    Bergmans, Wim; Jachmann, Hugo

    1983-01-01

    Five species of bats are recorded from Kasungu National Park, Malawi: Eidolon helvum (Kerr, 1792); Epomophorus anurus Heuglin, 1864; Epomophorus minor Dobson, 1880; Epomops dobsonii (Bocage, 1889); and Scotoecus hindei Thomas, 1901. Some other Malawian records of these species, based on literature

  8. Cholera Epidemic Control | Zachariah | Malawi Medical Journal

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 13, No 1 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Cholera Epidemic Control. R Zachariah. Full Text: EMAIL FREE ...

  9. A case study of Blantyre City, Malawi

    African Journals Online (AJOL)

    user

    African Journal of Environmental Science and Technology Vol. 6(2), pp. 94-103 ... that national authorities in Malawi need to spearhead public policies that will effectively regulate the operations of .... private sector combined with the commercialisation of ..... International Institute for Geo- Information Sciences and Earth.

  10. A comprehensive special educational diagnostic assessment of five-year-old children with developmental coordination disorder (case studies

    Directory of Open Access Journals (Sweden)

    Tjasa Filipcic

    2016-07-01

    Full Text Available Developmental coordination disorder (DCD is a neurodevelopmental disorder which affects different areas of an individual's everyday living and learning. Children with DCD are often diagnosed late, at school age, when difficulties with writing, organization and executive functions arise, even though one could have seen signs of probable DCD very early in childhood. The aim of this study was to further assess five-year-old, preschool children recognized as children with DCD, and develop a model for a comprehensive special educational diagnostic assessment of abilities and skills in five-year-old children with DCD. The comprehensive diagnostic assessment comprised observations and assessments of children’s everyday skills in their kindergartens. It also included semi-structured interviews with children, their parents and their preschool teachers. Further, children’s skills and abilities in all developmental domains (sensory and motor skills, cognitive abilities, social and emotional development, speech and language development, including emerging literacy skills, and early maths skills were assessed. A qualitative analysis was undertaken to compare individual children’s comprehensive assessments. The developed model included both the strengths and weaknesses of the assessed children.

  11. Strides in Preservation of Malawi's Natural Stone

    Science.gov (United States)

    Kamanga, Tamara; Chisenga, Chikondi; Katonda, Vincent

    2017-04-01

    The geology of Malawi is broadly grouped into four main lithological units that is the Basement Complex, the Karoo Super group, Tertiary to Quaternary sedimentary deposits and the Chilwa Alkaline province. The basement complex rocks cover much of the country and range in age from late Precambrian to early Paleozoic. They have been affected by three major phases of deformation and metamorphism that is the Irumide, Ubendian and The Pan-African. These rocks comprise gneisses, granulites and schists with associated mafic, ultramafic, syenites and granite rocks. The Karoo System sedimentary rocks range in age from Permian to lower Jurassic and are mainly restricted to two areas in the extreme North and extreme Alkaline Province - late Jurassic to Cretaceous in age, preceded by upper Karoo Dolerite dyke swarms and basaltic lavas, have been intruded into the Basement Complex gneisses of southern Malawi. Malawi is endowed with different types of natural stone deposits most of which remain unexploited and explored. Over twenty quarry operators supply quarry stone for road and building construction in Malawi. Hundreds of artisanal workers continue to supply aggregate stones within and on the outskirts of urban areas. Ornamental stones and granitic dimension stones are also quarried, but in insignificant volumes. In Northern Malawi, there are several granite deposits including the Nyika, which is the largest single outcrop occupying approximately 260.5 km2 , Mtwalo Amazonite an opaque to translucent bluish -green variety of microcline feldspar that occurs in alkali granites and pegmatite, the Ilomba granite (sodalite) occurring in small areas within biotite; apatite, plagioclase and calcite. In the Center, there are the Dzalanyama granites, and the Sani granites. In the South, there are the Mangochi granites. Dolerite and gabbroic rocks spread across the country, treading as black granites. Malawi is also endowed with many deposits of marble. A variety of other igneous

  12. Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi.

    Science.gov (United States)

    Pitchford, Nicola J

    2015-01-01

    Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-weeks period, for the equivalent of 30-min per day. Technical support was provided from the local Voluntary Service Overseas (VSO). Children were then post-tested on the same assessments as given at pre-test. A final sample of 283 children, from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standards 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child's developmental

  13. Development of early mathematical skills with a tablet intervention: a randomized control trial in Malawi

    Directory of Open Access Journals (Sweden)

    Nicola ePitchford

    2015-04-01

    Full Text Available Evaluation of educational interventions is necessary prior to wide-scale rollout. Yet very few rigorous studies have been conducted on the effectiveness of tablet-based interventions, especially in the early years and in developing countries. This study reports a randomized control trial to evaluate the effectiveness of a tablet intervention for supporting the development of early mathematical skills in primary school children in Malawi. A total sample of 318 children, spanning Standards 1-3, attending a medium-sized urban primary school, were randomized to one of three groups: maths tablet intervention, non-maths tablet control, and standard face-to-face practice. Children were pre-tested using tablets at the start of the school year on two tests of mathematical knowledge and a range of basic skills related to scholastic progression. Class teachers then delivered the intervention over an 8-week period, for the equivalent of 30-minutes per day. Technical support was provided from the local Voluntary Service Overseas. Children were then post-tested on the same assessments as given at pre-test.A final sample of 283 children from Standards 1-3, present at both pre- and post-test, was analyzed to investigate the effectiveness of the maths tablet intervention. Significant effects of the maths tablet intervention over and above standard face-to-face practice or using tablets without the maths software were found in Standard 2 and 3. In Standard 3 the greater learning gains shown by the maths tablet intervention group compared to both of the control groups on the tablet-based assessments transferred to paper and pencil format, illustrating generalization of knowledge gained. Thus, tablet technology can effectively support early years mathematical skills in developing countries if the software is carefully designed to engage the child in the learning process and the content is grounded in a solid well-constructed curriculum appropriate for the child

  14. Health Selection, Migration, and HIV Infection in Malawi.

    Science.gov (United States)

    Anglewicz, Philip; VanLandingham, Mark; Manda-Taylor, Lucinda; Kohler, Hans-Peter

    2018-04-27

    Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts.

  15. Mainstreaming conservation agriculture in Malawi: Knowledge gaps and institutional barriers.

    Science.gov (United States)

    Dougill, Andrew J; Whitfield, Stephen; Stringer, Lindsay C; Vincent, Katharine; Wood, Benjamin T; Chinseu, Edna L; Steward, Peter; Mkwambisi, David D

    2017-06-15

    Conservation agriculture (CA) practices of reduced soil tillage, permanent organic soil coverage and intercropping/crop rotation, are being advocated globally, based on perceived benefits for crop yields, soil carbon storage, weed suppression, reduced soil erosion and improved soil water retention. However, some have questioned their efficacy due to uncertainty around the performance and trade-offs associated with CA practices, and their compatibility with the diverse livelihood strategies and varied agro-ecological conditions across African smallholder systems. This paper assesses the role of key institutions in Malawi in shaping pathways towards more sustainable land management based on CA by outlining their impact on national policy-making and the design and implementation of agricultural development projects. It draws on interviews at national, district and project levels and a multi-stakeholder workshop that mapped the institutional landscape of decision-making for agricultural land management practices. Findings identify knowledge gaps and institutional barriers that influence land management decision-making and constrain CA uptake. We use our findings to set out an integrated roadmap of research needs and policy options aimed at supporting CA as a route to enhanced sustainable land management in Malawi. Findings offer lessons that can inform design, planning and implementation of CA projects, and identify the multi-level institutional support structures required for mainstreaming sustainable land management in sub-Saharan Africa. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Malaria research in Malawi from 1984 to 2016: a literature review and bibliometric analysis.

    Science.gov (United States)

    Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Mutero, Clifford M; Phiri, Kamija S

    2017-06-12

    Malaria research can play a vital role in addressing the malaria burden in Malawi. An organized approach in addressing malaria in Malawi started in 1984 by the establishment of the first National Malaria Control Programme and research was recognized to be significant. This study aimed to assess the type and amount of malaria research conducted in Malawi from 1984 to 2016 and its related source of funding. A systematic literature search was conducted in the Medline/PubMed database for Malawian publications and approved malaria studies from two Ethical Committees were examined. Bibliometric analysis was utilized to capture the affiliations of first and senior/last authors, funding acknowledgements, while titles, abstracts and accessed full text were examined for research type. A total of 483 publications and 165 approved studies were analysed. Clinical and basic research in the fields of malaria in pregnancy 105 (21.5%), severe malaria 97 (20.1%) and vector and/or agent dynamics 69 (14.3%) dominated in the publications while morbidity 33 (20%), severe malaria 28 (17%) and Health Policy and Systems Research 24 (14.5%) dominated in the approved studies. In the publications, 146 (30%) first authors and 100 (21%) senior authors, and 88 (53.3%) principal investigators in approved studies were affiliated to Malawian-based institutions. Most researchers were affiliated to the Malawi-Liverpool Wellcome Trust, College of Medicine, Blantyre Malaria Project, Ministry of Health, and Malaria Alert Centre. The major malaria research funders were the National Institute for Health/USA, Wellcome Trust and the US Agency for International Development. Only three (2.5%) out of 118 journals publishing research on malaria in Malawi were from Africa and the Malaria Journal, with 76 (15.7%) publications, published most of the research from Malawi, followed by the American Journal of Tropical Medicine and Hygiene with 57 (11.8%) in comparison to only 13 (2.7%) published in the local Malawi

  17. Developmental apraxia of speech in children. Quantitive assessment of speech characteristics

    NARCIS (Netherlands)

    Thoonen, G.H.J.

    1998-01-01

    Developmental apraxia of speech (DAS) in children is a speech disorder, supposed to have a neurological origin, which is commonly considered to result from particular deficits in speech processing (i.e., phonological planning, motor programming). However, the label DAS has often been used as

  18. Developmental Pathways to Conduct Disorder: Implications for Future Directions in Research, Assessment, and Treatment

    Science.gov (United States)

    Frick, Paul J.

    2012-01-01

    Research has indicated that there are several common pathways through which children and adolescents develop conduct disorder, each with different risk factors and each with different underlying developmental mechanisms leading to the child's aggressive and antisocial behavior. The current article briefly summarizes research on these pathways,…

  19. Invited Commentary: Applying Psychodynamic Developmental Assessment to Explore Mental Functioning in Adolescents

    Science.gov (United States)

    Czopp, Shira Tibon

    2012-01-01

    Recent publications in the "Journal of Youth and Adolescence" present a variety of topics exploring adolescents' mental functioning in the twenty first century. Conceptually, many of the articles address the intriguing, though rarely explicit, question of developmental continuities and change from adolescence to adulthood. Such…

  20. Assessment of Aberrant Behavior Maintained by Wheelchair Movement in a Child with Developmental Disabilities.

    Science.gov (United States)

    DeLeon, Iser G.; Kahng, SungWoo; Rodriguez-Catter, Vanessa; Sveinsdottir, Ingibjorg; Sadler, Christine

    2003-01-01

    An adolescent with developmental disabilities who used a wheelchair was anecdotally observed to display little aggressive behavior when being pushed, but higher rates when movement was terminated. A functional analysis confirmed the elevated aggression and the child was taught to request movement through appropriate means. Aggression decreased…

  1. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

    Directory of Open Access Journals (Sweden)

    Victoria K Fort

    2011-03-01

    Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

  2. IWRM and poverty reduction in Malawi: A socio-economic analysis

    Science.gov (United States)

    Mulwafu, Wapulumuka O.; Msosa, Hendrina K.

    Like most other countries in the SADC region, Malawi has swiftly endorsed the United Nations Millennium Development Goals. In the water sector, these principles are reflected in the National Water Policy (2004) and in the Malawi Poverty Reduction Strategy Paper (PRSP) (2002) which emphasize three key aspects. First, the articulation of a vision and policy objectives that address development and management of water for productive purposes, conservation and poverty reduction. Second, the recognition of international and regional conventions and agreements on water resources to which Malawi is a signatory, thereby promoting global partnership for development. Third, the provision of mechanisms for monitoring, assessment and development related to watershed management, conservation and the mitigation of floods and droughts. Both the Malawi Poverty Reduction Strategy Paper and the National Water Policy seek to reduce poverty by increasing access to water for domestic and productive purposes. In particular, the MPRSP will focus on constructing and rehabilitating water facilities, extend water supply capacity, promote community-based management and improve water resources conservation and management. In this paper, we examine the challenges of implementing these goals against the background of various institutional reforms in the water sector. We argue that although Malawi has come up with very clear strategies and guidelines for promoting MDGs, a combination of human and financial resources, bedevil the successful implementation of these ideas. In addition, the strategies do not articulate water as a medium for poverty alleviation in a holistic manner. The paper further demonstrates ways in which the promotion of IWRM can facilitate in reducing poverty.

  3. Assessing developmental toxicity of caffeine and sweeteners in medaka (Oryzias latipes)

    OpenAIRE

    Lee, Wenjau; Wang, Yun-Chi

    2015-01-01

    The use of artificial sweeteners (ASWs) has increased and become more widespread, and consequently ASWs have appeared in aquatic environments around the world. However, their safety to the health of humans and wildlife remains inconclusive. In this study, using medaka embryos (Oryzias latipes), we investigated developmental toxicity of aspartame (ASP) and saccharin (SAC). Since ASWs are often consumed with caffeine (CAF) and CAF with sucrose (SUC), we tested biological activities of these fou...

  4. Neural differentiation of mouse embryonic stem cells as a tool to assess developmental neurotoxicity in vitro.

    Science.gov (United States)

    Visan, Anke; Hayess, Katrin; Sittner, Dana; Pohl, Elena E; Riebeling, Christian; Slawik, Birgitta; Gulich, Konrad; Oelgeschläger, Michael; Luch, Andreas; Seiler, Andrea E M

    2012-10-01

    Mouse embryonic stem cells (mESCs) represent an attractive cellular system for in vitro studies in developmental biology as well as toxicology because of their potential to differentiate into all fetal cell lineages. The present study aims to establish an in vitro system for developmental neurotoxicity testing employing mESCs. We developed a robust and reproducible protocol for fast and efficient differentiation of the mESC line D3 into neural cells, optimized with regard to chemical testing. Morphological examination and immunocytochemical staining confirmed the presence of different neural cell types, including neural progenitors, neurons, astrocytes, oligodendrocytes, and radial glial cells. Neurons derived from D3 cells expressed the synaptic proteins PSD95 and synaptophysin, and the neurotransmitters serotonin and γ-aminobutyric acid. Calcium ion imaging revealed the presence of functionally active glutamate and dopamine receptors. In addition, flow cytometry analysis of the neuron-specific marker protein MAP2 on day 12 after induction of differentiation demonstrated a concentration dependent effect of the neurodevelopmental toxicants methylmercury chloride, chlorpyrifos, and lead acetate on neuronal differentiation. The current study shows that D3 mESCs differentiate efficiently into neural cells involving a neurosphere-like state and that this system is suitable to detect adverse effects of neurodevelopmental toxicants. Therefore, we propose that the protocol for differentiation of mESCs into neural cells described here could constitute one component of an in vitro testing strategy for developmental neurotoxicity. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Risk factor assessment to anticipate performance in the National Developmental Screening Test in children from a disadvantaged area.

    Science.gov (United States)

    Montes, Alejandro; Pazos, Gustavo

    2016-02-01

    Identifying children at risk of failing the National Developmental Screening Test by combining prevalences of children suspected of having inapparent developmental disorders (IDDs) and associated risk factors (RFs) would allow to save resources. 1. To estimate the prevalence of children suspected of having IDDs. 2. To identify associated RFs. 3. To assess three methods developed based on observed RFs and propose a pre-screening procedure. The National Developmental Screening Test was administered to 60 randomly selected children aged between 2 and 4 years old from a socioeconomically disadvantaged area from Puerto Madryn. Twenty-four biological and socioenvironmental outcome measures were assessed in order to identify potential RFs using bivariate and multivariate analyses. The likelihood of failing the screening test was estimated as follows: 1. a multivariate logistic regression model was developed; 2. a relationship was established between the number of RFs present in each child and the percentage of children who failed the test; 3. these two methods were combined. The prevalence of children suspected of having IDDs was 55.0% (95% confidence interval: 42.4%-67.6%). Six RFs were initially identified using the bivariate approach. Three of them (maternal education, number of health checkups and Z scores for height-for-age, and maternal age) were included in the logistic regression model, which has a greater explanatory power. The third method included in the assessment showed greater sensitivity and specificity (85% and 79%, respectively). The estimated prevalence of children suspected of having IDDs was four times higher than the national standards. Seven RFs were identified. Combining the analysis of risk factor accumulation and a multivariate model provides a firm basis for developing a sensitive, specific and practical pre-screening procedure for socioeconomically disadvantaged areas. Sociedad Argentina de Pediatría.

  6. Divorce and Remarriage in Rural Malawi

    Directory of Open Access Journals (Sweden)

    2003-09-01

    Full Text Available The demographic study of nuptiality in African countries is not very developed and often of secondary interest in a discussion of the proximate determinants of fertility. This paper uses unusual marriage history data to examine divorce and remarriage in rural Malawi. Life table probabilities of divorce range from 40 to 65 percent and are among the highest on the continent. An investigation into the determinants of marital instability using proportional hazards models confirms the importance of kinship systems and female empowerment, but the mechanism underlying the high divorce rates in Malawi seems to be more complicated than that. This is, for example, illustrated in the effect of the polygyny variables. Marriage, divorce, and remarriage are further considered as empowering strategies that women deploy throughout their lives.

  7. Developmental assessment of RELAP5/MOD3 code against ROSA-IV/TPTF horizontal two-phase flow experiments

    International Nuclear Information System (INIS)

    Kukita, Yutaka; Asaka, Hideaki; Anoda, Yoshinari; Ishiguro, Misako; Tasaka, Kanji; Mimura, Yuichi; Nemoto, Toshiyuki.

    1990-03-01

    A developmental version of the RELAP5/Mod3 code (as of June 1989) was assessed for accuracy using experimental data taken for high-pressure (7MPa) steam-water two-phase flow in a large-diameter (0.18 m) horizontal-pipe test section of the ROSA-IV Two-Phase Flow Test Facility (TPTF). The agreement between the measured and calculated test section void fractions was much better than that for the previous generation of RELAP5 (MOD2). The improvement was achieved primarily due to the code changes with respect to the flow stratification criterion and interfacial-drag calculation scheme. (author)

  8. AP600 large-break loss-of-collant-accident developmental assessment plan for TRAC-PF1/MOD2

    International Nuclear Information System (INIS)

    Knight, T.D.

    1996-07-01

    The Westinghouse AP600 reactor is an advanced pressurized water reactor with passive safety systems to protect the plant against possible accidents and transients. The design has been submitted to the U.S. NRC for design certification. The NRC has selected the Transient Reactor Analysis Code (TRAC)-PF1/MOD2 for performing large break loss-of coolant-accident (LBLOCA) analysis to support the certification effort. This document defines the tests to be used in the current phase of developmental assessment related to AP600 LBLOCA

  9. RELAP5-3D developmental assessment: Comparison of version 4.2.1i on Linux and Windows

    Energy Technology Data Exchange (ETDEWEB)

    Bayless, Paul D. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-06-01

    Figures have been generated comparing the parameters used in the developmental assessment of the RELAP5-3D code, version 4.2i, compiled on Linux and Windows platforms. The figures, which are the same as those used in Volume III of the RELAP5-3D code manual, compare calculations using the semi-implicit solution scheme with available experiment data. These figures provide a quick, visual indication of how the code predictions differ between the Linux and Windows versions.

  10. RELAP5-3D Developmental Assessment. Comparison of Version 4.3.4i on Linux and Windows

    International Nuclear Information System (INIS)

    Bayless, Paul David

    2015-01-01

    Figures have been generated comparing the parameters used in the developmental assessment of the RELAP5-3D code, version 4.3i, compiled on Linux and Windows platforms. The figures, which are the same as those used in Volume III of the RELAP5-3D code manual, compare calculations using the semi-implicit solution scheme with available experiment data. These figures provide a quick, visual indication of how the code predictions differ between the Linux and Windows versions.

  11. Variability of extreme wet events over Malawi

    Directory of Open Access Journals (Sweden)

    Libanda Brigadier

    2017-01-01

    Full Text Available Adverse effects of extreme wet events are well documented by several studies around the world. These effects are exacerbated in developing countries like Malawi that have insufficient risk reduction strategies and capacity to cope with extreme wet weather. Ardent monitoring of the variability of extreme wet events over Malawi is therefore imperative. The use of the Expert Team on Climate Change Detection and Indices (ETCCDI has been recommended by many studies as an effective way of quantifying extreme wet events. In this study, ETCCDI indices were used to examine the number of heavy, very heavy, and extremely heavy rainfall days; daily and five-day maximum rainfall; very wet and extremely wet days; annual wet days and simple daily intensity. The Standard Normal Homogeneity Test (SNHT was employed at 5% significance level before any statistical test was done. Trend analysis was done using the nonparametric Mann-Kendall statistical test. All stations were found to be homogeneous apart from Mimosa. Trend results show high temporal and spatial variability with the only significant results being: increase in daily maximum rainfall (Rx1day over Karonga and Bvumbwe, increase in five-day maximum rainfall (Rx5day over Bvumbwe. Mzimba and Chileka recorded a significant decrease in very wet days (R95p while a significant increase was observed over Thyolo. Chileka was the only station which observed a significant trend (decrease in extremely wet rainfall (R99p. Mzimba was the only station that reported a significant trend (decrease in annual wet-day rainfall total (PRCPTOT and Thyolo was the only station that reported a significant trend (increase in simple daily intensity (SDII. Furthermore, the findings of this study revealed that, during wet years, Malawi is characterised by an anomalous convergence of strong south-easterly and north-easterly winds. This convergence is the main rain bringing mechanism to Malawi.

  12. Dynamics of Community Participation, Student Achievement and School Management: The Case of Primary Schools in a Rural Area of Malawi

    Science.gov (United States)

    Taniguchi, Kyoko; Hirakawa, Yukiko

    2016-01-01

    School management in many sub-Saharan African countries has been enhanced through community participation in an attempt to improve education quality. This study uses field research in a rural district of Malawi to assess how community and parent participation differs between schools, the intentions of communities and parents when carrying out…

  13. Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

    Directory of Open Access Journals (Sweden)

    Shamsa Zafar

    Full Text Available For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective and psychological morbidities in two different low-income countries.Cross sectional study with assessment of morbidity in early pregnancy (34%, late pregnancy (35% and the postnatal period (31% among 3459 women from two rural communities in Pakistan (1727 and Malawi (1732. Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity.One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective. Both infective (Pakistan and non-infective morbidity (Pakistan and Malawi was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon ( 9. Complications during a previous pregnancy, infective morbidity (p <0.001, intra or postpartum haemorrhage (p <0.02 were associated with psychological morbidity in both settings.Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

  14. Age structure of elephants in Liwonde National Park, Malawi

    Directory of Open Access Journals (Sweden)

    R. Bhima

    1997-08-01

    Full Text Available The age structure of the elephant population in Liwonde National Park, Malawi was determined for the first time in 1993 and again in 1995 using the photogrammetric method. Sampling was done during a four year-long severe drought from 1991/92 to 1994/95. The drought reached its highest intensity in the first year. Therefore, the study also attempted to assess the impact of the drought on the population. The results show that the population consisted of mostly young animals 20 years old - 18.3 and 20.5 . The population is young and growing. The prolonged drought did not have any significant impact on the population.

  15. New attitudes key to progress in Malawi, Cameroon | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-11-08

    Nov 8, 2011 ... New attitudes key to progress in Malawi, Cameroon ... in Malawi — good laws protecting women's rights — but they are not working. Why? ... Colonial rule — first by the Germans and later the French and British — brought in a ...

  16. 1. A Qualitative Study of Medical Student Socialization in Malawi's ...

    African Journals Online (AJOL)

    students at the University of Malawi's College of Medicine.i. Malawi is both culturally ... influences of the structural adjustment programs mandated ... For five decades, social scientists have examined the moral ... studied the impact of medical training outside the global ... Wanted to help people. 42% .... political issues.15,16.

  17. Environmental risk factors for oesophageal cancer in Malawi: A case ...

    African Journals Online (AJOL)

    Methods A hospital-based case-control study of the association between environmental risk factors and oesophageal cancer was conducted at Kamuzu Central Hospital in Lilongwe, Malawi and Queen Elizabeth Central Hospital in Blantyre, Malawi. Ninety-six persons with squamous cell carcinoma and 180 controls were ...

  18. Language loss and language decay of Malawi's indigenous ...

    African Journals Online (AJOL)

    This article focuses on the decay of almost all of Malawi's indigenous languages with the exception of ciCewa. The languages facing loss and decay have been suppressed, neglected and not developed, particularly since Malawi attained her independence in 1964. This is a crucial matter in issues of national unity, group ...

  19. Establishing a children's orthopaedic hospital for Malawi: A review ...

    African Journals Online (AJOL)

    other providers in Lilongwe, the capital of Malawi located in the central region. BCIH is situated in Blantyre in the southern region of Malawi. Therefore it is not unexpected that there is likely to be a natural bias towards treatment of southern patients. This bias was noted at 5-years with 48% of operatively treated case hailing ...

  20. Determinants of adolescent fertility in Malawi | Palamuleni | Gender ...

    African Journals Online (AJOL)

    High adolescent fertility is recognized as a global challenge given its adverse consequences. As such understanding the factors that influence adolescent fertility is critical to addressing this challenge. This study aims at examining the causes of adolescent fertility in Malawi using the 2010 Malawi Demographic and Health ...

  1. Better processing and marketing of healthy fish products in Malawi

    International Development Research Centre (IDRC) Digital Library (Canada)

    In Malawi, fish provide 70% of the animal protein in people's diets: small fish, in particular, are a vital source of calcium, vi- tamin A, iron, and zinc. ... es in Malawi coincide with seasonal rains and high humidity, which interfere with drying and ...

  2. Family medicine training and practice in Malawi: History, progress ...

    African Journals Online (AJOL)

    Family medicine training and practice in Malawi: History, progress, and the anticipated role of the family physician in the Malawian health system. ... The idea of formal family medicine training and practice in Malawi started as early as 2001 but did not come to fruition until 2011, with the start of the undergraduate clerkship in ...

  3. Treadle pump irrigation in Malawi: adoption, gender and benefits

    NARCIS (Netherlands)

    Kamwamba-Mtethiwa, J.; Namara, R.; Fraiture, de C.M.S.; Mangisoni, J.; Owusu, E.

    2012-01-01

    As part of their irrigation strategy, the government and non-governmental organizations (NGOs) in Malawi are actively promoting the use of treadle pumps in smallholder irrigation. The positive impact of treadle pumps on food security and poverty reduction in Malawi and elsewhere in sub-Saharan

  4. Book Reviews Journalism Practice in Malawi: History, Progress, and ...

    African Journals Online (AJOL)

    zeleza

    Management of the Newspaper Industry in Malawi. ... The new media is the focus of Chapter Three titled Online Journalism in Malawi: Emergence, ... The chapter tackles a number of areas of national development and the beauty ... commodity, including market forces or regulations, which sometimes can restrict new market.

  5. A Retrospective Performance Assessment of the Developmental Neurotoxicity Study in Support of OECD Test Guideline 426

    DEFF Research Database (Denmark)

    Makris, Susan L.; Raffaele, Kathleen; Allen, Sandra

    2009-01-01

    OBJECTIVE: We conducted a review of the history and performance of developmental neurotoxicity mic (DNT) testing in support of the finalization and implementation of Organisation of Economic Co-operation and Development (OECD) DNT test guideline 426 (TG 426). INFORMATION SOURCES AND ANALYSIS......: In this review we summarize extensive scientific efforts that form the foundation for this testing paradigm, including basic neurotoxicology research, interlaboratory collaborative studies, expert workshops, and validation studies, and we address the relevance, applicability, and use of the DNT study in risk...... and international acceptance of new or updated test methods for hazard characterization. Multiple independent, expert scientific peer reviews affirm these conclusions....

  6. Physical attractiveness and women's HIV risk in rural Malawi

    Directory of Open Access Journals (Sweden)

    Margaret Frye

    2017-08-01

    Full Text Available Background: Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. Objective: We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country's severe AIDS epidemic. Methods: We use interviewers' ratings of respondents' attractiveness, along with HIV test results and women's assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15‒35. Results: Results show that women who are rated by interviewers as 'much less' or 'less' attractive than other women their age are 9Š more likely to test positive for HIV. We also find that attractiveness is associated with women's own assessments of their HIV risk: Among women who tested negative, those perceived as 'much less' or 'less' attractive than average report themselves to be at greater risk of HIV infection. Conclusions: These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. Contribution: This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.

  7. Brief report: Assessing youth well-being in global emergency settings: Early results from the Emergency Developmental Assets Profile.

    Science.gov (United States)

    Scales, Peter C; Roehlkepartain, Eugene C; Wallace, Teresa; Inselman, Ashley; Stephenson, Paul; Rodriguez, Michael

    2015-12-01

    The 13-item Emergency Developmental Assets Profile measures the well-being of children and youth in emergency settings such as refugee camps and armed conflict zones, assessing whether young people are experiencing adequate positive relationships and opportunities, and developing positive values, skills, and self-perceptions, despite being in crisis circumstances. The instrument was found to have acceptable and nearly identical internal consistency reliability in 22 administrations in non-emergency samples in 15 countries (.75), and in 4 samples of youth ages 10-18 (n = 1550) in the emergency settings (war refugees and typhoon victims, .74) that are the measure's focus, and evidence of convergent validity. Confirmatory Factor Analysis showed acceptable model fit among those youth in emergency settings. Measures of model fit showed that the Em-DAP has configural and metric invariance across all emergency contexts and scalar invariance across some. The Em-DAP is a promising brief cross-cultural tool for assessing the developmental quality of life as reported by samples of youth in a current humanitarian crisis situation. The results can help to inform international relief program decisions about services and activities to be provided for children, youth, and families in emergency settings. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  8. Development of the language subtest in a developmental assessment scale to identify Chinese preschool children with special needs.

    Science.gov (United States)

    Wong, Anita M-Y; Leung, Cynthia; Siu, Elaine K-L; Lam, Catherine C-C; Chan, Grace P-S

    2011-01-01

    This study reports on the development of the language subtest in the Preschool Developmental Assessment Scale (PDAS) for Cantonese-Chinese speaking children. A pilot pool of 158 items covering the two language modalities and the three language domains was developed. This initial item set was subsequently revised based on Rasch analyses of data from 324 multi-stage randomly selected children between 3 and 6 years of age. The revised 106-item set demonstrated adequate measurement properties, including targeting and uni-dimensionality. The revised 106-item set successfully discriminated preschool children in the three age groups, and between preschool children and their age peers with special education needs (SEN). Results from this study support the collection of normative data from a larger population sample of children to examine its accuracy in identifying language impairment in children with SEN. Test development procedures reported in this study provide insight for the development of language subtests in multi-domain developmental assessment tools for children speaking other varieties of Chinese. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Interventions for postnatal depression assessing the mother–infant relationship and child developmental outcomes: a systematic review

    Directory of Open Access Journals (Sweden)

    Tsivos ZL

    2015-04-01

    Full Text Available Zoe-Lydia Tsivos,1 Rachel Calam,1 Matthew R Sanders,1,2 Anja Wittkowski1 1School of Psychological Sciences, University of Manchester, Manchester, UK; 2Parenting and Family Support Center, University of Queensland, Brisbane, Australia Abstract: Postnatal depression (PND has negative effects on maternal well-being as well as implications for the mother–infant relationship, subsequent infant development, and family functioning. There is growing evidence demonstrating that PND impacts on a mother’s ability to interact with sensitivity and responsiveness as a caregiver, which may have implications for the infant’s development of self-regulatory skills, making the infant more vulnerable to later psychopathology. Given the possible intergenerational transmission of risk to the infant, the mother–infant relationship is a focus for treatment and research. However, few studies have assessed the effect of treatment on the mother–infant relationship and child developmental outcomes. The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother–infant dyad relationship and/or child outcomes in addition to maternal mood. Nineteen studies were selected for review, and their methodological quality was evaluated, where possible, effect sizes across maternal mood, quality of dyadic relationship, and child developmental outcomes were calculated. Finally, clinical implications in the treatment of PND are highlighted and recommendations made for further research. Keywords: postnatal depression, infant development, intervention, dyad, mother–infant relationship, systematic review

  10. Improving newborn care practices through home visits: lessons from Malawi, Nepal, Bangladesh, and Uganda

    Directory of Open Access Journals (Sweden)

    Deborah Sitrin

    2015-03-01

    Full Text Available Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. Design: Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable – home visit from a community health worker (CHW during pregnancy (0, 1–2, 3+ – and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. Results: There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. Conclusion: Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of

  11. On-the-job training of clinical officers in Malawi | Jiskoot | Malawi ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 3 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  12. Pervasive developmental disorder in the children of immigrant parents: comparison of different assessment instruments

    Directory of Open Access Journals (Sweden)

    Milena Pereira Ponde

    2013-11-01

    Full Text Available The objective of this study was to describe how the Childhood Autism Rating Scale (CARS behaves in relation to the Autism Diagnostic Observation Schedule (ADOS and to clinical diagnosis based on the criteria defined in the Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition (DSM-IV for children of immigrant parents. Forty-nine children of parents who had immigrated to Canada were evaluated. In this sample, the ADOS and the DSM-IV showed complete agreement. Using the standard cut-off point of 30, the CARS showed high specificity and poor sensitivity. The study proposes a cut-off point for the CARS that would include pervasive developmental disorder – not otherwise specified (PDD-NOS. Reducing the cut-off point to 20/21 increased the specificity of the instrument for this group of children without significantly reducing its sensitivity.

  13. Religion, condom use acceptability and use within marriage among rural women in Malawi.

    Science.gov (United States)

    Muula, Adamson S; Thomas, James C; Pettifor, Audrey E; Strauss, Ronald P; Suchindran, Chirayath M; Meshnick, Steve R

    2011-01-01

    Correct and consistent condom use within an HIV-discordant partnership could prevent sexual transmission of human immunodeficiency virus (HIV). Data on ever-married women from rural Malawi were obtained from the Malawi Diffusion and Ideational Change Project (MDICP) of 2006. We assessed the strength of association between religion and acceptability of condom use within marriage in general and also when one of the partners is suspected or known to be HIV infected. A total of 1,664 ever-married women participated in the MDICP 2006. Of these, 66.7% believed condom use was acceptable within marriage when one partner suspects or knows that the other was HIV infected; 38.2% believed condoms were acceptable within marriage generally. Only 13.8% reported ever having used condoms within the current or most recent marriage. Multivariate analysis found no difference in acceptability of condoms within marriage between Christians and Muslims, or between Catholics and all but one of the individual denominations assessed. Christian women in rural Malawi were no more or no less likely to accept condom use than Muslim women; there was also no difference in attitude toward condom use within marriage among Malawian women.

  14. Health assessment of gasoline and fuel oxygenate vapors: developmental toxicity in mice.

    Science.gov (United States)

    Roberts, L G; Gray, T M; Marr, M C; Tyl, R W; Trimmer, G W; Hoffman, G M; Murray, F J; Clark, C R; Schreiner, C A

    2014-11-01

    CD-1 mice were exposed to baseline gasoline vapor condensate (BGVC) alone or to vapors of gasoline blended with methyl tertiary butyl ether (G/MTBE). Inhalation exposures were 6h/d on GD 5-17 at levels of 0, 2000, 10,000, and 20,000mg/m(3). Dams were evaluated for evidence of maternal toxicity, and fetuses were weighed, sexed, and evaluated for external, visceral, and skeletal anomalies. Exposure to 20,000mg/m(3) of BGVC produced slight reductions in maternal body weight/gain and decreased fetal body weight. G/MTBE exposure did not produce statistically significant maternal or developmental effects; however, two uncommon ventral wall closure defects occurred: gastroschisis (1 fetus at 10,000mg/m(3)) and ectopia cordis (1 fetus at 2000mg/m(3); 2 fetuses/1 litter at 10,000mg/m(3)). A second study (G/MTBE-2) evaluated similar exposure levels on GD 5-16 and an additional group exposed to 30,000mg/m(3) from GD 5-10. An increased incidence of cleft palate was observed at 30,000mg/m(3) G/MTBE. No ectopia cordis occurred in the replicate study, but a single observation of gastroschisis was observed at 30,000mg/m(3). The no observed adverse effect levels for maternal/developmental toxicity in the BGVC study were 10,000/2000mg/m(3), 20,000/20,000 for the G/MTBE study, and 10,000/20,000 for the G/MTBE-2 study. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Providing lipid-based nutrient supplements does not affect developmental milestones among Malawian children.

    Science.gov (United States)

    Mangani, Charles; Cheung, Yin Bun; Maleta, Kenneth; Phuka, John; Thakwalakwa, Chrissie; Dewey, Kathryn; Manary, Mark; Puumalainen, Taneli; Ashorn, Per

    2014-01-01

    To assess whether using lipid-based nutrient supplements (LNS) to complement the diets of infants and young children affected when they achieved selected developmental milestones. In rural Malawi, 840 6-month-old healthy infants were enrolled to a randomised trial. Control participants received no supplements, others were provided with milk-containing LNS, soy-containing LNS or corn-soy blend (CSB) for 12 months. Outcomes were the age at which they achieved key milestone: motor (walking with assistance, standing and walking alone, running), social (drinking from a cup and eating by themselves) and language (saying single comprehensible words and waving goodbye). The mean age at which the subjects walked with assistance was 42.5, 42.3, 42.7 and 43.2 weeks in the control, milk-LNS, soy-LNS and CSB groups, respectively (p = 0.748). There were also no significant differences in the mean age at standing alone (45.0, 44.9, 45.1 and 46.3 weeks), walking alone (54.6, 55.1, 55.3, 56.5 weeks), running (64.6, 63.7, 64.8, 65.9 weeks) or any other social or language milestones (each p > 0.10). The findings do not support a hypothesis that providing tested formulations and doses of micronutrient-fortified LNS or CSB would have an impact on when young children in rural Malawi achieved selected developmental milestones. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  16. Test Review: Beaver, J. M., & Carter, M. A. (2006). "The Developmental Reading Assessment--Second Edition" (DRA2). Upper Saddle River, NJ--Pearson

    Science.gov (United States)

    McCarty, Allison M.; Christ, Theodore J.

    2010-01-01

    This article reviews the "Developmental Reading Assessment--Second Edition" (DRA2), a teacher-administered assessment that identifies students' instructional level, along with their strengths and weaknesses in reading. Once teachers calculate and interpret scores, the data can purportedly be used to inform, and possibly individualize,…

  17. Assessment of neuro-optometric rehabilitation using the Developmental Eye Movement (DEM) test in adults with acquired brain injury.

    Science.gov (United States)

    Kapoor, Neera; Ciuffreda, Kenneth Joseph

    This pilot study sought to determine the efficacy of using the Developmental Eye Movement (DEM) test in the adult, acquired brain injury (ABI) population to quantify clinically the effects of controlled, laboratory-performed, oculomotor-based vision therapy/vision rehabilitation. Nine adult subjects with mild traumatic brain injury (mTBI) and five with stroke were assessed before and after an eight-week, computer-based, versional oculomotor (fixation, saccades, pursuit, and simulated reading) training program (9.6h total). The protocol incorporated a cross-over, interventional design with and without the addition of auditory feedback regarding two-dimensional eye position. The clinical outcome measure was the Developmental Eye Movement (DEM) test score (ratio, errors) taken before, midway, and immediately following training. For the DEM ratio parameter, improvements were found in 80-89% of the subjects. For the DEM error parameter, improvements were found in 100% of the subjects. Incorporation of the auditory feedback component revealed a trend toward enhanced performance. The findings were similar for both DEM parameters, as well as for incorporation of the auditory feedback, in both diagnostic groups. The results of the present study demonstrated considerable improvements in the DEM test scores following the oculomotor-based training, thus reflecting more time-optimal and accurate saccadic tracking after the training. The DEM test should be considered as another clinical test of global saccadic tracking performance in the ABI population. Copyright © 2017 Spanish General Council of Optometry. All rights reserved.

  18. EST analysis in Ginkgo biloba: an assessment of conserved developmental regulators and gymnosperm specific genes

    Directory of Open Access Journals (Sweden)

    Runko Suzan J

    2005-10-01

    Full Text Available Abstract Background Ginkgo biloba L. is the only surviving member of one of the oldest living seed plant groups with medicinal, spiritual and horticultural importance worldwide. As an evolutionary relic, it displays many characters found in the early, extinct seed plants and extant cycads. To establish a molecular base to understand the evolution of seeds and pollen, we created a cDNA library and EST dataset from the reproductive structures of male (microsporangiate, female (megasporangiate, and vegetative organs (leaves of Ginkgo biloba. Results RNA from newly emerged male and female reproductive organs and immature leaves was used to create three distinct cDNA libraries from which 6,434 ESTs were generated. These 6,434 ESTs from Ginkgo biloba were clustered into 3,830 unigenes. A comparison of our Ginkgo unigene set against the fully annotated genomes of rice and Arabidopsis, and all available ESTs in Genbank revealed that 256 Ginkgo unigenes match only genes among the gymnosperms and non-seed plants – many with multiple matches to genes in non-angiosperm plants. Conversely, another group of unigenes in Gingko had highly significant homology to transcription factors in angiosperms involved in development, including MADS box genes as well as post-transcriptional regulators. Several of the conserved developmental genes found in Ginkgo had top BLAST homology to cycad genes. We also note here the presence of ESTs in G. biloba similar to genes that to date have only been found in gymnosperms and an additional 22 Ginkgo genes common only to genes from cycads. Conclusion Our analysis of an EST dataset from G. biloba revealed genes potentially unique to gymnosperms. Many of these genes showed homology to fully sequenced clones from our cycad EST dataset found in common only with gymnosperms. Other Ginkgo ESTs are similar to developmental regulators in higher plants. This work sets the stage for future studies on Ginkgo to better understand seed and

  19. Human DNA quantification and sample quality assessment: Developmental validation of the PowerQuant(®) system.

    Science.gov (United States)

    Ewing, Margaret M; Thompson, Jonelle M; McLaren, Robert S; Purpero, Vincent M; Thomas, Kelli J; Dobrowski, Patricia A; DeGroot, Gretchen A; Romsos, Erica L; Storts, Douglas R

    2016-07-01

    Quantification of the total amount of human DNA isolated from a forensic evidence item is crucial for DNA normalization prior to short tandem repeat (STR) DNA analysis and a federal quality assurance standard requirement. Previous commercial quantification methods determine the total human DNA and total human male DNA concentrations, but provide limited information about the condition of the DNA sample. The PowerQuant(®) System includes targets for quantification of total human and total human male DNA as well as targets for evaluating whether the human DNA is degraded and/or PCR inhibitors are present in the sample. A developmental validation of the PowerQuant(®) System was completed, following SWGDAM Validation Guidelines, to evaluate the assay's specificity, sensitivity, precision and accuracy, as well as the ability to detect degraded DNA or PCR inhibitors. In addition to the total human DNA and total human male DNA concentrations in a sample, data from the degradation target and internal PCR control (IPC) provide a forensic DNA analyst meaningful information about the quality of the isolated human DNA and the presence of PCR inhibitors in the sample that can be used to determine the most effective workflow and assist downstream interpretation. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

  20. Newborn survival in Malawi: a decade of change and future implications.

    Science.gov (United States)

    Zimba, Evelyn; Kinney, Mary V; Kachale, Fannie; Waltensperger, Karen Z; Blencowe, Hannah; Colbourn, Tim; George, Joby; Mwansambo, Charles; Joshua, Martias; Chanza, Harriet; Nyasulu, Dorothy; Mlava, Grace; Gamache, Nathalie; Kazembe, Abigail; Lawn, Joy E

    2012-07-01

    Malawi is one of two low-income sub-Saharan African countries on track to meet the Millennium Development Goal (MDG 4) for child survival despite high fertility and HIV and low health worker density. With neonatal deaths becoming an increasing proportion of under-five deaths, addressing newborn survival is critical for achieving MDG 4. We examine change for newborn survival in the decade 2000-10, analysing mortality and coverage indicators whilst considering other contextual factors. We assess national and donor funding, as well as policy and programme change for newborn survival using standard analyses and tools being applied as part of a multi-country analysis. Compared with the 1990s, progress towards MDG 4 and 5 accelerated considerably from 2000 to 2010. Malawi's neonatal mortality rate (NMR) reduced slower than annual reductions in mortality for children 1-59 months and maternal mortality (NMR reduced 3.5% annually). Yet, the NMR reduced at greater pace than the regional and global averages. A significant increase in facility births and other health system changes, including increased human resources, likely contributed to this decline. High level attention for maternal health and associated comprehensive policy change has provided a platform for a small group of technical and programme experts to link in high impact interventions for newborn survival. The initial entry point for newborn care in Malawi was mainly through facility initiatives, such as Kangaroo Mother Care. This transitioned to an integrated and comprehensive approach at community and facility level through the Community-Based Maternal and Newborn Care package, now being implemented in 17 of 28 districts. Addressing quality gaps, especially for care at birth in facilities, and including newborn interventions in child health programmes, will be critical to the future agenda of newborn survival in Malawi.

  1. Criteria for clinical audit of women friendly care and providers' perception in Malawi

    Directory of Open Access Journals (Sweden)

    van den Broek Nynke

    2008-07-01

    Full Text Available Abstract Background There are two dimensions of quality of maternity care, namely quality of health outcomes and quality as perceived by clients. The feasibility of using clinical audit to assess and improve the quality of maternity care as perceived by women was studied in Malawi. Objective We sought to (a establish standards for women friendly care and (b explore attitudinal barriers which could impede the proper implementation of clinical audit. Methods We used evidence from Malawi national guidelines and World Health Organisation manuals to establish local standards for women friendly care in three districts. We equally conducted a survey of health care providers to explore their attitudes towards criterion based audit. Results The standards addressed different aspects of care given to women in maternity units, namely (i reception, (ii attitudes towards women, (iii respect for culture, (iv respect for women, (v waiting time, (vi enabling environment, (vii provision of information, (viii individualised care, (ix provision of skilled attendance at birth and emergency obstetric care, (x confidentiality, and (xi proper management of patient information. The health providers in Malawi generally held a favourable attitude towards clinical audit: 100.0% (54/54 agreed that criterion based audit will improve the quality of care and 92.6% believed that clinical audit is a good educational tool. However, there are concerns that criterion based audit would create a feeling of blame among providers (35.2%, and that manager would use clinical audit to identify and punish providers who fail to meet standards (27.8%. Conclusion Developing standards of maternity care that are acceptable to, and valued by, women requires consideration of both the research evidence and cultural values. Clinical audit is acceptable to health professionals in Malawi although there are concerns about its negative implications to the providers.

  2. [Assessment of social networks between developmental physicians and welfare facilities/specialists for children with intellectual disabilities in Japan].

    Science.gov (United States)

    Inagaki, Masumi; Horiguchi, Toshihiro; Kaga, Makiko

    2004-05-01

    The social networks between Japanese child neurologists and welfare facilities/specialists for children with mental retardation (MR) were assessed. A total of 113 physicians answered our mail-in questionnaire. Most of the doctors had various connections with nursery homes for children with MR or severe motor and intellectual disabilities (SMID) and with public health centers, and often collaborated with teachers of schools and kindergartens. On the other hand, most physicians had little relation with residential and vocational facilities for adults with MR, and with specialists in residential or community care. There was a statistical correlation between the number of facilities or collaborated specialists and the number of persons seen by each physician; however, the physicians' experience and affiliations had no relation. In view of 'social participation', physicians who usually see children with developmental disorders can play an important role in decision making of their life-style with their families.

  3. Assessment of Leisure Preferences for Students with Severe Developmental Disabilities and Communication Difficulties

    Science.gov (United States)

    Kreiner, Janice; Flexer, Robert

    2009-01-01

    The purpose of this study was to develop and to evaluate the Preferences for Leisure Attributes (PLA) Assessment, a forced-choice computer software program for students with severe disabilities and communication difficulties. In order to determine content validity of the PLA Assessment, four experts in related fields assigned critical attributes…

  4. High-Stakes Testing in the Warm Heart of Africa:The Challenges and Successes of the Malawi National Examinations Board

    Directory of Open Access Journals (Sweden)

    Elias Chakwera

    2004-06-01

    Full Text Available In the United States, tests are held to high standards of quality. In developing countries such as Malawi, psychometricians must deal with these same high standards as well as several additional pressures such as widespread cheating, test administration difficulties due to challenging landscapes and poor resources, difficulties in reliably scoring performance assessments, and extreme scrutiny from political parties and the popular press. The purposes of this paper are to (a familiarize the measurement community in the US about Malawi’s assessment programs, (b discuss some of the unique challenges inherent in such a program, (c compare testing conditions and test administration formats between Malawi and the US, and (d provide suggestions for improving large-scale testing in countries such as the US and Malawi. By learning how a small country instituted and supports its current testing programs, a broader perspective on resolving current measurement problems throughout the world will emerge.

  5. Scaling-up antiretroviral therapy in Malawi.

    Science.gov (United States)

    Jahn, Andreas; Harries, Anthony D; Schouten, Erik J; Libamba, Edwin; Ford, Nathan; Maher, Dermot; Chimbwandira, Frank

    2016-10-01

    In Malawi, health-system constraints meant that only a fraction of people infected with human immunodeficiency virus (HIV) and in immediate need of antiretroviral treatment (ART) received treatment. In 2004, the Malawian Ministry of Health launched plans to scale-up ART nationwide, adhering to the principle of equity to ensure fair geographical access to therapy. A public health approach was used with standardized training and treatment and regular supervision and monitoring of the programme. Before the scale-up, an estimated 930 000 people in Malawi were HIV-infected, with 170 000 in immediate need of ART. About 3000 patients were on ART in nine clinics. By December 2015, cumulatively 872 567 patients had been started on ART from 716 clinics, following national treatment protocols and using the standard monitoring system. Strong national leadership allowed the ministry of health to implement a uniform system for scaling-up ART and provided benchmarks for implementation on the ground. New systems of training staff and accrediting health facilities enabled task-sharing and decentralization to peripheral health centres and a standardized approach to starting and monitoring ART. A system of quarterly supervision and monitoring, into which operational research was embedded, ensured stocks of drug supplies at facilities and adherence to national treatment guidelines.

  6. Similarities and dissimilarities between the movement ABC-2 and the Zurich neuromotor assessment in children with suspected developmental coordination disorder.

    Science.gov (United States)

    Kakebeeke, Tanja H; Egloff, Kristin; Caflisch, Jon; Chaouch, Aziz; Rousson, Valentin; Largo, Remo H; Jenni, Oskar G

    2014-11-01

    An established tool for the assessment of motor performance in children with developmental coordination disorder (DCD) is the Movement-ABC-2 (M-ABC-2). The Zurich Neuromotor Assessment (ZNA) is also widely used for the evaluation of children's motor performance, but has not been compared with the M-ABC-2. Fifty-one children (39 males) between 5 and 7 years of age with suspected DCD were assessed using the M-ABC-2 and the ZNA. Rank correlations between scores of different test components were calculated. The structure of the tests was explored using canonical-correlation analysis. The correlation between total scores of the two motor tests was reasonable (0.66; pABC-2, due to poor performance in the fine motor adaptive component and increased contralateral associated movements (CAM). The canonical-correlation analysis revealed that ZNA measures components like pure motor skills and CAM that are not represented in the M-ABC-2. Furthermore, there was also no equivalent for the aiming and catching items of the M-ABC-2 in ZNA. The two tests measure different motor characteristics in children with suspected DCD and, thus, can be used complementary for the diagnosis of the disorder. Copyright © 2014. Published by Elsevier Ltd.

  7. Malawi : tous les projets | Page 3 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sujet: URBAN HOUSING, HOUSING NEEDS, HOUSING CONDITIONS, LOW COST HOUSING, HOUSING POLICY, HOUSING PROGRAMMES, ENVIRONMENTAL HEALTH. Région: North of Sahara, South of Sahara, Malawi, Senegal, Tunisia, Uganda. Programme: Alimentation, environnement et santé. Financement total ...

  8. All projects related to malawi | Page 3 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Topic: CLIMATE CHANGE, ADAPTATION TO CHANGE, NATURAL DISASTERS, DISASTER PREPAREDNESS, DISASTER MANAGEMENT. Region: Kenya, Malawi, Sudan, Tanzania, Uganda, South Africa, Zambia, Zimbabwe, South of Sahara. Program: Climate Change. Total Funding: CA$ 1,398,500.00. Strengthening ...

  9. Immigrant-Host Community Relations in Malawi's Community Based ...

    African Journals Online (AJOL)

    government sponsored settlement schemes in Zimbabwe, for example, are viewed as ... diversity of community development projects and state provided public ..... Development Project in Malawi: case studies of beneficiary groups in Machinga ...

  10. Nurturing professional social work in Malawi | Kakowa | African ...

    African Journals Online (AJOL)

    Further to this, there is no regulating or coordinating body for social work ... A regulating body of social work in Malawi would enhance development of the ... A reflexive approach where curriculum and practice would inform each other is ...

  11. Untreated surgical conditions in Malawi: A randomised cross ...

    African Journals Online (AJOL)

    This was a multistage random cluster sampling national survey. Households ... sample size was estimated to be 1497 households from a pilot study that was ..... with fracture management by skeletal traction; a qualitative study from. Malawi.

  12. Bedside paediatric HIV testing in Malawi: Impact on testing rates

    African Journals Online (AJOL)

    2017-05-25

    May 25, 2017 ... Malawi Integrated Guidelines on 'Clinical Management of ... referred by nursing staff to attend the HIV counsellor's ... Implementation of a bedside testing service at Queen Elizabeth Central Hospital significantly increased HIV ...

  13. Magnetic Resonance Imaging in Malawi: Contributions to Clinical ...

    African Journals Online (AJOL)

    Magnetic Resonance Imaging in Malawi: Contributions to Clinical Care, Medical Education and Biomedical Research. MJ Potchen, S Kampondeni, GL Birbeck, CA Hammond, A Gonani, KS Phiri, KB Seydel, TE Taylor ...

  14. Improving high quality, equitable maternal health services in Malawi ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

  15. A Study of Journalists' Conditions of Service in Malawi

    African Journals Online (AJOL)

    zeleza

    establish journalists' salaries and benefits in Malawi; to determine if these salaries .... Agency reporter from the districts of Zomba, Dedza and Nkhata Bay, which were .... responsibilities of employers and employees and copyright ownership of ...

  16. Institutional Challenges to Viable Civil-Military Relations in Malawi

    National Research Council Canada - National Science Library

    Phiri, Mphatso J

    2008-01-01

    Malawi is one of the few African countries that has experienced neither a military coup nor a civil war, and has remained peaceful since independence despite being under a dictatorial regime for three decades...

  17. Violence against nurses in the southern region of Malawi

    African Journals Online (AJOL)

    Chimwemwe Kwanjo Banda

    reporting to managers, telling their friends, crying, retaliating, or ignoring the incident. Most ... Conclusions: Workplace violence against nurses exists in Malawi and it affects nurses ... safety, well-being or health” (WHO, 2010, p. 1).

  18. Basement and alluvial aquifers of Malawi: An overview of ...

    African Journals Online (AJOL)

    Elizabeth B Mapoma

    2014-02-17

    Feb 17, 2014 ... Malawi as regards water resources use and degradation ...... action plan for integrated water resource development and management that establishes rules and procedures to implement joint management of water resources.

  19. Research on human immunodeficiency virus (HIV) in Malawi: the ...

    African Journals Online (AJOL)

    Research on human immunodeficiency virus (HIV) in Malawi: the Johns Hopkins University- Ministry of Health (JHU-MOH) project. TE Taha, JK Canner, AM Wangel, JD Chiphangwi, NG Liomba, PG Miotti, GA Dallabetta, AJ Saah ...

  20. Establishing a children's orthopaedic hospital for Malawi: A review ...

    African Journals Online (AJOL)

    ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.

  1. Sleeping sickness surveys: game reserve adjacent villages in Malawi

    African Journals Online (AJOL)

    Sleeping sickness surveys: game reserve adjacent villages in Malawi. ... Sera from 160 game ranger volunteers and from 82 suspected cases_of Rhodesian sleeping sickness were tested by use of ELISA, ... AJOL African Journals Online.

  2. Prevention and treatment of childhood malnutrition in rural Malawi ...

    African Journals Online (AJOL)

    in rural Malawi: Lungwena nutrition studies ... a community based nutritional intervention for malnourished children in rural .... and height gain were similar in the two groups. .... A-M, Ashorn P. Socio-economic support for good health in rural.

  3. HIV and mental illness in Malawi and the neuropsychiatric sequelae ...

    African Journals Online (AJOL)

    ZMH) is the only government- run tertiary psychiatric referral hospital in Malawi. ... use, multiple sex partners and intravenous drug use,12,13 ... SPECIAL COMMUNICATION ... for psychiatric referral in subjects who have been informed about a ...

  4. Slow perceptual processing at the core of developmental dyslexia: a parameter-based assessment of visual attention.

    Science.gov (United States)

    Stenneken, Prisca; Egetemeir, Johanna; Schulte-Körne, Gerd; Müller, Hermann J; Schneider, Werner X; Finke, Kathrin

    2011-10-01

    The cognitive causes as well as the neurological and genetic basis of developmental dyslexia, a complex disorder of written language acquisition, are intensely discussed with regard to multiple-deficit models. Accumulating evidence has revealed dyslexics' impairments in a variety of tasks requiring visual attention. The heterogeneity of these experimental results, however, points to the need for measures that are sufficiently sensitive to differentiate between impaired and preserved attentional components within a unified framework. This first parameter-based group study of attentional components in developmental dyslexia addresses potentially altered attentional components that have recently been associated with parietal dysfunctions in dyslexia. We aimed to isolate the general attentional resources that might underlie reduced span performance, i.e., either a deficient working memory storage capacity, or a slowing in visual perceptual processing speed, or both. Furthermore, by analysing attentional selectivity in dyslexia, we addressed a potential lateralized abnormality of visual attention, i.e., a previously suggested rightward spatial deviation compared to normal readers. We investigated a group of high-achieving young adults with persisting dyslexia and matched normal readers in an experimental whole report and a partial report of briefly presented letter arrays. Possible deviations in the parametric values of the dyslexic compared to the control group were taken as markers for the underlying deficit. The dyslexic group showed a striking reduction in perceptual processing speed (by 26% compared to controls) while their working memory storage capacity was in the normal range. In addition, a spatial deviation of attentional weighting compared to the control group was confirmed in dyslexic readers, which was larger in participants with a more severe dyslexic disorder. In general, the present study supports the relevance of perceptual processing speed in disorders

  5. Trade Balance and the J-Curve Phenomenon in Malawi

    OpenAIRE

    Mataya, Charles S.; Veeman, Michele M.

    1997-01-01

    The effects of successive currency devaluations, since the 1980s, on Malawi's trade balance are analysed. The major hypothesis tested is that currency devaluation leads to an improvement in trade balance through changes in the real exchange rate. This hypothesis is not supported by the data for Malawi. Although there is evidence of a lagged adjustment yielding an improvement in the trade balance three years after devaluation, the magnitude of this improvement is insufficient to overcome the i...

  6. An early developmental vertebrate model for nanomaterial safety: bridging cell-based and mammalian toxicity assessment.

    Science.gov (United States)

    Webster, Carl A; Di Silvio, Desire; Devarajan, Aarthi; Bigini, Paolo; Micotti, Edoardo; Giudice, Chiara; Salmona, Mario; Wheeler, Grant N; Sherwood, Victoria; Bombelli, Francesca Baldelli

    2016-03-01

    With the rise in production of nanoparticles (NPs) for an ever-increasing number of applications, there is an urgent need to efficiently assess their potential toxicity. We propose a NP hazard assessment protocol that combines mammalian cytotoxicity data with embryonic vertebrate abnormality scoring to determine an overall toxicity index. We observed that, after exposure to a range of NPs, Xenopus phenotypic scoring showed a strong correlation with cell based in vitro assays. Magnetite-cored NPs, negative for toxicity in vitro and Xenopus, were further confirmed as nontoxic in mice. The results highlight the potential of Xenopus embryo analysis as a fast screening approach for toxicity assessment of NPs, which could be introduced for the routine testing of nanomaterials.

  7. Job-Preference and Job-Matching Assessment Results and Their Association with Job Performance and Satisfaction among Young Adults with Developmental Disabilities

    Science.gov (United States)

    Hall, Julie; Morgan, Robert L.; Salzberg, Charles L.

    2014-01-01

    We investigated the effects of preference and degree of match on job performance of four 19 to 20-year-old young adults with developmental disabilities placed in community-based job conditions. We identified high-preference, high-matched and low-preference, low-matched job tasks using a video web-based assessment program. The job matching…

  8. A systematic review of instruments for assessment of capacity in activities of daily living in children with developmental co-ordination disorder

    NARCIS (Netherlands)

    van der Linde, B W; van Netten, J J; Otten, E; Postema, K; Geuze, R H; Schoemaker, M M

    Children with developmental co-ordination disorder (DCD) face evident motor difficulties in activities of daily living (ADL). Assessment of their capacity in ADL is essential for diagnosis and intervention, in order to limit the daily consequences of the disorder. The aim of this study is to

  9. Link between cognitive neuroscience and education: The case of clinical assessment of developmental dyscalculia

    Directory of Open Access Journals (Sweden)

    Orly eRubinsten

    2015-05-01

    Full Text Available In recent years, cognitive neuroscience research has identified several biological and cognitive features of number processing deficits that may now make it possible to diagnose mental or educational impairments in arithmetic, even earlier and more precisely than is possible using traditional assessment tools. We provide two sets of recommendations for improving cognitive assessment tools, using the important case of mathematics as an example. (1 neurocognitive tests would benefit substantially from incorporating assessments (based on findings from cognitive neuroscience that entail systematic manipulation of fundamental aspects of number processing. Tests that focus on evaluating networks of core neurocognitive deficits have considerable potential to lead to more precise diagnosis and to provide the basis for designing specific intervention programs tailored to the deficits exhibited by the individual child. (2 implicit knowledge, derived from inspection of variables that are irrelevant to the task at hand, can also provide a useful assessment tool. Implicit knowledge is powerful and plays an important role in human development, especially in cases of psychiatric or neurological deficiencies (such as math learning disabilities

  10. Link between cognitive neuroscience and education: the case of clinical assessment of developmental dyscalculia.

    Science.gov (United States)

    Rubinsten, Orly

    2015-01-01

    In recent years, cognitive neuroscience research has identified several biological and cognitive features of number processing deficits that may now make it possible to diagnose mental or educational impairments in arithmetic, even earlier and more precisely than is possible using traditional assessment tools. We provide two sets of recommendations for improving cognitive assessment tools, using the important case of mathematics as an example. (1) neurocognitive tests would benefit substantially from incorporating assessments (based on findings from cognitive neuroscience) that entail systematic manipulation of fundamental aspects of number processing. Tests that focus on evaluating networks of core neurocognitive deficits have considerable potential to lead to more precise diagnosis and to provide the basis for designing specific intervention programs tailored to the deficits exhibited by the individual child. (2) implicit knowledge, derived from inspection of variables that are irrelevant to the task at hand, can also provide a useful assessment tool. Implicit knowledge is powerful and plays an important role in human development, especially in cases of psychiatric or neurological deficiencies (such as math learning disabilities or math anxiety).

  11. Drosophila embryos as model to assess cellular and developmental toxicity of multi-walled carbon nanotubes (MWCNT in living organisms.

    Directory of Open Access Journals (Sweden)

    Boyin Liu

    Full Text Available Different toxicity tests for carbon nanotubes (CNT have been developed to assess their impact on human health and on aquatic and terrestrial animal and plant life. We present a new model, the fruit fly Drosophila embryo offering the opportunity for rapid, inexpensive and detailed analysis of CNTs toxicity during embryonic development. We show that injected DiI labelled multi-walled carbon nanotubes (MWCNTs become incorporated into cells in early Drosophila embryos, allowing the study of the consequences of cellular uptake of CNTs on cell communication, tissue and organ formation in living embryos. Fluorescently labelled subcellular structures showed that MWCNTs remained cytoplasmic and were excluded from the nucleus. Analysis of developing ectodermal and neural stem cells in MWCNTs injected embryos revealed normal division patterns and differentiation capacity. However, an increase in cell death of ectodermal but not of neural stem cells was observed, indicating stem cell-specific vulnerability to MWCNT exposure. The ease of CNT embryo injections, the possibility of detailed morphological and genomic analysis and the low costs make Drosophila embryos a system of choice to assess potential developmental and cellular effects of CNTs and test their use in future CNT based new therapies including drug delivery.

  12. ATHENA [Advanced Thermal Hydraulic Energy Network Analyzer] solutions to developmental assessment problems

    International Nuclear Information System (INIS)

    Carlson, K.E.; Ransom, V.H.; Roth, P.A.

    1987-03-01

    The ATHENA (Advanced Thermal Hydraulic Energy Network Analyzer) code has been developed to perform transient simulation of the thermal hydraulic systems that may be found in fusion reactors, space reactors, and other advanced systems. As an assessment of current capability the code was applied to a number of physical problems, both conceptual and actual experiments. Results indicate that the numerical solution to the basic conservation equations is technically sound, and that generally good agreement can be obtained when modeling relevant hydrodynamic experiments. The assessment also demonstrates basic fusion system modeling capability and verifies compatibility of the code with both CDC and CRAY mainframes. Areas where improvements could be made include constitutive modeling, which describes the interfacial exchange term. 13 refs., 84 figs

  13. Does relative body fat influence the Movement ABC-2 assessment in children with and without developmental coordination disorder?

    Science.gov (United States)

    Faught, Brent E; Demetriades, Stephen; Hay, John; Cairney, John

    2013-12-01

    Developmental coordination disorder (DCD) is a condition that results in an impairment of gross and/or fine motor coordination. Compromised motor coordination contributes to lower levels of physical activity, which is associated with elevated body fat. The impact of elevated body fat on motor coordination diagnostic assessments in children with DCD has not been established. The purpose of this study was to determine if relative body fat influences performance on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) test items in children with and without DCD. A nested case-control, design was conducted within the Physical Health Activity Study Team longitudinal cohort study. The MABC-2 was used to assess motor coordination to categorize cases and matched controls. Relative body fat was assessed using whole body air displacement plethysmography. Relative body fat was negatively associated with the MABC-2 "balance" subcategory after adjusting for physical activity and DCD status. Relative body fat did not influence the subcategories of "manual dexterity" or "aiming and catching". Item analysis of the three balance tasks indicated that relative body fat significantly influences both "2-board balance" and "zig-zag hopping", but not "walking heel-toe backwards". Children with higher levels of relative body fat do not perform as well on the MABC-2, regardless of whether the have DCD or not. Dynamic balance test items are most negatively influenced by body fat. Health practitioners and researchers should be aware that body fat can influence results when interpreting MABC-2 test scores. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  14. Assessment of Body Composition Using Whole Body Air-Displacement Plethysmography in Children with and without Developmental Coordination Disorder

    Science.gov (United States)

    Cairney, John; Hay, John; Veldhuizen, Scott; Faught, Brent

    2011-01-01

    Developmental coordination disorder (DCD) is a neuro-developmental disorder characterized by poor fine and/or gross motor coordination. Children with DCD are hypothesized to be at increased risk for overweight and obesity from inactivity due to their motor coordination problems. Although previous studies have found evidence to support this…

  15. Assessment of neuro-optometric rehabilitation using the Developmental Eye Movement (DEM test in adults with acquired brain injury

    Directory of Open Access Journals (Sweden)

    Neera Kapoor

    2018-04-01

    Full Text Available Purpose: This pilot study sought to determine the efficacy of using the Developmental Eye Movement (DEM test in the adult, acquired brain injury (ABI population to quantify clinically the effects of controlled, laboratory-performed, oculomotor-based vision therapy/vision rehabilitation. Methods: Nine adult subjects with mild traumatic brain injury (mTBI and five with stroke were assessed before and after an eight-week, computer-based, versional oculomotor (fixation, saccades, pursuit, and simulated reading training program (9.6 h total. The protocol incorporated a cross-over, interventional design with and without the addition of auditory feedback regarding two-dimensional eye position. The clinical outcome measure was the Developmental Eye Movement (DEM test score (ratio, errors taken before, midway, and immediately following training. Results: For the DEM ratio parameter, improvements were found in 80–89% of the subjects. For the DEM error parameter, improvements were found in 100% of the subjects. Incorporation of the auditory feedback component revealed a trend toward enhanced performance. The findings were similar for both DEM parameters, as well as for incorporation of the auditory feedback, in both diagnostic groups. Discussion: The results of the present study demonstrated considerable improvements in the DEM test scores following the oculomotor-based training, thus reflecting more time-optimal and accurate saccadic tracking after the training. The DEM test should be considered as another clinical test of global saccadic tracking performance in the ABI population. Resumen: Objetivo: Este estudio piloto trató de determinar la eficacia del uso de la prueba DEM (Developmental Eye Movement en la población adulta con daño cerebral adquirido (DCA para cuantificar clínicamente los efectos de la rehabilitación/terapia visual controlada, realizada en laboratorio, y de carácter oculomotor. Métodos: Se valoraron nueve sujetos adultos con

  16. Developmental norms for eight instruments used in the neuropsychological assessment of children: studies in Brazil

    Directory of Open Access Journals (Sweden)

    Brito G.N.O.

    1998-01-01

    Full Text Available Norms for a battery of instruments, including Denckla's and Garfield's tests of Motor Persistence, Benton's Right-Left Discrimination, two recall modalities (Immediate and Delayed of the Bender Test, Wechsler's Digit Span, the Color Span Test and the Human Figure Drawing Test, were developed for the neuropsychological assessment of children in the greater Rio de Janeiro area. Additionally, the behavior of each child was assessed with the Composite Teacher Rating Scale (Brito GNO and Pinto RCA (1991 Journal of Clinical and Experimental Neuropsychology, 13: 417-418. A total of 398 children (199 boys and 199 girls balanced for age with a mean age of 9.3 years (SD = 2.8, who were attending a public school in Niterói, were the subjects of this study. Gender and age had significant effects on performance which depended on the instrument. Nonachievers performed worse than achievers in most neuropsychological tests. Comparison of our data to the available counterparts in the United States revealed that American children outperformed Brazilian children on the Right-Left Discrimination, Forward Digit Span, Color Span and Human Figure Drawing Tests. Further analysis showed that the neurobehavioral data consist of different factorial dimensions, including Human Body Representation, Motor Persistence of the Legs, Orbito-Orobuccal Motor Persistence, Attention-Memory, Visuospatial Memory, Neuropsychomotor Speed, Hyperactivity-Inattention, and Anxiety-Negative Socialization. We conclude that gender and age should be taken into account when using the normative data for most of the instruments studied in the present report. Furthermore, we stress the need for major changes in the Brazilian public school system in order to foster the development of secondary cognitive abilities in our children

  17. Developmental norms for eight instruments used in the neuropsychological assessment of children: studies in Brazil.

    Science.gov (United States)

    Brito, G N; Alfradique, G M; Pereira, C C; Porto, C M; Santos, T R

    1998-03-01

    Norms for a battery of instruments, including Denckla's and Garfield's tests of Motor Persistence, Benton's Right-Left Discrimination, two recall modalities (Immediate and Delayed) of the Bender Test, Wechsler's Digit Span, the Color Span Test and the Human Figure Drawing Test, were developed for the neuropsychological assessment of children in the greater Rio de Janeiro area. Additionally, the behavior of each child was assessed with the Composite Teacher Rating Scale (Brito GNO and Pinto RCA (1991) Journal of Clinical and Experimental Neuropsychology, 13: 417-418). A total of 398 children (199 boys and 199 girls balanced for age) with a mean age of 9.3 years (SD = 2.8), who were attending a public school in Niterói, were the subjects of this study. Gender and age had significant effects on performance which depended on the instrument. Nonachievers performed worse than achievers in most neuropsychological tests. Comparison of our data to the available counterparts in the United States revealed that American children outperformed Brazilian children on the Right-Left Discrimination, Forward Digit Span, Color Span and Human Figure Drawing Tests. Further analysis showed that the neurobehavioral data consist of different factorial dimensions, including Human Body Representation, Motor Persistence of the Legs, Orbito-Orobuccal Motor Persistence, Attention-Memory, Visuospatial Memory, Neuropsychomotor Speed, Hyperactivity-Inattention, and Anxiety-Negative Socialization. We conclude that gender and age should be taken into account when using the normative data for most of the instruments studied in the present report. Furthermore, we stress the need for major changes in the Brazilian public school system in order to foster the development of secondary cognitive abilities in our children.

  18. The reproductive biology of an open-water spawning Lake Malawi ...

    African Journals Online (AJOL)

    The reproductive biology of an open-water spawning Lake Malawi cichlid, Copadichromis chrysonotus. Lance W. Smith. Abstract. Copadichromis chrysonotus is a zooplanktivorous cichlid member of the diverse fish community inhabiting Lake Malawi's rocky, littoral habitat. Like most Lake Malawi cichlids, this species' ...

  19. Developmental Assessments during Injury Research: Is Enrollment of Very Young Children in Crèches Associated with Better Scores?

    Directory of Open Access Journals (Sweden)

    Divya Nair

    2017-09-01

    Full Text Available The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD” where children were enrolled either into crèches (daycare centers or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we compared problem-solving, communication, motor and personal-social outcomes assessed by the Ages and Stages Questionnaire in the two interventions. After controlling for variables such as home stimulation in multivariate regressions, children in crèches performed about a quarter of a standard deviation better in total scores (p < 0.10 and 0.45 standard deviations higher in fine motor skills (p < 0.05. Moreover, once the sample was stratified by length of exposure to the intervention, then children in crèches performed significantly better in a number of domains: those enrolled the longest (about 5 months have higher fine motor (1.47, p < 0.01, gross motor (0.40, p < 0.05 and personal-social skills (0.95, p < 0.01 than children in playpens. In addition, children in crèches with the longer exposure (about 5 months have significantly higher personal-social and problem-solving scores than those in crèches with minimum exposure. Enrollment in crèches of very young children may be positively associated with psychosocial scores after accounting for important confounding variables.

  20. Acute and developmental toxicity assessment of erincine A-enriched Hericium erinaceus mycelia in Sprague-Dawley rats.

    Science.gov (United States)

    Li, I-Chen; Chen, Wan-Ping; Chen, Yen-Po; Lee, Li-Ya; Tsai, Yueh-Ting; Chen, Chin-Chu

    2018-01-23

    This study aimed to establish an in vitro model to confirm the efficacy of erinacine A-enriched Hericium erinaceus (EAHE) mycelia and investigate its potential adverse effects in a preclinical experimental setting, including an assessment on the oral administration of EAHE mycelia in acute and prenatal developmental toxicity tests. At a single dose of 5000 mg/kg body weight, EAHE mycelia elicited no death or treatment-related signs of toxicity in ten Sprague-Dawley rats of both sexes during the 14 days of the experimental period. After considering the recommended dose range of EAHE mycelia from the acute toxicity test as well as the therapeutic doses, EAHE mycelia was administered to 66 pregnant rats in the low, medium, and high-dose groups by gavage at 875, 1750, and 2625 mg/kg body weight, respectively. All dams were subjected to a Caesarean section on the 20th day of pregnancy, and the fetuses were examined for any morphological abnormalities. Results indicated that weight of uterus, fetal body weight, number of corpora lutea, implantation sites, pre-implantation loss, and post-implantation loss of the treatment groups and the control group exhibited no statistical difference. In addition, no significant differences were observed in the fetal external, organ, and skeletal examinations. Taken together, it can be concluded that EAHE mycelia is considered safe and practically nontoxic for consumption within the appropriate doses and investigation period in this study.

  1. What Does the DAP:IQ Measure?: Drawing Comparisons between Drawing Performance and Developmental Assessments.

    Science.gov (United States)

    Rehrig, Gwendolyn; Stromswold, Karin

    2018-01-01

    Human figure drawing tasks such as the Draw-a-Person test have long been used to assess intelligence (F. Goodenough, 1926). The authors investigate the skills tapped by drawing and the risk factors associated with poor drawing. Self-portraits of 345 preschool children were scored by raters trained in using the Draw-a-Person Intellectual Ability test (DAP:IQ) rubric (C. R. Reynolds & J. A. Hickman, 2004). Analyses of children's fine motor, gross motor, social, cognitive, and language skills revealed that only fine motor skill was an independent predictor of DAP:IQ scores. Being a boy and having a low birth weight were associated with lower DAP:IQ scores. These findings suggest that although the DAP:IQ may not be a valid measure of cognitive ability, it may be a useful screening tool for fine motor disturbances in at-risk children, such as boys who were born at low birth weights. Furthermore, researchers who use human figure drawing tasks to measure intelligence should measure fine motor skill in addition to intelligence.

  2. Developmental assessment of the Fort St. Vrain version of the composite HTGR analysis program (CHAP-2)

    International Nuclear Information System (INIS)

    Stroh, K.R.

    1981-01-01

    The Composite HTGR Analysis Program (CHAP) consists of a model-independent systems analysis mainframe named LASAN and model-dependent linked code modules, each representing a component, subsystem, or phenomenon of an HTGR plant. The Fort St. Vrain version (CHAP-2) includes 21 coded modules that model the neutron kinetics and thermal response of the core; the thermal-hydraulics of the reactor primary coolant system, secondary steam supply system, and balance-of-plant; the actions of the control system and plant protection system; the response of the reactor building; and the relative hazard resulting from fuel particle failure. FSV steady-state and transient plant data are being used to partially verify the component modeling and dynamic simulation techniques used to predict plant response to postulated accident sequences. Results of these preliminary validation efforts are presented showing good agreement between code output and plant data for the portions of the code that have been tested. Plans for further development and assessment as well as application of the validated code are discussed. (author)

  3. The evaluation and adoption of annual legumes by smallholder maize farmers for soil fertility maintenance and food diversity in central Malawi

    NARCIS (Netherlands)

    Kamanga, B.C.G.; Kanyama-Phiri, G.Y.; Waddington, S.R.; Almekinders, C.J.M.; Giller, K.E.

    2014-01-01

    We studied the process of assessment and adoption of 10 grain- and green-manure legumes by smallholder maize farmers differing in resource endowment in Chisepo, central Malawi. The legumes had been promoted with the farmers from 1998 to 2004, primarily as a way to diversify food production and

  4. Analysis of Effectiveness of Modern Information and Communication Technologies on Maize Marketing Efficiency in Selected Markets of Malawi

    OpenAIRE

    Tione, S. E.; Katengeza, Samson P.; Mangisoni, Julius H.

    2013-01-01

    Developing countries have been promoting initiatives that aim at reducing information asymmetry among market players especially smallholder farmers. Using co-integration error correction models, the study assessed effectiveness of modern Information and Communication Technologies (ICT) based market interventions in improving maize market efficiency in Malawi. Considering that efficient markets are integrated markets when price difference is only a factor of transaction costs, Threshold Autore...

  5. Implementing electronic data capture at a well-established health and demographic surveillance site in rural northern Malawi

    OpenAIRE

    McLean, Estelle; Dube, Albert; Saul, Jacky; Branson, Keith; Luhanga, Mabvuto; Mwiba, Oddie; Kalobekamo, Fredrick; Geis, Steffen; Crampin, Amelia C

    2017-01-01

    ABSTRACT This article aims to assess multiple issues of resources, staffing, local opinion, data quality, cost, and security while transitioning to electronic data collection (EDC) at a long-running community research site in northern Malawi. Levels of missing and error fields, delay from data collection to availability, and average number of interviews per day were compared between EDC and paper in a complex, repeated annual household survey. Three focus groups with field and data staff with...

  6. An economic perspective on Malawi's medical "brain drain"

    Directory of Open Access Journals (Sweden)

    Mohiddin Abdu

    2006-12-01

    Full Text Available Abstract Background The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Discussion Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding. Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production" of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. Summary There is concern about the negative impacts of the medical "brain-drain". However a

  7. An economic perspective on Malawi's medical "brain drain"

    Science.gov (United States)

    Record, Richard; Mohiddin, Abdu

    2006-01-01

    Background The medical "brain drain" has been described as rich countries "looting" doctors and nurses from developing countries undermining their health systems and public health. However this "brain-drain" might also be seen as a success in the training and "export" of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. Discussion Many see this "brain drain" of medical staff as wrong with developed countries exploiting poorer ones. The effects are considerable with Malawi facing high vacancy rates in its public health system, and with migration threatening to outstrip training despite efforts to improve pay and conditions. This shortage of staff has made it more challenging for Malawi to deliver on its Essential Health Package and to absorb new international health funding. Yet, without any policy effort Malawi has been able to demonstrate its global competitiveness in the training ("production") of skilled health professionals. Remittances from migration are a large and growing source of foreign exchange for poor countries and tend to go directly to households. Whilst the data for Malawi is limited, studies from other poor countries demonstrate the power of remittances in significantly reducing poverty. Malawi can benefit from the export of health professionals provided there is a resolution of the situation whereby the state pays for training and the benefits are gained by the individual professional working abroad. Solutions include migrating staff paying back training costs, or rich host governments remitting part of a tax (e.g. income or national insurance) to the Malawi government. These schemes would allow Malawi to scale up training of health professionals for local needs and to work abroad. Summary There is concern about the negative impacts of the medical "brain-drain". However a closer look at the evidence

  8. Developmental Immunotoxicity

    Science.gov (United States)

    Animal models suggest that the immature immune system is more susceptible to xenobiotics than the fully mature system, and sequelae of developmental immunotoxicant exposure may be persistent well into adulthood. Immune maturation may be delayed by xenobiotic exposure and recover...

  9. Refractive errors, visual impairment, and the use of low-vision devices in albinism in Malawi.

    Science.gov (United States)

    Schulze Schwering, M; Kumar, N; Bohrmann, D; Msukwa, G; Kalua, K; Kayange, P; Spitzer, M S

    2015-04-01

    This study focuses on the refractive implications of albinism in Malawi, which is mostly associated with the burden of visual impairment. The main goal was to describe the refractive errors and to analyze whether patients with albinism in Malawi, Sub-Saharan Africa, benefit from refraction. Age, sex, refractive data, uncorrected and best-corrected visual acuity (UCVA, BCVA), colour vision, contrast sensitivity, and the prescription of sunglasses and low vision devices were collected for a group of 120 albino individuals with oculocutaneous albinism (OCA). Refractive errors were evaluated objectively and subjectively by retinoscopy, and followed by cycloplegic refraction to reconfirm the results. Best-corrected visual acuity (BCVA) was also assessed binocularly. One hundred and twenty albino subjects were examined, ranging in age from 4 to 25 years (median 12 years), 71 (59 %) boys and 49 (41 %) girls. All exhibited horizontal pendular nystagmus. Mean visual acuity improved from 0.98 (0.33) logMAR to 0.77 (0.15) logMAR after refraction (p < 0.001). The best improvement of VA was achieved in patients with mild to moderate myopia. Patients with albinism who were hyperopic more than +1.5 D hardly improved from refraction. With the rule (WTR) astigmatism was more present (37.5 %) than against the rule (ATR) astigmatism (3.8 %). Patients with astigmatism less than 1.5 D improved in 15/32 of cases (47 %) by 2 lines or more. Patients with astigmatism equal to or more than 1.5 D in any axis improved in 26/54 of cases (48 %) by 2 lines or more. Refraction improves visual acuity of children with oculocutaneous albinism in a Sub-Saharan African population in Malawi. The mean improvement was 2 logMAR units.

  10. Factors associated with milk producer's awareness and practices in relation to zoonoses in northern Malawi

    Directory of Open Access Journals (Sweden)

    Stanly Fon Tebug

    2013-10-01

    Full Text Available Background: Many diseases are known to be naturally transmissible between vertebrate animals, including cattle and humans. Currently, much effort is being made to promote dairy farming in Malawi but there is limited information about zoonotic diseases including public awareness and practices. This study was designed to determine factors associated with dairy producer's awareness and practices with regard to zoonoses in Northern Region of Malawi. Materials and Methods: A structured questionnaire was used to collect information from 140 randomly selected dairy producers between January and June 2011. Level of awareness and practices with respect to zoonotic infections was evaluated using a score ranging from 0 to 11. Chi-squared test followed by a multivariable logistic model were used to assess potential factors associated farmer's awareness and practices. Results: Awareness and practice level was unsatisfactory. Significantly higher number of respondents (75.7 vs. 32.9%,x2 = 51.81, df =1, p< 0.001 had satisfactory level of awareness when compared to those who practiced preventive measures. Awareness of the existence of zoonotic infections and practices was higher in farmers who acquired animals through loan (p =0.008, farmers with above primary education (p = 0.002 and farmers with more than six years of dairy farming experience (p= 0.010. Most farmers (59.3% received information about zoonoses through Agricultural extension services. Conclusion: Awareness and practices with respect to zoonotic infections was dependent on farmer's formal educational level, dairy farming experience and means of acquiring parent stock. Regular disease surveillance and promotion of education on the risk associated with zoonotic infections through dairy extension and medical services should result in increased awareness and efficient control of zoonoses in Malawi. [Vet World 2013; 6(5.000: 249-253

  11. The HIV Care Continuum among Female Sex Workers: A Key Population in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Kathryn Elizabeth Lancaster

    Full Text Available The HIV care continuum among female sex workers (FSW, a key population, has not been well characterized, especially within the generalized epidemics of sub-Saharan Africa. This was the first study to characterize the HIV care continuum among FSW in Lilongwe, Malawi.From July through September 2014, we used venue-based sampling to enroll 200 adult FSW in Lilongwe, Malawi into a cross-sectional evaluation assessing HIV care continuum outcomes. Seropositive FSW, identified using HIV rapid testing, received rapid CD4 counts in addition to viral loads using dried blood spots. We calculated proportions of HIV-infected FSW who had history of care, were on ART, and had suppressed viral load and we used Poisson regression to estimate the associations of demographic characteristics and transmission risk behaviors with each outcome.HIV seroprevalence was 69% (n = 138. Among all FSW the median age was 24 years (IQR: 22-28. Among the 20% who were newly diagnosed and reported previously testing negative, the median time since last HIV test was 11 months (interquartile range: 3-17. The majority (69% of HIV-infected FSW had a history of HIV care, 52% reported current ART use, and 45% were virally suppressed. Of the FSW who reported current ART use, 86% were virally suppressed. Transmission risk behaviors were not associated with continuum outcomes.FSW in Lilongwe were predominately young and have a high HIV prevalence. Only half of HIV-infected FSW reported current ART use, but the majority of those on ART were virally suppressed. To reduce ongoing transmission and improve health outcomes, increased HIV testing, care engagement, and ART coverage is urgently needed among FSW. Universal testing and treatment strategies for all FSW in Malawi must be strongly considered.

  12. Job satisfaction and retention of health-care providers in Afghanistan and Malawi.

    Science.gov (United States)

    Fogarty, Linda; Kim, Young Mi; Juon, Hee-Soon; Tappis, Hannah; Noh, Jin Won; Zainullah, Partamin; Rozario, Aleisha

    2014-02-17

    This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P job satisfaction (F(8,332) = 4.19; P job are highly dependent on the local context. Although health-care workers in both Afghanistan and Malawi reported satisfaction with their jobs, the predictors of satisfaction, and the extent to which those predictors explained variations in job satisfaction and intention to stay on the job, differed substantially. These findings demonstrate the need for more detailed comparative human resources for health-care research, particularly regarding the relative importance of different determinants of job satisfaction and intention to stay in different contexts and the effectiveness of interventions designed to improve health-care worker performance and retention.

  13. Developmental trajectories of infants and toddlers with good initial presentation following moderate or severe traumatic brain injury: a pilot clinical assessment project.

    Science.gov (United States)

    Pomerleau, Geneviève; Hurteau, Anne-Marie; Parent, Line; Doucet, Katrine; Corbin-Berrigan, Laurie-Ann; Gagnon, Isabelle

    2012-01-01

    The purpose of this study was to review the feasibility and usefulness of instituting a clinical protocol of scheduled assessments for children after a moderate or severe traumatic brain injury (TBI) sustained before the age of 2 years and showing no immediate deficits at hospital discharge, as well as to explore the early developmental trajectories of these children. Exploratory analytical cohort study. Pediatric Trauma Center Out-patient services. 31 children were followed within the clinical protocol of scheduled assessments. The protocol included an immediate post-injury clinical assessment of infants who sustained a TBI and follow-up assessments at the ages of 9 months, 18 months (if injured prior to that age), 30 months, and 42 months. Domains assessed at each scheduled visit included hearing, speech and language, motor performance, personal social abilities, and adaptive behaviors. Clinicians reported few difficulties with scheduling or administering the assessments, maintaining a 67% participation rate at the end of the follow-up period, thus demonstrating the feasibility of the protocol in this population. Scores on the majority of formal tests showed high variability and 15-20% of children presented with clinically significant motor and/or language delays. By 42 months of age, difficulties with adaptive behavior and personal social abilities were identified in our sample of children when compared to published norms. Qualitative clinical findings from professionals identified between 25-50% of children with potential attentional difficulties throughout the follow-up period. Findings from this study demonstrate the feasibility of implementing a clinical protocol of assessment for infants and toddlers who sustain a TBI before the age of 2 years and present with no impairments at the time of discharge from hospital. Developmental problems in this population appear to be easier to identify later in the toddler years as opposed to immediately following the TBI

  14. Forestry policy and woodfuel markets in Malawi

    International Nuclear Information System (INIS)

    Dewees, P.A.

    1995-01-01

    Forestry and energy policies in Malawi place the blame for the country's high rate of deforestation on the demand for woodfuel. The government has been involved in a range of questionable supply-side initiatives, as well as in a number of interventions in woodfuel markets, with the objective of slowing rates of deforestation. It seeks to encourage farmers to grow woodfuel to meet market demands, and has provided subsidies to do so. The Forest Department has kept prices for firewood from its plantations low, both in order to discourage the market for wood from free resources and because of concerns about the impact of high producer prices on the urban poor. In doing so, the government is less able to rely on the market to provide producers with the incentive to plant trees to meet market demands. In any event, the market accounts for a relatively small proportion of total woodfuel demand. Policies do not distinguish between rural household demands and the specific market demands which are having the greatest impact on deforestation: woodfuel for urban markets, for tobacco curring, and for small industries. These, coupled with the expansion of the estate sector, have had a far greater impact on woodland clearance than rural, subsistence woodfuel demands. Rural household energy demands need to be addressed from a much broader perspective which considers the household's larger needs for tree based products or outputs: income, food, fibre, fodder, soil fertility, as well as for fuel. (author). 24 refs, 3 figs, 2 tabs

  15. Remarkable rates of lightning strike mortality in Malawi.

    Science.gov (United States)

    Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

    2012-01-01

    Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.

  16. Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD): First psychometric evaluation of a new child and parenting assessment tool for children with a developmental disability.

    Science.gov (United States)

    Emser, Theresa S; Mazzucchelli, Trevor G; Christiansen, Hanna; Sanders, Matthew R

    2016-01-01

    This study examined the psychometric properties of the Child Adjustment and Parent Efficacy Scale-Developmental Disability (CAPES-DD), a brief inventory for assessing emotional and behavioral problems of children with developmental disabilities aged 2- to 16-years, as well as caregivers' self-efficacy in managing these problems. A sample of 636 parents participated in the study. Children's ages ranged from 2 to 15. Exploratory and confirmatory factor analyses supported a 21-item, three-factor model of CAPES-DD child adjustment with 13 items describing behavioral (10 items) and emotional (3 items) problems and 8 items describing prosocial behavior. Three additional items were included due to their clinical usefulness and contributed to a Total Problem Score. Factor analyses also supported a 16-item, one factor model of CAPES-DD self-efficacy. Psychometric evaluation of the CAPES-DD revealed scales had satisfactory to very good internal consistency, as well as very good convergent and predictive validity. The instrument is to be in the public domain and free for practitioners and researchers to use. Potential uses of the measure and implications for future validation studies are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. An Analysis of the Extent of Social Inclusion and Equity Consideration in Malawi's National HIV and AIDS Policy Review Process.

    Science.gov (United States)

    Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester

    2017-07-29

    Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. While the findings

  18. Assessing Emotional and Behavioral Problems in Children with Intellectual Disability: Revisiting the Factor Structure of the Developmental Behaviour Checklist.

    Science.gov (United States)

    Dekker, Marielle C.; Nunn, Russell J.; Einfeld, Stewart E.; Tonge, Bruce J.; Koot, Hans M.

    2002-01-01

    Analysis of parent and teacher Developmental Behavior Checklist (DBC) ratings on a combined sample of 1,536 Dutch and Australian children (ages 3-22) with mild to profound intellectual disabilities produced five subscales: Disruptive/Antisocial, Self-Absorbed, Communication Disturbance, Anxiety, and Social Relating. Internal consistency of the…

  19. Assessing the Quality of Life of Persons with Developmental Disabilities: Description of a New Model, Measuring Instruments, and Initial Findings.

    Science.gov (United States)

    Raphael, Dennis; And Others

    1996-01-01

    A conceptual model of quality of life, developed at the Centre for Health Promotion at the University of Toronto (Canada), and associated instrumentation for collecting data from persons with developmental disabilities are presented. Results from a preliminary study with 41 participants support the reliability and validity of the model's…

  20. Group-Based Preference Assessment for Children and Adolescents in a Residential Setting: Examining Developmental, Clinical, Gender, and Ethnic Differences

    Science.gov (United States)

    Volz, Jennifer L. Resetar; Cook, Clayton R.

    2009-01-01

    This study examines developmental, clinical, gender, and ethnic group differences in preference in residentially placed children and adolescents. In addition, this study considers whether residentially placed youth prefer stimuli currently being used as rewards as part of a campuswide token economy system and whether youth would identify preferred…

  1. Diagnostic yield of the comprehensive assessment of developmental delay/mental retardation in an institute of child neuropsychiatry.

    Science.gov (United States)

    Battaglia, A; Bianchini, E; Carey, J C

    1999-01-01

    The Consensus Conference of the American College of Medical Genetics has established guidelines regarding the evaluation of patients with mental retardation (MR) [Curry et al., Am. J. Med. Genet. 72:468-477, 1997]. They emphasized the high diagnostic utility of cytogenetic studies and of neuroimaging in certain clinical settings. However, data on the diagnostic yield of these studies in well-characterized populations of individuals with MR are scant. Majnemer and Shevell [J. Pediatr. 127:193-199, 1995] attained a diagnostic yield of 63%. However, this study included only 60 patients and the classification included pathogenetic and causal groups. The Stella Maris Institute has evaluated systematically patients with developmental delay (DD)/MR and performed various laboratory studies and neuroimaging in almost all patients. We report a retrospective analysis of the diagnostic yield of 120 consecutive patients observed at our Institute during the first 6 months of 1996. There were 77 males and 43 females; 47 were mildly delayed (IQ 70-50), 31 were moderately delayed (IQ 50-35), and 42 were severely delayed (IQ 35-20). Diagnostic studies (history, physical examination, standard cytogenetics, fragile X testing, molecular studies, electroencephalography, electromyography, nerve conduction studies, neuroimaging, and metabolic screening tests) yielded a causal diagnosis in 50 (41.6%) and a pathogenetic diagnosis in 47 (39.2%) of the 120 patients. Causal categories included chromosomal abnormalities (14), Fra(X) syndromes (4), known MCA/MR syndromes (19), fetal environmental syndromes (1), neurometabolic (3) disorders, neurocutaneous (3) disorders, hypoxic-ischemic encephalopathy (3), other encephalopathies (1), and congenital bilateral perisylvian syndrome (2). Pathogenetic categories included idiopathic MCA/MR syndromes (35), epileptic syndromes (10), and isolated lissencephaly sequence (2). Diagnostic yield did not differ across categories and degree of DD. Our results

  2. Prevalence and correlates of hunger among primary and secondary school children in Malawi: results from the 2009 Global School-based Health Survey.

    Science.gov (United States)

    Mwambene, J B; Muula, A S; Leo, J C

    2013-06-01

    Education is important in improving economies and creating literate, self-reliant and healthy societies. However, hunger is a barrier to basic education in Malawi. Hunger is also associated with a number of health risk behaviours, such as bullying, suicide ideation and unhygienic behaviours that may jeopardize the future of children. There are, however, limited data on the prevalence and associated factors of hunger among school children in Malawi. The study used data from the Malawi Global School-Based Health Survey conducted in 2009 to estimate the prevalence of self-reported hunger within the last 30 days among primary and secondary school age group. It also assessed the association between self-reported hunger and some selected list of independent variables using frequency distribution, chi-squared test and logistic regression. A total of 2359 students were available for analysis. The overall self-reported prevalence of hunger within the last 30 days was 12.5% (18.9% (172) in the rural and 8.3% (115) in urban areas; and 11.9%(123) for male and 12.5(148) for female children). In the final analysis, geographical location, eating fruits, having been bullied, suicide ideation, and washing hands with soap were significantly associated with hunger. Hunger in both primary and secondary school children in Malawi is a major social problem. The design of school feeding programmes aimed to reduce hunger should incorporate the factors identified as associated with hunger.

  3. Scaling up agroforestry farming systems: Lessons from the Malawi ...

    African Journals Online (AJOL)

    The study examined the factors affecting agroforestry technology upscaling and identified gaps in scaling up approaches of agroforestry technologies. One hundred and sixty-four farmers in Malawi Agroforestry Extension (MAFE) project districts of Mzimba, Ntcheu and Mangochi were interviewed. Logistic model was used in ...

  4. Exploring the ethical basis of animal treatment in Malawi

    African Journals Online (AJOL)

    City councils in Malawi have often considered shooting animals, especially .... believed that a hyena's tail makes people fall into a deep slumber and facilitates the .... Observing such animals performing acts akin to human beings helps us to love ... of indirect duties a human being who kills a dog belonging to someone or.

  5. Health spending, illicit financial flows and tax incentives in Malawi

    African Journals Online (AJOL)

    financing of health care services and a weak health system. Malawi is one of the ... and two-thirds of adults, who need antiretroviral treatment for HIV are ... health service delivery”4. There are two ... estimated the cost for the provision of minimal services .... However, the key issue is to differentiate between tax incentives that.

  6. Research On Human Immunodeficiency Virus (HIV) In Malawi: The ...

    African Journals Online (AJOL)

    The Johns Hopkins University- Ministry of Health OHU-MOH) Project ... HIV infection among low ... in Africa were infected with the virus; these women gave ... information and medical, repro(l1K;Y~ ;~d pregnancy ... white blood cell differentials were done with a ... Malawi are at increased risk during the postnatal period.

  7. malawi : tous les projets | Page 2 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sujet: HEALTH PERSONNEL, COOPERATION BETWEEN ORGANIZATIONS, TRAINING METHODS, TRAINING PROGRAMMES. Région: South of Sahara, Malawi, South Africa. Programme: Santé des mères et des enfants. Financement total : CA$ 307,640.00. Délégation des tâches en Afrique de l'Est : soins de la vue.

  8. Establishing a children's orthopaedic hospital for Malawi: A review ...

    African Journals Online (AJOL)

    At present the program has a total of 29 clinics, which .... Thus a total of 1154 paediatric orthopaedic operations were known to have taken place in Malawi during the 10th year of operational services with 53% of cases being performed at BCIH. ... regional hip replacement course, 1 regional knee replacement course for ...

  9. Life history traits of Bathyclarias nyasensis (Siluroidei) in Lake Malawi

    African Journals Online (AJOL)

    Life history traits, including age, growth, reproduction and diet of Bathyclarias nyasensis from Lake Malawi were studied between December 1996 and November 1998. Owing to reabsorp tion of pectoral spines with increasing fish size, and the relatively low number of spines that could be aged reliably, only otoliths were ...

  10. Cholera outbreak in districts around Lake Chilwa, Malawi: Lessons ...

    African Journals Online (AJOL)

    Cholera is endemic in Malawi with seasonal outbreaks during the wet season. People living around Lake Chilwa rely on the lake for their water supply. From May 2009 to May 2010, a cholera outbreak occurred in fishing communities around Lake Chilwa. This paper describes the outbreak response and lessons learned for ...

  11. Malawi Medical Journal - Vol 25, No 2 (2013)

    African Journals Online (AJOL)

    Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. NL Kalata, L Kamange, AS Muula, 50-52 ...

  12. Village health volunteers: key issues facing agencies in Malawi ...

    African Journals Online (AJOL)

    The participants discussed recruitment, training, rewards, retention, and roles of village health volunteers. This paper presents background data on village health volunteers in Malawi and elsewhere and reviews the key issues facing health care providers in working with village health volunteers. A copy of the workshop ...

  13. Avifauna of Vwaza Marsh Wildlife Reserve, Malawi | Engel | Journal ...

    African Journals Online (AJOL)

    Despite having a well-documented avifauna, some areas of Malawi, such as Vwaza Marsh Wildlife Reserve (986 km²), are still poorly known ornithologically. We spent 12 days in October 2009, before the wet season, and two days in November 2009, after the first rains, documenting the birds of Vwaza. We found six new ...

  14. Creating digital library collections: the experience of Malawi ...

    African Journals Online (AJOL)

    Activities around the creation of digital library collections in Malawi libraries started after some librarians attended workshops on the subject both within and outside the country. Major challenges to these projects include inadequate technical expertise and equipment, lack of OCR software, inappropriate copyright law, and ...

  15. Oesophageal cancer and Kaposi's Sarcoma in Malawi: a ...

    African Journals Online (AJOL)

    Given that oesophageal cancer (OC) is common in Malawi and its outcome is so dismal, would it be pragmatic to promptly mitigate the effects of smoking, alcohol and aflatoxins rather than seek a higher degree of local evidence for their role in OC? We retrospectively analysed a total of 13,217 OC and. Kaposi's sarcoma ...

  16. Factors associated with delayed Antenatal Care attendance in Malawi

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    1. Centre for Bioethics in Eastern and Southern Africa (CEBESA),. University of ... researchers found three main barriers to care, namely: (a) ... Malawi: (a) lack of interaction with health workers, (b) .... ah, this time we don't have schedules but we are planning ... three topics of six food groups, three topics maybe of birth.

  17. Maternal biomass smoke exposure and birth weight in Malawi ...

    African Journals Online (AJOL)

    We, therefore, investigated effects of exposure to biomass fuels on reduced birth weight in the Malawian population. Methods: We conducted a cross-sectional analysis using secondary data from the 2010 Malawi Demographic Health Survey with a total of 9124 respondents. Information on exposure to biomass fuels, ...

  18. Kenya-Malawi Health Research Capacity Strengthening Initiative ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This grant will support the creation of two task forces in Kenya and Malawi, respectively, to articulate nationally owned and strategies for an effective health research system in each country. The idea is to enhance the capacity of health research institutions to generate new scientific knowledge, and health policymaking ...

  19. Commentary - Cancer and palliative care | Chan | Malawi Medical ...

    African Journals Online (AJOL)

    'The rise of cancer in less affluent countries is an impending disaster' Malawi Medical Journal Vol. 20 (4) 2008: pp. 108-108. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i4.10978 · AJOL African Journals Online. HOW TO ...

  20. Palliative care; what do you really mean? | Mackriell | Malawi ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  1. Palliative care in Salima district | Finch | Malawi Medical Journal

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  2. Commentary - Cancer and palliative care | Chan | Malawi Medical ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  3. Interview with two palliative care nurses | Crutchlow | Malawi ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 4 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  4. Malawi Medical Journal - Vol 30, No 1 (2018)

    African Journals Online (AJOL)

    Perceptions of a mobile health intervention for Community Case Management in Malawi: Opportunities and challenges for Health Surveillance Assistants in a ... Relationship between tumour size and response to neoadjuvant chemotherapy among breast cancer patients in a tertiary center in Nigeria · EMAIL FREE FULL ...

  5. Motivation of health surveillance assistants in Malawi: A qualitative ...

    African Journals Online (AJOL)

    Background: Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of ...

  6. Better processing and marketing of healthy fish products in Malawi

    International Development Research Centre (IDRC) Digital Library (Canada)

    : small fish, in particular, are a vital source of calcium, vi- tamin A, iron, and zinc. Once caught, most fish are sun-dried, smoked, parboiled, or pan roasted. However, peak fish catches in Malawi coincide with seasonal rains and high humidity,.

  7. Reproductive decisions of couples living with HIV in Malawi: What ...

    African Journals Online (AJOL)

    policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for ... reflect the social cultural experiences of couples living with HIV. In addition, there is ... then, treatment is available free of charge in the public hospital facilities. ... started implementing an integrated antiretroviral / PMTCT programme ...

  8. Exploring the ethical basis of animal treatment in Malawi | Kayange ...

    African Journals Online (AJOL)

    The paper argues that the maltreatment/cruelty and destruction of animals common in Malawi is rooted in an African form of utilitarian ethics and a biased conception of animals that is promoted by Umunthu/Ubuntu ethical discourse. It explores the possibility of developing or discovering a moral ground for animal ethics ...

  9. Determinants of vaccination coverage in Malawi: Evidence from the ...

    African Journals Online (AJOL)

    has been decreasing: it was 67% in 1992, then 55%, 54% and 51% in 1996, 2000 and 2004, respectively. The review has also shown that birth order of the child, residence (rural/ urban) and mother's education are major determinants of the immunization status of the child. Malawi Medical Journal Biology Vol. 19 (2) 2007: ...

  10. Determinants Of Vaccination Coverage In Malawi: Evidence From ...

    African Journals Online (AJOL)

    also shown that birth order of the child, residence (rural/ urban) and mother's education are major determinants of the immunization status of the child. Introduction. Vaccination has been practised in Malawi since the arrival of the missionaries and colonial administrators. While these vaccinations were taking place, ...

  11. Malawi Medical Journal - Vol 10, No 1 (1994)

    African Journals Online (AJOL)

    Research on human immunodeficiency virus (HIV) in Malawi: the Johns Hopkins University- Ministry of Health (JHU-MOH) project · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. TE Taha, JK Canner, AM Wangel, JD Chiphangwi, NG Liomba, PG Miotti, GA Dallabetta ...

  12. Malawi Medical Journal - Vol 14, No 2 (2002)

    African Journals Online (AJOL)

    Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. R Zachariah, AD Harries, MP Spielmann, V Arendt, D Nchingula, ...

  13. Malawi Medical Journal - Vol 26, No 3 (2014)

    African Journals Online (AJOL)

    Presentation of Primary Open Angle Glaucoma (POAG) at Lions Sight First Eye Hospital in Blantyre, Malawi · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. PC Kayange, HB Nkume, A Feyi-Waboso, K Kalua, G Msukwa, M Schwering Schulze, 60-62 ...

  14. Molecular characterisation of Musa L. cultivars cultivated in Malawi ...

    African Journals Online (AJOL)

    enoh

    2012-03-01

    Mar 1, 2012 ... five plants (individuals) growing next to each other were collected representing each ... and Ecology Research Unit, DNA laboratory in Zomba, Malawi for analysis. ..... diversity in this case would be due to self pollination and inbreeding .... including the long-term evolutionary history of the species. (shifts in ...

  15. A medical career in Malawi – personal reflections

    African Journals Online (AJOL)

    After spending 30 of the last 40 years working in Malawi's health service, I am ... the infection in women attending the antenatal clinic, for example, rising from 0% .... possible exception of North Korea, that attempts to move forward on its own.

  16. Erasmus, Syphilis and the abuse of stigma | Whitty | Malawi Medical ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 13, No 1 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  17. Ward Round - a boy with multiple joint swellings | Tickell | Malawi ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 3 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  18. Ward Round - a boy with multiple joint swellings | Tickell | Malawi ...

    African Journals Online (AJOL)

    Ward Round - a boy with multiple joint swellings. D Tickell. Abstract. No Abstract Malawi Medical Journal Vol. 20 (3) 2008: pp. 99-100. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i3.10968 · AJOL African Journals Online.

  19. Malawi faith communities responding to HIV/AIDS: preliminary ...

    African Journals Online (AJOL)

    This paper reports on the preliminary findings (year one) of a four-year intervention and participatory-action research (PAR) project in Malawi. Project goals are to enhance the response capacity and effectiveness of faith community (FC) leaders to the problem of HIV/AIDS. Ethnographic interviews with FC leaders were ...

  20. Menstruation and School Absenteeism: Evidence from Rural Malawi

    Science.gov (United States)

    Grant, Monica; Lloyd, Cynthia; Mensch, Barbara

    2013-01-01

    The provision of toilets and menstrual supplies appears to be a promising strategy to promote adolescent girls' school attendance and performance in less developed countries. In this article, we use the first round of the Malawi Schooling and Adolescent Survey (MSAS) to examine the individual- and school-level factors associated with…

  1. Measuring Institutions: Indicators of Political and Property Rights in Malawi

    Science.gov (United States)

    Fedderke, Johannes; Garlick, Julia

    2012-01-01

    This paper constructs a new set of institutional indicators for Malawi. We develop indicators of political rights, of freehold, traditional (communitarian) and intellectual property rights, based on the Malawian legislative framework. In exploring the association between our rights measures and a range of indicators of socio-economic development,…

  2. Magnetic Resonance Imaging in Malawi: Contributions to Clinical ...

    African Journals Online (AJOL)

    Advanced medical imaging technologies are generally unavailable in low income, tropical settings despite the reality that neurologic disorders are disproportionately common in such environments. Through a series of donations as well as extramural research funding support, an MRI facility opened in Blantyre, Malawi in ...

  3. Where Did it Go Wrong? Marriage and Divorce in Malawi

    NARCIS (Netherlands)

    L. Cherchye (Laurens); B. de Rock (Bram); S. Walther (Selma); F. Vermeulen (Frederic)

    2016-01-01

    textabstractDo individuals divorce for economic reasons? Can we measure the attractiveness of new matches in the marriage market? We answer these questions using a structural model of the household and a rich panel dataset from Malawi. We propose a model of the household with consumption, production

  4. Case Report: Ward Round - A football injury? | Freeman | Malawi ...

    African Journals Online (AJOL)

    No Abstract Malawi Medical Journal Vol. 20 (1) 2008 pp. 23. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/mmj.v20i1.10952 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

  5. Case Report: Ward Round - A football injury? | Freeman | Malawi ...

    African Journals Online (AJOL)

    Malawi Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 20, No 1 (2008) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  6. Anticipatory child fostering and household economic security in Malawi

    Directory of Open Access Journals (Sweden)

    Lauren Bachan

    2014-04-01

    Full Text Available Background: While there is a rich literature on the practice of child fostering in sub-Saharan Africa, little is known about how fostering impacts receiving households, as few studies consider household conditions both before and after fostering. Despite the fact that circumstancessurrounding fostering vary, the literature's key distinction of fostering is often drawn along the simple line of whether or not a household is fostering a child. This paper argues that anticipation of fostering responsibilities, in particular, is a useful dimension to distinguish fostering experiences for receiving households. Objective: This paper examines the relationship between receiving a foster child and subsequent changes in household wealth. Particular emphasis is placed on how these changes are conditioned by differing levels of anticipation of the fostering event. Methods: This study uses data from Tsogolo la Thanzi (TLT, a longitudinal survey in Balaka, Malawi. Using data from 1754 TLT respondents, fixed effects pooled time-series models are estimated to assess whether and how receiving a foster child changes household wealth. Results: This paper demonstrates the heterogeneity of fostering experiences for receiving households.The results show that households that anticipate fostering responsibilities experience a greater increase in household wealth than both households that do not foster and those that are surprised by fostering. Conclusions: Households that anticipate fostering responsibilities exhibit the greatest increase in householdwealth. While fostering households that do not anticipate fostering responsibilities may not experience these gains, there is no evidence to indicate that such households are negatively impacted relative to households that do not foster. This finding suggests that additional childcare responsibilities may not be as detrimental to African households as some researchers have feared.

  7. Comments from the Developmental Neurotoxicology Committee of the Japanese Teratology Society on the OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426, Developmental Neurotoxicity Study, Draft Document (October 2006 version), and on the Draft Document of the Retrospective Performance Assessment of the Draft Test Guideline 426 on Developmental Neurotoxicity.

    Science.gov (United States)

    Ema, Makoto; Fukui, Yoshihiro; Aoyama, Hiroaki; Fujiwara, Michio; Fuji, Junichiro; Inouye, Minoru; Iwase, Takayuki; Kihara, Takahide; Oi, Akihide; Otani, Hiroki; Shinomiya, Mitsuhiro; Sugioka, Kozo; Yamano, Tsunekazu; Yamashita, Keisuke H; Tanimura, Takashi

    2007-06-01

    In October 2006, a new revision of the draft guideline (OECD Guideline for the Testing of Chemicals, Proposal for a New Guideline 426. Developmental Neurotoxicity Study) and Draft Document of the Retrospective Performance Assessment (RPA) of the Draft Test Guideline 426 on Developmental Neurotoxicity were distributed following incorporation of the results of the Expert Consultation Meeting in Tokyo on May 24-26, 2005. The draft guideline consists of 50 paragraphs and an appendix with 102 references; and the draft RPA consists of 37 paragraphs with 109 references. National coordinators were requested to arrange for national expert reviews of these draft documents in their member countries. Members of the Developmental Neurotoxicology (DNT) Committee of the Japanese Teratology Society (JTS) reviewed, discussed, and commented on the draft Test Guideline Proposal. The DNT Committee of the JTS also commented on the draft document of the RPA. These comments were sent to the OECD Secretariat. The DNT Committee of the JTS expects the comments to be useful for the finalization of these draft documents.

  8. Developmental Scaffolding

    DEFF Research Database (Denmark)

    Giorgi, Franco; Bruni, Luis Emilio

    2015-01-01

    . Within the developmental hierarchy, each module yields an inter-level relationship that makes it possible for the scaffolding to mediate the production of selectable variations. Awide range of genetic, cellular and morphological mechanisms allows the scaffolding to integrate these modular variations...... to the complexity of sign recognition proper of a cellular community. In this semiotic perspective, the apparent goal directness of any developmental strategy should no longer be accounted for by a predetermined genetic program, but by the gradual definition of the relationships selected amongst the ones...

  9. Developmental Education Evaluation Model.

    Science.gov (United States)

    Perry-Miller, Mitzi; And Others

    A developmental education evaluation model designed to be used at a multi-unit urban community college is described. The purpose of the design was to determine the cost effectiveness/worth of programs in order to initiate self-improvement. A needs assessment was conducted by interviewing and taping the responses of students, faculty, staff, and…

  10. Social networks, social participation, and health among youth living in extreme poverty in rural Malawi.

    Science.gov (United States)

    Rock, Amelia; Barrington, Clare; Abdoulayi, Sara; Tsoka, Maxton; Mvula, Peter; Handa, Sudhanshu

    2016-12-01

    Extensive research documents that social network characteristics affect health, but knowledge of peer networks of youth in Malawi and sub-Saharan Africa is limited. We examine the networks and social participation of youth living in extreme poverty in rural Malawi, using in-depth interviews with 32 youth and caregivers. We describe youth's peer networks and assess how gender and the context of extreme poverty influence their networks and participation, and how their networks influence health. In-school youth had larger, more interactive, and more supportive networks than out-of-school youth, and girls described less social participation and more isolation than boys. Youth exchanged social support and influence within their networks that helped cope with poverty-induced stress and sadness, and encouraged protective sexual health practices. However, poverty hampered their involvement in school, religious schools, and community organizations, directly by denying them required material means, and indirectly by reducing time and emotional resources and creating shame and stigma. Poverty alleviation policy holds promise for improving youth's social wellbeing and mental and physical health by increasing their opportunities to form networks, receive social support, and experience positive influence. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Trace elements geochemistry of fractured basement aquifer in southern Malawi: A case of Blantyre rural

    Science.gov (United States)

    Mapoma, Harold Wilson Tumwitike; Xie, Xianjun; Nyirenda, Mathews Tananga; Zhang, Liping; Kaonga, Chikumbusko Chiziwa; Mbewe, Rex

    2017-07-01

    In this study, twenty one (21) trace elements in the basement complex groundwater of Blantyre district, Malawi were analyzed. The majority of the analyzed trace elements in the water were within the standards set by World Health Organization (WHO) and Malawi Standards Board (MSB). But, iron (Fe) (BH16 and 21), manganese (Mn) (BH01) and selenium (Se) (BH02, 13, 18, 19 and 20) were higher than the WHO and MSB standards. Factor analysis (FA) revealed up to five significant factors which accounted for 87.4% of the variance. Factor 1, 2 and 3 suggest evaporite dissolution and silicate weathering processes while the fourth factor may explain carbonate dissolution and pH influence on trace element geochemistry of the studied groundwater samples. According to PHREEQC computed saturation indices, dissolution, precipitation and rock-water-interaction control the levels of trace elements in this aquifer. Elevated concentrations of Fe, Mn and Se in certain boreholes are due to the geology of the aquifer and probable redox status of groundwater. From PHREEQC speciation results, variations in trace element species were observed. Based on this study, boreholes need constant monitoring and assessment for human consumption to avoid health related issues.

  12. Understanding job satisfaction amongst mid-level cadres in Malawi: the contribution of organisational justice.

    Science.gov (United States)

    McAuliffe, Eilish; Manafa, Ogenna; Maseko, Fresier; Bowie, Cameron; White, Emma

    2009-05-01

    The migration of doctors and nurses from low- to high-income countries has left many countries relying on mid-level cadres as the mainstay of their health delivery system, Malawi being an example. Although an extremely important resource, little attention has been paid to the management and further development of these cadres. In this paper we use the concept of organisational justice - fairness of treatment, procedures and communication on the part of managers - to explore through a questionnaire how mid-level cadres in jobs traditionally done by higher-level cadres self-assessed their level of job satisfaction. All mid-level health workers present on the day of data collection in 34 health facilities in three health districts of Malawi, one district each from the three geographical regions, were invited to participate; 126 agreed. Perceptions of justice correlated strongly with level of job satisfaction, and in particular perceptions of how well they were treated by their managers and the extent to which they were informed about decisions and changes. Pay was not the only important element in job satisfaction; promotion opportunities and satisfaction with current work assignments were also significant. These findings highlight the important role that managers can play in the motivation, career development and performance of mid-level health workers.

  13. Job satisfaction and retention of health-care providers in Afghanistan and Malawi

    Science.gov (United States)

    2014-01-01

    Background This study describes job satisfaction and intention to stay on the job among primary health-care providers in countries with distinctly different human resources crises, Afghanistan and Malawi. Methods Using a cross-sectional design, we enrolled 87 health-care providers in 32 primary health-care facilities in Afghanistan and 360 providers in 10 regional hospitals in Malawi. The study questionnaire was used to assess job satisfaction, intention to stay on the job and five features of the workplace environment: resources, performance recognition, financial compensation, training opportunities and safety. Descriptive analyses, exploratory factor analyses for scale development, bivariate correlation analyses and bivariate and multiple linear regression analyses were conducted. Results The multivariate model for Afghanistan, with demographic, background and work environment variables, explained 23.9% of variance in job satisfaction (F(9,73) = 5.08; P job satisfaction. The multivariate model for intention to stay for Afghanistan explained 23.6% of variance (F(8,74) = 4.10; P job satisfaction (F(8,332) = 4.19; P job satisfaction and intention to stay on the job, differed substantially. These findings demonstrate the need for more detailed comparative human resources for health-care research, particularly regarding the relative importance of different determinants of job satisfaction and intention to stay in different contexts and the effectiveness of interventions designed to improve health-care worker performance and retention. PMID:24533615

  14. The developmental stages of the middle phalanx of the third finger (MP3): a sole indicator in assessing the skeletal maturity?

    Science.gov (United States)

    Madhu, S; Hegde, Amitha M; Munshi, A K

    2003-01-01

    Assessment of skeletal maturity is an integral part of interceptive diagnosis and treatment planning. The present day methods of skeletal maturity assessment like the hand-wrist radiographs or cervical vertebrae radiographs are expensive, require elaborate equipment and accounts for high radiation exposure, especially for growing children. The present study was thus undertaken to provide a simple and practical method of skeletal maturity assessment using the developmental stages of the middle phalanx of the third finger (MP3) as seen on an IOPA film taken using a standard dental x-ray machine. The results of the study showed that this simple method was highly reliable and could be used as an alternative method to assess the skeletal maturity of growing children.

  15. RELAP5-3D Developmental Assessment: Comparison of Versions 4.2.1i and 4.1.3i

    Energy Technology Data Exchange (ETDEWEB)

    Bayless, Paul D. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-06-01

    Figures have been generated comparing the parameters used in the developmental assessment of the RELAP5-3D code using versions 4.2.1i and 4.1.3i. The figures, which are the same as those used in Volume III of the RELAP5-3D code manual, compare calculations using the semi-implicit solution scheme with available experiment data. These figures provide a quick, visual indication of how the code predictions changed between these two code versions and can be used to identify cases in which the assessment judgment may need to be changed in Volume III of the code manual. Changes to the assessment judgments made after reviewing all of the assessment cases are also provided.

  16. Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance

    Directory of Open Access Journals (Sweden)

    Makoka Mwai H

    2012-03-01

    Full Text Available Abstract Background Life-threatening infections present major challenges for health systems in Malawi and the developing world because routine microbiologic culture and sensitivity testing are not performed due to lack of capacity. Use of empirical antimicrobial therapy without regular microbiologic surveillance is unable to provide adequate treatment in the face of emerging antimicrobial resistance. This study was conducted to determine antimicrobial susceptibility patterns in order to inform treatment choices and generate hospital-wide baseline data. Methods Culture and susceptibility testing was performed on various specimens from patients presenting with possible infectious diseases at Kamuzu Central Hospital, Lilongwe, Malawi. Results Between July 2006 and December 2007 3104 specimens from 2458 patients were evaluated, with 60.1% from the adult medical service. Common presentations were sepsis, meningitis, pneumonia and abscess. An etiologic agent was detected in 13% of patients. The most common organisms detected from blood cultures were Staphylococcus aureus, Escherichia coli, Salmonella species and Streptococcus pneumoniae, whereas Streptococcus pneumoniae and Cryptococcus neoformans were most frequently detected from cerebrospinal fluid. Haemophilus influenzae was rarely isolated. Resistance to commonly used antibiotics was observed in up to 80% of the isolates while antibiotics that were not commonly in use maintained susceptibility. Conclusions There is widespread resistance to almost all of the antibiotics that are empirically used in Malawi. Antibiotics that have not been widely introduced in Malawi show better laboratory performance. Choices for empirical therapy in Malawi should be revised accordingly. A microbiologic surveillance system should be established and prudent use of antimicrobials promoted to improve patient care.

  17. Variability in developmental timings of the knee in young American children as assessed through Pyle and Hoerr's radiographic atlas.

    Science.gov (United States)

    Schaefer, Maureen; Hackman, Lucina; Gallagher, John

    2016-03-01

    This study examines the accuracy of the Pyle and Hoerr radiographic atlas technique in an effort to document the extent of normal variation associated with developmental timings in the knee for purposes of age estimation. The atlas has been previously tested; however, accuracy rates were produced from a dataset, which spread in age from mostly 7-16 years. This study took a closer look at the younger age groups, examining radiographs from 297 children (147 female and 150 male) from birth to 6 years. Standard deviations representing the difference between the skeletal and chronological age were calculated according to two groupings. Each group represents episodes, or time periods, of differential developmental rates as expressed through the number of plates within the atlas dedicated to documenting each year of life. The beginning year of life is characterized by the most rapid of development as represented by the numerous image plates used to depict this time period. Individuals assigned to plates with a skeletal age between birth and 1 year were grouped collectively to document the variation associated with such rapidly changing morphology (SD = 2.5 months in female children; 2.3 months in male children). Years 1-3.8 years (female) and 1-4.5 years (male) were represented by two or three images within the atlas, and therefore, individuals assigned to plates with a skeletal age falling within this range were placed within a second grouping (SD = 5.2 months in female children; 7.0 months in male children). As expected, variation was observed to decrease as developmental processes accelerated in the younger children. The newly calculated standard deviations offer tighter predictions for estimating age in young children while at the same time maintaining an acceptable width that accounts for normal variation in developmental timings.

  18. Assessment of recent developmental immunotoxicity studies with bisphenol A in the context of the 2015 EFSA t-TDI

    Science.gov (United States)

    Hessel, Ellen V.S.; Ezendam, Janine; van Broekhuizen, Fleur A.; Hakkert, Betty; DeWitt, Jamie; Granum, Berit; Guzylack, Laurence; Lawrence, B. Paige; Penninks, Andre; Rooney, Andrew A.; Piersma, Aldert H.; van Loveren, Henk

    2017-01-01

    Summary Humans are exposed to bisphenol A (BPA) mainly through the diet, air, dust, skin contact and water. There are concerns about adverse health effects in humans due to exposure to bisphenol A (BPA). The European Food Safety Authority (EFSA) has extensively reviewed the available literature to establish a temporary Tolerable Daily Intake (t-TDI). This exposure level was based on all available literature published before the end of 2012. Since then, new experimental animal studies have emerged, including those that identified effects of BPA on the immune system after developmental exposure. These studies indicate that developmental immunotoxicity might occur at lower dose levels than previously observed and on which the current EFSA t-TDI is based. The Dutch National Institute for Public Health and the Environment (RIVM) organized an expert workshop in September 2015 to consider recently published studies on the developmental immunotoxicity of bisphenol A (BPA). Key studies were discussed in the context of other experimental studies. The workshop concluded that these new experimental studies provide credible evidence for adverse immune effects after developmental exposure to BPA at 5 μg/kg BW/day from gestation day 15 to postnatal day 21. Supportive evidence for adverse immune effects in similar dose ranges was obtained from other publications that were discussed during the workshop. The dose level associated with adverse immune effects is considerably lower than the dose used by EFSA for deriving the t-TDI. The workshop unanimously concluded that the current EFSA t-TDI warrants reconsideration in the context of all currently available data. PMID:27352639

  19. Developmental Work

    DEFF Research Database (Denmark)

    Møller, Niels; Hvid, Helge; Kristensen, Tage Søndergaard

    2003-01-01

    Human Deveoplment and Working Life - Work for Welfare explores whether the development of human resources at company level can improve individuals' quality of life, companies' possibilities of development, and welfare and democracy in society. Chapter two discuss the concept "developmental work...

  20. Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

    Science.gov (United States)

    Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

    2013-01-01

    this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics

  1. The experience of HIV reactive patients in rural Malawi - Part I

    Directory of Open Access Journals (Sweden)

    Y Sliep

    2001-09-01

    Full Text Available Malawi has a population of 9 million people with AIDS the leading cause of death in the 20 - 40 age group. The HIV positive prevalence rate, estimated at 23% in urban areas and 8% in rural areas, is one of the highest in the world (AIDSEC, 1994:1. Evaluation of counselling practices showed poor results with counsellors feeling ineffective and inadequate. Patients are mostly tested on medical indication but patients who do not see the benefit of knowing their HIV status increasingly refuse testing. The counselling practise as it is known in the Western world is a foreign concept for patients living in rural Malawi. The high stigma of AIDS complicates support of the patients. The goal of the research study was to describe a model of counselling that would meet the needs of an AIDS patient in rural community in Malawi. A qualitative research design that was explorative, descriptive and contextually specific to rural Malawi was used for the study. In order to describe a counselling model it was important to understand the illness experience of HIV reactive patients. The patients are seen in group context congruent with the African culture and therefore the experience of the primary care giver of AIDS patients is explored as the other major factor in the phenomenon examined. One phase of the research is described in this article namely exploring and describing the experience of the HIV reactive patient in rural Malawi. Results show that patients are in an advanced stage of AIDS when they are diagnosed and complain of weakness and an inability to do work, including an inability to do their daily chores. This causes a feeling of desperateness that is worsened by the perception that support systems are inadequate. Support systems are mostly identified as parents, partners and siblings to assist mainly with the physical care and financial support. Despite the fact that the family is very important to patients there is a reluctance to acknowledge their

  2. Use of the Bayley Scales of Infant and Toddler Development, Third Edition, to Assess Developmental Outcome in Infants and Young Children in an Urban Setting in South Africa.

    Science.gov (United States)

    Ballot, Daynia E; Ramdin, Tanusha; Rakotsoane, David; Agaba, Faustine; Davies, Victor A; Chirwa, Tobias; Cooper, Peter A

    2017-01-01

    The Bayley Scales of Infant and Toddler Development (III) is a tool developed in a Western setting. To evaluate the development of a group of inner city children in South Africa with no neonatal risk factors using the Bayley Scales of Infant and Toddler Development (III), to determine an appropriate cut-off to define developmental delay, and to establish variation in scores done in the same children before and after one year of age. Cohort follow-up study. 74 children had at least one Bayley III assessment at a mean age of 19.4 months (95% CI 18.4 to 20.4). The mean composite cognitive score was 92.2 (95% CI 89.4 to 95.0), the mean composite language score was 94.8 (95% CI 92.5 to 97.1), and mean composite motor score was 98.8 (95% CI 96.8 to 101.0). No child had developmental delay using a cut-off score of 70. In paired assessments above and below one year of age, the cognitive score remained unchanged, the language score decreased significantly ( p = 0.001), and motor score increased significantly ( p = 0.004) between the two ages. The Bayley Scales of Infant and Toddler Development (III) is a suitable tool for assessing development in urban children in southern Africa.

  3. Socially disempowered women as the key to addressing change in Malawi: how do they do it?

    Science.gov (United States)

    Macintyre, Linda M; Rankin, Sally; Pinderhughes, Howard; Waters, Catherine M; Schell, Ellen; Fiedler, Rachel

    2013-01-01

    Malawi women are in the ironic juxtaposition of being socially disempowered while, at the same time, thought to hold the key to shaping an effective community response to the HIV crisis. Based on this juxtaposition, a descriptive, qualitative study was conducted in Malawi and the United States where 26 participants from nongovernmental organizations (NGOs) and community-based organizations (CBOs) discussed the roles of Malawi women. Interviews were audiotaped, transcribed, and analyzed. We identified an improvement in women's economic status as the strongest factor in reducing gender inequities. Through providing stipends for rural Malawi women, one NGO created unintended changes in gender roles.

  4. Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi.

    Science.gov (United States)

    Msyamboza, Kelias Phiri; M'bang'ombe, Maurice; Hausi, Hannah; Chijuwa, Alexander; Nkukumila, Veronica; Kubwalo, Hudson Wenji; Desai, Sachin; Pezzoli, Lorenzo; Legros, Dominique

    2016-01-01

    Despite some improvement in provision of safe drinking water, proper sanitation and hygiene promotion, cholera still remains a major public health problem in Malawi with outbreaks occurring almost every year since 1998. In response to 2014/2015 cholera outbreak, ministry of health and partners made a decision to assess the feasibility and acceptability of conducting a mass oral cholera vaccine (OCV) as an additional public health measure. This paper highlights the burden of the 2014/15 cholera outbreak, successes and challenges of OCV campaign conducted in March and April 2015. This was a documentation of the first OCV campaign conducted in Malawi. The campaign targeted over 160,000 people aged one year or more living in 19 camps of people internally displaced by floods and their surrounding communities in Nsanje district. It was a reactive campaign as additional measure to improved water, sanitation and hygiene in response to the laboratory confirmed cholera outbreak. During the first round of the OCV campaign conducted from 30 March to 4 April 2015, a total of 156,592 (97.6%) people out of 160,482 target population received OCV. During the second round (20 to 25 April 2015), a total of 137,629 (85.8%) people received OCV. Of these, 108,247 (67.6%) people received their second dose while 29,382 (18.3%) were their first dose. Of the 134,836 people with known gender and sex who received 1 or 2 doses, 54.4% were females and over half (55.4%) were children under the age of 15 years. Among 108,237 people who received 2 doses (fully immunized), 54.4% were females and 51.9% were children under 15 years of age. No severe adverse event following immunization was reported. The main reason for non-vaccination or failure to take the 2 doses was absence during the period of the campaign. This documentation has demonstrated that it was feasible, acceptable by the community to conduct a large-scale mass OCV campaign in Malawi within five weeks. Of 320,000 OCV doses received

  5. The Management of Developmental Apraxia.

    Science.gov (United States)

    Gubbay, S. S.

    1978-01-01

    Of 39 children (5-12 years old) with developmental apraxia and agnosia, who were assessed neurologically, 19 were also given simple standarized tests of motor ability. Journal availability: see EC 112 661. (Author/SBH)

  6. Barriers to Uptake of Conservation Agriculture in southern Africa: Multi-level Analyses from Malawi

    Science.gov (United States)

    Dougill, Andrew; Stringer, Lindsay; Whitfield, Stephen; Wood, Ben; Chinseu, Edna

    2015-04-01

    Conservation agriculture is a key set of actions within the growing body of climate-smart agriculture activities being advocated and rolled out across much of the developing world. Conservation agriculture has purported benefits for environmental quality, food security and the sustained delivery of ecosystem services. In this paper, new multi-level analyses are presented, assessing the current barriers to adoption of conservation agriculture practices in Malawi. Despite significant donor initiatives that have targeted conservation agriculture projects, uptake rates remain low. This paper synthesises studies from across 3 levels in Malawi: i.) national level- drawing on policy analysis, interviews and a multi-stakeholder workshop; ii.) district level - via assessments of development plans and District Office and extension service support, and; iii) local level - through data gained during community / household level studies in Dedza District that have gained significant donor support for conservation agriculture as a component of climate smart agriculture initiatives. The national level multi-stakeholder Conservation Agriculture workshop identified three areas requiring collaborative research and outlined routes for the empowerment of the National Conservation Agriculture Task Force to advance uptake of conservation agriculture and deliver associated benefits in terms of agricultural development, climate adaptation and mitigation. District level analyses highlight that whilst District Development Plans are now checked against climate change adaptation and mitigation criteria, capacity and knowledge limitations exist at the District level, preventing project interventions from being successfully up-scaled. Community level assessments highlight the need for increased community participation at the project-design phase and identify a pressing requirement for conservation agriculture planning processes (in particular those driven by investments in climate

  7. Assessment of the developmental totipotency of neural cells in the cerebral cortex of mouse embryo by nuclear transfer

    Science.gov (United States)

    Yamazaki, Yukiko; Makino, Hatsune; Hamaguchi-Hamada, Kayoko; Hamada, Shun; Sugino, Hidehiko; Kawase, Eihachiro; Miyata, Takaki; Ogawa, Masaharu; Yanagimachi, Ryuzo; Yagi, Takeshi

    2001-01-01

    When neural cells were collected from the entire cerebral cortex of developing mouse fetuses (15.5–17.5 days postcoitum) and their nuclei were transferred into enucleated oocytes, 5.5% of the reconstructed oocytes developed into normal offspring. This success rate was the highest among all previous mouse cloning experiments that used somatic cells. Forty-four percent of live embryos at 10.5 days postcoitum were morphologically normal when premature and early-postmitotic neural cells from the ventricular side of the cortex were used. In contrast, the majority (95%) of embryos were morphologically abnormal (including structural abnormalities in the neural tube) when postmitotic-differentiated neurons from the pial side of the cortex were used for cloning. Whereas 4.3% of embryos cloned with ventricular-side cells developed into healthy offspring, only 0.5% of those cloned with differentiated neurons in the pial side did so. These facts seem to suggest that the nuclei of neural cells in advanced stages of differentiation had lost their developmental totipotency. The underlying mechanism for this developmental limitation could be somatic DNA rearrangements in differentiating neural cells. PMID:11698647

  8. Development and validation of a simple algorithm for initiation of CPAP in neonates with respiratory distress in Malawi.

    Science.gov (United States)

    Hundalani, Shilpa G; Richards-Kortum, Rebecca; Oden, Maria; Kawaza, Kondwani; Gest, Alfred; Molyneux, Elizabeth

    2015-07-01

    Low-cost bubble continuous positive airway pressure (bCPAP) systems have been shown to improve survival in neonates with respiratory distress, in developing countries including Malawi. District hospitals in Malawi implementing CPAP requested simple and reliable guidelines to enable healthcare workers with basic skills and minimal training to determine when treatment with CPAP is necessary. We developed and validated TRY (T: Tone is good, R: Respiratory Distress and Y=Yes) CPAP, a simple algorithm to identify neonates with respiratory distress who would benefit from CPAP. To validate the TRY CPAP algorithm for neonates with respiratory distress in a low-resource setting. We constructed an algorithm using a combination of vital signs, tone and birth weight to determine the need for CPAP in neonates with respiratory distress. Neonates admitted to the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi, were assessed in a prospective, cross-sectional study. Nurses and paediatricians-in-training assessed neonates to determine whether they required CPAP using the TRY CPAP algorithm. To establish the accuracy of the TRY CPAP algorithm in evaluating the need for CPAP, their assessment was compared with the decision of a neonatologist blinded to the TRY CPAP algorithm findings. 325 neonates were evaluated over a 2-month period; 13% were deemed to require CPAP by the neonatologist. The inter-rater reliability with the algorithm was 0.90 for nurses and 0.97 for paediatricians-in-training using the neonatologist's assessment as the reference standard. The TRY CPAP algorithm has the potential to be a simple and reliable tool to assist nurses and clinicians in identifying neonates who require treatment with CPAP in low-resource settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Development of QSAR models using artificial neural network analysis for risk assessment of repeated-dose, reproductive, and developmental toxicities of cosmetic ingredients.

    Science.gov (United States)

    Hisaki, Tomoka; Aiba Née Kaneko, Maki; Yamaguchi, Masahiko; Sasa, Hitoshi; Kouzuki, Hirokazu

    2015-04-01

    Use of laboratory animals for systemic toxicity testing is subject to strong ethical and regulatory constraints, but few alternatives are yet available. One possible approach to predict systemic toxicity of chemicals in the absence of experimental data is quantitative structure-activity relationship (QSAR) analysis. Here, we present QSAR models for prediction of maximum "no observed effect level" (NOEL) for repeated-dose, developmental and reproductive toxicities. NOEL values of 421 chemicals for repeated-dose toxicity, 315 for reproductive toxicity, and 156 for developmental toxicity were collected from Japan Existing Chemical Data Base (JECDB). Descriptors to predict toxicity were selected based on molecular orbital (MO) calculations, and QSAR models employing multiple independent descriptors as the input layer of an artificial neural network (ANN) were constructed to predict NOEL values. Robustness of the models was indicated by the root-mean-square (RMS) errors after 10-fold cross-validation (0.529 for repeated-dose, 0.508 for reproductive, and 0.558 for developmental toxicity). Evaluation of the models in terms of the percentages of predicted NOELs falling within factors of 2, 5 and 10 of the in-vivo-determined NOELs suggested that the model is applicable to both general chemicals and the subset of chemicals listed in International Nomenclature of Cosmetic Ingredients (INCI). Our results indicate that ANN models using in silico parameters have useful predictive performance, and should contribute to integrated risk assessment of systemic toxicity using a weight-of-evidence approach. Availability of predicted NOELs will allow calculation of the margin of safety, as recommended by the Scientific Committee on Consumer Safety (SCCS).

  10. Climate change in semi-arid Malawi: Perceptions, adaptation strategies and water governance

    Directory of Open Access Journals (Sweden)

    Miriam K. Joshua

    2016-04-01

    Full Text Available Climate change and variability are a threat to sustainable agricultural production in semi-arid areas of Malawi. Overdependence on subsistence rain-fed agriculture in these areas calls for the identification of sustainable adaptation strategies. A study was therefore conducted in Chikwawa, a semi-arid district in southern Malawi, to: (1 assess community’s perception of a changing climate against empirical evidence, (2 determine their local adaptive measures, (3 evaluate the potential of irrigated agriculture as an adaptive measure in household food security and (4 challenges over access to available water resources. The study employed focus group discussions and key informant interviews to assess people’s perceptions of climate change and variability and their desired interventions. To validate the people’s perceptions, rainfall and temperature data for the period 1960–2010 were analysed. A participatory complete randomised experimental design in both rain-fed and dry season–irrigated conditions was conducted to assess a maize cropping system that would improve adaptation. The study established persistent declining yields from rain-fed production in part because of perennial rainfall failure. In response, the community has shifted its focus to irrigation as an adaptation strategy, which has in turn triggered water conflicts in the community over the control of the resource. Water legislation however fails to adequately provide for rules governing sharing of water resources between various stakeholders. This article therefore recommends development of an appropriate institutional framework that forms a strong basis for equitable distribution of water for irrigation in areas most vulnerable to extreme climate events – including droughts and floods. Keywords: Food Security; Climate Change and Variability; Rainfall Variability; Irrigation; Water Resources; Governance Crisis

  11. The Causes of Dropout in Rural Primary Schools in Malawi

    OpenAIRE

    谷口, 京子

    2017-01-01

    High dropout rates is a critical issue in most of developing countries. Malawi follows this trend of student nonpersistence; in 2013, the primary school dropout rate was approximately 12.2%.This study aims to find the causes of dropout in rural Malawian primary schools. There are two features: data were collected through survival analysis, which has been used to study dropout in developed countries; a multilevel logistic regression was used to classify individual, family, teacher and school f...

  12. Real Effective Exchange Rate Dynamics in Malawi and South Africa

    OpenAIRE

    Kisu Simwaka

    2004-01-01

    This study investigates the main determinants of real effective exchange rate in Malawi and South Africa. In our empirical analysis, we conducted unit root and cointegration test in order to determine the time series properties of the data and establish whether there is a long run relationship between real effective exchange rate and explanatory variables. Having ascertained that almost all variiables are integrated of order one and cointegrated, an error correction model is formulated and es...

  13. How are health professionals earning their living in Malawi?

    Directory of Open Access Journals (Sweden)

    Maseko Fresier C

    2006-08-01

    Full Text Available Abstract Background The migration of health professionals from southern Africa to developed nations is negatively affecting the delivery of health care services in the source countries. Oftentimes however, it is the reasons for the out-migration that have been described in the literature. The work and domestic situations of those health professionals continuing to serve in their posts have not been adequately studied. Methods The present study utilized a qualitative data collection and analysis method. This was achieved through focus group discussions and in-depth interviews with health professionals and administrators to determine the challenges they face and the coping systems they resort to and the perceptions towards those coping methods. Results Health professionals identified the following as some of the challenges there faced: inequitable and poor remuneration, overwhelming responsibilities with limited resources, lack of a stimulating work environment, inadequate supervision, poor access to continued professionals training, limited career progression, lack of transparent recruitment and discriminatory remuneration. When asked what kept them still working in Malawi when the pressures to emigrate were there, the following were some of the ways the health professionals mentioned as useful for earning extra income to support their families: working in rural areas where life was perceived to be cheaper, working closer to home village so as to run farms, stealing drugs from health facilities, having more than one job, running small to medium scale businesses. Health professionals would also minimize expenditure by missing meals and walking to work. Conclusion Many health professionals in Malawi experience overly challenging environments. In order to survive some are involved in ethically and legally questionable activities such as receiving "gifts" from patients and pilfering drugs. The efforts by the Malawi government and the international

  14. What makes staff consider leaving the health service in Malawi?

    OpenAIRE

    Chimwaza, Wanangwa; Chipeta, Effie; Ngwira, Andrew; Kamwendo, Francis; Taulo, Frank; Bradley, Susan; McAuliffe, Eilish

    2014-01-01

    Background Malawi faces a severe shortage of health workers, a factor that has contributed greatly to high maternal mortality in the country. Most clinical care is performed by mid-level providers (MLPs). While utilization of these cadres in providing health care is a solution to the current shortages, demotivating factors within the Malawian health system are pushing them into private, non-governmental, and other non-health related positions. This study aims to highlight these demotivating f...

  15. Where Did it Go Wrong? Marriage and Divorce in Malawi

    OpenAIRE

    Cherchye, Laurens; Rock, Bram; Walther, Selma; Vermeulen, Frederic

    2016-01-01

    textabstractDo individuals divorce for economic reasons? Can we measure the attractiveness of new matches in the marriage market? We answer these questions using a structural model of the household and a rich panel dataset from Malawi. We propose a model of the household with consumption, production and revealed preference conditions for stability on the marriage market. We define marital instability in terms of the consumption gains to remarrying another individual in the same marriage marke...

  16. Institutional Challenges to Viable Civil-Military Relations in Malawi

    Science.gov (United States)

    2008-03-01

    teacher who was responsible for discipline and physical education and was the most feared teacher at every institution. In short, Banda successfully...of guidance is particularly evident in the higher education program of the armed forces. The Malawi Defense Force, in 2007, established a Centre for...has lost respect, due to what he termed childish and irresponsible, with opposition MPs and their leaders who use abusive language while transacting

  17. Menstruation and School Absenteeism: Evidence from Rural Malawi

    OpenAIRE

    Grant, Monica J.; Lloyd, Cynthia B.; Mensch, Barbara S.

    2013-01-01

    The provision of toilets and menstrual supplies has emerged as a promising programmatic strategy to support adolescent girls’ school attendance and performance in less developed countries. We use the first round of the Malawi Schooling and Adolescent Survey (MSAS) to examine the individual- and school-level factors associated with menstruation-related school absenteeism. The MSAS is a school-based longitudinal survey of adolescent students enrolled in coed public primary schools in the southe...

  18. Sources of Social Capital for Malawi People Living With HIV

    Directory of Open Access Journals (Sweden)

    Sally H. Rankin

    2016-11-01

    Full Text Available With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs, non-governmental organizations (NGOs, and community-based organizations (CBOs are expected to provide tangible and emotional support to people living with HIV (PLWH. Using Lin’s social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups.

  19. Lake Malawi cichlid evolution along a benthic/limnetic axis.

    Science.gov (United States)

    Hulsey, C D; Roberts, R J; Loh, Y-H E; Rupp, M F; Streelman, J T

    2013-07-01

    Divergence along a benthic to limnetic habitat axis is ubiquitous in aquatic systems. However, this type of habitat divergence has largely been examined in low diversity, high latitude lake systems. In this study, we examined the importance of benthic and limnetic divergence within the incredibly species-rich radiation of Lake Malawi cichlid fishes. Using novel phylogenetic reconstructions, we provided a series of hypotheses regarding the evolutionary relationships among 24 benthic and limnetic species that suggests divergence along this axis has occurred multiple times within Lake Malawi cichlids. Because pectoral fin morphology is often associated with divergence along this habitat axis in other fish groups, we investigated divergence in pectoral fin muscles in these benthic and limnetic cichlid species. We showed that the eight pectoral fin muscles and fin area generally tended to evolve in a tightly correlated manner in the Lake Malawi cichlids. Additionally, we found that larger pectoral fin muscles are strongly associated with the independent evolution of the benthic feeding habit across this group of fish. Evolutionary specialization along a benthic/limnetic axis has occurred multiple times within this tropical lake radiation and has produced repeated convergent matching between exploitation of water column habitats and locomotory morphology.

  20. The difficulties of conducting maternal death reviews in Malawi

    Directory of Open Access Journals (Sweden)

    van den Broek Nynke

    2008-09-01

    Full Text Available Abstract Background Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. Methods SWOT (strengths, weaknesses, opportunities and threats analysis of the process of maternal death review during a workshop in Malawi. Results Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Conclusion Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

  1. The difficulties of conducting maternal death reviews in Malawi.

    Science.gov (United States)

    Kongnyuy, Eugene J; van den Broek, Nynke

    2008-09-11

    Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges. SWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi. Strengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement. Challenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.

  2. A history of tobacco production and marketing in Malawi, 1890-2010

    DEFF Research Database (Denmark)

    Prowse, Martin Philip

    2013-01-01

    During the past century tobacco production and marketing in Nyasaland/Malawi has undergone periods of dynamism similar to changes since the early 1990s. This article highlights three recurrent patterns. First, estate owners have fostered or constrained peasant/smallholder production dependent...... on complementarities or competition with estates. Second, the rapid expansion of peasant/smallholder production has led to large multiplier effects in tobacco-rich districts. Third, such expansion has also led to re-regulation of the marketing of peasant/smallholder tobacco by the (colonial) state. The article...... concludes by assessing whether recent changes in the industry such as district markets, contract farming with smallholders, and the importance of credence factors have historical precedents, or are new developments in the industry....

  3. Life Skills and Reproductive Health Education Changes Behaviour in Students and Teachers: Evidence from Malawi

    Science.gov (United States)

    Kalanda, Boniface Francis

    2010-01-01

    Malawi is one of the countries with a youthful population. Youths are susceptible to various social-economic pressures that put their well being into jeopardy. One of the issues that affect youth is early drop out of school, drug abuse and contracting sexually transmitted diseases including HIV. To address these issues, the Malawi Government…

  4. Pentecostalism, gerontocratic rule and democratization in Malawi : the changing position of the young in political culture

    NARCIS (Netherlands)

    Dijk, van R.A.; Haynes, J.

    1999-01-01

    This chapter explores the relationship between the father-metaphor, gerontocratic power, democratization and religion in the context of changing political culture in Malawi. It argues that democratization in Malawi signalled a change in the nature of the dominant gerontocratic power relations

  5. The artisanal fishery of Metangula, Lake Malawi/Niassa, East Africa ...

    African Journals Online (AJOL)

    Malawi indicates that the fish populations at Metangula are not yet as impacted as they are on the populous and accessible Malawi coast. Some constraints on the fishery include the lack of management and financial support, poor gear and infrastructure, and the lack of access to markets. African Journal of Aquatic Science

  6. Bearing the Cost: An Examination of the Gendered Impacts of Water Policy Reform in Malawi

    Science.gov (United States)

    Marra, Simona

    2008-01-01

    Water insecurity is one of the most pressing issues currently faced by Malawi. The consequences of these issues are borne significantly by women, who are most directly involved with water provision and use, particularly at the household level. Since the mid-1990s, Malawi has undertaken a process of water policy reform. Reflective of international…

  7. Electrophysiological Assessment of Serotonin and GABA Neuron Function in the Dorsal Raphe during the Third Trimester Equivalent Developmental Period in Mice.

    Science.gov (United States)

    Morton, Russell A; Yanagawa, Yuchio; Valenzuela, C Fernando

    2015-01-01

    Alterations in the development of the serotonin system can have prolonged effects, including depression and anxiety disorders later in life. Serotonin axonal projections from the dorsal raphe undergo extensive refinement during the first 2 weeks of postnatal life in rodents (equivalent to the third trimester of human pregnancy). However, little is known about the functional properties of serotonin and GABA neurons in the dorsal raphe during this critical developmental period. We assessed the functional properties and synaptic connectivity of putative serotoninergic neurons and GABAergic neurons in the dorsal raphe during early [postnatal day (P) P5-P7] and late (P15-P17) stages of the third trimester equivalent period using electrophysiology. Our studies demonstrate that GABAergic neurons are hyperexcitable at P5-P7 relative to P15-P17. Furthermore, putative serotonin neurons exhibit an increase in both excitatory and GABAA receptor-mediated spontaneous postsynaptic currents during this developmental period. Our data suggest that GABAergic neurons and putative serotonin neurons undergo significant electrophysiological changes during neonatal development.

  8. Hearing Loss in HIV-Infected Children in Lilongwe, Malawi.

    Science.gov (United States)

    Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

    2016-01-01

    With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. This was a cross-sectional survey of 380 HIV-infected children aged 4-14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2-13.0) and ear drainage (OR 6.4, 3.6-11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2-4.5) or Stage 4 (OR 6.4, 2.7-15.2) and history of malnutrition (OR 2.1, 1.3-3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child's hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most hearing loss was conductive in nature, likely due to

  9. Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

    Science.gov (United States)

    Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

    2016-01-01

    Introduction With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. Methods This was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Results Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). Conclusions There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most

  10. Physical attractiveness and women’s HIV risk in rural Malawi

    Science.gov (United States)

    Frye, Margaret; Chae, Sophia

    2017-01-01

    BACKGROUND Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners. OBJECTIVE We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country’s severe AIDS epidemic. METHODS We use interviewers’ ratings of respondents’ attractiveness, along with HIV test results and women’s assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15–35. RESULTS Results show that women who are rated by interviewers as ‘much less’ or ‘less’ attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women’s own assessments of their HIV risk: Among women who tested negative, those perceived as ‘much less’ or ‘less’ attractive than average report themselves to be at greater risk of HIV infection. CONCLUSIONS These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic. CONTRIBUTION This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings. PMID:29242708

  11. Changes in Fertility at the Population Level in the Era of ART in Rural Malawi.

    Science.gov (United States)

    McLean, Estelle; Price, Alison; Chihana, Menard; Kayuni, Ndoliwe; Marston, Milly; Koole, Olivier; Zaba, Basia; Crampin, Amelia

    2017-08-01

    HIV reduces fertility through biological and social pathways, and antiretroviral treatment (ART) can ameliorate these effects. In northern Malawi, ART has been available since 2007 and lifelong ART is offered to all pregnant or breastfeeding HIV-positive women. Using data from the Karonga Health and Demographic Surveillance Site in Malawi from 2005 to 2014, we used total and age-specific fertility rates and Cox regression to assess associations between HIV and ART use and fertility. We also assessed temporal trends in in utero and breastfeeding HIV and ART exposure among live births. From 2005 to 2014, there were 13,583 live births during approximately 78,000 person years of follow-up of women aged 15-49 years. The total fertility rate in HIV-negative women decreased from 6.1 [95% confidence interval (CI): 5.5 to 6.8] in 2005-2006 to 5.1 (4.8-5.5) in 2011-2014. In HIV-positive women, the total fertility rate was more stable, although lower, at 4.4 (3.2-6.1) in 2011-2014. In 2011-2014, compared with HIV-negative women, the adjusted (age, marital status, and education) hazard ratio was 0.7 (95% CI: 0.6 to 0.9) and 0.8 (95% CI: 0.6 to 1.0) for women on ART for at least 9 months and not (yet) on ART, respectively. The crude fertility rate increased with duration on ART up to 3 years before declining. The proportion of HIV-exposed infants decreased, but the proportion of ART-exposed infants increased from 2.4% in 2007-2010 to 3.5% in 2011-2014. Fertility rates in HIV-positive women are stable in the context of generally decreasing fertility. Despite a decrease in HIV-exposed infants, there has been an increase in ART-exposed infants.

  12. Quality of malaria case management in Malawi: results from a nationally representative health facility survey.

    Science.gov (United States)

    Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-01-01

    Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have

  13. Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi.

    Science.gov (United States)

    Lindgren, T G; Deutsch, K; Schell, E; Bvumbwe, A; Hart, K B; Laviwa, J; Rankin, S H

    2011-01-01

    The majority of Malawians are impoverished and primarily dependant on subsistence farming, with 85% of the population living in a rural area. The country is highly affected by HIV and under-resourced rural health centers struggle to meet the government's goal of expanding HIV testing, antiretroviral treatment, and other basic services. This report describes the work of two four-wheel drive mobile clinics launched in 2008 to fill an identified service gap in the remote areas of Mulanje District, Malawi. The program was developed by an international non-governmental organization, Global AIDS Interfaith Alliance (GAIA), and the Mulanje District Health Office, with funding from the Elizabeth Taylor HIV/AIDS Foundation. The clinics provide: (1) rapid HIV testing and treatment referral; (2) diagnosis and treatment of malaria; (3) sputum collection for TB screening; (4) diagnosis and treatment of sexually transmitted and opportunistic infections; and (5) pre-natal care. The clinic vehicles provide medical supplies and personnel (a clinical officer, nurse, and nurse aide) to set up clinics in community buildings such as churches or schools. In such a project, the implementation process and schedule can be affected by medication, supply chain and infrastructural issues, as well as governmental and non-governmental requirements. Timelines should be sufficiently flexible to accommodate unexpected delays. Once established, service scheduling should be flexible and responsive; for instance, malaria treatment rather than HIV testing was most urgently needed in the season when these services were launched. Assessing the impact of healthcare delivery in Malawi is challenging. Although mobile clinic and the government Health Management Information System (HMIS) data were matched, inconsistent variables and gaps in data made direct comparisons difficult. Data collection was compromised by the competing demand of high patient volume; however, rather than reducing the burden on

  14. National poverty reduction strategies and HIV/AIDS governance in Malawi: a preliminary study of shared health governance.

    Science.gov (United States)

    Wachira, Catherine; Ruger, Jennifer Prah

    2011-06-01

    The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi's National HIV/AIDS Strategic Framework (NSF). In this article we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and allocation, monitoring, and evaluation? In 2007, we developed and conducted a survey of Malawian government ministries, United Nations agencies, members of the Country Coordination Mechanism, the Malawi National AIDS Commission (NAC), and NAC grantees (N = 125, 90% response rate), seeking survey respondents' retrospective perceptions of NSF resource levels, participation, inclusion, and governance before, during, and after Malawi's PRSP process (2000-2004). We also assessed principle health sector and economic indicators and budget allocations for HIV/AIDS. These indicators are part of a new conceptual framework called shared health governance (SHG), which seeks congruence among the values and goals of different groups and actors to reflect a common purpose. Under this framework, global health policy should encompass: (i) consensus among global, national, and sub-national actors on goals and measurable outcomes; (ii) mutual collective accountability; and (iii) enhancement of individual and group health agency. Indicators to assess these elements included: (i) goal alignment; (ii) adequate resource levels; (iii) agreement on key outcomes and indicators for evaluating those outcomes; (iv) meaningful inclusion and participation of groups and institutions; (v) special efforts to ensure participation of vulnerable groups; and (vi) effectiveness and efficiency measures. Results suggest that the PRSP process supported accountability for NSF resources. However, the process may have marginalized key stakeholders, potentially undercutting the

  15. Evaluation of a developmental hierarchy for breast cancer cells to assess risk-based patient selection for targeted treatment.

    Science.gov (United States)

    Bliss, Sarah A; Paul, Sunirmal; Pobiarzyn, Piotr W; Ayer, Seda; Sinha, Garima; Pant, Saumya; Hilton, Holly; Sharma, Neha; Cunha, Maria F; Engelberth, Daniel J; Greco, Steven J; Bryan, Margarette; Kucia, Magdalena J; Kakar, Sham S; Ratajczak, Mariusz Z; Rameshwar, Pranela

    2018-01-10

    This study proposes that a novel developmental hierarchy of breast cancer (BC) cells (BCCs) could predict treatment response and outcome. The continued challenge to treat BC requires stratification of BCCs into distinct subsets. This would provide insights on how BCCs evade treatment and adapt dormancy for decades. We selected three subsets, based on the relative expression of octamer-binding transcription factor 4 A (Oct4A) and then analysed each with Affymetrix gene chip. Oct4A is a stem cell gene and would separate subsets based on maturation. Data analyses and gene validation identified three membrane proteins, TMEM98, GPR64 and FAT4. BCCs from cell lines and blood from BC patients were analysed for these three membrane proteins by flow cytometry, along with known markers of cancer stem cells (CSCs), CD44, CD24 and Oct4, aldehyde dehydrogenase 1 (ALDH1) activity and telomere length. A novel working hierarchy of BCCs was established with the most immature subset as CSCs. This group was further subdivided into long- and short-term CSCs. Analyses of 20 post-treatment blood indicated that circulating CSCs and early BC progenitors may be associated with recurrence or early death. These results suggest that the novel hierarchy may predict treatment response and prognosis.

  16. Cost-effectiveness and affordability of community mobilisation through women's groups and quality improvement in health facilities (MaiKhanda trial) in Malawi.

    Science.gov (United States)

    Colbourn, Tim; Pulkki-Brännström, Anni-Maria; Nambiar, Bejoy; Kim, Sungwook; Bondo, Austin; Banda, Lumbani; Makwenda, Charles; Batura, Neha; Haghparast-Bidgoli, Hassan; Hunter, Rachael; Costello, Anthony; Baio, Gianluca; Skordis-Worrall, Jolene

    2015-01-01

    Understanding the cost-effectiveness and affordability of interventions to reduce maternal and newborn deaths is critical to persuading policymakers and donors to implement at scale. The effectiveness of community mobilisation through women's groups and health facility quality improvement, both aiming to reduce maternal and neonatal mortality, was assessed by a cluster randomised controlled trial conducted in rural Malawi in 2008-2010. In this paper, we calculate intervention cost-effectiveness and model the affordability of the interventions at scale. Bayesian methods are used to estimate the incremental cost-effectiveness of the community and facility interventions on their own (CI, FI), and together (FICI), compared to current practice in rural Malawi. Effects are estimated with Monte Carlo simulation using the combined full probability distributions of intervention effects on stillbirths, neonatal deaths and maternal deaths. Cost data was collected prospectively from a provider perspective using an ingredients approach and disaggregated at the intervention (not cluster or individual) level. Expected Incremental Benefit, Cost-effectiveness Acceptability Curves and Expected Value of Information (EVI) were calculated using a threshold of $780 per disability-adjusted life-year (DALY) averted, the per capita gross domestic product of Malawi in 2013 international $. The incremental cost-effectiveness of CI, FI, and combined FICI was $79, $281, and $146 per DALY averted respectively, compared to current practice. FI is dominated by CI and FICI. Taking into account uncertainty, both CI and combined FICI are highly likely to be cost effective (probability 98% and 93%, EVI $210,423 and $598,177 respectively). Combined FICI is incrementally cost effective compared to either intervention individually (probability 60%, ICER $292, EIB $9,334,580 compared to CI). Future scenarios also found FICI to be the optimal decision. Scaling-up to the whole of Malawi, CI is of greatest

  17. Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi?

    Science.gov (United States)

    Creanga, Andreea A; Gullo, Sara; Kuhlmann, Anne K Sebert; Msiska, Thumbiko W; Galavotti, Christine

    2017-05-22

    The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients' satisfaction with these services with a focus on quality of care. We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE's Community Score Card© intervention in Ntcheu district, Malawi. Women with a birth during the last year (N = 1301) were asked about seeking: 1) family planning, 2) antenatal, 3) delivery, and 4) postnatal care; the quality of care received; and their overall satisfaction with the care received. Specific quality of care items were assessed for each type of service, and up to five such items per type of service were used in analyses. Separate logistic regression models were fitted to examine predictors of family planning, antenatal, delivery, and postnatal service utilization and of complete satisfaction with each of these services; all models were adjusted for women's socio-demographic characteristics, perceptions of the closest facility to their homes, service use indicators, and quality of care items. We found higher levels of perinatal service use than previously documented in Malawi (baseline antenatal care 99.4%; skilled birth attendance 97.3%; postnatal care 77.5%; current family planning use 52.8%). Almost 73% of quality of perinatal care items assessed were favorably reported by > 90% of women. Women reported high overall satisfaction (≥85%) with all types of services examined, higher for antenatal and postnatal care than for family planning and delivery care. We found significant associations between perceived and actual quality of care and both women's use and satisfaction with the perinatal health

  18. Assessing Preferences for AAC Options in Communication Interventions for Individuals with Developmental Disabilities: A Review of the Literature

    Science.gov (United States)

    van der Meer, Larah; Sigafoos, Jeff; O'Reilly, Mark F.; Lancioni, Giulio E.

    2011-01-01

    We synthesized studies that assessed preference for using different augmentative and alternative communication (AAC) options. Studies were identified via systematic searches of electronic databases, journals, and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) communication options assessed, (d) design, (e)…

  19. Role of male partner involvement in ART retention and adherence in Malawi's Option B+ program.

    Science.gov (United States)

    Wesevich, Austin; Mtande, Tiwonge; Saidi, Friday; Cromwell, Elizabeth; Tweya, Hannock; Hosseinipour, Mina C; Hoffman, Irving; Miller, William C; Rosenberg, Nora E

    2017-11-01

    Malawi's Option B+ program provides all HIV-infected pregnant women free lifelong antiretroviral therapy (ART), but challenges remain regarding retention and ART adherence, potentially due to male partner barriers. We explored relationships between male partner involvement and Option B+ retention and adherence. In 2014, a randomized controlled trial in Malawi compared male recruitment strategies for couple HIV testing and counseling (cHTC) at an antenatal clinic. This secondary analysis was conducted among the entire cohort (N = 200) of women, irrespective of randomization status. We assessed whether cHTC attendance, early disclosure of HIV-positive status, and partner ART reminders were associated with retention and adherence at one month after starting treatment. Retention was defined as attending HIV clinic follow-up within one day of running out of pills. Adherence was defined as taking ≥95% of ARTs by pill count. We used binomial regression to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Median female age was 26 years. Most women (79%) were retained; of these, 68% were adherent. Receiving cHTC was associated with improved retention (aRR 1.33, 95% CI 1.12, 1.59). Receiving male partner ART reminders was weakly associated with retention (aRR 1.16, 95% CI 0.96, 1.39). Disclosure within one day was not associated with retention (aRR 1.08, 95% CI: 0.91, 1.28). Among those who were retained, these three behaviors were not associated with improved 95% adherence. CHTC could play an important role in improving Option B+ retention. Increasing cHTC participation and enhancing adherence-related messages within cHTC are important.

  20. A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa.

    Science.gov (United States)

    Dickinson, Natalie; Gulliver, John; MacPherson, Gordon; Atkinson, John; Rankin, Jean; Cummings, Maria; Nisbet, Zoe; Hursthouse, Andrew; Taylor, Avril; Robertson, Chris; Burghardt, Wolfgang

    2009-12-21

    Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial variability to maternal health and associated cultural and social aspects of nutrition. The aim is to establish the opportunity for concerted action to deliver step change improvements in the nutrition of developing countries. Field work undertaken in August 2007 and July/August 2008 involved the collection of blood, soil and crop samples, and questionnaires from ~100 pregnant women. Complex permissions and authorisation protocols were identified and found to be as much part of the cultural and social context of the work as the complexity of the interdisciplinary project. These issues are catalogued and discussed. A preliminary spatial evaluation is presented linking soil quality and food production to nutritional health. It also considers behavioural and cultural attitudes of women and children in two regions of southern Malawi, (the Shire Valley and Shire Highlands plateau). Differences in agricultural practice and widely varying soil quality (e.g. pH organic matter, C/N and metal content) were observed for both regions and full chemical analysis of soil and food is underway. Early assessment of blood data suggests major differences in health and nutritional status between the two regions. Differences in food availability and type and observations of life style are being evaluated through questionnaire analysis. The particular emphasis of the study is on the interdisciplinary opportunities and the barriers to progress in development support in subsistence communities. Engaging at the community level

  1. Moving malaria in pregnancy programs from neglect to priority: experience from Malawi, Senegal, and Zambia

    Science.gov (United States)

    Roman, Elaine; Wallon, Michelle; Brieger, William; Dickerson, Aimee; Rawlins, Barbara; Agarwal, Koki

    2014-01-01

    Background: Pregnant women and infants are particularly vulnerable to malaria. National malaria in pregnancy (MIP) programs in Malawi, Senegal, and Zambia were reviewed to identify promising strategies that have helped these countries achieve relatively high coverage of MIP interventions as well as ongoing challenges that have inhibited further progress. Methods: We used a systematic case study methodology to assess health system strengths and challenges in the 3 countries, including desk reviews of available reports and literature and key informant interviews with national stakeholders. Data were collected between 2009 and 2011 and analyzed across 8 MIP health systems components: (1) integration of programs and services, (2) policy, (3) commodities, (4) quality assurance, (5) capacity building, (6) community involvement, (7) monitoring and evaluation, and (8) financing. Within each program area, we ranked degree of scale up across 4 stages and synthesized the findings in a MIP table of analysis to reveal common themes related to better practices, remaining bottlenecks, and opportunities to accelerate MIP coverage, strengthen MIP programs, and improve results. Findings: Each of the 3 countries has malaria policies in place that reflect current MIP guidance from the World Health Organization. The 3 countries successfully integrated MIP interventions into a platform of antenatal care services, but coordination at the national level was disjointed. All 3 countries recognized the importance of having a MIP focal person to ensure collaboration and planning at the national level, but only Malawi had appointed one. Commodity stockouts were frequent due to problems at all levels of the logistics system, from quantification to distribution. Lack of support for quality assurance and weak monitoring and evaluation mechanisms across all 3 countries affected optimal coverage. Conclusions: MIP programs should address all 8 interconnected MIP health systems areas holistically, in

  2. Household costs among patients hospitalized with malaria: evidence from a national survey in Malawi, 2012.

    Science.gov (United States)

    Hennessee, Ian; Chinkhumba, Jobiba; Briggs-Hagen, Melissa; Bauleni, Andy; Shah, Monica P; Chalira, Alfred; Moyo, Dubulao; Dodoli, Wilfred; Luhanga, Misheck; Sande, John; Ali, Doreen; Gutman, Julie; Lindblade, Kim A; Njau, Joseph; Mathanga, Don P

    2017-10-02

    With 71% of Malawians living on malaria are likely a major economic burden for low income families and may constitute an important barrier to care seeking. Nevertheless, few efforts have been made to examine these costs. This paper describes household costs associated with seeking and receiving inpatient care for malaria in health facilities in Malawi. A cross-sectional survey was conducted in a representative nationwide sample of 36 health facilities providing inpatient treatment for malaria from June-August, 2012. Patients admitted at least 12 h before study team visits who had been prescribed an antimalarial after admission were eligible to provide cost information for their malaria episode, including care seeking at previous health facilities. An ingredients-based approach was used to estimate direct costs. Indirect costs were estimated using a human capital approach. Key drivers of total household costs for illness episodes resulting in malaria admission were assessed by fitting a generalized linear model, accounting for clustering at the health facility level. Out of 100 patients who met the eligibility criteria, 80 (80%) provided cost information for their entire illness episode to date and were included: 39% of patients were under 5 years old and 75% had sought care for the malaria episode at other facilities prior to coming to the current facility. Total household costs averaged $17.48 per patient; direct and indirect household costs averaged $7.59 and $9.90, respectively. Facility management type, household distance from the health facility, patient age, high household wealth, and duration of hospital stay were all significant drivers of overall costs. Although malaria treatment is supposed to be free in public health facilities, households in Malawi still incur high direct and indirect costs for malaria illness episodes that result in hospital admission. Finding ways to minimize the economic burden of inpatient malaria care is crucial to protect

  3. Awareness and perceived fairness of Option B+ in Malawi: A population-level perspective

    Science.gov (United States)

    Yeatman, Sara; Trinitapoli, Jenny

    2017-03-08

    Policies for rationing antiretroviral therapy (ART) have been subject to on-going ethical debates. Introduced in Malawi in 2011, Option B+ prioritized HIV-positive pregnant women for lifelong ART regardless of the underlying state of their immune system, shifting the logic of allocation away from medical eligibility. Despite the rapid expansion of this policy, we know little about how it has been understood and interpreted by the people it affects. We assessed awareness and perceived fairness of the prioritization system for ART among a population-based sample of young women (n = 1440) and their partners (n = 574) in southern Malawi. We use a card-sort technique to elicit understandings of who gets ART under Option B+ and who should be prioritized, and we compare perceptions to actual ART policy using sequence analysis and optimal matching. We then use ordered logistic regression to identify the factors associated with policy awareness. In 2015, only 30.7% of women and 21.1% of male partners understood how ART was being distributed. There was widespread confusion around whether otherwise healthy HIV-positive pregnant women could access ART under Option B + . Nonetheless, more young adults thought that the fairest policy should prioritize such women than believed the actual policy did. Women who were older, more educated or had recently engaged with the health system through antenatal care or ART had more accurate understandings of Option B + . Among men, policy awareness was lower, and was patterned only by education. Although most respondents were unaware that Option B+ afforded ART access to healthy-pregnant women, Malawians support the prioritization of pregnant women. Countries adopting Option B+ or other new ART policies such as universal test-and-treat should communicate the policies and their rationales to the public - such transparency would be more consistent with a fair and ethical process and could additionally serve to clarify confusion and

  4. Assessment of the quality of life in families with children who have intellectual and developmental disabilities in Slovenia.

    Science.gov (United States)

    Cagran, B; Schmidt, M; Brown, I

    2011-12-01

    Research was conducted, within the framework of the International Family Quality of Life Project, on the quality of life of families with a member who has a disability. We concentrated on the nine specific domains that the family life measure used, and recorded data from five of its six measurement dimensions: Importance, Opportunities, Initiative, Attainment and Satisfaction. The sample consisted of 20 families from Slovenia with children who have intellectual or developmental disabilities. The data were collected using the Family Quality of Life Survey-2006. Except for Community Interaction, the other domains (Health, Financial Well-Being, Family Relations, Support from Others, Support Services, Influence of Values, Careers, Leisure and Recreation) show statistically significant differences among the five dimensions measured. Importance was rated highest, and Attainment and Opportunities were rated lowest, while Initiative and Satisfaction were evaluated lower than Importance but higher than Attainment and Opportunities. Among the domains of family life, Family Relations was evaluated the highest from the perspective of all five dimensions. The family members rated Importance high for all of the quality of family life domains, but it appears from the lower Opportunities scores that their opportunities are limited; this may result in fewer possibilities for attaining a better quality of life. The results of our research are useful to Slovene researchers who work in the areas of special pedagogy and rehabilitation, politicians, non-governmental organisations and social services. The quality of life of families with children with disabilities, their empowerment and their inclusion into community life should be significantly enhanced when consideration is given to all the family members' support and service needs. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  5. Radiographic assessment of developmental dysplasia of the hip – A novel radiology reporting process and one year review of referrals

    International Nuclear Information System (INIS)

    Snaith, Beverly; Buckley, Kirsty

    2013-01-01

    Introduction: Developmental dysplasia of the hip (DDH) is the most common musculoskeletal disorder of childhood. Despite the introduction of ultrasound screening radiography remains the most common imaging investigation for children over 4–6 months. The use of picture archive and communications system (PACS) tools to review key measures is standard but annotation of these images supplemented by a radiology report has not been described previously. Method: Referral and demographic data were identified of all children under the age of 2 years attending for a non-trauma pelvic radiograph within a single NHS Trust between January and December 2012. Retrospective review of all radiographs and reports identified the clinical history, co-morbidities and outcome. Results: A total of 313 referrals were received, 230 initial and 83 follow-up examinations. 37 examinations identified a dysplastic acetabulum (n = 37/230; 16.1%) with the majority being girls (n = 23/37; 62.1%). A total of 25 abnormal findings in relation to the femoral head epiphyses were identified (n = 25/230; 10.9%) with 12 also having acetabular dysplasia. Children with a dysplastic acetabulum were significantly more likely to have a subluxation or dislocation (X 2 183.78, 2df, p ≤ 0.001). Children with acetabular dysplasia were significantly more likely to have been born in the autumn or winter months (proportional difference = 11.0%; 95% CI [0.019,0.202]; p = 0.024). Conclusion: This article presents a novel reporting process which is helping to standardise the results in young children undergoing investigation for DDH. The review of referrals confirmed the published evidence that DDH is more prevalent in girls and children born in the autumn and winter months

  6. Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi.

    Science.gov (United States)

    Fasawe, Olufunke; Avila, Carlos; Shaffer, Nathan; Schouten, Erik; Chimbwandira, Frank; Hoos, David; Nakakeeto, Olive; De Lay, Paul

    2013-01-01

    The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option. A decision model simulates the disease progression of a cohort of HIV-infected pregnant women receiving prophylaxis and antiretroviral therapy, and estimates the number of paediatric infections averted and maternal life years gained over a ten-year time horizon. We assess the cost-effectiveness from the Ministry of Health perspective while taking into account the practical realities of implementing ART services in Malawi. If implemented as recommended by the World Health Organization, options A, B and B+ are equivalent in preventing new infant infections, yielding cost effectiveness ratios between US$ 37 and US$ 69 per disability adjusted life year averted in children. However, when the three options are compared to the current practice, the provision of antiretroviral therapy to all mothers (Option B+) not only prevents infant infections, but also improves the ten-year survival in mothers more than four-fold. This translates into saving more than 250,000 maternal life years, as compared to mothers receiving only Option A or B, with savings of 153,000 and 172,000 life years respectively. Option B+ also yields favourable incremental cost effectiveness ratios (ICER) of US$ 455 per life year gained over the current practice. In Malawi, Option B+ represents a favorable policy option from a cost-effectiveness perspective to prevent future infant infections, save mothers' lives and reduce orphanhood. Although Option B+ would require more financial resources initially, it would save societal resources in the long-term and represents a strategic option to simplify and integrate HIV services into maternal, newborn and child

  7. An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi.

    Science.gov (United States)

    Kaplan, Julika Ayla; Kandodo, Jonathan; Sclafani, Joseph; Raine, Susan; Blumenthal-Barby, Jennifer; Norris, Alison; Norris-Turner, Abigail; Chemey, Elly; Beckham, John Michael; Khan, Zara; Chunda, Reginald

    2017-06-19

    Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor. A medical student at Baylor College of Medicine partnered with a Malawian research assistant in July 2015 to conduct in-depth qualitative interviews in Chichewa with 25 women living within the McGuire Wellness Centre's catchment area (rural Central Lilongwe District) who had received obstetric fistula repair surgery. This study assessed whether women's limited autonomy in rural Malawi reinforces childbearing practices that increase risk of obstetric fistula. We considered four dimensions of autonomy: sexual and reproductive decision-making, decision-making related to healthcare utilization, freedom of movement, and discretion over earned income. We found that participants had limited autonomy in these domains. For example, many women felt pressured by their husbands, families, and communities to become pregnant within three months of marriage; women often needed to seek permission from their husbands before leaving their homes to visit the clinic; and women were frequently prevented from delivering at the hospital by older women in the community. Many of the obstetric fistula patients in our sample had limited autonomy in several or all of the aforementioned domains, and their limited autonomy often led both directly and indirectly to an increased risk of prolonged labor and fistula. Reducing the prevalence of fistula in Malawi

  8. Spatial analysis and mapping of malaria risk in Malawi using point-referenced prevalence of infection data

    Directory of Open Access Journals (Sweden)

    Kazembe Lawrence N

    2006-09-01

    Full Text Available Abstract Background Current malaria control initiatives aim at reducing malaria burden by half by the year 2010. Effective control requires evidence-based utilisation of resources. Characterizing spatial patterns of risk, through maps, is an important tool to guide control programmes. To this end an analysis was carried out to predict and map malaria risk in Malawi using empirical data with the aim of identifying areas where greatest effort should be focussed. Methods Point-referenced prevalence of infection data for children aged 1–10 years were collected from published and grey literature and geo-referenced. The model-based geostatistical methods were applied to analyze and predict malaria risk in areas where data were not observed. Topographical and climatic covariates were added in the model for risk assessment and improved prediction. A Bayesian approach was used for model fitting and prediction. Results Bivariate models showed a significant association of malaria risk with elevation, annual maximum temperature, rainfall and potential evapotranspiration (PET. However in the prediction model, the spatial distribution of malaria risk was associated with elevation, and marginally with maximum temperature and PET. The resulting map broadly agreed with expert opinion about the variation of risk in the country, and further showed marked variation even at local level. High risk areas were in the low-lying lake shore regions, while low risk was along the highlands in the country. Conclusion The map provided an initial description of the geographic variation of malaria risk in Malawi, and might help in the choice and design of interventions, which is crucial for reducing the burden of malaria in Malawi.

  9. Combining web-based tools for transparent evaluation of data for risk assessment: developmental effects of bisphenol A on the mammary gland as a case study.

    Science.gov (United States)

    Molander, Linda; Hanberg, Annika; Rudén, Christina; Ågerstrand, Marlene; Beronius, Anna

    2017-03-01

    Different tools have been developed that facilitate systematic and transparent evaluation and handling of toxicity data in the risk assessment process. The present paper sets out to explore the combined use of two web-based tools for study evaluation and identification of reliable data relevant to health risk assessment. For this purpose, a case study was performed using in vivo toxicity studies investigating low-dose effects of bisphenol A on mammary gland development. The reliability of the mammary gland studies was evaluated using the Science in Risk Assessment and Policy (SciRAP) criteria for toxicity studies. The Health Assessment Workspace Collaborative (HAWC) was used for characterizing and visualizing the mammary gland data in terms of type of effects investigated and reported, and the distribution of these effects within the dose interval. It was then investigated whether there was any relationship between study reliability and the type of effects reported and/or their distribution in the dose interval. The combination of the SciRAP and HAWC tools allowed for transparent evaluation and visualization of the studies investigating developmental effects of BPA on the mammary gland. The use of these tools showed that there were no apparent differences in the type of effects and their distribution in the dose interval between the five studies assessed as most reliable and the whole data set. Combining the SciRAP and HAWC tools was found to be a useful approach for evaluating in vivo toxicity studies and identifying reliable and sensitive information relevant to regulatory risk assessment of chemicals. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Psychotherapy with people with developmental disabilities

    Directory of Open Access Journals (Sweden)

    Barbara Zafošnik

    2011-08-01

    Full Text Available People with developmental disabilities can experience any psychological abnormalitiy and psychiatric illness as do people without developmental disabilities. Due to different diagnostic criteria, assessment procedures and instruments, we lack definite prevalence rates for people with developmental disabilities, also suffering from mental health problems, eventhough most studies place the rate at 20 to 40%. One of the possible treatment alternatives for augmenting psychological well-being is psychotherapy, but is extremely rarely used for people with severe and profound disabilities, where speech cannot be the main therapeutic medium. So, those that are included in the psychotherapuetic process are predominantly clients with mild developmental disabilities, and they are mostly in cognitive-behavioral therapy. Recently, two models of (psychotherapy for persons with severe and profound developmental disabilities were developed: developmental-dynamic relationship therapy and attachment-based behaviour therapy for children. Conceptually, they both originate form developmental psychoanalytic theories.

  11. Self-Assessment Based Mini-After Action Review (SAMAAR) Methodology: Developmental Application to Division Artillery Staff Training

    National Research Council Canada - National Science Library

    Mirabella, Angelo

    1998-01-01

    .... In the SAMAAR approach, trainees, at the end of an exercise day or shift fill out rating forms to assess the units training progress and then convene with their completed forms to participate in a mini-AAR...

  12. School-age effects of the newborn individualized developmental care and assessment program for preterm infants with intrauterine growth restriction: preliminary findings.

    Science.gov (United States)

    McAnulty, Gloria; Duffy, Frank H; Kosta, Sandra; Weisenfeld, Neil I; Warfield, Simon K; Butler, Samantha C; Alidoost, Moona; Bernstein, Jane Holmes; Robertson, Richard; Zurakowski, David; Als, Heidelise

    2013-02-19

    The experience in the newborn intensive care nursery results in premature infants' neurobehavioral and neurophysiological dysfunction and poorer brain structure. Preterms with severe intrauterine growth restriction are doubly jeopardized given their compromised brains. The Newborn Individualized Developmental Care and Assessment Program improved outcome at early school-age for preterms with appropriate intrauterine growth. It also showed effectiveness to nine months for preterms with intrauterine growth restriction. The current study tested effectiveness into school-age for preterms with intrauterine growth restriction regarding executive function (EF), electrophysiology (EEG) and neurostructure (MRI). Twenty-three 9-year-old former growth-restricted preterms, randomized at birth to standard care (14 controls) or to the Newborn Individualized Developmental Care and Assessment Program (9 experimentals) were assessed with standardized measures of cognition, achievement, executive function, electroencephalography, and magnetic resonance imaging. The participating children were comparable to those lost to follow-up, and the controls to the experimentals, in terms of newborn background health and demographics. All outcome measures were corrected for mother's intelligence. Analysis techniques included two-group analysis of variance and stepwise discriminate analysis for the outcome measures, Wilks' lambda and jackknifed classification to ascertain two-group classification success per and across domains; canonical correlation analysis to explore relationships among neuropsychological, electrophysiological and neurostructural domains at school-age, and from the newborn period to school-age. Controls and experimentals were comparable in age at testing, anthropometric and health parameters, and in cognitive and achievement scores. Experimentals scored better in executive function, spectral coherence, and cerebellar volumes. Furthermore, executive function, spectral coherence

  13. Quantitative complete tooth variation among east Asians and Native Americans: developmental biology as a tool for the assessment of human divergence.

    Science.gov (United States)

    Shields, E D

    1996-01-01

    The quantification of total tooth structure derived from X-rays of Vietnamese, Southern Chinese, Mongolians, Western Eskimos, and Peruvian pre-Inca (Huari Empire) populations was used to examine dental divergence and the morphogenetics of change. Multivariate derived distances between the samples helped identify a quasicontinuous web of ethnic groups with two binary clusters ensconced within the web. One cluster was composed of Mongolians, Western Eskimos, and pre-Inca, and the other group consisted of the Southern Chinese and Vietnamese. Mongolians entered the quasicontinuum from a divergent angle (externally influenced) from that of the Southeast Asians. The Chinese and pre-Inca formed the polar samples of the distance superstructure. The pre-Inca sample was the most isolated, its closest neighbor being the Western Eskimos. Univariate and multivariate analyses suggested that the pre-Inca, whose ancestors arrived in America perhaps approximately 30,000 years ago, was the least derived sample. Clearly, microevolutionary change occurred among the samples, but the dental phenotype was resistant to environmental developmental perturbations. An assessment of dental divergence and developmental biology suggested that the overall dental phenotype is a complex multigenic morphological character, and that the observed variation evolved through total genomic drift. The quantified dental phenotype is greater than its highly multigenic algorithm and its development homeostasis is tightly controlled, or canalized, by the deterministic organization of a complex nonlinear epigenetic milieu. The overall dental phenotype quantified here was selectively neutral and a good character to help reconstruct the sequence of human evolution, but if the outlying homeostatic threshold was or will be exceeded in antecedents and descendants, respectively, evolutionary saltation occurs.

  14. Empirically based assessment and taxonomy of psychopathology for ages 1½-90+ years: Developmental, multi-informant, and multicultural findings.

    Science.gov (United States)

    Achenbach, Thomas M; Ivanova, Masha Y; Rescorla, Leslie A

    2017-11-01

    Originating in the 1960s, the Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of instruments for assessing problems and strengths for ages 1½-90+ years. To provide an overview of the ASEBA, related research, and future directions for empirically based assessment and taxonomy. Standardized, multi-informant ratings of transdiagnostic dimensions of behavioral, emotional, social, and thought problems are hierarchically scored on narrow-spectrum syndrome scales, broad-spectrum internalizing and externalizing scales, and a total problems (general psychopathology) scale. DSM-oriented and strengths scales are also scored. The instruments and scales have been iteratively developed from assessments of clinical and population samples of hundreds of thousands of individuals. Items, instruments, scales, and norms are tailored to different kinds of informants for ages 1½-5, 6-18, 18-59, and 60-90+ years. To take account of differences between informants' ratings, parallel instruments are completed by parents, teachers, youths, adult probands, and adult collaterals. Syndromes and Internalizing/Externalizing scales derived from factor analyses of each instrument capture variations in patterns of problems that reflect different informants' perspectives. Confirmatory factor analyses have supported the syndrome structures in dozens of societies. Software displays scale scores in relation to user-selected multicultural norms for the age and gender of the person being assessed, according to ratings by each type of informant. Multicultural norms are derived from population samples in 57 societies on every inhabited continent. Ongoing and future research includes multicultural assessment of elders; advancing transdiagnostic progress and outcomes assessment; and testing higher order structures of psychopathology. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Developmental dyscalculia.

    Science.gov (United States)

    Kucian, Karin; von Aster, Michael

    2015-01-01

    Numerical skills are essential in our everyday life, and impairments in the development of number processing and calculation have a negative impact on schooling and professional careers. Approximately 3 to 6 % of children are affected from specific disorders of numerical understanding (developmental dyscalculia (DD)). Impaired development of number processing skills in these children is characterized by problems in various aspects of numeracy as well as alterations of brain activation and brain structure. Moreover, DD is assumed to be a very heterogeneous disorder putting special challenges to define homogeneous diagnostic criteria. Finally, interdisciplinary perspectives from psychology, neuroscience and education can contribute to the design for interventions, and although results are still sparse, they are promising and have shown positive effects on behaviour as well as brain function. In the current review, we are going to give an overview about typical and atypical development of numerical abilities at the behavioural and neuronal level. Furthermore, current status and obstacles in the definition and diagnostics of DD are discussed, and finally, relevant points that should be considered to make an intervention as successful as possible are summarized.

  16. Informal alcohol in Malawi: stakeholder perceptions and policy recommendations.

    Science.gov (United States)

    Limaye, Rupali J; Rutkow, Lainie; Rimal, Rajiv N; Jernigan, David H

    2014-02-01

    Through the eyes of those involved in the alcohol policy-making process in Malawi, we explored the role of informal (non-commercial) alcohol in rural communities, its harmful effects, and implications for appropriate national policy. Harms included early drinking initiation, violence, and sexual risk exposure. Informants suggested that policy should address informal alcohol's content, selling times, and easy access. Because most informal alcohol producers are women who rely upon sales for subsistence, policies must avoid limiting women's economic opportunities while protecting community health.

  17. The Malawi National Tuberculosis Programme: an equity analysis

    Directory of Open Access Journals (Sweden)

    Chimzizi Rhehab

    2007-12-01

    Full Text Available Abstract Background Until 2005, the Malawi National Tuberculosis Control Programme had been implemented as a vertical programme. Working within the Sector Wide Approach (SWAp provides a new environment and new opportunities for monitoring the equity performance of the programme. This paper synthesizes what is known on equity and TB in Malawi and highlights areas for further action and advocacy. Methods A synthesis of a wide range of published and unpublished reports and studies using a variety of methodological approaches was undertaken and complemented by additional analysis of routine data on access to TB services. The analysis and recommendations were developed, through consultation with key stakeholders in Malawi and a review of the international literature. Results The lack of a prevalence survey severely limits the epidemiological knowledge base on TB and vulnerability. TB cases have increased rapidly from 5,334 in 1985 to 28,000 in 2006. This increase has been attributed to HIV/AIDS; 77% of TB patients are HIV positive. The age/gender breakdown of TB notification cases mirrors the HIV epidemic with higher rates amongst younger women and older men. The WHO estimates that only 48% of TB cases are detected in Malawi. The complexity of TB diagnosis requires repeated visits, long queues, and delays in sending results. This reduces poor women and men's ability to access and adhere to services. The costs of seeking TB care are high for poor women and men – up to 240% of monthly income as compared to 126% of monthly income for the non-poor. The TB Control Programme has attempted to increase access to TB services for vulnerable groups through community outreach activities, decentralising DOT and linking with HIV services. Conclusion The Programme of Work which is being delivered through the SWAp is a good opportunity to enhance equity and pro-poor health services. The major challenge is to increase case detection, especially amongst the poor

  18. Concordance of the Mini-Psychiatric Assessment Schedule for Adults Who Have Developmental Disabilities (PASADD) and the Brief Symptom Inventory

    Science.gov (United States)

    Beail, N.; Mitchell, K.; Vlissides, N.; Jackson, T.

    2015-01-01

    Background: When assessing the mental health needs of people who have intellectual disabilities (ID) it is important to use measures that have good validity and reliability to ensure accurate case recognition and reliable and valid outcome data. Measures developed for this purpose tend to be self-report or by informant report. Multi-trait…

  19. NIDCAP and developmental care

    Directory of Open Access Journals (Sweden)

    Dominique Haumont

    2014-06-01

    Full Text Available Perinatal mortality in very low birth weight infants has dramatically decreased during the last decades. However, 15-25% of these infants will show neurodevelopmental impairment later on. The aim of implementing early developmental care (EDC, emerged as a new field in neonatology, is to create an intervention program designed to provide support for optimal neurobehavioral development during this highly vulnerable period of brain growth. The theoretical framework, which underlies the approach, is supported by research in different scientific fields, including neuroscience, psychology, medicine and nursing. EDC utilizes a range of medical and nursing interventions that aim to decrease the stress of preterm neonates in neonatal intensive care units (NICUs. The Neonatal Individualized Developmental Care Assessment Program (NIDCAP is an integrated and holistic form of family-centered developmental care. Changing the traditional NICU towards an EDC-NICU includes training nursing and medical staff, investing in their quality and most importantly keeping parents in proximity to the infants. The new challenge of modern neonatology is to restore the mother-infant dyad applying “couplet care” starting at birth until discharge. Most of the European NICUs apply some elements of EDC, but it is more consistent in northern Europe. The development of NIDCAP training centers in Europe demonstrates the evolution of care. It is likely that future research and intervention programs will optimize our practices. Developmental care could prove to be an important recent step in improving outcome in extremely preterm neonates. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  20. Validity of a family-centered approach for assessing infants' social-emotional wellbeing and their developmental context: a prospective cohort study.

    Science.gov (United States)

    Hielkema, Margriet; De Winter, Andrea F; Reijneveld, Sijmen A

    2017-06-15

    -centered approach in well-child care to assess infants' social-emotional wellbeing and their developmental context. Agreement was reasonable to excellent regarding protective factors, but lower regarding risk factors. Netherlands Trialregister, NTR2681. Date of registration: 05-01-2011, URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2681 .

  1. Sociocultural factors contributing to teenage pregnancy in Zomba district, Malawi.

    Science.gov (United States)

    Kaphagawani, Nanzen Caroline; Kalipeni, Ezekiel

    2017-06-01

    This study explores sociocultural and other risk factors associated with unplanned teenage pregnancy in Zomba district of Malawi. Data were obtained from 505 participants under the age of 20 years using a questionnaire administered through face-to-face interviews held at five antenatal clinics. The data were analysed using descriptive statistics, frequency tables and chi-square analysis which allowed comparative understanding of the sociocultural risk factors for planned and unplanned teenage pregnancy in Zomba district. The findings revealed that teenage pregnancy is a major health and social problem. Over 76% of the teenage respondents in the study had experienced unplanned pregnancy. Among the prominent factors that stood out in the analysis for this high rate of teenage pregnancy were early sex and marriage, low contraceptive use, low educational levels, low socio-economic status, lack of knowledge of reproductive and sexual health, gender inequity, and physical/sexual violence. The consequences on teenage mothers of unplanned pregnancy have been tragic and have compromised their physical, psychological and socioeconomic wellbeing, not just on them but also their families and society at large. The findings point to the need for a multi-sectoral approach to tackle the problem on teenage pregnancy in this district, and likely throughout Malawi.

  2. The financial losses from the migration of nurses from Malawi

    Directory of Open Access Journals (Sweden)

    Muula Adamson S

    2006-11-01

    Full Text Available Abstract Background The migration of health professionals trained in Africa to developed nations has compromised health systems in the African region. The financial losses from the investment in training due to the migration from the developing nations are hardly known. Methods The cost of training a health professional was estimated by including fees for primary, secondary and tertiary education. Accepted derivation of formula as used in economic analysis was used to estimate the lost investment. Results The total cost of training an enrolled nurse-midwife from primary school through nurse-midwifery training in Malawi was estimated as US$ 9,329.53. For a degree nurse-midwife, the total cost was US$ 31,726.26. For each enrolled nurse-midwife that migrates out of Malawi, the country loses between US$ 71,081.76 and US$ 7.5 million at bank interest rates of 7% and 25% per annum for 30 years respectively. For a degree nurse-midwife, the lost investment ranges from US$ 241,508 to US$ 25.6 million at 7% and 25% interest rate per annum for 30 years respectively. Conclusion Developing countries are losing significant amounts of money through lost investment of health care professionals who emigrate. There is need to quantify the amount of remittances that developing nations get in return from those who migrate.

  3. Some characteristic features of Englishes in Lesotho, Malawi and Swaziland

    Directory of Open Access Journals (Sweden)

    Kamwangamalu, Nkonko

    2003-12-01

    Full Text Available This article discusses the function of the English and the local form it takes in three Southern African countries, namely Lesotho, Malawi and Swaziland. English was introduced in these countries as a result of contacts between the indigenous people and British traders and missionaries during the 19th century. English, which had initially been the language of trade, became the official language in colonial administration. Since then, English has had shifting but always important roles alongside the indigenous languages. As usually happens with languages in contact, there has been a fair amount of mutual influence. In this article, we examine some of the changes in English, concentrating on the usage of non-L1 speakers. Kachru (1982 speaks of this process as ‘indigenisation’: changing the language to suit the communicative needs of non-native users in new, un-English contexts. That explanation is only partly satisfactory. Languages influence one another in sophisticated sociolinguistic ways that require more penetrating analysis. In this article, we are concerned mainly with examining and describing the transfer of syntactic, phonological, lexical and semantic features from indigenous languages into English. From observation, most of the Africanisms that apply in the three countries discussed, particularly in Malawi, could well apply to Zambia and Zimbabwe as well. Finally, we reflect on some future possibilities.

  4. HIV/AIDS and time allocation in rural Malawi

    Directory of Open Access Journals (Sweden)

    Simona Bignami-Van Assche

    2011-05-01

    Full Text Available AIDS morbidity and mortality are expected to have a large impact on households' labor supply in rural Malawi since they reduce the time that adults can spend on production for subsistence and on income generating activities. However, the data demands for estimating this impact are high, limiting the amount of empirical evidence. In this paper, we utilize a unique combination of quantitative and qualitative data, including biomarkers for HIV, collected by the Malawi Diffusion and Ideational Change Project, to analyze the impact of AIDS-related morbidity and mortality on time allocation decisions for rural Malawians. We evaluate both the direct effect of HIV/AIDS on the time allocation of affected individuals as well as its indirect effect on the time allocation of surviving household members. We find that the latter is the most important effect of AIDS-related morbidity and mortality, especially on women's time. Specifically, AIDS induces diversification of income sources, with women reallocating their time from work-intensive (typically farming and heavy chores to cash-generating tasks (such as casual labor.

  5. Moral competence among nurses in Malawi: A concept analysis approach.

    Science.gov (United States)

    Maluwa, Veronica Mary; Gwaza, Elizabeth; Sakala, Betty; Kapito, Esnath; Mwale, Ruth; Haruzivishe, Clara; Chirwa, Ellen

    2018-01-01

    Nurses are expected to provide comprehensive, holistic and ethically accepted care according to their code of ethics and practice. However, in Malawi, this is not always the case. This article analyses moral competence concept using the Walker and Avant's strategy of concept analysis. The aim of this article is to analyse moral competence concept in relation to nursing practice and determine defining attributes, antecedents and consequences of moral competence in nursing practice. Analysis of moral competence concept was done using Walker and Avant's strategy of concept analysis. Deductive analysis was used to find the defining attributes of moral competence, which were kindness, compassion, caring, critical thinking, ethical decision making ability, problem solving, responsibility, discipline, accountability, communication, solidarity, honesty, and respect for human values, dignity and rights. The identified antecedents were personal, cultural and religious values; nursing ethics training, environment and guidance. The consequences of moral competence are team work spirit, effective communication, improved performance and positive attitudes in providing nursing care. Moral competence can therefore be used as a tool to improve care in nursing practice to meet patients' problems and needs and consequently increase public's satisfaction in Malawi.

  6. Assessment of reproductive and developmental effects of DINP, DnHP and DCHP using quantitative weight of evidence.

    Science.gov (United States)

    Dekant, Wolfgang; Bridges, James

    2016-11-01

    Quantitative weight of evidence (QWoE) methodology utilizes detailed scoring sheets to assess the quality/reliability of each publication on toxicity of a chemical and gives numerical scores for quality and observed toxicity. This QWoE-methodology was applied to the reproductive toxicity data on diisononylphthalate (DINP), di-n-hexylphthalate (DnHP), and dicyclohexylphthalate (DCHP) to determine if the scientific evidence for adverse effects meets the requirements for classification as reproductive toxicants. The scores for DINP were compared to those when applying the methodology DCHP and DnHP that have harmonized classifications. Based on the quality/reliability scores, application of the QWoE shows that the three databases are of similar quality; but effect scores differ widely. Application of QWoE to DINP studies resulted in an overall score well below the benchmark required to trigger classification. For DCHP, the QWoE also results in low scores. The high scores from the application of the QWoE methodology to the toxicological data for DnHP represent clear evidence for adverse effects and justify a classification of DnHP as category 1B for both development and fertility. The conclusions on classification based on the QWoE are well supported using a narrative assessment of consistency and biological plausibility. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  7. The quality of care of diabetic patients in rural Malawi: A case of ...

    African Journals Online (AJOL)

    Diabetes mellitus is a global public health problem. In Malawi ... Information Education and Communication messages ... health education, foot care and screening for signs of neuropathy .... knowledge about the recommended diabetes diet.

  8. Mother-tongue education in primary schools in Malawi: From policy ...

    African Journals Online (AJOL)

    Mother-tongue education in primary schools in Malawi: From policy to ... The policy remains fragmented, and suffers from a lack of appropriate planning and ... to bring about social change in terms of linguistic balance and social justice.

  9. Fourier Transform Infrared Spectroscopy (FT-IR) and Simple Algorithm Analysis for Rapid and Non-Destructive Assessment of Developmental Cotton Fibers.

    Science.gov (United States)

    Liu, Yongliang; Kim, Hee-Jin

    2017-06-22

    With cotton fiber growth or maturation, cellulose content in cotton fibers markedly increases. Traditional chemical methods have been developed to determine cellulose content, but it is time-consuming and labor-intensive, mostly owing to the slow hydrolysis process of fiber cellulose components. As one approach, the attenuated total reflection Fourier transform infrared (ATR FT-IR) spectroscopy technique has also been utilized to monitor cotton cellulose formation, by implementing various spectral interpretation strategies of both multivariate principal component analysis (PCA) and 1-, 2- or 3-band/-variable intensity or intensity ratios. The main objective of this study was to compare the correlations between cellulose content determined by chemical analysis and ATR FT-IR spectral indices acquired by the reported procedures, among developmental Texas Marker-1 (TM-1) and immature fiber ( im ) mutant cotton fibers. It was observed that the R value, CI IR , and the integrated intensity of the 895 cm -1 band exhibited strong and linear relationships with cellulose content. The results have demonstrated the suitability and utility of ATR FT-IR spectroscopy, combined with a simple algorithm analysis, in assessing cotton fiber cellulose content, maturity, and crystallinity in a manner which is rapid, routine, and non-destructive.

  10. Neuropsychological Aspects of Developmental Dyscalculia.

    Science.gov (United States)

    Shalev, R. S.; Manor, O.; Gross-Tsur, V.

    1997-01-01

    Classification of arithmetic disorders is predicated on neuropsychological features and associated learning disabilities. Assesses the compatibility of these classifications on a nonreferred, population-based cohort of children (N=139) with developmental dyscalculia. Concludes that children with dyscalculia and disabilities in reading and/or…

  11. Physical trauma experience among school children in periurban Blantyre, Malawi

    Directory of Open Access Journals (Sweden)

    Muula Adamson S

    2009-07-01

    Full Text Available Abstract Background Physical trauma is an important cause of childhood morbidity and mortality in Africa. There are however, few community-based reports on the subject on the continent. The present study was conducted to explore school children's experience of physical trauma in a disadvantaged periurban area of Blantyre, in Malawi. Methods A cross sectional questionnaire study was carried out among school children in Ndirande-Blantyre, Malawi in 2004. Data were obtained to describe the following aspects of trauma experience: being a victim or observer of motor vehicular accidents involving pedestrians; history of falls from heights; and knowledge about road safety. Sex differences were determined for some of the variables in order to gain insights as to whether there is a difference in trauma experience between boys and girls. Results A total of 217 school children, 99 (45.6% boys and 118 (54.4% girls participated in the study. Eight of them reported to have ever been hit by a motor vehicle, 87 (40.1% had witnessed a road accident where a pedestrian had been hit and 83 (38.2% had witnessed a pedestrian they knew having been hit by a motor vehicle. Of those that reported to have ever been hit by motor vehicle, 2 (25% reported that they had been hospitalized as a result of injury. With regard to falling from heights, 86 reported to have ever fallen from tree, 44 of these (51.2% were injured from the fall and 14 (16.3% were hospitalized as a result of injury sustained from the fall. Girls were more likely to fall from trees and getting injured as compared to males (p = 0.04 for both situations. Just under half (41.9% of the study participants were able to report the correct procedure of crossing the road despite the fact that the majority (80% reported having been taught road safety at home or school. Conclusion Many school children in Blantyre, Malawi have been exposed to trauma either involving themselves or someone they observed. Prevention

  12. Developmental colour agnosia.

    Science.gov (United States)

    van Zandvoort, Martine J E; Nijboer, Tanja C W; de Haan, Edward

    2007-08-01

    Colour agnosia concerns the inability to recognise colours despite intact colour perception, semantic memory for colour information, and colour naming. Patients with selective colour agnosia have been described and the deficit is associated with left hemisphere damage. Here we report a case study of a 43-year-old man who was referred to us with a stroke in his right cerebellar hemisphere. During the standard assessment it transpired that he was unable to name coloured patches. Detailed assessment of his colour processing showed that he suffers from a selective colour agnosia. As he claimed to have had this problem all his life, and the fact that the infratentorial infarct that he had incurred was in an area far away from the brain structures that are known to be involved in colour processing, we suggest that he is the first reported case of developmental colour agnosia.

  13. Mother-Newborn Pairs in Malawi Have Similar Antibody Repertoires to Diverse Malaria Antigens.

    Science.gov (United States)

    Boudová, Sarah; Walldorf, Jenny A; Bailey, Jason A; Divala, Titus; Mungwira, Randy; Mawindo, Patricia; Pablo, Jozelyn; Jasinskas, Algis; Nakajima, Rie; Ouattara, Amed; Adams, Matthew; Felgner, Philip L; Plowe, Christopher V; Travassos, Mark A; Laufer, Miriam K

    2017-10-01

    Maternal antibodies may play a role in protecting newborns against malaria disease. Plasmodium falciparum parasite surface antigens are diverse, and protection from infection requires allele-specific immunity. Although malaria-specific antibodies have been shown to cross the placenta, the extent to which antibodies that respond to the full repertoire of diverse antigens are transferred from the mother to the infant has not been explored. Understanding the breadth of maternal antibody responses and to what extent these antibodies are transferred to the child can inform vaccine design and evaluation. We probed plasma from cord blood and serum from mothers at delivery using a customized protein microarray that included variants of malaria vaccine target antigens to assess the intensity and breadth of seroreactivity to three malaria vaccine candidate antigens in mother-newborn pairs in Malawi. Among the 33 paired specimens that were assessed, mothers and newborns had similar intensity and repertoire of seroreactivity. Maternal antibody levels against vaccine candidate antigens were the strongest predictors of infant antibody levels. Placental malaria did not significantly impair transplacental antibody transfer. However, mothers with placental malaria had significantly higher antibody levels against these blood-stage antigens than mothers without placental malaria. The repertoire and levels of infant antibodies against a wide range of malaria vaccine candidate antigen variants closely mirror maternal levels in breadth and magnitude regardless of evidence of placental malaria. Vaccinating mothers with an effective malaria vaccine during pregnancy may induce high and potentially protective antibody repertoires in newborns. Copyright © 2017 American Society for Microbiology.

  14. The Quiet Rise of Medium-Scale Farms in Malawi

    Directory of Open Access Journals (Sweden)

    Ward Anseeuw

    2016-06-01

    Full Text Available Medium-scale farms have become a major force in Malawi’s agricultural sector. Malawi’s most recent official agricultural survey indicates that these account for over a quarter of all land under cultivation in Malawi. This study explores the causes and multifaceted consequences of the rising importance of medium-scale farms in Malawi. We identify the characteristics and pathways of entry into farming based on surveys of 300 medium-scale farmers undertaken in 2014 in the districts of Mchinji, Kasungu and Lilongwe. The area of land acquired by medium-scale farmers in these three districts is found to have almost doubled between 2000 and 2015. Just over half of the medium-scale farmers represent cases of successful expansion out of small-scale farming status; the other significant proportion of medium-scale farmers are found to be urban-based professionals, entrepreneurs and/or civil servants who acquired land, some very recently, and started farming in mid-life. We also find that a significant portion of the land acquired by medium-scale farmers was utilized by others prior to acquisition, that most of the acquired land was under customary tenure, and that the current owners were often successful in transferring the ownership structure of the acquired land to a long-term leaseholding with a title deed. The study finds that, instead of just strong endogenous growth of small-scale famers as a route for the emergence of medium-scale farms, significant farm consolidation is occurring through land acquisitions, often by urban-based people. The effects of farmland acquisitions by domestic investors on the country’s primary development goals, such as food security, poverty reduction and employment, are not yet clear, though some trends appear to be emerging. We consider future research questions that may more fully shed light on the implications of policies that would continue to promote land acquisitions by medium-scale farms.

  15. Haemorrhage in pregnancy: information given to women in Chiradzulu (Malawi

    Directory of Open Access Journals (Sweden)

    H Kapyepye

    2006-09-01

    Full Text Available Advising women on , haemorrhage in pregnancy could, be viewed, as an integral aspect of maternal health care in M alawi. The WHO (1999 confirmed, that haemorrhage in pregnancy was not only a direct reason for maternal mortality but also a major cause of maternal death. The question on the nature of information that midwives and traditional birth attendants (referred to as TBA’s in the Chiradzulu district in Malawi gave with regard to haemorrhage in pregnancy, therefore arose. Research available focused on the women’s knowledge about the complications of pregnancy but not on the nature of information women received from midwives and TBA’s. This study explored and described the nature of information that was given to rural women in the Chiradzulu district by the midwives and TBA’s regarding haemorrhage in pregnancy. The findings revealed that although both the midwives and TBA’s included important information about haemorrhage in pregnancy, there were deficiencies in some critical areas. Examples of these deficiencies were the definition of haemorrhage in pregnancy; the predisposing factors for antepartum and postpartum haemorrhage and deficiencies in the nature of information on the management and referral of haemorrhaging patients. The findings provided insights into the nature of the information that was provided to the women regarding haemorrhage in pregnancy in the Chiradzulu district in Malawi. Thereafter guidelines were developed for the provision of this information. Finally a follow-up study was recommended after implementation of these guidelines in the district to evaluate the change in the nature of the information communicated to patients regarding haemorrhage by midwives and TBA’s. In this study, haemorrhage during pregnancy referred to the perinatal phase, including antepartum, intrapartum and postpartum haemorrhage.

  16. Management of Health Information in Malawi: Role of Technology

    Directory of Open Access Journals (Sweden)

    Patrick Albert Chikumba

    2017-01-01

    Full Text Available This paper is an extended version of the conference paper presented at IST Africa Week Conference 2016 and it discusses in detail the existing technology gaps using DHIS2 (District Health Information System 2.0 as an example, and how Geographic Information System (GIS and mobile application, as specific examples of technology, can enhance health management information system (HMIS in Malawi. The paper focuses on management of health information. When organisation information is made available, it is expected that the decision-makers use it objectively making rational decisions. This can be achieved by how the information is organized, integrated and presented probably through technology. Along with the increase in strengthening HMIS, questions of how to support the management of information at various organizational levels arise. Research on technologies in health management in developing countries has been on single technologies. Therefore, in this paper, the interest is on multiple technologies and how they support each other to enhance health information management. It has been observed that when it comes to health information management, HMIS employs a mix of paper-based and technology-based practices. Taking into account the infrastructure in Malawi, as in many developing countries, this is probably the most feasible approach. Hence, discussions of existing technology gaps include both paper-based and technology-based practices and how to better support health information management practices through this mixed use of media. The case study confirms that technology plays a role in strengthening HMIS. However, this should be supported by enhancing a culture of information management. It has been noted that DHIS2 is the main information system but it requires the enhancement through inclusions of other technologies. The DHIS2 alone cannot do everything.

  17. Utility of electrocardiogram in the assessment and monitoring of pulmonary hypertension (idiopathic or secondary to pulmonary developmental abnormalities) in patients≤18 years of age.

    Science.gov (United States)

    Lau, Kelvin C; Frank, David B; Hanna, Brian D; Patel, Akash R

    2014-07-15

    Electrocardiograms have utility in disease stratification and monitoring in adult pulmonary arterial hypertension (PAH). We examined the electrocardiographic findings that are common in pediatric PAH and assessed for correlation with disease severity and progression. We retrospectively identified patients aged≤18 years followed at a single institution from January 2001 to June 2012 with catheterization-confirmed diagnosis of idiopathic PAH and PAH secondary to pulmonary developmental abnormalities. Patients with an electrocardiography performed within 60 days of catheterization were included. Primary and secondary outcomes are the prevalence of abnormal electrocardiographic findings at the time of catheterization and the association between electrocardiographic and hemodynamic findings and electrocardiographic changes with disease progression on follow-up catheterization, respectively. Of the 100 electrocardiography-catheterization pairs derived from the 46 patients identified, 93% had an electrocardiographic abnormality: 78% had right ventricular hypertrophy (RVH) and 52% had right axis deviation (RAD) for age. In patients with idiopathic PAH, the presence of RVH and RAD correlated with pulmonary vascular resistance and transpulmonary gradient. RAD and RVH on baseline electrocardiogram was associated with an increased risk of disease progression on subsequent catheterization (odds ratio 11.0, 95% confidence interval 1.3 to 96.2, p=0.03) after adjusting for PAH subgroup. The sensitivity, specificity, and positive and negative predictive values of RAD and RVH on baseline electrocardiogram for disease progression were 92%, 48%, 33%, and 95%, respectively. In conclusion, electrocardiographic abnormalities are common in pediatric PAH. RAD and RVH on electrocardiogram were associated with worse hemodynamics, whereas their absence is suggestive of a lack of disease progression. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Antiretroviral therapy (ART) rationing and access mechanisms and their impact on youth ART utilization in Malawi.

    Science.gov (United States)

    Dixon, Jimmy-Gama; Gibson, Sarah; McPake, Barbara; Maleta, Ken

    2011-06-01

    The World Health Organization (WHO) staging is a commonly used rationing mechanism for highly active antiretroviral therapy (HAART) among various HIV infected populations including youths in most developing countries. Rationing is defined as any policy or practice that restricts consumption of or access to certain goods due to its limited supply. However, as HIV prevalence is rapidly increasing among youth, understanding the capacity of the staging approach to achieve HAART uptake in youth is of considerable importance. This study aimed to explore how HAART rationing and access mechanisms impact on youth's utilization of HAART in Malawi. The study used mixed methods with quantitative analysis of existing Ministry of Health Clinical HIV Unit data used to determine existing levels of youth HAART use. Qualitative methods employed in-depth interviews that interviewed nine ART providers, nine HIV positive youth on HAART and nine HIV positive youth not on HAART; and field observations to nine ART clinics were used to understand HAART rationing and access mechanisms and how such mechanisms impact youth uptake of HAART. The findings revealed that ART providers use both explicit rationing mechanisms like WHO clinical staging and implicit rationing mechanisms like use of waiting lists, queues and referral in ART provision. However, the WHO staging approach had some challenges in its implementation. It was also observed that factors like non-comprehensive approach to HAART provision, costs incurred to access HAART, negative beliefs and misconceptions about HAART and HIV were among the key factors that limit youth access to HAART. The study recommends that while WHO staging is successful as a rationing mechanism in Malawi, measures should be put in place to improve access to CD4 assessment for clients who may need it. ART providers also need to be made aware of the implicit rationing mechanisms that may affect HAART access. There is also need to improve monitoring of those HIV

  19. A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa

    Directory of Open Access Journals (Sweden)

    Nisbet Zoe

    2009-12-01

    Full Text Available Abstract Background Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial variability to maternal health and associated cultural and social aspects of nutrition. The aim is to establish the opportunity for concerted action to deliver step change improvements in the nutrition of developing countries. Results Field work undertaken in August 2007 and July/August 2008 involved the collection of blood, soil and crop samples, and questionnaires from ~100 pregnant women. Complex permissions and authorisation protocols were identified and found to be as much part of the cultural and social context of the work as the complexity of the interdisciplinary project. These issues are catalogued and discussed. A preliminary spatial evaluation is presented linking soil quality and food production to nutritional health. It also considers behavioural and cultural attitudes of women and children in two regions of southern Malawi, (the Shire Valley and Shire Highlands plateau. Differences in agricultural practice and widely varying soil quality (e.g. pH organic matter, C/N and metal content were observed for both regions and full chemical analysis of soil and food is underway. Early assessment of blood data suggests major differences in health and nutritional status between the two regions. Differences in food availability and type and observations of life style are being evaluated through questionnaire analysis. Conclusion The particular emphasis of the study is on the interdisciplinary opportunities and the barriers to progress in development support in

  20. The Domain of Developmental Psychopathology.

    Science.gov (United States)

    Sroufe, L. Alan; Rutter, Michael

    1984-01-01

    Describes how developmental psychopathology differs from related disciplines, including abnormal psychology, psychiatry, clinical child psychology, and developmental psychology. Points out propositions underlying a developmental perspective and discusses implications for research in developmental psychopathology. (Author/RH)

  1. Strengthening community health supply chain performance through an integrated approach: Using mHealth technology and multilevel teams in Malawi.

    Science.gov (United States)

    Shieshia, Mildred; Noel, Megan; Andersson, Sarah; Felling, Barbara; Alva, Soumya; Agarwal, Smisha; Lefevre, Amnesty; Misomali, Amos; Chimphanga, Boniface; Nsona, Humphreys; Chandani, Yasmin

    2014-12-01

    In 2010, 7.6 million children under five died globally - largely due to preventable diseases. Majority of these deaths occurred in sub-Saharan Africa. As a strategy to reduce child mortality, the Government of Malawi, in 2008, initiated integrated community case management allowing health surveillance assistants (HSAs) to treat sick children in communities. Malawi however, faces health infrastructure challenges, including weak supply chain systems leading to low product availability. A baseline assessment conducted in 2010 identified data visibility, transport and motivation of HSAs as challenges to continuous product availability. The project designed a mHealth tool as part of two interventions to address these challenges. A mobile health (mHealth) technology - cStock, for reporting on community stock data - was designed and implemented as an integral component of Enhanced Management (EM) and Efficient Product Transport (EPT) interventions. We developed a feasibility and acceptability framework to evaluate the effectiveness and predict the likelihood of scalability and ownership of the interventions. Mixed methods were used to conduct baseline and follow up assessments in May 2010 and February 2013, respectively. Routine monitoring data on community stock level reports, from cStock, were used to analyze supply chain performance over 18-month period in the intervention groups. Mean stock reporting rate by HSAs was 94% in EM group (n = 393) and 79% in EPT group (n = 253); mean reporting completeness was 85% and 65%, respectively. Lead time for HSA drug resupply over the 18-month period was, on average, 12.8 days in EM and 26.4 days in EPT, and mean stock out rate for 6 tracer products was significantly lower in EM compared to EPT group. Results demonstrate that cStock was feasible and acceptable to test users in Malawi, and that based on comparison with the EPT group, the team component of the EM group was an essential pairing with cStock to achieve the best

  2. Strengthening community health supply chain performance through an integrated approach: Using mHealth technology and multilevel teams in Malawi

    Science.gov (United States)

    Shieshia, Mildred; Noel, Megan; Andersson, Sarah; Felling, Barbara; Alva, Soumya; Agarwal, Smisha; Lefevre, Amnesty; Misomali, Amos; Chimphanga, Boniface; Nsona, Humphreys; Chandani, Yasmin

    2014-01-01

    Background In 2010, 7.6 million children under five died globally – largely due to preventable diseases. Majority of these deaths occurred in sub–Saharan Africa. As a strategy to reduce child mortality, the Government of Malawi, in 2008, initiated integrated community case management allowing health surveillance assistants (HSAs) to treat sick children in communities. Malawi however, faces health infrastructure challenges, including weak supply chain systems leading to low product availability. A baseline assessment conducted in 2010 identified data visibility, transport and motivation of HSAs as challenges to continuous product availability. The project designed a mHealth tool as part of two interventions to address these challenges. Methods A mobile health (mHealth) technology – cStock, for reporting on community stock data – was designed and implemented as an integral component of Enhanced Management (EM) and Efficient Product Transport (EPT) interventions. We developed a feasibility and acceptability framework to evaluate the effectiveness and predict the likelihood of scalability and ownership of the interventions. Mixed methods were used to conduct baseline and follow up assessments in May 2010 and February 2013, respectively. Routine monitoring data on community stock level reports, from cStock, were used to analyze supply chain performance over 18–month period in the intervention groups. Results Mean stock reporting rate by HSAs was 94% in EM group (n = 393) and 79% in EPT group (n = 253); mean reporting completeness was 85% and 65%, respectively. Lead time for HSA drug resupply over the 18–month period was, on average, 12.8 days in EM and 26.4 days in EPT, and mean stock out rate for 6 tracer products was significantly lower in EM compared to EPT group. Conclusions Results demonstrate that cStock was feasible and acceptable to test users in Malawi, and that based on comparison with the EPT group, the team component of the EM group was an

  3. On-Farm Crop Species Richness Is Associated with Household Diet Diversity and Quality in Subsistence- and Market-Oriented Farming Households in Malawi.

    Science.gov (United States)

    Jones, Andrew D

    2017-01-01

    On-farm crop species richness (CSR) may be important for maintaining the diversity and quality of diets of smallholder farming households. The objectives of this study were to 1) determine the association of CSR with the diversity and quality of household diets in Malawi and 2) assess hypothesized mechanisms for this association via both subsistence- and market-oriented pathways. Longitudinal data were assessed from nationally representative household surveys in Malawi between 2010 and 2013 (n = 3000 households). A household diet diversity score (DDS) and daily intake per adult equivalent of energy, protein, iron, vitamin A, and zinc were calculated from 7-d household consumption data. CSR was calculated from plot-level data on all crops cultivated during the 2009-2010 and 2012-2013 agricultural seasons in Malawi. Adjusted generalized estimating equations were used to assess the longitudinal relation of CSR with household diet quality and diversity. CSR was positively associated with DDS (β: 0.08; 95% CI: 0.06, 0.12; P CSR and household diet diversity or quality (P ≥ 0.05). Households with greater CSR were more commercially oriented (least-squares mean proportion of harvest sold ± SE, highest tertile of CSR: 17.1 ± 0.52; lowest tertile of CSR: 8.92 ± 1.09) (P CSR may be a beneficial strategy for simultaneously supporting enhanced diet quality and diversity while also creating opportunities for smallholder farmers to engage with markets in subsistence agricultural contexts. © 2017 American Society for Nutrition.

  4. Burden of physical, psychological and social ill-health during and after pregnancy among women in India, Pakistan, Kenya and Malawi.

    Science.gov (United States)

    McCauley, Mary; Madaj, Barbara; White, Sarah A; Dickinson, Fiona; Bar-Zev, Sarah; Aminu, Mamuda; Godia, Pamela; Mittal, Pratima; Zafar, Shamsa; van den Broek, Nynke

    2018-01-01

    For every woman who dies during pregnancy and childbirth, many more suffer ill-health, the burden of which is highest in low-resource settings. We sought to assess the extent and types of maternal morbidity. Descriptive observational cross-sectional study at primary-level and secondary-level healthcare facilities in India, Pakistan, Kenya and Malawi to assess physical, psychological and social morbidity during and after pregnancy. Sociodemographic factors, education, socioeconomic status (SES), quality of life, satisfaction with health, reported symptoms, clinical examination and laboratory investigations were assessed. Relationships between morbidity and maternal characteristics were investigated using multivariable logistic regression analysis. 11 454 women were assessed in India (2099), Malawi (2923), Kenya (3145), and Pakistan (3287). Almost 3 out of 4 women had ≥1 symptoms (73.5%), abnormalities on clinical examination (71.3%) or laboratory investigation (73.5%). In total, 36% of women had infectious morbidity of which 9.0% had an identified infectious disease (HIV, malaria, syphilis, chest infection or tuberculosis) and an additional 32.5% had signs of early infection. HIV-positive status was highest in Malawi (14.5%) as was malaria (10.4%). Overall, 47.9% of women were anaemic, 11.5% had other medical or obstetric conditions, 25.1% reported psychological morbidity and 36.6% reported social morbidity (domestic violence and/or substance misuse). Infectious morbidity was highest in Malawi (56.5%) and Kenya (40.4%), psychological and social morbidity was highest in Pakistan (47.3%, 60.2%). Maternal morbidity was not limited to a core at-risk group; only 1.2% had all four morbidities. The likelihood of medical or obstetric, psychological or social morbidity decreased with increased education; adjusted OR (95% CI) for each additional level of education ranged from 0.79 (0.75 to 0.83) for psychological morbidity to 0.91 (0.87 to 0.95) for infectious morbidity

  5. Cost-of-illness of cholera to households and health facilities in rural Malawi.

    Directory of Open Access Journals (Sweden)

    Patrick G Ilboudo

    Full Text Available Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$ 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.

  6. Cost-of-illness of cholera to households and health facilities in rural Malawi.

    Science.gov (United States)

    Ilboudo, Patrick G; Huang, Xiao Xian; Ngwira, Bagrey; Mwanyungwe, Abel; Mogasale, Vittal; Mengel, Martin A; Cavailler, Philippe; Gessner, Bradford D; Le Gargasson, Jean-Bernard

    2017-01-01

    Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$) 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.

  7. Implementation research to improve quality of maternal and newborn health care, Malawi.

    Science.gov (United States)

    Brenner, Stephan; Wilhelm, Danielle; Lohmann, Julia; Kambala, Christabel; Chinkhumba, Jobiba; Muula, Adamson S; De Allegri, Manuela

    2017-07-01

    To evaluate the impact of a performance-based financing scheme on maternal and neonatal health service quality in Malawi. We conducted a non-randomized controlled before and after study to evaluate the effects of district- and facility-level performance incentives for health workers and management teams. We assessed changes in the facilities' essential drug stocks, equipment maintenance and clinical obstetric care processes. Difference-in-difference regression models were used to analyse effects of the scheme on adherence to obstetric care treatment protocols and provision of essential drugs, supplies and equipment. We observed 33 health facilities, 23 intervention facilities and 10 control facilities and 401 pregnant women across four districts. The scheme improved the availability of both functional equipment and essential drug stocks in the intervention facilities. We observed positive effects in respect to drug procurement and clinical care activities at non-intervention facilities, likely in response to improved district management performance. Birth assistants' adherence to clinical protocols improved across all studied facilities as district health managers supervised and coached clinical staff more actively. Despite nation-wide stock-outs and extreme health worker shortages, facilities in the study districts managed to improve maternal and neonatal health service quality by overcoming bottlenecks related to supply procurement, equipment maintenance and clinical performance. To strengthen and reform health management structures, performance-based financing may be a promising approach to sustainable improvements in quality of health care.

  8. The effectiveness of the TBA programme in reducing maternal mortality and morbidity in Malawi.

    Science.gov (United States)

    Bisika, Thomas

    2008-08-01

    The main objective of this study was to assess the role of TBAs and the quality of their services in contributing to the reduction of maternal deaths in Malawi. This study used a qualitative research methodology involving key informant and in-depth interviews, observation and focus group interviews. The study found that most of the people rely on traditional birth attendants although the quality of their services is poor due to illiteracy, their ailing age, lack of supplies and equipment and general absence of supervision. The study fiuther observed that although the hospital sees many pregnant women during antenatal care, very few women actually come back to the hospital for delivery. The study also found that there was high awareness among TBAs about what they were supposed to do but that their actual practices did not reflect compliance with their roles as assigned by the formal health system. The study concludes that TBAs are an important source of maternal care especially in rural areas and that they need to be empowered to comply with the requirement of ensuring infection free deliveries. This entails adequate supervision and provision of supplies. The study further observed that the utilization levels of TBAs is far much greater that presently acknowledged suggesting severe inadequacies within the formal health system.

  9. Investigating Climate Compatible Development Outcomes and their Implications for Distributive Justice: Evidence from Malawi

    Science.gov (United States)

    Wood, Benjamin T.; Quinn, Claire H.; Stringer, Lindsay C.; Dougill, Andrew J.

    2017-09-01

    Governments and donors are investing in climate compatible development in order to reduce climate and development vulnerabilities. However, the rate at which climate compatible development is being operationalised has outpaced academic enquiry into the concept. Interventions aiming to achieve climate compatible development "wins" (for development, mitigation, adaptation) can also create negative side-effects. Moreover, benefits and negative side-effects may differ across time and space and have diverse consequences for individuals and groups. Assessments of the full range of outcomes created by climate compatible development projects and their implications for distributive justice are scarce. This article develops a framework using a systematic literature review that enables holistic climate compatible development outcome evaluation over seven parameters identified. Thereafter, we explore the outcomes of two donor-funded projects that pursue climate compatible development triple-wins in Malawi using this framework. Household surveys, semi-structured interviews and documentary material are analysed. Results reveal that uneven outcomes are experienced between stakeholder groups and change over time. Although climate compatible development triple-wins can be achieved through projects, they do not represent the full range of outcomes. Ecosystem—and community-based activities are becoming popularised as approaches for achieving climate compatible development goals. However, findings suggest that a strengthened evidence base is required to ensure that these approaches are able to meet climate compatible development goals and further distributive justice.

  10. The state of HIV sector local governance in Malawi and Zambia: Evidence from five districts

    Directory of Open Access Journals (Sweden)

    Justin Steyn

    2014-07-01

    Full Text Available This paper encapsulates the outputs of a Swiss Agency for Development Cooperation (SDC funded project that aimed to improve the levels of HIV governance at the district level in Malawi and Zambia by encouraging public participation in an effort to more effective use of local resources. The methodology for this project, developed by the Institute for Democracy in Africa (Idasa and SDC, included a barometer which assessed perceptions of district HIV governance among key stakeholders. Perceptions were gathered on governance principles of effectiveness, efficiency, rule of law, accountability, participation and equity. The stakeholders ranged from administrators, political representatives, community-based organisations and the private sector on the supply side and citizens on the demand or beneficiary side. The findings of the research indicate specific sector governance issues that may be generalised to governance. Communication and transparency appear to be major issues underpinning the bottlenecks and shortcomings in the HIV sector governance at the district level. Information gaps have given rise to accountability deficits and coordination deficiencies. Addressing these matters would make more effective use of resources and lessen dependence on external funding sources.

  11. Use of laboratory test results in patient management by clinicians in Malawi.

    Science.gov (United States)

    Moyo, Kundai; Porter, Carol; Chilima, Ben; Mwenda, Reuben; Kabue, Mark; Zungu, Lutho; Sarr, Abdoulaye

    2015-11-18

    Malawi has a high burden of infectious disease. The expansion of programmes targeting these diseases requires a strong laboratory infrastructure to support both diagnosis and treatment. To assess the use of laboratory test results in patient management and to determine the requirements for improving laboratory services. A cross-sectional study was conducted in 2012 to survey practising clinicians. Two hospitals were purposively selected for observations of clinicians ordering laboratory tests. Twelve management-level key informants were interviewed. Descriptive statistics were conducted. A total of 242 clinicians were identified and 216 (89%) were interviewed. Of these, 189 (87%) reported doubting laboratory test results at some point. Clinicians most often doubted the quality of haematology (67%), followed by malaria (53%) and CD4 (22%) test results. A total of 151 (70%) clinicians reported using laboratory tests results in patient management. Use of laboratory test results at all times in patient management varied by the type of health facility ( P management. Key informants reported that the quality of laboratory services was good and useful, but that services were often unavailable. Gaps in the public laboratory system were evident. Key recommendations to enhance the use of laboratory test results in patient management were to strengthen the supply chain, reduce turn-around times, improve the test menu and improve the laboratory infrastructure.

  12. Estimating the Health Risk Associated with the Use of Ecological Sanitation Toilets in Malawi

    Directory of Open Access Journals (Sweden)

    Save Kumwenda

    2017-01-01

    Full Text Available Use of Ecological Sanitation (EcoSan sludge is becoming popular due to increasing price of organic fertilizers in Malawi; however, there is little evidence on the associated risks. Quantitative microbiological risk assessment (QMRA was done to determine health risks associated with use of EcoSan. Pathogens considered included Escherichia coli (E. coli, Salmonella, and soil transmitted helminths (STHs. Exponential and Beta Poisson models were used to estimate the risk from helminthic and bacterial pathogens, respectively. Main exposure pathways were through poor storage of sludge, contamination of foods during drying, walking barefoot on the ground contaminated with sludge, pit emptying without protection, and application of sludge in the fields. Estimated annual risk for Ascaris lumbricoides, Taenia, and hookworms was approximately over 5.6 × 10−1 for both Fossa Alternas (FAs and Urine Diverting Dry Toilet (UDDTs. Risk from E. coli and Salmonella was 8.9 × 10−2 and above. The risks were higher than WHO acceptable risk for use of faecal sludge in crops of 10−4 infections per year. Promoters and users of EcoSan latrines need to consider advocating for strict guidelines to reduce the risk.

  13. The cost of the district hospital: a case study in Malawi.

    Science.gov (United States)

    Mills, A J; Kapalamula, J; Chisimbi, S

    1993-01-01

    Described in an analysis of the cost to the Ministry of Health of providing district health services in Malawi, with particular emphasis on the district hospital. District resource allocation patterns were assessed by carefully disaggregating district costs by level of care and hospital department. A strikingly low proportion of district recurrent costs was absorbed by salaries and wages (27-39%, depending on the district) and a surprisingly high proportion by medical supplies (24-37%). The most expensive cost centre in the hospital was the pharmacy. A total of 27-39% of total recurrent costs were spent outside the hospital and 61-73% on hospital services. The secondary care services absorbed 40-58% of district recurrent costs. Unit costs by hospital department varied considerably by district, with one hospital being consistently the most expensive and another the cheapest. A total of 3-10 new outpatients could be treated for the average cost of 1 inpatient-day, while 34-55 could be treated for the average cost of 1 inpatient. The efficiency of hospital operations, the scope for redistributing resources districtwide, and the costing methodology are discussed.

  14. Effect of family planning interventions on couple years of protection in Malawi.

    Science.gov (United States)

    Lemani, Clara; Kamtuwanje, Nenani; Phiri, Billy; Speizer, Ilene S; Singh, Kavita; Mtema, Olive; Chisanu, Ndidza; Tang, Jennifer H

    2018-04-01

    The primary objective was to assess the effect of family planning interventions at two health facilities in Malawi on couple years of protection (CYP). A prospective quasi-experimental design was used to compare CYP and uptake of long-acting reversible contraception (LARC) between two intervention facilities (Area 25 Health Center and Kasungu District Hospital) and two nonintervention facilities (Mkanda Health Center and Dowa District Hospital). The interventions included community mobilization and demand generation for family planning, and training and mentoring of providers in LARC insertion. Monthly data were collected from 1 year prior to intervention implementation until 2 years thereafter. From the pre-intervention year to the second post-intervention year, CYP increased by 175.1% at Area 25, whereas it decreased by 33.8% at Mkanda. At Kasungu and Dowa, CYP increased by 90.7% and 64.4%, respectively. Uptake of LARC increased by 12.2% at Area 25 r, 6.2% at Kasungu, and 2.9% at Dowa, but decreased by 3.8% at Mkanda. The interventions led to an increase in CYP and LARC uptake. Future family planning programs should sensitize communities about family planning and train providers to provide all contraceptives so that women can make informed decisions and use the contraceptive of their choice. © 2018 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  15. Production of charcoal briquettes from cotton stalk in malawi: methodology for feasibility studies using experiences in Sudan

    NARCIS (Netherlands)

    Onaji, P.B.; Siemons, R.V.

    1993-01-01

    The feasibility of charcoal production from cotton stalks in Malawi was studied based on experience from Sudan. The country relies considerably on biomass fuels. Of the total energy consumption in Malawi of 2.376 MTOE in 1989, 92% was met by biomass (fuelwood: 83.6% and charcoal: 8.3% Petroleum

  16. Improving the efficiency of use of small amounts of nitrogen and phosphorus fertilizer on smallholders maize in Central Malawi

    NARCIS (Netherlands)

    Kamanga, B.C.G.; Waddington, S.R.; Almekinders, C.J.M.; Giller, K.E.

    2014-01-01

    Mineral fertiliser is a scarce input for smallholder maize farmers in Malawi. A recent provision of small amounts of subsidised fertilisers by government programmes to farmers throughout Malawi has increased fertiliser access and raised maize production, but fertiliser management and yield responses

  17. Centralization and Experimentation in the Implementation of a National Monitoring and Evaluation System: The Experience of Malawi.

    Science.gov (United States)

    Useem, Michael; Chipande, Graham

    1991-01-01

    To identify general principles of implementing a system of evaluation, the experience of Malawi in building a national system for agriculture is described. Applying principles of both centralization and decentralization and principles of trial and error has helped translate theories of evaluation into practice in Malawi. (SLD)

  18. Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi.

    Science.gov (United States)

    Uwemedimo, Omolara T; Lewis, Todd P; Essien, Elsie A; Chan, Grace J; Nsona, Humphreys; Kruk, Margaret E; Leslie, Hannah H

    2018-01-01

    Pneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi. Data were obtained from the 2013-2014 Service Provision Assessment survey, a census of health facilities in Malawi that included direct observation of care and re-examination of children by trained observers. We calculated sensitivity of pneumonia diagnosis and used multilevel log-binomial regression to assess factors associated with diagnostic sensitivity. 3136 clinical visits for children 2-59 months old were observed at 742 health facilities. Healthcare workers completed an average of 30% (SD 13%) of IMCI guidelines in each encounter. 573 children met the IMCI criteria for pneumonia; 118 (21%) were correctly diagnosed. Advanced practice clinicians were more likely than other providers to diagnose pneumonia correctly (adjusted relative risk 2.00, 95% CI 1.21 to 3.29). Clinical quality was strongly associated with correct diagnosis: sensitivity was 23% in providers at the 75th percentile for guideline adherence compared with 14% for those at the 25th percentile. Contextual factors, facility structural readiness, and training or supervision were not associated with sensitivity. Care quality for Malawian children is poor, with low guideline adherence and missed diagnosis for four of five children with pneumonia. Better sensitivity is associated with provider type and higher adherence to IMCI. Existing interventions such as training and supportive supervision are associated with higher guideline adherence, but are insufficient to meaningfully improve sensitivity

  19. Quality improvement practices to institutionalize supply chain best practices for iCCM: Evidence from Rwanda and Malawi.

    Science.gov (United States)

    Chandani, Yasmin; Duffy, Malia; Lamphere, Barbara; Noel, Megan; Heaton, Alexis; Andersson, Sarah

    2017-11-01

    Supply chain bottlenecks that prevent community health workers (CHWs) from accessing essential medicines significantly increase under-5 child mortality, particularly in poor and rural areas. Using implementation research, interventions aimed at improving supply chain practices and access to medicines were tested in Malawi and Rwanda. These interventions included simple demand-based resupply procedures, using mobile technology and traditional methods for communication, and multilevel, performance-driven quality improvement (QI) teams. Mixed-method evaluations were conducted at baseline (2010), midline (2013), and endline (2014). Baseline assessments identified common bottlenecks and established performance levels. Midline assessments identified which intervention package had the greatest impact. Endline surveys measured the progress of scale-up and institutionalization of each innovation. In both Rwanda and Malawi CHWs, health center staff, and district managers all cited many benefits of the establishment of resupply procedures and QI teams: such as providing structure and processes, a means to analyze and discuss problems and enhance collaboration between staff. Implementing simple, streamlined, demand-based resupply procedures formed the basis for informed and regular resupply, and increased the visibility of appropriate and timely community logistics data. QI teams played a critical role in reinforcing resupply procedures and routinely unlocking the bottlenecks that prevent the continuous flow of critical health products. While simple, streamlined, demand-based resupply procedures provide the basis for regular, functional, and efficient resupply of CHWs, the procedures alone are not sufficient to create consistent change in product availability. Supporting these procedures with multilevel QI teams reinforces the correct and consistent use of resupply procedures. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Modeling rain-fed maize vulnerability to droughts using the standardized precipitation index from satellite estimated rainfall—Southern Malawi case study

    Science.gov (United States)

    Funk, Christopher C.; Verdin, James; Adams Chavula,; Gregory J. Husak,; Harikishan Jayanthi,; Tamuka Magadzire,

    2013-01-01

    During 1990s, disaster risk reduction emerged as a novel, proactive approach to managing risks from natural hazards. The World Bank, USAID, and other international donor agencies began making efforts to mainstream disaster risk reduction in countries whose population and economies were heavily dependent on rain-fed agriculture. This approach has more significance in light of the increasing climatic hazard patterns and the climate scenarios projected for different hazard prone countries in the world. The Famine Early Warning System Network (FEWS NET) has been monitoring the food security issues in the sub-Saharan Africa, Asia and in Haiti. FEWS NET monitors the rainfall and moisture availability conditions with the help of NOAA RFE2 data for deriving food security status in Africa. This paper highlights the efforts in using satellite estimated rainfall inputs to develop drought vulnerability models in the drought prone areas in Malawi. The satellite RFE2 based SPI corresponding to the critical tasseling and silking phases (in the months of January, February, and March) were statistically regressed with drought-induced yield losses at the district level. The analysis has shown that the drought conditions in February and early March lead to most damage to maize yields in this region. The district-wise vulnerabilities to drought were upscaled to obtain a regional maize vulnerability model for southern Malawi. The results would help in establishing an early monitoring mechanism for drought impact assessment, give the decision makers additional time to assess seasonal outcomes, and identify potential food-related hazards in Malawi.

  1. Developmental toxicity of engineered nanomaterials in rodents

    Energy Technology Data Exchange (ETDEWEB)

    Ema, Makoto, E-mail: ema-makoto@aist.go.jp; Gamo, Masashi; Honda, Kazumasa

    2016-05-15

    We summarized significant effects reported in the literature on the developmental toxicity of engineered nanomaterials (ENMs) in rodents. The developmental toxicity of ENMs included not only structural abnormalities, but also death, growth retardation, and behavioral and functional abnormalities. Most studies were performed on mice using an injection route of exposure. Teratogenic effects were indicated when multi-walled carbon nanotubes (MWCNTs), single-walled carbon nanotubes (SWCNTs), and TiO{sub 2}-nanoparticles were administered to mice during early gestation. Reactive oxygen species levels were increased in placentas and malformed fetuses and their placentas after prenatal exposure to MWCNTs and SWCNTs, respectively. The pre- and postnatal mortalities and growth retardation in offspring increased after prenatal exposure to ENMs. Histopathological and functional abnormalities were also induced in placentas after prenatal exposure to ENMs. Maternal exposure to ENMs induced behavioral alterations, histopathological and biochemical changes in the central nervous system, increased susceptibility to allergy, transplacental genotoxicity, and vascular, immunological, and reproductive effects in offspring. The size- and developmental stage-dependent placental transfer of ENMs was noted after maternal exposure. Silver accumulated in the visceral yolk sac after being injected with Ag-NPs during early gestation. Although currently available data has provided initial information on the potential developmental toxicity of ENMs, that on the developmental toxicity of ENMs is still very limited. Further studies using well-characterized ENMs, state-of the-art study protocols, and appropriate routes of exposure are required in order to clarify these developmental effects and provide information suitable for risk assessments of ENMs. - Highlights: • We review the developmental toxicity studies of engineered nanomaterials (ENMs). • Various developmental endpoints have been

  2. A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi.

    Science.gov (United States)

    Burdon Bailey, Jordana L; Gamble, Luke; Gibson, Andrew D; Bronsvoort, Barend M deC; Handel, Ian G; Mellanby, Richard J; Mazeri, Stella

    2018-03-01

    Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children's knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both prabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both prabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren.

  3. A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi

    Science.gov (United States)

    Burdon Bailey, Jordana L.; Gamble, Luke; Gibson, Andrew D.; Bronsvoort, Barend M. deC.; Handel, Ian G.; Mellanby, Richard J.; Mazeri, Stella

    2018-01-01

    Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children’s knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both prabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both prabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren. PMID:29522517

  4. Assessment of the Participation of the Children with a Developmental Coordination Disorder (DCD) : A Review of the Questionnaires Addressed to Parents and/or Teachers

    NARCIS (Netherlands)

    Kaiser, Marie-Laure; Albaret, JM; Cantell, MH

    2015-01-01

    Objective: Children with Developmental Coordination Disorder (DCD) struggle with the activities of daily living which require motor coordination. In order to appreciate the impact of the DCD on the participation, several questionnaires for teachers and/or parents have been developed. The

  5. THE ASSESSMENT OF INDIVIDUAL-DIFFERENCES BETWEEN YOUNG-CHILDREN WITH A PERVASIVE DEVELOPMENTAL DISORDER BY MEANS OF BEHAVIOR SCALES WHICH ARE DERIVED FROM DIRECT OBSERVATION

    NARCIS (Netherlands)

    ALTHAUS, M; MINDERAA, RB; DIENSKE, H

    Data obtained by direct observation of 112 3-6-year-old normal children and 31 children with a pervasive developmental disorder aged 3-6 were used to construct behaviour scales by means of simultaneous component analysis. This is a technique for finding behaviour clusters (components) common to

  6. 2D and 3D assessment of neuropathology in rat brain after prenatal exposure to methylazoxymethanol, a model for developmental neurotoxicty

    NARCIS (Netherlands)

    Groot, D.M.G. de; Hartgring, S.; Horst, L. van de; Moerkens, M.; Otto, M.; Bos-Kuijpers, M.H.M.; Kaufmann, W.S.H.; Lammers, J.H.C.M.; O'Callaghan, J.P.; Waalkens-Berendsen, I.D.H.; Pakkenberg, B.; Gundersen, H.G.

    2005-01-01

    To evaluate the ability of a tiered quantitative morphological approach to reveal developmental neurotoxicity, morphometric parameters were measured in the offspring of rats treated with methylazoxymethanol (MAM) during days 13-15 of pregnancy. Treatment was aimed at inhibiting the proliferation

  7. What makes staff consider leaving the health service in Malawi?

    Science.gov (United States)

    Chimwaza, Wanangwa; Chipeta, Effie; Ngwira, Andrew; Kamwendo, Francis; Taulo, Frank; Bradley, Susan; McAuliffe, Eilish

    2014-03-19

    Malawi faces a severe shortage of health workers, a factor that has contributed greatly to high maternal mortality in the country. Most clinical care is performed by mid-level providers (MLPs). While utilization of these cadres in providing health care is a solution to the current shortages, demotivating factors within the Malawian health system are pushing them into private, non-governmental, and other non-health related positions. This study aims to highlight these demotivating factors by exploring the critical aspects that influence MLPs' intention to leave their jobs. This descriptive qualitative study formed part of the larger Health Systems Strengthening for Equity (HSSE) study. Data presented in this paper were collected in Malawi using the Critical Incident Analysis tool. Participants were asked to narrate an incident that had happened during the past three months which had made them seriously consider leaving their job. Data were subjected to thematic analysis using NVivo 8 software. Of the 84 respondents who participated in a Critical Incident Analysis interview, 58 respondents (69%) indicated they had experienced a demotivating incident in the previous three months that had made them seriously consider leaving their job. The most commonly cited critical factors were being treated unfairly or with disrespect, lack of recognition of their efforts, delays and inconsistencies in salary payments, lack of transparent processes and criteria for upgrading or promotion, and death of patients. Staff motivation and an enabling environment are crucial factors for retaining MLPs in the Malawian health system. This study revealed key 'tipping points' that drive staff to seriously consider leaving their jobs. Many of the factors underlying these critical incidents can be addressed by improved management practices and the introduction of fair and transparent policies. Managers need to be trained and equipped with effective managerial skills and staff should have access

  8. Extending beyond Policy: Reaching UNAIDS’ Three “90”s in Malawi

    Directory of Open Access Journals (Sweden)

    Zengani Chirwa

    2018-03-01

    Full Text Available Malawi, like other countries with a generalized HIV epidemic, is striving to reach the ambitious targets set by UNAIDS known as the three 90’s for testing, provision of antiretroviral therapy and viral suppression. Assisted by Malawi’s progressive policies on HIV/AIDS, it appears possible that Malawi will attain these targets, but only by employing innovative program approaches to service delivery which help fill policy gaps. This article describes how a dedicated cadre of layperson testers and HIV-positive peers appears to have helped attain increases in HIV and viral load testing and retention in care in four districts in Malawi, and situates these innovations in a policy framework analysis.

  9. Uitdagings vir die Ned Geref Kerk in Suidelike Afrika met Malawi en Zambi� as illustrasiegebiede

    Directory of Open Access Journals (Sweden)

    D. Crafford

    1990-08-01

    Full Text Available Challenges for the Dutch Reformed Church in Southern Africa with Malawi and Zambia as illustration areas What will be the challenges for the Dutch Reformed Church in South Africa if in the coming decades its isolation from Africa could be ended because of political developments in a post-apartheid era? The Dutch Reformed Church planted indigenous churches in many African Countries like Botswana, Malawi, Zimbabwe, Zambia, Mozambique and Namibia. The role of the church in Africa will be determined by its relations with these younger churches. The challenges in the fields of evangelism, church ministry, the youth and in the socioeconomic and political areas are illustrated specifically in the cases of Malawi and Zambia.

  10. Lessons from the recent rise in use of female sterilization in Malawi.

    Science.gov (United States)

    Jacobstein, Roy

    2013-03-01

    Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Malawi, however, despite daunting constraints, has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2 percent across Africa, and demand to limit births now exceeds demand to space births. Malawi's female sterilization prevalence surpasses that of some high-resource countries. Key service-delivery factors enabling this achievement include supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers. Challenges remain, but Malawi's achievement offers lessons for other countries with low availability of female sterilization and similar resource constraints. © 2013 The Population Council, Inc.

  11. Pigeon Pea and Cowpea-Based Cropping Systems Improve Vesicular Arbuscular Mycorrhizal Fungal Colonisation of Subsequent Maize on the Alfisols in Central Malawi

    Directory of Open Access Journals (Sweden)

    Keston O. W. Njira

    2017-01-01

    Full Text Available Mycorrhizal associations contribute to the sustainability of crop production systems through their roles in nutrient cycling and other benefits in the soil-plant ecosystems. A two-year study was conducted on the Alfisols of Lilongwe and Dowa districts, Central Malawi, to assess the vesicular-arbuscular mycorrhizal (VAM fungal colonisation levels in pigeon pea, cowpea, and maize grown in sole cropping, legume-cereal, and legume-legume intercropping systems and in the maize grown in short rotation (year 2 as influenced by the previous cropping systems and N fertilizer application. The gridline intersect method was used to assess the VAM fungal colonisation levels. Results showed that all treatments that included legumes whether grown as sole crop, in legume-cereal or in legume-legume cropping systems in the previous year, had significantly higher (P < 0.05 VAM fungal colonisation of the rotational maize crop roots by a range 39% to 50% and 19% to 47% than those in maize supplied and not supplied with N fertilizer, respectively, in a maize-maize short rotation, at the Lilongwe site. A similar trend was reported for the Dowa site. Furthermore, there were positive correlations between VAM fungal colonisation and the plant P content, dry matter yield, and nodule numbers. Further studies may help to assess the diversity of VAM fungal species in Malawi soils and identify more adaptive ones for inoculation studies.

  12. Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi.

    Science.gov (United States)

    Kabaghe, Alinune N; Phiri, Mphatso D; Phiri, Kamija S; van Vugt, Michèle

    2017-10-18

    Prompt and effective malaria treatment are key in reducing transmission, disease severity and mortality. With the current scale-up of artemisinin-based combination therapy (ACT) coverage, there is need to focus on challenges affecting implementation of the intervention. Routine indicators focus on utilization and coverage, neglecting implementation quality. A health system in rural Malawi was assessed for uncomplicated malaria treatment implementation in children. A cross-sectional health facility survey was conducted in six health centres around the Majete Wildlife Reserve in Chikwawa district using a health system effectiveness approach to assess uncomplicated malaria treatment implementation. Interviews with health facility personnel and exit interviews with guardians of 120 children under 5 years were conducted. Health workers appropriately prescribed an ACT and did not prescribe an ACT to 73% (95% CI 63-84%) of malaria rapid diagnostic test (RDT) positive and 98% (95% CI 96-100%) RDT negative children, respectively. However, 24% (95% CI 13-37%) of children receiving artemisinin-lumefantrine had an inappropriate dose by weight. Health facility findings included inadequate number of personnel (average: 2.1 health workers per 10,000 population), anti-malarial drug stock-outs or not supplied, and inconsistent health information records. Guardians of 59% (95% CI 51-69%) of children presented within 24 h of onset of child's symptoms. The survey presents an approach for assessing treatment effectiveness, highlighting bottlenecks which coverage indicators are incapable of detecting, and which may reduce quality and effectiveness of malaria treatment. Health service provider practices in prescribing and dosing anti-malarial drugs, due to drug stock-outs or high patient load, risk development of drug resistance, treatment failure and exposure to adverse effects.

  13. How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi.

    Science.gov (United States)

    Conroy, Amy A; Wong, Lauren H

    2015-11-01

    The majority of research on human immunodeficiency virus (HIV) disclosure utilizes the perspective from a single individual, which cannot be substantiated in the absence of supporting data such as from a primary partner. The objectives of this study were to evaluate: (1) the extent to which self-reported HIV disclosure was confirmed by a primary partner; (2) individual and relationship-level predictors of self-reported versus confirmed disclosure; and (3) whether confirmed disclosure was a stronger predictor of correctly assessing a partner's HIV status compared to self-reported disclosure. As part of an 8-wave longitudinal study from 2009 to 2011 in southern Malawi, 366 individuals (183 couples) were interviewed about their primary relationship (wave 3), individually tested for HIV (wave 4), and then asked whether they disclosed to their primary partner (wave 5). While 93% of respondents reported that they disclosed, only 64% of respondents had confirmed reports from their partner. Having communicated with partner about HIV was positively associated with self-reported disclosure; this association remained significant but became more precise in the models for confirmed disclosure. Confirmed disclosure, but not self-report, was a significant predictor of correctly assessing a partner's HIV status. Being male, having lower perceived partner infidelity, having higher relationship unity, and testing HIV-negative were positively and significantly associated with correct assessment. Dyadic data from two partners provide an improved measure of disclosure as compared to a single individual's self-report and could be used to identify behavioral and biomedical opportunities to prevent HIV transmission within couples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Democracy as a Limiting Factor for Politicised Cultural Populism in Malawi Demokratie und politisierter Kulturpopulismus in Malawi

    Directory of Open Access Journals (Sweden)

    Reuben Makayiko Chirambo

    2009-01-01

    Full Text Available Though Malawian democracy could still be described as in transition from authoritarianism, it has enabled an atmosphere for critical debate of and dissent against seemingly popular opinions, which was not possible during the authoritarian rule of former life president, Dr. H. K. Banda, 1964-1994. This article examines politicised cultural populism in Malawi under the dictatorship and democracy in comparative terms. President Banda, as a political populist, appropriated culture to legitimate and validate his political power as well as to cultivate popular support from the majority of ordinary people. Following reforms towards democracy since 1992, his successors have also tended towards populist politics by similarly appropriating culture and cultural activities, among other means, to cultivate popular support from mostly ordinary people for their regimes. Such politicised cultural populism involves adopting traditional roles, cultural symbols and images of power such as praise-titles, and participating in cultural activities such as traditional dances. This article examines the efforts of President Bingu wa Mutharika in the democratic dispensation to appropriate cultural artefacts used by Banda during a dictatorship in order to cultivate popular support for his regime. The article argues that Bingu’s efforts at politicised cultural populism are constrained, among other factors, by the nature and climate of democratic politics mainly because democracy, unlike a dictatorship, enables critical debate and the questioning of political leader’s behaviour and their motives. Auch wenn die Demokratie in Malawi sich immer noch in einem Übergangsstadium befindet, ist inzwischen eine Atmosphäre entstanden, in der eine kritische Debatte und das Äußern unpopulärer Meinungen möglich sind, was in den Jahren 1964-1994 unter dem früheren Präsidenten auf Lebenszeit, Dr. H. K. Banda, nicht denkbar war. Der Autor vergleicht die Nutzung von Elementen

  15. Are one-stop centres an appropriate model to deliver services to sexually abused children in urban Malawi?

    Science.gov (United States)

    Mulambia, Yabwile; Miller, Aaron J; MacDonald, Geraldine; Kennedy, Neil

    2018-04-30

    The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as 'Chikwanekwanes' - 'everything under one roof') to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country's first Chikwanekwane in the large, urban city of Blantyre. One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.

  16. Stroke outcomes in Malawi, a country with high prevalence of HIV: a prospective follow-up study.

    Directory of Open Access Journals (Sweden)

    Terttu Heikinheimo

    Full Text Available BACKGROUND: Stroke contributes significantly to disability and mortality in developing countries yet little is known about the determinants of stroke outcomes in such countries. 12% of Malawian adults have HIV/AIDS. It is not known whether having HIV-infection alters the outcome of stroke. The aim of this study was to document the functional outcome and mortality at 1 year of first-ever acute stroke in Malawi. Also to find out if the baseline variables, including HIV-infection, affect the outcome of stroke. METHODS AND FINDINGS: 147 adult patients with first-ever acute stroke were prospectively followed up for 12 months. Conventional risk factors and HIV-infection were assessed at baseline. Stroke severity was evaluated with modified National Institute of Health Stroke Scale (mNIHSS and functional outcome with modified Rankin scale (mRS. Fifty (34% of patients were HIV-seropositive. 53.4% of patients had a poor outcome (severe disability or death, mRS 4-6 at 1 year. Poor outcome was related to stroke severity and female gender but not to presence of HIV-infection. HIV-seropositive patients were younger and had less often common risk factors for stroke. They suffer more often ischemic stroke than HIV-seronegative patients. CONCLUSIONS: Mild stroke and male gender were associated with favourable outcome. HIV-infection is common in stroke patients in Malawi but does not worsen the outcome of stroke. However, it may be a risk factor for ischemic stroke for young people, who do not have the common stroke risk factors. Our results are significant, because stroke outcome in HIV-seropositive patients has not been studied before in a setting such as ours, with very limited resources and a high prevalence of HIV.

  17. Achieving the sustainable development goals: a case study of the complexity of water quality health risks in Malawi.

    Science.gov (United States)

    Holm, Rochelle; Wandschneider, Philip; Felsot, Allan; Msilimba, Golden

    2016-07-15

    Suppose 35 % of the households with children under 5 years of age in a low-income suburban neighborhood in a developing country have diarrhea where improved water sources are available. Clearly, something is amiss-but what? In addition to focusing on the need to examine water quality among water sources that meet the 'improved' category when assessing health risk, the relative importance of the range of transmission routes for diarrhea is unknown. In Malawi, relevant baseline data affecting human health are simply not available, and acquiring data is hampered by a lack of local analytical capacity for characterizing drinking water quality. The objective of this work is to develop a risk communication program with partnership among established regional development professionals for effectively meeting the sustainable development goals. A field study was conducted in the city of Mzuzu, Malawi, to study water quality (total coliform and Escherichia coli) and human dimensions leading to development of a public health risk communication strategy in a peri-urban area. A structured household questionnaire was administered to adult residents of 51 households, encompassing 284 individuals, who were using the 30 monitored shallow wells. The water quality data and human dimension questionnaire results were used to develop a household risk presentation. Sixty-seven percent and 50 % of well water and household drinking water samples, respectively, exceeded the WHO health guideline of zero detections of E. coli. Technology transfer was advanced by providing knowledge through household risk debriefing/education, establishing a water quality laboratory at the local university, and providing training to local technicians. Communicating the science of water quality and health risks in developing countries requires sample collection and analysis by knowledgeable personnel trained in the sciences, compiling baseline data, and, ultimately, an effective risk presentation back to

  18. An Analysis of the Last Clinical Encounter before Outpatient Mortality among Children with HIV Infection and Exposure in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Chris A Rees

    Full Text Available Human immunodeficiency virus (HIV contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting.This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children's Center of Excellence in Lilongwe, Malawi. We compared clinical indicators documented from the final outpatient encounter for patients who died in the outpatient setting versus those who were alive after their penultimate clinical encounter.Of the 8,546 patients who were attended to over a 10-year period at the Baylor Center of Excellence, 851 had died (10%. Of children who died, 392 (46% were directly admitted to the hospital after their last clinical encounter and died as inpatients. Of the remaining 459 who died as outpatients after their last visit, 53.5% had a World Health Organization (WHO stage IV condition at their last visit, and 25% had a WHO stage III condition. Multivariate regression analysis demonstrated that poor nutritional status, female gender, shorter time as a patient, more clinical encounters in the prior month, if last visit was an unscheduled sick visit, and if the patient had lost weight since their prior visit independently predicted increased mortality in the outpatient setting after the final clinical encounter.Clinical indicators may assist in identifying children with HIV who have increased risk of mortality in the outpatient setting. Recognizing these indicators may aid in identifying HIV-infected children who require a higher level of care or closer follow-up.

  19. Self-directed e-learning at a tertiary hospital in Malawi--a qualitative evaluation and lessons learnt.

    Science.gov (United States)

    Barteit, Sandra; Hoepffner, Philip; Huwendiek, Sören; Karamagi, Angela; Munthali, Charles; Theurer, Antje; Neuhann, Florian

    2015-01-01

    Malawi faces a severe lack of health workers. Despite initiatives to address this problem, a critical shortage of health care staff remains. This lack challenges the education and training of junior medical staff, especially medical interns in their final and crucial training year before they independently work as medical doctors. We have introduced an e-learning platform in the medical department of the Kamuzu Central Hospital (KCH) in Malawi. With the support of computer-assisted instruction, we aimed to improve the quality of medical training and education, as well as access to current medical materials, in particular for interns. From March to April 2012, we conducted a qualitative evaluation to assess relevance and appropriateness of the e-learning platform. Data was collected via face-to-face interviews, a guided group discussion and a checklist based observation log. Evaluation data was recorded and coded using content analysis, interviewees were chosen via purposive sampling. E-learning proved to be technically feasible in this setting. Users considered the e-learning platform to be relevant and appropriate. Concerns were raised about sustainability, accessibility and technical infrastructure, as well as limited involvement and responsibilities of Malawian partners. Interest in e-learning was high, yet, awareness of and knowledge about the e-learning platform among potential users was low. Evaluation results indicated that further adaptions to local needs are necessary to increase usage and accessibility. Interview results and our project experiences showed that, in the given setting, e-learning requires commitment from local stakeholders, adequate technical infrastructure, identification and assignation of responsibilities, as well as specific adaption to local needs.

  20. Self-directed e-learning at a tertiary hospital in Malawi – A qualitative Evaluation and Lessons learnt

    Science.gov (United States)

    Barteit, Sandra; Hoepffner, Philip; Huwendiek, Sören; Karamagi, Angela; Munthali, Charles; Theurer, Antje; Neuhann, Florian

    2015-01-01

    Background: Malawi faces a severe lack of health workers. Despite initiatives to address this problem, a critical shortage of health care staff remains. This lack challenges the education and training of junior medical staff, especially medical interns in their final and crucial training year before they independently work as medical doctors. Project description: We have introduced an e-learning platform in the medical department of the Kamuzu Central Hospital (KCH) in Malawi. With the support of computer-assisted instruction, we aimed to improve the quality of medical training and education, as well as access to current medical materials, in particular for interns. Method: From March to April 2012, we conducted a qualitative evaluation to assess relevance and appropriateness of the e-learning platform. Data was collected via face-to-face interviews, a guided group discussion and a checklist based observation log. Evaluation data was recorded and coded using content analysis, interviewees were chosen via purposive sampling. Results: E-learning proved to be technically feasible in this setting. Users considered the e-learning platform to be relevant and appropriate. Concerns were raised about sustainability, accessibility and technical infrastructure, as well as limited involvement and responsibilities of Malawian partners. Interest in e-learning was high, yet, awareness of and knowledge about the e-learning platform among potential users was low. Evaluation results indicated that further adaptions to local needs are necessary to increase usage and accessibility. Conclusions: Interview results and our project experiences showed that, in the given setting, e-learning requires commitment from local stakeholders, adequate technical infrastructure, identification and assignation of responsibilities, as well as specific adaption to local needs. PMID:25699110

  1. Reproductive and developmental toxicology

    National Research Council Canada - National Science Library

    Gupta, Ramesh C

    2011-01-01

    .... Reproductive and Developmental Toxicology is a comprehensive and authoritative resource providing the latest literature enriched with relevant references describing every aspect of this area of science...

  2. Couple decision making and use of cultural scripts in Malawi.

    Science.gov (United States)

    Mbweza, Ellen; Norr, Kathleen F; McElmurry, Beverly

    2008-01-01

    To examine the decision-making processes of husband and wife dyads in matrilineal and patrilineal marriage traditions of Malawi in the areas of money, food, pregnancy, contraception, and sexual relations. Qualitative grounded theory using simultaneous interviews of 60 husbands and wives (30 couples). Data were analyzed according to the guidelines of simultaneous data collection and analysis. The analysis resulted in development of core categories and categories of decision-making process. Data matrixes were used to identify similarities and differences within couples and across cases. Most couples reported using a mix of final decision-making approaches: husband-dominated, wife-dominated, and shared. Gender based and nongender based cultural scripts provided rationales for their approaches to decision making. Gender based cultural scripts (husband-dominant and wife-dominant) were used to justify decision-making approaches. Non-gender based cultural scripts (communicating openly, maintaining harmony, and children's welfare) supported shared decision making. Gender based cultural scripts were used in decision making more often among couples from the district with a patrilineal marriage tradition and where the husband had less than secondary school education and was not formally employed. Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Nurses who work with women and families should be aware of the variations that occur in actual couple decision-making approaches. Shared decision making can be used to encourage the involvement of men in reproductive health programs.

  3. Gestational Age at First Antenatal Care Visit in Malawi.

    Science.gov (United States)

    Mkandawire, Paul

    2015-11-01

    This paper examines the gestational age at first antenatal care (ANC) visit and factors associated with timely initiation of ANC in Malawi in a context where maternal and child health services are generally provided for free. Lognormal survival models are applied to Demographic and Health Survey data from a nationally representative sample of women (n = 13,588) of child-bearing age. The findings of this study show that less than 30 % of pregnant women initiate ANC within the World Health Organization recommended gestational timeframe of 16 weeks or earlier. The hazard analysis shows a gradient in the initiation of ANC by maternal education level, with least educated mothers most likely to delay their first ANC visit. However, after adjusting for variables capturing intimate partner violence in the multivariate models, the effect of maternal education attenuated and lost statistical significance. Other significant predictors of gestational age at first ANC include media exposure, perceived distance from health facility, age, and birth order. The findings of the study link domestic violence directly with the gestational age at which mothers initiate ANC, suggesting that gender-based violence may operate through delayed initiation of ANC to undermine maternal and child health outcomes.

  4. Speciation in rapidly diverging systems: lessons from Lake Malawi.

    Science.gov (United States)

    Danley, P D; Kocher, T D

    2001-05-01

    Rapid evolutionary radiations provide insight into the fundamental processes involved in species formation. Here we examine the diversification of one such group, the cichlid fishes of Lake Malawi, which have radiated from a single ancestor into more than 400 species over the past 700 000 years. The phylogenetic history of this group suggests: (i) that their divergence has proceeded in three major bursts of cladogenesis; and (ii) that different selective forces have dominated each cladogenic event. The first episode resulted in the divergence of two major lineages, the sand- and rock-dwellers, each adapted to a major benthic macrohabitat. Among the rock-dwellers, competition for trophic resources then drove a second burst of cladogenesis, which resulted in the differentiation of trophic morphology. The third episode of cladogenesis is associated with differentiation of male nuptial colouration, most likely in response to divergent sexual selection. We discuss models of speciation in relation to this observed pattern. We advocate a model, divergence with gene flow, which reconciles the disparate selective forces responsible for the diversification of this group and suggest that the nonadaptive nature of the tertiary episode has significantly contributed to the extraordinary species richness of this group.

  5. Parental Divorce and Children’s Schooling in Rural Malawi

    Science.gov (United States)

    Chae, Sophia

    2016-01-01

    A growing body of literature has examined the impact of different types of family structures on children’s schooling in sub-Saharan Africa. These studies have investigated how living arrangements, gender of the household head, parental death, and paternal migration are related to schooling. Although many sub-Saharan African countries have high divorce rates, very few studies have explored the impact of parental divorce on children’s schooling. The present study uses three waves of data from the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the effect of parental divorce on children’s schooling and the possible mechanisms driving this relationship. Unlike prior studies, this study uses child-level fixed-effects models to control for selection into divorce. Results show that parental divorce is associated with lower grade attainment and a larger schooling gap, defined as the number of years a child is behind in school (among children currently attending school). Although no association exists between parental divorce and current school attendance, girls affected by divorce are significantly less likely to be attending school. Differences in economic resources, maternal coresidence, or maternal psychological well-being do not explain the relationship between parental divorce and children’s schooling. PMID:27822897

  6. Parental Divorce and Children's Schooling in Rural Malawi.

    Science.gov (United States)

    Chae, Sophia

    2016-12-01

    A growing body of literature has examined the impact of different types of family structures on children's schooling in sub-Saharan Africa. These studies have investigated how living arrangements, gender of the household head, parental death, and paternal migration are related to schooling. Although many sub-Saharan African countries have high divorce rates, very few studies have explored the impact of parental divorce on children's schooling. The present study uses three waves of data from the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the effect of parental divorce on children's schooling and the possible mechanisms driving this relationship. Unlike prior studies, this study uses child-level fixed-effects models to control for selection into divorce. Results show that parental divorce is associated with lower grade attainment and a larger schooling gap, defined as the number of years a child is behind in school (among children currently attending school). Although no association exists between parental divorce and current school attendance, girls affected by divorce are significantly less likely to be attending school. Differences in economic resources, maternal coresidence, or maternal psychological well-being do not explain the relationship between parental divorce and children's schooling.

  7. The Parallel Economy in Malawi: Size, Effect on Tax Revenue and Policy Options

    OpenAIRE

    Chiumya, Chiza

    2007-01-01

    This study looks at the dynamics of the Parallel Economy. I estimate the size of the Parallel Economy in Malawi and its relationship with Tax Revenues. The Parallel Economy in Malawi was 12.3%, 23.1% and 17.3% of GDP in the 1970s, 1980s, and 1990s respectively. Income Taxes were a major driver of the Parallel Economy as compared to Import and Consumption Taxes. An increase in Tax Revenue led to an increase in the Parallel Economy and a decrease in tax Revenue led to a decrease in the Parallel...

  8. Characterizing the impact of sustained sulfadoxine/pyrimethamine use upon the Plasmodium falciparum population in Malawi

    DEFF Research Database (Denmark)

    Ravenhall, Matt; Benavente, Ernest Diez; Mipando, Mwapatsa

    2016-01-01

    BACKGROUND: Malawi experienced prolonged use of sulfadoxine/pyrimethamine (SP) as the front-line anti-malarial drug, with early replacement of chloroquine and delayed introduction of artemisinin-based combination therapy. Extended use of SP, and its continued application in pregnancy is impacting...... the genomic variation of the Plasmodium falciparum population. METHODS: Whole genome sequence data of P. falciparum isolates covering 2 years of transmission within Malawi, alongside global datasets, were used. More than 745,000 SNPs were identified, and differences in allele frequencies between countries...

  9. Current status of developmental neurotoxicity: regulatory view

    DEFF Research Database (Denmark)

    Hass, Ulla

    2003-01-01

    in the testing strategy for new and existing substances, and biocides. Hopefully, this will lead to an improved database for risk assessment of potential developmental neurotoxicants. However, the regulatory authorities and toxicologists will also be faced with the challenge that decisions have to be made......The need for developmental neurotoxicity testing has been recognized for decades and guidelines are available, as the USEPA guideline and the OECD draft TG 426. Regulatory testing of industrial chemicals for developmental neurotoxicity is required to some extent, especially for pesticides in the US....... Until recently, however, developmental neurotoxicity testing of industrial chemicals has not been a clear regulatory requirement in EU, probably due to the lack of an accepted OECD TG. The revised EU Technical Guidance Document for Risk Assessment (EU-TGD) has now included the OECD draft TG 426...

  10. Examining the Criterion-Related Validity of the Pervasive Developmental Disorder Behavior Inventory

    Science.gov (United States)

    McMorris, Carly A.; Perry, Adrienne

    2015-01-01

    The Pervasive Developmental Disorder Behavior Inventory is a questionnaire designed to aid in the diagnosis of pervasive developmental disorders or autism spectrum disorders. The Pervasive Developmental Disorder Behavior Inventory assesses adaptive and maladaptive behaviors associated with pervasive developmental disorders and provides an…

  11. The classification of motor neuron defects in the zebrafish embryo toxicity test (ZFET) as an animal alternative approach to assess developmental neurotoxicity.

    Science.gov (United States)

    Muth-Köhne, Elke; Wichmann, Arne; Delov, Vera; Fenske, Martina

    2012-07-01

    Rodents are widely used to test the developmental neurotoxicity potential of chemical substances. The regulatory test procedures are elaborate and the requirement of numerous animals is ethically disputable. Therefore, non-animal alternatives are highly desirable, but appropriate test systems that meet regulatory demands are not yet available. Hence, we have developed a new developmental neurotoxicity assay based on specific whole-mount immunostainings of primary and secondary motor neurons (using the monoclonal antibodies znp1 and zn8) in zebrafish embryos. By classifying the motor neuron defects, we evaluated the severity of the neurotoxic damage to individual primary and secondary motor neurons caused by chemical exposure and determined the corresponding effect concentration values (EC₅₀). In a proof-of-principle study, we investigated the effects of three model compounds thiocyclam, cartap and disulfiram, which show some neurotoxicity-indicating effects in vertebrates, and the positive controls ethanol and nicotine and the negative controls 3,4-dichloroaniline (3,4-DCA) and triclosan. As a quantitative measure of the neurotoxic potential of the test compounds, we calculated the ratios of the EC₅₀ values for motor neuron defects and the cumulative malformations, as determined in a zebrafish embryo toxicity test (zFET). Based on this index, disulfiram was classified as the most potent and thiocyclam as the least potent developmental neurotoxin. The index also confirmed the control compounds as positive and negative neurotoxicants. Our findings demonstrate that this index can be used to reliably distinguish between neurotoxic and non-neurotoxic chemicals and provide a sound estimate for the neurodevelopmental hazard potential of a chemical. The demonstrated method can be a feasible approach to reduce the number of animals used in developmental neurotoxicity evaluation procedures. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Developmental assessment and performance analysis of vertical jump in schoolchildren. DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n4p460

    Directory of Open Access Journals (Sweden)

    Dalker Roberto Walter

    2012-07-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2012v14n4p460The vertical jump involves different levels of skill complexity and offers the individual a wide range of motor experiences. This study aimed to determine which movements in the developmental sequence performed by schoolchildren are associated with age and vertical jump performance. The sample consisted of 137 elementary school children of both sexes, aged 7-10y, with height of 1.19-1.63 m, and weight of 20-60 kg. All children were selected from first- to fourth-grade classrooms of a public school of the city of Maringá, state of Pa- raná, Brazil. A Gallahue & Ozmun matrix and a jumping platform were used as research instruments. During the experiment, each child performed three jumps. Simultaneous and coordinated upward arm lift was observed in 7-year-old children. In 9-year-old children, inconsistent preparatory crouch and lack of coordination between limb movements and trunk were observed. A prevalence of upper limb motor acts was observed when considering the significant associations found between elements of the developmental sequence and vertical jump performance. In children aged 7-10y, age group and jumping performance are associated with elements of the developmental sequence of the human body as a whole, especially with regard to the upper limbs.

  13. Reasons for low uptake of referrals to ear and hearing services for children in Malawi.

    Directory of Open Access Journals (Sweden)

    Tess Bright

    Full Text Available Early detection and appropriate intervention for children with hearing impairment is important for maximizing functioning and quality of life. The lack of ear and hearing services in low income countries is a significant challenge, however, evidence suggests that even where such services are available, and children are referred to them, uptake is low. The aim of this study was to assess uptake of and barriers to referrals to ear and hearing services for children in Thyolo District, Malawi.This was a mixed methods study. A survey was conducted with 170 caregivers of children who were referred for ear and hearing services during community-based screening camps to assess whether they had attended their referral and reasons for non-attendance. Semi-structured interviews were conducted with 23 caregivers of children who did not take up their referral to explore in-depth the reasons for non-uptake. In addition, 15 stakeholders were interviewed. Thematic analysis of the interview data was conducted and emerging trends were analysed.Referral uptake was very low with only 5 out of 150 (3% children attending. Seven main interacting themes for non-uptake of referral were identified in the semi-structured interviews: location of the hospital, lack of transport, other indirect costs of seeking care, fear and uncertainty about the referral hospital, procedural problems within the camps, awareness and understanding of hearing loss, and lack of visibility and availability of services.This study has highlighted a range of interacting challenges faced by families in accessing ear and hearing services in this setting. Understanding these context specific barriers to non-uptake of ear and hearing services is important for designing appropriate interventions to increase uptake.

  14. Communication Deficits in Infants and Toddlers with Developmental Disabilities

    Science.gov (United States)

    Hattier, Megan A.; Matson, Johnny L.; Sipes, Megan; Turygin, Nicole

    2011-01-01

    Research that focuses on detecting and assessing the presence of communication impairments in children with developmental disabilities exists. However, more research is needed which compares these deficits across individuals with various developmental disabilities. This information could inform the assessment process and treatment programs.…

  15. Motivation of health surveillance assistants in Malawi: A qualitative study.

    Science.gov (United States)

    Chikaphupha, Kingsley R; Kok, Maryse C; Nyirenda, Lot; Namakhoma, Ireen; Theobald, Sally

    2016-06-01

    Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of HSAs. A qualitative study capturing the perspectives of purposively selected participants was conducted in two districts: Salima and Mchinji. Participants included HSAs, health managers, and various community members. Data were collected through focus group discussions (n = 16) and in-depth interviews (n = 44). The study sample was comprised of 112 women and 65 men. Qualitative data analysis was informed by existing frameworks on factors influencing health worker motivation. Our analysis identified five key themes shaping HSA motivation: salary, accommodation, human resource management, supplies and logistics, and community links. Each of these played out at different levels-individual, family, community, and organisational-with either positive or negative effects. Demotivating factors related primarily to the organisational level, while motivating factors were more often related to individual, family, and community levels. A lack of financial incentives and shortages of basic supplies and materials were key factors demotivating HSAs. Supervision was generally perceived as unsupportive, uncoordinated, and top-down. Most HSAs complained of heavy workload. Many HSAs felt further recognition and support from the Ministry of Health, and the development of a clear career pathway would improve their motivation. Factors shaping motivation of HSAs are complex and multilayered; experiences at one level will impact other levels. Interventions are required to enhance HSA motivation, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. HSAs have unique experiences, and there is need to hear

  16. Adopt or Adapt: Sanitation Technology Choices in Urbanizing Malawi.

    Science.gov (United States)

    Chunga, Richard M; Ensink, Jeroen H J; Jenkins, Marion W; Brown, Joe

    2016-01-01

    This paper presents the results of a mixed-methods study examining adaptation strategies that property owners in low-income, rapidly urbanizing areas in Malawi adopt to address the limitations of pit latrines, the most common method of disposing human excreta. A particular challenge is lack of space for constructing new latrines as population density increases: traditional practice has been to cap full pits and simply move to a new site, but increasing demands on space require new approaches to extend the service life of latrines. In this context, we collected data on sanitation technology choices from January to September 2013 through 48 in-depth interviews and a stated preference survey targeting 1,300 property owners from 27 low-income urban areas. Results showed that property owners with concern about space for replacing pit latrines were 1.8 times more likely to select pit emptying service over the construction of new pit latrines with a slab floor (p = 0.02) but there was no significant association between concern about space for replacing pit latrines and intention to adopt locally promoted, novel sanitation technology known as ecological sanitation (ecosan). Property owners preferred to adapt existing, known technology by constructing replacement pit latrines on old pit latrine locations, reducing the frequency of replacing pit latrines, or via emptying pit latrines when full. This study highlights potential challenges to adoption of wholly new sanitation technologies, even when they present clear advantages to end users. To scale, alternative sanitation technologies for rapidly urbanising cities should offer clear advantages, be affordable, be easy to use when shared among multiple households, and their design should be informed by existing adaptation strategies and local knowledge.

  17. Why might clinicians in Malawi not offer HIV testing to their patients ...

    African Journals Online (AJOL)

    In order to identify reasons clinicians in Malawi might not offer HIV testing to patients, a cross-sectional descriptive postal census with telephone and fax follow-up was conducted. Proportions were calculated for each reason given for not offering HIV testing. Multiple logistic regression was used to determine whether ...

  18. Late Pleistocene temperature history of Southeast Africa: A TEX(86) temperature record from Lake Malawi

    NARCIS (Netherlands)

    Woltering, M.; Johnson, T.C.; Werne, J.P.; Schouten, S.; Sinninghe Damsté, J.S.

    2011-01-01

    We present a TEX86-derived surface water temperaturerecord for LakeMalawi that provides the first continuous continental record of temperature variability in the continental tropics spanning the past ∼ 74 kyr with millennial-scale resolution. Average temperature during Marine Isotope Stage (MIS) 5A

  19. Understanding the earth systems of Malawi: Ecological sustainability, culture, and place-based education

    Science.gov (United States)

    Glasson, George E.; Frykholm, Jeffrey A.; Mhango, Ndalapa A.; Phiri, Absalom D.

    2006-07-01

    The purpose of this 2-year study was to investigate Malawian teacher educators' perspectives and dispositions toward teaching about ecological sustainability issues in Malawi, a developing country in sub-Sahara Africa. This study was embedded in a larger theoretical framework of investigating earth systems science through the understanding of nature-knowledge-culture systems from local, place-based perspectives. Specifically, we were interested in learning more about eco-justice issues that are related to environmental degradation in Malawi and the potential role of inquiry-oriented pedagogies in addressing these issues. In a science methods course, the African educators' views on deforestation and teaching about ecological sustainability were explored within the context of the local environment and culture. Teachers participated in inquiry pedagogies designed to promote the sharing of perspectives related to the connections between culture and ecological degradation. Strategies encouraging dialogue and reflection included role-playing, class discussions, curriculum development activities, teaching experiences with children, and field trips to a nature preserve. Data were analyzed from postcolonial and critical pedagogy of place theoretical perspectives to better understand the hybridization of viewpoints influenced by both Western and indigenous science and the political hegemonies that impact sustainable living in Malawi. Findings suggested that the colonial legacy of Malawi continues to impact the ecological sustainability issue of deforestation. Inquiry-oriented pedagogies and connections to indigenous science were embraced by the Malawian educators as a means to involve children in investigation, decision making, and ownership of critical environmental issues.

  20. Teachers' Views about Technical Education: Implications for Reforms towards a Broad Based Technology Curriculum in Malawi

    Science.gov (United States)

    Chikasanda, Vanwyk Khobidi; Otrel-Cass, Kathrin; Jones, Alister

    2011-01-01

    Internationally there has been concern about the direction of technical education and how it is positioned in schools. This has also been the case in Malawi where the curriculum has had a strong focus on skills development. However, lately there has been a call for enhancing technological literacy of students, yet little support has been provided…

  1. Malnutrition and Neutropenia in Children Treated for Burkitt Lymphoma in Malawi

    NARCIS (Netherlands)

    Israëls, Trijn; van de Wetering, Marianne D.; Hesseling, Peter; van Geloven, Nan; Caron, Huib N.; Molyneux, Elizabeth M.

    2009-01-01

    Background. infection in neutropenic children is a major cause of morbidity and mortality in children treated for cancer. In developing countries, children with cancer are often malnourished at diagnosis. In Blantyre, Malawi, children with Burkitt lymphoma are treated with a local protocol with

  2. Applying a Reading Program Based on Cognitive Science in Rural Areas of Malawi: Preliminary Results

    Science.gov (United States)

    Iyengar, Radhika; Karim, Alia; Chagwira, Florie

    2016-01-01

    Reading fluency is a skill foundational to academic performance, and acquiring this skill in early grades is crucial. Throughout sub-Saharan Africa, reading levels of students are far below grade level, and Malawi is no exception. Research suggests that students, particularly in consistently spelled languages, acquire automaticity most easily by…

  3. The Epidemiology of District Surgery in Malawi: a Two Year Study of ...

    African Journals Online (AJOL)

    Background: The true surgical requirement of a rural African population is also not precisely known. Methods: Data gathered over a 2-year period from 1993 to 1995 on surgical and anaesthetic activities in 18 District Hospitals in Malawi are presented. Results: Theatre records showed that 45,032 operations were carried out ...

  4. Insights on skilled attendance at birth in Malawi - the findings of a ...

    African Journals Online (AJOL)

    Increasing the number of women who access skilled attendance at birth is the goal of many developing countries including Malawi. The Skilled Attendance for Everyone (SAFE) international research programme coordinated by the Dugald Baird Centre for research on Women\\'s Health at the University of Aberdeen, ...

  5. Explanations for Child Sexual Abuse Given by Convicted Offenders in Malawi: No Evidence for "HIV Cleansing"

    Science.gov (United States)

    Mtibo, Charles; Kennedy, Neil; Umar, Eric

    2011-01-01

    Objective: A commonly cited, but unproven reason given for the rise in reported cases of child sexual abuse in Sub-Saharan Africa is the "HIV cleansing myth"--the belief that an HIV infected individual can be cured by having sex with a child virgin. The purpose of this study was to explore in Malawi the reasons given by convicted sex…

  6. What factors drive fishery yields in the Lower Shire River, Malawi ...

    African Journals Online (AJOL)

    The Shire River drains from Lake Malawi to the Lower Zambezi River. Annual flow is dependent mainly on lake level, partially controlled by the operation of a barrage at Liwonde to regulate flows for hydroelectricity generation in the escarpment reaches of the river. Downstream of the escarpment, the floodplains of the ...

  7. 76 FR 21044 - Notice of Entering Into a Compact With the Republic of Malawi

    Science.gov (United States)

    2011-04-14

    ... Malawi in connection with the Program, (ii) sales tax, value added tax, excise tax, property transfer tax... Resources; Budget Section 2.7 Limitations of the Use of MCC Funding Section 2.8 Taxes Article 3... means of family planning. Section 2.8 Taxes (a) Unless the Parties specifically agree otherwise in...

  8. Immunisation of smallholder dairy cattle against anaplasmosis and babesiosis in Malawi

    DEFF Research Database (Denmark)

    Tjørnehøj, Kirsten; Lawrence, J. A.; Kafuwa, P. T.

    1997-01-01

    A field study was conducted in the Southern Region of Malawi to evaluate the possible benefits of immunisation of improved dairy cattle against Anaplasma marginale, Babesia bigemina and Babesia bovis. Friesian crossbred heifers were immunised when they were being reared on Government farms. They ...

  9. Local health workers' perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

    NARCIS (Netherlands)

    Beltman, Jogchum Jan; van den Akker, Thomas; Bwirire, Dieudonne; Korevaar, Anneke; Chidakwani, Richard; van Lonkhuijzen, Luc; van Roosmalen, Jos

    2013-01-01

    Background: To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers. Methods: Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians ('medical

  10. Local health workers' perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

    NARCIS (Netherlands)

    Beltman, J.J.; van den Akker, T.; Bwirire, D.; Korevaar, A.; Chidakwani, R.; van Lonkhuijzen, L.; van Roosmalen, J.

    2013-01-01

    Background: To identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers.Methods: Three focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians ('medical

  11. Situation Report--Hong Kong, Malawi, Pakistan, Panama, Philippines, Ryukyu Islands (Okinawa), Sabah, Sarawak.

    Science.gov (United States)

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in eight foreign countries are presented in these situation reports. Countries included are Hong Kong, Malawi, Pakistan, Panama, Philippines, Ryukyu Islands (Okinawa), Sabah, and Sarawak. Information is provided where appropriate and available, under two topics, general background and family planning…

  12. Transition and Tertiary Education: A Case Study of Mzuzu University, Malawi

    Science.gov (United States)

    Zozie, Paxton Andrew; Kayira, Peter Benwell

    2012-01-01

    This article reviews the role of guidance and counselling in Malawi in reducing dropout and easing the transition of students to tertiary education, as well as in helping them during their time in tertiary education. It begins by identifying key success factors in guidance and counselling services for learners in both developed and developing…

  13. Implementing Free Primary Education Policy in Malawi and Ghana: Equity and Efficiency Analysis

    Science.gov (United States)

    Inoue, Kazuma; Oketch, Moses

    2008-01-01

    Malawi and Ghana are among the numerous Sub-Saharan Africa countries that have in recent years introduced Free Primary Education (FPE) policy as a means to realizing the 2015 Education for All and Millennium Development Goals international targets. The introduction of FPE policy is, however, a huge challenge for any national government that has…

  14. Epidemiology of measles in Blantyre, Malawi: analyses of passive surveillance data from 1996 to 1998

    NARCIS (Netherlands)

    Yamaguchi, S.; Dunga, A.; Broadhead, R. L.; Brabin, B. J.

    2002-01-01

    Measles surveillance data in Blantyre, Malawi were reviewed for 1996-8 to describe the epidemiology of infection and to estimate vaccine efficacy (VE) by the screening method. A total of 674 measles cases were reported to the Blantyre District Health Office during this period. Age distribution

  15. an epidemiologic study of drug abuse and hiv and aids in malawi

    African Journals Online (AJOL)

    Administrator

    1University of Pretoria, School of Health Systems and Public Health, 2Centre for Social Research,. University of Malawi, 3Zomba Mental Hospital, Ministry of Health, 4Zomba Central Hospital,. Ministry of ... childbearing age group of 16.4%. Youth aged 15-24 claim 46% of new HIV ... same drugs are responsible for their.

  16. HIV/AIDS messages in Malawi and their implications for effective ...

    African Journals Online (AJOL)

    We consider the role of institutional and personal actors involved in Malawi's recently instated and decentralised behaviour-change intervention strategy, as well as the form and function of interpersonal social networks that mediate this information. The research reveals that the organisational capacity of actors and the ...

  17. "Home is always home" : (former) street youth in Blantyre, Malawi, and the fluidity of constructing home

    NARCIS (Netherlands)

    Hendriks, T.D.

    2016-01-01

    For many Malawians the concept of home is strongly associated with the rural areas and one's (supposedly rural) place of birth. This 'grand narrative about home', though often reiterated, doesn't necessarily depict lived reality. Malawi's history of movement and labor migration coupled with

  18. The HIV/AIDS pandemic in Malawi: cultural and gender perspectives

    African Journals Online (AJOL)

    first step towards behaviour change lies in whether or not people accept that the illness they ... account the issues of culture and gender. The problem I ..... transmission, see J.C. Chakanza, "HIV/AIDS and Culture in Malawi," The. Lamp, 43 ...

  19. Road traffic collisions in Malawi: Trends and patterns of mortality on ...

    African Journals Online (AJOL)

    Background: Worldwide, 90% of injury deaths occur in low- and middle-income countries (LMIC). Road traffic collisions (RTCs) are increasingly common and result in more death and disability in the developing world than in the developed world. We aimed to examine the prehospital case fatality rate from RTCs in Malawi.

  20. Non-use of Formal Health Services in Malawi: Perceptions from Non ...

    African Journals Online (AJOL)

    for those who were non-users of health services due to poor attitudes of health workers, they ..... services (especially mother and child services) free of charge to the .... Ngozo C: Malawi: vaccination foiled by divine intervention. Africaonline: the ...

  1. Integrated tick and tick-borne disease control trials in crossbred dairy cattle in Malawi

    DEFF Research Database (Denmark)

    Tjørnehøj, Kirsten; Whiteland, A. P.; Mfitilodze, M. W.

    1996-01-01

    Crossbred dairy heifers on a farm in an East Coast fever (ECF) endemic area in Malawi were immunised against Theileria parva, Anaplasma spp., Babesia bigemina, Babesia bovis and Cowdria ruminantium. They were treated at infrequent intervals with chlorfenvinphos to limit infestation with adult tic...

  2. Reflections on the first twenty-five years of the University of Malawi ...

    African Journals Online (AJOL)

    September 2016 marks 25 years since the College of Medicine of the University of Malawi was established. In this article we reflect on its conception, birth, adolescence, and youth. The contributions of multiple stakeholders are celebrated while being mindful of the ongoing efforts to consolidate past and current gains.

  3. Farmer evaluation of phosphorus fertilizer application to annual legumes in Chisepo, Central Malawi

    NARCIS (Netherlands)

    Kamanga, B.C.G.; Whitbread, A.M.; Wall, P.; Waddington, S.R.; Almekinders, C.J.M.; Giller, K.E.

    2010-01-01

    Building from the perception that farmers have an intimate knowledge of their local environment, production problems, crop priorities and criteria for evaluation, an on-farm experiment was conducted with farmers in 2003/4 in Chisepo, central Malawi, to evaluate the response of six annual legumes to

  4. Poor people and poor fields? : integrating legumes for smallholder soil fertility management in Chisepo, central Malawi

    NARCIS (Netherlands)

    Kamanga, B.

    2011-01-01

    Soil infertility undermines the agriculture-based livelihoods in Malawi, where it is blamed for poor crop yields and the creation of cycles of poverty. Although technologies and management strategies have been developed to reverse the decline in soil fertility, they are under-used by smallholder

  5. Education, Health, and Labor Force Supply: Broadening Human Capital for National Development in Malawi

    Science.gov (United States)

    Smith, William C.; Ikoma, Sakiko; Baker, David P.

    2016-01-01

    Education and health are both capital investments in national development, often viewed as independent factors on a country's labor force supply and productivity. This study uses the 2010-2011 Third Integrated Household Survey in Malawi to propose an Education-enhanced Health Human Capital (EHHC) model where education influences labor force supply…

  6. "Home is always home" : (former) street youth in Blantyre, Malawi, and the fluidity of constructing home

    NARCIS (Netherlands)

    Hendriks, T.D.

    2017-01-01

    For many Malawians the concept of home is strongly associated with the rural areas and one's (supposedly rural) place of birth. This 'grand narrative about home', though often reiterated, doesn't necessarily depict lived reality. Malawi's history of movement and labor migration coupled with

  7. Risk factors for fetal anaemia in a malarious area of Malawi

    NARCIS (Netherlands)

    Brabin, B. J.; Kalanda, B. F.; Verhoeff, F. H.; Chimsuku, L. H.; Broadhead, R. L.

    2004-01-01

    The prevalence of infants born with low cord haemoglobin (fetal anaemia) is high in areas where malaria and iron deficiency anaemia in pregnancy are common. The objective of the present study was to determine risk factors for fetal anaemia in an area of high malaria transmission in southern Malawi.

  8. Post-neonatal infant mortality in Malawi: the importance of maternal health

    NARCIS (Netherlands)

    Verhoeff, Francine H.; le Cessie, Saskia; Kalanda, Boniface F.; Kazembe, Peter N.; Broadhead, Robin L.; Brabin, Bernard J.

    2004-01-01

    In a cohort study of mothers and their infants, information was collected from women attending the antenatal services of two hospitals in a rural area of Malawi and 561 of their babies were enrolled in a follow-up study. There were 128 with a low birthweight (LBW, <2500 g), 138 with fetal anaemia

  9. Use of the Bayley Scales of Infant and Toddler Development, Third Edition, to Assess Developmental Outcome in Infants and Young Children in an Urban Setting in South Africa

    OpenAIRE

    Ballot, Daynia E.; Ramdin, Tanusha; Rakotsoane, David; Agaba, Faustine; Davies, Victor A.; Chirwa, Tobias; Cooper, Peter A.

    2017-01-01

    Background. The Bayley Scales of Infant and Toddler Development (III) is a tool developed in a Western setting. Aim. To evaluate the development of a group of inner city children in South Africa with no neonatal risk factors using the Bayley Scales of Infant and Toddler Development (III), to determine an appropriate cut-off to define developmental delay, and to establish variation in scores done in the same children before and after one year of age. Methods. Cohort follow-up study. Results. 7...

  10. Life Span Developmental Approach

    Directory of Open Access Journals (Sweden)

    Ali Eryilmaz

    2011-03-01

    Full Text Available The Life Span Developmental Approach examines development of individuals which occurs from birth to death. Life span developmental approach is a multi-disciplinary approach related with disciplines like psychology, psychiatry, sociology, anthropology and geriatrics that indicates the fact that development is not completed in adulthood, it continues during the life course. Development is a complex process that consists of dying and death. This approach carefully investigates the development of individuals with respect to developmental stages. This developmental approach suggests that scientific disciplines should not explain developmental facts only with age changes. Along with aging, cognitive, biological, and socioemotional development throughout life should also be considered to provide a reasonable and acceptable context, guideposts, and reasonable expectations for the person. There are three important subjects whom life span developmental approach deals with. These are nature vs nurture, continuity vs discontinuity, and change vs stability. Researchers using life span developmental approach gather and produce knowledge on these three most important domains of individual development with their unique scientific methodology.

  11. Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

    Directory of Open Access Journals (Sweden)

    Melanie Y. Hami

    2014-10-01

    Vroue se vermeende vatbaarheid en benutting van servikale kanker dienste in Malawi  Agtergrond: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand. Doelwitte: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. ’n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies. Metode: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het. Resultate: ’n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003 en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df = 1; p = 0.041 op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar ’n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is. Gevolgtrekkings: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien ’n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging

  12. The effect of seasonality on burn incidence, severity and outcome in Central Malawi.

    Science.gov (United States)

    Tyson, Anna F; Gallaher, Jared; Mjuweni, Stephen; Cairns, Bruce A; Charles, Anthony G

    2017-08-01

    In much of the world, burns are more common in cold months. However, few studies have described the seasonality of burns in sub-Saharan Africa. This study examines the effect of seasonality on the incidence and outcome of burns in central Malawi. A retrospective analysis was performed at Kamuzu Central Hospital and included all patients admitted from May 2011 to August 2014. Demographic data, burn mechanism, total body surface area (%TBSA), and mortality were analyzed. Seasons were categorized as Rainy (December-February), Lush (March-May), Cold (June-August) and Hot (September-November). A negative binomial regression was used to assess the effect of seasonality on burn incidence. This was performed using both the raw and deseasonalized data in order to evaluate for trends not attributable to random fluctuation. A total of 905 patients were included. Flame (38%) and Scald (59%) burns were the most common mechanism. More burns occurred during the cold season (41% vs 19-20% in the other seasons). Overall mortality was 19%. Only the cold season had a statistically significant increase in burn . The incidence rate ratios (IRR) for the hot, lush, and cold seasons were 0.94 (CI 0.6-1.32), 1.02 (CI 0.72-1.45) and 1.6 (CI 1.17-2.19), respectively, when compared to the rainy season. Burn severity and mortality did not differ between seasons. The results of this study demonstrate the year-round phenomenon of burns treated at our institution, and highlights the slight predominance of burns during the cold season. These data can be used to guide prevention strategies, with special attention to the implications of the increased burn incidence during the cold season. Though burn severity and mortality remain relatively unchanged between seasons, recognizing the seasonal variability in incidence of burns is critical for resource allocation in this low-income setting. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  13. Young People's Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment.

    Directory of Open Access Journals (Sweden)

    Christine Michaels-Igbokwe

    Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.

  14. Comparison of the effectiveness of three retinal camera technologies for malarial retinopathy detection in Malawi

    Science.gov (United States)

    Soliz, Peter; Nemeth, Sheila C.; Barriga, E. Simon; Harding, Simon P.; Lewallen, Susan; Taylor, Terrie E.; MacCormick, Ian J.; Joshi, Vinayak S.

    2016-03-01

    The purpose of this study was to test the suitability of three available camera technologies (desktop, portable, and iphone based) for imaging comatose children who presented with clinical symptoms of malaria. Ultimately, the results of the project would form the basis for a design of a future camera to screen for malaria retinopathy (MR) in a resource challenged environment. The desktop, portable, and i-phone based cameras were represented by the Topcon, Pictor Plus, and Peek cameras, respectively. These cameras were tested on N=23 children presenting with symptoms of cerebral malaria (CM) at a malaria clinic, Queen Elizabeth Teaching Hospital in Malawi, Africa. Each patient was dilated for binocular indirect ophthalmoscopy (BIO) exam by an ophthalmologist followed by imaging with all three cameras. Each of the cases was graded according to an internationally established protocol and compared to the BIO as the clinical ground truth. The reader used three principal retinal lesions as markers for MR: hemorrhages, retinal whitening, and vessel discoloration. The study found that the mid-priced Pictor Plus hand-held camera performed considerably better than the lower price mobile phone-based camera, and slightly the higher priced table top camera. When comparing the readings of digital images against the clinical reference standard (BIO), the Pictor Plus camera had sensitivity and specificity for MR of 100% and 87%, respectively. This compares to a sensitivity and specificity of 87% and 75% for the i-phone based camera and 100% and 75% for the desktop camera. The drawback of all the cameras were their limited field of view which did not allow complete view of the periphery where vessel discoloration occurs most frequently. The consequence was that vessel discoloration was not addressed in this study. None of the cameras offered real-time image quality assessment to ensure high quality images to afford the best possible opportunity for reading by a remotely located

  15. Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

    Science.gov (United States)

    Wood, Siri; Foster, Jennifer; Kols, Adrienne

    2012-08-01

    In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not

  16. Early experience after developing a pathology laboratory in Malawi, with emphasis on cancer diagnoses.

    Directory of Open Access Journals (Sweden)

    Satish Gopal

    Full Text Available BACKGROUND: Despite increasing cancer burden in Malawi, pathology services are limited. We describe operations during the first 20 months of a new pathology laboratory in Lilongwe, with emphasis on cancer diagnoses. METHODS AND FINDINGS: We performed a cross-sectional study of specimens from the Kamuzu Central Hospital pathology laboratory between July 1, 2011 and February 28, 2013. Patient and specimen characteristics, and final diagnoses are summarized. Diagnoses were categorized as malignant, premalignant, infectious, other pathology, normal or benign, or nondiagnostic. Patient characteristics associated with premalignancy and malignancy were assessed using logistic regression. Of 2772 specimens, 2758 (99% with a recorded final diagnosis were included, drawn from 2639 unique patients. Mean age was 38 years and 63% were female. Of those with documented HIV status, 51% had unknown status, and 36% with known status were infected. Histologic specimens comprised 91% of cases, and cytologic specimens 9%. Malignant diagnoses were most common overall (n = 861, 31%. Among cancers, cervical cancer was most common (n = 117, 14%, followed by lymphoma (n = 91, 11%, esophageal cancer (n = 86, 10%, sarcoma excluding Kaposi sarcoma (n = 75, 9%, and breast cancer (n = 61, 7%. HIV status was known for 95 (11% of malignancies, with HIV prevalence ranging from 9% for breast cancer to 81% for cervical cancer. Increasing age was consistently associated with malignancy [bivariable odds ratio 1.24 per decade increase (95% CI 1.19-1.29 among 2685 patients with known age; multivariable odds ratio 1.33 per decade increase (95% CI 1.14-1.56 among 317 patients with known age, gender, and HIV status], while HIV infection and gender were not. CONCLUSIONS: Despite selection and referral bias inherent in these data, a new pathology laboratory in Lilongwe has created a robust platform for cancer care and research. Strategies to effectively capture clinical information for

  17. Vision Impairment and Ocular Morbidity in a Refugee Population in Malawi.

    Science.gov (United States)

    Kaphle, Dinesh; Gyawali, Rajendra; Kandel, Himal; Reading, Angela; Msosa, Joseph Matiya

    2016-02-01

    To provide screening services and obtain information on the eye health status and distribution of visual impairments in a refugee population of the sole refugee camp in Malawi. A general eye screening at Dzaleka refugee settlement camp was organized in November 2012. Final-year optometry students conducted detailed optometry examinations, including visual acuity (VA) assessment for near and distance, retinoscopy, and subjective refraction in cases with distance VA less than 6/12 or near VA less than N8, anterior and posterior segment evaluation. Their findings were then verified by an optometrist. The World Health Organization definition of vision impairment was followed, and the cause of vision impairment was determined at the end of each examination. Where possible, participants requiring refractive correction were provided spectacles free of cost. Of a total 635 participants examined, around one-half were male with 61% in the 16 to 49 years age group. The overall prevalence of presenting blindness, severe vision impairment, and vision impairment were 1.3% (95% confidence interval [95% CI], 0.5 to 2.4), 0.5% (95% CI, 0.0 to 1.1), and 3.6% (95% CI, 2.3 to 5.2), respectively. Overall vision impairment (VA vision impairment, and vision impairment were cataracts, refractive errors, and corneal opacities, respectively; and more than 90% of the overall vision impairment was avoidable. Refractive errors and presbyopia were the most common morbidity, present in more than two-thirds of the participants examined. Only 5% of all the participants ever had a previous eye examination. The prevalence and causes of blindness and vision impairment in a refugee population are comparable with those of the general population. Lack of basic eye care services in the health center for refugees is a major concern. The health care facility in the settlement camp needs to be upgraded to provide comprehensive eye care including refractive care services.

  18. Malaria control in rural Malawi: implementing peer health education for behaviour change.

    Science.gov (United States)

    Malenga, Tumaini; Kabaghe, Alinune Nathanael; Manda-Taylor, Lucinda; Kadama, Asante; McCann, Robert S; Phiri, Kamija Samuel; van Vugt, Michèle; van den Berg, Henk

    2017-11-20

    Interventions to reduce malaria burden are effective if communities use them appropriately and consistently. Several tools have been suggested to promote uptake and use of malaria control interventions. Community workshops on malaria, using the 'Health Animator' approach, are a potential behaviour change strategy for malaria control. The strategy aims to influence a change in mind-set of vulnerable populations to encourage self-reliance, using community volunteers known as Health Animators. The aim of the paper is to describe the process of implementing community workshops on malaria by Health Animators to improve uptake and use of malaria control interventions in rural Malawi. This is a descriptive study reporting feasibility, acceptability, appropriateness and fidelity of using Health Animator-led community workshops for malaria control. Quantitative data were collected from self-reporting and researcher evaluation forms. Qualitative assessments were done with Health Animators, using three focus groups (October-December 2015) and seven in-depth interviews (October 2016-February 2017). Seventy seven health Animators were trained from 62 villages. A total of 2704 workshops were conducted, with consistent attendance from January 2015 to June 2017, representing 10-17% of the population. Attendance was affected by social responsibilities and activities, relationship of the village leaders and their community and involvement of Community Health Workers. Active discussion and participation were reported as main strengths of the workshops. Health Animators personally benefited from the mind-set change and were proactive peer influencers in the community. Although the information was comprehended and accepted, availability of adequate health services was a challenge for maintenance of behaviour change. Community workshops on malaria are a potential tool for influencing a positive change in behaviour towards malaria, and applicable for other health problems in rural

  19. Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi.

    Science.gov (United States)

    Sherr, L; Hensels, I S; Skeen, S; Tomlinson, M; Roberts, K J; Macedo, A

    2016-01-01

    Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings. This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children. Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61). Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  20. Movement ecology of five Afrotropical waterfowl species from Malawi, Mali and Nigeria

    Science.gov (United States)

    Takekawa, John Y.; Heath, Shane R.; Iverson, S.R.L.; Gaidet, Nicolas; Cappelle, Julien; Dodman, Tim; Hagemeijer, Ward; Eldridge, William D.; Petrie, Scott A.; Yarris, Gregory S.; Manu, Shiiwua; Olsen, Glenn H.; Prosser, Diann J.; Spragens, Kyle A.; Douglas, David C.; Newman, Scott H.

    2015-01-01

    Habitat availability for Afrotropical waterbirds is highly dynamic with unpredictable rainfall patterns and ephemeral wetlands resulting in diverse movement strategies among different species. Movement strategies among waterfowl encompass resident, regional and intercontinental migrants, but little quantitative information exists on their specific movement patterns. We studied the movement ecology of five Afrotropical waterfowl species marked with satellite transmitters in Malawi, Mali and Nigeria. Resident species, including White-faced Whistling Ducks Dendrocygna viduata, Fulvous Whistling Ducks Dendrocygna bicolor and Spur-winged Geese Plectropterus gambensis, remained sedentary during the rainy season and only flew limited distances during other months. In contrast, Knob-billed Ducks Sarkidiornis melanotos made short regional movements >50 km in all months and showed little site fidelity to previously used habitats in subsequent years. Garganey Anas quequedula followed an intercontinental strategy and made long-distance jumps across the Sahara and Mediterranean to their Eurasian breeding grounds. Most species flew farthest during the dry season, as mean daily movements varied from 1.5 to 14.2 km and was greatest in the winter months (January-March). Total distance moved varied from 9.5 km for White-faced Whistling Ducks (October-December) to 45.6 km for Knob-billed Ducks (April-June). Nomadic behaviour by Knob-billed Ducks was evidenced by long exploratory flights, but small mean daily movements suggested that they were relying on previous experience. Improving our understanding of these movement strategies increases our ability to assess connectivity of wetland resources that support waterfowl throughout their annual cycle and focuses conservation efforts on their most important habitats.