Children with Hydrocephalus and Spina Bifida in East Africa: Can family and community resources improve the odds?

Hydrocephalus and spina bifida are life-threatening conditions that often result in severe disabilities. Risks are much reduced by immediate surgery and careful management, but neither has been available for most of the sub-Saharan African population. This paper traces the growth of solutions and some socio-cultural resources that historically have supported family and community care for children with severe disabilities, mainly in Tanzania, and nearby Uganda, Kenya, Malawi, Zambia and Zimbabwe. Some community-based rehabilitation (CBR) work with children with spina bifida and hydrocephalus is described, and challenges to the CBR approach are noted from the increased survival of people with disabilities requiring complex care. More appropriate information, recognition of indigenous knowledge, enlistment of community resources and financial assistance are needed to enhance the lives of East Africans with hydrocephalus, spina bifida and other severely disabling conditions.     

A Quantitative Assessment of the Risks from Illegally Imported Meat Contaminated with Foot and Mouth Disease Virus to Great Britain

Foot and mouth disease (FMD) is considered by many as the most important animal disease in the world. FMD is highly contagious and outbreaks incur significant costs as affected countries are severely limited in their ability to trade. A number of trade commodities may be contaminated with FMD virus (FMDV) including animal products, for example, meat. As a member of the European Union, Great Britain (GB) has put in place a number of regulations to prevent the importation of pathogens in imported meat products. However, the illegal importation of meat provides a route by which safety controls may be circumvented and meat from FMD affected areas may be imported. This study assesses the FMD infection risk posed to the livestock population of GB from the illegal importation of meat, and estimates the major contributors to this overall risk, through the development of a quantitative risk assessment model. From model results, the total amount of illegal meat entering GB each year is estimated on average to be 11,875 tonnes. with 90% certainty that this is between 4,398 and 28,626 tonnes per year; of which between 64.5 and 565 kg are contaminated with FMDV. This flow of illegal meat results in an estimate of a frequency of FMD infection in GB livestock of 0.015 cases of infected animals per year, with 90% certainty it is between 0.0017 and 0.053. Imports from the region Near and Middle East account for 47% of this risk, and 68% of the risk is attributed to bone-in and dried de-boned products.     

Engaging with the Disability Rights Movement: the experience of community-based rehabilitation in southern Africa

This paper argues that unless community-based rehabilitation CBR programmes enter into genuine consultation with the disability rights movement they are in danger of repeating the mistakes of institution-based rehabilitation. Partnership between CBR programmes, and disabled people's and parents' organisations in southern Africa has led to the development of a more consumer focused approach to CBR Where disabled adults and parents have been fully involved in the design and implementation of programmes, CBR workers have a clearer understanding of disability as a development issue. Education, employment and poverty alleviation have been given a higher priority than medical rehabilitation in these programmes. The evolving concept of CBR and its relationship with the disability rights movement has been observed and documented by The Save the Children Fund, and forms the basis of this paper.     

Passing Encounters East and West: Comparing Japanese and American Pedestrian Interactions

This study examined the microinteractions of pedestrians in Japan and in the United States as they walked past a confederate. Specifically, the effects of culture, condition (avoid, look-only, and look plus smile) and sex of confederate on glances, smiles, nods, and greetings by passing pedestrians were examined in a field study on over 1000 participants. The hypotheses of (1) lower responsiveness in Japanese pedestrians than in American pedestrians and (2) increased responsiveness as a function of condition were supported in a series of log-linear analyses of pedestrian glances, smiles, nods, and greetings. Both of these main effects were, however, qualified by Culture X Condition interactions on smiles, nods, and greetings, with the large condition effects present in the American pedestrians, but absent in the Japanese pedestrians. The results are discussed in terms of the functions of glances, smiles, nods, and greetings in these brief encounters and how differing cultural norms affect Japanese and American responsiveness. Finally, the limitations of this study and the broader utility of this research paradigm are discussed.

Exploring Heideggerian hermeneutic phenomenology: A perfect fit for midwifery research

BackgroundHeideggerian hermeneutic phenomenology has been used widely to understand the meaning of lived experiences in health research. For midwifery scholars this approach enables deep understanding of women's and midwives’ lived experiences of specific phenomena. However, for beginning researchers this is not a methodology for the faint hearted. It requires a period of deep immersion to come to terms with at times impenetrable language and perplexing concepts.ObjectivesThis paper aims to assist midwives to untangle and examine some of the choices they face when they first come to terms with an understanding of this methodology and highlights the methodology's capacity to reveal midwifery authenticity and holistic practice.DiscussionThe illumination of a selection of various concepts underpinning hermeneutic phenomenology will inform midwives considering this methodology as suitable framework for exploring contemporary midwifery phenomena.     

Using relative utility curves to evaluate risk prediction

Summary.  Because many medical decisions are based on risk prediction models that are constructed from medical history and results of tests, the evaluation of these prediction models is important. This paper makes five contributions to this evaluation: the relative utility curve which gauges the potential for better prediction in terms of utilities, without the need for a reference level for one utility, while providing a sensitivity analysis for misspecification of utilities, the relevant region, which is the set of values of prediction performance that are consistent with the recommended treatment status in the absence of prediction, the test threshold, which is the minimum number of tests that would be traded for a true positive prediction in order for the expected utility to be non-negative, the evaluation of two-stage predictions that reduce test costs and connections between various measures of performance of prediction. An application involving the risk of cardiovascular disease is discussed.     

Temporal Patterns of Accuracy Confidence in Social Judgments: A New Method and Initial Results

An integrated, computer-based system was developed to record participants’ continuous judgment changes on a revised form of the Interpersonal Perception Task (IPT-15). Consistent with the considerable research on “thin slice” judgments, the mean latency for greater than chance accuracy confidence was just 16 s (median = 10 s) for the ten one-part scenes on the IPT. There was also a clear and strong linear trend for increasing accuracy confidence across the first 25 s of the ten one-part scenes. For the five-two-part scenes, where comparative judgments were required (e.g., which statement is truthful, which is a lie?), no clear pattern of increasing accuracy confidence was found, with mean scores hovering near chance. The utility of the new system for analyzing the time course of social judgments is discussed and the potential reasons for the contrasting results for the one-part and two-part scenes were examined.