Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania : an open label prospective study

Background: Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. Methods: An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results: A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p <= 0.046). Conclusions: Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for scaling-up implementation of HMM with AL in Tanzania.

The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge. Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff. Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed. Trial registration: NCT01806480

Review of the effectiveness of vehicle activated signs

This paper reviews the effectiveness of vehicle activated signs. Vehicle activated signs are being reportedly used in recent years to display dynamic information to road users on an individual basis in order to give a warning or inform about a specific event. Vehicle activated signs are triggered individually by vehicles when a certain criteria is met. An example of such criteria is to trigger a speed limit sign when the driver exceeds a pre-set threshold speed. The preset threshold is usually set to a constant value which is often equal, or relative, to the speed limit on a particular road segment. This review examines in detail the basis for the configuration of the existing sign types in previous studies and explores the relation between the configuration of the sign and their impact on driver behavior and sign efficiency. Most of previous studies showed that these signs have significant impact on driver behavior, traffic safety and traffic efficiency. In most cases the signs deployed have yielded reductions in mean speeds, in speed variation and in longer headways. However most experiments reported within the area were performed with the signs set to a certain static configuration within applicable conditions. Since some of the aforementioned factors are dynamic in nature, it is felt that the configurations of these signs were thus not carefully considered by previous researchers and there is no clear statement in the previous studies describing the relationship between the trigger value and its consequences under different conditions. Bearing in mind that different designs of vehicle activated signs can give a different impact under certain conditions of road, traffic and weather conditions the current work suggests that variable speed thresholds should be considered instead.

Too Many Bad Cooks Spoiling the Broth? Effectiveness of NGOs in Addressing Child Labour in El Salvador

The reaction of the first world to the persevering plight of a large part of the third world varies. In response to the sometimes glaring disparities, many international organizations and multinational corporations have recently adopted a pro-development rhetoric with relation to the problem of global poverty. However, the rhetoric rarely translates into action. As David Bacon discusses, leaders of corporations and organizations now tend to conclude their speeches by expressing a desire to reduce the suffering of the third world. However, when it comes to agreeing on specific concessions that could indeed improve the world-wide economic situation, first world countries are reluctant to act. A good example of this type of behavior is the current negotiation of the WTO, the “development round of Doha,” in which the United States along with the European Union pressure countries of the developing South to open up their markets, while at the same time refusing to remove or even decrease their own agricultural subsidies. The first world civil society observes the behavior of international organizations and western based multinational corporations as ineffectual. Taking the matter in its own hands, especially in the past couple of decades, this civil society has created a countless number of development-oriented nongovernmental organizations. These are supposed to compensate for the lack of action by international organizations. Development NGOs are believed to be more locally responsive as well as free of business or political considerations in choosing their strategies, and thus generally more efficient than IOs. However, if they really were how they are alleged to be, the problems of the third world would already be ameliorated by a significant amount, if not completely eradicated. Do development-NGOs indeed possess the characteristics that they claim to possess? What is their real affect on human rights? And how effective are they in their work?

Compliance to law and effectiveness of the rule of law in Brazil

The goal of this paper is to debate the degree of effectiveness of the rule of law in Brazil, through a survey measuring perceptions, attitudes and habits of Brazilians in regard to compliance to law. The survey conducted in Brazil is based on the study conducted by Tom R. Tyler in the United States, entitled Why People Obey the Law? (New Haven, CT: Yale University Press, 1990). The main argument of Tyler´s study is that people obey the law when they believe it’s legitimate, and not because they fear punishment. We test the same argument in Brazil, relying on five indicators: (i) behavior, which depicts the frequency with which respondents declared to have engaged in conducts in disobedience to the law; (ii) instrumentality, measuring perception of losses associated with the violation of the law, specially fear of punishment; (iii) morality, measuring perception of how much is right or wrong to engage in certain conducts in violation of the law; (iv) social control, which measures perception of social disapproval of certain types of behavior in violation of the law, and (v) legitimacy, which measures the perception of respect to the law and to some authorities. Results indicate that fear of sanctions is not the strongest drive in compliance to law, but more than legitimacy, indicators of morality and social control are the strongest in explaining why people obey the law in Brazil.

Leader-organization fit: comparing the effectiveness of paternalistic and transformational leadership in different organizational cultures

Research on paternalistic leadership (PL) has been based exclusively on national cultures´ differences. However there are cues that other contextual variables can add to the explanation of this construct. Due to its capacity to influence expectations of individuals in organizations, organizational culture can contribute to fill this gap. To test if organizational culture influences the effectiveness of leadership style, we conducted two experimental studies using Amazon’s Mechanical Turk, comparing effects of paternalistic and transformational leadership on followers’ outcomes. Using video clips and vignettes, we found that PL is better related to followers´ outcomes in cultures oriented to people than outcome, and that TL has a better relationship in cultures oriented to innovation than stability. The results suggest that organizational culture helps in explaining PL endorsement, and that further analysis of the influence of this variable to PL can provide a better understanding of the expression of this leadership style in organizations.

Effectiveness of different solid-phase microextraction fibres for differentiation of selected Madeira island fruits based on their volatile metabolite profile: identification of novel compounds

A headspace solid-phase microextraction (HS-SPME) procedure based on five commercialised fibres (85 μm polyacrylate – PA, 100 μm polydimethylsiloxane – PDMS, 65 μm polydimethylsiloxane/divinylbenzene – PDMS/DVB, 70 μm carbowax/divinylbenzene – CW/DVB and 85 μm carboxen/polydimethylsiloxane – CAR/PDMS) is presented for the characterization of the volatile metabolite profile of four selected Madeira island fruit species, lemon (Citrus limon), kiwi (Actinidia deliciosa), papaya (Carica papaya L.) and Chickasaw plum (Prunus angustifolia). The isolation of metabolites was followed by thermal desorption gas chromatography–quadrupole mass spectrometry (GC–qMS) methodology. The performance of the target fibres was evaluated and compared. The SPME fibre coated with CW/DVB afforded the highest extraction efficiency in kiwi and papaya pulps, while in lemon and plum the same was achieved with PMDS/DVB fibre. This procedure allowed for the identification of 80 compounds, 41 in kiwi, 24 in plums, 23 in papaya and 20 in lemon. Considering the best extraction conditions, the most abundant volatiles identified in kiwi were the intense aldehydes and ethyl esters such as (E)-2-hexenal and ethyl butyrate, while in Chicasaw plum predominate 2-hexenal, 2-methyl-4-pentenal, hexanal, (Z)-3-hexenol and cyclohexylene oxide. The major compounds identified in the papaya pulp were benzyl isothiocyanate, linalool oxide, furfural, hydroxypropanone, linalool and acetic acid. Finally, lemon was shown to be the most divergent of the four fruits, being its aroma profile composed almost exclusively by terpens, namely limonene, γ-terpinene, o-cymene and α-terpinolene. Thirty two volatiles were identified for the first time in the fruit or close related species analysed and 14 volatiles are reported as novel volatile metabolites in fruits. This includes 5 new compounds in kiwi (2-cyclohexene-1,4-dione, furyl hydroxymethyl ketone, 4-hydroxydihydro-2(3H)-furanone, 5-acetoxymethyl-2-furaldehyde and ethanedioic acid), 4 in plum (4-hydroxydihydro-2(3H)-furanone, 5-methyl-2-pyrazinylmethanol, cyclohexylene oxide and 1-methylcyclohexene), 4 in papaya (octaethyleneglycol, 1,2-cyclopentanedione, 3-methyl-1,2-cyclopentanedione and 2-furyl methyl ketone) and 2 in lemon (geranyl farnesate and safranal). It is noteworthy that among the 15 volatile metabolites identified in papaya, 3-methyl-1,2-cyclopentanedione was previously described as a novel PPARγ (peroxisome proliferator-activated receptor γ) agonist, having a potential to minimize inflammation.

Effectiveness of high-throughput miniaturized sorbent- and solid phase microextraction techniques combined with gas chromatography–mass spectrometry analysis for a rapid screening of volatile and semi-volatile composition of wines: a comparative study

In this study the feasibility of different extraction procedures was evaluated in order to test their potential for the extraction of the volatile (VOCs) and semi-volatile constituents (SVOCs) from wines. In this sense, and before they could be analysed by gas chromatography–quadrupole first stage masss spectrometry (GC–qMS), three different high-throughput miniaturized (ad)sorptive extraction techniques, based on solid phase extraction (SPE), microextraction by packed sorbents (MEPS) and solid phase microextraction (SPME), were studied for the first time together, for the extraction step. To achieve the most complete volatile and semi-volatile signature, distinct SPE (LiChrolut EN, Poropak Q, Styrene-Divinylbenzene and Amberlite XAD-2) and MEPS (C2, C8, C18, Silica and M1 (mixed C8-SCX)) sorbent materials, and different SPME fibre coatings (PA, PDMS, PEG, DVB/CAR/PDMS, PDMS/DVB, and CAR/PDMS), were tested and compared. All the extraction techniques were followed by GC–qMS analysis, which allowed the identification of up to 103 VOCs and SVOCs, distributed by distinct chemical families: higher alcohols, esters, fatty acids, carbonyl compounds and furan compounds. Mass spectra, standard compounds and retention index were used for identification purposes. SPE technique, using LiChrolut EN as sorbent (SPELiChrolut EN), was the most efficient method allowing for the identification of 78 VOCs and SVOCs, 63 and 19 more than MEPS and SPME techniques, respectively. In MEPS technique the best results in terms of number of extractable/identified compounds and total peak areas of volatile and semi-volatile fraction, were obtained by using C8 resin whereas DVB/CAR/PDMS was revealed the most efficient SPME coating to extract VOCs and SVOCs from Bual wine. Diethyl malate (18.8 ± 3.2%) was the main component found in wine SPELiChrolut EN extracts followed by ethyl succinate (13.5 ± 5.3%), 3-methyl-1-butanol (13.2 ± 1.7%), and 2-phenylethanol (11.2 ± 9.9%), while in SPMEDVB/CAR/PDMS technique 3-methyl-1-butanol (43.3 ± 0.6%) followed by diethyl succinate (18.9 ± 1.6%), and 2-furfural (10.4 ± 0.4%), are the major compounds. The major VOCs and SVOCs isolated by MEPSC8 were 3-methyl-1-butanol (26.8 ± 0.6%, from wine total volatile fraction), diethyl succinate (24.9 ± 0.8%), and diethyl malate (16.3 ± 0.9%). Regardless of the extraction technique, the highest extraction efficiency corresponds to esters and higher alcohols and the lowest to fatty acids. Despite some drawbacks associated with the SPE procedure such as the use of organic solvents, the time-consuming and tedious sampling procedure, it was observed that SPELiChrolut EN, revealed to be the most effective technique allowing the extraction of a higher number of compounds (78) rather than the other extraction techniques studied.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Effectiveness of fused magnesium potassium phosphate for marandu grass

O alto custo atual do KCl e a grande dependência de sua importação para suprir a demanda nacional sugerem a necessidade de estudos que procurem avaliar a eficiência de outras fontes de K, principalmente aquelas baseadas em matéria-prima nacional. Nesse sentido, foi conduzido um experimento em casa de vegetação com amostras de um Latossolo Vermelho distrófico textura média, adotando-se o delineamento inteiramente casualizado em esquema fatorial 4 x 3 x 2, sendo quatro doses de K (0, 60, 120 e 180 mg kg-1 de K), três fontes [(cloreto de potássio (KCl)], termofosfato magnesiano potássico (FMPP) e a mistura de 70 % FMPP + 30 % KCl) e duas granulometrias (100 e 60 mesh), com três repetições. Verificou-se que a adubação potássica promoveu incrementos significativos na produção de matéria seca (parte aérea) e nos teores de K no solo e na planta, não havendo diferenças entre as fontes e suas granulometrias. Os níveis críticos de K no solo e na parte aérea das plantas foram de 1,53 mmol c dm-3 e 19,1 g kg-1, respectivamente.

Effectiveness of Photogem (R) activated by LED on the decontamination of artificial carious bovine dentin

The aim of this study was the evaluation of the effectiveness of photodynamic therapy on the decontamination of artificially induced carious bovine dentin, using Photoge(R) as the photosensitizer agent and an LED device as a light source. Dentin samples obtained from bovine incisors were immersed in sterile broth supplemented by Lactobacillus acidophillus 10(8) colony formation units (CFU) and Streptococcus mutans 10 8 CFU. Different concentrations of photosensitizer, PA = 1 mg/ml, PB = 2 mg/ml, and PC = 3 mg/ml, and two fluences, D = 24 J/cm(2) and D = 48 J/cm(2), were investigated. After CFU counting per milligram of carious dentin and statistical analysis, we observed that the photodynamic therapy (PDT) parameters used were effective for bacterial reduction in the in vitro model under study. The best result was achieved with the application of Photoge(R) at 2 mg/ml and photoactivated under 24 J/cm(2) showing a survival factor of 0.14. At higher photosensitizer concentrations, a higher dark toxicity was observed. We propose a simple mathematical expression for the determination of PDT parameters of photosensitizer concentration and light fluence for different survival factor values. Since LED devices are simpler and cheaper compared to laser systems, it would be interesting to verify their efficacy as a light source in photodynamic therapy for the decontamination of carious dentin.

Evaluation of Preservative Effectiveness of Liquid Crystalline Systems with Retynil Palmitate by the Challenge Test and D-value

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparative study of the topical effectiveness of the andiroba oil (Carapa guianensis) and DEET 50% as repellent for Aedes sp

O DEET (N, N-dietil-3-metilbenzamida) é hoje o repelente mais efetivo disponível, porém, seu uso pode apresentar importantes efeitos colaterais tópicos e sistêmicos. Alguns compostos botânicos, como a Andiroba (Carapa guianensis), têm demonstrado propriedades repelentes a um baixo custo e baixa toxicidade. Quatro voluntários hígidos submeteram seus antebraços recobertos com óleo de Andiroba a 100%, DEET 50% (controle positivo), óleo de soja refinado, óleo de Andiroba 15% e na ausência de produtos (controles negativos), diretamente a picadas de fêmeas saudáveis de Aedes sp. Foram aferidos os tempos da primeira e terceira picadas. Os resultados mostraram que a mediana da primeira picada nos antebraços sem produto foi 17.5s e a terceira picada, 40.0s. No óleo de soja, as picadas ocorreram em 60.0s e 101.5s. No óleo de Andiroba 100%, em 56.0s e 142.5s. Com Andiroba 15%, em 63.0s e 97.5s. Usando DEET 50% não houve picadas após 3600s na maioria dos experimentos (p < 0.001 Wilcoxon). O óleo de Andiroba 100% comparado ao óleo de soja, antebraço sem produto e óleo de Andiroba 15%, mostrou discreta superioridade (p < 0.001 Wilcoxon). Concluímos que o óleo puro de Andiroba apresenta efeito repelente discreto contra picada de Aedes sp., sendo significativamente inferior ao DEET 50%.