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Objectives : To investigate appropriate measurements to predict height in children with physical impairments to facilitate the accurate assessment of nutritional status in field studies. Design : Case–control cross-sectional study. Setting : Dharavi, a large slum in Mumbai, India. Subjects : In total, 141 children with mixed disabilities and 162 nondisabled control children, aged 2–6 y. Methods : Height/length, armspan, arm length and tibia length were measured to the nearest 0.1 cm using standard procedures. The relations between armspan, arm length and tibia length with height in controls were investigated using linear regression. Results : Armspan ( R 2 =0.93, P <0.001, n =158), arm length ( R 2 =0.81, P <0.001, n =162) and tibia length ( R 2 =0.72, P <0.001, n =161) were found to be strong predictors of height based on data from nondisabled control children. These measurements could be used to determine a more accurate height for children with physical impairments where the nature of the impairment may interfere with height measurements. Conclusions : Armspan, arm length and tibia length can be used to determine accurate height for children with physical impairments, for example, children with a nonambulatory status or those with kyphosis or scoliosis of the spine. Sponsorship : Department for International Development (DFID), UK.

Asphalt is traditionally an insulator to the flow of electric current, but it can be transformed into a self-sensing conductive material by incorporating recyclable and environmentally friendly additives. These additives offer a range of smart and sustainable applications in the pavement industry. However, there is still much to be learned about the production and performance behavior of conductive asphalt. This study presents a comprehensive review of the literature on conductive additives used in asphalt to provide a holistic understanding of the current state of research in this field. The objective of the study is to critically review and characterize conductive additives used in asphalt to achieve electric conductivity in it and resultingly explore its self-sensing features. The development of conductive asphalt has significant research potential, and improving its piezoresistivity and conductive network is the focus of future smart asphalt technology research. The review provides an in-depth understanding of conductive asphalt concrete and identifies current research themes and corresponding challenges. This study serves as a valuable resource for researchers and industry professionals working in the field of conductive asphalt.

The combination of vertical Bell Labs layered space time (V-BLAST) and space time block coding (STBC), known as a Layered STBC (LSTBC) system, offers high spectral efficiency with a higher order of diversity. The system structure, computational complexity and error performance of the V-BLAST and LSTBC multiple-input multiple-output orthogonal frequency division multiplexing systems, are analysed and compared. It is shown that, compared with V-BLAST, the overall diversity order of LSTBC increases two fold. This diversity gain is achieved at the expense of a four-fold increase in the computational complexity of the QR decomposition (QRD) algorithm, required at the receiver of both LSTBC and V-BLAST. The authors propose a modified QRD algorithm which reduces this four-fold complexity to two fold.

The authors investigate the dirty paper coding (DPC) in intercell cooperative multiple-input multiple-output-orthogonal frequency division multiplexing (MIMO-OFDM). Based on the multidimensional structure of intercell cooperative MIMO-OFDM, the DPC model has been modified by introducing a block QR decomposition (BQRD) algorithm which transforms the multiuser channel to a block lower triangular structure. The overall error performance of the proposed BQRD-based DPC is dominated by the error performance of the last precoded user. To improve the last user's performance, it was first shown that, in a system with U active users, the channel gain matrix remains unchanged for any user acting as the last user among all (U 2 1)! possible permutations of the other users. The simulation results confirm that the performance of the greedy ordering scheme approaches that of the brute force search. Furthermore, they show that the proposed BQRD-based DPC expands the multiuser rate region and increases the sum rate over block diagonalisation based zero forcing method.

To assess the concentration of serum leptin in a population of malnourished children and to compare the leptin levels of disabled and non-disabled children in this population. Case-control study. Eighty-one children, comprising 41 children with mixed disabilities and 40 non-disabled controls, were selected from 425 children involved in a case-control study assessing the nutritional status of children with disabilities in an Indian slum population. Leptin was measured in the serum samples and was compared with anthropometry (weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ), weight-for-height Z-scores (WHZ), body mass index (BMI), mid-upper-arm circumference (MUAC), sub-scapular skinfold thickness and triceps skinfold thickness) and serum acute phase proteins. The children were very malnourished with WAZ=-2.07 (s.d. 1.15), HAZ=-2.15 (s.d. 1.85) and WHZ=-1.07 (s.d. 0.83). Leptin was extremely low in both the disabled (1.44 ng/ml; 95% confidence interval, CI, 1.23-1.69) and the non-disabled (1.19 ng/ml; 95% CI 1.04-1.35) children. There were no differences between the disabled and non-disabled groups as a whole but 15 children with neurological disabilities had significantly higher (P<0.05) serum leptin (1.65 ng/ml; 95% CI 1.29-2.06) than the non-disabled children. Girls (1.55 ng/ml; 95% CI 1.29-1.87) had significantly higher concentrations of leptin than boys (1.11 ng/ml; 95% CI 1.02-1.22; P=0.002). Leptin did not correlate with any biochemical or anthropometric measures. In this population, where malnutrition was common, serum leptin levels were very low and did not correlate with anthropometry. UK Department for International Development; Virgin Airways through the Great Ormond Street Hospital Trustees.

To compare the nutritional status of disabled children in Nigeria with their non-disabled siblings and neighbours. A second aim was to investigate anthropometric techniques appropriate for disabled children in this situation. A cross-sectional survey. Nasarawa and Plateau States and the Federal Capital Territory in Central Nigeria. 311 children under 10 years of age were studied: 112 with various disabilities, 87 siblings and 112 neighbours. Selected anthropometric measurements, (height, weight, mid-upper arm circumference (MUAC), demispan and halfspan), and blood haemoglobin levels were assessed by trained personnel. All measurements of disabled subjects were compared to the non-disabled controls. The disabled subjects had mean height for age (ht/age) and weight for age (wt/age) significantly lower than the control group (P<0.05). These differences were due largely to the very low Z scores in children with neurological impairments, (ht/age= 3.07 (s.d.=1.6); wt/age= 2.0 (s.d.=1.2)). Measurement difficulties contributed to low height values in disabled children and halfspan was found to be a useful proxy for height in these children. MUAC results were higher for the children with disabilities due to polio than for controls. The mean haemoglobin levels were slightly but significantly higher (P<0.05) in the disabled and sibling groups compared to the neighbourhood group. Disabled children with neurological impairments and consequent feeding difficulties are nutritionally at risk, but others are no worse off than their non-disabled peers in this area. Halfspans may serve as a useful proxy indicator for estimating height in some children with physical impairments. The study was funded by a TEAR fund grant to JT for her MSc studies.

There is a general scarcitly of resources for delivery of services to the population in all social welfare and development sectors, with the health sector being no exception. In developing countries, lack of trained manpower, illiteracy and compliance issues make health care interventions even more complex. Various community-based projects have used women as a specific group for delivery of health care interventions. The objective of this paper was to review published studies that evaluated women's groups for the promotion of health and prevention of disease. A total of 8 studies were reviewed. Women's groups have proved to be a convenient and workable option for delivering health care interventions in several developing countries.

Research understanding the lives of children with disabilities in low-income and middle-income countries has predominantly focused on prevalence studies with little progress on evidence-based service development. At the same time, global attention in child health has shifted from child survival strategies to those that bring child survival and development together. This review examines whether intervention research can be better aligned with current theoretical constructs of disability and international guidelines that advocate for the realisation of rights for children with disabilities and inclusive early childhood development.

Stimulation and nutrition delivered through health programmes at a large scale could potentially benefit more than 200 million young children worldwide who are not meeting their developmental potential. We investigated the feasibility and effectiveness of the integration of interventions to enhance child development and growth outcomes in the Lady Health Worker (LHW) programme in Sindh, Pakistan. We implemented a community-based cluster-randomised effectiveness trial through the LHW programme in rural Sindh, Pakistan, with a 2 × 2 factorial design. We randomly allocated 80 clusters (LHW catchments) of children to receive routine health and nutrition services (controls; n=368), nutrition education and multiple micronutrient powders (enhanced nutrition; n=364), responsive stimulation (responsive stimulation; n=383), or a combination of both enriched interventions (n=374). The allocation ratio was 1:20 (ie, 20 clusters per intervention group). The data collection team were masked to the allocated intervention. All children born in the study area between April, 2009, and March, 2010, were eligible for enrolment if they were up to 2·5 months old without signs of severe impairments. Interventions were delivered by LHWs to families with children up to 24 months of age in routine monthly group sessions and home visits. The primary endpoints were child development at 12 and 24 months of age (assessed with the Bayley Scales of Infant and Toddler Development, Third Edition) and growth at 24 months of age. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT007159636. 1489 mother–infant dyads were enrolled into the study, of whom 1411 (93%) were followed up until the children were 24 months old. Children who received responsive stimulation had significantly higher development scores on the cognitive, language, and motor scales at 12 and 24 months of age, and on the social–emotional scale at 12 months of age, than did those who did not receive the intervention. Children who received enhanced nutrition had significantly higher development scores on the cognitive, language, and social-emotional scales at 12 months of age than those who did not receive this intervention, but at 24 months of age only the language scores remained significantly higher. We did not record any additive benefits when responsive stimulation was combined with nutrition interventions. Responsive stimulation effect sizes (Cohen's d) were 0·6 for cognition, 0·7 for language, and 0·5 for motor development at 24 months of age; these effect sizes were slightly smaller for the combined intervention group and were low to moderate for the enhanced nutrition intervention alone. Children exposed to enhanced nutrition had significantly better height-for-age Z scores at 6 months (p<0·0001) and 18 months (p=0·02) than did children not exposed to enhanced nutrition. Longitudinal analysis showed a small benefit to linear growth from enrolment to 24 months (p=0·026) in the children who received the enhanced nutrition intervention. The responsive stimulation intervention can be delivered effectively by LHWs and positively affects development outcomes. The absence of a major effect of the enhanced nutrition intervention on growth shows the need for further analysis of mediating variables (eg, household food security status) that will help to optimise future nutrition implementation design. UNICEF.

Effective integration of home visit interventions focused on early childhood development into existing service platforms is important for expanding access in low- and middle-income countries (LMICs). We designed and evaluated a home visit intervention integrated into community health worker (CHW) operations in South Africa. We conducted a cluster-randomized controlled trial in Limpopo Province, South Africa. CHWs operating in ward-based outreach teams (WBOTs; clusters) and caregiver-child dyads they served were randomized to the intervention or control group. Group assignment was masked from all data collectors. Dyads were eligible if they resided within a participating CHW catchment area, the caregiver was at least 18 years old, and the child was born after December 15, 2017. Intervention CHWs were trained on a job aid that included content on child health, nutrition, developmental milestones, and encouragement to engage in developmentally appropriate play-based activities, for use during regular monthly home visits with caregivers of children under 2 years of age. Control CHWs provided the local standard of care. Household surveys were administered to the full study sample at baseline and endline. Data were collected on household demographics and assets; caregiver engagement; and child diet, anthropometry, and development scores. In a subsample of children, electroencephalography (EEG) and eye-tracking measures of neural function were assessed at a lab concurrent with endline and at 2 interim time points. Primary outcomes were as follows: height-for-age z-scores (HAZs) and stunting; child development scores measured using the Malawi Developmental Assessment Tool (MDAT); EEG absolute gamma and total power; relative EEG gamma power; and saccadic reaction time (SRT)-an eye-tracking measure of visual processing speed. In the main analysis, unadjusted and adjusted impacts were estimated using intention-to-treat analysis. Adjusted models included a set of demographic covariates measured at baseline. On September 1, 2017, we randomly assigned 51 clusters to intervention (26 clusters, 607 caregiver-child dyads) or control (25 clusters, 488 caregiver-child dyads). At endline (last assessment June 11, 2021), 432 dyads (71%) in 26 clusters remained in the intervention group, and 332 dyads (68%) in 25 clusters remained in the control group. In total, 316 dyads attended the first lab visit, 316 dyads the second lab visit, and 284 dyads the third lab visit. In adjusted models, the intervention had no significant impact on HAZ (adjusted mean difference (aMD) 0.11 [95% confidence interval (CI): -0.07, 0.30]; p = 0.220) or stunting (adjusted odds ratio (aOR) 0.63 [0.32, 1.25]; p = 0.184), nor did the intervention significantly impact gross motor skills (aMD 0.04 [-0.15, 0.24]; p = 0.656), fine motor skills (aMD -0.04 [-0.19, 0.11]; p = 0.610), language skills (aMD -0.02 [-0.18, 0.14]; p = 0.820), or social-emotional skills (aMD -0.02 [-0.20, 0.16]; p = 0.816). In the lab subsample, the intervention had a significant impact on SRT (aMD -7.13 [-12.69, -1.58]; p = 0.012), absolute EEG gamma power (aMD -0.14 [-0.24, -0.04]; p = 0.005), and total EEG power (aMD -0.15 [-0.23, -0.08]; p < 0.001), and no significant impact on relative gamma power (aMD 0.02 [-0.78, 0.83]; p = 0.959). While the effect on SRT was observed at the first 2 lab visits, it was no longer present at the third visit, which coincided with the overall endline assessment. At the end of the first year of the intervention period, 43% of CHWs adhered to monthly home visits. Due to the COVID-19 pandemic, we were not able to assess outcomes until 1 year after the end of the intervention period. While the home visit intervention did not significantly impact linear growth or skills, we found significant improvement in SRT. This study contributes to a growing literature documenting the positive effects of home visit interventions on child development in LMICs. This study also demonstrates the feasibility of collecting markers of neural function like EEG power and SRT in low-resource settings. PACTR 201710002683810; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=2683; South African Clinical Trials Registry, SANCTR 4407.