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This article sheds light on the collection and use of data by libraries in sixteen countries across Africa. It highlights the challenges that librarians and library organizations face in gathering, analyzing, and presenting data of various types for self-advocacy. In this study, qualitative data from a meeting of library representatives was analyzed to identify main challenges including: data integrity in terms of completeness, accuracy, credibility, and relevancy; infrastructure; capacity; local investment in libraries; time; and participation of data collectors and respondents. Implications for those collecting data on African libraries as well as those supporting the use of data in these contexts are discussed. The purpose of this paper is not to feed into representations of African libraries as chronically under-resourced and lacking in capacity, but rather, to constructively engage with first-hand accounts of how librarians are experiencing and navigating barriers in order to offer potential avenues forward for the field.

The gut is home to millions of microscopic organisms, which together are called the gut microbiota. Most of these microorganisms live in peace with the rest of our cells, help us get energy from food, and give us essential nutrients that we cannot make ourselves. The cells lining the gut’s surface keep these microorganisms separated from the rest of the body, like the “Great Wall” of our kingdom. On the inside of this Great Wall, the heroes of the mighty immune system watch over and protect us. But how can the immune system tell the difference between our own cells and the gut microorganisms? Or between helpful microorganisms and disease-causing ones? It is an amazing storey, full of secrets. In this article, we will explain how the gut coaches the immune system to recognise enemies, and how some aspects of modern life might be interfering with this process.

Background: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. Objective: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. Methods: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. Results: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). Conclusions: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.

Objective The study aimed to describe the cases of neurological disease related to the outbreak of enterovirus (EV) in three regions in Northern Spain during 2016. Materials and Methods Multicenter retrospective observational study. Clinical, radiological, and microbiological data were analyzed from patients younger than 15 years with confirmed EV-associated neurological disease admitted to 10 hospitals of Asturias, Cantabria, and Castile and Leon between January 1 and December 31, 2016. Results Fifty-five patients were included. Median age was 24 months (interquartile range = 18.5 months). Fifteen patients were classified as aseptic meningitis (27.3%). In total, 37 cases presented brainstem encephalitis (67.3%), 25 of them due to EV-A71 with excellent prognosis (84.6% asymptomatic 2 months following the onset). Three cases of acute flaccid myelitis (5.5%) by EV-D68 were reported and presented persistent paresis 2 months following the onset. Microbiological diagnosis by reverse transcriptase polymerase chain reaction was performed in all cases, finding EV in cerebrospinal fluid in meningitis, but not in brainstem encephalitis and acute flaccid myelitis, where EV was found in respiratory or rectal samples. Step therapy was administrated with intravenous immunoglobulin (IVIG; 32.7%), methylprednisolone (10%), and plasmapheresis (3.6%). Four patients received fluoxetine (7.3%). Twenty patients needed to be admitted to pediatric intensive care unit (36.4%). Conclusion Clinical, microbiological, and radiological diagnosis is essential in outbreaks of EV neurological disease, taking into account that it can be difficult to identify EV-A71 and EV-D68 in CSF, requiring throat or rectal samples. There is not specific treatment to these conditions and the efficacy and understanding of the mechanism of action of immune-modulatory treatment (IVIG, corticosteroids, and plasmapheresis) is limited.

Purpose of Review This review presents an in-depth overview of the sleep–wake phenotype of patients with cirrhosis, together with available pharmacological and non-pharmacological treatment strategies. A set of simple, practical recommendations is also provided. Recent Findings The understanding of the pathophysiology of sleep disorders in this patient population has improved over the past decade, especially in relation to the interplay between homeostatic and circadian sleep regulation. In addition, new tools have been utilised for both screening and in-depth investigation of the sleep–wake profile of these patients. Finally, a number of studies have evaluated the efficacy of novel treatment strategies, often with encouraging results. Summary Since sleep disturbances are common in patients with cirrhosis, more so than in patients with other chronic diseases of similar severity, their assessment should become routine hepatological practice, along with the initiation of adequate treatment.

Treatment of congenital cytomegalovirus infection is mandatory in cases with severe systemic and/or neurological involvement. However, some patients are paucisymptomatic, with very subtle systemic manifestations and/or minimal brain alterations. Current international guidelines do not clearly state whether these children should be treated, and this decision is not straightforward for clinicians. Of a small series of six infants with congenital cytomegalovirus infection admitted to our neonatal unit between 2015 and 2019, half showed paucisymptomatic neurological manifestations. In these cases, the determination of s2-microglobulin in cerebrospinal fluid and magnetic resonance imaging aided in the decision-making concerning the therapeutic approach to follow.

Chronic leg ulcers can have a major impact on the quality of life of patients. These wounds can be complex and hard to heal, as several factors may affect the outcome. Underlying conditions, bacterial growth and excess moisture may prevent wounds from healing. We describe the case of a patient with known chronic venous disease, who was admitted to our hospital for several complex, irregular and infected chronic venous ulcers in his lower legs. The management was frustrating for several months, until we began to use methacrylate powder dressing for his hard-to-heal wounds.

A popular method to estimate proximal/distal temperature (TPROX and TDIST) consists in calculating a weighted average of nine wireless sensors placed on pre-defined skin locations. Specifically, TPROX is derived from five sensors placed on the infra-clavicular and mid-thigh area (left and right) and abdomen, and TDIST from four sensors located on the hands and feet. In clinical practice, the loss/removal of one or more sensors is a common occurrence, but limited information is available on how this affects the accuracy of temperature estimates. The aim of this study was to determine the accuracy of temperature estimates in relation to number/position of sensors removed. Thirteen healthy subjects wore all nine sensors for 24 hours and reference TPROX and TDIST time-courses were calculated using all sensors. Then, all possible combinations of reduced subsets of sensors were simulated and suitable weights for each sensor calculated. The accuracy of TPROX and TDIST estimates resulting from the reduced subsets of sensors, compared to reference values, was assessed by the mean squared error, the mean absolute error (MAE), the cross-validation error and the 25th and 75th percentiles of the reconstruction error. Tables of the accuracy and sensor weights for all possible combinations of sensors are provided. For instance, in relation to TPROX, a subset of three sensors placed in any combination of three non-homologous areas (abdominal, right or left infra-clavicular, right or left mid-thigh) produced an error of 0.13°C MAE, while the loss/removal of the abdominal sensor resulted in an error of 0.25°C MAE, with the greater impact on the quality of the reconstruction. This information may help researchers/clinicians: i) evaluate the expected goodness of their TPROX and TDIST estimates based on the number of available sensors; ii) select the most appropriate subset of sensors, depending on goals and operational constraints.

BACKGROUND & AIMS: Sleep preparation/onset are associated with peripheral vasodilatation and a decrease in body temperature. The hyperdynamic syndrome exhibited by patients with cirrhosis may impinge on sleep preparation, thus contributing to their difficulties falling asleep. The aim of this study was the assessment of skin temperature, in relation to sleep-wake patterns, in patients with cirrhosis. METHODS: Fifty three subjects were initially recruited, and 46 completed the study. Of the final 46, twelve were outpatients with cirrhosis, 13 inpatients with cirrhosis, 11 inpatients without cirrhosis and 10 healthy volunteers. All underwent baseline sleep-wake evaluation and blood sampling for inflammatory markers and morning melatonin levels. Proximal/distal skin temperature and their gradient (DPG) were recorded for 24 hours by a wireless device. Over this period subjects kept a sleep-wake diary. RESULTS: Inpatients with cirrhosis slept significantly less well than the other groups. Inpatients and outpatients with cirrhosis had higher proximal temperature and blunted rhythmicity compared to the other groups. Inpatients with/without cirrhosis had higher distal temperature values and blunted rhythmicity compared to the other groups. Inpatients and outpatients with cirrhosis had significantly lower DPG values compared to the other groups, and DPG reached near-zero values several hours later. Significant correlations were observed between temperature and sleep-wake variables and inflammatory markers. CONCLUSIONS: Alterations of distal/proximal skin temperature, their gradient and their time-course were observed in patients with cirrhosis, which may contribute to their sleep disturbances. This article is protected by copyright. All rights reserved.

Digital and social inclusion intermediaries play a crucial role in providing digital literacy to excluded groups and in using Information and Communication Technologies (ICTs) to support social inclusion. However, information on the main characteristics of these actors is lacking. This paper presents the preliminary results of part of the MIREIA research conducted by the Institute for Prospective Technological Studies of the European Commission's Joint Research Centre, which aimed to characterise eInclusion intermediary actors in Europe and measure their socio-economic impact. This article explores the role of third sector organisations in the broader landscape of eInclusion intermediary actors. It first presents a conceptualization of the role and impacts of eInclusion intermediary actors, based on the results of a literature review and detailed 'locality mappings' conducted in three areas in Europe, in order to provide a definition of these actors. It then presents the methodology and main findings of an online survey designed to provide a 'map' of the eInclusion actors operating in Europe, answering the following questions: What are eInclusion actors? How can they be classified? Which services do they provide, to which targets groups?, and finally How do they operate and innovate? Findings show that the vast majority of eInclusion actors in the third sector are small organizations, in terms of staff numbers and budget, providing ICT services mainly to senior citizens, young adults and unemployed people. The results are consistent with the theoretical framework proposed and thus confirm that the configuration of the main characteristics of eInclusion intermediary actors is influenced by several factors including these actors' own intrinsic characteristics (mission, human and financial resources, etc.) and the external conditions (institutional environment, needs of the population where they operate, etc.). At the same time, these external factors and the different features of the intermediaries are linked and interrelated. These preliminary conclusions point to the fact that, despite the limitations inherent in the approach used, the findings presented in this paper can be considered relevant because: 1) they are the results of the first attempt in Europe to collect primary data from eInclusion intermediary actors and aim to create at least a baseline for future research; 2) the link between this activity and policy-making at EU level and the direct involvement of pan-European stakeholders and practitioners from the field will form the basis for further research and policy actions, informed by the results of the investigation; 3) the findings of the analysis provide useful insights and help shed light on the diversity and role of eInclusion intermediary actors and the contributions of their programmes to advancing social and economic inclusion in Europe. Further research is, however, required to systematise the findings and confirm the preliminary results with more in-depth investigation and analysis.

BACKGROUND: Clamping and cutting of the umbilical cord is the most prevalent of all operations, but the optimal timing of cord clamping is controversial, with different timings offering advantages and disadvantages. This study, for the first time, compares the influence of early and late cord clamping in correlation with oxidative stress and inflammation signaling, Because cord clamping timing may have a significant influence on placenta-to-infant blood transfer, thereby modifying oxygenation of maternal and fetal tissues, and on the transfer of inflammatory mediators throughout the placenta. METHODS: Sixty-four pregnant subjects were selected at the Gynecology and Obstetrics Services Department of the Clinico San Cecilio Hospital, Granada, Spain, based on disease-free women who experienced a normal course of pregnancy and a spontaneous, vaginal, single delivery. Half of the subjects had deliveries with early-clamped newborn infants (at 10 s), and the other half had late-clamped deliveries (at 2 min). RESULTS: Erythrocyte catalase activity was significantly greater in the late-clamped group than in the early-clamped group (P < .01 for the umbilical vein and P < .001 for the artery). The values for superoxide dismutase, total antioxidant status, and soluble tumor necrosis factor receptor II were all significantly higher in the late-clamped group compared with the early-clamped group (P < .01, P < .001, and P < .001, respectively). CONCLUSIONS: The results suggest a beneficial effect of late cord clamping, produced by an increase in antioxidant capacity and moderation of the inflammatory-mediated effects induced during delivery of term neonates.

Little is known about the pathogenesis of cerebral sinovenous thrombosis (CSVT) in the neonate. Although thrombophilia has been described as increasing the risk of CSVT in adults, it remains controversial in pediatric patients, and prospective case–control studies regarding neonatal CSVT are lacking. From 2008 to 2017, all 26 consecutive newborn infants ≥35 weeks of gestation diagnosed with neonatal CSVT, and their mothers, were tested for factor V Leiden (FV) G1691A, FII G20210A, and methylenetetrahydrofolate reductase C677T (MTHFR C677T) mutations. Eighty-five mother–infant pairs were recruited as controls. All infants except 1 with CSVT were suspected due to clinical symptoms, mainly seizures (22/25). Magnetic resonance imaging was performed in 24/26 infants. Heterozygous FV G1691A, FII G20210A, and homozygous MTHFR C677T mutations were present in 1/26, 3/26, and 3/20 infants with CSVT, respectively. FII (odds ratio: 10.96; 95% confidence interval [CI]: 1.09-110.35) and male sex (3.93; 95% CI: 1.43-10.76) were associated with CSVT. When FII G20210A analysis was adjusted for sex, the OR for FII G20210A was 6.70 (95% CI: 0.65-69.22). No differences were found for FV G1691A or homozygous MTHFR mutations between neonates with CSVT and their mothers, compared to controls.

Gender is a crucial determinant of life span, but little is known about gender differences in free radical homeostasis and inflammatory signaling. The aim of the study was to determine gender-related differences concerning oxidative stress and inflammatory signaling of healthy neonates and mothers. Fifty-six mothers with normal gestational course and spontaneous delivery were selected. Blood samples were collected from the mother (at the beginning of delivery and start of expulsive period) and from neonate (from umbilical cord vein and artery). The mothers of girls featured a higher total antioxidant status and lower plasma hydroperoxides than the mother of boys. Regarding the neonates, the girls featured a higher total antioxidant status and lower plasma membrane hydroperoxides in umbilical cord artery together with higher catalase, glutathione peroxidase, and superoxide dismutase activities. Lower levels of interleukin 6, tumor necrosis factor alpha, and prostaglandin E2 were observed in the mothers of girls and higher level of soluble tumor necrosis factor receptor II. In the neonates, lower levels of interleukin 6 and tumor necrosis factor alpha were observed in umbilical artery and higher soluble tumor necrosis factor receptor II in umbilical cord vein and artery of girls. An association between gender, oxidative stress, and inflammation signaling exists, leading to a renewed interest in the neonate’s sex as a potential risk factor to several alterations.

Human papilloma virus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) has a better prognosis than it's HPV negative (HPV(-)) counterpart. This may be due to the higher numbers of tumor-infiltrating lymphocytes (TILs) in HPV positive (HPV(+)) tumors. RNA-Sequencing (RNA-Seq) was used to evaluate whether the differences in clinical behaviour simply reflect a numerical difference in TILs or whether there is a fundamental behavioural difference between TILs in these two settings. Thirty-nine HNSCC tumors were scored for TIL density by immunohistochemistry. After the removal of 16 TILlow tumors, RNA-Seq analysis was performed on 23 TILhigh/med tumors (HPV(+) n=10 and HPV(-) n=13). Using EdgeR, differentially expressed genes (DEG) were identified. Immune subset analysis was performed using Functional Analysis of Individual RNA-Seq/ Microarray Expression (FAIME) and immune gene RNA transcript count analysis. In total, 1,634 DEGs were identified, with a dominant immune signature observed in HPV(+) tumors. After normalizing the expression profiles to account for differences in B- and T-cell number, 437 significantly DEGs remained. A B-cell associated signature distinguished HPV(+) from HPV(-) tumors, and included the DEGs CD200, GGA2, ADAM28, STAG3, SPIB, VCAM1, BCL2 and ICOSLG; the immune signal relative to T-cells was qualitatively similar between TILs of both tumor cohorts. Our findings were validated and confirmed in two independent cohorts using TCGA data and tumor-infiltrating B-cells from additional HPV(+) HNSCC patients. A B-cell associated signal segregated tumors relative to HPV status. Our data suggests that the role of B-cells in the adaptive immune response to HPV(+) HNSCC requires re-assessment.

The article Assessment and Management of Sleep Disturbance in Cirrhosis, written by Chiara Formentin, Maria Garrido, and Sara Montagnese, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 13 February 2018 without open access.

Background Providing structured information for the understanding of hepatic encephalopathy (HE) might be relevant to the prevention and management of the syndrome. The aim of our study was to design a brief, structured educational intervention and evaluate its usefulness in preventing HE-related hospitalisation over time. Methods Thirty-nine cirrhotic outpatients with a history of HE were enrolled and randomly assigned to an intervention (group A; n=20) or control group (group B; n=19). All of them underwent evaluation of HE (clinical and quantitative neuropsychiatric assessment) and completed the Questionnaire on the Awareness of Encephalopathy. A 15 min educational session was then provided to patients in group A, including basic information on the pathophysiology, hygienic and medical management of HE. Results No demographic/clinical differences were observed at baseline between the two groups. Similarly, there were no significant differences in HE-related information available at baseline between the two groups; knowledge of HE was limited in both. The intervention was highly effective in increasing patients’ understanding of treatment of the condition (from 5% to 80%). The educational intervention also reduced the risk of developing an episode of HE over a period of 12 months. Conclusion The educational intervention confirmed the poor knowledge of patients with previous HE about their condition, served as a tool to increase patients’ awareness, and minimised HE-related readmission rates over a period of 1 year.

Este estudo objetiva descrever uma experiência de formação para marisqueiras, conduzida junto à comunidade pesqueira de Ilha do Paty, São Francisco do Conde, em um contexto de ações para promoção da saúde e da segurança alimentar. Estudo de intervenção, com planejamento de atividades por equipe multidisciplinar. As atividades foram desenvolvidas em cinco etapas: sondagem de temas; sensibilização; rotina de trabalho das marisqueiras; curso de boas práticas no beneficiamento de mariscos; e roda de conversa. As metodologias incluíram exposição dialogada, dinâmica de grupos, oficinas, teatro, uso de imagens, atividades dirigidas e distribuição de materiais didáticos. Ao final, solicitou-se a avaliação dos participantes quanto a distintos itens. Em geral, registrou-se satisfação do público-alvo, para a maioria dos indicadores, o que pode relacionar-se tanto à utilização de recursos audiovisuais e estratégias que permitiram troca de experiências, quanto ao reconhecimento da importância da formação. A experiência demonstra o potencial de desenvolvimento de atividades educativas junto a comunidades pesqueiras, com resultados que contribuem para o fortalecimento de cadeias produtivas locais, com promoção da segurança alimentar e da saúde do trabalhador. This study describes an experience in the training of female shellfish gatherers in the fishing community in Ilha do Paty, São Francisco do Conde, within the context of actions to promote health and food safety. This is an intervention study with planning of activities by a multidisciplinary team. The activities were developed in five stages: survey of topics of interest; awareness; female shellfish gatherers' work routine; teaching of best practices in the processing of shellfish; and group conversation. The methodologies included exposure through dialogue, group dynamics, workshops, theater, work with images, directed activities and the distribution of educational materials. At the end, an evaluation by the participants regarding the different aspects was conducted. Overall there was satisfaction among the audience for most indicators, which may relate to both the use of audiovisual resources and strategies that permitted the exchange of experiences regarding the recognition of the importance of training by the target audience. The experiment demonstrates the potential of developing educational activities with the fishing communities, with results that contribute to the bolstering of the local supply chain, with the promotion of food safety and occupational health.

BackgroundApple allergy manifests as two main groups of clinical entities reflecting different patterns of allergen sensitization: oral allergy syndrome (OAS) and generalized symptoms (GS).ObjectiveWe analysed the sensitization profile to a wide panel of different components of food allergens (rMal d 1, Mal d 2, rMal d 3, rMal d 4, rPru p 3, rBet v 1 and Pho d 2) for a population of Mediterranean patients with OAS and GS to apple.MethodsPatients (N = 81) with a history of apple allergy that could be confirmed by positive prick-prick test and/or double-blind-placebo-controlled food challenge (DBPCFC), were included. Skin prick test (SPT) and ELISA were performed using a panel of inhalant, fruit and nut allergens. ELISA and ELISA inhibition studies were performed in order to analyse the sensitization patterns.ResultsThirty-five cases (43.2%) had OAS and 46 (56.8%) GS. SPT showed a significantly higher number of positive results with peach, cherry and hazelnut in those with GS. ELISA showed a significantly high percentage of positive cases to rMal d 3, rMal d 4, rPru p 3 and Pho d 2 in patients with OAS and GS compared to controls, and to rBet v 1 in patients with OAS vs controls and between OAS and GS patients. Three different patterns of recognition were detected: positive to LTP (rMal d 3 or rPru p 3), positive to profilin (rMal d 4 and Pho d 2), or positive to both. There were also patients with rMal d 1 recognition who showed cross-reactivity to rBet v 1.ConclusionIn an apple allergy population with a high incidence of pollinosis different patterns of sensitization may occur. LTP is most often involved in those with GS. Profilin, though more prevalent in patients with OAS, has been shown to sensitise patients with both types of symptoms.

Food allergy caused by lipid transfer protein (LTP) from peach (Pru p 3) is frequently associated with sensitization to mugwort LTP (Art v 3). Although in vitro cross-reactivity is already well known, it has yet to be elucidated whether a pollen LTP can induce rhinitis.The aim of this study was to investigate whether mugwort LTP could elicit respiratory symptoms and whether a primary food LTP allergy could lead to a respiratory allergy.Patients with confirmed Pru p 3 allergy and control subjects were selected. Immediate responses to nasal allergen provocation tests (NAPTs) with Art v 3, Pru p 3, and mugwort were assessed by using the visual analog scale score, total nasal symptom score, and acoustic rhinometry. Tryptase and cysteinyl leukotriene (cysLT) levels were measured in nasal lavage fluid. Immunoblotting, ELISAs, and ELISA inhibition assays were also performed.Fifteen patients and 9 control subjects were selected. NAPT results with Art v 3 and Pru p 3 showed significant changes in acoustic rhinometry, visual analog scale scores, total nasal symptom scores, and cysLT levels (P.001). Tryptase levels were only increased in NAPTs with Pru p 3. NAPTs with mugwort were used in those patients who were only sensitized to Art v 3, with similar results (P.05). No significant changes were detected in control subjects.The results demonstrated that a pollen LTP can elicit rhinitis in sensitized patients. Findings also suggest that a primary sensitization to Pru p 3 can lead to a respiratory allergy through cross-reactivity.

Objective. The main objective of this study was to systematically review all the scientific studies that analyse the effectiveness of mud pack therapy on patients diagnosed with knee OA. Methods. One hundred and fifteen publications were identified through an electronic and manual search and 20 of those studies were chosen based on the inclusion criteria: randomized clinical trials, systematic reviews or meta-analyses whose objective was to analyse the effect of mud pack therapy on perceived pain, function and quality of life, with a sample size of 520 subjects, published since 2000 and showing conclusive results. Results. In the studies that met the inclusion criteria, 12 analyse functionality, 17 perceived pain, 5 quality of life and all showed a significant improvement in the three analysed variables. The methodological quality of the studies had a moderate risk of bias. Conclusion. Mud pack therapy is considered an alternative and effective therapy in the clinical management of knee OA. Studies with better methodology are needed to prove its scope.

This article proposes an analytical framework to better understand the role that information and communication technology (ICT) skills play in improving employment opportunities for low-income groups. The paper draws upon research with over seventy non-governmental organizations (NGOs) that provide ICT training and other employment services in 30 countries around the world. It explores the linkage between ICT skills and employability on three levels: NGO program design, characteristics of individual job seekers or trainees, and environmental dynamics that influence employment outcomes. The researchers argue that basic ICT skills are often important, but are usually insufficient for members of disadvantaged groups to improve their employment situation. The proposed multilevel framework identifies some of the common elements that help situate basic ICT skills in relation to other factors that can facilitate or impede employability.

The history and definition of minority status in this country is a central consideration in our analysis of the conditions that affect the etiology, identification, assessment, incidence, and treatment of developmental psychopathology in these populations. As history clearly illustrates, the status of a minority in a country is not a function of numerical representation. In South Africa, the “minority” population created by the system of apartheid was actually the numerical majority of its habitants. Minority status is not a matter of numbers: It is a matter of access to resources and the power to determine their allocation and distribution.

Large phonetic corpora including both standard and variant transcriptions are available for many languages. However, applications requiring the use of dynamic vocabularies make necessary to transcribe words not present in the dictionary. Also, additional alternative pronunciations to standard forms have shown to improve recognition accuracy. Therefore, new techniques to automatically generate variants in pronunciations have been investigated and proven to be very effective. However, rule-based systems still remain useful to generate standard transcriptions not previously available or to build new corpora, oriented chiefly to synthesis applications. The present paper describes a letter-to-phone conversion system for Spanish designed to supply transcriptions to the flexible vocabulary speech recogniser and to the synthesiser, both developed at CSELT (Centro Studi e Laboratori Telecomunicazioni), Turin, Italy. Different sets of rules are designed for the two applications. Symbols inventories also differ, although the IPA alphabet is the reference system for both. Rules have been written in ANSI C and implemented on DOS and Windows 95 and can be selectively applied. Two speech corpora have been transcribed by means of these grapheme-to-phoneme conversion rules: a) the SpeechDat Spanish corpus which includes 4444 words extracted from the phonetically balanced sentences of the database b) a corpus designed to train an automatic aligner to segment units for synthesis, composed of 303 sentences (3240 words) and 338 isolated words; rule-based transcriptions of this corpus were manually corrected. The phonetic forms obtained by the rules matched satisfactorily the reference transcriptions: most mistakes on the first corpus were caused by the presence of secondary stresses in the SpeechDat transcriptions, which were not assigned by the rules, whereas errors on the synthesis corpus appeared mostly on hiatuses and on words of foreign origin. Further developments oriented to recognition can imply addition of rules to account for Latin American pronunciations (especially Mexican, Argentinian and Paraguayan); for synthesis, on the other hand, rules to represent coarticulatory phenomena at word boundaries can be implemented, in order to transcribe whole sentences.

A 100-gram oral glucose tolerance test (OGTT) was performed on a selected group of normal women at each trimester of pregnancy to establish reference values for hyperglycemia and hypoglycemia. Ninety three OGTT were performed in the first trimester, 121 in the second trimester, and 98 in the last trimester. The fasting serum glucose did not differ significantly between the trimesters. The values at 60 and 120 minutes were significantly different for the fifth, fiftieth, and ninety-fifth percentiles between each trimester of pregnancy. For the 180-minute readings, the fifth and fiftieth percentiles were not significantly different between the first and second trimester of pregnancy, but the results of the third trimester were significantly higher than those of the other trimesters. The mean fasting insulinemia remained relatively constant during pregnancy. Insulin response to OGTT increased during the progression of the pregnancy. The interpretation of the glucose tolerance tests during pregnancy, either to detect gestational diabetes or hypoglycemia, should take these physiologic changes into account.

This study provides a conceptual framework for the analysis of the questions of out-of-court debt restructuring from a policy-oriented perspective. The starting point of the analysis is given by the World Bank principles for effective insolvency and creditor rights systems. The study offers an overview of out-of-court restructuring, which is not seen as fundamentally opposed to formal insolvency procedures. Actually, the study contemplates different restructuring techniques as forming a continuum to the treatment of financial difficulties. The study discusses the advantages and disadvantages of all the debt restructuring techniques, and concludes, in this regard, that a legal system may contain a number of options a menu that can cover different sets of circumstances. In the end, the law may offer a toolbox with very different instruments that the parties may use depending on the specific facts of the case. The study also provides a checklist that can be used to examine the features of a legal system that bear a direct influence on debt restructuring activities.