Assessment of Thigh Angular Velocity by an Activity Monitor to Describe Sit-to-Stand Performance.

The assessment of sit-to-stand (STS) performance is highly relevant, especially in older persons, but testing STS performance in the laboratory does not necessarily reflect STS performance in daily life. Therefore, the aim was to validate a wearable sensor-based measure to be used under unsupervised daily life conditions. Since thigh orientation from horizontal to vertical is characteristic for STS movement, peak angular velocity (PAV) of the thigh was chosen as the outcome variable. A total of 20 younger and older healthy persons and geriatric patients (mean age: 55.5 ± 20.8 years; 55% women) with a wide range of STS performance were instructed to stand up from a chair at their usual pace. STS performance was measured by an activity monitor, force plates, and an opto-electronic system. The association between PAV measured by the thigh-worn activity monitor and PAV measured by the opto-electronic system (gold standard) was r = 0.74. The association between PAV measured by the thigh-worn activity monitor and peak power measured by force plate and opto-electronic system was r = 0.76. The Intra-Class Coefficient (ICC) of agreement between the 2 trials was ICC(A,1) = 0.76. In this sample of persons with a wide range of physical performance, PAV as measured by a thigh-worn acceleration sensor was a valid and reliable measure of STS performance.

Quality of antiepileptic drugs in sub-Saharan Africa: A study in Gabon, Kenya, and Madagascar.

OBJECTIVE: Epilepsy is a major public health issue in low- and middle-income countries, where the availability and accessibility of quality treatment remain important issues, the severity of which may be aggravated by poor quality antiepileptic drugs (AEDs). The primary objective of this study was to measure the quality of AEDs in rural and urban areas in 3 African countries. METHODS: This cross-sectional study was carried out in Gabon, Kenya, and Madagascar. Both official and unofficial supply chains in urban and rural areas were investigated. Samples of oral AEDs were collected in areas where a patient could buy or obtain them. Pharmacological analytical procedures and Medicine Quality Assessment Reporting Guidelines were used to assess quality. RESULTS: In total, 102 batches, representing 3782 units of AEDs, were sampled. Overall, 32.3% of the tablets were of poor quality, but no significant difference was observed across sites: 26.5% in Gabon, 37.0% in Kenya, and 34.1% in Madagascar (P = .7). The highest proportions of substandard medications were found in the carbamazepine (38.7%; 95% confidence interval [CI] 21.8-57.8) and phenytoin (83.3%; 95% CI 35.8-99.5) batches, which were mainly flawed by their failure to dissolve. Sodium valproate was the AED with the poorest quality (32.1%; 95% CI 15.8-42.3). The phenobarbital (94.1%; 95% CI 80.3-99.2) and diazepam (100.0%) batches were of better quality. The prevalence of substandard quality medications increased in samples supplied by public facilities (odds ratio [OR] 9.9; 95% CI 1.2-84.1; P < .04) and manufacturers located in China (OR 119.8; 95% CI 8.7-1651.9; P < .001). The prevalence of AEDs of bad quality increased when they were stored improperly (OR 5.4; 95% CI 1.2-24.1; P < .03). SIGNIFICANCE: No counterfeiting was observed. However, inadequate AED storage conditions are likely to lead to ineffective and possibly dangerous AEDs, even when good-quality AEDs are initially imported.

Demographic dynamics and off-take of cattle herds in southern Mali.

The herds of 95 families were monitored for 1 year in eight villages in the cotton-growing region of southern Mali. In 2006-2007, reproduction performances were average, with 0.54 calvings/year per cow, and mortality was low. Herd numerical productivity is not very high, less than 0.13/year, because of the high proportion of males kept for animal draught. Depending on the herd size, the behaviour of the families differs, in terms of off-take and in-take of animals. Families that only have one or two draught animals seek to increase their animal draught capacity, with a negative net off-take (-0.13/year). Families with two to three cows have a very low net off-take (0.02/year), with culling of adult animals compensated by purchase. They therefore capitalised this year, with an annual herd growth of 8%. Families with a very large herd (20 to 50 cows) take off more of their stock, with a net off-take of 0.08/year (very few animal purchases) and make a stock growth of 5%. And finally, families with an average-sized herd (6 to 19 cows) take off the whole of the year's production, with a net off-take of 0.11/year and a nil stock growth rate. The use of a demographic model made it possible to measure the sensitivity of the productivity rate to the different demographic parameters.