The Partnership Paperchase: Structuring Partnership Agreements in Water and Sanitation in Low-income Communities

Tripartite partnerships between water utilities, local government and civil society are often seen as a good way to deliver services to informal urban communities and slums. However, while these 'partnerships' can be seen as benign relationships, they often fail because the incentives and interests of the partners are not well aligned. In this report, the authors argue that the development of robust documentation (in forms which consitute a 'contractual' agreement) can enhance the performance of such partnerships. Aspects of the partnership which should be included in such documentation include roles and responsibilities, financing, objectives and indicators of success and dispute-resolution mechanisms. The report provides practical guidance and examples of good practice to guide the reader through a process of developing such documentation

The Partnership Paperchase: Structuring Partnership Agreements in Water and Sanitation in Low-income Communities

Tripartite partnerships between water utilities, local government and civil society are often seen as a good way to deliver services to informal urban communities and slums. However, while these 'partnerships' can be seen as benign relationships, they often fail because the incentives and interests of the partners are not well aligned. In this report, the authors argue that the development of robust documentation (in forms which consitute a 'contractual' agreement) can enhance the performance of such partnerships. Aspects of the partnership which should be included in such documentation include roles and responsibilities, financing, objectives and indicators of success and dispute-resolution mechanisms. The report provides practical guidance and examples of good practice to guide the reader through a process of developing such documentation

Evaluation of peer support for borderline personality disorder

Background: When someone with lived experience of mental health difficulties provides help to others with similar difficulties, it is generally called peer support. Peer support may be one way to enhance interpersonal relationships, a factor known to improve recovery from borderline personality disorder (BPD). There is little known about peer support in BPD. Method: Four qualitative studies evaluated peer support for BPD. First, theory was built through an exploration to determine perceptions and possible models of peer support for BPD (Study One). Next, the application of peer support for consumers with BPD and their carers was examined from multiple perspectives (Study Two and Three). Finally, a new peer and clinician co-facilitated group for consumers with BPD was piloted (Study Four). Results: Consumers with BPD reported experiencing increased hope and connectedness through peer support. Consumer peer workers, however can experience stigma and mistreatment in the workplace (Study One). Participants expressed how a unique contribution of consumer peer workers is their ability to provide skills based on lived experience. Consumer peer workers reported experiencing negative emotions when exposed to consumer distress (Study Two). Carers described helpful aspects of carer peer support, including feeling understood. Carer peer workers can be distinguished from clinicians due to their reciprocal approach (Study Three). Participants reported how a peer and clinician co-facilitated group helped consumers by providing skills to enhance recovery. The peer worker’s personal understanding of BPD enabled consumers to share openly, whilst the clinician delivered skills based on professional training (Study Four). Discussion: These studies provide evidence for how peer support may be uniquely helpful for consumers and carers with lived experience of BPD. Challenges in peer support for BPD may also be experienced, including managing boundaries and the impact on the worker’s mental health. Two models of peer support were developed: an integrated model where peer workers are within a treatment team and a complementary model where peer workers are separate from a team. Limitations of the research included possible biases due to purposive sampling strategies. Future research is required to determine how both peer support and clinical interventions can best be delivered to consumers

Searching in the Dark: Shining a Light on Non-Response to Psychotherapy for Borderline Personality Disorder

Background: Health practitioners have long recognised that a proportion of patients with Borderline Personality Disorder (BPD) struggle to improve even after being provided with evidence-based treatments. Despite this, there are few studies and little known about the size and factors behind non-response. This thesis by compilation presents three studies exploring non-response to psychotherapy for BPD. Method: First, a systematic review was conducted to obtain an informed estimate from the literature on the proportion of people who are not responding to psychotherapy for BPD (Chapter Two). Second, a quantitative study that sought to identify factors that may increase the likelihood of non-response to psychotherapy for BPD in 184 individuals after 12 months of treatment in the community was conducted (Chapter Three). Third, a qualitative study sought to understand the problem of non-response from the perspective of people with a lived experience of BPD. Thematic analysis was conducted on interviews regarding people’s insights into non-response to psychotherapy for BPD (Chapter Four). The thesis is concluded with a discussion of overall findings and future directions (Chapter Five). Results: The systematic review identified 28 studies that reported individual response rates to psychotherapy for BPD in 2436 people. Of these participants, M = 48.80% (SD = 22.77) did not respond to treatment (Chapter Two). The quantitative study (N = 18) revealed that preoccupied attachment style, dismissive attachment style, high anger and high paranoia were associated with increased likelihood of being a non-responder after 12 months of psychotherapy in the community (Chapter Three). The results of the qualitative study demonstrated that participants consistently attributed an unsafe therapeutic alliance as the main cause of non-response to psychotherapy for BPD (Chapter Four). Conclusion: As a whole, the present research has produced an informed estimate of the proportion of people who are not responding to psychotherapy for BPD, identified factors that increase the likelihood of non-response, and explored patient perspectives on non-response. The reasons for non-response appear complex and individual, although interpersonal fears of patients’ and struggles to relate well to therapists were prominent in the findings. Future research needs to extend further the personal and interpersonal factors that are making it hard for people to benefit from treatment

BPM News - Folge 3

Die BPM-Kolumne des EMISA-Forums berichtet über aktuelle Themen, Projekte und Veranstaltungen aus dem BPM-Umfeld. Schwerpunkt der vorliegenden Kolumne bildet das Thema Standardisierung von Prozessbeschreibungssprachen und -notationen im Allgemeinen und BPEL4WS (Business Process Execution Language for Web Services) im Speziellen. Hierzu liefert Jan Mendling von der Wirtschaftsuniversität Wien in aktuelles Schlagwort. Des weiteren erhalten Leser eine Zusammenfassung zweier im ersten Halbjahr 2006 veranstalteten Workshops zu den Themen „Flexibilität prozessorientierter Informationssysteme“ und „Kollaborative Prozesse“ sowie einen BPM Veranstaltungskalender für die 2. Jahreshälfte 2006

Guidelines for the Nutritional Management of Bariatric Surgery Patients: Pre- and Post-Operatively

Objective: The purpose of this thesis was to explore the nutritional management of bariatric surgery patients. This thesis utilized a literature review to locate the guidelines which address the nutritional management of bariatric surgery patients. To this end, a literature search was completed to find the guidelines. Many components of the nutritional guidelines reviewed were based on limited research, and mostly on expert opinion. The guidelines for the nutritional management of bariatric surgery are categorized by preoperative assessment/education, post-operative diet progression, supplement use and long-term follow-up. Another aim was to find out if these guidelines are used in practice and followed by individuals who have had bariatric surgery. After the guidelines were reviewed and summarized, another literature search was undertaken to find empirical research regarding the diet quality of individuals who have had bariatric surgery. Finally, the available research is critiqued and recommendations are made for directions of future research.Method: PubMed searches were the primary source of literature to be used for this review. Conclusion: The nutritional management of individuals who have had bariatric surgery is complex and must be carried out for the long-term. Deficiencies of vitamins, minerals and protein were reported with some frequency, but other concerns relate to inadequate weight loss to achieve clinical significance. More work needs to be done to understand how patients can maximize their weight loss after surgery while maintaining adequate nutritional status. Results of the research reviewed were highly variable, but many studies were conducted using convenience samples. The public health significance of this paper lies in the fact that as the obesity epidemic persists in the United States; more and more patients are turning to bariatric surgery as a treatment for obesity. Well-researched guidelines are imperative to the care of these individuals and to ensure that the health care dollars spent on the surgery are being used effectively

BRUCELLOSIS TRANSMISSION BETWEEN WILDLIFE AND LIVESTOCK IN THE GREATER YELLOWSTONE ECOSYSTEM: INFERENCES FROM DNA GENOTYPING

Brucellosis transmission between wildlife species and cattle in the greater Yellowstone ecosystem has been difficult to assess because the causative agent Brucella abortus bacteria is extremely difficult to isolate for DNA genotyping. We examined transmission of B. abortus between bison, elk, and cattle using nine variable-number tandem repeat (VNTR) markers on DNA from 98 isolates of B. abortus recovered from elk, bison, and cattle. All specimens were from geographically distinct populations in Idaho, Montana, and Wyoming. A haplotype network consisting of 54 individual haplogroups was generated from these isolates using Network v4.61. Network assessments of genetic relatedness among Brucella isolates showed that genotypes from the 2008 cattle outbreak in Wyoming matched elk B. abortus genotypes, confirming elk as the likely source. Network assessments showed substantial interspecific transmission between elk and bison populations in Montana. The B. abortus from the two recent outbreaks (2007, 2008) in Montana cattle had genotypes similar to isolates from both bison and elk. Because wild bison have been excluded from the Montana cattle areas for decades as part of wildlife management policy, our findings suggest transmission likely occurred between bison and elk in Yellowstone before eventually being transmitted to cattle in southern Montana. Finally, the occurrence of identical B. abortus genotypes between individual Montana elk suggests that brucellosis might have recently become established in Montana, either by transmission from northern Yellowstone bison or from infected elk immigrants from Wyoming

Using the Personality Assessment Inventory to Discriminate among Borderline Personality Disorder, Bipolar Disorder, and Post-traumatic Stress Disorder

This study explored the use of the PAI as a tool to help differentiate borderline personality disorder from two other similar and frequently comorbid disorders of bipolar disorder (I & II) and posttraumatic stress disorder. Using discriminant analysis, the PAI profile scale scores of college counseling center clients that had been given one of these three diagnoses were analyzed. The analysis was able to predict group assignment accurately using four particular scores. A discussion of the predictor variables and clinical presentation of these disorders is offered. Support for the use of the PAI as a routine screening tool in college counseling centers also is suggested

Head circumference measurements in fetus and newborn children: how accurate are we?

As part of the medical studies at the University of Lausanne, students are asked to achieve a personal research project and write a master thesis in addition to other exams in order to achieve a medical degree. As I have always been attracted to obstetrics, it became obvious that I would ask to perform this research project in this field. This master thesis has taken place at the Klinik für Geburtshilfe, at the Universitätsspital in Zürich (USZ) from March 2017 to April 2018 and aims at assessing the accuracy of fetal and newborn HCs measurements, combined with it’s relation to delivery. It has always been considered obvious that the larger the head of the fetus, the higher risk of delivery difficulties. This relationship seems, however, nowadays still quite imprecise. The objective of the current Master thesis is therefore to provide, in a first part, an overview of the history up to today's aspects of childbirth and the methods used over time to assess the fetal head circumference (HC). This first part aims for a better understanding of the second part and does not provide a complete overview of the obstetric history. In the second part, the design and initial results of a prospective study are presented. In this study, the accuracy of the post-birth HC measurement will be verified by measuring inter-observer variability, the accuracy of the pre-birth HC's ultrasonographic assessment will be verified by comparing the data with those obtained immediately, as well as two days after birth