The World Starts With Me: using intervention mapping for the systematic adaptation and transfer of school-based sexuality education from Uganda to Indonesia

Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme’s effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. Intervention Mapping, a protocol for the development of evidence-based behaviour change interventions, was used to adapt the comprehensive school-based sexuality education programme ‘The World Starts With Me’. The programme was developed for a priority population in Uganda and adapted to a programme for Indonesian secondary school students. The approach helped to systematically address the complexity and challenges of programme adaptation and to find a balance between preservation of essential programme elements (i.e. logic models) that may be crucial to the programme’s effectiveness, including key objectives and theoretical behaviour change methods, and the adaptation of the programme to be acceptable to the new priority group and the programme implementers

Business ethics as practice

In this article we develop a conceptualization of business ethics as practice. Starting from the view that the ethics that organizations display in practice will have been forged through an ongoing process of debate and contestation over moral choices, we examine ethics in relation to the ambiguous, unpredictable, and subjective contexts of managerial action. Furthermore, we examine how discursively constituted practice relates to managerial subjectivity and the possibilities of managers being moral agents. The article concludes by discussing how the 'ethics as practice' approach that we expound provides theoretical resources for studying the different ways that ethics manifest themselves in organizations as well as providing a practical application of ethics in organizations that goes beyond moralistic and legalistic approaches. © 2006 British Academy of Management

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Determining Wetlands Distribution, Lake Depths, and Topography Using Airborne Lidar and Imagery on the North Slope, Deadhorse Area, Alaska

On the Alaskan North Slope, a permafrost-dominated coastal plain above the Arctic Circle, the ability of lakes to support a fish population is a function of water depth, and wetlands classification is highly dependent on soil saturation (and thus microtopography). Using a new airborne lidar instrument that combines laser ranging at near-infrared wavelengths for topography and green wavelengths for bathymetry, we flew a pilot study over a 490-km2 area south of Prudhoe Bay in August 2012 to measure surface topography at a density of about 20 points/m2 and water-body depths at a density of about 2 points/m2. High-resolution digital elevation models, having vertical accuracies of a few centimeters, have been generated from the topographic laser data that was acquired at a 400 kHz pulse rate. These models and associated point clouds can be used along with high-resolution color-infrared imagery to map permafrost landscape features such as soil/ice polygons and pingos and identify microtopographic features that influence soil moisture and consequently wetlands distribution. Bathymetric lidar data, acquired at a pulse rate of 36 kHz, can be used to produce elevation models for the water surface and the water bottom, allowing water depths to be determined for shallow, freshwater lakes and anastomosing stream channels. Water penetration to depths greater than 6 m has been achieved in lakes with reported turbidities ranging from 0.7 to 4.3 nephelometric turbidity units (NTU). Topographic and bathymetric lidar data were used to establish the boundaries, measure water depths, and estimate total and incremental water volumes for 283 shallow lakes in the survey area having surface areas greater than about 0.8 ha. These lakes together are estimated to contain 20,343,051 m3 (5,374,064,326 gal) of water, of which 724,813 m3 (191,475,524 gal) is found in 83 lakes with depths greater than 1.5 m (5 ft) and 116,753 m3 (30,842,854 gal) is found in 38 lakes with depths greater than 2.1 m (7 ft).Bureau of Economic Geolog