Knowledge in development aid and healthcare: a comparative analysis

Effective delivery in the fields of development aid and healthcare relies on knowledge and its communication. Institutions, practitioners and the end-users are examined in these two fields as key actors in the production and communication of knowledge. Similarities and differences, and strengths and weaknesses of their approaches to knowledge are compared. Knowledge is shown to be an intrinsically political process in which institutions and practitioners play a critical role in its communication. Establishing a common background is essential to communicate knowledge effectively. The World Bank’s notion that knowledge is a simple commodity should be challenged

Discrete second order constrained Lagrangian systems: first results

We briefly review the notion of second order constrained (continuous) system (SOCS) and then propose a discrete time counterpart of it, which we naturally call discrete second order constrained system (DSOCS). To illustrate and test numerically our model, we construct certain integrators that simulate the evolution of two mechanical systems: a particle moving in the plane with prescribed signed curvature, and the inertia wheel pendulum with a Lyapunov constraint. In addition, we prove a local existence and uniqueness result for trajectories of DSOCSs. As a first comparison of the underlying geometric structures, we study the symplectic behavior of both SOCSs and DSOCSs.Comment: 17 pages, 6 figure

Clinical and neuroimaging prognostic markers in Alzheimer's Disease and Lewy Body Dementia: The role of muscle status and nutrition

Alzheimer's Disease and Lewy body dementia are the two most common neurodegenerative dementias. They have a progressive course with devastating consequences for the people living with these diseases and their families, but there are large individual variations. Finding early markers and markers of progression and prognosis could promote actions to improve the quality of life of the people affected with these diseases. Nutrition and muscle status are closely related and have systemic functions and interactions that affect the brain. This thesis describes the role of nutritional and muscle status biomarkers in the prognosis of people diagnosed with mild Alzheimer's disease, Lewy body dementia, and mild subjective cognitive decline. Methods For the aim of this thesis, I used data from 2 community-based prospective Norwegian multicenter cohort studies: DemVest (The Dementia Study of Western Norway) and DDI (Dementia Disease Initiation). In DemVest, patients with mild dementia, defined as a Mini-Mental Status Examination (MMSE) score; equal or higher to 20 or Clinical Dementia Rating (CDR) global score equal to 1, with different types of dementia, were included. The DDI study was designed to investigate early cognitive impairment and dementia markers. DDI participants included in this thesis were those classified as having Subjective cognitive decline (SCD) according to the SCD-I framework. Comprehensive clinical assessments, including measures of cognition, daily functioning and anthropometric measurement, blood samples, and brain MRI were performed in both studies. Brain morphology was studied using FreeSurfer segmentation and muscle morphology using slice O-Matic software. Results This thesis findings first indicate that nutritional status has an essential role in the 5-year prognosis of people living with dementia in the capacity to perform daily life activities and mortality. Second, the quality of the muscle, here the muscle of the tongue, and its amount of fat infiltration were associated with malnutrition onset in people with dementia. Finally, in patients with SCD, muscle function measured with the timed up and go test (TUG) was associated with cognitive decline. TUG, in addition, was associated with cortical thickness in areas related with cognitive and motor functioning. Conclusion Nutritional and muscular status predict prognosis in people with SCD and with dementia. These findings suggest that interventions focused on these areas may improve outcomes such as cognition, function, and survival in these groups