Development that works, March 31, 2011

This repository item contains a single issue of the Pardee Conference Series, On March 31, 2011, more than 100 people participated in a conference titled “Development That Works,” sponsored by Boston University’s Frederick S. Pardee Center for the Study of the Longer-Range Future in collaboration with the BU Global Development program. In the pages that follow, four essays written by Boston University graduate students capture the salient points and overarching themes from the four sessions, each of which featured presentations by outstanding scholars and practitioners working in the field of development. The conference agenda and speakers’ biographies are included following the essays.The theme and the title of the conference—”Development That Works”—stemmed from the conference organizers’ desire to explore, from a groundlevel perspective, what programs, policies, and practices have been shown—or appear to have the potential—to achieve sustained, long-term advances in development in various parts of the world. The intent was not to simply showcase “success stories,” but rather to explore the larger concepts and opportunities that have resulted in development that is meaningful and sustainable over time. The presentations and discussions focused on critical assessments of why and how some programs take hold, and what can be learned from them. From the influence of global economic structures to innovative private sector programs and the need to evaluate development programs at the “granular” level, the expert panelists provided well-informed and often provocative perspectives on what is and isn’t working in development programs today, and what could work better in the future

Is the NEI-VFQ-25 a useful tool in identifying visual impairment in an elderly population?

BACKGROUND: The use of self-report questionnaires to substitute for visual acuity measurement has been limited. We examined the association between visual impairment and self reported visual function in a population sample of older people in the UK. METHODS: Cross sectional study of people aged more than 75 years who initially participated in a trial of health screening. The association between 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ) scores and visual impairment (defined as an acuity of less than 6/18 in the better eye) was examined using logistic regression. RESULTS: Visual acuity and NEI-VFQ scores were obtained from 1807 participants (aged 77 to 101 years, 36% male), from 20 general practices throughout the UK. After adjustment for age, gender, practice and NEI-VFQ sub-scale scores, those complaining of poor vision in general were 4.77 times (95% CI 3.03 to 7.53) more likely to be visually impaired compared to those who did not report difficulty. Self-reported limitations with social functioning and dependency on others due to poor vision were also associated with visual impairment (odds ratios, 2.52, 95% CI 1.55 to 4.11; 1.73, 95% CI 1.05 to 2.86 respectively). Those reporting difficulties with near vision and colour vision were more likely to be visually impaired (odds ratios, 2.32, 95% CI 1.30 to 4.15; 2.25, 95% CI 1.35 to 3.73 respectively). Other NEI-VFQ sub-scale scores were unrelated to measures of acuity. Similar but weaker odds ratios were found with reduced visual acuity (defined as less than 6/12 in the better eye). Although differences in NEI-VFQ scores were small, scores were strongly associated with visual acuity, binocular status, and difference in acuity between eyes. CONCLUSION: NEI-VFQ questions regarding the quality of general vision, social functioning, visual dependency, near vision and colour vision are strongly and independently associated with an objective measure of visual impairment in an elderly population

BLOOM: A 176B-Parameter Open-Access Multilingual Language Model

Large language models (LLMs) have been shown to be able to perform new tasks based on a few demonstrations or natural language instructions. While these capabilities have led to widespread adoption, most LLMs are developed by resource-rich organizations and are frequently kept from the public. As a step towards democratizing this powerful technology, we present BLOOM, a 176B-parameter open-access language model designed and built thanks to a collaboration of hundreds of researchers. BLOOM is a decoder-only Transformer language model that was trained on the ROOTS corpus, a dataset comprising hundreds of sources in 46 natural and 13 programming languages (59 in total). We find that BLOOM achieves competitive performance on a wide variety of benchmarks, with stronger results after undergoing multitask prompted finetuning. To facilitate future research and applications using LLMs, we publicly release our models and code under the Responsible AI License

An Institutional Ethnography Exploring Developers’ Perspectives of the Municipal Development Approvals Process

Contemporary planning literature describes what should be in municipal plans, but does not describe implementation as fully. Municipal planning authorities create plans to guide development, and also operate approvals processes to regulate it, but a question remained: What might explain any drift between what the plans call for and the final built outcome? In this institutional ethnography, the municipal planning and development processes are explored through the experiences of developers in Calgary, Canada. This research highlights the ways in which 10 key informant developers and/or planning consultants interact with municipal texts, as well as with the public, and workers at City Hall, in order to develop land in the context of the Municipal Development Plan. What is ostensibly a process dominated by technical review is actually heavily influenced by political and financial risks and influences. Developers described struggling with: (1), municipal policy proliferation; (2), policy vagueness and inter-policy misalignment; (3), unwritten-yet-enforced expectations coupled with municipal obsession with minutiae at the cost of the big picture; (4), a lack of municipal leadership to proactively amend plans; (5), the ways in which individual members of the public, and community associations, are engaged, both in policy and in specific development applications; and (6), redundant, expensive, and lengthy processes including (a), paying for plan creation, (b), having to fund infrastructure, (c), going through Growth Management Overlay removal, (d), amending area plans, (e), enduring various pre-applications, and then (f), finally getting to the start of the multi-stage formal approvals processes. Several factors contribute to a drift between the Municipal Development Plan, related policies, and built form outcomes. Ten problems and solutions resulting from the ethnographic analysis of the key informant interviews are presented in the conclusion. Planners, developers, elected officials, and/or members of the public, may find this research helpful in better understanding how the municipal land development approvals process functions from insiders’ experiences

The genetic landscape of polycystic kidney disease in Ireland.

Polycystic Kidney Diseases (PKDs) comprise the most common Mendelian forms of renal disease. It is characterised by the development of fluid filled renal cysts, causing progressive loss of kidney function, culminating in the need for renal replacement therapy or kidney transplant. Ireland represents a valuable region for the genetic study of PKD, as family sizes are traditionally large and the population relatively homogenous. Studying a cohort of 169 patients, we describe the genetic landscape of PKD in Ireland for the first time, compare the clinical features of patients with and without a molecular diagnosis and correlate disease severity with autosomal dominant pathogenic variant type. Using a combination of molecular genetic tools, including targeted next generation sequencing, we report diagnostic rates of 71-83% in Irish PKD patients, depending on which variant classification guidelines are used (ACMG or Mayo clinic respectively). We have catalogued a spectrum of Irish autosomal dominant PKD pathogenic variants including 36 novel variants. We illustrate how apparently unrelated individuals carrying the same autosomal dominant pathogenic variant are highly likely to have inherited that variant from a common ancestor. We highlight issues surrounding the implementation of the ACMG guidelines for variant pathogenicity interpretation in PKD, which have important implications for clinical genetics.</div

Patient Participation: Current Knowledge and Applicability to Patient Safety

Patient participation is increasingly recognized as a key component in the redesign of health care processes and is advocated as a means to improve patient safety. The concept has been successfully applied to various areas of patient care, such as decision making and the management of chronic diseases. We review the origins of patient participation, discuss the published evidence on its efficacy, and summarize the factors influencing its implementation. Patient-related factors, such as acceptance of the new patient role, lack of medical knowledge, lack of confidence, comorbidity, and various sociodemographic parameters, all affect willingness to participate in the health care process. Among health care workers, the acceptance and promotion of patient participation are influenced by other issues, including the desire to maintain control, lack of time, personal beliefs, type of illness, and training in patient-caregiver relationships. Social status, specialty, ethnic origin, and the stakes involved also influence patient and health care worker acceptance. The London Declaration, endorsed by the World Health Organization World Alliance for Patient Safety, calls for a greater role for patients to improve the safety of health care worldwide. Patient participation in hand hygiene promotion among staff to prevent health care—associated infection is discussed as an illustrative example. A conceptual model including key factors that influence participation and invite patients to contribute to error prevention is proposed. Further research is essential to establish key determinants for the success of patient participation in reducing medical errors and in improving patient safety