610 research outputs found
Money Can't Buy Love But Can It Buy Peace? Evidence from the EU Programme for Peace and Reconciliation
In 1998, the Good Friday Agreement concluded a period of violence in Northern Ireland yet the scars of the conflict remained prevalent in the political landscape. Rival communities remained divided, economic performance was poor and intercommunity tensions frequently manifested. In a bid to reinforce progress towards a peaceful and stable society, over 1bn of public money was spent between 2000 and 2006 on small-scale community and business ventures. Despite the scale of expenditure, however, little rigorous effort has been made to test the success of the programmes. Splitting Northern Ireland into 582 electoral wards, we merge individual-level on perceptions of neighbourhood quality from the British Household Panel Survey with detailed PEACE II accounts. Noting potential selection and omitted variables biases, we implement two-stage random effects models and show that neither level of spending, nor number of projects, in a region is associated with improvements in perceptions of neighbourhood quality
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Money can’t buy love but can it buy peace? Evidence from the EU Programme for Peace and Reconciliation (PEACE II)
Efforts to evaluate third-party peacebuilding interventions are welcome but many studies rely on experimental approaches that might be at odds with the theories that underpin the discipline. Rigorously evaluating interventions ill-suited to experimental analyses is just as important, however, especially when programmes adopt novel approaches. In this article, we employ an instrumental variables approach to evaluate one such intervention – the EU Programme for Peace and Reconciliation (PEACE II). Following contemporary peacebuilding theories, PEACE II disseminated funds to grassroots organizations via unique intermediate funding bodies and an innovative open competition. Splitting Northern Ireland into 582 wards, we merge panel data on individuals’ perceptions of neighbourhood quality with PEACE II’s accounts. One-stage analyses show that individuals in treatment regions report significantly elevated perceptions. Two-stage approaches, accounting for biases arising from the rollout method, show no significant relationship. Post-estimation analyses imply that funding did not reach areas with the poorest observable indicators. We thus remain agnostic on the effectiveness of the funded projects but conclude that, despite solid theoretical foundations, weaknesses in the application of these theories hampered potential positive impacts. Future interventions can learn from this and should ensure stronger ties between the theoretical base and how these theories are applied to funding disbursement
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Can jobs programs build peace?
In the last decade, well over $10 billion has been spent on employment programs designed to contribute to peace and stability. Despite the outlay, whether these programs perform, and how they do so, remain open questions. This study conducts three reviews to derive the status quo of knowledge. First, it draws on academic literature on the microfoundations of instability to distill testable theories of how employment programs could affect stability at the micro level. Second, it analyses academic and grey literature that directly evaluates the impacts of employment programs on peace-related outcomes. Third, it conducts a systematic review of program-based learning from over 400 interventions. This study finds good theoretical reasons to believe that employment programs could contribute to peace. However, only very limited evidence exists on overall impacts on peace or on the pathways underlying the theories of change. At the program level, the review finds strong evidence that contributions to peace and stability are often simply assumed to have occurred. This provides a major challenge for the justification of continued spending on jobs for peace programs. Instead, systematic and rigorous learning on the impacts of jobs for peace programs needs to be scaled up urgently
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Assets for alimentation? The nutritional impact of assets-based programming in Niger
A recent strand of aid programming aims to develop household assets by removing the stresses associated with meeting basic nutritional needs. In this study, the authors posit that such nutrition-sensitive programmes can reduce malnourishment by encouraging further investment in diet. To test this hypothesis, they analyse the World Food Programme’s (WFP) Protracted Relief and Recovery Operation (PRRO), in Niger, a conflict-affected, low-income country with entrenched food insecurity. Under the PRRO, a household falls into one of three groups at end line: receiving no assistance, receiving nutrition-specific assistance, or receiving nutrition-specific assistance and nutrition-sensitive food for assets-based programming. If provided alone, food aid has no nutritional impact relative to receiving no assistance. However, the study observes pronounced positive effects if food aid is paired with assets-based programming. The authors conclude, first, that certain forms of food aid function well in complex, insecure environments; second, that assets-based programmes deliver positive nutritional spillovers; and, third, that there are theoretical grounds to believe that assets-based nutrition-sensitive programmes interact positively with nutrition-specific programming
Absolute Humidity and the Seasonal Onset of Influenza in the Continental United States
Here, the authors demonstrate that variations of absolute humidity explain both the onset of wintertime influenza transmission and the overarching seasonality of this pathogen in temperate regions
Determinants of the Spatiotemporal Dynamics of the 2009 H1N1 Pandemic in Europe: Implications for Real-Time Modelling
Influenza pandemics in the last century were characterized by successive waves and differences in impact and timing between different regions, for reasons not clearly understood. The 2009 H1N1 pandemic showed rapid global spread, but with substantial heterogeneity in timing within each hemisphere. Even within Europe substantial variation was observed, with the UK being unique in experiencing a major first wave of transmission in early summer and all other countries having a single major epidemic in the autumn/winter, with a West to East pattern of spread. Here we show that a microsimulation model, parameterised using data about H1N1pdm collected by the beginning of June 2009, explains the occurrence of two waves in UK and a single wave in the rest of Europe as a consequence of timing of H1N1pdm spread, fluxes of travels from US and Mexico, and timing of school vacations. The model provides a description of pandemic spread through Europe, depending on intra-European mobility patterns and socio-demographic structure of the European populations, which is in broad agreement with observed timing of the pandemic in different countries. Attack rates are predicted to depend on the socio-demographic structure, with age dependent attack rates broadly agreeing with available serological data. Results suggest that the observed heterogeneity can be partly explained by the between country differences in Europe: marked differences in school calendars, mobility patterns and sociodemographic structures. Moreover, higher susceptibility of children to infection played a key role in determining the epidemiology of the 2009 pandemic. Our work shows that it would have been possible to obtain a broad-brush prediction of timing of the European pandemic well before the autumn of 2009, much more difficult to achieve with simpler models or pre-pandemic parameterisation. This supports the use of models accounting for the structure of complex modern societies for giving insight to policy makers
The role of rapid diagnostics in managing Ebola epidemics
Ebola emerged in West Africa around December 2013 and swept through Guinea, Sierra Leone and Liberia, giving rise to 27,748 confirmed, probable and suspected cases reported by 29 July 2015. Case diagnoses during the epidemic have relied on polymerase chain reaction-based tests. Owing to limited laboratory capacity and local transport infrastructure, the delays from sample collection to test results being available have often been 2 days or more. Point-of-care rapid diagnostic tests offer the potential to substantially reduce these delays. We review Ebola rapid diagnostic tests approved by the World Health Organization and those currently in development. Such rapid diagnostic tests could allow early triaging of patients, thereby reducing the potential for nosocomial transmission. In addition, despite the lower test accuracy, rapid diagnostic test-based diagnosis may be beneficial in some contexts because of the reduced time spent by uninfected individuals in health-care settings where they may be at increased risk of infection; this also frees up hospital beds. We use mathematical modelling to explore the potential benefits of diagnostic testing strategies involving rapid diagnostic tests alone and in combination with polymerase chain reaction testing. Our analysis indicates that the use of rapid diagnostic tests with sensitivity and specificity comparable with those currently under development always enhances control, whether evaluated at a health-care-unit or population level. If such tests had been available throughout the recent epidemic, we estimate, for Sierra Leone, that their use in combination with confirmatory polymerase chain-reaction testing might have reduced the scale of the epidemic by over a third
Chronic non-specific low back pain - sub-groups or a single mechanism?
Copyright 2008 Wand and O'Connell; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Low back pain is a substantial health problem and has subsequently attracted a
considerable amount of research. Clinical trials evaluating the efficacy of a variety of interventions
for chronic non-specific low back pain indicate limited effectiveness for most commonly applied
interventions and approaches.
Discussion: Many clinicians challenge the results of clinical trials as they feel that this lack of
effectiveness is at odds with their clinical experience of managing patients with back pain. A
common explanation for this discrepancy is the perceived heterogeneity of patients with chronic
non-specific low back pain. It is felt that the effects of treatment may be diluted by the application
of a single intervention to a complex, heterogeneous group with diverse treatment needs. This
argument presupposes that current treatment is effective when applied to the correct patient.
An alternative perspective is that the clinical trials are correct and current treatments have limited
efficacy. Preoccupation with sub-grouping may stifle engagement with this view and it is important
that the sub-grouping paradigm is closely examined. This paper argues that there are numerous
problems with the sub-grouping approach and that it may not be an important reason for the
disappointing results of clinical trials. We propose instead that current treatment may be ineffective
because it has been misdirected. Recent evidence that demonstrates changes within the brain in
chronic low back pain sufferers raises the possibility that persistent back pain may be a problem of
cortical reorganisation and degeneration. This perspective offers interesting insights into the
chronic low back pain experience and suggests alternative models of intervention.
Summary: The disappointing results of clinical research are commonly explained by the failure of
researchers to adequately attend to sub-grouping of the chronic non-specific low back pain
population. Alternatively, current approaches may be ineffective and clinicians and researchers may
need to radically rethink the nature of the problem and how it should best be managed
Role of Occult and Post-acute Phase Replication in Protective Immunity Induced with a Novel Live Attenuated SIV Vaccine
In order to evaluate the role of persisting virus replication during occult phase immunisation in the live attenuated SIV vaccine model, a novel SIVmac239Δnef variant (SIVrtTA) genetically engineered to replicate in the presence of doxycycline was evaluated for its ability to protect against wild-type SIVmac239. Indian rhesus macaques were vaccinated either with SIVrtTA or with SIVmac239Δnef. Doxycycline was withdrawn from 4 of 8 SIVrtTA vaccinates before challenge with wild-type virus. Unvaccinated challenge controls exhibited ~107 peak plasma viral RNA copies/ml persisting beyond the acute phase. Six vaccinates, four SIVmac239Δnef and two SIVrtTA vaccinates exhibited complete protection, defined by lack of wild-type viraemia post-challenge and virus-specific PCR analysis of tissues recovered post-mortem, whereas six SIVrtTA vaccinates were protected from high levels of viraemia. Critically, the complete protection in two SIVrtTA vaccinates was associated with enhanced SIVrtTA replication in the immediate post-acute vaccination period but was independent of doxycycline status at the time of challenge. Mutations were identified in the LTR promoter region and rtTA gene that do not affect doxycycline-control but were associated with enhanced post-acute phase replication in protected vaccinates. High frequencies of total circulating CD8+T effector memory cells and a higher total frequency of SIV-specific CD8+ mono and polyfunctional T cells on the day of wild-type challenge were associated with complete protection but these parameters were not predictive of outcome when assessed 130 days after challenge. Moreover, challenge virus-specific Nef CD8+ polyfunctional T cell responses and antigen were detected in tissues post mortem in completely-protected macaques indicating post-challenge control of infection. Within the parameters of the study design, on-going occult-phase replication may not be absolutely required for protective immunity
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