993 research outputs found
The southern African poultry value chain : corporate strategies, investments and agro-industrial policies
Abstract: Following various regional investments in the last decade, production and participation in the poultry value chain in southern Africa has increased. One of the factors that determines entry into, and success in, a global value chain is the governance structure. This paper adopts a modular approach to analyse the governance structures in the poultry value chains in Botswana, South Africa, Zambia and Zimbabwe. A key finding is that various stakeholders have an influence on the regional poultry value chain in southern Africa, with the sources of influence depending on the formality of structures within the value chain
Cultivating compliance: governance of North Indian organic basmati smallholders in a global value chain
Focusing on a global value chain (GVC) for organic basmati rice, we study how farmers’ practices are governed through product and process standards, organic certification protocols, and contracts with buyer firms. We analyze how farmers’ entry into the GVC reconfigures their agencements (defined as heterogeneous arrangements of human and nonhuman agencies which are associated with each other). These reconfigurations entail the severance of some associations among procedural and material elements of the agencements and the formation of new associations, in order to produce cultivation practices that are accurately described by the GVC’s standards and protocols. Based on ethnography of two farmers in Uttarakhand, North India, we find that the same standards were enacted differently on the two farmers’ fields, producing variable degrees of (selective) compliance with the ‘official’ GVC standards. We argue that the disjuncture between the ‘official’ scripts of the standards and actual cultivation practices must be nurtured to allow farmers’ agencements to align their practices with local sociotechnical relations and farm ecology. Furthermore, we find that compliance and disjuncture were facilitated by many practices and associations that were officially ungoverned by the GVC
“I’m Not Gonna Pull the Rug out from under You”: Patient-Provider Communication about Opioid Tapering
In response to increases in harms associated with prescription opioids, opioid prescribing has come under greater scrutiny, leading many healthcare organizations and providers to consider or mandate opioid dose reductions (tapering) for patients with chronic pain. Communicating about tapering can be difficult, particularly for patients on long-term opioids who perceive benefits and are using their medications as prescribed. Given the importance of effective patient-provider communication for pain management and recent health system-level initiatives and provider practices to taper opioids, this study used qualitative methods to understand communication processes related to opioid tapering, to identify best practices and opportunities for improvement. Up to 3 clinic visits per patient were audio-recorded, and individual interviews were conducted with patients and their providers. Four major themes emerged: 1) Explaining—Patients needed to understand individualized reasons for tapering, beyond general, population-level concerns such as addiction potential; 2) Negotiating—Patients needed to have input, even if it was simply the rate of tapering; 3) Managing difficult conversations—When patients and providers did not reach a shared understanding, difficulties and misunderstandings arose; 4) Non-abandonment—Patients needed to know that their providers would not abandon them throughout the tapering process
Association Between State Policies Using Medicaid Exclusions to Sanction Noncompliance With Welfare Work Requirements and Medicaid Participation Among Low-Income Adults
Twenty states have pursued community engagement requirements (ie, work requirements) as a condition for Medicaid eligibility among adults considered able-bodied. Work requirements seek to improve health by incentivizing work, but may result in coverage losses.
The impact of work requirements on Medicaid coverage may extend beyond qualifying beneficiaries, by increasing confusion around benefit rules or deterring individuals from applying for coverage. However, the spillover effects of work requirements on individuals not directly subject to them are difficult to study because these programs have only recently been implemented. To examine this possibility, we studied Temporary Assistance for Needy Families (TANF), the cash welfare program enacted under welfare reform in 1996. The TANF program requires able-bodied beneficiaries to fulfill work requirements, and states can elect to terminate Medicaid benefits as a sanction for nonpregnant adult TANF participants who do not comply with them. In states adopting these sanctions, Medicaid eligibility for dual TANF-Medicaid enrollees was effectively conditional on meeting work requirements. This quasi-experimental cohort study examines whether TANF-Medicaid sanctions had spillover effects on Medicaid coverage among low-income adults who were not likely to participate in TANF and, therefore, were not directly subject to these sanctions
An analytical approach for prediction of elastohydrodynamic friction with inlet shear heating and starvation
An analytical friction model is presented, predicting the coefficient of friction in elastohydrodynamic (EHD) contacts. Three fully formulated SAE 75W-90 axle lubricants are examined. The effect of inlet shear heating (ISH) and starvation is accounted for in the developed friction model. The film thickness and the predicted friction are compared with experimental measurements obtained through optical interferometry and use of a mini traction machine. The results indicate the significant contribution of ISH and starvation on both the film thickness and coefficient of friction. A strong interaction between those two phenomena is also demonstrated, along with their individual and combined contribution on the EHD friction
Comprehensive vs. Assisted Management of Mood and Pain Symptoms (CAMMPS) trial: Study design and sample characteristics
Background
Pain is the most common presenting somatic symptom in medical outpatients, and depression and anxiety are the two most common mental disorders. They frequently co-occur, are under-treated, and result in substantial disability and reduced health-related quality of life.
Objectives
The Comprehensive vs. Assisted Management of Mood and Pain Symptoms (CAMMPS) study is a randomized comparative effectiveness trial designed to test the relative effectiveness of a lower-resource vs. a higher-resource technology-assisted intervention for the management of patients suffering from pain plus anxiety and/or depression.
Methods/design
CAMMPS has enrolled 294 primary care patients with chronic pain plus comorbid anxiety and/or depression and randomized them to either: 1) Assisted Symptom Management (ASM) consisting of automated symptom monitoring by interactive voice recording or Internet and prompted pain and mood self-management; or 2) Comprehensive Symptom Management (CSM) which combines ASM with optimized medication management delivered by a nurse-physician specialist team and facilitated mental health care. Outcomes are assessed at baseline, 1, 3, 6, and 12 months. The primary outcome is a composite pain-anxiety-depression (PAD) severity score. Secondary outcomes include individual pain, anxiety, and depression scores, health-related quality of life, disability, healthcare utilization, and treatment satisfaction.
Discussion
CAMMPS provides an integrated approach to PAD symptoms rather than fragmented care of single symptoms; coordinated symptom management in partnership with primary care clinicians and psychologists embedded in primary care; efficient use of health information technology; attention to physical and psychological symptom comorbidity; and the coupling of self-management with optimized medication management and facilitated mental health care
Stevin numbers and reality
We explore the potential of Simon Stevin's numbers, obscured by shifting
foundational biases and by 19th century developments in the arithmetisation of
analysis.Comment: 22 pages, 4 figures. arXiv admin note: text overlap with
arXiv:1104.0375, arXiv:1108.2885, arXiv:1108.420
Electronic structure of β-RbSm(MoO4)(2) and chemical bonding in molybdates
Microcrystals of orthorhombic rubidium samarium molybdate, β-RbSm(MoO4)2, have been fabricated by solid state synthesis at T = 450 °C, 70 h, and at T = 600 °C, 150 h. The crystal structure has been refined by the Rietveld method in space group Pbcn with cell parameters a = 5.0984(2), b = 18.9742(6) and c = 8.0449(3) Å (RB = 1.72%). Thermal properties of β-RbSm(MoO4)2 were traced by DSC over the temperature range of T = 20–965 °C, and the earlier reported β ↔ α phase transition at T ∼ 860–910 °C was not verified. The electronic structure of β-RbSm(MoO4)2 was studied by employing theoretical calculations and X-ray photoelectron spectroscopy. It has been established that the O 2p-like states contribute mainly to the upper part of the valence band and occupy the valence band maximum, whereas the Mo 4d-like states contribute mainly to the lower part of the valence band. Chemical bonding effects have been analysed from the element core level binding energy data. In addition, it was found that the luminescence spectrum of β-RbSm(MoO4)2 is rather peculiar among the Sm3+ containing materials. The optical refractive index dispersion in β-RbSm(MoO4)2 was also predicted by the first-principles calculations
Markov analysis of stochastic resonance in a periodically driven integrate-fire neuron
We model the dynamics of the leaky integrate-fire neuron under periodic
stimulation as a Markov process with respect to the stimulus phase. This avoids
the unrealistic assumption of a stimulus reset after each spike made in earlier
work and thus solves the long-standing reset problem. The neuron exhibits
stochastic resonance, both with respect to input noise intensity and stimulus
frequency. The latter resonance arises by matching the stimulus frequency to
the refractory time of the neuron. The Markov approach can be generalized to
other periodically driven stochastic processes containing a reset mechanism.Comment: 23 pages, 10 figure
Elastohydrodynamic lubrication properties and friction behaviors of several ester base stocks
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