The contribution of international health volunteers to the health workforce in sub-Saharan Africa

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In search of the authentic nation: landscape and national identity in Canada and Switzerland

While the study of nationalism and national identity has flourished in the last decade, little attention has been devoted to the conditions under which natural environments acquire significance in definitions of nationhood. This article examines the identity-forming role of landscape depictions in two polyethnic nation-states: Canada and Switzerland. Two types of geographical national identity are identified. The first – what we call the ‘nationalisation of nature’– portrays zarticular landscapes as expressions of national authenticity. The second pattern – what we refer to as the ‘naturalisation of the nation’– rests upon a notion of geographical determinism that depicts specific landscapes as forces capable of determining national identity. The authors offer two reasons why the second pattern came to prevail in the cases under consideration: (1) the affinity between wild landscape and the Romantic ideal of pure, rugged nature, and (2) a divergence between the nationalist ideal of ethnic homogeneity and the polyethnic composition of the two societies under consideration

Global Health Actors Claim To Support Health System Strengthening—Is This Reality or Rhetoric?

Bruno Marchal and colleagues argue that most current strategies aimed at health systems strengthening remain selectively targeted at specific diseases

Turning around an ailing district hospital: a realist evaluation of strategic changes at Ho Municipal Hospital (Ghana)

<p>Abstract</p> <p>Background</p> <p>There is a growing consensus that linear approaches to improving the performance of health workers and health care organisations may only obtain short-term results. An alternative approach premised on the principle of human resource management described as a form of 'High commitment management', builds upon a bundles of balanced practices. This has been shown to contribute to better organisational performance. This paper illustrates an intervention and outcome of high commitment management (HiCom) at an urban hospital in Ghana. Few studies have shown how HiCom management might contribute to better performance of health services and in particular of hospitals in low and middle-income settings.</p> <p>Methods</p> <p>A realist case study design was used to analyse how specific management practices might contribute to improving the performance of an urban district hospital in Ho, Volta Region, in Ghana. Mixed methods were used to collect data, including document review, in-depth interviews, group discussions, observations and a review of routine health information.</p> <p>Results</p> <p>At Ho Municipal Hospital, the management team dealt with the crisis engulfing the ailing urban district hospital by building an alliance between hospital staff to generate a sense of ownership with a focus around participative problem analysis. The creation of an alliance led to improving staff morale and attitude, and contributed also to improvements in the infrastructure and equipment. This in turn had a positive impact on the revenue generating capacity of the hospital. The quick turn around in the state of this hospital showed that change was indeed possible, a factor that greatly motivated the staff.</p> <p>In a second step, the management team initiated the development of a strategic plan for the hospital to maintain the dynamics of change. This was undertaken through participative methods and sustained earlier staff involvement, empowerment and feelings of reciprocity. We found that these factors acted as the core mechanisms underlying the changes taking place at Ho Municipal Hospital.</p> <p>Conclusions</p> <p>This study shows how a hospital management team in Ghana succeeded in resuscitating an ailing hospital. Their high commitment management approach led to the active involvement and empowerment of staff. It also showed how a realist evaluation approach such as this, could be used in the research of the management of health care organisations to explain how management interventions may or may not work.</p

Gaia Data Release 2: All-sky classification of high-amplitude pulsating stars

Out of the 1.69 billion sources in the Gaia Data Release 2 (DR2), more than half a million are published with photometric time series that exhibit light variations during 22 months of observation. An all-sky classification of common high-amplitude pulsators (Cepheids, long-period variables, Delta Scuti / SX Phoenicis, and RR Lyrae stars) is provided for stars with brightness variations greater than 0.1 mag in the G band. A semi-supervised classification approach was employed, firstly training multi-stage Random Forest classifiers with sources of known types in the literature, followed by a preliminary classification of the Gaia data and a second training phase that included a selection of the first classification results to improve the representation of some classes, before the application of the improved classifiers to the Gaia data. Dedicated validation classifiers were used to reduce the level of contamination in the published results. A relevant fraction of objects were not yet sufficiently sampled for reliable Fourier series decomposition, so classifiers were based on features derived from statistics of photometric time series in the G, BP, and RP bands, as well as from some astrometric parameters. The published classification results include 195,780 RR Lyrae stars, 150,757 long-period variables, 8550 Cepheids, and 8882 Delta Scuti / SX Phoenicis stars. All of these results represent candidates, whose completeness and contamination are described as a function of variability type and classification reliability. Results are expressed in terms of class labels and classification scores, which are available in the vari_classifier_result table of the Gaia archive

<i>Gaia</i> Data Release 1. Summary of the astrometric, photometric, and survey properties

Context. At about 1000 days after the launch of Gaia we present the first Gaia data release, Gaia DR1, consisting of astrometry and photometry for over 1 billion sources brighter than magnitude 20.7. Aims. A summary of Gaia DR1 is presented along with illustrations of the scientific quality of the data, followed by a discussion of the limitations due to the preliminary nature of this release. Methods. The raw data collected by Gaia during the first 14 months of the mission have been processed by the Gaia Data Processing and Analysis Consortium (DPAC) and turned into an astrometric and photometric catalogue. Results. Gaia DR1 consists of three components: a primary astrometric data set which contains the positions, parallaxes, and mean proper motions for about 2 million of the brightest stars in common with the HIPPARCOS and Tycho-2 catalogues – a realisation of the Tycho-Gaia Astrometric Solution (TGAS) – and a secondary astrometric data set containing the positions for an additional 1.1 billion sources. The second component is the photometric data set, consisting of mean G-band magnitudes for all sources. The G-band light curves and the characteristics of ∼3000 Cepheid and RR-Lyrae stars, observed at high cadence around the south ecliptic pole, form the third component. For the primary astrometric data set the typical uncertainty is about 0.3 mas for the positions and parallaxes, and about 1 mas yr−1 for the proper motions. A systematic component of ∼0.3 mas should be added to the parallax uncertainties. For the subset of ∼94 000 HIPPARCOS stars in the primary data set, the proper motions are much more precise at about 0.06 mas yr−1. For the secondary astrometric data set, the typical uncertainty of the positions is ∼10 mas. The median uncertainties on the mean G-band magnitudes range from the mmag level to ∼0.03 mag over the magnitude range 5 to 20.7. Conclusions. Gaia DR1 is an important milestone ahead of the next Gaia data release, which will feature five-parameter astrometry for all sources. Extensive validation shows that Gaia DR1 represents a major advance in the mapping of the heavens and the availability of basic stellar data that underpin observational astrophysics. Nevertheless, the very preliminary nature of this first Gaia data release does lead to a number of important limitations to the data quality which should be carefully considered before drawing conclusions from the data

Gaia Data Release 2. Rotational modulation in late-type dwarfs

Context. Amongst the ≈5 × 10e+05 sources identified as variable stars in Gaia Data Release 2 (DR2), 26% are rotational modulation variable candidates of the BY Dra class. Gaia DR2 provides their multi-band (G, G_BP, and G_RP) photometric time series collected by the European Space Agency spacecraft Gaia during the first 22 months of operations as well as the essential parameters related to their flux modulation induced by surface inhomogeneities and rotation. Aims: We developed methods to identify the BY Dra variable candidates and to infer their variability parameters. Methods: BY Dra candidates were pre-selected from their position in the Hertzsprung-Russel diagram, built from Gaia parallaxes, G magnitudes, and (G_BP - G_RP) colours. Since the time evolution of the stellar active region can disrupt the coherence of the signal, segments not much longer than their expected evolution timescale were extracted from the entire photometric time series, and period search algorithms were applied to each segment. For the Gaia DR2, we selected sources with similar periods in at least two segments as candidate BY Dra variables. Results were further filtered considering the time-series phase coverage and the expected approximate light-curve shape. Results: Gaia DR2 includes rotational periods and modulation amplitudes of 147 535 BY Dra candidates. The data unveil the existence of two populations with distinctive period and amplitude distributions. The sample covers 38% of the whole sky when divided into bins (HEALPix) of ≈0.84 square degrees, and we estimate that this represents 0.7-5% of all BY Dra stars potentially detectable with Gaia. Conclusions: The preliminary data contained in Gaia DR2 illustrate the vast and unique information that the mission is going to provide on stellar rotation and magnetic activity. This information, complemented by the exquisite Gaia parallaxes, proper motions, and astrophysical parameters, is opening new and unique perspectives for our understanding of the evolution of stellar angular momentum and dynamo action

Hepatocyte and keratinocyte growth factors and their receptors in human lung emphysema

BACKGROUND: Hepatocyte and keratinocyte growth factors are key growth factors in the process of alveolar repair. We hypothesized that excessive alveolar destruction observed in lung emphysema involves impaired expression of hepatocyte and keratinocyte growth factors or their respective receptors, c-met and keratinocyte growth factor receptor. The aim of our study was to compare the expression of hepatocyte and keratinocyte growth factors and their receptors in lung samples from 3 groups of patients: emphysema; smokers without emphysema and non-smokers without emphysema. METHODS: Hepatocyte and keratinocyte growth factor proteins were analysed by immunoassay and western blot; mRNA expression was measured by real time quantitative polymerase chain reaction. RESULTS: Hepatocyte and keratinocyte growth factors, c-met and keratinocyte growth factor receptor mRNA levels were similar in emphysema and non-emphysema patients. Hepatocyte growth factor mRNA correlated negatively with FEV1 and the FEV1/FVC ratio both in emphysema patients and in smokers with or without emphysema. Hepatocyte and keratinocyte growth factor protein concentrations were similar in all patients' groups. CONCLUSION: The expression of hepatocyte and keratinocyte growth factors and their receptors is preserved in patients with lung emphysema as compared to patients without emphysema. Hepatocyte growth factor mRNA correlates with the severity of airflow obstruction in smokers