A cross-sectional study of the income sources of primary care health workers in the Democratic Republic of Congo.

BACKGROUND: In the Democratic Republic of Congo (DRC), the state system to remunerate health workers is poorly functional, encouraging diversification of income sources and corruption. Given the central role that health workers play in health systems, policy-makers need to ensure health workers are remunerated in a way which best incentivises them to provide effective and good quality services. This study describes the different sources and quantities of income paid to primary care health workers in Equateur, Maniema, Kasai Occidental, Province Orientale and Kasai Oriental provinces. It also explores characteristics associated with the receipt of different sources of income. METHODS: Quantitative data on the income received by health workers were collected through baseline surveys. Descriptive statistics explored the demographic characteristics of health workers surveyed, and types and amounts of incomes received. A series of regression models were estimated to examine the health worker and facility-level determinants of receiving each income source and of levels received. Qualitative data collection was carried out in Kasai Occidental province to explore perceptions of each income source and reasons for receiving each. RESULTS: Nurses made up the majority of workers in primary care. Only 31% received a government salary, while 75% reported compensation from user fees. Almost half of all nurses engaged in supplemental non-clinical activities. Receipt of government payments was associated with income from private practice and non-clinical activities. Male nurses were more likely to receive per diems, performance payments, and higher total remuneration compared to females. Contextual factors such as provincial location, presence of externally financed health programmes and local user fee policy also influenced the extent to which nurses received many income sources. CONCLUSIONS: The receipt of government payments was unreliable and had implications for receipt of other income sources. A mixture of individual, facility and geographical factors were associated with the receipt of various income sources. Greater co-ordination is needed between partners involved in health worker remuneration to design more effective financial incentive packages, reduce the fragmentation of incomes and improve transparency in the payment of workers in the DRC

Echinoderms have bilateral tendencies

Echinoderms take many forms of symmetry. Pentameral symmetry is the major form and the other forms are derived from it. However, the ancestors of echinoderms, which originated from Cambrian period, were believed to be bilaterians. Echinoderm larvae are bilateral during their early development. During embryonic development of starfish and sea urchins, the position and the developmental sequence of each arm are fixed, implying an auxological anterior/posterior axis. Starfish also possess the Hox gene cluster, which controls symmetrical development. Overall, echinoderms are thought to have a bilateral developmental mechanism and process. In this article, we focused on adult starfish behaviors to corroborate its bilateral tendency. We weighed their central disk and each arm to measure the position of the center of gravity. We then studied their turning-over behavior, crawling behavior and fleeing behavior statistically to obtain the center of frequency of each behavior. By joining the center of gravity and each center of frequency, we obtained three behavioral symmetric planes. These behavioral bilateral tendencies might be related to the A/P axis during the embryonic development of the starfish. It is very likely that the adult starfish is, to some extent, bilaterian because it displays some bilateral propensity and has a definite behavioral symmetric plane. The remainder of bilateral symmetry may have benefited echinoderms during their evolution from the Cambrian period to the present

Tuned MSSM Higgses as an inflaton

We consider the possibility that the vacuum energy density of the MSSM (Minimal Supersymmetric Standard Model) flat direction condensate involving the Higgses H_1 and H_2 is responsible for inflation. We also discuss how the finely tuned Higgs potential at high vacuum expectation values can realize {\it cosmologically} flat direction along which it can generate the observed density perturbations, and after the end of inflation -- the coherent oscillations of the Higgses reheat the universe with all the observed degrees of freedom, without causing any problem for the electroweak phase transition.Comment: 6 pages, 5 figure

Comparative Morphology of the Penis and Clitoris in Four Species of Moles (Talpidae).

The penile and clitoral anatomy of four species of Talpid moles (broad-footed, star-nosed, hairy-tailed, and Japanese shrew moles) were investigated to define penile and clitoral anatomy and to examine the relationship of the clitoral anatomy with the presence or absence of ovotestes. The ovotestis contains ovarian tissue and glandular tissue resembling fetal testicular tissue and can produce androgens. The ovotestis is present in star-nosed and hairy-tailed moles, but not in broad-footed and Japanese shrew moles. Using histology, three-dimensional reconstruction, and morphometric analysis, sexual dimorphism was examined with regard to a nine feature masculine trait score that included perineal appendage length (prepuce), anogenital distance, and presence/absence of bone. The presence/absence of ovotestes was discordant in all four mole species for sex differentiation features. For many sex differentiation features, discordance with ovotestes was observed in at least one mole species. The degree of concordance with ovotestes was highest for hairy-tailed moles and lowest for broad-footed moles. In relationship to phylogenetic clade, sex differentiation features also did not correlate with the similarity/divergence of the features and presence/absence of ovotestes. Hairy-tailed and Japanese shrew moles reside in separated clades, but they exhibit a high degree of congruence. Broad-footed and hairy-tailed moles reside within the same clade but had one of the lowest correlations in features and presence/absence of ovotestes. Thus, phylogenetic affinity and the presence/absence of ovotestes are poor predictors for most sex differentiation features within mole external genitalia

Inflection point inflation: WMAP constraints and a solution to the fine-tuning problem

We consider observational constraints and fine-tuning issues in a renormalizable model of inflection point inflation, with two independent parameters. We derive constraints on the parameter space of this model arising from the WMAP 7-year power spectrum. It has previously been shown that it is possible to successfully embed this potential in the MSSM. Unfortunately, to do this requires severe fine-tuning. We address this issue by introducing a hybrid field to dynamically uplift the potential with a subsequent smooth phase transition to end inflation at the necessary point. Large parameter regions exist where this drastically reduces the fine-tuning required without ruining the viability of the model. A side effect of this mechanism is that it increases the width of the slow-roll region of the potential, thus also alleviating the problem of the fine-tuning of initial conditions. The MSSM embedding we study has been previously shown to be able to explain the smallness of the neutrino masses. The hybrid transition does not spoil this feature as there exist parameter regions where the fine-tuning parameter is as large as $10^{-1}$ and the neutrino masses remain small.Comment: 12 pages, 2 figures, JCAP style. Version accepted for publication in JCAP. Modifications made to improve readability, as requested by the referee; results and conclusions unchanged. References update