Why district assemblies disburse resources to district health systems for service delivery at district level in the context of decentralization: a comparative study of two districts in the Volta Region of Ghana

ObjectivesTo explore why the District Assembly disburses financial and other resources to the District Health System.DesignMultiple case study with a single unit of analysis (holistic) using quantitative and qualitative methods of data collection involving a desk review, analysis of routine health management information system data and key informant interviews.SettingTwo districts in the Volta Region of Ghana.ParticipantsTwelve key officials of each district assembly and the district health system (24 total) who had worked in the district at least a year or more.InterventionsNone.ResultsBoth District Assemblies had moderate decision space which was influenced by their capacity, power and contextual factors like politics, economics, legal and situational factors. Disbursement of financial and other resources to the District Health Systems was influenced by financial capacity, use of power by stakeholders, context and the decision space of the District Assembly. Political actors appeared to have more power in resource disbursement decision making than community members and technocrats in a context of resource constraints and inadequate funding. The funding available was used predominantly for capital investments, mainly construction of Community Based Health Planning and Services (CHPS) compounds.ConclusionIt is important to make policies that will regulate the relative power among the political appointees like the District Chief Executives (DCEs), public and civil servants in decentralized departments and agencies and Community members to make resource disbursement more sensitive to communities and decentralized departments

Ex Situ and In Situ Ellipsometric Studies of the Thermal Oxide on InP

The thermally grown InP oxide as etched by an aqueous dilute HF solution has been studied by ellipsometric techniques. The ex-situ measurement reveals a two-layer structure for the oxide grown at 440°C. The refractive indices for both oxide layers have been determined using a two-layer optical model. The etching process has also been monitored ellipsometrically in the real etching environment, in-situ. A fused silica cell, which enables the windows to be aligned properly, has been specifically designed for the in-situ solution measurement. A liquid layer at the solutionoxide interface has been identified, and the layer is shown to contain P and In species resulting from the etching reactions. A theory based on the Lorentz-Lorenz relation results in a reasonable qualitative description of the liquid layer. During the etching of the oxide the liquid layer shrinks at a linear rate, and after removal of the outer oxide layer the liquid layer forms a dense electric double layer

Interplay of dFOXO and Two ETS-Family Transcription Factors Determines Lifespan in Drosophila melanogaster

Forkhead box O (FoxO) transcription factors (TFs) are key drivers of complex transcriptional programmes that determine animal lifespan. FoxOs regulate a number of other TFs, but how these TFs in turn might mediate the anti-ageing programmes orchestrated by FoxOs in vivo is unclear. Here, we identify an E-twenty six (ETS)-family transcriptional repressor, Anterior open (Aop), as regulated by the single Drosophila melanogaster FoxO (dFOXO) in the adult gut. AOP, the functional orthologue of the human Etv6/Tel protein, binds numerous genomic sites also occupied by dFOXO and counteracts the activity of an ETS activator, Pointed (Pnt), to prevent the lifespan-shortening effects of co-activation of dFOXO and PNT. This detrimental synergistic effect of dFOXO and PNT appears to stem from a mis-regulation of lipid metabolism. At the same time, AOP activity in another fly organ, the fat body, has further beneficial roles, regulating genes in common with dfoxo, such as the secreted, non-sensory, odorant binding protein (Obp99b), and robustly extending lifespan. Our study reveals a complex interplay between evolutionarily conserved ETS factors and dFOXO, the functional significance of which may extend well beyond animal lifespan

Trajectories of self-rated health in people with diabetes: Associations with functioning in a prospective community sample

© 2013 Schmitz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: Self-rated health (SRH) is a single-item measure that is one of the most widely used measures of general health in population health research. Relatively little is known about changes and the trajectories of SRH in people with chronic medical conditions. The aims of the present study were to identify and describe longitudinal trajectories of self-rated health (SRH) status in people with diabetes. Methods: A prospective community study was carried out between 2008 and 2011. SRH was assessed at baseline and yearly at follow-ups (n=1288). Analysis was carried out through trajectory modeling. The trajectory groups were subsequently compared at 4 years follow-up with respect to functioning. Results: Four distinct trajectories of SRH were identified: 1) 72.2% of the participants were assigned to a persistently good SRH trajectory; 2) 10.1% were assigned to a persistently poor SRH trajectory; 3) mean SRH scores changed from good to poor for one group (7.3%); while 4) mean SRH scores changed from poor to medium/good for another group (10.4%). Those with a persistently poor perception of health status were at higher risk for poor functioning at 4 years follow-up than those whose SRH scores decreased from good to poor. Conclusions: SRH is an important predictor for poor functioning in diabetes, but the trajectory of SRH seems to be even more important. Health professionals should pay attention to not only SRH per se, but also changes in SRH over time.This work was supported by Operating Grant MOP-84574 from the Canadian Institutes of Health Research (CIHR). GG was supported by a doctoral fellowship from the CIHR. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

JWST Imaging of the Cartwheel Galaxy Reveals Dust Associated with SN 2021afdx

We present near- and mid-infrared (0.9-18 $\mu$m) photometry of supernova (SN) 2021afdx, which was imaged serendipitously with the James Webb Space Telescope (JWST) as part of its Early Release Observations of the Cartwheel Galaxy. Our ground-based optical observations show it is likely to be a Type IIb SN, the explosion of a yellow supergiant, and its infrared spectral energy distribution (SED) $\approx$200 days after explosion shows two distinct components, which we attribute to hot ejecta and warm dust. By fitting models of dust emission to the SED, we derive a dust mass of $(3.8_{-0.3}^{+0.5}) \times 10^{-3}\ M_\odot$, which is the highest yet observed in a Type IIb SN but consistent with other Type II SNe observed by the Spitzer Space Telescope. We also find that the radius of the dust is significantly larger than the radius of the ejecta, as derived from spectroscopic velocities during the photospheric phase, which implies that we are seeing an infrared echo off of preexisting dust in the progenitor environment, rather than dust newly formed by the SN. Our results show the power of JWST to address questions of dust formation in SNe, and therefore the presence of dust in the early universe, with much larger samples than have been previously possible.Comment: updated to match accepted versio