138 research outputs found

    The Performance of Performance Standards

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    Using a variety of data sources, the contributors explore how performance standards and incentives affect the behavior of public managers and agency employees, their approaches to service delivery, and ultimately, the outcomes for participants.https://research.upjohn.org/up_press/1225/thumbnail.jp

    Livelihood and vulnerability in the wake of Typhoon Yolanda: lessons of community and resilience

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    Livelihood strategies that are crafted in ‘extra-ordinary’ post-disaster conditions should also be able to function once some semblance of normalcy has resumed. This article aims to show that the vulnerability experienced in relation to Typhoon Yolanda was, and continues to be, directly linked to inadequate livelihood assets and opportunities. We examine the extent to which various livelihood strategies lessened vulnerability post-Typhoon Yolanda and argue that creating conditions under which disaster survivors have the freedom to pursue sustainable livelihood is essential in order to foster resilience and reduce vulnerability against future disasters. We offer suggestions to improve future relief efforts, including suggestions made by the survivors themselves. We caution against rehabilitation strategies that knowingly or unknowingly, resurrect pre-disaster vulnerability. Strategies that foster dependency, fail to appreciate local political or ecological conditions or undermine cooperation and cohesion in already vulnerable communities will be bound to fail. Some of the livelihood strategies that we observed post-Typhoon Yolanda failed on some or all of these points. It is important for future policy that these failings are addressed

    Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

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    Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

    Aquaculture governance: five engagement arenas for sustainability transformation

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    A greater focus on governance is needed to facilitate effective and substantive progress toward sustainability transformations in the aquaculture sector. Concerted governance efforts can help move the sector beyond fragmented technical questions associated with intensification and expansion, social and environmental impacts, and toward system-based approaches that address interconnected sustainability issues. Through a review and expert-elicitation process, we identify five engagement arenas to advance a governance agenda for aquaculture sustainability transformation: (1) setting sustainability transformation goals, (2) cross-sectoral linkages, (3) land–water–sea connectivity, (4) knowledge and innovation, and (5) value chains. We then outline the roles different actors and modes of governance can play in fostering sustainability transformations, and discuss action items for researchers, practitioners, and policymakers to operationalize activities within their engagement arenas

    Is resilience socially constructed? Empirical evidence from Fiji, Ghana, Sri Lanka, and Vietnam

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    The objective of this paper is to better understand the various individual and household factors that influence resilience, that is, people⬢s ability to respond adequately to shocks and stressors. One of our hypotheses is that resilience does not simply reflect the expected effects of quantifiable factors such as level of assets, or even less quantifiable social processes such as people⬢s experience, but is also determined by more subjective dimensions related to people⬢s perceptions of their ability to cope, adapt or transform in the face of adverse events. Data collected over two years in Fiji, Ghana, Sri Lanka and Vietnam confirms the importance of wealth in the recovery process of households affected by shocks and stressors. However our results challenge the idea that within communities, assets are a systematic differentiator in people⬢s response to adverse events. The findings regarding social capital are mixed and call for more research: social capital had a strong positive influence on resilience at the community level, yet our analysis failed to demonstrate any tangible positive correlation at the household level. Finally, the data confirm that, like vulnerability, resilience is at least in part socially constructed, endogenous to individual and groups, and hence contingent on knowledge, attitudes to risk, culture and subjectivity

    Pen to paper : sharing stories from the field; a case study writing toolkit

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    Library has Arabic version: Pen to paper : sharing stories from the field; a case study writing toolkit [Arabic]Writing can be a fun, creative process, especially case study writing which lets you explore more 'personal' stories. However, starting to write is often the hardest thing! Although lots of books have been written on 'how to' write a case study, they are often long and somewhat confusing. The best way to learn to write a case study is to try writing one
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