Is the Water Sector Lagging behind Education and Health on Aid Effectiveness? Lessons from Bangladesh, Ethiopia and Uganda

A study in three countries (Bangladesh, Ethiopia and Uganda) assessed progress against the Paris Principles for Aid Effectiveness (AE) in three sectors – water, health and education – to test the assumption that the water sector is lagging behind. The findings show that it is too simplistic to say that the water sector is lagging, although this may well be the case in some countries. The study found that wider governance issues are more important for AE than having in place sector-specific mechanics such as Sector-Wide Approaches alone. National political leadership and governance are central drivers of sector AE, while national financial and procurement systems and the behaviour of actors who have not signed up to the Paris Principles – at both national and global levels – have implications for progress that cut across sectors. Sectors and sub-sectors do nonetheless have distinct features that must be considered in attempting to improve sector-level AE. In light of these findings, using political economy approaches to better understand and address governance and strengthening sector-level monitoring is recommended as part of efforts to improve AE and development results in the water sector

QCD matter with a crossover and a first-order phase transition

We present a phenomenological parametrization of the phase diagram of QCD as a function of temperature $T$ and baryochemical potential $\mu$. The parametrization is constructed by introducing a switching function which controls the nature of the transition between the Hadron-Resonance Gas (HRG) and Quark-Gluon Plasma (QGP) phases of nuclear matter, such that the equation of state (EOS) possesses a rapid crossover at large $T$ and small $\mu$, a critical point placed anywhere along the phase transition line, and a first-order transition at small $T$ and large $\mu$. This EOS offers a convenient phenomenological tool for assessing the possible effects of the conjectured QCD critical point on heavy-ion observables.Comment: 11 pages, 5 Figures, Proceedings for contribution to CPOD 201

Effect of Myostatin Depletion on Weight Gain, Hyperglycemia, and Hepatic Steatosis during Five Months of High-Fat Feeding in Mice

The marked hypermuscularity in mice with constitutive myostatin deficiency reduces fat accumulation and hyperglycemia induced by high-fat feeding, but it is unclear whether the smaller increase in muscle mass caused by postdevelopmental loss of myostatin activity has beneficial metabolic effects during high-fat feeding. We therefore examined how postdevelopmental myostatin knockout influenced effects of high-fat feeding. Male mice with ubiquitous expression of tamoxifen-inducible Cre recombinase were fed tamoxifen for 2 weeks at 4 months of age. This depleted myostatin in mice with floxed myostatin genes, but not in control mice with normal myostatin genes. Some mice were fed a high-fat diet (60% of energy) for 22 weeks, starting 2 weeks after cessation of tamoxifen feeding. Myostatin depletion increased skeletal muscle mass ∼30%. Hypermuscular mice had ∼50% less weight gain than control mice over the first 8 weeks of high-fat feeding. During the subsequent 3 months of high-fat feeding, additional weight gain was similar in control and myostatin-deficient mice. After 5 months of high-fat feeding, the mass of epididymal and retroperitoneal fat pads was similar in control and myostatin-deficient mice even though myostatin depletion reduced the weight gain attributable to the high-fat diet (mean weight with high-fat diet minus mean weight with low-fat diet: 19.9 g in control mice, 14.1 g in myostatin-deficient mice). Myostatin depletion did not alter fasting blood glucose levels after 3 or 5 months of high-fat feeding, but reduced glucose levels measured 90 min after intraperitoneal glucose injection. Myostatin depletion also attenuated hepatic steatosis and accumulation of fat in muscle tissue. We conclude that blocking myostatin signaling after maturity can attenuate some of the adverse effects of a high-fat diet

Breakfast and exercise contingently affect postprandial metabolism and energy balance in physically active males

The present study examined the impact of breakfast and exercise on postprandial metabolism, appetite and macronutrient balance. A sample of twelve (blood variables n 11) physically active males completed four trials in a randomised, crossover design comprising a continued overnight fast followed by: (1) rest without breakfast (FR); (2) exercise without breakfast (FE); (3) breakfast consumption(1859 kJ) followed by rest (BR); (4) breakfast consumption followed by exercise (BE). Exercise was continuous, moderate-intensity running (expending approximately 2·9MJ of energy). The equivalent time was spent sitting during resting trials. A test drink (1500 kJ) was ingested on all trials followed 90 min later by an ad libitum lunch. The difference between the BR and FR trials in blood glucose time-averaged AUC following test drink consumption approached significance (BR: 4·33 (SEM 0·14) v. FR: 4·75 (SEM 0·16) mmol/l; P¼0·08); but it was not different between FR and FE (FE: 4·77 (SEM 0·14) mmol/l; P¼0·65); and was greater in BE (BE: 4·97 (SEM 0·13) mmol/l) v. BR(P¼0·012). Appetite following the test drink was reduced in BR v. FR (P¼0·006) and in BE v. FE (P¼0·029). Following lunch, the most positive energy balance was observed in BR and least positive in FE. Regardless of breakfast, acute exercise produced a less positive energy balance following ad libitum lunch consumption. Energy and fat balance is further reduced with breakfast omission. Breakfast improved the overall appetite responses to foods consumed later in the day, but abrogated the appetite suppressive effect of exercise

De inpassing van de Barbierbeek in het gecontroleerd overstromingsgebied Kruibeke-Bazel-Rupelmonde

This report deals with the possibilities to fit the Barbier-brook in the Controlled lnundation Area of Kruibeke, Bazel en Rupelmonde that was planned according the Sigmaplan. The so called CIA-KBR is situated upstream Antwerp. The CIA-KBR will be inundated when a certain flood on the river Schelde overflows the lowered river dike. The result is a decrease of the peak of the flood. A dike at the polder side will fulfill the defensive function during the period of inundation. This dike is called the "ringdike". The Barbier-brook cuts through the CIA-KBR. Within the CIA the Barbier-brook is diked in since the 13th century. Further on in this text these dikes will be called Barbier-brook dikes. Nowadays, the area between these dikes forms the storage for the Barbier-brook.The study participates in the preparations for the CIA-KBR. Co-ordinated by the Institute of Nature Conservation in Brussels some studies for possibilities of nature development within the CIA-KBR are carried out.In this report the technical possibilities to fit the Barbier-brook in the CIA-KBR as weIl as the perspectives for nature developrnent are studied. The perspectives for nature development can be split in:.nature development influenced by the Barbier-brook.nature development influenced by the Barbier-brook and a controlled reduced tide, controlled reduced tide stands for: a tide controlled by culverts for the in- and outlet of water from the river Schelde with a reduced tide amplitude with an average of 0,25 to 0,5 m.This last perspective corresponds most to the historical natural situation of the area, which consists of freshwater marshes and mud plains.To be able to work out these aspects it is necessary to carry out also a study ofthe water quality and quantity of the Barbier-brook.No discharge data from the Barbier-brook are known at all. Based on the discharge data of the Kleine Molenbeek near Liezele, which has a similar catchment area except the size, the discharge frorn the Barbier-brook could be abstracted. To do so, the surface area of the Kleine Molenbeek is multiplied by a factor 1,43. Frorn these discharge data follows a mean discharge of the Barbier-brook which varies seasonally between 3 and 5 m3/s. These data show also an increase in the annual maximum 24h-discharges starting from approximately 1980.The quality of the water of the Barbier-brook off the CIA-KBR is very bad. The brook is heavily polluted with domestic, industrial and agricultural wastewater. Nearby the site where the brook discharges into the Schelde it is characterised as "biologically dead". The involved communities have made sewerage plans which will decrease the pollution of the Barbier-brook with dornestic wastewater with about 80%. Concerning the houses which are not covered by the sewerage plans the following measures are given: 1) yet inc1ude into the sewerage plans, and 2) provide small-scale biological treatment.After completion of the sewerage plans and the extra measures the following reductions of the pollution by wastewater on the Barbier-brook could be reached:dornestic wastewater: 92%; industrial wastewater: 90%; agricultural wastewater: 31 %To make it technically possible to fit the Barbier-brook in the CIA-KBR it is necessary to compensate the storage of the Barbier-brook in order to prevent the brook to cause trouble at the houses of Bazel that stand close to the brookside. For this reason the following measures will be elaborated:The realisation of a storage along the ringdike which is connected with the CIA by means of a culvert. The surface needed for the storage is regulated by the maximum water level that is tolerated in the storage. From calculations follows that there is enough place to realise a storage that can guarantee a safety for a situation with a return period of 1 per 1000 years. No houses need to be removed.The realisation of a storage in the natural valley of the Barbier-brook situated upstream Bazel and the CIA. This storage needs to be fit in the protected landscape without large works. From calculations follows that the available storage volume is insufficient to guarantee a safety for a situation with a return period of 1 per 1000 years.Placing a pumping station at the ringdike with sufficient capacity to pump over a discharge of the Barbier-brook with a return period of 1 per 400 years which is 8,7 m3/s. It is technically possible to reach this with a "screw-up-pumping station" as well as with a "screw-centrifugal-pumping station”Not until the quality of the water of the Barbier-brook improves strongly, nature development can be effectively worked out. In this study the following perspectives for nature development are elaborated in order to increase the value of nature in that part of the CIA that can be influenced by the Barbier-brook:.Concerning the area between the Barbier-brook dikes possible measures are worked out to improve the present potential values of nature. Thus rich zones along the Creek of Kruibeke can be expected and the higher grounds will be rich in flowering plants. When the dikes around the Barbier-brook are preserved the introduction of a controlled reduced tide is of no influence concerning nature development of the Barbier-brook..Concerning a part of the polder of Kruibeke space will be created for development of a more natural Barbier-brook. The agricultural activities on the other grounds will be preserved. Different measures will make this possible of which one is the removal of the Northern Barbier-brook dike. There will be aimed towards broad and rich developed zones along the brook with gradation in vegetation types. The introduction of a controlled reduced tide is not considered because of the present function of agriculture in the polder ..Concerning the polders of Kruibeke and Bazel measures are worked out to provide a total free development of the Barbier-brook. The most effective measure to reach this is the removal of the Barbier-brook dikes except that part of the dikes between the new ringdike and the natural height in the polder of Bazel. There will be a striving towards a large scaled landscape dominated by reeds and rich developed wetlands. The introduction of a controlled reduced tide is of great influence of the nature development in this situation. It might even re sult in freshwater marshes and mud plains in the CIA-KBR

Diverse Stakeholder Perspectives on Rural Health Care Reform in a U.S. State that Rejected the Affordable Care Act: A Case Study

Purpose: This case study identifies rural health care stakeholder perspectives on the Affordable Care Act (ACA) and describes the health policy context in Idaho, the only state in the United States to reject Medicaid expansion yet develop a state-run health insurance exchange. Sample: The sample included 20 rural health care stakeholders, including clinicians, elected officials, state agency administrators, health care facility administrators, and interest group leaders. Method: A single-case study of stakeholder perspectives on the ACA and rural health care access in Idaho was conducted from 2014 to 2016. Data sources include qualitative interviews with 20 rural health care stakeholders and public documents relating to the ACA and rural health care from Idaho governmental and nongovernmental entities’ websites. Findings: Since the 2010 passage of the ACA, opposition to “Obamacare” became associated with a conservative stance on health care reform. However, in this case study, diverse health care stakeholders who criticized aspects of the ACA identified several components of the policy, including Medicaid expansion, as essential in ensuring access to rural health care. Some stakeholders called for federal legislation authorizing nurse practitioners to practice as independent primary care providers. However, the politics of medical sovereignty present challenges to this relevant strategy and to full implementation of Idaho’s Nurse Practice Act for increasing access to primary care in a rural state. Conclusions: The case study approach can be effective in illuminating stakeholder perspectives and policy strategies that may fall outside of polarized health care policy debates. Examination of the state-level political context of rural health care must consider concurrent battles about state sovereignty over health care policy and professional-clinical battles about sovereignty over primary care

Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources