Measurement and valuation of health providers' time for the management of childhood pneumonia in rural Malawi - An empirical study

Background: Human resources are a major cost driver in childhood pneumonia case management. Introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in Malawi can lead to savings on staff time and salaries due to reductions in pneumonia cases requiring admission. Reliable estimates of human resource costs are vital for use in economic evaluations of PCV-13 introduction. Methods: Twenty-eight severe and twenty-four very severe pneumonia inpatients under the age of five were tracked from admission to discharge by paediatric ward staff using self-administered timesheets at Mchinji District Hospital between June and August 2012. All activities performed and the time spent on each activity were recorded. A monetary value was assigned to the time by allocating a corresponding percentage of the health workers' salary. All costs are reported in 2012 US$. Results: A total of 1,017 entries, grouped according to 22 different activity labels, were recorded during the observation period. On average, 99 min (standard deviation, SD = 46) were spent on each admission: 93 (SD = 38) for severe and 106 (SD = 55) for very severe cases. Approximately 40$ 2 per bed-day and, on average, US$29.5 per severe pneumonia admission and US$ 37.7 per very severe admission. Conclusions: Self-reporting was successfully used in this context to generate reliable estimates of human resource time and costs of childhood pneumonia treatment. Assuming vaccine efficacy of 41 % and 90 % coverage, PCV-13 introduction in Malawi can save over US$ 2 million per year in staff costs alone

Changes in Glial Cell Line-derived Neurotrophic Factor Expression in the Rostral and Caudal Stumps of the Transected Adult Rat Spinal Cord

Limited information is available regarding the role of endogenous Glial cell line-derived neurotrophic factor (GDNF) in the spinal cord following transection injury. The present study investigated the possible role of GDNF in injured spinal cords following transection injury (T9–T10) in adult rats. The locomotor function recovery of animals by the BBB (Basso, Beattie, Bresnahan) scale score showed that hindlimb support and stepping function increased gradually from 7 days post operation (dpo) to 21 dpo. However, the locomotion function in the hindlimbs decreased effectively in GDNF-antibody treated rats. GDNF immunoreactivty in neurons in the ventral horn of the rostral stump was stained strongly at 3 and 7 dpo, and in the caudal stump at 14 dpo, while immunostaining in astrocytes was also seen at all time-points after transection injury. Western blot showed that the level of GDNF protein underwent a rapid decrease at 7 dpo in both stumps, and was followed by a partial recovery at a later time-point, when compared with the sham-operated group. GDNF mRNA-positive signals were detected in neurons of the ventral horn, especially in lamina IX. No regenerative fibers from corticospinal tract can be seen in the caudal segment near the injury site using BDA tracing technique. No somatosensory evoked potentials (SEP) could be recorded throughout the experimental period as well. These findings suggested that intrinsic GDNF in the spinal cord could play an essential role in neuroplasticity. The mechanism may be that GDNF is involved in the regulation of local circuitry in transected spinal cords of adult rats

Evidence for distinct stages of magma history recorded by the compositions of accessory apatite and zircon

Accessory minerals contain a robust and accessible record of magma evolution. However, they may reflect relatively late-stage conditions in the history of the host magmas. In the normally zoned Criffell granitic pluton (Scotland), whole-rock (WR) compositions reflect open system assimilation and fractional crystallisation at depths of >11 km, whereas amphibole barometry and the absence of inherited zircon suggest that the observed mineral assemblages crystallised following emplacement of magmas with little or no crystal cargo at depths of 4–6 km. The crystallisation history is documented by large trace-element variations amongst apatite crystals from within individual samples: decreasing LREE and Th concentrations in apatite crystals from metaluminous samples reflect broadly synchronous crystallisation of allanite, whereas lower LREE and Th, and more negative Nd anomalies in apatites from peraluminous samples reflect the effects of monazite crystallisation. WR evolution is likely to have occurred within a deep crustal hot zone where H2O-rich (~6 wt%), low-viscosity magmas segregated and ascended adiabatically in a super-liquidus state, leading to resorption of most entrained crystals. Stalling, emplacement and crystallisation resulted from intersection with the H2O-saturated liquidus at ~4 km. H2O contents are as important as temperature in the development of super-liquidus magmas during ascent, blurring distinctions between apparently ‘hot’ and ‘cold’ granites. The trace-element contents of most accessory minerals are controlled by competitive crystallisation of other accessory minerals in small melt batches, consistent with the incremental assembly of large granitic plutons

Triggers for the formation of porphyry ore deposits in magmatic arcs

Porphyry ore deposits are the source of much of the copper, molybdenum, gold and silver used by humans. Porphyry ore typically forms in magmatic arcs above subduction zones. However, generation of the largest deposits is often restricted to specific arc segments and limited periods of time. Here, I outline a hierarchy of four key triggers that may be involved in the formation of large porphyry deposits. The first process is characterized by a cyclical enrichment of magmas with metals and water in the deep crust. Second, saturation of the magma with sulphide facilitates the concentration of metals into smaller volumes of material from which they can later be released. The third process is an efficient transfer of metals into hydrothermal fluids that are exsolved from the magmas. Finally, localized processes trigger the precipitation of ore minerals in the crust. Although some or all of these processes must act in concert to generate large ore deposits, I argue that sulphide saturation of the magma is the most important step and that this can explain the temporal and spatial distribution of ores. Consequently, the fingerprint of sulphide saturation in igneous rocks could be used to identify those parts of magmatic arcs that are particularly predisposed to ore formation.© 2013 Macmillan Publishers Limited. All rights reserved. The attached document is the author’s final accepted version of the journal article. You are advised to consult the publisher’s version if you wish to cite from it