3,883 research outputs found

    The quality of medical advice in low-income countries

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    This paper provides an overview of recent work on quality measurement of medical care and its correlates in four low and middle-income countries-India, Indonesia, Tanzania, and Paraguay. The authors describe two methods-testing doctors and watching doctors-that are relatively easy to implement and yield important insights about the nature of medical care in these countries. The paper discusses the properties of these measures, their correlates, and how they may be used to evaluate policy changes. Finally, the authors outline an agenda for further research and measurement.Health Monitoring&Evaluation,Health Systems Development&Reform,Gender and Health,Health Economics&Finance,Disease Control&Prevention

    The growth of bilateralism

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    One of the most notable international economic events over the past 20 years has been the proliferation of bilateral free trade agreements (FTAs). Bilateral agreements account for 80 percent of all agreements notified to the WTO, 94 percent of those signed or under negotiation, and currently 100 percent of those at the proposal stage. Some have argued that the growth of bilateralism is attributable to governments having pursued a policy of “competitive liberalization" - implementing bilateral FTAs to offset potential trade diversion caused by FTAs of “third-country-pairs" - but the growth of bilateralism can also be attributed potentially to “tariff complementarity" - the incentive for FTA members to reduce their external tariffs on nonmembers. Guided by new comparative statics from the numerical general equilibrium monopolistic competition model of FTA economic determinants in Baier and Bergstrand (2004), we augment their parsimonious logit (and probit) model of the economic determinants of bilateral FTAs to incorporate theory-motivated indexes to examine the influence of existing memberships on subsequent FTA formations. The model can predict correctly 90 percent of the bilateral FTAs within five years of their formation, while still predicting “No-FTA" correctly in 90 percent of the observations when no FTA exists, using a sample of over 350,000 observations for pairings of 146 countries from 1960-2005. Even imposing the higher correct prediction rate of “No-FTA" of 97 percent in Baier and Bergstrand (2004), the parsimonious model still predicts correctly 75 percent of these rare FTA events; only 3 percent of the observations reflect a country-pair having an FTA in any year. The results suggest that - while evidence supports that “competitive liberalization" is a force for bilateralism - the effect on the likelihood a pair of countries forming an FTA of the pair's own FTAs with other countries (i.e., tariff complementarity) is likely just as important as the effect of third-country-pairs' FTAs (i.e., competitive liberalization) for the growth of bilateralism

    Metastatic Ewing's sarcoma to the right ventricle

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    Ewing's sarcoma is a round cell neoplasm derived from neural crest cells that is part of the primitive neuroectodermal tumor (PNET) family. It is a rare, aggressive malignancy that affects young people, most commonly in the second decade of life. The treatment of localized disease has improved greatly over the past four decades, but the prognosis for metastatic disease remains poor. Cardiac metastases of Ewing's sarcoma are exceedingly rare, with only a few reported cases. This article presents a case of a 22 year old man with a history of Ewing's sarcoma of the bone involving the right kneepeer-reviewe

    Sustainability Research in the CGIAR: Its Status and Future

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    Preliminary report of the CGIAR Committee on Sustainability of Agricultural Production Systems, prepared by World Wildlife Fund Vice President Jeffrey Leonard. The report offers an overview of sustainability issues addressed by IARC programs, and of the contributions of IARC work to understanding of the physical, biological, and socioeconomic determinants of sustainability. It also identifies seven areas considered to be gaps in the Group's attention to sustainability. Agenda document, CGIAR meeting May-June 1989

    UNSTEADY-STATE SPHERICAL FLOW WITH STORAGE AND SKIN.

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    This paper presents short-time interpretation methods for radial-spherical (or radial-hemispherical) flow in homogeneous and isotropic reservoirs inclusive of wellbore storage, wellbore phase redistribution, and damage skin effects. New dimensionless groups are introduced to facilitate the classic transformation from radial flow in the sphere to linear flow in the rod. Analytical expressions, type curves (in log-log and semi log format), and tabulated solutions are presented, both in terms of pressure and rate, for all flow problems considered. A new empirical equation to estimate the duration of wellbore and near-wellbore effects under spherical flow is also proposed

    Environmental Performance Index for the Forest

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    Comparative environmental performance indices for energy use, global warming potential (GWP), air, water, and solid waste emissions covering the stages of processing from the harvesting of wood and the extraction of non-renewable materials to the construction of a house using different materials are developed in other articles. Developing performance indices that compare renewable resources and their environmental impacts on the land base to the depletion of non-renewable resources is problematic. Materials that involve mining are inherently not renewable compared to forest resources, which are renewable over some rotation age of the forest. The environmental impacts on the forest are dynamic and are impacted by landscape changes with some related to the production of wood for markets. Forest ecology metrics are developed to show the impact of management alternatives based on changing stand structures. Forest diversity, measured by structure classes, is impacted by longer rotation and thinning alternatives as well as preservation and protection policies.Management alternatives can contribute to some restoration of pre-settlement conditions of forests and provides a benchmark from which to evaluate reduced stand structure diversity and loss of habitat. While a century of commercial management has reduced the diversity in the forest and in particular has increased the share of acres in both the stand initiation stage and the closed canopy or stem exclusion stage, the trend has already turned in response to demands for more forest acres under increased protection and preservation status. Increased thinning from more intensive management and policies to protect threatened species are both contributing to increased understory reinitiation and ultimately more complex old forest structures. Longer rotation management could add to this effect but at a substantial cost since the economics of long rotation management falls below acceptable levels for economic investments

    To Find Or Not To Find: Public Accounting Auditors Versus Governmental Auditors

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    This study examines the impact that the type of auditor (OfficeOffice of the Auditor General (OAG auditor) or CPA firm auditor) has on the number of compliance audit findings reported for select state agencies in a major Midwestern state. In the state studied, The OAG is responsible for conducting compliance audits of government agencies on at least a biennial basis. These audits are either performed by the Auditor General’s state auditors or by Certified Public Accounting (CPA) firms under contract to the OAG. A sample of agencies with audits that were sometimes performed by CPA firms and sometimes by OAG auditors was chosen. A statistical analysis concluded the number of compliance audit findings reported by OAG auditors was significantly higher than the number of compliance audit findings reported by CPA firm auditors, for the same set of state agencies

    Information Sharing and Situational Awareness: Insights from the Cascadia Rising Exercise of June 2016

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    In a catastrophic incident gaining situational awareness (SA) is the foremost prerequisite that ena-bles responders to save and sustain lives, stabilize the incident, and protect the environment and property from further damage. However, catastrophes severely damage and disrupt critical infrastructures including response assets. Initially and for days and even weeks, essential information remains incomplete, unverified, and is changing as the catastrophic incident unfolds, all of which leads to a distorted common operating picture (COP). The lack of clear and comprehensive SA/COP prevents incident commanders from efficiently directing the response effort. This study reports on the challenges emergency responders faced with regard to situational awareness in a recent large-scale exercise under the name of Cascadia Rising 2016 (CR16) conducted in the Pacific Northwest of the United States. The exercise involved a total of 23,000 active participants. Over four days in June of 2016, CR16 simulated the coordinated response to a rupture of the 800-mile Cascadia Subduction Zone resulting in a magnitude-9 earthquake and tsunami similar to the catastrophic incident in Eastern Japan in 2011. Responders at all levels were severely challenged, and the exercise revealed major vulnerabilities in critical infrastructures. Situational awareness was very difficult to establish. The exercise demonstrated that the challenges to SA/COP and to response management, in general, during catastrophic incidents cannot be regarded as a linear extension of non-catastrophic emergency and disaster responses. It rather requires the rethinking and revising of practices and procedures when responding under the constraints of massively degraded critical information infrastructures and harshly decimated assets
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