161 research outputs found
Analysis of the impact of alternative enterprise interventions on poverty and livelihoods in rural Ghana
Despite the spate of urbanisation fuelled among other factors by rural-urban migration across the African region, majority of people continue to reside in rural communities with greater burden of poverty and livelihood vulnerabilities. Ghana’s case has not been different. However, in response to the high incidence of rural poverty, the seasonal nature of agricultural livelihoods and the attendant increase of unemployed youth engaged in rural-urban drift, successive governments of Ghana introduced and supported the Rural Enterprise Programme (REP) to promote livelihood diversification and restructuring of the rural economy. The REP phases I (1995-2002) and II (2003-2011) sought to contribute to the development of competitive rural medium and small-scale enterprises (MSEs) in beneficiary districts backed by good quality, relevant, sustainable and market-driven business development support services. For almost two decades of implementation, the REP has run on policy assumption that, focusing on direct agricultural activities alone cannot produce substantial rural poverty reduction and support the actualisation of the sustainable development goals (SDGs) in rural Ghana. However, performance of the REP on its assumption requires verification. Following mixed research techniques, this paper uses the experiences of selected beneficiary communities from the Ajumako- Enyan-Essiam District to examine how the alternative livelihood development interventions of the REP have impacted rural livelihoods and poverty. The extent to which rural enterprise development interventions have engendered livelihood diversification and affected the asset-base of rural households, and how the interventions have produced positive livelihood outcomes and poverty reduction in the intervention area studied are discussed in this paper. Keywords: Rural Development; Poverty; Livelihoods; Micro-enterprise Development; Ghan
Conserving socio-ecological landscapes: An analysis of traditional and responsive management practices for floodplain meadows in England
Contemporary practice in the conservation of socio-ecological landscapes draws on both a model of responsive management, and also on ideas about historic management. This study considered what evidence might exist for the exercise of these approaches to management in the conservation of floodplain meadows in England, in order to inform understanding and knowledge of conservation management and assessment practice.
Evidence for a model of responsive management was limited, with managing stakeholders often alternating between this model and an alternative approach, called here the ‘traditional management approach’, based on ideas, narratives and prescriptions of long-established land management practices. Limited monitoring and assessment appeared to undermine the former model, whilst uncertainty over past long-standing management practices undermined the latter. As a result of the relative power of conservation actors over farmers delivering site management, and their framings of meadows as ‘natural’ spaces, management tended to oscillate between aspects of these two approaches in a sometimes inconsistent manner.
Conservation managers should consider the past motivating drivers and management practices that created the landscapes they wish to conserve, and bear in mind that these are necessarily implicated in aspects of the contemporary landscape value that they wish to maintain. They should ensure that assessment activity captures a broad range of indicators of site value and condition, not only biological composition, and also record data on site management operations in order to ensure management effectiveness
Relative contribution of various chronic diseases and multi-morbidity to potential disability among Dutch elderly
BACKGROUND: The amount of time spent living with disease greatly influences elderly people’s wellbeing, disability
and healthcare costs, but differs by disease, age and sex.
METHODS: We assessed how various single and combined diseases differentially affect life years spent living with
disease in Dutch elderly men and women (65+) over their remaining life course. Multistate life table calculations
were applied to age and sex-specific disease prevalence, incidence and death rates for the Netherlands in 2007. We
distinguished congestive heart failure, coronary heart disease (CHD), breast and prostate cancer, colon cancer, lung
cancer, diabetes, COPD, stroke, dementia and osteoarthritis.
RESULTS: Across ages 65, 70, 75, 80 and 85, CHD caused the most time spent living with disease for Dutch men
(from 7.6 years at age 65 to 3.7 years at age 85) and osteoarthritis for Dutch women (from 11.7 years at age 65 to 4.
8 years at age 85). Of the various co-occurrences of disease, the combination of diabetes and osteoarthritis led to
the most time spent living with disease, for both men (from 11.2 years at age 65 to 4.9 -years at age 85) and
women (from 14.2 years at age 65 to 6.0 years at age 85).
CONCLUSIONS: Specific single and multi-morbid diseases affect men and women differently at different phases in the
life course in terms of the time spent living with disease, and consequently, their potential disability. Timely sex and
age-specific interventions targeting prevention of the single and combined diseases identified could reduce
healthcare costs and increase wellbeing in elderly people
Learning theories and tools for the assessment of core nursing competencies in simulation: A theoretical review
Aim: To identify the theories used to explain learning in simulation and to examine
how these theories guided the assessment of learning outcomes related to core
competencies in undergraduate nursing students.
Background: Nurse educators face the challenge of making explicit the outcomes of
competency-based education, especially when competencies are conceptualized as
holistic and context dependent.
Design: Theoretical review.
Data Sources: Research papers (N = 182) published between 1999–2015 describing
simulation in nursing education.
Review Methods: Two members of the research team extracted data from the
papers, including theories used to explain how simulation could engender learning
and tools used to assess simulation outcomes. Contingency tables were created to
examine the associations between theories, outcomes and tools.
Results: Some papers (N = 79) did not provide an explicit theory. The 103 remaining
papers identified one or more learning or teaching theories; the most frequent
were the National League for Nursing/Jeffries Simulation Framework, Kolb’s theory
of experiential learning and Bandura’s social cognitive theory and concept of selfefficacy.
Students’ perceptions of simulation, knowledge and self-confidence were
the most frequently assessed, mainly via scales designed for the study where they
were used. Core competencies were mostly assessed with an observational
approach.
Conclusion: This review highlighted the fact that few studies examined the use of
simulation in nursing education through learning theories and via assessment of core
competencies. It also identified observational tools used to assess competencies in
action, as holistic and context-dependent constructs
Meaning in life in the Federal Republic of Germany: results of a representative survey with the Schedule for Meaning in Life Evaluation (SMiLE)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens
How Much Will Safe Sanitation for all Cost? Evidence from Five Cities
Global sustainable development goals call for universal access to safely managed sanitation by 2030. Here, we demonstrate methods to estimate the financial requirements for meeting this commitment in urban settings of low-income countries. Our methods considered two financial requirements: (i) the subsidies needed to bridge the gap between the willingness-to-pay of low-income households and actual market prices of toilets and emptying services and (ii) the amounts needed to expand the municipal waste management infrastructure for unserved populations. We applied our methods in five cities– Kisumu, Malindi, Nakuru in Kenya; Kumasi in Ghana; and Rangpur in Bangladesh and compared three to five sanitation approaches in each city. We collected detailed cost data on the sanitation infrastructure, products, and services from 76 key informants across the five cities, and we surveyed a total of 2381 low-income households to estimate willingness-to-pay. We found that the total financial requirements for achieving universal sanitation in the next 10 years and their breakdown between household subsidies and municipal infrastructure varied greatly between sanitation approaches. Across our study cities, sewerage was the costliest approach (total financial requirements of 16–24 USD/person/year), followed by container-based sanitation (10–17 USD/person/year), onsite sanitation (2–14 USD/person/year), and mini-sewers connecting several toilets to communal septic tanks (3–5 USD/person/year). Further applications of our methods can guide sanitation planning in other cities
The effect of ABCA1 gene polymorphisms on ischaemic stroke risk and relationship with lipid profile
<p>Abstract</p> <p>Background</p> <p>Ischaemic stroke is a common disorder with genetic and environmental components contributing to overall risk. Atherothromboembolic abnormalities, which play a crucial role in the pathogenesis of ischaemic stroke, are often the end result of dysregulation of lipid metabolism. The ATP Binding Cassette Transporter (<it>ABCA1</it>) is a key gene involved in lipid metabolism. It encodes the cholesterol regulatory efflux protein which mediates the transfer of cellular phospholipids and cholesterol to acceptor apolipoproteins such as apolipoprotein A-I (ApoA-I). Common polymorphisms in this gene affect High Density Lipoprotein Cholesterol (HDL-C) and Apolipoprotein A-I levels and so influence the risk of atherosclerosis. This study has assessed the distribution of <it>ABCA1 </it>polymorphisms and haplotype arrangements in patients with ischaemic stroke and compared them to an appropriate control group. It also examined the relationship of these polymorphisms with serum lipid profiles in cases and controls.</p> <p>Methods</p> <p>We studied four common polymorphisms in <it>ABCA1 </it>gene: G/A-L158L, G/A-R219K, G/A-G316G and G/A-R1587K in 400 Caucasian ischaemic stroke patients and 487 controls. Dynamic Allele Specific Hybridisation (DASH) was used as the genotyping assay.</p> <p>Results</p> <p>Genotype and allele frequencies of all polymorphisms were similar in cases and controls, except for a modest difference in the <it>ABCA1 </it>R219K allele frequency (P-value = 0.05). Using the PHASE2 program, haplotype frequencies for the four loci (158, 219, 316, and 1587) were estimated in cases and controls. There was no significant difference in overall haplotypes arrangement in patients group compared to controls (p = 0.27). 2211 and 1211 haplotypes (1 = common allele, 2 = rare allele) were more frequent in cases (p = 0.05). Adjusted ORs indicated 40% and 46% excess risk of stroke for these haplotypes respectively. However, none of the adjusted ORs were statistically significant. Individuals who had R219K "22" genotype had a higher LDL level (p = 0.001).</p> <p>Conclusion</p> <p>Our study does not support a major role for the <it>ABCA1 </it>gene as a risk factor for ischaemic stroke. Some haplotypes may confer a minor amount of increased risk or protection. Polymorphisms in this gene may influence serum lipid profile.</p
Assessment of gene-by-sex interaction effect on bone mineral density
To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.Sexual dimorphism in various bone phenotypes, including bone mineral density (BMD), is widely observed; however, the extent to which genes explain these sex differences is unclear. To identify variants with different effects by sex, we examined gene-by-sex autosomal interactions genome-wide, and performed expression quantitative trait loci (eQTL) analysis and bioinformatics network analysis. We conducted an autosomal genome-wide meta-analysis of gene-by-sex interaction on lumbar spine (LS) and femoral neck (FN) BMD in 25,353 individuals from 8 cohorts. In a second stage, we followed up the 12 top single-nucleotide polymorphisms (SNPs; p < 1 × 10(-5) ) in an additional set of 24,763 individuals. Gene-by-sex interaction and sex-specific effects were examined in these 12 SNPs. We detected one novel genome-wide significant interaction associated with LS-BMD at the Chr3p26.1-p25.1 locus, near the GRM7 gene (male effect = 0.02 and p = 3.0 × 10(-5) ; female effect = -0.007 and p = 3.3 × 10(-2) ), and 11 suggestive loci associated with either FN- or LS-BMD in discovery cohorts. However, there was no evidence for genome-wide significant (p < 5 × 10(-8) ) gene-by-sex interaction in the joint analysis of discovery and replication cohorts. Despite the large collaborative effort, no genome-wide significant evidence for gene-by-sex interaction was found to influence BMD variation in this screen of autosomal markers. If they exist, gene-by-sex interactions for BMD probably have weak effects, accounting for less than 0.08% of the variation in these traits per implicated SNP. © 2012 American Society for Bone and Mineral Research.Medtronic
NIH R01 AG18728
R01HL088119
R01AR046838
U01 HL084756
R01 AR43351
P01-HL45522
R01-MH-078111
R01-MH-083824
Nutrition and Obesity Research Center of Maryland P30DK072488
NIAMS/NIH F32AR059469
Instituto de Salud Carlos III-FIS (Spanish Health Ministry) PI 06/0034
PI08/0183
Canadian Institutes of Health Research (CIHR)
NHLBI HHSN268201200036C
N01-HC-85239
N01-HC-85079
N01-HC-85086
N01-HC-35129
N01 HC15103
N01 HC-55222
N01-HC-75150
N01-HC-45133
HL080295
HL087652
HL105756
NIA AG-023629
AG-15928
AG-20098
AG-027058
N01AG62101
N01AG62103
N01AG62106
1R01AG032098-01A1
National Center of Advancing Translational Technologies CTSI UL1TR000124
National Institute of Diabetes and Digestive and Kidney Diseases DK063491
EUROSPAN (European Special Populations Research Network)
European Commission FP6 STRP grant 018947
LSHG-CT-2006-01947
Netherlands Organisation for Scientific Research
Erasmus MC
Centre for Medical Systems Biology (CMSB)
Netherlands Brain Foundation (HersenStichting Nederland)
US National Institute for Arthritis, Musculoskeletal and Skin Diseases
National Institute on Aging R01 AR/AG41398
R01 AR050066
R21 AR056405
National Heart, Lung, and Blood Institute's Framingham Heart Study N01-HC-25195
Affymetrix, Inc. N02-HL-6-4278
Canadian Institutes of Health Research from Institute of Aging 165446
Institute of Genetics 179433
Institute of Musculoskeletal health 221765
Intramural Research Program of the NIH, National Institute on Aging
National Institutes of Health HHSN268200782096C
Hong Kong Research Grant Council HKU 768610M
Bone Health Fund of HKU Foundation
KC Wong Education Foundation
Small Project Funding 201007176237
Matching Grant
CRCG Grant
Osteoporosis and Endocrine Research Fund
Genomics Strategic Research Theme of The University of Hong Kong
Netherlands Organisation of Scientific Research NWO Investments 175.010.2005.011
911-03-012
Research Institute for Diseases in the Elderly 014-93-015
Netherlands Genomics Initiative (NGI)/Netherlands Consortium for Healthy Aging (NCHA) 050-060-810
Erasmus Medical Center and Erasmus University, Rotterdam
Netherlands Organization for the Health Research and Development (ZonMw)
Research Institute for Diseases in the Elderly (RIDE)
Ministry of Education, Culture and Science
Ministry for Health, Welfare and Sports
European Commission (DG XII)
Municipality of Rotterdam
German Bundesministerium fur Forschung und Technology 01 AK 803 A-H
01 IG 07015
Continuing outcomes relevant to Evista:Breast cancer incidence in postmenopausal osteoporotic women in a randomized trial of Raloxifene
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