Investigating disability-inclusion in social protection programmes in low- and middle-income countries, with case studies from Vietnam and Nepal

Background: Social protection is increasingly used by governments in low- and middle-income countries (LMICs) as a strategy for alleviating poverty “in all its forms”. People with disabilities are frequently targeted as key beneficiaries due to high levels of poverty and marginalisation. Little is known, however, on whether people with disabilities are accessing existing programmes, and whether these programmes adequately meet their needs. Aim: To explore the need for, access to and adequacy of social protection amongst people with disabilities in LMICs. Methods: Systematic reviews were used to compile and evaluate evidence from across LMICs on 1) the link between monetary poverty and disability, and 2) access to and impact of social protection amongst people with disabilities. Case studies were then undertaken in the districts of Cam Le, Vietnam and Tanahun, Nepal in 2016 to explore in-depth the need for, access to and adequacy of social protection amongst people with disabilities in these areas. Data was collected through population-based surveys (n=12,397, across both settings), with nested case-control studies of people with and without disabilities (n=359, each) matched by age, sex and location. Further, qualitative research was conducted with people with disabilities recruited from the surveys and key informants involved in the design or implementation of social protection. Need for social protection was assessed using monetary and multidimensional indicators of poverty amongst people with disabilities ages 15+. Access to social protection was measured through participation in disability-targeted and non-targeted programmes. Adequacy of social assistance was then evaluated by measuring levels of monetary and multidimensional poverty amongst social assistance recipients. All analyses compared indicators between people with and without disabilities, and amongst people without disabilities (e.g. recipients versus non-recipients). Key findings: Evidence from the systematic review and research in Nepal and Vietnam indicate a high need for social protection among people with disabilities. In the systematic review, 80% of the 150 included studies found a link between disability and economic poverty. In both Vietnam and Nepal, people with disabilities were more likely to be living in both monetary and multidimensional poverty compared to people without disabilities, and faced high disability-related extra costs. People with disabilities in Vietnam and Nepal were more likely to access social assistance compared to people without disabilities (Vietnam: aOR 9.6, 5.6-16.5; Nepal: aOR 3.0, 1.6-5.3). However, evidence from the case studies and from the systematic review indicate that many people with disabilities are not accessing social protection benefits for which they are eligible. Factors affecting access included the accessibility of the application process, complexity of disability assessment procedures, awareness of programmes and their eligibility requirements and the perceived utility of benefits. Further, the systematic review and research in Vietnam and Nepal indicated that social protection is often inadequate to protect many recipients with disabilities from poverty. For example, a quarter to a third of social assistance recipients with disabilities were living in monetary poverty and half were multidimensionally poor in Vietnam and Nepal. Social protection was particularly insufficient at promoting social inclusion amongst people with disabilities, as well as ensuring sustainable livelihoods. Conclusion: People with disabilities face a substantial need for social protection, given high levels of monetary and multidimensional poverty, in both absolute terms and relative to people without disabilities. However, many people with disabilities were not accessing programmes for which they were eligible, indicating a need to increase awareness of programmes and address barriers encountered during the application process. Further, evidence from this research indicates that more transformational approaches to social protection design and delivery are necessary, such as providing meaningful coverage for disability-related extra costs and addressing drivers of social exclusion

The experience of sleep for women with borderline personality disorder: An occupational perspective

Introduction: Sleep difficulties are prevalent in borderline personality disorder (BPD); however, the experience of sleep for individuals with a diagnosis of BPD has not been considered from an occupational therapy perspective. Method: This study adopted a qualitative methodology. Semi-structured interviews were utilised to explore how sleep is experienced by four women with a diagnosis of BPD, in an inpatient setting. Interviews were recorded and transcribed verbatim. Findings: Through thematic analysis four themes were identified: ‘there isn’t a proper pattern or structure to my sleeps’, ‘sleep is getting away for me’, ‘before I came in [to the unit] my life-work balance was all chaotic’ and ‘I know the routine, but it doesn’t really seem to affect me’. These findings described the variety of problems experienced by participants in regards to sleep and the implications of sleep difficulties on occupational performance and participation. Conclusion: Women with BPD on an inpatient unit experienced a variety of sleep difficulties which impact on their ability to engage in occupations. Sleep and sleep difficulties should be explicitly addressed by occupational therapists and sleep interventions should be individually tailored; further research is required to examine occupational therapy interventions for sleep

Non-Abelian discrete gauge symmetries in 4d string models

We study the realization of non-Abelian discrete gauge symmetries in 4d field theory and string theory compactifications. The underlying structure generalizes the Abelian case, and follows from the interplay between gaugings of non-Abelian isometries of the scalar manifold and field identifications making axion-like fields periodic. We present several classes of string constructions realizing non-Abelian discrete gauge symmetries. In particular, compactifications with torsion homology classes, where non-Abelianity arises microscopically from the Hanany-Witten effect, or compactifications with non-Abelian discrete isometry groups, like twisted tori. We finally focus on the more interesting case of magnetized branes in toroidal compactifications and quotients thereof (and their heterotic and intersecting duals), in which the non-Abelian discrete gauge symmetries imply powerful selection rules for Yukawa couplings of charged matter fields. In particular, in MSSM-like models they correspond to discrete flavour symmetries constraining the quark and lepton mass matrices, as we show in specific examples.Comment: 58 pages; minor typos corrected and references adde

Electroanalytical thread-device for estriol determination using screen-printed carbon electrodes modified with carbon nanotubes

Microflow systems are powerful analytical tools that explore similar principles of typical flow injection analysis driven to in a microfluidic device. Generally, microfluidic devices can promote a low consumption of reagents and samples, high speed of analysis and possibility of portability. Several advances have been reached applying a simple and low cost device based on cotton thread as microfluidic channel where the transportation of solutions is based on capillary force helped by gravity. In the present work, we have demonstrated the versatility of thread-based electroanalytical devices (μTED) constructed using a cotton thread as the solution channel and screen-printed electrodes (SPE) surface modified with carbon nanotubes (CNT) as electrochemical detectors for the amperometric determination of estriol hormone in pharmaceutical samples. The parameters involved in the amperometric detection and microflow system were studied and optimized, using the best experimental conditions (flow rate of 0.50 μL s−1, 10 mm of analytical path, 2.0 μL of volume of injection and potential of detection of 0.75 V) a linear response was observed for concentration range (LDR) of 1.0 to 1000 μmol L−1 with limits of detection (LOD) and quantification (LOQ) of 0.53 μmolL−1 and 1.77 μmolL−1, respectively, and frequency of injection of 32 per hour. The proposed methodology was applied for determination of estriol in commercial samples and results were compared with those provided by spectrophotometric method (official methodology). The obtained results are in agreement at a 95% of confidence level

Narrative explorations into the professional development of lecturers teaching higher education in English further education colleges

The diversification of settings in which higher education is delivered has resulted in a growing proportion of lecturers entering teaching from professional backgrounds. This is a challenging transition as lecturers are rarely given the space to consider the implications of this move on their identities and practice styles. Writing is recognised as a powerful methodology through which individuals can make sense of experiences and conceptualise them in light of historical, theoretical and social perspectives. In this paper we consider the experiences of 10 college lecturers who used writing to explore this transition as part of a professional development initiative to promote their writing skills. They were providing higher education in further education colleges across South West England. This project ran over two years, involving a year-long professional development intervention and a subsequent evaluation. Over this time the lecturers produced a number of written pieces. We present the different styles and forms of writing used, and how these engaged with their emergent voices and growing sense of legitimacy. We highlight how writing can provide a reflexive medium and assist in the identification of developmental goals, something particularly valuable during professional transitions

A mathematical model for breath gas analysis of volatile organic compounds with special emphasis on acetone

Recommended standardized procedures for determining exhaled lower respiratory nitric oxide and nasal nitric oxide have been developed by task forces of the European Respiratory Society and the American Thoracic Society. These recommendations have paved the way for the measurement of nitric oxide to become a diagnostic tool for specific clinical applications. It would be desirable to develop similar guidelines for the sampling of other trace gases in exhaled breath, especially volatile organic compounds (VOCs) which reflect ongoing metabolism. The concentrations of water-soluble, blood-borne substances in exhaled breath are influenced by: (i) breathing patterns affecting gas exchange in the conducting airways; (ii) the concentrations in the tracheo-bronchial lining fluid; (iii) the alveolar and systemic concentrations of the compound. The classical Farhi equation takes only the alveolar concentrations into account. Real-time measurements of acetone in end-tidal breath under an ergometer challenge show characteristics which cannot be explained within the Farhi setting. Here we develop a compartment model that reliably captures these profiles and is capable of relating breath to the systemic concentrations of acetone. By comparison with experimental data it is inferred that the major part of variability in breath acetone concentrations (e.g., in response to moderate exercise or altered breathing patterns) can be attributed to airway gas exchange, with minimal changes of the underlying blood and tissue concentrations. Moreover, it is deduced that measured end-tidal breath concentrations of acetone determined during resting conditions and free breathing will be rather poor indicators for endogenous levels. Particularly, the current formulation includes the classical Farhi and the Scheid series inhomogeneity model as special limiting cases.Comment: 38 page

Revisiting the symptom iceberg in today's primary care: results from a UK population survey

Peer reviewedPublisher PD

The Carbon_h-Factor: Predicting Individuals' Research Impact at Early Stages of Their Career

Assessing an individual's research impact on the basis of a transparent algorithm is an important task for evaluation and comparison purposes. Besides simple but also inaccurate indices such as counting the mere number of publications or the accumulation of overall citations, and highly complex but also overwhelming full-range publication lists in their raw format, Hirsch (2005) introduced a single figure cleverly combining different approaches. The so-called h-index has undoubtedly become the standard in scientometrics of individuals' research impact (note: in the present paper I will always use the term “research impact” to describe the research performance as the logic of the paper is based on the h-index, which quantifies the specific “impact” of, e.g., researchers, but also because the genuine meaning of impact refers to quality as well). As the h-index reflects the number h of papers a researcher has published with at least h citations, the index is inherently positively biased towards senior level researchers. This might sometimes be problematic when predictive tools are needed for assessing young scientists' potential, especially when recruiting early career positions or equipping young scientists' labs. To be compatible with the standard h-index, the proposed index integrates the scientist's research age (Carbon_h-factor) into the h-index, thus reporting the average gain of h-index per year. Comprehensive calculations of the Carbon_h-factor were made for a broad variety of four research-disciplines (economics, neuroscience, physics and psychology) and for researchers performing on three high levels of research impact (substantial, outstanding and epochal) with ten researchers per category. For all research areas and output levels we obtained linear developments of the h-index demonstrating the validity of predicting one's later impact in terms of research impact already at an early stage of their career with the Carbon_h-factor being approx. 0.4, 0.8, and 1.5 for substantial, outstanding and epochal researchers, respectively

First- and second-order contributions to depth perception in anti-correlated random dot stereograms.

The binocular energy model of neural responses predicts that depth from binocular disparity might be perceived in the reversed direction when the contrast of dots presented to one eye is reversed. While reversed-depth has been found using anti-correlated random-dot stereograms (ACRDS) the findings are inconsistent across studies. The mixed findings may be accounted for by the presence of a gap between the target and surround, or as a result of overlap of dots around the vertical edges of the stimuli. To test this, we assessed whether (1) the gap size (0, 19.2 or 38.4 arc min) (2) the correlation of dots or (3) the border orientation (circular target, or horizontal or vertical edge) affected the perception of depth. Reversed-depth from ACRDS (circular no-gap condition) was seen by a minority of participants, but this effect reduced as the gap size increased. Depth was mostly perceived in the correct direction for ACRDS edge stimuli, with the effect increasing with the gap size. The inconsistency across conditions can be accounted for by the relative reliability of first- and second-order depth detection mechanisms, and the coarse spatial resolution of the latter