Environmental Policy Update 2012: Development Strategies and Environmental Policy in East Africa

The seven chapters that comprise this report explore ways to integrate sustainability goals and objectives into Ethiopia's current development strategies

Need for better and broader training in cardio-obstetrics: A national survey of cardiologists, cardiovascular team members, and cardiology fellows in training

Background Team-based models of cardio-obstetrics care have been developed to address the increasing rate of maternal mortality from cardiovascular diseases. Cardiovascular clinician and trainee knowledge and comfort with this topic, and the extent of implementation of an interdisciplinary approach to cardio-obstetrics, are unknown. Methods and Results We aimed to assess the current state of cardio-obstetrics knowledge, practices, and services provided by US cardiovascular clinicians and trainees. A survey developed in conjunction with the American College of Cardiology was circulated to a representative sample of cardiologists (N=311), cardiovascular team members (N=51), and fellows in training (N=139) from June 18, 2020, to July 29, 2020. Knowledge and attitudes about the provision of cardiovascular care to pregnant patients and the prevalence and composition of cardio-obstetrics teams were assessed. The widest knowledge gaps on the care of pregnant compared with nonpregnant patients were reported for medication safety (42%), acute coronary syndromes (39%), aortopathies (40%), and valvular heart disease (30%). Most respondents (76%) lack access to a dedicated cardio-obstetrics team, and only 29% of practicing cardiologists received cardio-obstetrics didactics during training. One third of fellows in training reported seeing pregnant women 0 to 1 time per year, and 12% of fellows in training report formal training in cardio-obstetrics. Conclusions Formalized training in cardio-obstetrics is uncommon, and limited access to multidisciplinary cardio-obstetrics teams and large knowledge gaps exist among cardiovascular clinicians. Augmentation of cardio-obstetrics education across career stages is needed to reduce these deficits. These survey results are an initial step toward developing a standard expectation for clinicians\u27 training in cardio-obstetrics

Embedding mentoring to support trial processes and implementation fidelity in a randomised controlled trial of vocational rehabilitation for stroke survivors

Background: Little guidance exists regarding how best to upskill and support those delivering complex healthcareinterventions to ensure robust trial outcomes and implementation fidelity. Mentoring was provided to occupationaltherapists (OTs) delivering a complex vocational rehabilitation (VR) intervention to stroke survivors. This study aimedto explore mentors’ roles in supporting OTs with intervention delivery and fidelity, and to describe factors affectingthe mentoring process and intervention delivery.Methods: Quantitative data (duration, mode and total time of mentoring support) was extracted from mentoringrecords and emails between mentors and OTs, alongside qualitative data on barriers and facilitators to interventiondelivery. Semi-structured interviews with mentors (n = 6) and OTs (n = 19) explored experiences and perceptions ofintervention training, delivery and the mentoring process. Mean total and monthly time spent mentoring werecalculated per trial site. Qualitative data were analysed thematically.Results: Forty-one OTs across 16 sites were mentored between March 2018 and April 2020. Most mentoring wasprovided by phone or Microsoft Teams (range: 88.6–100%), with the remainder via email and SMS (Short MessageService) text messages. Mentors suggested strategies to enhance trial recruitment, improved OTs’ understanding ofandadherence to trial processes, intervention delivery and fidelity, and facilitated independent problem-solving.Barriers to mentoring included OT non-attendance at mentoring sessions and mentors struggling to balancementoring with clinical roles. Facilitators included support from the trial team and mentors having protected timefor mentoring.Conclusions: Mentoring supported mentee OTs in various ways, but it remains unclear to what extent the OTSwould have been able to deliver the intervention without mentoring support, or how this might have impactedfidelity. Successful implementation of mentoring alongside new complex interventions may increase the likelihoodof intervention effectiveness being observed and sustained in real-life contexts. Further research is needed toinvestigate how mentors could be selected, upskilled, funded and mentoring provided to maximise impact. Theclinical- and cost-effectiveness of mentoring as an implementation strategy and its impact on fidelity also requirestesting in a future trial

US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017.Comment: 102 pages + reference

Immigrant Labour Market Assimilation and Arrival Effects: Evidence from the Labour Force Survey.

We estimate models of earnings and employment outcomes for a sample of white and non-white male immigrants drawn from the Labour Force Survey between 1993 and 2002. Two hypotheses are investigated: (i) whether immigrant outcomes assimilate towards those of natives and (ii) whether labour market conditions at time of entry to the UK labour market have a permanent impact on outcomes. We find positive earnings assimilation for all immigrant groups and strong employment assimilation for those immigrants who complete their education in the UK. We find negative employment assimilation for South Asian immigrants who completed their education overseas. There is some evidence of unemployment rates at time of entry to the labour market causing permanently lower earnings for non-white immigrants.Immigrants, assimiation, earnings, employment.

The Over-Education of UK Immigrants: Evidence from the Labour Force Survey.

We investigate the incidence of over-education, as well as the effect on earnings, for immigrants and natives drawn from the Labour Force Survey between 1993 and 2003. This paper investigates whether immigrants are more or less likely to be over and under-educated than are natives and if there is any evidence of economic assimilation in such propensity differences. In addition we examine whether immigrants exhibit a larger or smaller earnings for over-education compared to natives. We find that native born non-whites and immigrants are more likely to be over-educated, even after conditioning on all other socio-economic factors (including ethnicity and English speaking country of origin). However, we also find evidence of assimilation in the incidence of immigrant over-education towards that of natives. Finally, we find that over-education implies a lower return to earnings for immigrants and non-white natives, compared to native born whites. The largest loss in earnings due to over-education actually applies to white education entrants, moreover we find no significant return to over-education for non-white labour market entrants, once we distinguish between these two immigrant groups.over-education, earnings, immigrants, assimilation.

The relative income hypothesis: does it exist over time? Evidence from the BHPS.

The relative income hypothesis suggests that income inequality has a detrimental affect on people´s health. This previously well accepted relationship has recently come under scrutiny. Some claim it is a statistical artefact, while others argue that aggregate level data are not sophisticated enough to adequately test for its existence. This paper adds to the debate by estimating the relationship between income inequality and health using panel data. A random effects ordered probit is used to estimate the relationship between net household income, regional income inequality and self-reported health, for 3736 individuals over 9 years, while controlling for individual socioeconomic characteristics like gender, social class and age. Significant differences in income inequality across regions and considerable changes in health are found across years, however, the panel data estimating regressions find no significant association between any of the measures of income inequality and self-reported health. Therefore, it would appear that the relative income hypothesis does not exist over time and does not exist within Britain.Self rated health, income inequalities, random effects ordered probit, BHPS

Immigrant Wage Differentials, Ethnicity and Occupational Clustering.

The economic performance and a related discussion on the existence, or otherwise, of racial discrimination in the UK labour market for migrants and ethnic minorities are of great interest to policymakers. In this paper we investigate the concept of occupational clustering as an explanation for the relatively poor earnings performance of non-white migrants and non-white natives. Although occupational clustering and other human capital and socio-economic factors provide a partial explanation for the raw earnings differential, evidence of ethnic based disadvantage persists.Discrimination, earnings, occupation.