Water Partnership Program Annual Report 2011: "Strengthen, Secure, Sustain"

This annual report outlines the World Bank's Water Partnership Program's activities and progress in its key focus areas of water resources management, climate change, food security, and energy security. The program is a multi-donor trust that was established in 2009 and is transitioning, as of June 2012, into a bolder Phase II of its operations. In addition to investing in research, technology and practice, the program is building partnerships, networks, and capacity, and working towards its new objective of green growth

Platelet Function Testing in Patients with Acute Ischemic Stroke: An Observational Study

Background: The measurement of platelet reactivity in patients with stroke undergoing antiplatelet therapies is not commonly performed in clinical practice. We assessed the prevalence of therapy responsiveness in patients with stroke and further investigated differences between patients on prevention therapy at stroke onset and patients naive to antiplatelet medications. We also sought differences in responsiveness between etiological subtypes and correlations between Clopidogrel responsiveness and genetic polymorphisms. Methods: A total of 624 stroke patients on antiplatelet therapy were included. Two different groups were identified: "non-naive patients", and "naive patients". Platelet function was measured with multiple electrode aggregometry, and genotyping assays were used to determine CYP2C19 polymorphisms. Results: Aspirin (ASA) responsiveness was significantly more frequent in naive patients compared with non-naive patients (94.9% versus 82.6%, P < .0010). A better responsiveness to ASA compared with Clopidogrel or combination therapy was found in the entire population (P < .0010), in non-naive patients (P < .0253), and in naive patients (P < .0010). Multivariate analysis revealed a strong effect of Clopidogrel as a possible "risk factor" for unresponsiveness (odds ratio 3.652, P < .0001). No difference between etiological subgroups and no correlations between responsiveness and CYP2C19 polymorphisms were found. Conclusion: In our opinion, platelet function testing could be potentially useful in monitoring the biological effect of antiplatelet agents. A substantial proportion of patients with stroke on ASA were "resistant", and the treatment with Clopidogrel was accompanied by even higher rates of unresponsiveness. Longitudinal studies are needed to assess whether aggregometry might supply individualized prognostic information and whether it can be considered a valid tool for future prevention strategies

An econometric study of illegal electricity connections in the urban favelas of Belo Horizonte, Brazil

The data from the project "Conviver," launched in 2006 in Belo Horizonte (Brazil), provides a unique opportunity to study illegal electricity connections. Based on an original dataset of 15,279 low-income households, this paper studies the incidence and determinants of illegality in the context of low-income urban favelas. The probability of engaging in illegal behavior is explained not just by low income, but by a combination of concurring factors: sub-standard energy provision and equipment; inefficient/incorrect use of domestic electric appliances and running an informal in-house business. These recurrent issues in the urban favelas aggravate a sense of exclusion from growth, which is generally recognized as a trigger of illegality. The impact of energy demand on energy-related illegality is carefully analyzed, and different empirical strategies adopted to circumvent some simultaneity problem between both decision processes. The effectiveness of consumption-based energy subsidies is also explored. In spite of some contrary arguments in the literature, in the context of peri-urban slums, such measures may exert a positive impact in mitigating illegal access and use of energy. Effectiveness will be enhanced by accompanying measures such as: perceivable improvements of equipment, metering and maintenance, promotion of beneficiaries' awareness of energy usage, and energy-saving behaviors.Slum electrification Energy consumption subsidies Illegal electricity connections