Technology adoption and the role of government: examining the national information and communication technology policies in developing countries

With this dissertation, I seek to provide an in-depth understanding of the role developing country governments can play in accelerating ICT adoption. By analyzing the institutional, technology, and market factors, this study seeks to provide a solid foundation for examining the design and implementation of successful ICT strategies. This research uses a combination of empirical and case study evidence to highlight the key challenges of reforming ICT policies and institutions within developing countries. Further, this study clarifies the role of national governments in sponsoring and promoting ICT access and usage. Currently, there is a growing disparity between those developing countries that have successfully integrated ICTs into their economies and those that have not. Many developing countries have created national ICT policies and institutions to bolster technological deployment with the goal of supporting productivity gains and new business development. However, for many countries, these initiatives have not translated to higher levels of ICT adoption or improved economic development. This has left developing country governments with a great deal of uncertainty over what policies to implement and which initiatives to fund. The case study analysis within this study has identified several key barriers to accelerating ICT adoption within developing countries. These barriers include a lack of affordable services, low levels of local expertise, and poor infrastructure, which combine to prevent latecomer countries from developing self-sustaining demand within the sector. This study’s results suggest that the critical determinant for overcoming these barriers is a high level of government involvement after ICT market privatization. Those developing countries with accelerated growth in their ICT sectors tend to have institutions capable of adapting their policies and institutions to the rapid pace technological and market evolution. This is also confirmed by my empirical research, which showed a positive and significant relationship between ICT institutions and levels of ICT adoption, while controlling for economic and social factors. In contrast, those developing country governments without an active role in regulating ICT competition or supporting ICT adoption and innovation have been unable to sustain rapid growth of their sector

Prioritizing Key Resilience Indicators to Support Coral Reef Management in a Changing Climate

Managing coral reefs for resilience to climate change is a popular concept but has been difficult to implement because the empirical scientific evidence has either not been evaluated or is sometimes unsupportive of theory, which leads to uncertainty when considering methods and identifying priority reefs. We asked experts and reviewed the scientific literature for guidance on the multiple physical and biological factors that affect the ability of coral reefs to resist and recover from climate disturbance. Eleven key factors to inform decisions based on scaling scientific evidence and the achievability of quantifying the factors were identified. Factors important to resistance and recovery, which are important components of resilience, were not strongly related, and should be assessed independently. The abundance of resistant (heat-tolerant) coral species and past temperature variability were perceived to provide the greatest resistance to climate change, while coral recruitment rates, and macroalgae abundance were most influential in the recovery process. Based on the 11 key factors, we tested an evidence-based framework for climate change resilience in an Indonesian marine protected area. The results suggest our evidence-weighted framework improved upon existing un-weighted methods in terms of characterizing resilience and distinguishing priority sites. The evaluation supports the concept that, despite high ecological complexity, relatively few strong variables can be important in influencing ecosystem dynamics. This is the first rigorous assessment of factors promoting coral reef resilience based on their perceived importance, empirical evidence, and feasibility of measurement. There were few differences between scientists\u27 perceptions of factor importance and the scientific evidence found in journal publications but more before and after impact studies will be required to fully test the validity of all the factors. The methods here will increase the feasibility and defensibility of including key resilience metrics in evaluations of coral reefs, as well as reduce costs. Adaptation, marine protected areas, priority setting, resistance, recovery

Laparoscopic vs. open feeding jejunostomy insertion in oesophagogastric cancer.

BACKGROUND: Jejunal feeding is an invaluable method by which to improve the nutritional status of patients undergoing neoadjuvant and surgical treatment of oesophageal malignancies. However, the insertion of a feeding jejunostomy can cause significant postoperative morbidity. The aim of this study is to compare the outcomes of patients undergoing placement of feeding jejunostomy by conventional laparotomy with an alternative laparoscopic approach. METHODS: A retrospective review of data prospectively collected at the Oxford Oesophagogastric Centre between August 2017 and July 2019 was performed including consecutive patients undergoing feeding jejunostomy insertion. RESULTS: In the study period, 157 patients underwent jejunostomy insertion in the context of oesophageal cancer therapy, 126 (80%) by open technique and 31 (20%) laparoscopic. Pre-operative demographic and nutritional characteristics were broadly similar between groups. In the early postoperative period jejunostomy-associated complications were noted in 54 cases (34.4%) and were significantly more common among those undergoing open as compared with laparoscopic insertion (38.1% vs. 19.3%, P = 0.049). Furthermore, major complications were more common among those undergoing open insertion, whether as a stand-alone or at the time of staging laparoscopy (n = 11/71), as compared with insertion at the time of oesophagectomy (n = 3/86, P = 0.011). CONCLUSIONS: This report represents the largest to our knowledge single-centre comparison of open vs. laparoscopic jejunostomy insertion in patients undergoing oesophagectomy in the treatment of gastroesophageal malignancy. We conclude that the laparoscopic jejunostomy insertion technique described represents a safe and effective approach to enteral access which may offer superior outcomes to conventional open procedures

Reforming UK health care to improve health

The current debate about reforming the NHS is surprising in a number of ways. Timmins (1988) points out that it was unforeseen and not part of the Government’s main concerns after winning the election in June 1987. It is surprising in another way because it is only six years ago since there was another debate about the NHS which resulted in no radical change. This raises two questions: what was it that led to the debate emerging so quickly in late 1987, and what has happened in the last six years which could lead to the current debate producing proposals for change in contrast to the debate of six years ago? Timmins (1988) supplies a clear guide to the first question, and it is not our purpose to add to his account. What matters for this paper is that the way the debate was forced onto the political agenda has understandably largely determined the initial focus of the Government’s secret Review, and the wider-public debate which has sought to influence that Review. The Review was a response to an alleged financial crisis in the NHS and closures of acute hospital beds. These may be seen as inevitable consequences of policies of giving priority to services other than acute within a total constrained by cash planning with cumulative underfunding of inflation since 1982-83 (Timmins, 1989). A purpose of the financial squeeze of cash planning was to create incentives for more efficient use of health care resources: DHSS performance indicators suggest considerable variations between districts in the intensity with which resources are used. Unfortunately, using resources more intensively commonly increases total costs, and does not therefore necessarily ease financial pressures. To set the context for a different approach, new values were taken to be important for a service created in a time of rationing: the need to regard patients as “consumers” and to provide choice to enable those who are able to pay more to get benefits from doing so. Introducing choice implies ending the virtual monopoly of the state over finance and delivery of service. Greater pluralism in finance has been seen as one way of easing financial pressures on health care, because private finance of health care in the UK is much lower than in the other OECD countries (OECD, 1987). The context of the Review has thus resulted in concerns with finance, acute medicine and introducing consumerism. It is assumed that providing more acute care in response to consumers’ choices will be beneficial. Introducing choice into the finance and provision of health care means that individuals can buy convenience and luxury privately and it is intended that hospitals through competing in a market will become more “efficient” 9i.e. reduce costs). Some changes may not, however, be without problems: they may lead to dual standards of care; and will the “efficient” hospital actually be more attractive to patients – another supposed benefit of choice? Thus attempting to introduce consumer choice may threaten other values which are the concern of this paper: promoting equity of access according to health care according to need; and improving the impact on health outcomes from the limited budget available for health care in the UK. The primary questions considered by this paper are: how effective are different types of health care, is the current balance between these types appropriate, and how could this balance be altered to improve cost-effectiveness and equity? This paper argues that answers to these primary questions require research into health care rather than the imposition of generalised solutions which are deemed to work in organising the production and distribution of other economic commodities. Health care differs from other economic commodities in three important respects. Firstly, as is explained below, there is consensus that those in need of care ought not to be denied access on ground of ability to pay, hence equity is a fundamental objective. Secondly, “consumers” of health care do not know how ill they are, what methods of diagnosis and treatment are available, their likely costs and outcomes. And indeed an important part of the relationship established between “consumers” and their physicians may include passing the burden of making decisions on diagnosis and treatment to physicians (McGuire et al, 1985). Thirdly, little is known about the effectiveness of most health care. Fuchs (1985) suggested, as a plausible hypothesis, that 80% of secondary care improves individual patients’ health, 10% has no effect, and 10% reduces health status, but that we do not know for much of health care the category to which different components belong. This paper examines below the current fashion for introducing a provider (or “internal” market) into UK health care. Without research to illuminate further what such change might lead to, the UK would be repeating mistakes of previous reorganisations of health care. The NHS was reorganised in the 1970s on the basis of a belief in planning, and in the mid 1980s on a belief in management. These reorganisations have been based on passing fashions, rather than a well-researched argument about how to optimise the use of scarce resources available for health care for improved health. Although the organisation of health care needs to take account of changing views about the most effective ways of organising enterprises, it is also necessary to recognise the elusive nature of assessing effectiveness in health care and the little we know about the cost-effectiveness of these activities.reform, equity, efficiency

Effect of glass markings on drinking rate in social alcohol drinkers.

BACKGROUND: The main aim of these studies was to explore the influence of volume information on glassware on the time taken to consume an alcoholic beverage. METHODS: In Study 1, male and female social alcohol consumers ( n = 159) were randomised to drink 12 fl oz of either low or standard strength lager, from either a curved glass marked with yellow tape at the midpoint or an unmarked curved glass, in a between-subjects design. In Study 2, male and female social alcohol consumers ( n = 160) were randomised to drink 12 fl oz of standard strength lager from either a curved glass marked with ¼, ½ and ¾ volume points or an unmarked curved glass, in a between-subjects design. The primary outcome measure for both studies was total drinking time of an alcoholic beverage. RESULTS: In Study 1, after removing outliers, total drinking time was slower from the glass with midpoint volume marking [mean drinking times (min): 9.98 (marked) vs. 9.55 (unmarked), mean difference = 0.42, 95% CI: -0.90, 1.44]. In Study 2, after removing outliers, total drinking time was slower from the glass with multiple volume marks [mean drinking times: 10.34 (marked) vs. 9.11 (unmarked), mean difference = 1.24, 95% CI: -0.11, 2.59]. However, in both studies confidence intervals were wide and also consistent with faster consumption from marked glasses. CONCLUSION: Consumption of an alcoholic beverage may be slower when served in glasses with volume information. Replication in larger studies is warranted

Effect of Cyclic Heat Stress on Hypothalamic Oxygen Homeostasis and Inflammatory State in the Jungle Fowl and Three Broiler-Based Research Lines

Heat stress (HS) is devastating to poultry production sustainability due its detrimental effects on performance, welfare, meat quality, and profitability. One of the most known negative effects of HS is feed intake depression, which is more pronounced in modern high-performing broilers compared to their ancestor unselected birds, yet the underlying molecular mechanisms are not fully defined. The present study aimed, therefore, to determine the hypothalamic expression of a newly involved pathway, hypoxia/oxygen homeostasis, in heat-stressed broiler-based research lines and jungle fowl. Three populations of broilers (slow growing ACRB developed in 1956, moderate growing 95RB from broilers available in 1995, and modern fast growing MRB from 2015) and unselected Jungle fowl birds were exposed to cyclic heat stress (36 degrees C, 9 h/day for 4 weeks) in a 2 x 4 factorial experimental design. Total RNAs and proteins were extracted from the hypothalamic tissues and the expression of target genes and proteins was determined by real-time quantitative PCR and Western blot, respectively. It has been previously shown that HS increased core body temperature and decreased feed intake in 95RB and MRB, but not in ACRB or JF. HS exposure did not affect the hypothalamic expression of HIF complex, however there was a line effect for HIF-1 alpha (P = 0.02) with higher expression in JF under heat stress. HS significantly up regulated the hypothalamic expression of hemoglobin subunits (HBA1, HBBR, HBE, HBZ), and HJV in ACRB, HBA1 and HJV in 95RB and MRB, and HJV in JF, but it down regulated FPN1 in JF. Additionally, HS altered the hypothalamic expression of oxygen homeostasis- up and down-stream signaling cascades. Phospho-AMPK(Thr172) was activated by HS in JF hypothalamus, but it decreased in that of the broiler-based research lines. Under thermoneutral conditions, p-AMPK(Thr172) was higher in broiler-based research lines compared to JF. Ribosomal protein S6K1, however, was significantly upregulated in 95RB and MRB under both environmental conditions. HS significantly upregulated the hypothalamic expression of NF-kappa B2 in MRB, RelB, and TNF alpha in ACRB, abut it down regulated RelA in 95RB. The regulation of HSPs by HS seems to be family- and line-dependent. HS upregulated the hypothalamic expression of HSP60 in ACRB and 95RB, down regulated HSP90 in JF only, and decreased HSP70 in all studied lines. Taken together, this is the first report showing that HS modulated the hypothalamic expression of hypoxia- and oxygen homeostasis-associated genes as well as their up- and down-stream mediators in chickens, and suggests that hypoxia, thermotolerance, and feed intake are interconnected, which merit further in-depth investigations

The contribution of statistical physics to evolutionary biology

Evolutionary biology shares many concepts with statistical physics: both deal with populations, whether of molecules or organisms, and both seek to simplify evolution in very many dimensions. Often, methodologies have undergone parallel and independent development, as with stochastic methods in population genetics. We discuss aspects of population genetics that have embraced methods from physics: amongst others, non-equilibrium statistical mechanics, travelling waves, and Monte-Carlo methods have been used to study polygenic evolution, rates of adaptation, and range expansions. These applications indicate that evolutionary biology can further benefit from interactions with other areas of statistical physics, for example, by following the distribution of paths taken by a population through time.Comment: 18 pages, 3 figures, glossary. Accepted in Trend in Ecology and Evolution (to appear in print in August 2011