The cost of the district hospital : a case study from Malawi

The author analyzes the cost to the Ministry of Health of providing district health services in Malawi, with an emphasis on the cost of the district hospital. She reaches several conclusions : 1) except for drugs and food, there seems to be little scope for major savings in hospital operation costs, unless the flow of patients to the hospital is reduced; 2) to increase the hospital's role in district-wide activities, efforts should be made to increase staff motivation to work outside the hospital; and 3) detailed costing of hospital activities is feasible in a low-income country like Malawi. The author's analysis provides firm evidence to assess district resource allocation patterns by carefully disaggregating district costs by level of care and department. The report focuses on average costs and the distribution of cost by input category, cost center, and direct service department. A strikingly low proportion of district recurrent costs was absorbed by salaries and wages: between 27 and 39 percent, depending on the district; while a surprisingly high proportion was absorbed by drugs and medical stores: between 24 and 37 percent. The hospital's largest cost center - in terms of resources it controlled - was the pharmacy. Average costs by hospital department showed variation by district, with one hospital being consistently the most expensive and another the cheapest.Business Environment,Business in Development,Health Monitoring&Evaluation,Economic Theory&Research,Pharmaceuticals&Pharmacoeconomics

Spatio-temporal patterns in the Hantavirus infection

We present a model of the infection of Hantavirus in deer mouse, Peromyscus maniculatus, based on biological observations of the system in the North American Southwest. The results of the analysis shed light on relevant observations of the biological system, such as the sporadical disappearance of the infection, and the existence of foci or ``refugia'' that perform as reservoirs of the virus when environmental conditions are less than optimal.Comment: 6 pages, 5 inlined figures, RevTeX 4 forma

Comparison of tide-gauge data and a saltmarsh-derived reconstruction of mean sea-level for the Mersey Estuary

Using saltmarsh sediment cores, Mills (2011) reconstructed the historic trend of mean sea-level in the Mersey over a period since 1975. The analysis is based on the foraminifera species identified at different levels within the sediment core; each species being associated with a tidal elevation (for example, mean high water neap) identified from present-day vertical distribution of saltmarsh foraminifera at the coring sites. While the reconstruction at Decoy Marsh matched the tide gauge record at Gladstone Dock, the reconstruction at Oglet Bay for the period 1993 and 2003 disagreed. During this period the reconstruction suggested an initial drop in mean tidal level (MTL) of 50 cm followed by a 50 cm rise back to the underlying trend after 2002. Because a local drop in sea-level (SL) is unlikely, and the foraminifera fossils used in the reconstruction are unlikely to have changed their tolerance to inundation, another factor must account for this sea-level anomaly. Here using the 3D hydrodynamic Proudman Oceanographic Laboratory Coastal Ocean modelling System (POLCOMS), the impact of the position of the main estuarine channel and historic sea-level elevations on the tidal dynamics are investigated relative to the conditions in 2008. Changes in the proportion of time that certain elevations at the saltmarsh coring sites are inundated could explain the deviation observed in the reconstruction. Such an effect is hypothesised to occur in response to local changes in the tidal dynamics, i.e. changes in tidal range or asymmetry in tidal elevation. It is found that in response to changes in channel configuration to test the scenario of a northern channel migrating up-estuary through Oglet Bay, a change in inundation characteristics caused by a change in the bank drying phase of the tidal cycle, may well have contributed to the anomalous reconstruction

Anthropogenic alteration of nutrient supply increases the global freshwater carbon sink

Lakes have a disproportionate effect on the global carbon (C) cycle relative to their area, mediating C transfer from land to atmosphere, and burying organic-C in their sediments. The magnitude and temporal variability of C burial is, however, poorly constrained, and the degree to which humans have influenced lake C cycling through landscape alteration has not been systematically assessed. Here, we report global and biome specific trajectories of lake C sequestration based on 516 lakes and show that some lake C burial rates (i.e., those in tropical forest and grassland biomes) have quadrupled over the last 100 years. Global lake C-sequestration (~0.12 Pg year−1) has increased by ~72 Tg year−1 since 1900, offsetting 20% of annual CO2 freshwater emissions rising to ~30% if reservoirs are included and contributing to the residual continental C sink. Nutrient availability explains ~70% of the observed increase, while rising temperatures have a minimal effect

European mineral statistics 2009-13 : a product of the World Mineral Statistics database

This volume is the latest edition of a series that began in 2002 following the replacement of ‘World Mineral Statistics’ with ‘World Mineral Production’. It contains mineral production, import and export data for more than 70 mineral commodities, for 36 European countries including all EU Member States and EU Candidate Countries, plus Norway and Switzerland. These data are presented in two sections: by individual country and by commodity; the latter is illustrated by graphics. It remains the only freely available and up-to-date publication dedicated to statistical information about minerals and metals in Europe

'Ain el-Gazzareen: Developments in the Old Kingdom settlement

De produktie van steles in het oude Egypt

European Mineral Statistics 2010-14: a product of the World Mineral statistics database

European Mineral Statistics provides statistical information about minerals and metals in Europe. It provides the essential background intelligence for any European minerals-related activities. Production, export and import tables are presented for all EU members and EU candidate countries, plus Norway and Switzerland, in two sections: •by individual country •by commodity, with bullets on salient features and graphics More than 70 different mineral commodities are included from Aluminium to Zirconium, plus statistics relating to primary aggregates and cement. The book also includes commentary discussing the different categories of minerals – construction minerals, industrial minerals, metals and energy minerals – in the European context and contains general information on the compilation of data

A single transcription factor is sufficient to induce and maintain secretory cell architecture

We hypothesized that basic helix–loop–helix (bHLH) MIST1 (BHLHA15) is a “scaling factor” that universally establishes secretory morphology in cells that perform regulated secretion. Here, we show that targeted deletion of MIST1 caused dismantling of the secretory apparatus of diverse exocrine cells. Parietal cells (PCs), whose function is to pump acid into the stomach, normally lack MIST1 and do not perform regulated secretion. Forced expression of MIST1 in PCs caused them to expand their apical cytoplasm, rearrange mitochondrial/lysosome trafficking, and generate large secretory granules. Mist1 induced a cohort of genes regulated by MIST1 in multiple organs but did not affect PC function. MIST1 bound CATATG/CAGCTG E boxes in the first intron of genes that regulate autophagosome/lysosomal degradation, mitochondrial trafficking, and amino acid metabolism. Similar alterations in cell architecture and gene expression were also caused by ectopically inducing MIST1 in vivo in hepatocytes. Thus, MIST1 is a scaling factor necessary and sufficient by itself to induce and maintain secretory cell architecture. Our results indicate that, whereas mature cell types in each organ may have unique developmental origins, cells performing similar physiological functions throughout the body share similar transcription factor-mediated architectural “blueprints.

Millimeter-scale unipolar transport in high sensitivity organic-inorganic semiconductor X-Ray detectors

Hybrid inorganic-in-organic semiconductors are an attractive class of materials for optoelectronic applications. Traditionally, the thicknesses of organic semiconductors are kept below 1 micron due to poor charge transport in such systems. However, recent work suggests that charge carriers in such organic semiconductors can be transported over centimeter length scales opposing this view. In this work, a unipolar X-ray photoconductor based on a bulk heterojunction architecture, consisting of poly(3-hexylthiophene), a C70 derivative and high atomic number bismuth oxide nanoparticles operating in the 0.1 – 1 mm thickness regime is demonstrated, having a high sensitivity of ~160 µCmGy-1cm-3. The high performance enabled by hole drift lengths approaching a millimeter facilitates a device architecture allowing a high fraction of the incident X-rays to be attenuated. An X-ray imager is demonstrated with sufficient resolution for security applications such as portable baggage screening at border crossings and public events and scalable medical applications

Direct sublattice imaging of interface dislocation structures in CdTe/GaAs(001)

This paper presents directly interpretable atomic resolution images of dislocation structures at interfaces in CdTe/GaAs(001) systems. This is achieved using the technique of Z-contrast imaging in a 300 kV scanning transmission electron microscope in conjunction with maximum entropy image analysis. In addition to being used to further the understanding of the relation between growth conditions and exhibited properties, the data presented provides direct information on the atomic arrangements at dislocation cores