From medical relief to community health care: a case study of a non-governmental organisation (Frontier Primary Health Care) in North West Frontier Province, Pakistan

This case study is designed to answer the question whether refugees can make a positive contribution to host countries, not simply as individual participants in economic activity, but by contributing to welfare. The thesis provides a detailed study of an NGO originally established to provide medical relief for refugees but which now provides basic health care for local people. Since 1995 this NGO has adopted a policy of providing the same basic care to refugees and to people in local Pakistani villages, thus making no distinction between refugees and the residents of a specific geographical area. The case study also shows that an NGO can be an appropriate and effective provider of primary health care (PHC) as promoted by the 1978 Declaration of Alma Ata. The thesis uses several approaches to demonstrate why this happened and how it was achieved. Firstly, it narrates the history over the twenty-year period 1980-2000 of an international health project originally started for a group of Afghan refugees, and its transformation in 1995 into an indigenous Pakistani NGO called “Frontier Primary Health Care (FPHC)”. Secondly, the study explores the theoretical utility and limitations of the PHC strategy generally. Thirdly, the thesis provides an analysis of the extent to which the underlying principles or “pillars” of PHC, that is, participation, inter-sectoral collaboration and equity have affected the process and outcomes of the project. Locating the case study in the Pakistani context provides evidence of the persistent difficulties and shortcomings of official government basic health care in Pakistan, particularly for rural poor people, showing that the field is open for other providers of health care, such as NGOs. The thesis goes on to discuss strengths and weaknesses of NGOs in general, and particularly as health care providers. In investigating characteristics of the NGO sector in Pakistan, the study pays special attention to the discrete health care system for Afghan refugees created in the early 1980s, including its introduction of Community Health Workers. In order to assess the impact of the NGO on people’s health, the study uses data from mother/child health and family planning programmes (as far as available) demonstrating that this NGO is a more effective provider than the other two agencies i.e. the Government of Pakistan and the Afghan Refugee Health Programme. Placing the NGO in this context also shows that it has a better understanding of the underlying “pillars” and has made more determined and effective efforts to implement them, especially in regard to community involvement. It is unusual for a project initially refugee-oriented to have matured sufficiently to be making a contribution, as a matter of formal policy, to basic welfare in the host country, itself a developing country. The study concludes that the significant factors in its success are continuity of leadership; boundaries of population, geography and administration; dependable income and material resources; rigorous supervision; support, but not takeover, by experienced consultants; capacity to use learning to adapt and move on; and sensitivity to local cultural norms. All these have enabled the project to survive and develop as an indigenous autonomous organisation beyond the twenty years covered by the case study. FPHC is still operational in 2004

Returning for a Better Life: The Habitus of Temporary Senegalese Male Migrants

In this thesis, I study the narratives and practices which maintain Senegal’s temporary migration regime. This form of migration functions not as an individual endeavor, but rather as a family and community project which provides its participants—migrants and others—with cultural capital and prestige. I consider how the cultural imaginary of Senegalese male migration encourages young men to migrate in search of masculine social adulthood. I ultimately examine the habitus of temporary Senegalese male migrants in order to understand how their migration projects are oriented towards return to Senegal

High pressure processing of foods for microbiological safety and quality

Consumers are demanding foods that are “natural”, of good nutritional and sensory quality, free from chemical preservatives, microbiologically safe and with extended shelf-life. High pressure processing can, potentially, meet these criteria. Recent advances in equipment design now allow foods to be processed up to 900 MegaPascals (130,000 psi). However, further work is required to more fully understand the factors that can affect the response of microorganisms, including pathogens, to pressure so that treatments can be optimised and microbiological safety can be assured. This paper describes how the pressure resistance of microorganisms can vary depending on factors such as species, strain, stage of growth and food composition. Strategies for overcoming the problem of pressure resistance will be discussed, for example the use of pressure cycling and the combination of pressure with mild heat. The current commercial uses of high pressure to preserve foods will be reported and potential applications will also be discussed

Contrasting Adult Literacy Learners With and Without Specific Learning Disabilities

Contrasting adult literacy learners with and without specific learning disabilities This study of 311 adult education (AE) learners found 29% self-reported having a specific learning disability (SLD). Significant differences in demographic, academic, and life experience variables between the adult learners with and without SLD included: prior participation in special education, having both an SLD diagnosis and a high school diploma, low reading scores, middle age, and negative perceptions about limitations due to reading abilities. A post-hoc regression analysis found SLD status significantly contributes to variance in reading level when controlling for age and IQ. From these findings we conclude that SLD status should be considered an educationally relevant variable in adult education that warrants a diagnostic or clinical teaching approach

Program Characteristics that Predict Improved Learner Outcomes

This study identifies adult education program characteristics that predict improved learner outcomes through statistical analyses of data across four years in a single state. Data indicate that, collectively, several predictors contribute to our understanding of learner outcomes, including (a) learner entry level, (b) size of community, (c) staff qualifications, and (d) learner exposure to high quality services. A surprising finding was the lack of robust outcome predictors that maintain consistency from one year to another

The Hα/Hβ ratio in solar flares

We have measured the ratio of Hα to Hβ central intensities in the peak kernels of 14 flares, using simultaneous filtergrams. The ratio is typically one with some scatter. By contrast, in stellar flares the ratio is about 0.8

Perceptions of effective leadership in a medical school context

Background: There have been calls for the development of leadership attributes in healthcare practitioners through leadership development programs. However, understanding how leadership is conceptualized is needed to assure effective participant-centred leadership development programs. The purpose of this study was to elucidate how the construct of leadership is conceptualized by multiple stakeholder groups associated with medical school leadership programs. Methods: We conducted a total of 77 semi-structured interviews with six major demographic groups: Trainees (n= 16), Mid-Level University Leaders (n= 10), Clinician Leaders (n= 17), Senior University Leaders (n= 10), Medical Scientists (n= 12), and Senior Leaders, external to the University (n = 12) to address the research question. Results: Content analyses revealed that the leaders were expectedto create a compelling vision and a foster a motivating culture within the organization. Integrity and a sense of passion about leading were viewed as being principal characteristics of a leader. The twin skills of technical competence and communication were endorsed as most important for a leader. Finally, leaders are expected to be accountable for outcomes. Conclusion: Medical school leadershiptraining programs should strive to incorporate these characteristics, given their broad appeal to diverse interest groups

The Hα/Hβ ratio in solar flares

We have measured the ratio of Hα to Hβ central intensities in the peak kernels of 14 flares, using simultaneous filtergrams. The ratio is typically one with some scatter. By contrast, in stellar flares the ratio is about 0.8

Voicing the unspoken: Breaking through the barriers of mainstream institutionalized deafness to Pacific therapeutic practices

This paper explores the development of two significant crosscultural research projects in Pasifika psychology. Both projects were designed to speak into the “silent space” of unexplored Pasifika practices and needs in the field of mental health