369 research outputs found
The promotion of local wellbeing: A primer for policymakers
There is growing interest among policymakers in the promotion of wellbeing as an
objective of public policy. In particular, local authorities have been given powers to
undertake action to promote wellbeing in their area. Recent advances in the academic
literature on wellbeing are giving rise to an increasingly detailed picture of the factors
that determine people’s subjective wellbeing (how they think and feel about their lives).
However, the concept of subjective wellbeing is poorly understood within local
government and much of the evidence base is extremely recent. I therefore review the
literature on the definition, measurement, and determinants of wellbeing, and discuss
some of its implications for local public policy
A Multistage Stochastic Programming Approach to the Dynamic and Stochastic VRPTW - Extended version
We consider a dynamic vehicle routing problem with time windows and
stochastic customers (DS-VRPTW), such that customers may request for services
as vehicles have already started their tours. To solve this problem, the goal
is to provide a decision rule for choosing, at each time step, the next action
to perform in light of known requests and probabilistic knowledge on requests
likelihood. We introduce a new decision rule, called Global Stochastic
Assessment (GSA) rule for the DS-VRPTW, and we compare it with existing
decision rules, such as MSA. In particular, we show that GSA fully integrates
nonanticipativity constraints so that it leads to better decisions in our
stochastic context. We describe a new heuristic approach for efficiently
approximating our GSA rule. We introduce a new waiting strategy. Experiments on
dynamic and stochastic benchmarks, which include instances of different degrees
of dynamism, show that not only our approach is competitive with
state-of-the-art methods, but also enables to compute meaningful offline
solutions to fully dynamic problems where absolutely no a priori customer
request is provided.Comment: Extended version of the same-name study submitted for publication in
conference CPAIOR201
CHY representations for gauge theory and gravity amplitudes with up to three massive particles
We show that a wide class of tree-level scattering amplitudes involving
scalars, gauge bosons, and gravitons, up to three of which may be massive, can
be expressed in terms of a Cachazo-He-Yuan representation as a sum over
solutions of the scattering equations. These amplitudes, when expressed in
terms of the appropriate kinematic invariants, are independent of the masses
and therefore identical to the corresponding massless amplitudes.Comment: 20 pages, 1 figure; v2: minor typos corrected, published versio
Global nuts and local mangoes: a critical reading of the UNDP Growing Sustainable Business Initiative in Kenya
This article provides a conceptual and empirical assessment of UN brokered partnerships that seek to deepen or create inclusive and sustainable agricultural supply chains in sub-Saharan Africa. More specifically it appraises the decision-making mechanisms, processes of partnership brokerage and project implementation within the UNDP Growing Sustainable Business Initiative (GSB) in Kenya. The paper argues that the lack of bottom-up participation in decision-making mechanisms and the predominantly economic imperatives driving the GSB partnership projects have failed to reach out to the partnerships’ intended beneficiaries—Kenyan small producers of nuts and mangoes. In conclusion it is suggested that opening up the GSB platform might hold the promise of reconciling sustainable business models with (some) poverty reduction
SĂndrome de Stevens-Johnson. Apresentação de Caso ClĂnico
Introdução: A SĂndrome de Stevens-Johnson (SSJ) Ă© uma doença mucocutânea rara e potencialmente fatal, mais frequente no sexo masculino, cuja incidĂŞncia aumenta com a idade e em determinados grupos de risco. A SSJ e a NecrĂłlise TĂłxica EpidĂ©rmica (NET) sĂŁo duas entidades da mesma doença, com severidade diferente. A etiologia nĂŁo Ă© clara, mas pensa-se que se deva maioritariamente a reacções adversas a fármacos.
Caso clĂnico: Um jovem de 17 anos de idade, sem antecedentes pessoais relevantes, foi observado no Serviço de UrgĂŞncia por surgimento de lesões maculopapulares, com 3 dias de evolução, dispersas pela face, cavidade oral, tronco e extremidades, com prostração e taquicardia. Foi internado com o diagnĂłstico de SSJ.
Discussão e Conclusões: O SSJ e a NET têm grande morbilidade e considerável mortalidade. O rápido reconhecimento desta identidade, com a remoção do fármaco desencadeador é essencial. A perda da função de barreira da pele, com a consequente alteração da homeostasia, implica muitas vezes a manutenção da terapêutica de suporte em Unidades de Cuidados Intensivos ou de Queimados.info:eu-repo/semantics/publishedVersio
Utilisation of malaria preventive measures during pregnancy and birth outcomes in Ibadan, Nigeria
<p>Abstract</p> <p>Background</p> <p>Malaria remains a major public health problem in sub Saharan Africa and the extent of utilisation of malaria preventive measures may impact on the burden of malaria in pregnancy. This study sought to determine the association between malaria preventive measures utilized during pregnancy and the birth outcomes of birth weight and preterm delivery.</p> <p>Methods</p> <p>This cross sectional survey involved 800 mothers who delivered at the University College Hospital, and Adeoyo Maternity Hospital, Ibadan. Data obtained included obstetric information, gestational age, birth weight and self reported use of malaria prevention strategies in index pregnancy.</p> <p>Results</p> <p>Most (95.6%) mothers used one or more malaria control measures. The most commonly used vector control measures were window net (84.0%), insecticide spray (71.5%) and insecticide treated bed nets (20.1%), while chemoprophylactic agents were pyrimethamine (23.5%), Intermittent Preventive Treatments with Sulphadoxine-Pyrimethamine (IPTsp) (18.5%) and intermittent chloroquine (9.5%) and 21.7% used herbal medications. The mean ± SD birthweight and gestational age of the babies were 3.02 kg ± 0.56 and 37.9 weeks ± 2.5 respectively. Preterm delivery rate was 19.4% and 9% had low birth weight.</p> <p>Comparing babies whose mothers had IPTsp with those who did not, mean birth weight was 3.13 kg ± 0.52 versus 3.0 kg ± 0.56 (p = 0.016) and mean gestational age was 38.5 weeks ± 2.1 versus 37.8 weeks ± 2.5 (p = 0.002).</p> <p>The non-use of IPTsp was associated with increased risk of having low birth weight babies (AOR: 2.27, 95% CI: 0.98; 5.28) and preterm birth (AOR: 1.93, 95% CI: 1.08, 3.44). The non use of herbal preparations (AOR: 0.55, 95% CI: 0.36, 0.85) was associated with reduced risk of preterm birth. The mean ± SD birth weight and gestational ages of babies born to mothers who slept under ITNs were not significantly different from those who did not (p = 0.07 and 0.09 respectively).</p> <p>Conclusions</p> <p>There is a need for improved utilisation of IPTsp as well as discouraging the use of herbal medications in pregnancy in order to reduce pregnancy outcome measures of low birth weight and preterm deliveries in this environment.</p
The cost of uncomplicated childhood fevers to Kenyan households: implications for reaching international access targets
BACKGROUND: Fever is the clinical hallmark of malaria disease. The Roll Back Malaria (RBM) movement promotes prompt, effective treatment of childhood fevers as a key component to achieving its optimistic mortality reduction goals by 2010. A neglected concern is how communities will access these new medicines promptly and the costs to poor households when they are located in rural areas distant to health services. METHODS: We assemble data developed between 2001 and 2002 in Kenya to describe treatment choices made by rural households to treat a child's fever and the related costs to households. Using a cost-of-illness approach, we estimate the expected cost of a childhood fever to Kenyan households in 2002. We develop two scenarios to explore how expected costs to households would change if more children were treated at a health care facility with an effective antimalarial within 48 hours of fever onset. RESULTS: 30% of uncomplicated fevers were managed at home with modern medicines, 38% were taken to a health care facility (HCF), and 32% were managed at home without the use of modern medicines. Direct household cash expenditures were estimated at 1.91. An estimated mean of 1.42 days of caretaker time devoted to each fever accounts for the majority of household costs of managing fevers. The aggregate cost to Kenyan households of managing uncomplicated childhood fevers was at least 1.86 because caretakers also save time with prompt treatment if the child has malaria. CONCLUSION: The management of uncomplicated childhood fevers imposes substantial costs on Kenyan households. Achieving substantial improvements in the numbers of fevers treated within 48 hours at a HCF with an effective antimalarial drug (Scenario 1) will not impose additional costs on households. Achieving additional improvements in fevers treated promptly at a HCF (Scenario 2) will impose additional costs on some households roughly equal to average cash expenses for transportation to a HCF. Additional financing mechanisms that further reduce the costs of accessing care at a HCF and/or that make artemisinin-based combination therapies (ACTs) accessible for home management need to be developed and evaluated as a top priority
Developments in the Ni–Nb–Zr amorphous alloy membranes
Most of the global H2 production is derived from hydrocarbon-based fuels, and efficient H2/CO2 separation is necessary to deliver a high-purity H2 product. Hydrogen-selective alloy membranes are emerging as a viable alternative to traditional pressure swing adsorption processes as a means for H2/CO2 separation. These membranes can be formed from a wide range of alloys, and those based on Pd are the closest to commercial deployment. The high cost of Pd (USD *31,000 kg-1) is driving the development of less-expensive alternatives, including inexpensive amorphous (Ni60Nb40)100-xZrx alloys. Amorphous alloy membranes can be fabricated directly from the molten state into continuous ribbons via melt spinning and depending on the composition can exhibit relatively high hydrogen permeability between 473 and 673 K. Here we review recent developments in these low-cost membrane materials, especially with respect to permeation behavior, electrical transport properties, and understanding of local atomic order. To further understand the nature of these solids, atom probe tomography has been performed, revealing amorphous Nb-rich and Zr-rich clusters embedded in majority Ni matrix whose compositions deviated from the nominal overall composition of the membrane
Chronic non-specific low back pain - sub-groups or a single mechanism?
Copyright 2008 Wand and O'Connell; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Low back pain is a substantial health problem and has subsequently attracted a
considerable amount of research. Clinical trials evaluating the efficacy of a variety of interventions
for chronic non-specific low back pain indicate limited effectiveness for most commonly applied
interventions and approaches.
Discussion: Many clinicians challenge the results of clinical trials as they feel that this lack of
effectiveness is at odds with their clinical experience of managing patients with back pain. A
common explanation for this discrepancy is the perceived heterogeneity of patients with chronic
non-specific low back pain. It is felt that the effects of treatment may be diluted by the application
of a single intervention to a complex, heterogeneous group with diverse treatment needs. This
argument presupposes that current treatment is effective when applied to the correct patient.
An alternative perspective is that the clinical trials are correct and current treatments have limited
efficacy. Preoccupation with sub-grouping may stifle engagement with this view and it is important
that the sub-grouping paradigm is closely examined. This paper argues that there are numerous
problems with the sub-grouping approach and that it may not be an important reason for the
disappointing results of clinical trials. We propose instead that current treatment may be ineffective
because it has been misdirected. Recent evidence that demonstrates changes within the brain in
chronic low back pain sufferers raises the possibility that persistent back pain may be a problem of
cortical reorganisation and degeneration. This perspective offers interesting insights into the
chronic low back pain experience and suggests alternative models of intervention.
Summary: The disappointing results of clinical research are commonly explained by the failure of
researchers to adequately attend to sub-grouping of the chronic non-specific low back pain
population. Alternatively, current approaches may be ineffective and clinicians and researchers may
need to radically rethink the nature of the problem and how it should best be managed
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