162 research outputs found

    Invisibility in billiards

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    The question of invisibility for bodies with mirror surface is studied in the framework of geometrical optics. We construct bodies that are invisible/have zero resistance in two mutually orthogonal directions, and prove that there do not exist bodies which are invisible/have zero resistance in all possible directions of incidence

    Multistate Shigellosis Outbreak and Commercially Prepared Food, United States

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    In 2000, shigellosis traced to a commercially prepared dip developed in 406 persons nationwide. An ill employee may have inadvertently contaminated processing equipment. This outbreak demonstrates the vulnerability of the food supply and how infectious organisms can rapidly disseminate through point-source contamination of a widely distributed food item

    Getting it right when budgets are tight: Using optimal expansion pathways to prioritize responses to concentrated and mixed HIV epidemics.

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    BACKGROUND: Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain. METHODS: We examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package was used to estimate the optimal distribution of resources across interventions associated with a range of budget envelopes. We constructed "investment staircases", a useful tool for understanding investment priorities. These were used to estimate the best attainable cost-effectiveness of the response at each investment level. FINDINGS: We find that when budgets are very limited, the optimal HIV response consists of a smaller number of 'core' interventions. As budgets increase, those core interventions should first be scaled up, and then new interventions introduced. We estimate that the cost-effectiveness of HIV programming decreases as investment levels increase, but that the overall cost-effectiveness remains below GDP per capita. SIGNIFICANCE: It is important for HIV programming to respond effectively to the overall level of funding availability. The analytic tools presented here can help to guide program planners understand the most cost-effective HIV responses and plan for an uncertain future

    How should HIV resources be allocated? Lessons learnt from applying Optima HIV in 23 countries.

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    INTRODUCTION: With limited funds available, meeting global health targets requires countries to both mobilize and prioritize their health spending. Within this context, countries have recognized the importance of allocating funds for HIV as efficiently as possible to maximize impact. Over the past six years, the governments of 23 countries in Africa, Asia, Eastern Europe and Latin America have used the Optima HIV tool to estimate the optimal allocation of HIV resources. METHODS: Each study commenced with a request by the national government for technical assistance in conducting an HIV allocative efficiency study using Optima HIV. Each study team validated the required data, calibrated the Optima HIV epidemic model to produce HIV epidemic projections, agreed on cost functions for interventions, and used the model to calculate the optimal allocation of available funds to best address national strategic plan targets. From a review and analysis of these 23 country studies, we extract common themes around the optimal allocation of HIV funding in different epidemiological contexts. RESULTS AND DISCUSSION: The optimal distribution of HIV resources depends on the amount of funding available and the characteristics of each country's epidemic, response and targets. Universally, the modelling results indicated that scaling up treatment coverage is an efficient use of resources. There is scope for efficiency gains by targeting the HIV response towards the populations and geographical regions where HIV incidence is highest. Across a range of countries, the model results indicate that a more efficient allocation of HIV resources could reduce cumulative new HIV infections by an average of 18% over the years to 2020 and 25% over the years to 2030, along with an approximately 25% reduction in deaths for both timelines. However, in most countries this would still not be sufficient to meet the targets of the national strategic plan, with modelling results indicating that budget increases of up to 185% would be required. CONCLUSIONS: Greater epidemiological impact would be possible through better targeting of existing resources, but additional resources would still be required to meet targets. Allocative efficiency models have proven valuable in improving the HIV planning and budgeting process

    Leveraging human capital to reduce maternal mortality in India: enhanced public health system or public-private partnership?

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    Developing countries are currently struggling to achieve the Millennium Development Goal Five of reducing maternal mortality by three quarters between 1990 and 2015. Many health systems are facing acute shortages of health workers needed to provide improved prenatal care, skilled birth attendance and emergency obstetric services – interventions crucial to reducing maternal death. The World Health Organization estimates a current deficit of almost 2.4 million doctors, nurses and midwives. Complicating matters further, health workforces are typically concentrated in large cities, while maternal mortality is generally higher in rural areas. Additionally, health care systems are faced with shortages of specialists such as anaesthesiologists, surgeons and obstetricians; a maldistribution of health care infrastructure; and imbalances between the public and private health care sectors. Increasingly, policy-makers have been turning to human resource strategies to cope with staff shortages. These include enhancement of existing work roles; substitution of one type of worker for another; delegation of functions up or down the traditional role ladder; innovation in designing new jobs;transfer or relocation of particular roles or services from one health care sector to another. Innovations have been funded through state investment, public-private partnerships and collaborations with nongovernmental organizations and quasi-governmental organizations such as the World Bank. This paper focuses on how two large health systems in India – Gujarat and Tamil Nadu – have successfully applied human resources strategies in uniquely different contexts to the challenges of achieving Millennium Development Goal Five

    Media practice and new approaches to mise-en-scene and auteur theory in broadcast radio

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    This PhD by Published Work aims to present a coherent programme of original radio research practice produced by the author and placed in an appropriate academic context that explores new approaches to mise-en-scùne and auteur theory. The research methodology employs an interrogation of traditional definitions of mise-en-scùne and auteur and then reframes and adopts redefinitions of these theories when used to contextualise broadcast radio. The portfolio consists of the scripts and broadcast recordings of a set of five original BBC Radio 4 plays, and includes reference to a set of related academic publications and conference papers in which critical reflection about the media and creative practice of writing the plays took place. The work draws on approaching four decades of experience as a professional freelance writer and performer. The practice-based research focuses on explorations of the inter-relationships between the form, content and production of the five original radio dramas he was commissioned to write. All of the plays were broadcast by BBC Radio 4, the major public service arena available for radio drama in the United Kingdom, from 2000 to 2012. These years constituted a period of significant change in creative and administrative protocols at the BBC, and form the context for exploration of auteur innovations. The dramas achieved considerable critical attention attracting favourable reviews and provoking public debate. For example, Bell in the Ball (2010) prompted a discussion concerning writing about disability on the BBC’s In Touch programme (2010). It is a significant marker of their quality that a number of the plays have been repeated on various BBC Radio channels, as well as broadcast overseas. As part of the critical interrogation of the author’s media and creative practice, excerpts of the plays have also been included in academic papers presented at national and international conferences

    ‘The lion's den’: Social workers' understandings of risk to infants

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    Recent research has highlighted the increasing trends in newborn and very young children entering child welfare processes and care proceedings in a number of countries. Furthermore, differential responses to risk within young families across different geographical locations and communities in the same child protection system have been found. Safe care arrangements for newborn babies may include placement with kinship carers, or with foster carers not previously known to the family. The distinctive needs of the increasing population of infants in the care system are only beginning to be fully recognised. The short and long term impact of contested infant removals on birth mothers has been powerfully highlighted, although the impact on fathers remains under-reported. There has been limited research evidence available on how decisions about the care arrangements for newborn babies are reached. In this paper, the author draws on data from an ethnographic study of pre-birth child protection in order to explore how social workers understand and frame risk to infants when assessing families during pregnancy. Data from interviews with practitioners reveal the extent to which their conceptualisations of and anxiety about risks to unborn babies, shape plans for the future care of infants

    Lessons from the removal of lead from gasoline for controlling other environmental pollutants: A case study from New Zealand

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    <p>Abstract</p> <p>Background</p> <p>It took over two decades to achieve the removal of leaded gasoline in this country. This was despite international evidence and original research conducted in New Zealand on the harm to child cognitive function and behaviour from lead exposure.</p> <p>Objective</p> <p>To identify lessons from the New Zealand experience of removing leaded gasoline that are potentially relevant to the control of other environmental pollutants.</p> <p>Discussion</p> <p>From the available documentation, we suggest a number of reasons for the slow policy response to the leaded gasoline hazard. These include: (1) industry power in the form of successful lobbying by the lead additive supplier, Associated Octel; (2) the absence of the precautionary principle as part of risk management policy; and (3) weak policymaking machinery that included: (a) the poor use of health research evidence (from both NZ and internationally), as well as limited use of expertise in academic and non-governmental organisations; (b) lack of personnel competent in addressing technically complex issues; and (c) diffusion of responsibility among government agencies.</p> <p>Conclusion</p> <p>There is a need for a stronger precautionary approach by policymakers when considering environmental pollutants. Politicians, officials and health workers need to strengthen policymaking processes and effectively counter the industry tactics used to delay regulatory responses.</p

    Getting it right when budgets are tight: Using optimal expansion pathways to prioritize responses to concentrated and mixed HIV epidemics

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    Published: October 3, 2017Background: Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain. Methods: We examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package was used to estimate the optimal distribution of resources across interventions associated with a range of budget envelopes. We constructed “investment staircases”, a useful tool for understanding investment priorities. These were used to estimate the best attainable cost-effectiveness of the response at each investment level. Findings: We find that when budgets are very limited, the optimal HIV response consists of a smaller number of ‘core’ interventions. As budgets increase, those core interventions should first be scaled up, and then new interventions introduced. We estimate that the cost-effectiveness of HIV programming decreases as investment levels increase, but that the overall cost-effectiveness remains below GDP per capita. Significance: It is important for HIV programming to respond effectively to the overall level of funding availability. The analytic tools presented here can help to guide program planners understand the most cost-effective HIV responses and plan for an uncertain future.Robyn M. Stuart, Cliff C. Kerr, Hassan Haghparast-Bidgoli, Janne Estill, Laura Grobicki, Zofia Baranczuk, Lorena Prieto, Vilma Montañez, Iyanoosh Reporter, Richard T. Gray, Jolene Skordis-Worrall, Olivia Keiser, Nejma Cheikh, Krittayawan Boonto, Sutayut Osornprasop, Fernando Lavadenz, Clemens J. Benedikt, Rowan Martin-Hughes, S. Azfar Hussain, Sherrie L. Kelly, David J. Kedziora, David P. Wilso
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