Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania.

Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers' shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants' practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based

Electrode Polarization Effects in Broadband Dielectric Spectroscopy

In the present work, we provide broadband dielectric spectra showing strong electrode polarization effects for various materials, belonging to very different material classes. This includes both ionic and electronic conductors as, e.g., salt solutions, ionic liquids, human blood, and colossal-dielectric-constant materials. These data are intended to provide a broad data base enabling a critical test of the validity of phenomenological and microscopic models for electrode polarization. In the present work, the results are analyzed using a simple phenomenological equivalent-circuit description, involving a distributed parallel RC circuit element for the modeling of the weakly conducting regions close to the electrodes. Excellent fits of the experimental data are achieved in this way, demonstrating the universal applicability of this approach. In the investigated ionically conducting materials, we find the universal appearance of a second dispersion region due to electrode polarization, which is only revealed if measuring down to sufficiently low frequencies. This indicates the presence of a second charge-transport process in ionic conductors with blocking electrodes.Comment: 9 pages, 6 figures, experimental data are provided in electronic form (see "Data Conservancy"

Domestic horses (Equus caballus) discriminate between negative and positive human nonverbal vocalisations

The ability to discriminate between emotion in vocal signals is highly adaptive in social species. It may also be adaptive for domestic species to distinguish such signals in humans. Here we present a playback study investigating whether horses spontaneously respond in a functionally relevant way towards positive and negative emotion in human nonverbal vocalisations. We presented horses with positively- and negatively-valenced human vocalisations (laughter and growling, respectively) in the absence of all other emotional cues. Horses were found to adopt a freeze posture for significantly longer immediately after hearing negative versus positive human vocalisations, suggesting that negative voices promote vigilance behaviours and may therefore be perceived as more threatening. In support of this interpretation, horses held their ears forwards for longer and performed fewer ear movements in response to negative voices, which further suggest increased vigilance. In addition, horses showed a right-ear/left-hemisphere bias when attending to positive compared with negative voices, suggesting that horses perceive laughter as more positive than growling. These findings raise interesting questions about the potential for universal discrimination of vocal affect and the role of lifetime learning versus other factors in interspecific communication

The Flux-Line Lattice in Superconductors

Magnetic flux can penetrate a type-II superconductor in form of Abrikosov vortices. These tend to arrange in a triangular flux-line lattice (FLL) which is more or less perturbed by material inhomogeneities that pin the flux lines, and in high-$T_c$ supercon- ductors (HTSC's) also by thermal fluctuations. Many properties of the FLL are well described by the phenomenological Ginzburg-Landau theory or by the electromagnetic London theory, which treats the vortex core as a singularity. In Nb alloys and HTSC's the FLL is very soft mainly because of the large magnetic penetration depth: The shear modulus of the FLL is thus small and the tilt modulus is dispersive and becomes very small for short distortion wavelength. This softness of the FLL is enhanced further by the pronounced anisotropy and layered structure of HTSC's, which strongly increases the penetration depth for currents along the c-axis of these uniaxial crystals and may even cause a decoupling of two-dimensional vortex lattices in the Cu-O layers. Thermal fluctuations and softening may melt the FLL and cause thermally activated depinning of the flux lines or of the 2D pancake vortices in the layers. Various phase transitions are predicted for the FLL in layered HTSC's. The linear and nonlinear magnetic response of HTSC's gives rise to interesting effects which strongly depend on the geometry of the experiment.Comment: Review paper for Rep.Prog.Phys., 124 narrow pages. The 30 figures do not exist as postscript file

Age-hardening characteristics of Cu–2.4Ni–0.6Si alloy produced by the spray forming process

The microstructural features and heat treatment response of a spray formed Cu–2.4Ni–0.6Si (wt.%) alloy have been investigated. The alloy was aged at 450 ◦C either in the as spray formed condition or after a cold deformation of 40% reduction in original thickness. Some of the samples were subjected to a solution treatment at 900 ◦C for 1 h prior to their cold deformation to 40% of original thickness and subsequent ageing. The variation in hardness and electrical conductivity of the alloys wasmeasured as a function of ageing time. The results indicated the highest peak hardness value of approximately 250 kgfmm−2 for the alloy aged after the solution treatment and cold rolling, compared to the maximum hardness of 220 kgfmm−2 for samples aged directly in as spray formed condition. However, the electrical conductivity was observed to be a maximum of 62% IACS in samples which had only been cold rolled. This behaviour is discussed in the light of microstructural characteristics associated with different processing conditions of this alloy

Exploratory querying of SPARQL endpoints in space and time

The linked data Web provides a simple and flexible way of accessing information resources in a self-descriptive format. This offers a realistic chance of perforating existing data silos. However, in order to do so, space, time and other semantic concepts need to function as dimensions for effectively exploring, querying and filtering contents. While triple stores, SPARQL endpoints, and RDF were designed for machine access, large burdens are still placed on a user to simultaneously explore and query the contents of a given endpoint according to these dimensions. First, one has to know the semantic concepts and the type of knowledge contained in an endpoint a-priori in order to query content effectively. Second, one has to be able to write and understand SPARQL and RDF. And third, one has to understand complex data type literals for space and time. In this article, we propose a way to deal with these challenges by interactive visual query construction, i.e., by letting query results feedback into both (space-time) exploration and filtering, and thus enabling exploratory querying. We propose design principles for SPEX (Spatio-temporal content explorer), a tool which helps people unfamiliar with the content of SPARQL endpoints or their syntax to explore the latter in space and time. In a preliminary user study on a repository of historical maps, we found that our feedback principles were effective, however, that successful question answering still requires improvements regarding space-time filtering, vocabulary explanation and the linking of space-time windows with other displays