The Age of the Universe and the Cosmological Constant Determined from Cosmic Microwave Background Anisotropy Measurements

If Omega_tot = 1 and structure formed from adiabatic initial conditions then the age of the Universe, as constrained by measurements of the cosmic microwave background (CMB), is t_0=14.0 +/- 0.5 Gyr. The uncertainty is surprisingly small given that CMB data alone constrain neither h nor Omega_Lambda significantly. It is due to the tight (and accidental) correlation, in these models, of the age with the angle subtended by the sound horizon on the last--scattering surface and thus with the well-determined acoustic peak locations. If we assume either the HST Key Project result h = 0.72 \pm .08 or simply that h > 0.55, we find Omega_Lambda > 0.4 at 95% confidence--another argument for dark energy, independent of supernovae observations. Our analysis is greatly simplified by the Monte Carlo Markov chain approach to Bayesian inference combined with a fast method for calculating angular power spectra.Comment: 5 pages, including 2 figures and one table final published versio

The linear growth rate of structure in Parametrized Post Friedmannian Universes

A possible solution to the dark energy problem is that Einstein's theory of general relativity is modified. A suite of models have been proposed that, in general, are unable to predict the correct amount of large scale structure in the distribution of galaxies or anisotropies in the Cosmic Microwave Background. It has been argued, however, that it should be possible to constrain a general class of theories of modified gravity by focusing on properties such as the growing mode, gravitational slip and the effective, time varying Newton's constant. We show that assuming certain physical requirements such as stability, metricity and gauge invariance, it is possible to come up with consistency conditions between these various parameters. In this paper we focus on theories which have, at most, 2nd derivatives in the metric variables and find restrictions that shed light on current and future experimental constraints without having to resort to a (as yet unknown) complete theory of modified gravity. We claim that future measurements of the growth of structure on small scales (i.e. from 1-200 h^{-1} Mpc) may lead to tight constraints on both dark energy and modified theories of gravity.Comment: 15 Pages, 11 Figure

Learning Online: A Case Study Exploring Student Perceptions and Experience of a Course in Economic Evaluation

This study explored the perceptions and experiences of a group of students enrolled in an online course in Economic Evaluation. A mixed methods approach was adopted for the data collection, and thematic analysis was used to synthesize the data collected and highlight key findings. The participants identified several positive and negative perceived attributes of online learning, many of which are well documented in the literature. In addition, after exposure to the course, participants reported several factors that affected their learning experience on this course, some of which have not yet been reported in the wider literature. The five main factors affecting learning on this course include; 1) Pace of learning in an online environment, 2) Learning style, 3) Immediacy of feedback, 4) Method of content delivery, and 5) Issues around navigating content. These findings could help improve online teaching practice and learning quality in future courses

Is the Job Satisfaction Survey a good tool to measure job satisfaction amongst health workers in Nepal? Results of a validation analysis

BACKGROUND: Job satisfaction is an important predictor of an individual's intention to leave the workplace. It is increasingly being used to consider the retention of health workers in low-income countries. However, the determinants of job satisfaction vary in different contexts, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool developed by Paul Spector, and used mixed methods to assess its validity and reliability in measuring job satisfaction among maternal and newborn health workers (MNHWs) in government facilities in rural Nepal. METHODS: We administered the tool to 137 MNHWs and collected qualitative data from 78 MNHWs, and district and central level stakeholders to explore definitions of job satisfaction and factors that affected it. We calculated a job satisfaction index for all MNHWs using quantitative data and tested for validity, reliability and sensitivity. We conducted qualitative content analysis and compared the job satisfaction indices with qualitative data. RESULTS: Results from the internal consistency tests offer encouraging evidence of the validity, reliability and sensitivity of the tool. Overall, the job satisfaction indices reflected the qualitative data. The tool was able to distinguish levels of job satisfaction among MNHWs. However, the work environment and promotion dimensions of the tool did not adequately reflect local conditions. Further, community fit was found to impact job satisfaction but was not captured by the tool. The relatively high incidence of missing responses may suggest that responding to some statements was perceived as risky. CONCLUSION: Our findings indicate that the adapted job satisfaction survey was able to measure job satisfaction in Nepal. However, it did not include key contextual factors affecting job satisfaction of MNHWs, and as such may have been less sensitive than a more inclusive measure. The findings suggest that this tool can be used in similar settings and populations, with the addition of statements reflecting the nature of the work environment and structure of the local health system. Qualitative data on job satisfaction should be collected before using the tool in a new context, to highlight any locally relevant dimensions of job satisfaction not already captured in the standard survey

Validating a tool to measure auxiliary nurse midwife and nurse motivation in rural Nepal

© 2015 Morrison et al.; licensee BioMed Central. Background: A global shortage of health workers in rural areas increases the salience of motivating and supporting existing health workers. Understandings of motivation may vary in different settings, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool, previously used in Kenya, and explored its validity and reliability to measure the motivation of auxiliary nurse midwives (ANM) and staff nurses (SN) in rural Nepal. Method: Qualitative and quantitative methods were used to assess the content validity, the construct validity, the internal consistency and the reliability of the tool. We translated the tool into Nepali and it was administered to 137 ANMs and SNs in three districts. We collected qualitative data from 78 nursing personnel and district- and central-level stakeholders using interviews and focus group discussions. We calculated motivation scores for ANMs and SNs using the quantitative data and conducted statistical tests for validity and reliability. Motivation scores were compared with qualitative data. Descriptive exploratory analysis compared mean motivation scores by ANM and SN sociodemographic characteristics. Results: The concept of self-efficacy was added to the tool before data collection. Motivation was revealed through conscientiousness. Teamwork and the exertion of extra effort were not adequately captured by the tool, but important in illustrating motivation. The statement on punctuality was problematic in quantitative analysis, and attendance was more expressive of motivation. The calculated motivation scores usually reflected ANM and SN interview data, with some variation in other stakeholder responses. The tool scored within acceptable limits in validity and reliability testing and was able to distinguish motivation of nursing personnel with different sociodemographic characteristics. Conclusions: We found that with minor modifications, the tool provided valid and internally consistent measures of motivation among ANMs and SNs in this context. We recommend the use of this tool in similar contexts, with the addition of statements about self-efficacy, teamwork and exertion of extra effort. Absenteeism should replace the punctuality statement, and statements should be worded both positively and negatively to mitigate positive response bias. Collection of qualitative data on motivation creates a more nuanced understanding of quantitative scores

Validating an Agency-based Tool for Measuring Women’s Empowerment in a Complex Public Health Trial in Rural Nepal

Despite the rising popularity of indicators of women’s empowerment in global development programmes, little work has been done on the validity of existing measures of such a complex concept. We present a mixed methods validation of the use of the Relative Autonomy Index for measuring Amartya Sen’s notion of agency freedom in rural Nepal. Analysis of think-aloud interviews (n = 7) indicated adequate respondent understanding of questionnaire items, but multiple problems of interpretation including difficulties with the four-point Likert scale, questionnaire item ambiguity and difficulties with translation. Exploratory Factor Analysis of a calibration sample (n = 519) suggested two positively correlated factors (r = 0.64) loading on internally and externally motivated behaviour. Both factors increased with decreasing education and decision-making power on large expenditures and food preparation. Confirmatory Factor Analysis on a validation sample (n = 509) revealed good fit (Root Mean Square Error of Approximation 0.05–0.08, Comparative Fit Index 0.91–0.99). In conclusion, we caution against uncritical use of agency-based quantification of women’s empowerment. While qualitative and quantitative analysis revealed overall satisfactory construct and content validity, the positive correlation between external and internal motivations suggests the existence of adaptive preferences. High scores on internally motivated behaviour may reflect internalized oppression rather than agency freedom

Do Participatory Learning and Action Women’s Groups Alone or Combined with Cash or Food Transfers Expand Women’s Agency in Rural Nepal?

Participatory learning and action women’s groups (PLA) have proven effective in reducing neonatal mortality in rural, high-mortality settings, but their impacts on women’s agency in the household remain unknown. Cash transfer programmes have also long targeted female beneficiaries in the belief that this empowers women. Drawing on data from 1309 pregnant women in a four-arm cluster-randomised controlled trial in Nepal, we found little evidence for an impact of PLA alone or combined with unconditional food or cash transfers on women’s agency in the household. Caution is advised before assuming PLA women’s groups alone or with resource transfers necessarily empower women

Eddington-Born-Infeld gravity and the large scale structure of the Universe

It has been argued that a Universe governed by Eddington-Born-Infeld gravity can be compatible with current cosmological constraints. The extra fields introduced in this theory can behave both as dark matter and dark energy, unifying the dark sector in one coherent framework. We show the various roles the extra fields can play in the expansion of the Universe and study the evolution of linear perturbations in the various regimes. We find that, as a unified theory of the dark sector, Eddington-Born-Infeld gravity will lead to excessive fluctuations in the Cosmic Microwave Background on large scales. In the presence of a cosmological constant, however, the extra fields can behave as a form of non-particulate dark matter and can lead to a cosmology which is entirely compatible with current observations of large scale structure. We discuss the interpretation of this form of dark matter and how it can differ from standard, particulate dark matter.Comment: 12 pages, 8 figures, very minor corrections and reference additions, no change to the result

Participatory women’s groups and counseling through home visits to improve child growth in rural eastern India: protocol for a cluster randomised controlled trial

Background: Childhood stunting (low height-for-age) is a marker of chronic undernutrition and predicts children’s subsequent physical and cognitive development. An estimated 52 million children in India are stunted. There is a broad consensus on determinants of child undernutrition and interventions to address it, but a lack of operational research testing strategies to increase the coverage of these interventions in high burden areas. Our study aims to assess the impact, costeffectiveness, and scalability of a community intervention involving a government-proposed community-based worker to improve growth in children under two

Self-transfer and mortality amongst adults lost to follow-up in ART programmes in low- and middle-income countries: systematic review and meta-analysis

To ascertain estimates of adult patients, recorded as lost to follow-up (LTFU) within antiretroviral treatment (ART) programmes, who have self-transferred care, died or truly stopped ART in low- and middle-income countries