Rapid Inventory of Earthquake Damage (RIED)

The 25 January 1999 Quindío earthquake in Colombia was a major disaster for the coffee-growing region in Colombia. Most of the damage occurred in the city of Armenia and surrounding villages. Damage due to earthquakes is strongly related to topographic and subsurface geotechnical conditions underneath structures and houses. The RIED project used aerial photographs to obtain a rapid inventory of the earthquake damage right after the seismic event. This inventory was subsequently used to identify any existing relation with subsurface- and topographic conditions. Hazard zonation maps were made on the basis of seismic response analysis of a three-dimensional model of the subsurface that has been created in the GIS. Also indicative zonation maps were created outlining potential areas where topographic amplification may occur. These seismic zonation maps delineate those areas that are most likely affected by subsurface and topographic resonance effects during a future and similar earthquake. The maps have been presented to the city planning authorities of Armenia so that reconstruction of the damaged areas can be carried out in such a way that high risk areas will be avoided or that structures and houses will be built according to the standards for high seismic risk areas

Physiological functions should be considered as true end points of nutritional intervention studies

With the beginning of this millennium it has become fashionable to only follow ‘evidence-based' practices. This generally-accepted approach cruelly negates experience or intelligent interpretation of pathophysiology. Another problem is that the great ‘meta-analysts' of the present era only accept end points that they consider ‘hard'. In the metabolic and nutritional field these end points are infection-related morbidity and mortality, and all other end points are considered ‘surrogate'. The aim of this presentation is to prove that this claim greatly negates the contribution of more-fundamentally-oriented research, the fact that mortality has multifactorial causes, and that infection is a crude measure of immune function. The following problems should be considered: many populations undergoing intervention have low mortality, requiring studies with thousands of patients to demonstrate effects of intervention on mortality; nutrition is only in rare cases primary treatment, and in many populations is a prerequisite for survival rather than a therapeutic modality; once the effect of nutritional support is achieved, the extra benefit of modulation of the nutritional support regimen can only be modest; cost-benefit is not a valid end point, because the better it is done the more it will cost; morbidity and mortality are crude end points for the effect of nutritional intervention, and are influenced by many factors. In fact, it is a yes or no factor. In the literature the most important contributions include new insights into the pathogenesis of disease, the diminution of disease-related adverse events and/or functional improvement after therapy. In nutrition research the negligence of these end points has precluded the development and validation of functional end points, such as muscle, immune and cognitive functions. Disability, quality of life, morbidity and mortality are directly related to these functional variables. It is, therefore, of paramount importance to validate functional end points and to consider them as primary rather than surrogate end point

Defining malnutrition: a plea to rethink

In a recent consensus report in Clinical Nutrition the undernourished category of malnutrition was proposed to be defined and diagnosed on the basis of a low BMI or unintentional weight loss combined with low BMI or FFMI with certain cut off points. The definition was endorsed by ESPEN despite recent endorsement of a very different definition. The approach aims to assess whether nutritional intake is sufficient but is imprecise because a low BMI does not always indicate malnutrition and individuals with increasing BMI's may have decreasing FFM's. The pathophysiology of individuals, considered to be malnourished in rich countries and in areas with endemic malnutrition, results predominantly from deficient nutrition combined with infection/inflammation. Both elements jointly determine body composition and function and consequently outcome of disease, trauma or treatment. When following the consensus statement only an imprecise estimate is acquired of nutritional intake without knowing the impact of inflammation. Most importantly, functional abilities are not assessed. Consequently it will remain uncertain how well the individual can overcome stressful events, what the causes are of dysfunction, how to set priorities for treatment and how to predict the effect of nutritional support. We therefore advise to consider the pathophysiology of malnourished individuals leading to inclusion of the following elements in the definition of malnutrition: a disordered nutritional state resulting from a combination of inflammation and a negative nutrient balance, leading to changes in body composition, function and outcome. A precise diagnosis of malnutrition should be based on assessment of these element

Rural piped-water enterprises in Cambodia: A pathway to women's empowerment?

© 2019 by the authors. This research examined the extent to which women's ownership and management of water supply schemes led to their empowerment, including their economic empowerment, in rural Cambodia. Privately managed water supply schemes in rural Cambodia serve over one million people. This study is the first of its kind to systematically investigate the experiences and needs of female water supply scheme owners, using well-established theoretical frameworks for women's empowerment, namely Longwe's stages of empowerment, and Rowlands, VeneKlasen and Miller's elaboration on different types of power. Business management frameworks relevant to the water, sanitation and hygiene (WASH) sector were also drawn on to assess operational constraints and enablers. Fifteen structured interviews were conducted with female water entrepreneurs in rural Cambodia. Female entrepreneurs reported encountering four key barriers to establishing and managing water supply schemes. The first were operational, and government and regulatory related issues, followed by financial issues and limited demand for water services. Three important enablers were reported by entrepreneurs: social enablers, economic enablers and program support from government, associations and non-government organisations (NGOs). This study found that, whilst there was evidence of empowerment reported by female water enterprise owners, the complexity of the ongoing empowerment process, challenges and limitations were also observed. Women's empowerment can be advanced through leadership of, and involvement in water enterprises, as evidenced by this study, however, gender norms constrained women, especially with respect to mobility (leaving the home for extended periods), and household and family duties impacting on income-generating work or vice versa. As such, targeted strategies are needed by a range of actors to address such constraints. The findings of this study can assist NGOs, donors and governments incentivizing entrepreneurship in water services, to ensure that these interventions are not gender blind, and to draw on evidence of the barriers and enablers for female entrepreneurs and how these are influenced by contextualized gender norms

Reduction of sleeping metabolic rate after vertical banded gastroplasty.

Department of Surgery, University Hospital Maastricht, The Netherlands. OBJECTIVE: To investigate whether long-term weight loss after vertical banded gastroplasty (VBG) results in a sustained reduction of sleeping metabolic rate (SMR) as a persistent risk factor for weight regain. DESIGN: Longitudinal clinical intervention study of morbidly obese patients undergoing VBG. PATIENTS: Group I: Six patients in which body composition and SMR were measured before and at 3, 6 and 12 months after VBG. Group II (long-term effect): nine patients in which body mass (BM) was measured before VBG, and body composition and SMR were measured 98+/-30 months after VBG. MEASUREMENTS: Body composition was assessed by deuterium dilution and hydrostatic weighing. SMR was measured (SMRm) in a respiration chamber and predicted (SMRp) based on body composition. RESULTS: In group I, fat mass and fat free mass decreased significantly after VBG (P < 0.05). SMRm decreased from 11.1+/-1.8 (s.d.) MJ/d before VBG to 8.1+/-0.9 MJ/d (P < 0.05) at 12 months after VBG. In group II at a mean of 98 months after VBG, the SMRm (6.9+/-0.7 MJ/d) was lower than the preoperative value of group I (P < 0.05). SMRm was lower than SMRp at all intervals after VBG (P < 0.05). The ratio measured vs predicted SMR was in group I: 1.02+/-0.05 before VBG, 0.91+/-0.08 at 12 months after VBG (P<0.05), and in group 11: 0.94+/-0.08 at a mean of 98 months after VBG (P < 0.05). CONCLUSION: The reduction of SMR adjusted for body composition after VBG is sustained as long as weight loss is maintained. The sustained and disproportional reduction of SMR may reflect the persistent susceptibility of the postobese to weight regain

Infusing with ERP Systems: A Longitudinal Investigation of the Impact of Control and Empowerment

Organizations have made significant investments in ERP systems with the strategic expectation that employees will utilize this technology to enhance organizational performance. However, research indicates that ERP systems are under-utilized. In order to entangle the challenge of under-utilization, this paper addresses the impact of control and empowerment on infusion – the deep and comprehensive usage of an information system. We apply a longitudinal design with two measurements to research whether the level of infusion of ERP users changes over time, and if so to what extent. Moreover we hypothesize that ‘soft’ characteristics like the organizational position, organization commitment and trust influence the relation between control, empowerment and the level of infusion of the ERP user. A survey was conducted in a large public organization which has been using an ERP system for several years. A sample of 178 matched pairs (For T1 and T2) of ERP system users and their supervisors has been collected. In this research in progress we present the theoretical mechanisms and methodological framework we employed for the data collection