Joint Learning Network for Universal Health Coverage

The Joint Learning Network (JLN) is a key innovation and central part of The Rockefeller Foundation'sefforts to promote universal health coverage (UHC) in low- and middle-income countries (LMICs)under its Transforming Health Systems (THS) initiative (2009-2017). Launched in 2010, the JLN is acountry-led, global learning network that connects practitioners around the globe, in order to advanceknowledge and learning about approaches to accelerate country progress toward UHC. The JLNcurrently includes 27 member countries across Africa, Asia, Europe, and Latin America that engagein multilateral workshops, country learning exchanges, and virtual dialogues to share experiences anddevelop tools to support the design and implementation of UHC-oriented reforms.The core vehicles for shared learning and resource development under the JLN are technical initiatives,which are managed by several technical partners and organized around key levers for reaching UHCobjectives, including i) provider payment mechanisms, ii) information technology, iii) primary health care,iv) population coverage, v) quality improvement, and vi) health financing innovations. To address moretargeted technical needs, the JLN has also established technical collaboratives, which fall within or cutacross technical initiatives, as well as the "Joint Learning Fund" (JLF), a flexible funding pool to addresscountry-specific learning needs. A global Steering Group, comprised of member countries, technicalpartners, and network funders, ensures that the technical initiatives and other joint learning efforts arealigned with country priorities. It also sets the strategic direction of the network, implemented by a NetworkCoordinating Team of technical and coordinating partners. At the country level, country core groups(CCGs), comprised of staff at government agencies, organize and facilitate country participation in the JLN.The Rockefeller Foundation is a founding funder of the JLN and has actively supported the network'sactivities and goal of becoming a high-impact, country-led, and sustainable learning platform. Under theTHS initiative, the Foundation has provided almost $19 million in grant funding to the JLN, accounting forroughly 70 percent of total donor funding for the network to date. THS grants to JLN partner organizationshave supported the design and launch of the network, ongoing network coordination, management ofthe JLF, and facilitation of three technical initiatives (Provider Payment Mechanisms [PPM], InformationTechnology [IT], and Quality). The Foundation has also engaged in a range of non-grant activities aimedat strengthening the JLN's influence and sustainability. These include coordinating with and buildingsupport for the network from other donors

Building Youth Life Skills: 6 Lessons for Government Officials

There is growing recognition that youth need more than academic knowledge and technical expertise to transition successfully into employment and adulthood (Dupuy et al. 2018). They also need "life skills," a set of cognitive, personal, and interpersonal strengths that position them for success in their lives and livelihoods. Life skills can enhance young people's agency and resilience, improve their psychosocial well-being, and predict a range of long-term outcomes, including health, job performance, and wages (Kwauk et al. 2018; OECD 2018; Kautz et al. 2014). The Partnership to Strengthen Innovation and Practice in Secondary Education (PSIPSE), a donor collaborative, has invested in 18 projects that focus on developing life skills among youth (see left). Mathematica, the PSIPSE's learning partner, recently conducted an in-depth study of these projects. The study used interviews with implementing organizations, an extensive review of project documents and evaluation reports, and high-level literature and landscape scans to examine project experiences, set them in context, and draw out lessons for a range of stakeholders. This brief summarizes the lessons for government officials—on how to successfully devise, roll out, scale, and strengthen life skills policies for youth in low-and middle-income countries (LMICs)

Building Youth Life Skills: Lessons Learned on How to Design, Implement, Assess, and Scale Successful Programming

There is growing recognition that youth need more than formal or vocational education to thrive in school, work, and life. They also need life skills - a set of cognitive, personal, and interpersonal strengths that position them for success in their lives and livelihoods. To leverage the growing momentum and give youth access to these vital tools for success, the Partnership to Strengthen Innovation and Practice in Secondary Education (PSIPSE) supports grantee partners testing diverse approaches to strengthening life skills. The PSIPSE commissioned an in-depth study of 18 projects in 7 countries, uncovering actionable lessons on how to design, implement, assess, and scale youth life skills programming in low- and middle-income countries. The study is intended for practitioners and government officials interested in building, improving, and expanding work around life skills, as well as donors looking to advance this field and provide useful guidance to their grantees

Validation of an MRI-only planning workflow for definitive pelvic radiotherapy

Purpose: Previous work on Magnetic Resonance Imaging (MRI) only planning has been applied to limited treatment regions with a focus on male anatomy. This research aimed to validate the use of a hybrid multi-atlas synthetic computed tomography (sCT) generation technique from a MRI, using a female and male atlas, for MRI only radiation therapy treatment planning of rectum, anal canal, cervix and endometrial malignancies. Patients and methods: Forty patients receiving radiation treatment for a range of pelvic malignancies, were separated into male (n = 20) and female (n = 20) cohorts for the creation of gender specific atlases. A multi-atlas local weighted voting method was used to generate a sCT from a T1-weighted VIBE DIXON MRI sequence. The original treatment plans were copied from the CT scan to the corresponding sCT for dosimetric validation. Results: The median percentage dose difference between the treatment plan on the CT and sCT at the ICRU reference point for the male cohort was − 0.4% (IQR of 0 to − 0.6), and − 0.3% (IQR of 0 to − 0.6) for the female cohort. The mean gamma agreement for both cohorts was &gt; 99% for criteria of 3%/2 mm and 2%/2 mm. With dose criteria of 1%/1 mm, the pass rate was higher for the male cohort at 96.3% than the female cohort at 93.4%. MRI to sCT anatomical agreement for bone and body delineated contours was assessed, with a resulting Dice score of 0.91 ± 0.2 (mean ± 1 SD) and 0.97 ± 0.0 for the male cohort respectively; and 0.96 ± 0.0 and 0.98 ± 0.0 for the female cohort respectively. The mean absolute error in Hounsfield units (HUs) within the entire body for the male and female cohorts was 59.1 HU ± 7.2 HU and 53.3 HU ± 8.9 HU respectively. Conclusions: A multi-atlas based method for sCT generation can be applied to a standard T1-weighted MRI sequence for male and female pelvic patients. The implications of this study support MRI only planning being applied more broadly for both male and female pelvic sites. Trial registration This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (www.anzctr.org.au) on 04/10/2017. Trial identifier ACTRN12617001406392.</p

Thermal cycle parameter effects on the stress state, failure mechanisms and life prediction of thermal barrier coatings

The primary objectives of this study are (1) to examine the effects of bond coat composition and processing method on the trends in photoluminescence piezospectroscopy (PLPS) characteristics as a function of cycles for two [(Ni, Pt) Al] bond coated (outward diffusing and inward diffusing) thermal barrier coatings (TBCs), (2) to define the spallation mechanisms for the two TBCs in furnace cyclic tests at three temperatures and two hold times, and (3) use the above data to generate mechanisms-based TBC life prediction methods. ^ For both TBCs evaluated using the 1-hour tests, progressive rumpling of the TGO/bond coat interface is responsible for failure occurring at the YSZ/TGO interface at all 3 temperatures. For the 24-hour tests, failure occurs at the TGO/bond coat interface and is driven by the stored strain energy in the TGO. A mechanism for rumpling in these TBCs is proposed that involves plastic deformation at the maximum temperatures in the cycle and cracking of the ceramic upon cool-down. The single-valued relationship between the TGO thickness and rumpling amplitude, independent of temperature and cycle time, also confirms this notion that the in-plane TGO growth that occurs at the peak temperature directly appears as rumpling displacements of the TGO. ^ The TGO stress, measured by PLPS, exhibits a monotonic decline with cycles. This relationship is independent of cycle temperature for both TBCs, and changes slightly with cycle hold time. There is a constant TGO stress at failure for both TBCs independent of temperature. Correlations between the maximum TGO stress and spallation life and between the slope of the TGO stress versus cycles curve and spallation life are identified: longer life specimens exhibit higher initial TGO stress and shallower slopes. ^ Two-level cyclic tests consisting of multiple temperatures and multiple hold times have been conducted for the first time. The slopes of the stress versus life curves obtained from these tests indicate that while a change in the cyclic temperature amplitude does not affect the normalized stress response of the system, a change in the hold time does alter it. This is consistent with a spallation mechanism that is independent of temperature but changes with hold time. This necessitates that TGO stress versus cycles or TBC life data are generated separately for every cycle with a different hold time. ^ Temperature-blind remaining life predictions were made using three spectral features, the TGO stress, peak width and the standard deviation of stress, using standard regression analyses. (Abstract shortened by UMI.)

Improving Teacher Quality: Lessons Learned from Grantees of the Partnership to Strengthen Innovation and Practice in Secondary Education

Drawn from the experiences of eight partners of the Partnership to Strengthen Innovation and Practice in Secondary Education (PSIPSE) testing approaches to in-service teacher training in East Africa and India, the study surfaces a variety of practical lessons on how to design, implement, and scale efforts to train, motivate, and support teachers in order to improve educational outcomes. High-quality teaching is central to creating an educational environment that supports learning for all. In designing, implementing, evaluating and scaling teacher training programs as a pathway to shaping education systems, design a cost-effective model that adopts a streamlined, appropriately sequenced approach to influencing how and/or what teachers teach. Shift towards a long-term focus to improving the effectiveness of the teaching force by being intentional about whom you train, leveraging both intrinsic and extrinsic motivators, and engaging both government and pre-service teacher training institutions as key partners. These and other practical, cross-organizational learnings and concrete examples highlighted in the study offer concrete guidance that can be leveraged to strengthen the design, implementation, evaluation and scaling of interventions to improve the quality of teaching.

Revascularization in endodontics

© Nova Science Publishers, Inc.Ideal endodontic therapy would be one wherein diseased tissue is removed and replaced by healthy tissue. This is termed regenerative endodontics. The presently clinically viable treatment modality following this regenerative approach is the revascularization treatment where the root canal system of an immature or mature necrotic tooth is disinfected thoroughly using either locally delivered (intracanal) antibiotics or antiseptics, followed by induction of a blood clot and coronal sealing. This review discusses the basis and rationale behind revascularization, the treatment protocol and mechanisms. A thorough review of literature regarding the treatment protocol and disinfection methods is also presented.Link_to_subscribed_fulltex

The Rockefeller Foundations Transforming Health Systems Initiative: Final Evaluation

In the decade leading up to the 2008 economic crisis, health policy experts increasingly questionedthe donor community's prevailing focus on interventions targeting specific diseases, such as HIV/AIDS,tuberculosis, and malaria. Though these disease-specific interventions produced major, measureableresults, they did so at the cost of creating coordination, financial, and reporting challenges for recipientcountries which already had overstretched health systems.When The Rockefeller Foundation launched its Transforming Health Systems (THS) initiative in 2009, itcommitted itself to driving renewed attention to strengthening health systems as a whole. The Foundationbelieved that this was essential for meeting its overall commitment to equity – so that national healthsystems could provide quality care to everyone, rich and poor alike.This final evaluation – conducted by the Foundation's monitoring and evaluation grantee, MathematicaPolicy Research – assesses and documents the initiative in its entirety. It reviews the outcomes of theinitiative's global advocacy, regional networks, and country-level investments, and its overall effectivenessand influence, as well as the Foundation's legacy for advancing UHC. By sharing this evaluation report, it isthe Foundation's hope that others will join us in celebrating our successes, learning from our challenges,and building on this knowledge base to continue advancing Sustainable Development Goal 3 – healthand wellbeing for all

Building Youth Life Skills: 8 Tips for Practitioners

There is growing recognition that youth need more than academic knowledge to transition successfully into employment and adulthood (Dupuy et al. 2018). They also need "life skills," a set of cognitive, personal, and interpersonal strengths that position them for success in their lives and livelihoods. Life skills can enhance young people's agency and resilience, improve their psychosocial well-being, and predict a range of long-term outcomes, including health, job performance, and wages (Kwauk et al. 2018; OECD 2018, Kautz et al. 2014). The Partnership to Strengthen Innovation and Practice in Secondary Education (PSIPSE), a donor collaborative, has invested in 18 projects to strengthen life skills in young people. This brief offers eight lessons based on the experiences of these projects—on the design, delivery, measurement, and scale-up of youth life skills programming in lowand middle-income countries (LMICs)