Creaming and parking in marketized employment services: an Anglo-German comparison

The delivery of public services by nonprofit and for-profit providers alters the nature of services and jobs, often in unintended and undesired ways. We argue that these effects depend on the degree to which the service is ‘marketised’, i.e. whether its funder subjects it to price-based competition. Using case studies of British and German employment services, this paper scrutinises the link between funding practices and service quality. Of particular concern in marketised employment services is the problem of ‘creaming and parking’, in which providers select job-ready clients for services and neglect clients more distant from the labour market. We explore three questions. What are the mechanisms through which marketization produces creaming and parking? What are the differences between these mechanisms in commercial and non-commercial service providers? Which national institutions might serve as a buffer for the landscape of service provision facing price-based competition

Improving Efficiency of Power Systems by Demand Side Management Method

In the smart grid infrastructure based power systems, it is necessary to consider the demand side management to enhance the energy reduction and system control. In many countries the resources are very less so the available resources have to be used in an efficient manner without any loss. The total loss cannot be avoided but it can be reduced. In the proposed system, the Particle Swarm Optimization (PSO) technique is used to distribute the power in the smart grid. Here, the grids are arranged in such a way that the losses in it are reduced. The load connected to the grid is rearranged according to their use. It uses a new and stochastic scheduling technique to handle the uncertainties in the power system. Solar and wind power are taken in account for twenty four hours and the values are given to the PSO algorithm. The   experiment was conducted by MATLAB and the results show that the efficiency level of wind and solar power systems was increased by an appreciable level. The proposed technique is compared with the normal system without using Demand Side Management (DSM) and it shows that the proposed system gives better results than the existing systems

Insertion as an alternative to workfare: active labour-market schemes in the Parisian suburbs

Many governments have tightened the link between welfare and work by attaching conditionality to out-of-work benefits, extending these requirements to new client groups, and imposing market competition and greater managerial control in service delivery – principles typically characterised as ‘workfare’. Based on field research in Seine-Saint-Denis, we examine French ‘insertion’ schemes aimed at disadvantaged but potentially job-ready clients, characterized by weak conditionality, low marketization, strong professional autonomy, and local network control. We show that insertion systems have resisted policy attempts to expand workfare-derived principles, reflecting street-level actors’ belief in the key advantages of the former over the latter. In contrast with arguments stressing institutional and cultural stickiness, our explanation for this resistance thus highlights the decentralized network governance of front-line services and the limits to central government power

Cultural differences in postnatal quality of life among German-speaking women - a prospective survey in two countries.

Assessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. The tool has not been applied for making a cross-cultural comparison before. This study investigated (a) responses to the MGI in German-speaking women in Germany and Switzerland; and (b) associations between MGI scores on the one hand and maternity and midwifery care on the other

Differential Plasmodium falciparum surface antigen expression among children with Malarial Retinopathy

Retinopathy provides a window into the underlying pathology of life-threatening malarial coma (“cerebral malaria”), allowing differentiation between 1) coma caused by sequestration of Plasmodium falciparum-infected erythrocytes in the brain and 2) coma with other underlying causes. Parasite sequestration in the brain is mediated by PfEMP1; a diverse parasite antigen that is inserted into the surface of infected erythrocytes and adheres to various host receptors. PfEMP1 sub-groups called “DC8” and “DC13” have been proposed to cause brain pathology through interactions with endothelial protein C receptor. To test this we profiled PfEMP1 gene expression in parasites from children with clinically defined cerebral malaria, who either had or did not have accompanying retinopathy. We found no evidence for an elevation of DC8 or DC13 PfEMP1 expression in children with retinopathy. However, the proportional expression of a broad subgroup of PfEMP1 called “group A” was elevated in retinopathy patients suggesting that these variants may play a role in the pathology of cerebral malaria. Interventions targeting group A PfEMP1 may be effective at reducing brain pathology

On Virtual Displacement and Virtual Work in Lagrangian Dynamics

The confusion and ambiguity encountered by students, in understanding virtual displacement and virtual work, is discussed in this article. A definition of virtual displacement is presented that allows one to express them explicitly for holonomic (velocity independent), non-holonomic (velocity dependent), scleronomous (time independent) and rheonomous (time dependent) constraints. It is observed that for holonomic, scleronomous constraints, the virtual displacements are the displacements allowed by the constraints. However, this is not so for a general class of constraints. For simple physical systems, it is shown that, the work done by the constraint forces on virtual displacements is zero. This motivates Lagrange's extension of d'Alembert's principle to system of particles in constrained motion. However a similar zero work principle does not hold for the allowed displacements. It is also demonstrated that d'Alembert's principle of zero virtual work is necessary for the solvability of a constrained mechanical problem. We identify this special class of constraints, physically realized and solvable, as {\it the ideal constraints}. The concept of virtual displacement and the principle of zero virtual work by constraint forces are central to both Lagrange's method of undetermined multipliers, and Lagrange's equations in generalized coordinates.Comment: 12 pages, 10 figures. This article is based on an earlier article physics/0410123. It includes new figures, equations and logical conten

Cyclic vomiting syndrome in adults

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72300/1/j.1365-2982.2008.01113.x.pd

HIV Incidence and Risk Factors for Acquisition in HIV Discordant Couples in Masaka, Uganda: An HIV Vaccine Preparedness Study

To determine the incidence of and risk factors for HIV acquisition in a cohort of HIV-uninfected partners from HIV discordant couples in Masaka, Uganda, and to establish its suitability for HIV vaccine trials.HIV-uninfected adults living in HIV discordant couple relationships were enrolled and followed for 2 years. Interviews, medical investigations, HIV counseling and testing, syphilis and urine pregnancy (women) tests were performed at quarterly visits. Sexual risk behaviour data were collected every 6 months.495 participants were enrolled, of whom 34 seroconverted during 786.6 person-years of observation (PYO). The overall HIV incidence rate [95% confidence interval (CI)] was 4.3 [3.1-6]; and 4.3 [2.8-6.4] and 4.4 [2.5-8] per 100 PYO in men and women respectively. Independent baseline predictors for HIV acquisition were young age [18-24 (aRR = 4.1, 95% CI 1.6-10.8) and 25-34 (aRR = 2.7, 95% CI 1.2-5.8) years]; alcohol use (aRR = 2.6, 95% CI 1.1-6); and reported genital discharge (aRR = 3.4, 95% CI 1.6-7.2) in the past year. Condom use frequency in the year preceding enrolment was predictive of a reduced risk of HIV acquisition [sometimes (aRR = 0.4, 95% CI 0.2-0.8); always (aRR = 0.1, 95% CI 0.02-0.9)]. In the follow-up risk analysis, young age [18-24 (aRR = 6.2, 95% CI 2.2-17.3) and 25-34 (aRR = 2.3, 95% CI 1.1-5.0) years], reported genital discharge (aRR = 2.5, 95% CI 1.1-5.5), serological syphilis (aRR 3.2, 95% CI 1.3-7.7) and the partner being ART naïve (aRR = 4.8, 95% CI 1.4-16.0) were independently associated with HIV acquisition. There were no seroconversions among participants who reported consistent condom use during the study.The study has identified important risk factors for HIV acquisition among HIV discordant couples. HIV-uninfected partners in discordant couples may be a suitable population for HIV vaccine efficacy trials. However, recent confirmation that ART reduces heterosexual HIV transmission may make it unfeasible to conduct HIV prevention trials in this population

An interpretative phenomenological study of midwives supporting home birth for women with complex needs

Background As the landscape of women presenting for maternity care changes, so do the challenges associated with providing quality, informed and compassionate care, particularly for women with complex needs. Aim To explore the lived experience of midwives in facilitating care for women with complex needs who choose to birth at home. Method A qualitative design is employed, using an interpretative phenomenological analysis informed by hermeneutic principles. Purposive sampling is used to recruit midwives through social media and JiscMail. Data are collected via semi-structured interviews. Findings Two interpretative themes arose. A ‘radical midwife’ embraces the phrase ‘radical’ by positioning midwives between traditional beliefs and practices, physiological processes, midwife knowledge and skill set by applying current evidence and professional context. A ‘conflicted midwife’ arises out of this dichotomy and exposes the realities of striving for radicality while the negotiating ‘the system’. Conclusions It is no longer acceptable to assume that home birth for women with complex needs is exceptional. This must be the catalyst to move towards a constructive discourse with midwives, women and the wider team to address and expand the evidence base and pathways to support those who are already facilitating this care and those who will inevitably continue to provide care ‘outside of current guidelines