PNEUMATOSIS INTESTINALIS - A RARE CLINICAL FINDING REQUIRING MULTIMODALITY TREATMENT

This is a case report of Pneumatosis intestinalis (PI), which has traditionally been associated with immediate operative intervention and a high mortality rate. We present a case of ulcerative colitis that developed Pneumatosis intestinalis and was managed at our hospital. A 29 year old male with known history of ulcerative colitis presented with an acute exacerbation. A week into his treatment, PI developed. Emergency total colectomy with end ileostomy was performed. Postoperatively, he remained critically ill and expired during same hospitalization after 45 days.Key words: Pneumatosis intestinalis, Ulcerative Colitis, Adalumima

Rethinking Sustainability, Scaling Up, and Enabling Environment: A Framework for Their Implementation in Drinking Water Supply

The terms sustainability, scaling up, and enabling environment are inconsistently used in implementing water supply projects. To clarify these terms we develop a framework based on Normalization Process Theory, and apply the framework to a hypothetical water supply project in schools. The resulting framework provides guidance on how these terms could be implemented and analyzed in water supply projects. We conclude that effective use of the terms sustainability, scaling up, and enabling environment would focus on purpose, process, and perspective. This is the first known attempt to analyze the implementation of the three terms together in the context of water supply services

Drinking water quality governance: A comparative case study of Brazil, Ecuador, and Malawi

Human health is greatly affected by inadequate access to sufficient and safe drinking water, especially in low and middle-income countries. Drinking water governance improvements may be one way to better drinking water quality. Over the past decade, many projects and international organizations have been dedicated to water governance; however, water governance in the drinking water sector is understudied and how to improve water governance remains unclear. We analyze drinking water governance challenges in three countries—Brazil, Ecuador, and Malawi—as perceived by government, service providers, and civil society organizations. A mixed methods approach was used: a clustering model was used for country selection and qualitative semi-structured interviews were used with direct observation in data collection. The clustering model integrated political, economic, social and environmental variables that impact water sector performance, to group countries. Brazil, Ecuador and Malawi were selected with the model so as to enhance the generalizability of the results. This comparative case study is important because similar challenges are identified in the drinking water sectors of each country; while, the countries represent diverse socio-economic and political contexts, and the selection process provides generalizability to our results. We find that access to safe water could be improved if certain water governance challenges were addressed: coordination and data sharing between ministries that deal with drinking water services; monitoring and enforcement of water quality laws; and sufficient technical capacity to improve administrative and technical management of water services at the local level. From an analysis of our field research, we also developed a conceptual framework that identifies policy levers that could be used to influence governance of drinking water quality on national and sub-national levels, and the relationships between these levers

Translating the Human Right to Water and Sanitation into Public Policy Reform

Abstract The development of a human right to water and sanitation under international law has created an imperative to implement human rights in water and sanitation policy. Through forty-three interviews with informants in international institutions, national governments, and non-governmental organizations, this research examines interpretations of this new human right in global governance, national policy, and local practice. Exploring obstacles to the implementation of rights-based water and sanitation policy, the authors analyze the limitations of translating international human rights into local water and sanitation practice, concluding that system operators, utilities, and management boards remain largely unaffected by the changing public policy landscape for human rights realization. To understand the relevance of human rights standards to water and sanitatio

Understanding Portfolio Efficiency with Conditioning Information *

Abstract I develop two new types of portfolio efficiency when returns are predictable. The first type maximizes the unconditional Sharpe ratio of excess returns and differs from unconditional efficiency unless the safe asset return is constant over time. The second type maximizes conditional mean-variance preferences and differs from unconditional efficiency unless, additionally, the maximum conditional Sharpe ratio is constant. Using stock data, I quantify and test their performance differences with respect to unconditionally and fixed-weight efficient returns. I also show the relevance of the two new portfolio strategies to test conditional asset pricing models

Introducing knowledge management as both desirable and undesirable processes

Knowledge management (KM), as a topic for academic research and practical implementation, has had a short history dating back only to the early 1990s. Due to knowledge management’s recent debut as we know it, it is not surprising that much of the writing and research on the subject is controversial. In this article we note the need of a critical awareness of desirable and undesirable shades of knowledge management processes

Theoretical and practical aspects of knowledge management

The last decade of the 20th century saw the emergence of a new discipline within the realm of information systems, which became known as knowledge management (KM). As such, it has become one of the most discussed issues amongst academics and practitioners working in the information systems and human resource management arenas (Prusack, 2001). Amongst academics it has become an area of specialisation with research projects, journals, conferences, books, encyclopaedias, and numerous papers devoted to the topic. Businesses are investing heavily in buying or developing KM supportive systems. However, predominately researchers and practitioners in this area have tended to see (see for example, Alavi & Leidner, 2001; Baskerville, 1998): 1. consider the context in which knowledge management takes place as teams of knowledge workers in communities of practice, whose performance and the performance of their organisation, can be enhanced by knowledge sharing; 2. focus on the process—the creation and application of knowledge management programmes and systems as an organisational resource—neglecting, with some exceptions (Alvesson & Karreman, 2001; Swan & Scarborough, 2001; Schultze, 1999), the wider context in which knowledge management takes place and the fact that resources can be used in ways that can be both creative and destructive, facilitating and manipulative; and 3. stress the role of technology as the enabling agent for KM

Theoretical and practical aspects of knowledge management

The last decade of the 20th century saw the emergence of a new discipline within the realm of information systems, which became known as knowledge management (KM). As such, it has become one of the most discussed issues amongst academics and practitioners working in the information systems and human resource management arenas (Prusack, 2001). Amongst academics it has become an area of specialisation with research projects, journals, conferences, books, encyclopaedias, and numerous papers devoted to the topic. Businesses are investing heavily in buying or developing KM supportive systems. However, predominately researchers and practitioners in this area have tended to see (see for example, Alavi & Leidner, 2001; Baskerville, 1998): 1. consider the context in which knowledge management takes place as teams of knowledge workers in communities of practice, whose performance and the performance of their organisation, can be enhanced by knowledge sharing; 2. focus on the process—the creation and application of knowledge management programmes and systems as an organisational resource—neglecting, with some exceptions (Alvesson & Karreman, 2001; Swan & Scarborough, 2001; Schultze, 1999), the wider context in which knowledge management takes place and the fact that resources can be used in ways that can be both creative and destructive, facilitating and manipulative; and 3. stress the role of technology as the enabling agent for KM

Knowledge management processes

Knowledge management (KM), as a topic for academic research and practical implementation, has had a short history dating back only to the early 1990s. Due to knowledge management’s recent debut as we know it, it is not surprising that much of the writing and research on the subject is controversial. In this article we note the need of a critical awareness of desirable and undesirable shades of knowledge management processes