Between the Devil and the Deep Blue Sea: Internally Displaced Women and Girls in Liberia and Uganda and the Role of the International Community

This article provides a brief background on the civil war in Liberia and the ongoing political violence in Uganda that have left thousands of people internally displaced, especially woman and girls. It analyzes the willing and unwilling roles of women and girls in both conflicts as combatants, wives, and rape survivors, etc. It discusses how women’s bodies became an extension of the battlefield as all participants in the conflict perpetrated gross human rights violations against women and girls in the forms of rapes, gang rapes, torture, and beatings. These violations have forced many women and girls, especially in Liberia to seek safety outside their home areas while others fled to camps for the internally displaced. The conflict in Uganda is contained within specific districts in the northern part of the country where the government has established camps. The camps often do not serve as a sanctuary as women and girls face many problems due to overcrowding, gender-based violence, lack of medical facilities, and little economic opportunities. A discussion of the internationalization of the conflict is included for fuller understanding of factors that produced or exacerbated internal displacement. In Liberia, the roles of the Economic Community of West African States’ (ECOWAS) military group (ECOMIL), along with the support provided by neighboring countries to different insurgent groups are examined. The internationalization of the conflict in Uganda is analyzed by discussing the role of the governments of the United States and Sudan and their support of Sudanese People’s Liberation Army and Lord’s Resistance Army respectively. Lastly, the article focuses on the role of women in both countries’ peace building efforts

A Classification Scheme for Medical Expenditures

Medical care represents a significant portion of society\u27s response to problems affecting social welfare. While the problems surrounding medical care are complex, a major part of these problems can be attributed to the fact that medical care expenditures are viewed indiscriminately without regard for the nature of the expenditures themselves. This paper presents a framework to differentiate various types of medical care expenditures. The paper argues that medical care expenditures can be classified as either instrumental-consummatory or as external-internal relative to the medical care system. The consequences of this classification and some conclusions which may be drawn from it are explicated in the paper

Russian-speaking Estonians : Bridging the Gap of Understanding

Tämän tutkimuksen tavoitteena on selvittää millä tavalla venäjää puhuva yhteisö Narvassa, Virossa kokee identiteettinsä ja kuulumisensa Viroon ja Venäjään. Identiteettiä ja kuulumisen tunnetta tarkastellaan itsereflektioissa. Kuudentoista Narvassa asuvan ihmisen haastatteluiden kautta paljastetaan havaintoja heidän syrjinnästään ja integraatiostaan sekä haastatteluita ympäröiviä diskursseja sisällyttämisestä ja syrjäytymisestä, jotka vaikuttavat siihen, miten venäjänkieliset ihmiset tasapainottavat suhdettaan sekä Venäjän että Viron yhteiskuntaan. Teoreettisena viitekehyksenä on psykologisia ja sosiologisia teorioita, jotka tutkivat haastateltavien kuvaamia henkilökohtaisia ja sosiaalisia vaikutuksia suhteissansa. Tutkimus korostaa sitä, miten hyödyllistä on ymmärtää syvästi vähemmistöjä jotka asuvat kriittisillä rajoilla, jotta olisi mahdollista kehittää sopivaa ja tehokasta politiikkaa kansallisella tasolla, mikä vaikuttaa vähemmistöihin, heidän asuttamassaan maassa ja heidän alkuperäisessä kotimaassaan. Tutkimuksen tarkoituksena on lisätä tietoja tutkimuksen kenttiin, jotka käsittelevät vähemmistöyhteisöä kriittisillä rajoilla ja erityisesti venäjänkielisten yhteisöä, joka on levinnyt entisen Neuvostoliiton läpi sekä kuvailla tekijöitä jotka vaikuttavat heidän mobilisaatioonsa ja transnationalismia.This research explores the way in which the Russian-speaking community of Narva, Estonia perceives their identity and sense of belongingness in relation to Estonia and Russia through self-reflection. Sixteen interviews with residents of Narva reveal perceptions of discrimination and integration and the surrounding discourses on inclusion and exclusion which define and influence how Russian-speaking Estonians balance their relationship with Russian and Estonian societies. The theoretical framework is composed of psychological and sociological theories which examine the individual and social aspects involved in the relationships the interviewees describe. The research underlines the value in having a deeper understanding of minority populations along critical borders to develop appropriate and effective national-level policies which affect the community, country of residence and country of origin of the minority community. This research aims to add to the existing literature focused on the study of minority communities along critical borders in general and Russian-speaking communities spread across the Post-Soviet Space in particular as well as describe the factors that influence their mobilization and transnationalism

Sexual Dimorphism of the Zebra Finch Syrinx Indicates Adaptation for High Fundamental Frequencies in Males

In many songbirds the larger vocal repertoire of males is associated with sexual dimorphism of the vocal control centers and muscles of the vocal organ, the syrinx. However, it is largely unknown how these differences are translated into different acoustic behavior.Here we show that the sound generating structures of the syrinx, the labia and the associated cartilaginous framework, also display sexual dimorphism. One of the bronchial half rings that position and tense the labia is larger in males, and the size and shape of the labia differ between males and females. The functional consequences of these differences were explored by denervating syringeal muscles. After denervation, both sexes produced equally low fundamental frequencies, but the driving pressure generally increased and was higher in males. Denervation strongly affected the relationship between driving pressure and fundamental frequency.The syringeal modifications in the male syrinx, in concert with dimorphisms in neural control and muscle mass, are most likely the foundation for the potential to generate an enhanced frequency range. Sexually dimorphic vocal behavior therefore arises from finely tuned modifications at every level of the motor cascade. This sexual dimorphism in frequency control illustrates a significant evolutionary step towards increased vocal complexity in birds

A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

BACKGROUND: Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. METHODS: Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. RESULTS: Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). CONCLUSIONS: A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up

Regional governance: strategies and disputes in health region management

OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table). The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical) services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of governance and intermediate institutionalism. The regional interagency committee’s managerial routine needs to incorporate more democratic devices for connecting with educational institutions, devices that are more permeable to social demands relating to regional policy making

Resource allocation and priority setting in health care: a multi-criteria decision analysis problem of value?

A methodological approach is needed for allocating health care resources in an efficient and fair way that gives legitimacy to decisions. Currently, most priority setting approaches tend to focus on single or limited benefit dimensions, even though the value of new health care interventions is multi-dimensional. Explicit elicitation of social value trade-offs is usually not possible and decision-makers often adopt intuitive or heuristic modes for simplification purposes as part of an ad hoc decision-making process which might diminish the reasonableness and credibility of the decisions. In this paper, we suggest that multi-criteria decision analysis could provide a more comprehensive and transparent approach in health care to systematically capture decision-makers’ concerns, compare value trade-offs and elicit their value preferences. We conclude that such methods could inform the development of a decision support system in health care, contributing towards more efficient, rational and legitimate resource allocation decisions

Book ReviewThe Emerging Researcher: Nurturing Passion, Developing Skills, Producing OutputBy De Gruchy, John W and Lynn Holness (2007)

Cape Town: UCT Press. ISBN: 9781919895017. xiii, 194 pp. ZAR185.00(paper).JOURNAL OF THE MUSICAL ARTS IN AFRICA VOLUME 7 2010, 99&ndash;10

Scansion No. 22 – Thursday, 30th December, 1954

Seeing that the year has had it's chips I'll hand out the fan academy awards. There are ten jugs of assorted ale to be distributed and two special prizes of rusty jam tins (empty.) Wally Judd gets the first jug of ale for his organisation of the Third Australian Science Fiction Convention. This turned out to be the most successful fan gathering ever. We all are sorry to see that the effort killed Wally's interest in fandom but it is to be hoped he will see his way clear to join us again at some future date. What about it, Wally