189 research outputs found

    Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania.

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    Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers' shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants' practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based

    Psychological climates in action learning sets: A manager’s perspective

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    Action Learning (AL) is often viewed as a process that facilitates professional learning through the creation of a positive psychological climate (Marquart, 2000; Schein, 1979). An psychological climate that fosters an environment in which learning set members feel psychologically safe enough to reflect upon both the successes, and failures in their professional life without any form of repercussion. However, there has been little attention given to the ways that that psychological climate develops, and the differing facets that create that climate. In response to such deficit, this paper reports the outcomes of interviews with eleven managers, all of whom are former AL set members on their experiences of action learning set membership. Drawing upon an interpretivist philosophy, the paper explores the key themes that emerged from the analysis of those interviews. The analysis serves to illustrate the differing facets that collectively contribute creation of a positive psychological climate that is conducive for learning. Analysis points to the relative importance of such facets as: trust, honesty, vulnerability, reciprocity, confidentiality and personal disclosure, all of which have the capacity to lead to a positive psychological climate in action learning sets. This paper is useful for developing an understanding of the differing facets in AL sets that create a psychological climate conducive for learning. As such, it has utility for action learning facilitators, set members, academics and educational consultants

    Linear and nonlinear optical properties of realistic quantum-wire structures: The dominant role of Coulomb correlation

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    A systematic analysis of the linear and nonlinear optical properties of realistic quantum wires is presented. The proposed theoretical approach, based on a set of generalized semiconductor Bloch equations, provides a full three-dimensional multisubband description of carrier-carrier correlation for any profile of the confinement potential, thus allowing a direct comparison with experiments on available structures. In agreement with previous investigations based on simplified one-dimensional models, our analysis shows that, also for realistic quantum-wire structures, electron-hole Coulomb correlation completely removes the one-dimensional band-edge singularities from the linear-absorption spectra. Moreover, we find that this effect is present also at high densities (corresponding to gain regimes) and contributes significantly in suppressing the ideal sharp features of the free-carrier density of states. The multisubband nature of available state-of-the-art structures is found to play a dominant role in determining the overall spectral shape in the whole density range

    Electrode Polarization Effects in Broadband Dielectric Spectroscopy

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    In the present work, we provide broadband dielectric spectra showing strong electrode polarization effects for various materials, belonging to very different material classes. This includes both ionic and electronic conductors as, e.g., salt solutions, ionic liquids, human blood, and colossal-dielectric-constant materials. These data are intended to provide a broad data base enabling a critical test of the validity of phenomenological and microscopic models for electrode polarization. In the present work, the results are analyzed using a simple phenomenological equivalent-circuit description, involving a distributed parallel RC circuit element for the modeling of the weakly conducting regions close to the electrodes. Excellent fits of the experimental data are achieved in this way, demonstrating the universal applicability of this approach. In the investigated ionically conducting materials, we find the universal appearance of a second dispersion region due to electrode polarization, which is only revealed if measuring down to sufficiently low frequencies. This indicates the presence of a second charge-transport process in ionic conductors with blocking electrodes.Comment: 9 pages, 6 figures, experimental data are provided in electronic form (see "Data Conservancy"

    Social use of facial expressions in hylobatids

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    Non-human primates use various communicative means in interactions with others. While primate gestures are commonly considered to be intentionally and flexibly used signals, facial expressions are often referred to as inflexible, automatic expressions of affective internal states. To explore whether and how non-human primates use facial expressions in specific communicative interactions, we studied five species of small apes (gibbons) by employing a newly established Facial Action Coding System for hylobatid species (GibbonFACS). We found that, despite individuals often being in close proximity to each other, in social (as opposed to non-social contexts) the duration of facial expressions was significantly longer when gibbons were facing another individual compared to non-facing situations. Social contexts included grooming, agonistic interactions and play, whereas non-social contexts included resting and self-grooming. Additionally, gibbons used facial expressions while facing another individual more often in social contexts than non-social contexts where facial expressions were produced regardless of the attentional state of the partner. Also, facial expressions were more likely ‘responded to’ by the partner’s facial expressions when facing another individual than non-facing. Taken together, our results indicate that gibbons use their facial expressions differentially depending on the social context and are able to use them in a directed way in communicative interactions with other conspecifics

    Cryomodule development for the CEBAF upgrade

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    Long term plans for CEBAF at Jefferson Lab call for achieving 12 GeV in the middle of the next decade and 24 GeV after 2010. In support of these plans, an Upgrade Cryomodule capable of providing more than three times the voltage of the original CEBAF cryomodule specification within the same length is under development. Development activities have been focused on critical areas thought to have maximum impact on the overall design. These have included the cavity structure, rf power coupling, cavity suspension, alignment, cavity tuning, and beamline interface. It has been found that all design and development areas are tightly coupled and can not be developed independently. Substantial progress has been made toward an integrated design for the Jefferson Lab Upgraded Cryomodule

    In search of the authentic nation: landscape and national identity in Canada and Switzerland

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    While the study of nationalism and national identity has flourished in the last decade, little attention has been devoted to the conditions under which natural environments acquire significance in definitions of nationhood. This article examines the identity-forming role of landscape depictions in two polyethnic nation-states: Canada and Switzerland. Two types of geographical national identity are identified. The first – what we call the ‘nationalisation of nature’– portrays zarticular landscapes as expressions of national authenticity. The second pattern – what we refer to as the ‘naturalisation of the nation’– rests upon a notion of geographical determinism that depicts specific landscapes as forces capable of determining national identity. The authors offer two reasons why the second pattern came to prevail in the cases under consideration: (1) the affinity between wild landscape and the Romantic ideal of pure, rugged nature, and (2) a divergence between the nationalist ideal of ethnic homogeneity and the polyethnic composition of the two societies under consideration

    The Flux-Line Lattice in Superconductors

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    Magnetic flux can penetrate a type-II superconductor in form of Abrikosov vortices. These tend to arrange in a triangular flux-line lattice (FLL) which is more or less perturbed by material inhomogeneities that pin the flux lines, and in high-TcT_c supercon- ductors (HTSC's) also by thermal fluctuations. Many properties of the FLL are well described by the phenomenological Ginzburg-Landau theory or by the electromagnetic London theory, which treats the vortex core as a singularity. In Nb alloys and HTSC's the FLL is very soft mainly because of the large magnetic penetration depth: The shear modulus of the FLL is thus small and the tilt modulus is dispersive and becomes very small for short distortion wavelength. This softness of the FLL is enhanced further by the pronounced anisotropy and layered structure of HTSC's, which strongly increases the penetration depth for currents along the c-axis of these uniaxial crystals and may even cause a decoupling of two-dimensional vortex lattices in the Cu-O layers. Thermal fluctuations and softening may melt the FLL and cause thermally activated depinning of the flux lines or of the 2D pancake vortices in the layers. Various phase transitions are predicted for the FLL in layered HTSC's. The linear and nonlinear magnetic response of HTSC's gives rise to interesting effects which strongly depend on the geometry of the experiment.Comment: Review paper for Rep.Prog.Phys., 124 narrow pages. The 30 figures do not exist as postscript file
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