Limited access orders in the developing world :a new approach to the problems of development

The upper-income, advanced industrial countries of the world today all have market economies with open competition, competitive multi-party democratic political systems, and a secure government monopoly over violence. Such open access orders, however, are not the only norm and equilibrium type of society. The middle and low-income developing countries today, like all countries before about 1800, can be understood as limited access orders that maintain their equilibrium in a fundamentally different way. In limited access orders, the state does not have a secure monopoly on violence, and society organizes itself to control violence among the elite factions. A common feature of limited access orders is that political elites divide up control of the economy, each getting some share of the rents. Since outbreaks of violence reduce the rents, the elite factions have incentives to be peaceable most of the time. Adequate stability of the rents and thus of the social order requires limiting access and competition-hence a social order with a fundamentally different logic than the open access order. This paper lays out such a framework and explores some of its implications for the problems of development today.Corporate Law,Labor Policies,Public Sector Corruption&Anticorruption Measures,E-Business,Disability

Re-Structuring Evaluation Findings into Useful Knowledge

Background: A long research stream has shown that when knowledge is more structured it is more likely to be effective in practical application. Building on that research, the authorsapplied Integrative Proposition Analysis to visualize, integrate, and assess the quality and usefulness of knowledge gained from the NMAC (formerly National Minority AIDS Council) Strong Communities evaluation. Purpose: Demonstrate an innovative method to rigorously integrate and strengthen knowledge gained from evaluation and to encourage discussion of future directions for developing stronger theories for more effective evaluation and more effective action. Setting: Birmingham, Alabama Intervention: A project to identify local strategies for community-based organizations and community health centers that serve African American and Latinx gay and bisexual men and transgender women to collaboratively meet HIV-related community needs. Research Design:  The researchers applied Integrative Propositional Analysis to integrate and map concepts and causal connections emerging from the evaluation findings. The authorsthen analyzed the resulting map to identify top-mentioned concepts, better understood concepts, reinforcing loops, and knowledge gaps. Data Collection and Analysis: Integrative Propositional Analysis applied to a literature review and stakeholder interview transcripts collected for the evaluation. Findings: Integrating literature and interview results helped to identify several actions where providers of HIV-related services could increase their impact on combating the HIV epidemic among the communities they serve. The authorsalso identified a reinforcing loop; this shows opportunity to improve two desired outcomes by increasing one. In addition, the authorsidentified blank spots on the map; these show where additional research could strengthen the quality and usefulness of the mapped knowledge. Keywords: evaluation syntheses; Integrative Propositional Analysis; complexity; systems thinking; HIV; African American; Latinx; gay men; bisexual men; transgender wome

Motivations for choosing an allied health profession career: findings from a scoping review

Fourteen professions are recognised as AHPs in England representing the third largest workforce in health and care. Although there is a need to significantly grow the AHP workforce in England, recruitment to many AHP courses is an issue. To increase course applications and encourage individuals to choose AHP careers, we need to understand the decision-making process in choosing an AHP career. The aim of this scoping review was to examine the nature and breadth of evidence internationally regarding the motivations for choosing an AHP career as well as any sources of influence and barriers. A comprehensive search identified 61 relevant studies. Findings revealed inconsistency in the evidence base and the literature focused on a select number of professions and countries. No relevant studies were found for three professions. Whilst many motivations and sources of influence were identified, barriers to entering an AHP career were explored less. The opportunity to help people was a key motivation with financially based motivations less important. Personal influences, such as a relative working in healthcare, were the most influential source to choosing this career pathway, media was the least. The main barrier to choosing an AHP career identified was a lack of awareness of the profession. There is a need to further investigate career choice motivations, sources of influence and barriers for all AHPs; gaining this knowledge will help tailor future healthcare career promotion and advice for each profession and assist with overall AHP recruitment

Coronary bypass grafting using crossclamp fibrillation does not result in reliable reperfusion of the myocardium when the crossclamp is intermittently released: a prospective cohort study

BACKGROUND: Cross-clamp fibrillation is a well established method of performing coronary grafting, but its clinical effect on the myocardium is unknown. We sought to measure these effects clinically using the Khuri Intramyocardial pH monitor. METHODS: 50 episodes of cross-clamping were recorded in 16 patients who underwent CABG with crossclamp-fibrillation. An Intramyocardial pH probe measured the level of acidosis in the anterior and posterior myocardium in real-time. The pH at the start and end of each period of cross-clamping was recorded. RESULTS: It became very apparent that the pH of some patients recovered quickly while others entirely failed to recover. Thus the patients were split into 2 groups according to whether the pH recovered to above 6.8 after the first crossclamp-release (N = 8 in each group). Initial pH was 7.133 (range 6.974–7.239). After the first period of crossclamping the pH dropped to 6.381 (range 6.034–6.684). The pH in recoverers prior to the second XC application was 6.990(range 6.808–7.222) compared to only 6.455 (range 6.200–6.737) in patient's whose myocardium did not recover (P < 0.0005). This finding was repeated after the second XC release (mean pH 7.005 vs 6.537) and the third (mean pH 6.736 vs 6.376). However prior to separation from bypass the pH was close to the initial pH in both groups (7.062 vs 7.038). CONCLUSION: Crossclamp fibrillation does not result in reliable reperfusion of the myocardium between periods of crossclamping

Influence of renal replacement modalities on amikacin population pharmacokinetics in critically ill patients on continuous renal replacement therapy

The objective of this study was to describe amikacin pharmacokinetics (PK) in critically ill patients receiving equal doses (30 ml/kg of body weight/h) of continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodiafiltration (CVVHDF). Patients receiving amikacin and undergoing CVVH or CVVHDF were eligible. Population pharmacokinetic analysis and Monte Carlo simulation were undertaken using the Pmetrics software package for R. Sixteen patients (9 undergoing CVVH, 11 undergoing CVVHDF) and 20 sampling intervals were analyzed. A two-compartment linear model best described the data. Patient weight was the only covariate that was associated with drug clearance. The mean +/- standard deviation parameter estimates were 25.2 +/- 17.3 liters for the central volume, 0.89 +/- 1.17 h(-1) for the rate constant for the drug distribution from the central to the peripheral compartment, 2.38 +/- 6.60 h(-1) for the rate constant for the drug distribution from the peripheral to the central compartment, 4.45 +/- 2.35 liters/h for hemodiafiltration clearance, and 4.69 +/- 2.42 liters/h for hemofiltration clearance. Dosing simulations for amikacin supported the use of high dosing regimens (>= 25 mg/kg) and extended intervals (36 to 48 h) for most patients when considering PK/pharmacodynamic (PD) targets of a maximum concentration in plasma (C-max)/MIC ratio of >= 8 and a minimal concentration o

The IT framework of the European Archive of Historical Earthquake Data (AHEAD)

The European Archive of Historical EArthquake Data (AHEAD) has been developed in the frame of the EC project NERIES and maintained in the frame of the EC project SHARE.AHEAD makes available on the web the result of a networked historical earthquake data research, formalised in terms of studies (papers, reports, macroseismic data points, etc). It provides an updated wealth of data that are unique for many European events in the time-window 1000-1963.A series of IT solutions have been developed in order to support both the research and the networking activities carried out within the building process of AHEAD. The resulting framework is an equally balanced effort in both the back-end and front-end design and implementation, a key feature in a research approach very much human-centred, where the quantity of data is small if compared to terabytes of instrumental data.AHEAD is composed of five mutually dependent data-components: 1) the “Digital Library”, where all the historical earthquake studies are stored and described by bibliographical metadata, 2) the “Consensus Earthquake Inventory”, where the relevant macroseismic data (event date, epicentral area, number of macroseismic data-point, maximum observed intensity) are extrapolated, the best available information are selected and fake earthquakes are highlighted, 3) the “European Macroseismic Database”, where all the available macroseismic data-points (MDPs) are stored, 4) the “Parameters Laboratory”, where earthquakes parameterisation methods are applied to MDPs in order to obtain epicentral locations and magnitudes and 5) the “European Earthquake Catalogue”.The presentation will demonstrate the adopted IT solutions separately for the back-end and the front-end, both for the access-restricted website and the general-purpose implementation designed to be included in the “Earthquake Data Portal”, developed within the EC project NERIES, which targets a much broader scientific community

Issues with fracturing ice during an ice drilling project in Greenland (EastGRIP)

Drilling an ice core through an ice sheet (typically 2000 to 3000 m thick) is a technical challenge that nonetheless generates valuable and unique information on palaeo-climate and ice dynamics. As technically the drilling cannot be done in one run, the core has to be fractured approximately every 3 m to retrieve core sections from the bore hole. This fracture process is initiated by breaking the core with core-catchers which also clamp the engaged core in the drill head while the whole drill is then pulled up with the winch motor. This standard procedure is known to become difficult and requires extremely high pulling forces (Wilhelms et al. 2007), in the very deep part of the drill procedure, close to the bedrock of the ice sheet, especially when the ice material becomes warm (approximately -2°C) due to the geothermal heat released from the bedrock. Recently, during the EastGRIP (East Greenland Ice coring Project) drilling we observed a similar issue with breaking off cored sections only with extremely high pulling forces, but started from approximately 1800 m of depth, where the temperature is still very cold (approximately -20°C). This has not been observed at other ice drilling sites. As dependencies of fracture behaviour on crystal orientation and grain size are known (Schulson & Duval 2009) for ice, we thus examined the microstructure in the ice samples close to and at the core breaks. First preliminary results suggest that these so far unexperienced difficulties are due to the profoundly different c-axes orientation distribution (CPO) in the EastGRIP ice core. In contrast to other deep ice cores which have been drilled on ice domes or ice divides, EastGRIP is located in an ice stream. This location means that the deformation geometry (kinematics) is completely different, resulting in a different CPO (girdle pattern instead of single maximum pattern). Evidence regarding additional grain-size dependence will hopefully help to refine the fracturing procedure, which is possible due to a rather strong grain size layering observed in natural ice formed by snow precipitation. --------------------- Wilhelms, F.; Sheldon, S. G.; Hamann, I. & Kipfstuhl, S. Implications for and findings from deep ice core drillings - An example: The ultimate tensile strength of ice at high strain rates. Physics and Chemistry of Ice (The proceedings of the International Conference on the Physics and Chemistry of Ice held at Bremerhaven, Germany on 23-28 July 2006), 2007, 635-639 Schulson, E. M. & Duval, P. Creep and Fracture of Ice. Cambridge University Press, 2009, 40

Distributional reinforcement learning in prefrontal cortex

The prefrontal cortex is crucial for learning and decision-making. Classic reinforcement learning (RL) theories center on learning the expectation of potential rewarding outcomes and explain a wealth of neural data in the prefrontal cortex. Distributional RL, on the other hand, learns the full distribution of rewarding outcomes and better explains dopamine responses. In the present study, we show that distributional RL also better explains macaque anterior cingulate cortex neuronal responses, suggesting that it is a common mechanism for reward-guided learning

Pengaruh Pemberian Biskuit Tepung Ikan Mujair dan Tepung Beras Merah terhadap Status Gizi Siswa SD di KecamatanLamasi

Penelitian ini bertujuan untuk mengetahui : 1) status gizi siswa SD Lamasi sebelum mengkonsumsi biskuit tepung ikan mujair dan tepung beras merah 2) status gizi siswa SD Lamasi setelah mengkonsumsi biskuit tepung ikan mujair dan tepung beras merah 3) pengaruh biskuit tepung ikan mujair dan tepung beras merah terhadap status gizi siswa SD Lamasi. Jenis penelitian yang digunakan adalah penelitian kuantitatif dengan metode eksperimen yaitu Quasi Experimental design dan Desain penelitian Randomized Controlled Trial (RCT) Single Blind Pre-post Study, jumlah sampel sebanyak 26 orang yang dipilih secara purposive sampling, dari 3 sekolah sebanyak 104 siswa SD kelas V di Kecamatan Lamasi, yang berumur 10-11 tahun. Data penelitian diperoleh dengan teknik angket (ffqdan food recall), wawancara (profilkeluarga), observasi (keadaanlingkungan), dan dokumentasi (data dinaspendidikandan data sekolah). Teknik analisis data yang digunakan adalah analisis deskriptif, uji T dan analisis regresi. Hasil penelitian menunjukkan 1) berkurangnya status gizi kurang siswa dari 11 sampel menjadi 10 sampel, dan meningkatnya status gizi ideal siswa dari 2 sampel menjadi 3 sampel setelah mengkonsumsi biskuit untuk kelompok kontrol, sedangkan untuk kelompok perlakuan sebelum dan setelah mengkonsumsi biskuit terdapat status gizi kurang sebanyak 12 sampel menjadi 11 sampel, dan status gizi ideal sebanyak 1 sampel menjadi 2 sampel. 2) Hasil pengujian pada tabel diketahui nilai t sebesar -1.573 dengan nilai P Value> 0,05 maka dapat disimpulkan bahwa tidak ada pengaruh yang signifikan atau lemah pada konsumsi biskuit tehadap status gizi siswa, dan nilai R = 0.312menunjukkan hubungan antara variabel bebas dan variabel terikat termasuk pada kategori lemah, variabel terikat atau R Square = 9,8% dan 90.2% dipengaruhi oleh faktor lain. Kata kunci: biskuit tepung ikan mujair dan tepung beras merah, status gizi

Kidney after nonrenal transplantation-the impact of alemtuzumab induction

BACKGROUND.: Calcineurin inhibitor nephrotoxicity in nonrenal allograft recipients can lead to end-stage renal disease and the need for kidney transplantation. We sought to evaluate the role of alemtuzumab induction in this population. PATIENTS AND METHODS.: We evaluated 144 patients undergoing kidney transplantation after nonrenal transplantation between May 18, 1998, and October 8, 2007. Seventy-two patients transplanted between January 15, 2003, and October 8, 2007, received alemtuzumab induction and continued their pretransplant immunosuppression. Seventy-two patients transplanted between May 18, 1998, and July 21, 2007, did not receive alemtuzumab induction, but received additional steroids and maintenance immunosuppression. Donor and recipient demographics were comparable. RESULTS.: Overall, 1-and 3-year patient survival and renal function were comparable between the two groups. One-and 3-year graft survival was 93.0% and 75.3% in the alemtuzumab group and 83.3% and 68.7% in the no alemtuzumab group, respectively (P=0.051). The incidence of acute rejection was lower in the alemtuzumab group, 15.3%, than in the no alemtuzumab group, 41.7% (P=0.0001). The incidence of delayed graft function was lower in the alemtuzumab group, 9.7%, than in the no alemtuzumab group, 25.0% (P=0.003). The incidence of viral complications was comparable. CONCLUSION.: Alemtuzumab induction with simple resumption of baseline immunosuppression in patients undergoing kidney transplantation after nonrenal transplantation represents a reasonable immunosuppressive strategy. Copyright © 2009 by Lippincott Williams & Wilkins