The determinants of individual health care expenditures in prison: evidence from Switzerland.

Prison health systems are subject to increasing pressures given the specific health needs of a growing and aging prison population. Identifying the drivers of medical spending among incarcerated individuals is therefore key for health care governance in prisons. This study assesses the determinants of individual health care expenditures within the prisons of the canton of Vaud, a large region of Switzerland. We use a unique dataset linking demographic and prison stay characteristics as well as objective measures of morbidity to detailed medical invoice data. We adopt a multivariate regression approach to model total, somatic and psychiatric outpatient health care expenditures. We find that chronic infectious, musculoskeletal and skin diseases are strong predictors of total and somatic costs. Schizophrenia, neurotic and personality disorders as well as the abuse of illicit drugs and pharmaceuticals drive total and psychiatric costs. Furthermore, cumulating psychiatric and somatic comorbidities has an incremental effect on costs. By identifying the characteristics associated with health care expenditures in prison, this study constitutes a key step towards a more efficient use of medical resources in prison

Exploring differences in healthcare utilization of prisoners in the Canton of Vaud, Switzerland.

Prison healthcare is an important public health concern given the increasing healthcare needs of a growing and aging prison population, which accumulates vulnerability factors and suffers from higher disease prevalence than the general population. This study identifies the key factors associated with outpatient general practitioner (GP), nursing or psychiatric healthcare utilization (HCU) within prisons. Cross-sectional data systematically collected by the prison medical staff were obtained for a sample of 1664 adult prisoners of the Canton of Vaud, Switzerland, for the year 2011. They contain detailed information on demographics (predisposing factors), diagnosed chronic somatic and psychiatric disorders (needs factors), as well as prison stay characteristics (contextual factors). For GP, nurse and psychiatric care, two-part regressions are used to model separately the probability and the volume of HCU. Predisposing factors are generally not associated with the probability to use healthcare services after controlling for needs factors. However, female inmates use higher volumes of care, and the volume of GP consultations increases with age. Chronic somatic and psychiatric conditions are the most important predictors of the probability of HCU, but associations with volumes differ in their magnitude and significance across disease groups. Infectious, musculoskeletal, nervous and circulatory diseases actively mobilize GP and nursing staff. Schizophrenia, illicit drug and pharmaceuticals abuse are strongly positively associated with psychiatric and nurse HCU. The occupancy rate displays positive associations among contextual factors. Prison healthcare systems face increasingly complex organizational, budgetary and ethical challenges. This study provides relevant insights into the HCU patterns of a marginalized and understudied population

Indigenous Mountain People’s Risk Perception to Environmental Hazards in Border Conflict Areas

This study aims to understand community risk perception to environmental hazards in a border conflict zone context in high-mountain areas. Participatory rural appraisal (PRA) tools were applied by the social science team. The results were validated with a hazard map prepared by a separate team comprised of geologists. Turtuk, the northernmost village in Ladakh, India located near the line of control with Pakistan was undertaken as a case study. Turtuk represents a high mountain indigenous rural community which has experienced several major disasters (flash flooding and landslides in 2010, 2014, and 2015) and territorial conflicts (wars in 1971 and 1999 with Pakistan) in recent times. The villagers were able to identify various environmental hazards and associated risk zones through participatory timeline, hazard and dream mapping exercises. The PRA maps matched the geological hazard map of Turtuk, demonstrating that community people are highly aware of surrounding hazards regardless of differences in age, sex, education, occupation, and religion. They apply indigenous knowledge to deal with the adverse climate and calamities. The technique, of analysing community vulnerability in the context of conflict and disasters by applying qualitative PRA tools and validating the mapping results, as piloted in this study is novel and replicable in similar settings

Static Test on Full Scale Rammed Earth Building with Mesh-Wrap Retrofitting Strategy

This paper reports the experimental campaign for static tests performed on unreinforced (URE) and mesh retrofitted (RRE) full scale rammed earth building. Amongst varying building patterns of traditional rammed earth houses found in Bhutan, a two-storied building with a full solid wall (small openings) on the first floor and larger opening in the front facade of the second floor was chosen. The proposed mesh–wrap retrofitting of the walls involved the use of standard mild steel welded mesh as the main mesh, M–Mesh (Ø 1.8 mm and 34 mm c/c spacing) and light and galvanized welded mesh as a lapping mesh, L–Mesh (Ø 1.45 mm and 28 mm c/c spacing) provided at the corners and along the height of the walls. The static test loading protocol involved the displacement controlled loading with drift-control over the building. Cracks and damage observations were made at the storey drift ratios of: 1/2000, 1/1000, 1/750, 1/500 for URE building. The same URE building was retrofitted afterward and retested as RRE to storey drift ratios of: 1/2000, 1/1000, 1/750, 1/500, 1/250, 1/150, 1/100 and 1/75. The mesh retrofitting is found effective in both damage control as well as strength enhancement over the unreinforced one. The URE specimen showed a clear opening of shear and vertical cracks in the in-plane loaded walls near the openings and Jugshing holes. For the RRE specimen, cracks dispersed over a large region of the in–plane loaded walls. No delamination of mesh–wrap was observed, showing the effectiveness of the proposed technique. The RRE specimen showed enhancement in base shear by 2.5 times, ductility 2.3 times, and energy absorption 12 times the URE counterpart

Identification of novel mutations causing pediatric cataract in Bhutan, Cambodia, and Sri Lanka

Background: Pediatric cataract is an important cause of blindness and visual impairment in children. A large proportion of pediatric cataracts are inherited, and many genes have been described for this heterogeneous Mendelian disease. Surveys of schools for the blind in Bhutan, Cambodia, and Sri Lanka have identified many children with this condition and we aimed to identify the genetic causes of inherited cataract in these populations.Methods: We screened, in parallel, 51 causative genes for inherited cataracts in 33 probands by Ampliseq enrichment and sequencing on an Ion Torrent PGM. Rare novel protein coding variants were assessed for segregation in family members, where possible, by Sanger sequencing.Results: We identified 24 rare (frequency Conclusion: This study found that 20%-30% of patients in these countries have a mutation in a known cataract causing gene, which is considerably lower than the 60%-70% reported in Caucasian cohorts. This suggests that additional cataract genes remain to be discovered in this cohort of Asian pediatric cataract patients

Heat-tolerant maize for rainfed hot, dry environments in the lowland tropics: from breeding to improved seed delivery

Climate change-induced heat stress combines two challenges: high day- and nighttime temperatures, and physiological water deficit due to demand-side drought caused by increase in vapor-pressure deficit. It is one of the major factors in low productivity of maize in rainfed stress-prone environments in South Asia, affecting a large population of smallholder farmers who depend on maize for their sustenance and livelihoods. The International Maize and Wheat Improvement Center (CIMMYT) maize program in Asia, in partnership with public-sector maize research institutes and private-sector seed companies in South Asian countries, is implementing an intensive initiative for developing and deploying heat-tolerant maize that combines high yield potential with resilience to heat and drought stresses. With the integration of novel breeding tools and methods, including genomics-assisted breeding, doubled haploidy, field-based precision phenotyping, and trait-based selection, new maize germplasm with increased tolerance to heat stress is being developed for the South Asian tropics. Over a decade of concerted effort has resulted in the successful development and release of 20 high-yielding heat-tolerant maize hybrids in CIMMYT genetic backgrounds. Via public–private partnerships, eight hybrids are presently being deployed on over 50,000 ha in South Asian countries, including Bangladesh, Bhutan, India, Nepal, and Pakistan

Deformation analysis of a metropolis from C- to X-band PSI: proof-of-concept with Cosmo-Skymed over Rome, Italy

Stability of monuments and subsidence of residential quarters in Rome (Italy) are depicted based on geospatial analysis of more than 310,000 Persistent Scatterers (PS) obtained from Stanford Method for Persistent Scatterers (StaMPS) processing of 32 COSMO-SkyMed 3m-resolution HH StripMap ascending mode scenes acquired between 21 March 2011 and 10 June 2013. COSMO-SkyMed PS densities and associated displacement velocities are compared with almost 20 years of historical C-band ERS- 1/2, ENVISAT and RADARSAT-1/2 imagery. Accounting for differences in image processing algorithms and satellite acquisition geometries, we assess the feasibility of ground motion monitoring in big cities and metropolitan areas by coupling newly acquired and legacy SAR in full time series. Limitations and operational benefits of the transition from medium resolution C-band to high resolution X-band PS data are discussed, alongside the potential impact on the management of expanding urban environments

Enhancing the Reading for Pleasure Habit of the Students of Samtse College of Education

Reading is an essential skill for everybody especially for the students of Samtse College of Education who are future teachers. They need to read to enhance their communication skills, upgrade their knowledge and skills and be role models in reading for their students. However, we have found that the reading for pleasure habit among the students is poor. Students generally use social media during their leisure time instead of reading which is a concern both for their lecturers and the institution. An action research study was carried out to improve students’ reading for pleasure habit. Data for the study were gathered using a survey and interview. A total of 325 students completed the survey and 57 students participated in the interview. The data were collected twice; before (baseline) and after the intervention. Comparison of means was used to analyse the quantitative data and the qualitative data were analysed thematically. Following the analysis of the baseline data, three intervention strategies were employed; Our Time To Enjoy Reading (OTTER), Self-indulgence Reading, and Raffle Draw. These strategies were implemented in all the 16 classes for a period of 8 weeks. The comparison of the analysis of the pre-and post-data showed that the interventions have been effective in promoting the reading for pleasure habit of the students

ACKR4 in Tumor Cells Regulates Dendritic Cell Migration to Tumor-Draining Lymph Nodes and T-Cell Priming

Colorectal cancer (CRC) is one of the most common malignancies in both morbidity and mortality. Immune checkpoint blockade (ICB) treatments have been successful in a portion of mismatch repair-deficient (dMMR) CRC patients but have failed in mismatch repair-proficient (pMMR) CRC patients. Atypical Chemokine Receptor 4 (ACKR4) is implicated in regulating dendritic cell (DC) migration. However, the roles of ACKR4 in CRC development and anti-tumor immunoregulation are not known. By analyzing human CRC tissues, transgenic animals, and genetically modified CRC cells lines, our study revealed an important function of ACKR4 in maintaining CRC immune response. Loss of ACKR4 in CRC is associated with poor immune infiltration in the tumor microenvironment. More importantly, loss of ACKR4 in CRC tumor cells, rather than stromal cells, restrains the DC migration and antigen presentation to the tumor-draining lymph nodes (TdLNs). Moreover, tumors with ACKR4 knockdown become less sensitive to immune checkpoint blockade. Finally, we identified that microRNA miR-552 negatively regulates ACKR4 expression in human CRC. Taken together, our studies identified a novel and crucial mechanism for the maintenance of the DC-mediated T-cell priming in the TdLNs. These new findings demonstrate a novel mechanism leading to immunosuppression and ICB treatment resistance in CRC