Social safety nets in fragile states : a community-based school feeding program in Togo

This paper reviews a small community-based school feeding program launched in Togo in response to the 2007/08 food price crisis. The discussion focuses on the operational and policy lessons emerging from the program, to better understand opportunities for scale up and sustainability in the future. A focus of the discussion is how to build safety nets in fragile states and in situations where there is weak and fragmented government capacity to deliver services to disadvantaged and vulnerable communities. In this context school feeding is explored as an entry point through the use of informal mechanisms based on the commitment of communities and civil society. The analysis is premised on quantitative and qualitative analysis carried out at program sites. The discussion identifies the operational challenges and opportunities in customizing school feeding within Togo with an emphasis on targeting, cost effectiveness, procurement and institutional aspects. Evidence on the economic and social benefits of the program is also presented, focusing on dietary impacts, as well as household and local community effects. The objective of the discussion is to share lessons learned from evaluation findings so that they can be useful for implementing similar programs in the future in Togo itself or in other countries. Findings from the analysis highlight the possibilities of implementing school feeding in a low capacity setting and the scope for using the program as a springboard towards a broader and more comprehensive social safety net.Food&Beverage Industry,Education For All,Safety Nets and Transfers,Disability,Rural Poverty Reduction

INSTITUTO DE PREVIDÊNCIA DOS SERVIDORES DO MUNICÍPIO DE NILÓPOLIS E OS PROBLEMAS ACARRETADOS PELA ROTATIVIDADE DOS SERVIDORES QUE ATUAM NO SETOR

Staff turnover is one of the great difficulties encountered by the public service. The cause of this problem may be related to factors such as remuneration and reward, routineization, conflicts, employee satisfaction/dissatisfaction, motivation/demotion, political issues, among others. It is in this turnover of personnel that the present study is problematized, which aims to point out measures that help solve the problem of turnover of commissioned employees of the Pension Institute of the municipality of Nilópolis, proposing solutions that can contribute to the solution of the problem found in that institute. The study sought to know the possible causes for the departure of the servers, the reason for turnover, in order to propose measures that can help in a review of the processes and policies of organization and management of that institute, thus combating the turnover and operational costs resulting from it. One of the measures proposed to minimize the turnover of personnel in the institute under analysis is the elaboration of strategies that help to recognize the motivations for the departure of the servers, because from this knowledge it is possible to elaborate measures of improvements in the management processes and organization of that institute, in order to create policies of valorization and incentive for these professionals to wish to remain in the server framework, when this is possible.La rotación de personal es una de las principales dificultades con las que se encuentra el servicio público. La causa de este problema puede estar relacionada con factores como: remuneración y recompensa, rutina, conflictos, satisfacción / insatisfacción de los empleados, motivación / degradación, temas políticos, entre otros. Es en esta rotación de personal donde se problematiza el presente estudio, que tiene como objetivo señalar medidas que ayuden a solucionar el problema de la rotación de empleados contratados del Instituto de la Seguridad Social en el municipio de Nilópolis, proponiendo soluciones que puedan contribuir a la solución. del problema encontrado en ese instituto. El estudio buscó conocer las posibles causas de la salida de los servidores, el motivo que provoca la rotación, con el fin de proponer medidas que puedan ayudar en una revisión de los procesos y políticas de organización y gestión de ese instituto, combatiendo así la rotación. . y los costos operativos resultantes. Una de las medidas propuestas para minimizar la rotación de personal en el instituto analizado es el desarrollo de estrategias que ayuden a reconocer las motivaciones para dejar los servidores, ya que a partir de este conocimiento es posible desarrollar medidas para mejorar los procesos de gestión y organización de los mismos. . instituto, con el fin de crear políticas de valoración e incentivos para que estos profesionales deseen permanecer en la plantilla, cuando sea posible.A rotatividade de pessoal é uma das grandes dificuldades encontradas pelo serviço público. A causa desse problema pode estar relacionada a fatores como: remuneração e recompensa, rotinização, conflitos, satisfação/insatisfação dos colaboradores, motivação/demotion, questões políticas, entre outros. É nessa rotatividade de pessoal que se problematiza o presente estudo que tem por objetivo apontar medidas que ajudem a solucionar o problema da rotatividade dos servidores comissionados do Instituto de Previdência do município Nilópolis, propondo soluções que possam contribuir com a solução do problema encontrado naquele instituto. Procurou-se com o estudo conhecer as possíveis causas para a saída dos servidores, motivo causador da rotatividade, de modo a propor medidas que possam auxiliar em uma revisão dos processos e políticas de organização e gestão daquele instituto, combatendo, desse modo, a rotatividade e os custos operacionais dela decorrentes. Uma das medidas propostas para minimizar a rotatividade de pessoal no instituto em análise é a elaboração de estratégias que ajudem a reconhecer as motivações para a saída dos servidores, pois a partir desse conhecimento é possível elaborar medidas de melhorias nos processos de gestão e organização do referido instituto, de modo a criar políticas de valorização e incentivo para que estes profissionais desejem permanecer no quadro de servidores, quando isso se fizer possível

Impact of Labor-Intensive Public Works in Liberia: Results from a Light Evaluation Survey

The President and the Government of Liberia have placed a strategic priority on youth employment and have asked development partners for support in these areas. The Office of the President, the government, and development partners have undertaken over the last two years several steps to generate immediate employment. These include the Cash for Work Temporary Employment Project (CfWTEP) financed by the World Bank Food Price Crisis Response initiative. This chapter provides an assessment of the experience to-date with CfWTEP,as well as a discussion of options for the expansion and continuation of the program. Over 2009-2010, CfWTEP has provided jobs to 17000 people in the country. In order to assess the program and suggest options for its continuation,a light evaluation survey was implemented in the country in November-December 2009 with four objectives: (i) Assessing the targeting performances of the program; (ii) Measuring the wage substitution effects among the participant; (iii) Analyzing the patterns of use of the wages received by households; and (iv) Documenting other aspects of the program. The results suggest that the performance of the program in all four areas of the evaluation was relatively good, but targeting to the very poor could be improved in the future

Autosuficiència energètica i hídrica de la masia de Mongofra Nou

El projecte s'ha realitzat a la finca de Mongofra Nou, un lloc menorquí situat dintre del parc natural de s'Albufera, a 12km de la capital, Maó. Es tracta d'una finca de 208 Ha. on s'hi desenvolupen diverses activitats generadores d'alts consums energètics (elèctrics, gas i gasoil) hídrics (33% pou i 67% pluja). L'objectiu principal del projecte és arribar a l'autosuficiència energètica mitjançant la substitució d'energies no renovables per energies renovables i no contaminants. De forma paral·lela es proposa una millora de la gestió hídrica, així com un model que doni resposta a l'agroturisme. S'ha realitzat un inventari dels punts de consum energètics i hídrics de la finca i un posterior tractament de dades per determinar les millors solucions possibles per assolir els objectius sense afectar al correcte desenvolupament i confortabilitat de les activitats actuals. A més s'analitza la viabilitat d'oferir un servei d'agroturisme de cara al futur. Els resultats indiquen que el consum energètic de gasoil per abastir la calefacció és el més elevat (77%), seguit de l'elèctric (21%) i finalment el butà (2%). Aquesta seqüència, i tenint en compte l'impacte que generen, permet establir un grau de prioritats en relació amb l' implantació de mesures correctores. Pel que fa al consum d'aigua, el punt crític de consum correspon amb el sector ramader boví (67%). Seguint l'exemple dels llocs més representatius de Menorca en l'àmbit de l'autosuficiència, es conclou que a Mongofra hi ha la possibilitat d'assolir l'autosuficiència energètica i hídrica a través de la instal·lació de plaques solars, fotovoltaiques i tèrmiques, una caldera híbrida de biomassa, una millora en la gestió de l'aigua i l'aplicació de mesures d'eficiència.El proyecto se ha realizado en la finca de Mongofra Nou, un "lloc" menorquín situado dentro del parque natural de S'albufera, a 12km de la capital, Mahón. Se trata de una finca de 208 Ha. donde se desarrollan diversas actividades generadoras de altos consumos energéticos (eléctricos, gas y gasoil) e hídricos (33% pozo y 67% lluvia). El objetivo principal del proyecto es llegar a la autosuficiencia energética mediante la substitución de energías no renovables por otras renovables y no contaminantes. De forma paralela se propone una mejora de la gestión hídrica, así como un modelo que da respuesta al agroturismo. Se ha realizado un inventario de los puntos de consumo energéticos e hídricos de la finca, y un posterior tratamiento de datos para determinar las mejores soluciones posibles para alcanzar los objetivos sin afectar al correcto desarrollo y confortabilidad de les actividades actuales. Además, se analiza la viabilidad de ofrecer un servicio de agroturismo de cara al futuro. Los resultados indican que el consumo energético de gasóleo para abastecer la calefacción es el más elevado (77%), seguido de l'eléctrico (21%) y finalmente el butano (2%). Esta secuencia, y teniendo en cuenta el impacto que generan, permiten establecer un grado de prioridades en relación a la implantación de medidas correctoras. En referencia al consumo de agua, el punto crítico de consumo corresponde con el sector ganadero bobino (67%). Siguiendo el ejemplo de los "llocs" más representativos de Menorca, se concluye que en Mongofra existe la posibilidad de lograr la autosuficiencia energética e hídrica mediante la instalación de placas solares, fotovoltaicas i térmicas, una caldera híbrida de biomasa, una mejora en la gestión del agua y la aplicación de medidas de eficiencia.The project was developed in an estate called Mongofra Nou, which is a traditional farmhouse located in S'Albufera des Grau, a natural park 12 km far from the capital of Menorca, Maó. There are big tracts of land in the property, 208 Ha. where different activities that generate high levels of energy (electricity, gas and gasoil) and water consumption are performed (67% rain water and 33% well). The main aim of the project is to achieve the energy self-sufficiency through the substitution of non-renewable energies for others that are renewable and clean. In the same way, we propose a better water management and also a model capable to maintain the agritourism. An inventory of the energy and water consumption points was carried out. The subsequent data treatment determined which are the best solutions to reach the objective without impacting the correct performance and comfort of the present and future activities. Furthermore, the viability to offer a future service of agritourism is analyzed. The results show that the energy consumption of gasoil, which supplies the heating, is the highest being the 77%, followed by the electric consume, 21% and finally the butane with the 2%. This sequence, bearing in mind the impact they generate, allows establishing a degree priority in relation with the implantation of improvement proposals. Having a regard on water consumes, the critical point is the consume which corresponds to the livestock (67%). Following the examples of the most representative places in Menorca in the self-sufficiency scope, it can be concluded that in Mongofra Nou there exists the chance of reaching it trough the setting up of solar panels, photovoltaic and thermal, a biomass hybrid boiler, a water management improvement and the implementation of efficiency measures

Hospital admissions for hypertensive crisis in the Emergency Departments: a large multicenter Italian study

Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001). Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001). Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs

Broadening INPP5E phenotypic spectrum: detection of rare variants in syndromic and non-syndromic IRD

Pathogenic variants in INPP5E cause Joubert syndrome (JBTS), a ciliopathy with retinal involvement. However, despite sporadic cases in large cohort sequencing studies, a clear association with non-syndromic inherited retinal degenerations (IRDs) has not been made. We validate this association by reporting 16 non-syndromic IRD patients from ten families with bi-allelic mutations in INPP5E. Additional two patients showed early onset IRD with limited JBTS features. Detailed phenotypic description for all probands is presented. We report 14 rare INPP5E variants, 12 of which have not been reported in previous studies. We present tertiary protein modeling and analyze all INPP5E variants for deleteriousness and phenotypic correlation. We observe that the combined impact of INPP5E variants in JBTS and non-syndromic IRD patients does not reveal a clear genotype–phenotype correlation, suggesting the involvement of genetic modifiers. Our study cements the wide phenotypic spectrum of INPP5E disease, adding proof that sequence defects in this gene can lead to early-onset non-syndromic IRD

Focus on the management of thunderclap headache: from nosography to treatment

Thunderclap headache (TCH) is an excruciating headache characterized by a very sudden onset. Recognition and accurate diagnosis of TCH are important in order to rule out the various, serious underlying brain disorders that, in a high percentage of cases, are the real cause of the headache. Primary TCH, which may recur intermittently and generally has a spontaneous, benign evolution, can thus be diagnosed only when all other potential underlying causes have been excluded through accurate diagnostic work up. In this review, we focus on the management of TCH, paying particular attention to the diagnostic work up and treatment of the condition