Exploring the eligibility criteria of the child support grant and its impact on poverty

One of the most important policy objectives in the post-apartheid South African economy is to reduce poverty. Although economic growth and job creation are the preferred sources of alleviating poverty and inequality, social grant spending has contributed significantly to reduce poverty (Van der Berg et al. in Poverty trends since the transition: what we know. Stellenbosch Economic Working Papers: 19/09. Stellenbosch: Stellenbosch University, 2009). Recently proposals were tabled by the Department of Social Development of South Africa (Fin24 in R3.3bn plan to extend child support grant to 21. www.fin24.com/Economy/R33bn-child-care-grant-extension-to-21-on-cards-20150316. Accessed August 7, 2015, 2015) to extend the age eligibility of the child support grant (CSG) to 21 years (at the time of writing children aged up to 18 years are eligible). This sparked an interest to investigate the impact on poverty of changes to the eligibility criteria of CSG, as well as its fiscal implications. Using person and household data from the 2010/2011 Income and Expenditure Survey, various simulations are performed to assess the impact on poverty rates and changes to social spending, given the following changes: (1) if all age-eligible children applied; (2) if all beneficiaries received the grant amount for the full 12-month duration; (3) if the age eligibility criterion is extended; and (4) if the monthly child grant income amount is revised upwards. We also examine how changes in the eligibility criteria affect the income distribution.IS

Weather sensitivity in migraineurs

The scientific evidence for weather being a trigger factor for migraine attacks is inconclusive. We investigated the association between weather components and the onset and severity of attacks. Headache diaries of 20 migraineurs were analyzed retrospectively and correlated in 4-h intervals to atmospheric air pressure, temperature, and relative air humidity in Berlin (Germany) for a period of 12 consecutive months. Absolute values and relative changes within the preceding 24 h were analyzed. Migraine attacks started most frequently at 4 a.m. and reached the highest intensity between 4 and 8 a.m. A highly significant association between meteorological variables and the occurrence of migraine attacks was found in six patients. The onset of an attack as well as high headache intensity was associated with lower temperature and higher humidity. Our data indicate that a subgroup of migraineurs is highly sensitive to changes of certain weather components

Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries

Background: Self-management of long term conditions can promote quality of life whilst delivering benefits to the financing of health care systems. However, rarely are the meso-level influences, likely to be of direct relevance to these desired outcomes, systematically explored. No specific international guidelines exist suggesting the features of the most appropriate structure and organisation of health care systems within which to situate self-management approaches and practices. This review aimed to identify the quantitative literature with regard to diabetes self-management arrangements currently in place within the health care systems of six countries (The United Kingdom, The Netherlands, Norway, Spain, Bulgaria, and Greece) and explore how these are integrated into the broader health care and welfare systems in each country. Methods: The methodology for a realist review was followed. Publications of interest dating from 2000 to 2013 were identified through appropriate MeSH terms by a systematic search in six bibliographic databases. A search diary was maintained and the studies were assessed for their quality and risk of bias. Results: Following the multi-step search strategy, 56 studies were included in the final review (the majority from the UK) reporting design methods and findings on 21 interventions and programmes for diabetes and chronic disease self-management. Most (11/21, 52%) of the interventions were designed to fit within the context of primary care. The majority (11/21, 52%) highlighted behavioural change as an important goal. Finally, some (5/21, 24%) referred explicitly to Internet-based tools. Conclusions: This review is based on results which are derived from a total of at least 5,500 individuals residing in the six participating countries. It indicates a policy shift towards patient-centred self-management of diabetes in a primary care context. The professional role of diabetes specialist nurses, the need for multidisciplinary approaches and a focus on patient education emerge as fundamental principles in the design of relevant programmes. Socio-economic circumstances are relevant to the capacity to self-manage and suggest that any gains and progress will be hard to maintain during economic austerity. This realist review should be interpreted within the wider context of a whole systems approach regarding self-care support and chronic illness management

Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013

Multi-pulse atomic layer deposition of p-type SnO thin films: growth processes and the effect on TFT performance

This work demonstrates p-type SnO thin film transistors, where the SnO active layers were deposited with atomic layer deposition (ALD) using the Sn(II) alkoxide precursor, Sn(II) bis(tert-butoxide). The deposition optimisation explores the use of multiple Sn pulses per ALD cycle and the use of an exposure mode (where the pump extraction is paused before the Sn precursor purge) to increase the residence time and allow for more effective saturation of the surface. The fabricated devices required post deposition annealing of the active layer, with device performance further improved by back-channel passivation using ALD Al₂O₃. The performance of devices deposited using the varying precursor delivery modes has also been compared, with the devices utilizing deposition with multiple Sn pulses and a post deposition anneal at 250ºC achieving an on/off ratio of ∼4×10⁴ and field effect mobility (μFE) of 0.6 cm²(Vs)‾¹. The growth processes present during deposition with the different precursor delivery modes was investigated using fractal geometry and topographical scaling methods, with the poor device performance for the single Sn pulse deposition attributed to 2D lateral island growth