Techniques for improving client relations in family planning programs

Demand for children and demand for contraceptives are not independent of the system of supply. And client transactions are the major means for lowering costs. Family planning workers, providers of services and mass media campaigns, are the harbingers of new ideas and new delivery systems that could modify the demand for fertility regulation and patterns of contraceptive use. The authors describe four broad techniques for improving client relations, emphasizing their potential as entry points into program development (systematic change). These techniques are presented as a sampling of experience that can be brought to bear on dysfunctional client relations. Among examples described: Patient flow analysis (PFA). A self-administered time-and-motion diagnosis that allows computerized documentation of patient flow and personnel use in health service clinics. Using relatively unobtrusive data collection, PFA seeks to get a representative snapshot of a program and its dysfunctions, replicating a typical clinic session. Data are later diagnosed and remedies proposed for bottlenecks and inefficiencies. Training and visit (T&V). A managerial approach for dealing with geographically scattered outreach programs. The four main principles of T&V: focus on a few key tasks, frequent in-service training and supervision, regularity and predictability, and face-to-face communication. The T&V model focuses on what workers should be doing with their time in the field to meet client needs. A goal of T&V: to enable all clients to name their worker and the day of the week s/he visits, and identify a few themes from their most recent encounter. Activity planning. The antithesis of T&V, activity planning calls for abandoning rigid time-place-movement schedules and specific messages and replacing them with a fluid work schedule adapted to local conditions. Workers must be well-trained in collecting data, listening and building rapport, and communicating with conviction. The quality of the worker-client relationship is all-important. A weakness is that if the workers have no objective they lose control of the exchange with clients. Training and worker empowerment. Training by itself is not enough for systematic change - training for what? But training can serve as an entry point into organizational development when it is rooted in methodologies that help to develop the participant's technical and interpersonal skills and ability to innovate. But training must be accompanied by changes in the system of supply that supports and facilitates innovation and quality of care. Techniques to improve client relations can address either the client-provider interface directly or the system of underlying determinants. It is important to ask basic questions: Is the idea to fix a single worker-client dysfunction or is it to provide a continuous program for modification and growth? Who will be affected by the change? Whoor what will be responsible for initiating and overseeing the course of action? What are the short- and long-run goals of intervention?Health Monitoring&Evaluation,ICT Policy and Strategies,Adolescent Health,Poverty Monitoring&Analysis,Geographical Information Systems

Predictive modelling of a novel anti-adhesion therapy to combat bacterial colonisation of burn wounds

As the development of new classes of antibiotics slows, bacterial resistance to existing antibiotics is becoming an increasing problem. A potential solution is to develop treatment strategies with an alternative mode of action. We consider one such strategy: anti-adhesion therapy. Whereas antibiotics act directly upon bacteria, either killing them or inhibiting their growth, anti-adhesion therapy impedes the binding of bacteria to host cells. This prevents bacteria from deploying their arsenal of virulence mechanisms, while simultaneously rendering them more susceptible to natural and artificial clearance. In this paper, we consider a particular form of anti-adhesion therapy, involving biomimetic multivalent adhesion molecule 7 coupled polystyrene microbeads, which competitively inhibit the binding of bacteria to host cells. We develop a mathematical model, formulated as a system of ordinary differential equations, to describe inhibitor treatment of a Pseudomonas aeruginosa burn wound infection in the rat. Benchmarking our model against in vivo data from an ongoing experimental programme, we use the model to explain bacteria population dynamics and to predict the efficacy of a range of treatment strategies, with the aim of improving treatment outcome. The model consists of two physical compartments: the host cells and the exudate. It is found that, when effective in reducing the bacterial burden, inhibitor treatment operates both by preventing bacteria from binding to the host cells and by reducing the flux of daughter cells from the host cells into the exudate. Our model predicts that inhibitor treatment cannot eliminate the bacterial burden when used in isolation; however, when combined with regular or continuous debridement of the exudate, elimination is theoretically possible. Lastly, we present ways to improve therapeutic efficacy, as predicted by our mathematical model

The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The FLUXNET2015 dataset provides ecosystem-scale data on CO2, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.Peer reviewe

Mathematical modelling of the agr operon in Staphylococcus aureus

First published online in 2009taphylococcus aureus is a pathogenic bacterium that utilises quorum sensing (QS), a cell-to-cell signalling mechanism, to enhance its ability to cause disease. QS allows the bacteria to monitor their surroundings and the size of their population, and S. aureus makes use of this to regulate the production of virulence factors. Here we describe a mathematical model of this QS system and perform a detailed time-dependent asymptotic analysis in order to clarify the roles of the distinct interactions that make up the QS process, demonstrating which reactions dominate the behaviour of the system at various timepoints. We couple this analysis with numerical simulations and are thus able to gain insight into how a large population of S. aureus shifts from a relatively harmless state to a highly virulent one, focussing on the need for the three distinct phases which form the feedback loop of this particular QS system.Sara Jabbari, John R. King, Adrian J. Koerber and Paul William

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The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

Abstract The FLUXNET2015 dataset provides ecosystem-scale data on CO2, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible