91 research outputs found

    The Rockefeller Brothers Fund's Western Balkans Program: Midterm Impact Assessment

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    The Rockefeller Brothers Fund (RBF) commissioned an impact assessment of its Western Balkans program from 2010 to 2015. As the team who carried out this assessment, our overall conclusion from the assessment is that the RBF program in the Western Balkans is having meaningful positive impact, and it is relevant to the developments in Serbia, Montenegro, Kosovo, and the rest of the region. We believe the program is well designed and is achieving a lot with a relatively small amount of money

    Managing Criminalized Power Structures: The Predominant Spoilers of Peace Processes

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    Criminalized Power Structures (CPS) exploit illicit wealth acquisition to usurp political power and constitute a leading source of obstruction when the international community intervenes in states struggling to emerge from civil conflict. Structures operating outside domestic or international law may constitute a crucial barrier or spoiler for UN and coalition peace operations. This held true in the post-Cold War interregnum before 9/11 and is likely to continue for stabilization operations, regardless of outcomes from enormous international security investments in Afghanistan and Iraq. By understanding the different types of spoilers acting across cases, the United States and partners in the international community can align their responses so as to manage threats from CPS

    International circular economy strategies and their impacts on agricultural water use

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    Publisher Copyright: © 2022 The AuthorsThe concept of Circular Economy (CE) is becoming increasingly important in the pursuit of more sustainable societies. CE strategies are being applied in the sustainable management of a plethora of areas, such as energy, water, food and eco-industrial parks. The present paper focuses on the question of how CE principles can support the sustainable management of water in the agricultural sector around the world, considering different legislative environments, water resources management guidelines, environmental stressors, and CE practices. Considering these practices and circumstances, seven countries were compared: Brazil, Germany, Japan, Mexico, Morocco, Portugal, and Taiwan. Together, CE experts in the seven countries developed a set of 44 criteria to assess each of these areas. Broader establishment and respect of water resources legislation was found to be strongly correlated with lower agricultural water use. While the application of CE practices was found to not be correlated with lower consumption, this is still novel in most countries. Based on the studied countries, it can be concluded that a global CE agenda has not been reached for water resources. Further application and variety of practices is required to better represent the impact of CE on a national scale, but local success stories could support the wider application of CE in agriculture. The findings and the framework of the study can be applied to other countries in directing CE strategies for more sustainable water use in agriculture. Increasing CE implementation, motivated by legislation and better management can help ensure water security throughout nations.publishersversionpublishe

    Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis:an OA Trial Bank protocol for a systematic review

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    BACKGROUND: Based on small to moderate effect sizes for the wide range of symptomatic treatments in osteoarthritis (OA), and on the heterogeneity of OA patients, treatment guidelines for OA have stressed the need for research on clinical predictors of response to different treatments. A meta-analysis to quantify the effect modified by the predictors using individual patient data (IPD) is suggested. The initiative to collect and analyze IPD in OA research is commenced by the OA Trial Bank. The study aims are therefore: to evaluate the efficacy of intra-articular glucocorticoids for knee or hip OA in specific subgroups of patients with severe pain and (mild) inflammatory signs, over both short-term and long-term follow-up, using IPD from existing studies; to reach consensus on the rules for cooperation in a consortium; and to develop and explore the methodological issues of meta-analysis with individual OA patient data. METHODS/DESIGN: For the current IPD analysis we will collect and synthesize IPD from randomized trials studying the effect of intra-articular glucocorticoid injections in patients with hip or knee OA. Subgroup analyses will be performed for the primary outcome of pain at both short-term and long-term follow-up, in the subgroups of patients with and without severe pain and with and without inflammatory signs. DISCUSSION: This study protocol includes the first study of the OA Trial Bank, an international collaboration that initiates meta-analyses on predefined subgroups of OA patients from existing literature. This approach ensures a widely supported initiative and is therefore likely to be successful in data collection of existing trials. The collaboration developed (that is, the OA Trial Bank) may also lead to future IPD analyses on subgroups of patients with several intervention strategies applied in OA patients

    Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis

    Get PDF
    Based on small to moderate effect sizes for the wide range of symptomatic treatments in osteoarthritis (OA), and on the heterogeneity of OA patients, treatment guidelines for OA have stressed the need for research on clinical predictors of response to different treatments. A meta-analysis to quantify the effect modified by the predictors using individual patient data (IPD) is suggested. The initiative to collect and analyze IPD in OA research is commenced by the OA Trial Bank. The study aims are therefore: to evaluate the efficacy of intra-articular glucocorticoids for knee or hip OA in specific subgroups of patients with severe pain and (mild) inflammatory signs, over both short-term and long-term follow-up, using IPD from existing studies; to reach consensus on the rules for cooperation in a consortium; and to develop and explore the methodological issues of meta-analysis with individual OA patient data. For the current IPD analysis we will collect and synthesize IPD from randomized trials studying the effect of intra-articular glucocorticoid injections in patients with hip or knee OA. Subgroup analyses will be performed for the primary outcome of pain at both short-term and long-term follow-up, in the subgroups of patients with and without severe pain and with and without inflammatory signs. This study protocol includes the first study of the OA Trial Bank, an international collaboration that initiates meta-analyses on predefined subgroups of OA patients from existing literature. This approach ensures a widely supported initiative and is therefore likely to be successful in data collection of existing trials. The collaboration developed (that is, the OA Trial Bank) may also lead to future IPD analyses on subgroups of patients with several intervention strategies applied in OA patients

    The North Staffordshire Osteoarthritis Project – NorStOP: Prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults

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    BACKGROUND: The clinical syndrome of joint pain and stiffness in older people is the commonest cause of disability and health care consultation in this age group. Yet there have been few prospective studies of its course over time and its impact on personal and social life. We plan a cohort study in the general population aged 50 years and over to determine the course and prognosis of hand, hip, knee and foot pain, and the impact of these syndromes on participation levels and health care use. METHODS: All patients aged 50 years and over registered with 3 local general practices are to be recruited to a population-based cohort study through the use of a two-stage mailing process. Participants will initially complete a "Health Survey" questionnaire. This will collect information on several areas of life including socio-demographics, general health, physical function, participation, and bodily pain. Those who state that they have experienced any hand problem or any pain in their hands, hips, knees, or feet in the previous 12 months, and also give permission to be re-contacted, will be mailed a "Regional Pains Survey" questionnaire which collects detailed information on the four selected body regions (hand, hips, knees, feet). Follow-up data for the three-year period subsequent to cohort recruitment will be collected through two sources: i) general practice medical records and ii) repeat mailed survey
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