Steps Toward An Effective Health Management Information System In Lao People\u27s Democratic Republic

Health Management Information System (HMIS) is a specially designed information system that assists in the management and planning of health programs, within the overall national Health Information System (HIS) that integrates data collection, processing, reporting and use of information to improve health service effectiveness and efficiency through better management at all levels, for all actors and institutions. HMIS plays a fundamental role in the overall HIS through organizing and streamlining the business processes of health programs and links the purchasers and providers. In this study, data was collected through case study methods during a field visit to the Vientiane Province. Observations and interviews were conducted during site visits to the central processing offices (CPOs) of the insurance schemes and Vientiane government health facilities. Results show that the existing HIS is fragmented, unstandardized and repetitive because the HMIS processes are disparate and operate separately around the individual needs of the different insurance schemes. Analysis of results from the case study in Vientiane, Lao PDR points to three major underlying issues that must be addressed across the central, provincial and district levels of management and among the insurance CPOs - 1) lack of HIS awareness and collaboration, 2) need for coordination of international donor agencies and respective data requirements, and 3) need for capacity building to properly support and execute HMIS processes. The development and implementation of a HMIS is particularly important in the current landscape of Lao PDR, with the recent National Merger of the insurance schemes. Effective integration of HMIS processes, will contribute to the Lao PDR vision towards developing a unified HIS to provide timely, high quality, evidence-based information for policy formulation, decision making, program implementation, monitoring and evaluation for all national and international health stakeholders by 2015

The Bionomics of the Teak Skeletoniser, Paliga Damastesalis Walker (Lepidoptera: Crambidae) and its Defoliation Impact on Young Teak, Tectona Grandis Linnaeus

The distribution and feeding behaviour of a teak skeletoniser, Paliga damastesalis Walker, and the impact of its defoliation on the growth of young teak was investigated in a series of laboratory and field studies in Malaysia. A laboratory study on feeding behaviour showed that instar II to V larvae of P. damastesalis significantly preferred consuming leaf disks cut from young, expanding leaves of nodes 1 to 2 on two year-old trees, instead of leaf disks cut from mature, fully expanded leaves of nodes 3 to 5. Also, larvae that were confined to young leaves on pollarded two year-old trees a field study, fed and developed normally on those whole young leaves, indicating that secondary metabolites present in young whole leaves do not deter feeding or retard the growth of this insect significantly. Additionally, in that field study, larvae that were caged over mature leaves consumed a significantly larger leaf area in the fifth instar and had a significantly longer larval period than larvae caged over young leaves, while adult dry weights were not significantly different than that of larvae caged over young leaves. This indicates that P. damastesalis may be able to compensate for lower nutritional leaf content by feeding longer and increasing consumption of the nutrient-poor leaves. The findings of the laboratory study on the preference of P. damastesalis for younger leaves were supported by a subsequent study on the within-tree distribution of the immature stages on 6 to 12 month-old teak planted along a highway. The larvae were strongly associated with the upper node leaves in the field, which are comparatively younger than the lower node leaves, suggesting that the larvae preferred and actively sought younger leaves to consume. However, oviposition behaviour may also have influenced larval distribution as the larvae may have completed their development on or not far from the eggs were laid. Since over 60% of the larvae were found on leaves of nodes two to four, sampling of leaves from these nodes was recommended for young teak grown in similar conditions, during non-outbreak periods. On another note, a skewed sex ratio with males consistently forming less than 3.5% of the samples was reported, and it was suggested that a pathogen causing male mortality in the embrogenic stage of P. damastesalis may be exerting an influence on those field populations of the insect. In a ten-month study on the impact of P. damastesalis defoliation on the growth of six month-old teak in a plantation environment, severity of defoliation showed a significant negative assocation with production of new leaves and relative growth rates for tree height and tree collar diameter, only for the first two months after the defoliation. For the remainder of the study there was no difference in the growth of the trees in relation to the level of defoliation they experienced

LEGAL ANALYSIS OF DUAL CITIZENSHIP RULE IN INDONESIA

Globalization has transformed the perception of national borders as barriers to human interaction, resulting in an increase in mixed marriages. Issues often arise, particularly concerning the citizenship status of a spouse married to a foreigner and their children resulting from such mixed marriages. The method employed in this study is normative juridical, thereby analyzing legal issues within the framework of applicable laws and legal theories. The findings of this research reveal that mixed marriages frequently face disputes regarding the citizenship status of children, as exemplified by the case under study, which involves the marriage between Marcellina, an Indonesian citizen from Surabaya, and John, a citizen of the United States. Meanwhile, according to the prevailing national law, children from mixed marriages will hold dual citizenship until the age of 18 or upon marriage. This research emphasizes the importance of understanding the relevant legal provisions and complying with the procedures established by the Indonesian government concerning mixed marriages. The objective is to maintain clarity and the validity of the citizenship status of both the spouses and the children involved in mixed marriages

Investigation of the Genes sll1354, sll1165, and sll1520 in Genomic Instability in Cyanobacterium Synechocystis sp. PCC 6803

The model cyanobacterium Synechocystis sp. PCC 6803 is used extensively in the studies of oxygenic photosynthesis as well as genetic engineering. The ability to incorporate exogenous DNA into its genome through homologous recombination makes it a potential biosystem that can be manipulated to produce valuable compounds. Synechocystis sp. PCC 6803 possesses an advanced DNA recombination and repair mechanism that enables the survival of the bacterium in various environments. This mechanism serves as a double edge sword as it improves the plasticity of the cyanobacterium; on the other hand, it also promotes genomic instability. This study investigated the role of the genes sll1354 (recJ), sll1165 (mutS1), and sll1520 (recN) in genomic instability. A PS II mutant strain showed signs of genomic instability where it grew photoautotrophically in pH 7.5 medium, which it is incapable of growing initially. When the constructs of interrupted genes of interest were introduced into the strain, the mutants' ability to grow photoautotrophically in pH 7.5 medium was compared to the control. The interruption of sll1354 and sll1520 was found to show a minimal effect on the growth rate reversion, whereas disruption on sll1165 was found to restored photoautotrophic growth in pH7.5 medium. This preliminary data in this study suggested that the gene sll1165 may be one of the genes that is involved in the DNA recombination and repair mechanism in Synechocystis sp. PCC 6803, which, in turn, may plays a role in cyanobacterial genomic instability

Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol

Introduction: Private sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC. Methods and analysis: This review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with 90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results. Ethics and dissemination: The results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research

Online language learning to develop english reading and listening skills in university students: a pilot stuy in Hong Kong

The range of technological applications in different educational contexts makes it necessary for continued inquiry into online language learning (OLL), especially in relation to its impact on different learner populations whose perception and acceptance of OLL can vary across settings. This pilot study involved 66 Chinese students in a Hong Kong university and examined their OLL experience in online reading and listening activities. Results of the study suggest the easy availability of internet resources can greatly enhance students’ OLL experience, while raising four challenges in the areas of online materials development, student motivation, pedagogy-technology interface, and intercultural communicative competence. Possible ways of tackling such challenges are outlined. The article concludes with a view that successful OLL needs to be predicated on a tripartite framework of hardware, software and humanware

Fluidized Bed Membrane Reactor for Steam Reforming of Higher Hydrocarbons: Model Sensitivity

A fluidized bed membrane reactor (FBMR) was built and operated at temperatures \u3c600°C to reform higher hydrocarbons like propane and heptane. A two-phase reactor model is utilized to simulate the FBMR with hydrogen withdrawn from both phases. The superficial gas velocities in the reactor change because of variations in molar flow due to reaction and hydrogen withdrawal through the membranes, as well as variations in temperature, pressure and cross-sectional area. Sensitivity studies show that the FBMR performance is primarily controlled by chemical equilibrium and hydrogen permeation through the membranes, while being insensitive to errors in accurately characterizing the chemical kinetics and hydrodynamics