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Affordable
Terms modified by Affordable Selected AbstractsMaking Medical Education More AffordableANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2009Arthur J. Moss M.D. No abstract is available for this article. [source] An environment for prosperity and quality living accommodating growth in the Thames ValleyCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 1 2004Hugh Howes The Thames Valley is seen as the powerhouse of the British economy, and one of the best performing regions in Europe. This economic base offers opportunities for expansion with the potential for it to become the knowledge capital of Europe. Business interests view the area as a highly desirable location, not only because of its markets, skills and proximity to the City and Heathrow but also because of its high quality environment. Companies, however, complain of skills shortages, traffic congestion, lack of suitable premises and housing that is affordable to the workforce. Much of the Thames Valley is either Green Belt or Areas of Outstanding Natural Beauty. Furthermore, the availability of future water supplies, the maintenance of the quality of water in the rivers and managing flood risk are also likely to act as constraints on development in the future. How economic growth is to be achieved with minimal additional development and without detriment to the environment is the central question that is likely to dominate planning in the this region over the next few years. Is it possible to achieve more with existing resources? Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment. [source] Local Food, Local Engagement: Community-Supported Agriculture in Eastern IowaCULTURE, AGRICULTURE, FOOD & ENVIRONMENT, Issue 1 2010Brandi Janssen Abstract This paper examines some of the daily realities of operating a Community-Supported Agriculture (CSA) farm in eastern Iowa and addresses the concept of community among growers. Popular depictions of local foods systems often emphasize the close relationships that develop between producers and consumers. This picture, however, may gloss over the necessary complexities of a healthy local food system. CSA has been promoted as a direct marketing strategy for small-scale growers and touted as a way of developing positive relationships between producers and consumers. Nevertheless, it is also important to understand that successful CSA initiatives are often reliant on a broad network of support that includes more than just growers and eaters. Ethnographic descriptions of CSA farms presented here show how involvement by media and other organizations contribute to successful CSAs as well as an overall concept of "civic agriculture." These descriptions also show that access to affordable, reliable labor tends to be among the greatest challenges for CSA growers. [source] A North American multilaboratory study of CD4 counts using flow cytometric panleukogating (PLG): A NIAID-DAIDS Immunology Quality Assessment Program Study,,§¶CYTOMETRY, Issue S1 2008Thomas N. Denny Abstract Background The global HIV/AIDS pandemic and guidelines for initiating anti-retroviral therapy (ART) and opportunistic infection prophylaxis demand affordable, reliable, and accurate CD4 testing. A simple innovative approach applicable to existing technology that has been successfully applied in resource-challenged settings, PanLeukogated CD4 (PLG), could offer solutions for cost saving and improved precision. Methods Day-old whole blood from 99 HIV+ donors was simultaneously studied in five North-American laboratories to compare the performance of their predicate methods with the dual-platform PLG method. The predicate technology included varying 4-color CD45/CD3/CD4/CD8 protocols on different flow cytometers. Each laboratory also assayed eight replicate specimens of day-old blood from 10 to 14 local donors. Bias and precision of predicate and PLG methods was studied between- and within-participating laboratories. Results Significantly (P < 0.0001) improved between-laboratory precision/coefficient of variation (CV%) was noted using the PLG method (overall median 9.3% vs. predicate median CV 13.1%). Within-laboratory precision was also significantly (P < 0.0001) better overall using PLG (median 4.6% vs. predicate median CV 6.2%) and in 3 of the 5 laboratories. PLG counts tended to be 11% smaller than predicate methods (P < 0.0001) for shipped (median of predicate,PLG = 31) and local specimens (median of predicate,PLG = 23), both overall and in 4 of 5 laboratories (median decreases of 4, 16, 20, and 21% in shipped specimens); the other laboratory had a median increase of 5%. Conclusion Laboratories using predicate CD4 methods similar to those in this study could improve their between-laboratory and their within-laboratory precision, and reduce costs, by switching to the PLG method after adequate training, if a change (usually, a decrease) in CD4 counts is acceptable to their health systems. © 2008 Clinical Cytometry Society [source] Affordable diagnostics,Changing the paradigm in India,,CYTOMETRY, Issue S1 2008Bala S. Manian Abstract A successful strategy for developing affordable diagnostics begins with a shift in viewpoint. Diagnostics is a tool for generating clinical information. Amassed experience in different parts of the globe has shown that this process of generating and utilizing clinical information is not only different among various countries but also different in microenvironments within the same country. The development of affordable diagnostics requires consideration not only of the component costs such as hardware and consumables but also other related costs that contribute to the generation and delivery of that information. It is important to recognize that these costs associated with public health in resource-poor settings cannot remain at the mercy of charitable contributions from western nations. Therefore, the challenge of technological innovation is to create solutions that are locally affordable and sustainable in the long run within the local macroeconomic constraints. The solutions should permit generation of local economic activity that will reinforce long-term economic sustainability. For this reason it is essential not only to analyze the diagnostic process but also to define a pathway by which local healthcare systems in recipient nations can be endowed with elements that empower them to acquire and practice up-to-date modern diagnostic skills. The objective of this paper is to provide a wider view of diagnostic cost components and to show how solutions developed and delivered locally have resulted in economically affordable as well as sustainable products. © 2008 Clinical Cytometry Society [source] Highly Purified 1000-cSt Silicone Oil for Treatment of Human Immunodeficiency Virus-Associated Facial Lipoatrophy: An Open Pilot TrialDERMATOLOGIC SURGERY, Issue 10 2004Derek H. Jones MD Background. Among human immunodeficiency virus-infected individuals, facial lipoatrophy has become epidemic. Those affected are stigmatized, leading to psychological distress, social and career impediments, and impaired compliance to human immunodeficiency virus medications. Temporary treatment options are limited by excessive cost, necessity of frequent treatments, and lack of a natural look or feel beneath the skin. Affected patients require more persistent, affordable, safe, and effective treatment options. Objective. The objective was to evaluate the safety and efficacy of highly purified 1000-cSt silicone oil injected by microdroplet serial puncture technique for the treatment of human immunodeficiency virus-associated lipoatrophy. Methods. Data on 77 patients with a complete correction were analyzed to determine the number of treatments, amount of silicone, and time required to reach complete correction, relative to initial severity. Results. The volume of silicone, number of treatments, and time required to reach a complete correction were directly related to initial severity of lipoatrophy (p < 0.0001). Supple, even facial contours were routinely restored, with all patients tolerating treatments well. No adverse events were noted. Conclusion. In this pilot trial, we have demonstrated that highly purified 1000-cSt silicone oil is a safe and effective treatment option for human immunodeficiency virus facial lipoatrophy. Longer-term safety and efficacy in human immunodeficiency virus patients remain to be proven. [source] Education for All: How Much Will It Cost?DEVELOPMENT AND CHANGE, Issue 1 2004Enrique Delamonica In 1990, a target of universal access to basic education by the year 2000 was set by two global conferences. Ten years later, however, it was clear that the target had not been met. Too many countries had made insufficient progress, and although many of the reasons for this inadequate progress were country-specific, one factor stood out in virtually all countries: inadequate public finance for primary education. In 2000, the Millennium Summit set a new target date for achieving ,education for all' of 2015. This article updates the global and regional cost estimates for reaching that target. The estimates are based on the most recent country-by-country data on budgetary expenditure, population and enrolment trends, and unit cost. The annual additional cost of achieving ,education for all' in developing countries by 2015 is estimated at US$ 9.1 billion. Although this is affordable at the global level, individual countries will need considerably more resources than are currently available. However, official development assistance (ODA) has been declining, and the share of ODA allocated to basic education has changed little over the past decade. Therefore, although affordable, the target of universal basic education by 2015 is likely to be missed, just as it was in 2000, without a major change both in ODA and national budgets. [source] Accounting for uncertainty in DEMs from repeat topographic surveys: improved sediment budgetsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 2 2010Joseph M. Wheaton Abstract Repeat topographic surveys are increasingly becoming more affordable, and possible at higher spatial resolutions and over greater spatial extents. Digital elevation models (DEMs) built from such surveys can be used to produce DEM of Difference (DoD) maps and estimate the net change in storage terms for morphological sediment budgets. While these products are extremely useful for monitoring and geomorphic interpretation, data and model uncertainties render them prone to misinterpretation. Two new methods are presented, which allow for more robust and spatially variable estimation of DEM uncertainties and propagate these forward to evaluate the consequences for estimates of geomorphic change. The first relies on a fuzzy inference system to estimate the spatial variability of elevation uncertainty in individual DEMs while the second approach modifies this estimate on the basis of the spatial coherence of erosion and deposition units. Both techniques allow for probabilistic representation of uncertainty on a cell-by-cell basis and thresholding of the sediment budget at a user-specified confidence interval. The application of these new techniques is illustrated with 5 years of high resolution survey data from a 1,km long braided reach of the River Feshie in the Highlands of Scotland. The reach was found to be consistently degradational, with between 570 and 1970,m3 of net erosion per annum, despite the fact that spatially, deposition covered more surface area than erosion. In the two wetter periods with extensive braid-plain inundation, the uncertainty analysis thresholded at a 95% confidence interval resulted in a larger percentage (57% for 2004,2005 and 59% for 2006,2007) of volumetric change being excluded from the budget than the drier years (24% for 2003,2004 and 31% for 2005,2006). For these data, the new uncertainty analysis is generally more conservative volumetrically than a standard spatially-uniform minimum level of detection analysis, but also produces more plausible and physically meaningful results. The tools are packaged in a wizard-driven Matlab software application available for download with this paper, and can be calibrated and extended for application to any topographic point cloud (x,y,z). Copyright © 2009 John Wiley & Sons, Ltd. [source] Children's Housing Environments: Welfare Families in IowaFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 2 2006Seongyeon Auh This study uses qualitative data to examine how rural low-income women confront the housing needs of their young children in the midst of changes in public policy. The focus is on the strategies employed and the difficulties faced in the provision of safe, affordable and stable homes. The data are drawn from in-home interviews conducted every 6 months with 13 mothers who were welfare-dependent at the start of the research. The investigation depicts several dimensions of the circumstances of poor children that have not had much previous attention in the literature: serial housing inadequacy and chronic mobility. Several families with children with disabilities reported severe housing deficiencies. This research provides initial evidence of the important role of housing in promoting the goals of family stability and economic self-sufficiency as well as the need to improve health and developmental outcomes for children living in poverty. [source] Hydrogen for the Mobility of the Future Results of GM/Opel's Well-to-Wheel Studies in North America and EuropeFUEL CELLS, Issue 3 2003U. Winter Abstract General Motors conducted two well-to-wheel studies for fundamental clarification on the question of which is the cleanest and most environmentally sustainable source of energy for the mobility of the future. In both studies the complete energy chains were analyzed from fuel production using primary energy to the actual consumption of the fuel in the car, i.e. from the well up to the wheels of the vehicle (well to wheel). The aim of the studies was to evaluate total energy consumption on the one hand and, on the other, the total greenhouse gas emissions arising between the production of a fuel and its final use to power an automobile. The results of the studies clearly show that fuel cell vehicles can greatly reduce greenhouse gas emissions from passenger cars or, if they run on hydrogen from renewable energy sources, they can eliminate them entirely. Regenerative fuels, however, will be more expensive than current products. With the fuel cell, because of its superior efficiency (35 , 45% less energy consumption well to wheel), it will be possible to keep individual mobility affordable in the future. [source] Assessing the Value of the NHIS for Studying Changes in State Coverage Policies: The Case of New YorkHEALTH SERVICES RESEARCH, Issue 6p2 2007Sharon K. Long Research Objective. (1) To assess the effects of New York's Health Care Reform Act of 2000 on the insurance coverage of eligible adults and (2) to explore the feasibility of using the National Health Interview Survey (NHIS) as opposed to the Current Population Survey (CPS) to conduct evaluations of state health reform initiatives. Study Design. We take advantage of the natural experiment that occurred in New York to compare health insurance coverage for adults before and after the state implemented its coverage initiative using a difference-in-differences framework. We estimate the effects of New York's initiative on insurance coverage using the NHIS, comparing the results to estimates based on the CPS, the most widely used data source for studies of state coverage policy changes. Although the sample sizes are smaller in the NHIS, the NHIS addresses a key limitation of the CPS for such evaluations by providing a better measure of health insurance status. Given the complexity of the timing of the expansion efforts in New York (which encompassed the September 11, 2001 terrorist attacks), we allow for difference in the effects of the state's policy changes over time. In particular, we allow for differences between the period of Disaster Relief Medicaid (DRM), which was a temporary program implemented immediately after September 11th, and the original components of the state's reform efforts,Family Health Plus (FHP), an expansion of direct Medicaid coverage, and Healthy New York (HNY), an effort to make private coverage more affordable. Data Sources. 2000,2004 CPS; 1999,2004 NHIS. Principal Findings. We find evidence of a significant reduction in uninsurance for parents in New York, particularly in the period following DRM. For childless adults, for whom the coverage expansion was more circumscribed, the program effects are less promising, as we find no evidence of a significant decline in uninsurance. Conclusions. The success of New York at reducing uninsurance for parents through expansions of both public and private coverage offers hope for new strategies to expand coverage. The NHIS is a strong data source for evaluations of many state health reform initiatives, providing a better measure of insurance status and supporting a more comprehensive study of state innovations than is possible with the CPS. [source] Regulation of gene expression in inflammatory bowel disease and correlation with IBD drugs.INFLAMMATORY BOWEL DISEASES, Issue 1 2004Screening by DNA microarrays Abstract Potential biomarkers for Crohn's disease (CD) and ulcerative colitis (UC) were identified from two sets of full thickness pathologic samples utilizing DermArray® and PharmArray® DNA microarrays relative to uninvolved (Un) colon or normal colon. Seven of the over-expressed genes were verified using quantitative RT-PCR (i.e., TMPT, FABP1, IFI27, LCN2, COL11A2, HXB, and metallothionein). By correlating gene expression profiles between inflammatory bowel disease (IBD) tissue samples and IBD drug-treated cell cultures it might be possible to identify new candidate molecular target genes for IBD therapy and drug discovery. Potential biomarkers for CaCo2 cell cultures, which are routinely used as a GI tract surrogate model for in vitro pharmacokinetic studies, treated with azathioprine, 5-aminosalicylic acid, metronidazole, and prednisone were also identified from another experiment. Metallothionein mRNA expression was found to be down-regulated in azathioprine-treated CaCo2 cells, and was coincidentally up-regulated in the CD sample, thus resulting in an anti-correlation. These results suggest that this new screening methodology is feasible, that metallothioneins might be biomarkers for azathioprine therapy in vivo in CD, and that azathioprine might mechanistically down-regulate metallothionein gene expression. Correlations were also observed between IBD samples and either metronidazole- or 5-aminosalicylic acid-treated CaCo2 cells. Similar comparisons of disease tissue samples in vivo vs drug-treated cell cultures in vitro might reveal new mechanistic insights concerning established or experimental drug therapies. This affordable in vitro methodology is promising for expanded studies of IBD and other diseases. [source] Parallel computation of a highly nonlinear Boussinesq equation model through domain decompositionINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 1 2005Khairil Irfan Sitanggang Abstract Implementations of the Boussinesq wave model to calculate free surface wave evolution in large basins are, in general, computationally very expensive, requiring huge amounts of CPU time and memory. For large scale problems, it is either not affordable or practical to run on a single PC. To facilitate such extensive computations, a parallel Boussinesq wave model is developed using the domain decomposition technique in conjunction with the message passing interface (MPI). The published and well-tested numerical scheme used by the serial model, a high-order finite difference method, is identical to that employed in the parallel model. Parallelization of the tridiagonal matrix systems included in the serial scheme is the most challenging aspect of the work, and is accomplished using a parallel matrix solver combined with an efficient data transfer scheme. Numerical tests on a distributed-memory super-computer show that the performance of the current parallel model in simulating wave evolution is very satisfactory. A linear speedup is gained as the number of processors increases. These tests showed that the CPU time efficiency of the model is about 75,90%. Copyright © 2005 John Wiley & Sons, Ltd. [source] Success factors for the effective implementation of renewable energy options for rural electrification in India,Potentials of the CLEAN DEVELOPMENT MECHANISMINTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 12 2008Gudrun Elisabeth Benecke Abstract Developing countries as well as international development assistance have for a long time aspired to combat energy poverty in rural areas of developing countries. However, until now a major part of national and international public and private attempts to provide affordable and stable energy supply have failed due to various economic, political, social and institutional obstacles. This situation is reflected in case of India where in comparison with other South Asian states the status of rural electrification and of energy supply are in a dismal state despite the promotion of renewable energy and rural electrification as early as from the 1960s. Embedded in the global context of the international climate change regime, the Clean Development Mechanism (CDM) of the Kyoto Protocol has now emerged as a new option to facilitate investment in climate change mitigating projects. In this respect, promoting the deployment of renewable energy through this project-based mechanism opens new avenues for rural electrification. The main objective of this paper is, hence, to examine the context conditions and factors determining the effective application of renewable energy options for rural electrification in a developing country context, namely India. Understanding contextual requirements for renewable energy investment has proved imminently important in order to appreciate the potentials provided by new market-based mechanisms such as the CDM for rural poverty alleviation. Comparative political science case study research methods are applied to the analysis of CDM biomass projects in the context of the four Indian states of Tamil Nadu, Maharashtra, Punjab and Andhra Pradesh. This allows for the conclusion that socio-political and historic framework conditions matter for the implementation of new renewable energy options. Copyright © 2008 John Wiley & Sons, Ltd. [source] The Chengzhongcun Land Market in China: Boon or Bane?INTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 2 2008A Perspective on Property Rights Abstract With the rapid expansion of China's cities since the 1978 economic reform, more and more villages have been swallowed up by urban sprawl. The retention of collective land ownership in chengzhongcun has, on the one hand, made low-rent housing affordable for migrants; on the other hand, however, it has exposed chengzhongcun to many social, economic and environmental problems. Based on a case study of chengzhongcun in Guangzhou, and using an analytical framework of property rights, this article has found that maintaining collective land ownership in chengzhongcun has been socially and economically costly, but a redevelopment strategy without a complementary affordable housing scheme may be problematic. In order to solve the problems of chengzhongcun, an institutional reform of collective land is required. Résumé Les villes chinoises s'étant rapidement étendues depuis la réforme économique de 1978, un grand nombre de villages a été absorbé par les tentacules urbains. La préservation d'une propriété foncière collective dans les chengzhongcun a permis que les migrants accèdent à un logement à loyer modéré, tout en exposant cet habitat à de multiples problèmes sociaux, économiques et environnementaux. S'appuyant sur l'étude de cas du chengzhongcun de Guangzhou et sur un cadre analytique de droits de propriété, cet article montre que le maintien de la propriété foncière collective dans le chengzhongcun s'est révélé coûteux sur le plan social et économique et que, par ailleurs, une stratégie de réaménagement sans un système de logement complémentaire accessible pourrait être problématique. Résoudre les problèmes du chengzhongcun appelle à une réforme institutionnelle des terrains collectifs. [source] Housing Allowances and Economic EfficiencyINTERNATIONAL JOURNAL OF URBAN AND REGIONAL RESEARCH, Issue 4 2006MARIETTA E.A. HAFFNER Housing allowances aim to make rental housing affordable for the recipients. Whether affordability for tenants is achieved in an economically efficient way is the question that is discussed in this essay. Three aspects of efficiency are focused on: disincentives to work, over-consumption of housing and horizontal inefficiency. These topics are tackled through a discussion that focuses mainly on the principles, but also on some of the outcomes, of the means-tested housing allowance systems in six Western countries: Belgium, Germany, the Netherlands, the United Kingdom, the United States and Sweden. Conclusions concern the apparent unimportance of the poverty trap or the unemployment trap specifically for rental housing, the concept of notional rent used to tackle over-consumption, and the frequent existence of some form of horizontal inefficiency. [source] The football: an intuitive dressing for offloading neuropathic plantar forefoot ulcerationsINTERNATIONAL WOUND JOURNAL, Issue 1 2008Andrew J Rader Abstract A reproducible, affordable, efficacious and safe modality for offloading neuropathic plantar foot ulcerations was previously presented in a pilot study. A follow-up retrospective multicentre analysis of the football dressing is now presented. Wound healing rates are compared with published data on the total contact cast (TCC) and instant total contact cast (iTCC). Overall wound healing rates for University of Texas Health Science Center class 1A, 1B, 1C, 1D, 2A, 2B, 2C and 3B plantar forefoot ulcerations is 2·91 weeks with a 95% confidence interval of 2·36,3·47 weeks for complete wound epithelialisation. The cost associated with this dressing technique is a fraction of that associated with the TCC and iTCC. The ease of application coupled with reliable healing rates and affordable materials makes the football dressing a worthy partner against the sequelae of plantar forefoot ulcerations. [source] Antimicrobial therapy in DermatologyJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 1 2006Cord Sunderkötter Antiseptika; Antibiotika; ,-Laktam-Resistenz; Weichteilinfektion Summary The extensive and sometimes indiscriminate use of antibiotics sometimes without strict indications has led to increases in both bacterial resistance and sensitization of patients. Systemic antibiotics in skin infections are indicated when a severe local infection occurs which spreads into the surrounding tissue or when there are signs of systemic infection. There are special indications in patients with peripheral arterial occlusive disease,diabetes or immunosuppression. Topical use of antibiotics should be abandoned and replaced by antiseptics. The ,-lactam antibiotics are the antibiotics of first choice for many skin infections. They are usually effective, have a well-defined profile of adverse events and most are affordable. Penicillin G or V are the first line treatment for erysipelas. Infections with Staphylococcus aureus are usually treated with isoxazolyl penicillins or second generation cephalosporins. In mixed infections in patients with diabetes or peripheral arterial occlusive disease,the treatment of choice is metronidazole plus ,-lactam-/,-lactamase inhibitor antibiotics, but quinolones or second generation cephalosporins can also be used, once again with metronidazole. The aim of this review is to define the indications for antibiotics in dermatology, to highlight their modes of action and adverse effects and to make suggestions for rational antibiotic therapy in cutaneous infections frequently encountered in the practice of dermatology. Zusammenfassung Der bisweilen unkritische Einsatz von Antibiotika hat die Resistenzentwicklung beschleunigt und die Sensibilisierungsrate bei Patienten erhöht. Systemische Antibiotika sind bei kutanen Superinfektionen in der Regel dann indiziert, wenn eine schwere lokale Infektion mit Ausbreitung in das umgebende Gewebe vorliegt oder wenn sich gleichzeitig Zeichen einer systemischen Infektion einstellen. Bei peripherer arterieller Verschlusskrankheit, Diabetes mellitus oder Immunsuppression kann die Indikation auch früher gestellt werden. Lokale Antibiotika sollten in der Regel gemieden und durch moderne Antiseptika ersetzt werden. ,-Laktam-Antibiotika stellen für viele bakterielle Infektionserkrankungen in der ambulanten und klinischen Dermatologie die Antibiotika der ersten Wahl dar. Sie sind häufig ausreichend wirksam, besitzen ein gut definiertes Nebenwir-kungsprofil und sind zumeist preisgünstig. So wird das klassische Streptokokken-Erysipel mit Penicillin G oder V therapiert, bei Infektionen durch S. aureus kommen primär Isoxazolyl-Penicilline oder Zweit-Generations-Cephalosporine zum Einsatz. Im Falle von Mischinfektionen bei Diabetes mellitus oder pAVK sind ,-Laktam/,-Laktamaseinhibitoren indiziert, alternativ auch Chinolone oder Zweitgenerations-Cephalosporine, jeweils in Kombination mit Metronidazol. Diese Übersicht möchte die Indikationen für Antibiotika in der Dermatologie aufzeigen, das Wichtigste zu deren Wirkungsweise und Nebenwirkungen aufzählen und Therapievorschläge für häufige Infektionen der Haut in der dermatologischen Praxis geben. [source] Influence of crop residue ration supplementation on the attainment of puberty and postpartum reproductive activities of Red Sokoto goatsJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 1-2 2005B. S. Malau-Aduli Summary The general objective of this study was to come up with an appropriate, affordable and locally available crop residue supplementation package that would enhance reproductive performance in small ruminants. Specifically, 28 Red Sokoto weaner does between 3 and 4 months of age weighing between 2 and 3 kg were used in the first experiment to determine the influence of crop residue supplementation on age and weight at puberty as determined by blood progesterone levels. In the second experiment, another 28 adult does (,2 years old) of the same breed in the same flock with lactation numbers between 1 and 3 were used to determine the length of postpartum acyclic period. In both experiments, a 3 × 2 factorial experimental design comprising three dietary supplements (A, B, C) at two feeding levels (1% and 2% of body weight) fed in addition to a basal diet of Digitaria smutsii hay and natural pasture ad libitum with an unsupplemented negative control group (D) and four goats per treatment was utilized. In ration A, a conventional concentrate supplement consisting of maize, wheat offal, cottonseed cake and bonemeal was utilized; in rations B and C, the supplement consisted of guinea-corn bran, cowpea husk and groundnut haulms; and maize offal, groundnut shells and groundnut haulms respectively. Unsupplemented (ration D) weaner does reached puberty at a later age and had lighter body weights than all the others. Weaner does on ration 2A (concentrate fed at 2% of body weight) attained puberty at the earliest age and heaviest body weight, although the age at puberty was not significantly different from those on rations 1A (concentrate fed at 1% body weight), 1C and 2C. Blood progesterone profiles before and after puberty ranged from 0.05 to 9.0 ng/ml, respectively, and was highest in does fed rations A and C and least in the unsupplemented does. The mean interval between kidding and initiation of ovarian activity was 54.28 ± 17.61 days and the mean interval between kidding and conception was 63.04 ± 25.34 days. Only 25% of the unsupplemented does conceived again during the period under study compared with 100% in rations 1A, 2A, 1C and 2C; 75% in ration 2B and 50% in ration 1B. It was concluded that implementation of supplementary feeding in the dry season improves reproductive performance in the Red Sokoto doe. Furthermore, ration C, a crop residue-based ration, was a suitable dry season supplementation alternative to the expensive conventional concentrate ration for the smallholder goat farmer in the subhumid tropics of Nigeria. [source] The rationale of value-laden medicineJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2002Michael H. Kottow MA(Soc) MD Abstract Medicine is becoming increasingly confident that scientific advances, especially in the area of genetics, will allow a major improvement in the control and eradication of disease. This development seems to go hand in hand with health-enhancement strategies, erasing the distinction between the states of health and disease, and blurring the specific goals of medical services. Medicine tends to become an increasingly technocentric practice that relies heavily on expert knowledge and on epidemiological evidence, neglecting the lived-body experience of being ill, and tending to transform costly medical services into commodities only affordable by the affluent. This paper argues that disease is not merely a functional description, but rather a definitely value-laden organismic state that is experienced by the patient, needs to be explored and treated by medical practitioners, and requires the assessment and participation of social institutions concerned with the delivery and support of medical services. Each of these perspectives introduces its own set of values, both in the clinical encounter and in public health programmes. Bioethics seems to be the appropriate discipline to discuss all these values involved, and help assign them properly in order to rescue the caring concern of medicine for the sick, as well as uphold a principle of fairness in publicly funded medical services. [source] Third S. S. Ratnam Memorial Lecture 2007.JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2009Ovarian cancer: Is there hope for women? Abstract Ovarian cancer is today the most lethal female cancer with an overall survival of only 49.9%. The currently available screening modalities are disappointing in detecting highly curable early stage ovarian cancer. Natural history of ovarian cancer is unknown; it appears it can develop quickly from normal looking ovaries. Timely referral of women with non-specific symptoms (such as abdominal bloating, pelvic pain) for an ultrasound scan or blood CA125 assessments may help in the early diagnosis. Patients with Stage IA or IB disease with grade 1 tumors have a cure rate of >90%; this is likely to be compromised by laparoscopic surgery. In selected patients fertility preservation with good obstetric outcome is possible. However, the relapse rate in ,high risk' early stage ovarian cancers is 40,45%; adjuvant chemotherapy is needed. Only 20,25% of those with stage III and IV disease are cured. Despite a high primary response (70%) majority (70,75%) will relapse and all are likely to succumb. Optimal debulking surgery followed by adjuvant chemotherapy are needed for stages III and IV disease; the outcome is superior if managed by gynecologic oncologists. Where cost of drugs is an important consideration, an alternative is carboplatin (an affordable and equally effective drug). The role of vaccines needs further study. When relapses occur palliation will be the aim in most instances. Oral contraceptives, breast feeding, tubal sterilization and hysterectomy also have a protective effect. Risk-reducing salpingo-oopherectomy has been suggested in women with BRCA mutations. [source] Maternity waiting homes in Southern Lao PDR: The unique ,silk home'JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2008Elizabeth Eckermann Abstract The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People's Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR. [source] Digital soil mapping in Germany,a reviewJOURNAL OF PLANT NUTRITION AND SOIL SCIENCE, Issue 3 2006Thorsten Behrens Abstract Digital soil mapping as a tool to generate spatial soil information provides solutions for the growing demand for high-resolution soil maps worldwide. Even in highly developed countries like Germany, digital soil mapping becomes essential due to the decreasing, time-consuming, and expensive field surveys which are no longer affordable by the soil surveys of the individual federal states. This article summarizes the present state of soil survey in Germany in terms of digitally available soil data, applied digital soil mapping, and research in the broader field of pedometrics and discusses future perspectives. Based on the geomorphologic conditions in Germany, relief is a major driving force in soil genesis. This is expressed by the digital,soil mapping research which highlights the great importance of digital terrain attributes in combination with information on parent material in soil prediction. An example of digital soil mapping using classification trees in Thuringia is given as an introduction in digital soil-class mapping based on correlations to environmental covariates within the scope of the German classification system. [source] The Implementation of Target Costing in the United States: Theory Versus PracticeJOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 1 2006Lisa M. Ellram SUMMARY Target costing has been touted as a process that can significantly improve new product development results in the accounting, engineering, operations management, and purchasing literature. The target costing process considers the voice of the customer, incorporates earlier supplier involvement and concurrent engineering, utilizes cross-functional teams, and focuses on creating a good or service that is both desirable and affordable to the customer and profitable to the producing organization. Unlike previous studies, which have focused on Japanese firms, or used single case studies, this paper uses the findings from case studies of 11 organizations actively engaged in the target costing process. This paper explores how the target costing process is used in practice in the United States, comparing it with the popular theoretical model of target costing. It helps shed light on to target costing practices of U.S. and other Western firms, and highlights the often overlooked role of the purchasing function in successful target costing efforts. [source] The production of provitamin A-rich vegetables in home-gardens as a means of addressing vitamin A deficiency in rural African communitiesJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 3 2007Mieke Faber Abstract Vitamin A deficiency remains a public health problem in the developing world. The highest prevalence of vitamin A deficiency is in Africa and Asia (>30%). Dietary modification, a long-term strategy to address vitamin A deficiency, complements food fortification and vitamin A supplementation programmes. Provitamin A carotenoids from foods of plant origin are more affordable than preformed vitamin A from animal foods, and many resource-poor households rely on yellow/orange-fleshed vegetables and fruits and dark-green leafy vegetables as their main source of vitamin A. The provitamin A carotenoid content in plant foods varies widely and differences among cultivars of the same food exist. Several factors influence the bioavailability of provitamin A carotenoids. The potential contribution of plant foods to vitamin A status depends on the retention of provitamin A carotenoids after storage, preparation and processing. Home-gardens can provide households with direct access to provitamin A-rich vegetables that are not readily available or within their financial reach. The components and critical issues of home-garden projects are described. Copyright © 2006 Society of Chemical Industry [source] The promise and challenges of bioengineered recombinant clotting factorsJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 8 2005S. W. PIPE Summary., The past 10 years of clinical experience have demonstrated the safety and efficacy of recombinant clotting factors. With the adoption of prophylactic strategies, there has been considerable progress in avoiding the complications of hemophilia. Now, insights from our understanding of clotting factor structure and function, mechanisms of hemophilia and inhibitors, gene therapy advances and a worldwide demand for clotting factor concentrates leave us on the brink of embracing targeted bioengineering strategies to further improve hemophilia therapeutics. The ability to bioengineer recombinant clotting factors with improved function holds promise to overcome some of the limitations in current treatment, the high costs of therapy and increase availability to a broader world hemophilia population. Most research has been directed at overcoming the inherent limitations of rFVIII expression and the inhibitor response. This includes techniques to improve rFVIII biosynthesis and secretion, functional activity, half-life and antigenicity/immunogenicity. Some of these proteins have already reached commercialization and have been utilized in gene therapy strategies, while others are being evaluated in pre-clinical studies. These novel proteins partnered with advances in gene transfer vector design and delivery may ultimately achieve persistent expression of FVIII leading to an effective long-term treatment strategy for hemophilia A. In addition, these novel FVIII proteins could be partnered with new advances in alternative recombinant protein production in transgenic animals yielding an affordable, more abundant supply of rFVIII. Novel rFIX proteins are being considered for gene therapy strategies whereas novel rVIIa proteins are being evaluated to improve the potency and extend their plasma half-life. This review will summarize the status of current recombinant clotting factors and the development and challenges of recombinant clotting factors bioengineered for improved function. [source] Why Medical Child Support is Important,and ComplexJUVENILE AND FAMILY COURT JOURNAL, Issue 2 2008Susan F. Paikin ABSTRACT Courts resolving child support cases involving separated, divorced, and non-marital children are charged with defining responsibility for health care coverage for the children under that order. This article explores historical and current medical child support requirements under Title IV-D of the Social Security Act,the national child support enforcement ("IV-D") program. It analyzes legal requirements and policy recommendations, and provides a practical tool judges may use to determine whether health care coverage available to either or both parents is appropriate,that is, comprehensive, accessible, and affordable. [source] Tuneable Femtosecond Fiber Lasers , Ultra-short laser pulses from green to IRLASER TECHNIK JOURNAL, Issue 2 2005Jan Posthumus Dr. There is a wealth of applications for ultra-short, pulsed lasers in many areas of science and technology, material processing and also in medicine. However, their widespread use is severely hampered by the size and cost of these lasers, both in terms of acquisition and maintenance. This implies that there could be a large market for affordable, turn-key femtosecond lasers (1 fs = 10,15 s). A technical solution is now possible with a new generation of fiber lasers, which are made of standard telecom components. These fiber lasers are compact (A4 size) and scalable in cost and performance. They can also be produced in large volumes. They render water cooling methods and large power supplies obsolete. [source] Seeing the Past: Visual Media in ArchaeologyAMERICAN ANTHROPOLOGIST, Issue 2 2006RUTH M. VAN DYKE As digital media become increasingly affordable and accessible, visual representation in archaeology is expanding across several dimensions. In this essay, I examine some emerging forms of visual media in archaeology, including online documentaries, maps and photographs, hypermedia, experimental films, and peripatetic video. Visual media offer powerful opportunities for engagement with the public. In addition, archaeologists are finding new ways to use the visual in interpretation, analysis, and critique. Experimental visual works often are self-consciously reflexive, questioning and exposing the ways archaeological knowledge is constructed, represented, and disseminated. [source] A "cure" for Parkinson's disease: Can neuroprotection be proven with current trial designs?MOVEMENT DISORDERS, Issue 5 2004Carl E. Clarke BSc Abstract Current medical and surgical therapies for Parkinson's disease provide symptomatic control of motor impairments rather than slowing or halting the progression of the disease. Previous clinical trials examining drugs such as dopamine agonists and selegiline for neuroprotective effects used "surrogate" outcomes, including clinical measures (rating scales, time to require levodopa), neuroimaging techniques (,-CIT single photon emission computed tomography; fluorodopa positron emission tomography), and mortality tracking. These studies failed to provide conclusive results because of design faults such as failing to control for symptomatic effects, small sample size, and not accounting for the possible effects of drugs on radionuclide tracer handling. Lessons must be learned from these failed neuroprotection trials. This review summarises the problems with previous neuroprotection studies and makes recommendations for future trial design. It is concluded that the primary outcome of explanatory trials should continue to be clinical measures such as the Unified Parkinson's Disease Rating Scale (UPDRS). It should be assumed that all agents have a symptomatic effect, which necessitates evaluation after a prolonged drug washout period. To achieve the evaluation after a prolonged drug washout period more effectively, trials must be performed in early disease and over a short period (6,12 months) so that symptomatic therapy is not required. To achieve adequate statistical power, these trials will need to include thousands of patients. Radionuclide imaging can only be used in such trials after considerable methodological work has been performed to establish its validity and reliability. To be affordable, such large explanatory trials need more streamlined designs with fewer hospital visits, fewer outcome measures, and rationalised safety monitoring. The clinical effectiveness of promising compounds from explanatory trials will need to be established in large long-term pragmatic trials using outcome measures such as quality of life, cost-effectiveness, and mortality. Such pragmatic trials could be continuations of the explanatory trials: after the primary outcome of the explanatory study (e.g., UPDRS) has been reported in an interim analysis, the trial could be continued for a further 5 to 10 years to report on quality of life and health economics outcomes. © 2004 Movement Disorder Society [source] | |||||||||||||||||||||||||||||||||||||||||||