Full Text Available Abstract Background The cost-effectiveness of insecticide-treated nets (ITNs in reducing morbidity and mortality is well established. International focus has now moved on to how best to scale up coverage and what financing mechanisms might be used to achieve this. The approach in Tanzania has been to deliver a targeted subsidy for those most vulnerable to the effects of malaria while at the same time providing support to the development of the commercial ITN distribution system. In October 2004, with funds from the Global Fund to Fight AIDS Tuberculosis and Malaria, the government launched the Tanzania National Voucher Scheme (TNVS, a nationwide discounted voucher scheme for ITNs for pregnant women and their infants. This paper analyses the costs and effects of the scheme and compares it with other approaches to distribution. Methods Economic costs were estimated using the ingredients approach whereby all resources required in the delivery of the intervention (including the user contribution are quantified and valued. Effects were measured in terms of number of vouchers used (and therefore nets delivered and treated nets years. Estimates were also made for the cost per malaria case and death averted. Results and Conclusion The total financial cost of the programme represents around 5% of the Ministry of Health's total budget. The average economic cost of delivering an ITN using the voucher scheme, including the user contribution, was $7.57. The cost-effectiveness results are within the benchmarks set by other malaria prevention studies. The Government of Tanzania's approach to scaling up ITNs uses both the public and private sectors in order to achieve and sustain the level of coverage required to meet the Abuja targets. The results presented here suggest that the TNVS is a cost-effective strategy for delivering subsidized ITNs to targeted vulnerable groups.
Keywords: Diaspora Engagement, National Development, Tanzania. 1. Darlene K. Mutalemwa is a ... having its unique features in regards to home country, migration patterns and historical experiences. ..... recipients, supplement their income and provide them with funds that can be used for consumption, savings, or ...
Senkoro Ahadieli R
Full Text Available Abstract Background The oral health education programs which have been organised and delivered in Tanzania were not based on a thorough understanding of behaviours which influence oral health. Therefore, evaluation of these programs became difficult. This study aimed at investigating the oral health related behaviours and their determinants among Tanzanian adults. Methods A national pathfinder cross sectional survey was conducted in 2006 involving 1759 respondents from the six geographic zones of mainland Tanzania. Frequency distributions, Chi square and multiple logistic regression analyses were performed using SPSS version 13.0. Results The rates of abstinence from alcohol for the past 30 days and life time smoking were 61.6% and 16.7% respectively, with males being more likely to smoke (OR 9.2, CI 6.3 -12.9, p Conclusion The findings of this study demonstrated social demographic disparities in relation to oral health related behaviors, while dental pain was associated with low consumption of sugar and high likelihood to take alcohol.
Magesa, Stephen M; Lengeler, Christian; deSavigny, Don; Miller, Jane E; Njau, Ritha JA; Kramer, Karen; Kitua, Andrew; Mwita, Alex
Introduction Malaria is the largest cause of health services attendance, hospital admissions and child deaths in Tanzania. At the Abuja Summit in April 2000 Tanzania committed itself to protect 60% of its population at high risk of malaria by 2005. The country is, therefore, determined to ensure that sustainable malaria control using insecticide-treated nets is carried out on a national scale. Case description Tanzania has been involved for two decades in the research process for developing insecticide-treated nets as a malaria control tool, from testing insecticides and net types, to assessing their efficacy and effectiveness, and exploring new ways of distribution. Since 2000, the emphasis has changed from a project approach to that of a concerted multi-stakeholder action for taking insecticide-treated nets to national scale (NATNETS). This means creating conditions that make insecticide-treated nets accessible and affordable to all those at risk of malaria in the country. This paper describes Tanzania's experience in (1) creating an enabling environment for insecticide-treated nets scale-up, (2) promoting the development of a commercial sector for insecticide-treated nets, and (3) targeting pregnant women with highly subsidized insecticide-treated nets through a national voucher scheme. As a result, nearly 2 million insecticide-treated nets and 2.2 million re-treatment kits were distributed in 2004. Conclusion National upscaling of insecticide-treated nets is possible when the programme is well designed, coordinated and supported by committed stakeholders; the Abuja target of protecting 60% of those at high risk is feasible, even for large endemic countries. PMID:16042780
Kramer, Karen; Mandike, Renata; Nathan, Rose; Mohamed, Ally; Lynch, Matthew; Brown, Nick; Mnzava, Ally; Rimisho, Wilhelmina; Lengeler, Christian
The Tanzania National Voucher Scheme (TNVS) was a public private partnership managed by the Ministry of Health that provided pregnant women and infants with highly subsidized (long-lasting) insecticide-treated nets between 2004 and 2014. It was implemented in the context of the National Insecticide Treated Nets (NATNETS) Programme and was the main keep up strategy for vulnerable populations. The programme design was adjusted considerably over time to incorporate new evidence, shifting public health policies, and changing donor priorities. Three TNVS models can be distinguished: (1) the fixed discount; (2) the fixed top-up; (3) the hybrid voucher model. The changes improved equity and effectiveness, but also had a profound effect on how the programme was managed and implemented. The TNVS reached the majority of beneficiaries with vouchers, and significantly increased household ownership and use of LLINs. While two mass distribution campaigns implemented between 2009 and 2011 achieved universal coverage and equity, the TNVS ensured continuous protection of the vulnerable populations before, during and after the campaigns. The TNVS stimulated and maintained a large national retail network which managed the LLIN supply chain. The effectiveness of the TNVS was a function of several interdependent factors, including the supply chain of vouchers through the public health system; the supply chain of nets in the commercial sector; the demand for nets from voucher recipients; management and risk mitigation measures; and the influence of global and donor objectives. The TNVS was a highly innovative and globally influential programme, which stimulated the thinking around effectively and equitably distributing ITNs, and contributed directly to the evolution of global policy. It was a fundamental component of the NATNETS programme which protected a malaria-vulnerable population for over a decade.
Department of Housing and Urban Development — The U.S. Department of Housing and Urban Developments (HUD) Housing Choice Voucher Program (HCVP) is the federal government's major program for assisting very...
Nkuba, Mabula; Hermenau, Katharin; Hecker, Tobias
Though the Sustainable Development Goals of the United Nations aim to end all forms of violence against minors, child maltreatment remains a globally prevalent phenomenon. Despite the fact that parents in numerous countries apply violent discipline methods to control children's behavior, little is known about the prevalence of maltreatment and violent discipline in Sub-Saharan Africa. In this study, we examined the prevalence of maltreatment and violent discipline from both the adolescents' and parents' perspectives. In addition, we explored risk factors that could be associated with violent discipline by parents. We administered questionnaires to a nationally representative sample of 700 Tanzanian secondary school students (52% girls, mean age: 14.92 years, SD = 1.02, range: 12-17) and 333 parents or primary guardians (53% females; mean age: of 43.47 years, SD = 9.02, range: 19-71). More than 90% of all students reported exposure to violent discipline by a parent within the past year. Concurrently, more than 80% of parents acknowledged using violent discipline techniques. Using a path model, we found that violent discipline by parents was associated with parental stress. Other risk factors contributed to a higher stress level but were not directly linked to maltreatment. Our findings indicate high levels of violent discipline in Tanzanian families. There is a pressing need to design and implement interventions that prevent children from experiencing violence at home. Reducing parents' stress levels may be a starting point for intervention. Yet, due to the high levels of violent discipline, societal beliefs also need to be considered. Copyright © 2018 Elsevier Ltd. All rights reserved.
Nkuba, Mabula; Hermenau, Katharin; Goessmann, Katharina; Hecker, Tobias
Little is known about the prevalence of mental health problems among adolescents in Sub-Saharan Africa. Research consistently determined violence and maltreatment to be important risk factors. In this study, we examined the prevalence of mental health problems among adolescents in Tanzania, as well as the association with exposure to violence and maltreatment. We administered a set of questionnaires (e.g., strength and difficulties questionnaire; conflict tactic scale) to a nationally representative sample of 700 Tanzanian secondary school children (52% girls; age 14.92 years, SD = 1.02) and 333 parents or primary caregivers (53% females; age 43.47 years, SD = 9.02). 41% of the students reported an elevated level of mental health problems (emotional problems 40%, peer problems 63%, conduct problems 45%, hyperactivity 17%) in the past 6 months. Concordantly, 31% of parents reported observing an elevated level of mental health problems in their children (emotional problems 37%, peer problems 54%, conduct problems 35%, hyperactivity 17%). After controlling for other risk factors, we found significant associations between physical violence by parents and adolescent's mental health problems reported by students (β = 0.15) and their parents (β = 0.33). Our findings suggest a high prevalence of mental health problems using screening tools among secondary school students in Tanzania as well as an association between physical violence by parents and adolescents' mental health problems. Our findings emphasize the need to inform the population at large about the potentially adverse consequences associated with violence against children and adolescents.
Cleaveland, S; Mlengeya, T; Kazwala, R R; Michel, A; Kaare, M T; Jones, S L; Eblate, E; Shirima, G M; Packer, C
Bovine tuberculosis, caused by Mycobacterium bovis, is a pathogen of growing concern in free-ranging wildlife in Africa, but little is known about the disease in Tanzanian wildlife. Here, we report the infection status of Mycobacterium bovis in a range of wildlife species sampled from protected areas in northern Tanzania. M. bovis was isolated from 11.1% (2/18) migratory wildebeest (Connochaetes taurinus) and 11.1% (1/9) topi (Damaliscus lunatus) sampled systematically in 2000 during a meat cropping program in the Serengeti ecosystem, and from one wildebeest and one lesser kudu (Tragelaphus imberbis) killed by sport hunters adjacent to Tarangire National Park. A tuberculosis antibody enzyme immunoassay (EIA) was used to screen serum samples collected from 184 Serengeti lions (Panthera leo) and 19 lions from Ngorongoro Crater sampled between 1985 and 2000. Samples from 212 ungulates collected throughout the protected area network between 1998 and 2001 also were tested by EIA. Serological assays detected antibodies to M. bovis in 4% of Serengeti lions; one positive lion was sampled in 1984. Antibodies were detected in one of 17 (6%) buffalo (Syncerus caffer) in Tarangire and one of 41 (2%) wildebeest in the Serengeti. This study confirms for the first time the presence of bovine tuberculosis in wildlife of northern Tanzania, but further investigation is required to assess the impact on wildlife populations and the role of different wildlife species in maintenance and transmission.
The author exposes some of the myths still surrounding the use of vouchers in mass privatization. He explains why using vouchers will not affect the price level in the economy-even though they carry a face value. He shows that vouchers allow assets to sell despite minimum acceptable bid prices because the secondary market discount of voucher prices acts as a safety valve. And he argues that ...
Full Text Available Abstract Background The Tanzania National Voucher Scheme (TNVS uses the public health system and the commercial sector to deliver subsidised insecticide-treated nets (ITNs to pregnant women. The system began operation in October 2004 and by May 2006 was operating in all districts in the country. Evaluating complex public health interventions which operate at national level requires a multidisciplinary approach, novel methods, and collaboration with implementers to support the timely translation of findings into programme changes. This paper describes this novel approach to delivering ITNs and the design of the monitoring and evaluation (M&E. Methods A comprehensive and multidisciplinary M&E design was developed collaboratively between researchers and the National Malaria Control Programme. Five main domains of investigation were identified: (1 ITN coverage among target groups, (2 provision and use of reproductive and child health services, (3 "leakage" of vouchers, (4 the commercial ITN market, and (5 cost and cost-effectiveness of the scheme. Results The evaluation plan combined quantitative (household and facility surveys, voucher tracking, retail census and cost analysis and qualitative (focus groups and in-depth interviews methods. This plan was defined in collaboration with implementing partners but undertaken independently. Findings were reported regularly to the national malaria control programme and partners, and used to modify the implementation strategy over time. Conclusion The M&E of the TNVS is a potential model for generating information to guide national and international programmers about options for delivering priority interventions. It is independent, comprehensive, provides timely results, includes information on intermediate processes to allow implementation to be modified, measures leakage as well as coverage, and measures progress over time.
...-NEW. Type of Request: New collection. Abstract: Information is completed by tenants, voucher holders..., Rural Development Housing Assistance Payments contract, and the voucher itself. The collection of... ``Rural Development Assistance Payment Contract,'' ``Voucher,'' ``Voucher assistance,'' ``Voucher holder...
... 32 National Defense 3 2010-07-01 2010-07-01 true Preparation and forwarding of payment vouchers... Preparation and forwarding of payment vouchers. (a) An unrepresented claimant will be listed as the sole payee... attorney, only one payment voucher will be issued with the claimant and the attorney as joint payees. The...
Based largely on wildlife and natural attractions, Tanzanian tourism has become one of the mainstays of the national economy. Within the tourism sector, the role of tour operators involved in safari style game drives cannot be underestimated. Visits to Ngorogoro crater, Mount Kilimandjaro and the Serengeti plains have ...
The thesis aims to analyze distributional impacts of meal voucher sys- tem in the Czech Republic, especially in the context of income inequality between different income groups. In the first part, we study the features of the Czech meal voucher scheme, relevant legislative framework and offer a comparison of the Czech meal voucher system with other European coun- tries. In the second part, we perform an analysis of the redistributive effects of meal allowances on various income deciles, quant...
Ralph, John H.
Political and social changes that have increased the public's interest in educational vouchers are summarized in three categories. The first category, new support for the arguments made by voucher advocates, includes Milton Friedman's suggestion of a free and competitive market for education, and John E. Coons and Stephen D. Sugarman's…
Watts, Jennifer J; Segal, Leonie
This paper explores the economic implications of vouchers for chronic disease management with respect to achieving objectives of equity and efficiency. Vouchers as a payment policy instrument for health care services have a set of properties that suggest they may address both demand-side and supply-side issues, and contribute to equity and efficiency. They provide a means whereby health care services can be targeted at selected groups, enabling consumer choice of provider, and encouraging competition in the supply of health services. This analysis suggests that, when structured appropriately, vouchers can support consumers to choose services that will meet their health care needs and encourage competition among providers. Although they may not be appropriate across the entire health care system, there are features of vouchers that make them a potentially attractive option, especially for the management of chronic disease.
US Agency for International Development — This process provides a workflow and eSignature capability which allows the CFO to router vouchers for review and electronic signature approval to COTRs in AIDW. It...
Ford, Michael R.
This article uses originally collected survey data to determine how leaders of private schools in the nation's oldest school-voucher program define accountability and perceive the state agency charged with holding them accountable. The results indicate voucher-school administrators' views on accountability are influenced by their school's level of…
... named. No payment of any part of the amount due on account of an award will be made unless a voucher... Department. A voucher application for each payment on account of an award must be signed by each person whose... partnership or corporation named, the voucher shall be executed by the person entitled to payment as provided...
... may be responsible for the full payment of rent. The Rural Development Voucher Program applies to any... contract must be executed before Rural Development Voucher payments can be made. Rural Development will use...- place. Also, in no event may the Rural Development Voucher payment exceed the actual tenant lease rent...
Reel, Jordan; Block, Walter E.
Milton Friedman is famous for his book title: “Free to Choose.” He also favors educational vouchers, which denies the freedom to choose to people who do not wish to subsidize the education of other people’s children. Thus, he is guilty of a logical contradiction. Why is it important to assess whether Friedman’s views on educational vouchers are logically consistent with his widespread reputation as an advocate of free enterprise, and, thus, freedom to chose? It is important to assess all figu...
Grimesey, Robert P., Jr.
In September 2010, the U.S. Senate's Armed Services Committee approved an amendment to the proposed National Defense Authorization Act. The amendment, known as Section 583, authorized a Defense Department pilot voucher program to mitigate the cost of private school tuition for special-needs children of military parents. Sen. Jim Webb, a member of…
The reform of higher education in Russia, based on standardized tests and educational vouchers, was intended to reduce inequalities in access to higher education. The initiative with the vouchers has failed and by now is already forgotten while the national test is planned to be introduced nationwide in 2009. The national test called to replace the present corrupt system of entry examinations has experienced numerous problems so far and will likely have even more problems in the future. This ...
Buly A Cardak
This paper uses a growth model with public and private education alternatives to investigate the implications of education voucher for economic growth and the evolution of income inequality. The results indicate that introducing education vouchers can increase economic growth. families that switch from public to private education due to vouchers experience higher incomes, leading to growth in the tax base which in turn raises public education expenditures and increases the growth of the whole...
Dennis N. Epple; Richard Romano
Two significant challenges hamper analyses of the collective choice of educational vouchers. One is the multi-dimensional choice set arising from the interdependence of the voucher, public education spending, and taxation. Second, even absent a voucher, preferences over public spending are not single-peaked; a middling level of public school spending may be less attractive to a household than either high public school spending or private education coupled with low public spending. We show tha...
Background: Despite of the recommendations to use population specific blood pressure (BP) references which consider time, ethnicity and environmental factors, there is limited information regarding BP profile among Tanzanians. This cross sectional study was done to determine casual BP profile among healthy volunteer ...
Spherical Polymeric Particles (SPP) have been prepared from Tanzanian Cashew Nut Shell Liquid (CNSL) by suspension polymerization technique involving either step-growth or chain- growth polymerization mechanisms. The sizes of the SPP, which ranged from 0.1 to 2.0 mm were strongly influenced by the amounts of ...
including its private companies, in Tanzanian agricultural investments, development and transformation. The paper concludes with some final remarks broadly stating that while Tanzania has enormous potential for attracting private investment in agriculture, there are serious constraints to. India's effective engagement in ...
Conclusions: This study provides baseline data on the need for orthodontic treatment among Tanzanian children that may be useful for the public oral health service to determine priority for orthodontic treatment as part of comprehensive child oral health care in Tanzania. East African Medical Journal Vol.81(1) 2004: 10-15 ...
Full Text Available The use of Housing Purchase Vouchers offers IDPs durablehousing and community integration, while allowing theman opportunity to choose their own homes and their owndurable solution.
This report presents the case for competition in education, tenders the voucher plan as a means of fostering competition and providing choice in education, and discusses some problems associated with education voucher proposals. Two primary problems -- segregation and church-state conflict -- are given particular attention. The author also…
Salganik, Laura Hersh
Recent changes in the age and race composition of the population and in educational governance indicate that the public will be more receptive to educational vouchers. These changes, points of agreement and disagreement, and the history of educational vouchers are described. (CJ)
Full Text Available Milton Friedman is famous for his book title: “Free to Choose.” He also favors educational vouchers, which denies the freedom to choose to people who do not wish to subsidize the education of other people’s children. Thus, he is guilty of a logical contradiction. Why is it important to assess whether Friedman’s views on educational vouchers are logically consistent with his widespread reputation as an advocate of free enterprise, and, thus, freedom to chose? It is important to assess all figures in political economy, and indeed all of scholarship, for logical consistency. It is particularly important to do so in the present case, given the prestige in certain quarters accorded to this Nobel prize-winning economist. We argue in this paper that Friedman’s reputation for logical consistency, and adherence to the philosophy of laissez faire capitalism, are both overblown. Our solution to this challenge is to completely privatize education. Friedman does not advocate that vouchers be utilized for food, clothing or shelter; we see no relevant difference in the case of education. What is the justification of the undertaken topic? This topic is important because education of the next generation is crucial for the upkeep and improvement of society. What is the aim of the present study? It is to demonstrate that the solution offered by M. Friedman and R. Friedman (1990 is highly problematic. What is the methodology used in the study? We quote from this author, and criticize his analysis. What are our main results and conclusions/recommendations? We conclude that the last best hope for the educational industry is laissez faire capitalism, not the mixed economy recommended by Friedman.
After describing the history of the educational voucher movement, this paper briefly discusses the various voucher models that have been proposed and considers some of the issues for and against the establishment of voucher systems. Tracing the voucher concept back to Adam Smith, Thomas Paine, and John Stuart Mill, the author notes that after the…
..., Submission of Vouchers for Payment. (b) The auditor shall retain an unpaid copy of the voucher. (c) When a... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Submission of vouchers... ADMINISTRATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Submission of Vouchers 1842.7101...
The abundance of some elements in hair from Tanzanian children. NK Mohammed. Abstract. Reference values for elements in human hair of people from different countries have been published in literature. However, the data did not include the hair elemental concentrations of the Tanzanian population. Therefore, this ...
The purpose of the study was to determine the oral health status and treatment needs among Tanzanians of different age groups. The findings of the study indicate that Dental caries experience is still very low among Tanzanians (mean DMFT for 12 year olds was 0.3 and for the whole population 1.8). This is in agreement ...
Bellows, Benjamin; Mackay, Anna; Dingle, Antonia; Tuyiragize, Richard; Nnyombi, William; Dasgupta, Aisha
From 2001 to 2011, modern contraceptive prevalence in Uganda increased from 18% to 26%. However, modern method use, in particular use of long-acting reversible contraceptives (LARCs) and permanent methods (PMs), remained low. In the 2011 Uganda Demographic and Health Survey, only 1 of 5 married women used a LARC or PM even though 34% indicated an unmet need for contraception. Between 2011 and 2014, a social franchise and family planning voucher program, supporting 400 private facilities to provide family planning counseling and broaden contraceptive choice by adding LARCs and PMs to the service mix, offered a voucher to enable poor women to access family planning services at franchised facilities. This study analyzes service trends and voucher client demographics and estimates the contribution of the program to increasing contraceptive prevalence in Uganda, using the Impact 2 model developed by Marie Stopes International. Between March 2011 and December 2014, 330,826 women received a family planning service using the voucher, of which 70% of voucher clients chose an implant and 25% chose an intrauterine device. The median age of voucher users was 28 years; 79% had no education or only a primary education; and 48% reported they were unemployed or a housewife. We estimated that by 2014, 280,000 of the approximately 8,600,000 women of reproductive age in Uganda were using a contraceptive method provided by the program and that 120,000 of the clients were "additional users" of contraception, contributing 1.4 percentage points to the national modern contraceptive prevalence rate. The combination of family planning vouchers and a franchise-based quality improvement initiative can leverage existing private health infrastructure to substantially expand family planning access and choice for disadvantaged populations and potentially improve contraceptive prevalence when scaled nationally. © Bellows et al.
The literature on vouchers often concludes that a vouchers-based system cannot be the outcome of a majority vote. This paper shows that, when the value of vouchers and who is entitled to receive them are fixed exogenously, the majority of voters are in favour of selective vouchers. On top of that, as long as the introduction of vouchers does not undermine the existence of the public school system, introducing selective vouchers induces a Pareto improvement. Middle class agents are the only on...
Broughton, Edward Ivor; Hameed, Waqas; Gul, Xaher; Sarfraz, Shabnum; Baig, Imam Yar; Villanueva, Monica
This study reports on the effectiveness and efficiency from the program funder's perspective of the Suraj Social Franchise (SSF) voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016. A decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs) to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program. A total of 168,206 married women of reproductive age (MWRA) received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient). The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62-5.31). The result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.
Sangeda A. Z.; Malole J. L.
Livestock are central to the livelihoods of Tanzanians who rely on them for income via sales of milk, meat, skins and draught power. Owning livestock is amongst the ways in which many Tanzanians could diversify their risks, increase assets and improve their resilience to changes in climate. Though local coping strategies can deal with shocks in the short-term, they are hardly able to cope with more frequent and severe climate events. Observably, temperature, rainfall and atmospheric CO2 conce...
... 23 Highways 1 2010-04-01 2010-04-01 false Progress and final vouchers. 140.609 Section 140.609 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT Reimbursement for Bond Issue Projects § 140.609 Progress and final vouchers. (a) Progress vouchers may be...
... Assistance Payment § 982.502 Conversion to voucher program. (a) New HAP contracts. On and after the merger... part, including calculation of the voucher housing assistance payment in accordance with § 982.505... requirements under this part, including calculation of the voucher housing assistance payment in accordance...
Proponents of private school vouchers argue that vouchers empower poor families and raise the academic achievement of poor children. They also argue that vouchers may improve achievement by forcing the public schools to compete in an education marketplace in which poor parents hold the power of the purse. Juxtaposed against this issue of vouchers…
Bellows, Ben W; Conlon, Claudia M; Higgs, Elizabeth S; Townsend, John W; Nahed, Matta G; Cavanaugh, Karen; Grainger, Corinne G; Okal, Jerry; Gorter, Anna C
-based distribution of vouchers; and tracking individual claims for performance purposes. Maternal voucher programmes differed on whether contracted providers were given training on clinical or administrative issues; whether some form of service verification was undertaken at facility or community-level; and the relative size of programme management costs in the overall programme budget. Evidence suggests voucher programmes can serve populations with national-level impact. Reaching scale depends on whether the voucher programme can: (i) keep management costs low, (ii) induce a large demand-side response among the bottom two quintiles, and (iii) achieve a quality of care that translates a greater number of facility-based deliveries into a reduction in maternal morbidity and mortality.
Robelen, Erik W.
Washington is a safe distance from the powerful winds that have wreaked havoc on the Gulf Coast, but a political storm continued to brew in the capital over President Bush's plan to help pay the costs of private school tuition for students displaced by Hurricane Katrina. As voucher opponents decried the president's plan, Louisiana's two U.S.…
This paper discusses how successful Tanzanian beauty contestants mark themselves as educated sophisticates through clusters of semiotic materials. At lower-level and provincial competitions, contestants’ ability to speak ‘pure,’ if non-fluent and non-standard, English helps them achieve victory. This register is coupled with local, often outlandish, interpretations of international fashions and hairstyles. Yet in the capital city, and especially at the national competition, winning contesta...
Priority review vouchers (PRVs) were introduced in 2007 by the US Congress as an incentive mechanism to spur pharmaceutical firms' R&D efforts for neglected diseases (NDs). A voucher, which a firm can obtain upon approval of a new treatment for NDs, entitles the holder to prioritize the FDA review for any drug. The proposal generated much controversy regarding its ability to effectively stimulate R&D for NDs. Here, after reviewing the main issues of the debate, i use a stylized economic model to discuss the strength of PRVs as an economic incentive to invest in research. My findings suggest that R&D investments might be higher when the developer could prioritize a valuable compound. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available The celebrated fossil locality of Tendaguru (Tanzania, East Africa has been well known for its unique Late Jurassic dinosaur assemblages since the early decades of the 20th century. Recently, within the scope of the German-Tanzanian Tendaguru project, an expedition returned to Tendaguru with the aim of collecting microvertebrates, micro- and macroinvertebrates, plant fossils and new sedimentological and stratigraphical data. Applying a multidisciplinary research approach, the data collected were used to address various controversial issues regarding the Tendaguru Beds. These include their exact age, depositional environments and reconstructions of the palaeoecosystems in which the dinosaurs lived. Field work resulted in a new standard section for the Tendaguru Beds. Preliminary biostratigraphic results, based on ammonites, charophytes and palynomorphs, support a Late Kimmeridgian age for the Nerinea Bed, an early Tithonian age for the Trigonia smeei Bed, and an Early Cretaceous (possibly Valanginian to Hauterivian age for the Trigonia schwarzi Bed. Facies analysis of the Tendaguru Beds indicates environments ranging from storm- and tide-influenced, siliciclastic coastal barrier systems, ooid sand bar complexes and backbarrier tidal flats to sabkha-like coastal plains with brackish lakes and pools. Sedimentological indicators of palaeoclimate and palynological data point to a subtropical to tropical climate with pronounced dry seasons. In concert with sedimentological data, quantitative palaeoecological analysis of macroinvertebrates helped to finetune understanding of environmental factors such as substrate conditions, salinity, sedimentation rate and water depth. Along with abundant microvertebrate remains and fragments of fusain and cuticles, these new data have considerably improved our knowledge of the fauna and flora found in the Tendaguru Beds, and provide a solid basis for developing a better understanding of the Late Jurassic and Early
This paper analyzes the effect of school vouchers on student sorting - defined as a flight to private schools by high-income and committed public-school students - and whether vouchers can be designed to reduce or eliminate it. Much of the existing literature investigates sorting in cases where private schools can screen students. However, publicly funded U.S. voucher programs require a private school to accept all students unless it is oversubscribed and to pick students randomly if it is ov...
Edward Ivor Broughton
Full Text Available IntroductionThis study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016.MethodA decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program.ResultsA total of 168,206 married women of reproductive age (MWRA received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient. The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31.ConclusionThe result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.
Objective: To identify Candida strains isolated from Tanzanian women (13 to 45 years) with vaginal candidiasis. Design: A cross-sectional study. Setting: Antenatal clinic in llala district hospital in Dar es Salaam, Tanzania from March 1998 to December 2000. Results: The identities of the 272 isolates tested with API Candida ...
Prof Alex C Asigbo
find a Nigerian film in the Tanzanian market because Kiswahili video films have taken over. The growth of Kiswahili ... production, there is a mix of both actors and crewmembers who are amateurs and professionals. ..... presented, it is evident that they are both dimensions of underlying politics. Peter Geschiere (1997, p.
This paper report on assessment of the chemicals derived from Tanzanian botanical resource as a viable source of safe, environmentally friendly and low cost mosquitocidal agents, but has yet to be developed into simple blends and formulations to be used in malaria control campaigns. Selection of bioactive plant species ...
The purpose of this study was to assess knowledge related to breast cancer and breast self-examination (BSE) among Tanzanian women. This hospital-based study was conducted at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Face-to-face interviews were conducted with 130 women aged 20-69 years ...
Globalization has a lot of controversies with regard to the rise of global culture. American and Western norms and practices are gradually being transported across the globe as acceptable ways of behaviour. In view of this, the rich and dynamic Tanzanian culture is being diluted. This paper critically assesses influence of ...
River classification is important for reporting ecological status and for the general ecological management of river systems by partitioning natural variability. A priori river classification by abiotic variables and validation of classifications obtained using aquatic macroinvertebrates from reference sites for selected Tanzanian ...
The three Tanzanian wild mushroom species Termitomyces letestui, Lactarius edulis and Agaricus sp. aff. arvensis yielded ergosterol, 5,8-peroxyergosterol and ergosta-5,22-dien-3β-ol, and a mixture of ergosterol, ergosta-7,22-dien-3β-ol and ergosta-7-en-3β-ol whose composition was deduced from gas ...
Anticancer Activity of Extracts from some Endemic Tanzanian Plants. CM Nshimo, A Kamuhabwa, Z Mbwambo, P De Witte. Abstract. Plants have shown to be good sources of a variety of drugs for human ailments including cancer. Tanzania is rich in plant species most of which have not been investigated for any biological ...
The success of such strategies depends on both the diversity and the level of efficiency within small-scale fishing households. This paper examines the technical efficiency of Tanzanian small-scale fishing households, based on data from two coastal villages located near Bagamoyo and Zanzibar, using a stochastic frontier ...
This paper aims at increasing knowledge and understanding of the contribution of India including its private companies, in Tanzanian agricultural investments, development and transformation. The paper concludes with some final remarks broadly stating that while Tanzania has enormous potential for attracting private ...
One of the critical issues deliberated amongst researchers on gender and education is that of choosing and decision-making. Often, the focus of analysis is framed through the concept of agency. In this paper, the analytical focus is on educational advancement and agency. The paper is based on narratives of 10 highly educated Tanzanian women.…
The films tell stories of the problems and joys of the contemporary Tanzanian society, and revolve around themes such as gender relations, love and/or sex, witchcraft and politics. Using selected films from prominent filmmakers, this article analyses the nature of Kiswahili filmmaking in Tanzania and the ways in which some ...
This study examined information needs and seeking behaviour of Tanzanian forestry researchers in the growing global electronic environment. A questionnaire based survey was conducted in three forestry research institutions. The findings indicated a wide range of information needs among forestry researchers in the ...
Coprinus cinereus is a Tanzanian wild edible mushroom whose cultivation in the laboratory was performed in solid-state fermentation bioreactors using sisal decortication wastes namely; sisal dusts, sisal fibres and sisal leaves as basal substrates supplemented with chicken manure at various rates. Bioreactors containing ...
Soluble reactive silica (SRSi) concentrations and diatom abundance were determined during four surveys in the Tanzanian waters of Lake Victoria between 2005 and 2008. The SRSi concentrations increased towards offshore sites, while the opposite was true for diatom abundance. The water directly above the sediment ...
Using this regeneration system Situka M-1, Staha and TMV-1 can now be improved against various production constraints through genetic engineering. Key words: 2, 4-dichlorophexyacetic acid, embryogenic callus, immature zygotic embryos, regeneration frequency, somatic embryos, Tanzanian open pollinated maize.
Educational audit on drug dose calculation learning in a Tanzanian school of nursing. Angela Ruth Savage. St John's University of Tanzania. Abstract. Background: Patient safety is a key concern for nurses; ability to calculate drug doses correctly is an essential skill to prevent and reduce medication errors. Literature ...
individual sharing and a cash-centred economy. While fishers in the study area have remained rather passive in the wake of declining resources, those in other areas of the world such as Bangladesh (Kabir et al., 2011) and Nicaragua (Daw, 2008) have. Changes in Fisheries and Social Dynamics in Tanzanian Coastal ...
Full Text Available Orientation: Chinese organisations have a long tradition of operating in Tanzania, and even today, Tanzania is the gateway for Chinese interests entering sub-Saharan markets. Research purpose: The purpose of this article was to explore and understand the perceptions of Chinese and Tanzanian employees working in a private Chinese organisation in Tanzania. Motivation for the study: The authors would like to contribute to the discourse on Chinese and Tanzanian collaboration in southern Africa to improve context-based intercultural collaboration from a human resource management perspective. Research design, approach and method: The study used a case study approach within a hermeneutical research paradigm. Data were collected through semi-structured interviews and observation in a selected private Chinese organisation. Data were analysed by content analysis using Terre Blanche’s five-step model of content analysis. Main findings: The findings show that intercultural collaboration is a challenge for both Chinese and Tanzanian employees. Chinese employees share a mostly positive view of their organisation, while Tanzanians tend to be more critical. Members of both groups, however, feel that intercultural collaboration could improve if members of ‘the other group’ made recommended changes. Despite this, both groups adhere to their perceptions of ‘the other’ and maintain a favourable view of the self. Practical/managerial implications: Chinese organisations need to create opportunities for the improvement of intercultural collaboration by reflecting on the self and ‘the other’ in terms of understanding thought styles, experiences, knowledge, and the impact of cultural values on collaboration behaviour. As such, cultural knowledge-sharing might contribute to a sustainable long-term intercultural collaboration. Contribution: The study contributes to filling the gap of in-depth qualitative research on perceptions of Chinese and Tanzanian
Full Text Available Orientation: Chinese organisations have a long tradition of operating in Tanzania, and even today, Tanzania is the gateway for Chinese interests entering sub-Saharan markets.Research purpose: The purpose of this article was to explore and understand the perceptions of Chinese and Tanzanian employees working in a private Chinese organisation in Tanzania.Motivation for the study: The authors would like to contribute to the discourse on Chinese and Tanzanian collaboration in southern Africa to improve context-based intercultural collaboration from a human resource management perspective.Research design, approach and method: The study used a case study approach within a hermeneutical research paradigm. Data were collected through semi-structured interviews and observation in a selected private Chinese organisation. Data were analysed by content analysis using Terre Blanche’s five-step model of content analysis.Main findings: The findings show that intercultural collaboration is a challenge for both Chinese and Tanzanian employees. Chinese employees share a mostly positive view of their organisation, while Tanzanians tend to be more critical. Members of both groups, however, feel that intercultural collaboration could improve if members of ‘the other group’ made recommended changes. Despite this, both groups adhere to their perceptions of ‘the other’ and maintain a favourable view of the self.Practical/managerial implications: Chinese organisations need to create opportunities for the improvement of intercultural collaboration by reflecting on the self and ‘the other’ in terms of understanding thought styles, experiences, knowledge, and the impact of cultural values on collaboration behaviour. As such, cultural knowledge-sharing might contribute to a sustainable long-term intercultural collaboration.Contribution: The study contributes to filling the gap of in-depth qualitative research on perceptions of Chinese and Tanzanian
... Types Single Room Occupancy (sro) § 982.604 SRO: Voucher housing assistance payment. (a) For a person... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false SRO: Voucher housing assistance payment. 982.604 Section 982.604 Housing and Urban Development Regulations Relating to Housing and Urban...
Sutton, Lenford C.; King, Richard A.
Legal scrutiny of school voucher policies initially focused on the establishment clause concerning with allocating public dollars to schools sponsored by religious organizations. In recent years, advocates asserted that the exclusion of faith-based organizations from voucher plans that permit expenditures in secular private organizations violates…
Witte, John F.
This paper is the first summary of two studies and 10 years of evaluating the Milwaukee Parental Choice (voucher) Program (MPCP). This paper discusses school voucher evaluations in general terms and how these studies are carried out. The paper outlines the types of studies completed in "Study I" and "Study II" and the results…
Public funding of private K-12 schooling through vouchers continues to be a contentious issue across the U.S., even though a solid majority of Americans continues to oppose them. The voucher plans run the risk of legal challenge for how they handle the rights of students with disabilities and whether they violate state constitutional provisions…
Vossensteyn, Johan J.
As market-like mechanisms become more important in higher education, demand driven funding, and more specific vouchers, gain a lot of attention. As such, the advantages and disadvantages of vouchers have been discussed in a wide variety of settings. However, hardly any country has been prepared to
Okal, Jerry; Kanya, Lucy; Obare, Francis; Njuki, Rebecca; Abuya, Timothy; Bange, Teresah; Warren, Charlotte; Askew, Ian; Bellows, Ben
Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include public sector facilities. Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving public sector facilities were investigated. The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher
Doyle, Denis P.
This monograph analyzes trends in American educational philosophy and history in its proposal to implement an all-public statewide school voucher system. Following an introduction, section 1, "Alternative Voucher Systems," discusses three concepts: universal unregulated vouchers, favored by Milton Friedman; regulated compensatory vouchers,…
... voucher. In addition to the items necessary per FAR 52.232-25, “Prompt Payment”, the voucher shall show... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Voucher Submission (Cost... Voucher Submission (Cost-Reimbursement). As prescribed in 632.908(b), the contracting officer may insert a...
... may be responsible for the full payment of rent. The Rural Development Voucher Program applies to any... executed before Rural Development Voucher payments can be made. Rural Development will use its best efforts... the Rural Development Voucher payment exceed the actual tenant lease rent. The amount of the voucher...
Full Text Available Sport funding at the municipal level has a long tradition, especially in Europe. Youth involvement in sport is usually an important aspect of grant policies. There are questions regarding how to allocate public resources more efficiently and how to increase youth participation in sport. We analyse sport vouchers as a tool for increasing transparency and efficiency as well as the involvement of young people and their parents in sport policy at the local level.Vouchers typically transfer purchasing power directly to the target group. Using sport vouchers as a tool for allocating public resources is still quite rare. Some attempts with sport vouchers were made in Australia and the UK, and there are examples of sport vouchers in the Czech Republic.The aim of this paper is to discuss the advantages of vouchers as an alternative method of sport funding at the municipal level. We also formulate recommendations for implementing a voucher system.
Sarita, P.T.N.; Witter, D.J.; Kreulen, C.M.; Matee, M.I.N.; Hof, M.A. van 't; Creugers, N.H.J.
PURPOSE: This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population. MATERIALS AND METHODS: The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on
Lubienski, Christopher; Brewer, T. Jameson
Voucher proponents have increasingly pursued empirical evidence on the effectiveness of vouchers as a form of education improvement, in addition to advocating for vouchers on moral or ethical grounds. Voucher proponents contend that randomized assignment studies of students in voucher programs have consistently confirmed the effectiveness of…
de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian
There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and
VALBONESI Paola; BIAGI FEDERICO
This report discusses analyses ICT Innovation vouchers and provides insights on how such instruments can be used to support small- and medium-sized enterprises (SMEs) in developing and adopting information communication technology (ICT) and digital innovation in order to enhance their competitiveness and growth. This report suggests that the effectiveness of ICT innovation voucher programmes are affected by the granting government’s choices, which should be grounded on a preliminary analysis ...
Jelinek, Tomas; Bisoffi, Zeno; Bonazzi, Lucio; van Thiel, Pieter; Bronner, Ulf; de Frey, Albie; Gundersen, Svein Gunnar; McWhinney, Paul; Ripamonti, Diego
Game parks in Tanzania have long been considered to be at low risk for African trypanosomiasis; however, nine cases of the disease associated with these parks were recently reported. The outbreak was detected through TropNetEurop, a sentinel surveillance network of clinical sites throughout Europe
Over the past ten years there has been a significant change in African governments' perception of their diasporas. In the previous three decades, diasporas were not seen as a resource that countries of origin could tap into for their development needs. This is no longer the case. Now, diasporas are increasingly seen as ...
... executed before Rural Development Voucher payments can be made. Rural Development will use its best efforts... effective date of the voucher HAP contracts, Rural Development may not execute a housing assistance payments... tenant chooses to stay in-place. Also, in no event may the Rural Development Voucher payment exceed the...
... Proposed Information Collection to OMB; Housing Choice Voucher Program AGENCY: Office of the Chief... assistance payments, and budget and payment documentation. In some cases, PHAs voluntarily divest their voucher programs to a receiving PHA. PHAs may also project-base a portion of their vouchers or use their...
... FMRs for FY 2011 to be used to determine payment standard amounts for the Housing Choice Voucher (HCV... . Questions related to use of FMRs or voucher payment standards should be directed to the respective local HUD... voucher tenants in a metropolitan area. Any PHA that is part of the Demonstration Project must use payment...
... that the above bill is correct and just and that payment has not been received. Vouchers, vendors... employee, in which case the voucher may be in the name of the officer or employee who made the payment. (c... 19 Customs Duties 1 2010-04-01 2010-04-01 false Vouchers; vendors' bills of sale; invoices. 24.34...
... required by the clause at FAR 52.232-25, Prompt Payment, the voucher shall show the elements of cost for... contractor is also requested to clearly indicate on the mailing envelope that a payment voucher is enclosed... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Voucher submission (cost...
Kinsman, Rachel H; Gruffydd-Jones, Tim J; Clements, Jane; Murray, Jane K
Animal welfare organisations in the UK invest substantial resources to fund subsidised neutering vouchers to increase feline neutering rates. Little evidence exists to quantify factors influencing voucher redemption. This cross-sectional study assessed risk factors (including voucher value and expiry period) for redemption of neutering vouchers issued by staff of the feline welfare charity Cats Protection. Data were collected using telephone interview-administered questionnaires of cat owners who were issued a neutering voucher(s) and from Cats Protection voucher payment records. During the four-month study 2655 owners were issued 3935 vouchers. Multivariable logistic regression analysis revealed that owners of cats that had produced ≥1 litter before voucher request, owners eligible for a voucher due to receiving benefits and owners who rented their homes or lived with family were less likely to redeem vouchers than owners whose cats had not had a litter, were eligible for a voucher for other reasons and/or owners who owned their home, respectively. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
... circumstances may Rural Development make voucher rental payments for any period of time prior to the date that...) contract, Form HUD-52641. The HAP contract must be executed before Rural Development Voucher payments can... payment to the owner for that period. In establishing the effective date of the voucher HAP contracts...
... with a priority review voucher. The payment of this priority review user fee is required in addition to... voucher. This fee must be paid in addition to any other fee due under PDUFA. Payment must be made in U.S...] Fee for Using a Priority Review Voucher in Fiscal Year 2014 AGENCY: Food and Drug Administration, HHS...
... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Voucher tenancy: Payment standard... Rent and Housing Assistance Payment § 982.503 Voucher tenancy: Payment standard amount and schedule. (a... voucher payment standard amounts for each FMR area in the PHA jurisdiction. For each FMR area, the PHA...
... and Clauses 1852.216-87 Submission of vouchers for payment. As prescribed in 1816.307-70(e), insert the following clause: Submission for Vouchers for Payment (MAR 1998) (a) The designated billing office for cost vouchers for purposes of the Prompt Payment clause of this contract is indicated below...
... effect through September 30, 2013, for applications submitted with a priority review voucher. The payment...] Fee for Using a Priority Review Voucher in Fiscal Year 2013 AGENCY: Food and Drug Administration, HHS... for using a tropical disease priority review voucher for fiscal year (FY) 2013. The Federal Food, Drug...
... Proposed Information Collection to OMB Housing Choice Voucher Program AGENCY: Office of the Chief... assistance payments, and budget and payment documentation. In some cases PHAs voluntarily divest their voucher programs to a receiving PHA. PHAs may also project-base a portion of their vouchers or use their...
... contractor to submit an invoice or voucher in order to receive payment under the contract. The invoice or..., Public Voucher for Purchases and Services Other Than Personal (Continuation Sheet), to request payments... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Invoice and voucher review...
... primary uses of FMRs are to determine payment standards for the Housing Choice Voucher (HCV) program, to... voucher payment standards should be directed to the respective local HUD program staff. Questions on how... Proposed Fair Market Rents for the Housing Choice Voucher Program and Moderate Rehabilitation Single Room...
... of FMRs are to determine payment standards for the Housing Choice Voucher (HCV) program, to determine... after publication of final FY 2014 FMRs. Questions related to use of FMRs or voucher payment standards... for the Housing Choice Voucher Program, Moderate Rehabilitation Single Room Occupancy Program and...
... Information Collection for Public Comment; Request Voucher for Grant Payment and Line of Credit Control System... information: Title Of Proposal: Request Voucher for Grant Payment and Line of Credit Control System (LOCCS... and proposed use: Payment request vouchers for distribution of grant funds using the automated Voice...
... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Voucher tenancy: Payment standard... ASSISTANCE: HOUSING CHOICE VOUCHER PROGRAM Rent and Housing Assistance Payment § 982.504 Voucher tenancy: Payment standard for family in restructured subsidized multifamily project. (a) This section applies to...
...; Subsidy Layering Reviews for Proposed Section 8 Project-Based Voucher Housing Assistance Payments... voucher housing assistance payments (HAP) contracts for existing housing, a subsidy layering review in... assistance payment subsidy under the project-based voucher program with other governmental assistance results...
... DEPARTMENT OF THE TREASURY Fiscal Service Proposed Collection of Information: Voucher for Payment... Financial Management Service solicits comments concerning the form ``Voucher for Payment of Awards.'' DATES... of information described below: Title: Voucher for Payment of Awards. OMB Number: 1510-0037. Form...
... provisional payment and sent to the disbursing office after a pre- payment review. Interim vouchers not... after a pre-payment review. Interim vouchers not selected for a pre-payment review will be considered to...] RIN 0750-AH52 Defense Federal Acquisition Regulation Supplement; DoD Voucher Processing AGENCY...
... are to determine payment standards for the Housing Choice Voucher (HCV) program, to determine initial... after publication of final FY 2013 FMRs. Questions related to use of FMRs or voucher payment standards... for the Housing Choice Voucher Program and Moderate Rehabilitation Single Room Occupancy Program...
Lee, Amelia N. Y.; Bagley, Carl
This paper seeks to question what impact education vouchers have on the process of school choice. The context examined in the paper is the Pre-primary Education Voucher Scheme ("Voucher Scheme") introduced in 2007 in Hong Kong. Using a Straussian grounded theory method, data collected from 40 parent interviews are coded, analysed and…
Gauri, Varun; Vawda, Ayesha
Voucher programs consist of three simultaneous reforms: (1) allowing parents to choose schools, (2) creating intense incentives for schools to increase enrollment, and (3) granting schools management autonomy to respond to demand. As a result, voucher advocates and critics tend to talk past each other. A principal-agent framework clarifies the argument for education vouchers. Central findi...
Epple, Dennis N.; Romano, Richard
Two significant challenges hamper analyses of collective choice of educational vouchers. One is the multi-dimensional choice set arising from the interdependence of the voucher, public education spending, and taxation. The other is that household preferences between public and private schooling vary with the policy chosen. Even absent a voucher,…
Marek Pavlik; Michiel S. de Vries
Sport funding at the municipal level has a long tradition, especially in Europe. Youth involvement in sport is usually an important aspect of grant policies. There are questions regarding how to allocate public resources more efficiently and how to increase youth participation in sport. We analyse sport vouchers as a tool for increasing transparency and efficiency as well as the involvement of young people and their parents in sport policy at the local level.Vouchers typically transfer purcha...
V. A. Barinova
Full Text Available The article aims to explore innovative international practice for advancing the mechanisms of distributing grant funding. Authors analyze a practical case study of successful implementation of innovative vouchers overseas, and draw parallels with regard to already formed institutes in Russia, corresponding with foreign in terms of their functional. Possible mechanisms for implementing successful foreign practices of utilizing innovative vouchers in Russia were studied in this article. On the basis of conducted analysis authors evaluate perspectives of implementing the suggested scheme in Russia.
Erick J. Mazyala; Makaranga Revocatus; Mange Manyama; Sifael Msuya; Peter Rambau; Emmanuel Kimwaga; Ndulu Magelle; Yanga Machimu; Mathayo Joshua; Cassian C. Magori
Introduction. Studying anatomy through dissection of human cadavers requires a regular supply of human bodies. Tanzanian medical schools depend entirely on collecting unclaimed bodies in hospital mortuaries. This method is no longer reliable. This study aimed at evaluating sources and profile of cadavers in Tanzanian medical schools and addressing challenges and suggests appropriate lasting solutions. Methods. Seven spreadsheets were sent electronically to seven medical schools in Tanzania to...
... vouchers are subject to the payment requirements at § 645.230(a)(3) of this subpart. If an operating entity... boards use contracts or vouchers? 645.221 Section 645.221 Employees' Benefits EMPLOYMENT AND TRAINING... vouchers? (a) Local boards and PIC's must provide the following activities and services through vouchers or...
Hanousek, Jan; Filer, Randall K.
Roč. 21, č. 3 (2002), s. 491-498 ISSN 0273-3072 Institutional research plan: CEZ:AV0Z7085904 Keywords : Czech Republic * voucher privatization Subject RIV: AH - Economics http://search. ebscohost .com/login.aspx?direct=true&db=a9h&AN=6463493&site=ehost-live
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Leasing units to voucher holders. 401.556 Section 401.556 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Implementation of the Restructuring Plan After Closing § 401.556 Leasing units to...
Bushnell, David S.
Opportunities for career advancement, an adequate pool of trained manpower, and the growth of our economy are inextricably connected with the availability of continuing education and training opportunities to working adults. Availability is a function of access to training and successful participation in training. The federally funded voucher plan…
Elisante, Eliapenda; Muzuka, Alfred N. N.
More than 25 % of Tanzanian depends on groundwater as the main source of water for drinking, irrigation and industrial activities. The current trend of land use may lead to groundwater contamination and thus increasing risks associated with the usage of contaminated water. Nitrate is one of the contaminants resulting largely from anthropogenic activities that may find its way to the aquifers and thus threatening the quality of groundwater. Elevated levels of nitrate in groundwater may lead to human health and environmental problems. The current trend of land use in Tanzania associated with high population growth, poor sanitation facilities and fertilizer usage may lead to nitrate contamination of groundwater. This paper therefore aimed at providing an overview of to what extent human activities have altered the concentration of nitrate in groundwater aquifers in Tanzania. The concentration of nitrate in Tanzanian groundwater is variable with highest values observable in Dar es Salaam (up to 477.6 mg/l), Dodoma (up to 441.1 mg/l), Tanga (above 100 mg/l) and Manyara (180 mg/l). Such high values can be attributed to various human activities including onsite sanitation in urban centres and agricultural activities in rural areas. Furthermore, there are some signs of increasing concentration of nitrate in groundwater with time in some areas in response to increased human activities. However, reports on levels and trends of nitrate in groundwater in many regions of the country are lacking. For Tanzania to appropriately address the issue of groundwater contamination, a deliberate move to determine nitrate concentration in groundwater is required, as well as protection of recharge basins and improvement of onsite sanitation systems.
Young Tanzanians and the Cinema: A Study of the Effects of Selected Basic Motion Picture Elements and Population Characteristics on Filmic Comprehension of Tanzanian Adolescent Primary School Children.
Giltrow, David Roger
A study was conducted of Tanzanian adolescent school children's responses to filmic elements. The design included a very large sample in a complicated factorial design, varying such factors as color, type of action, background and sound of the film, and the demographic characteristics of the subjects. Results showed that of these variables,…
Background One approach to delivering healthcare in developing countries is through voucher programs, where vouchers are distributed to a specific population for free or subsidized health care. Recent evaluations suggest that vouchers have the potential to extend coverage of priority health services to the poor in developing countries. In Cambodia, a reproductive health voucher program was implemented in January 2011. This study aims to explore women’s early experiences accessing health services with their vouchers at accredited clinics. Methods This qualitative exploratory study used focus group methodology to gather information from five groups of older (>25 years) and four groups of younger (18–25 years) women who were eligible for the voucher program in three rural provinces. Focus groups were digitally recorded, transcribed and translated from Khmer into English. Data analysis was an iterative process, which comprised of open coding to find commonalities that reflected categories or themes and axial coding to relate initial themes to each other. Next, a basic framework for analysis was formed by integrating the themes into the framework. Results Two overarching themes were identified in the data: 1) factors that facilitate voucher use and 2) factors that inhibit voucher use. Within each of these themes, three subthemes were identified: 1) pre-existing factors, 2) distribution factors, and 3) redemption factors. Overall, women expressed positive feelings towards the voucher program, while several areas for program improvement were identified including the importance of addressing pre-existing demand-side barriers to using reproductive health services, the need for more comprehensive counselling during voucher distribution, and the persistent cost of unofficial payments expected by midwives after delivery irrespective of voucher use. Conclusions Early information from program beneficiaries can lead to timely and responsive changes that can help to maximize
Mazvimavi, Kizito; Murendo, Conrad; Minde, Isaac J.; Kunzekweguta, Machiweyi
Using data from ICRISAT 2010/11 household and fertilizer retailer surveys, the study reveals that open vouchers enhance farmers input choice. The targeting of vulnerable farmers was efficient in selecting, households with less livestock ownership and those affected by HIV/AIDS. The use of open vouchers enabled retailers to sale agricultural inputs, boost revenue and link them to suppliers. The use of open voucher is preferable in areas where retailer’s infrastructure and mobile telephone netw...
Russian higher education is in the process of reforming. Introduction of the standardized computer-graded test and educational vouchers was intended to increase accessibility of higher education, make its funding more effective, and reduce corruption in admissions to public colleges. The idea of vouchers failed while the test faces furious opposition and crises. This paper considers vouchers, standardized tests, educational loans, and privatization as related to educational corruption. The te...
Erick J. Mazyala
Full Text Available Introduction. Studying anatomy through dissection of human cadavers requires a regular supply of human bodies. Tanzanian medical schools depend entirely on collecting unclaimed bodies in hospital mortuaries. This method is no longer reliable. This study aimed at evaluating sources and profile of cadavers in Tanzanian medical schools and addressing challenges and suggests appropriate lasting solutions. Methods. Seven spreadsheets were sent electronically to seven medical schools in Tanzania to capture data related to sources and profiles of cadavers received. Only 2 out of 7 responded timely. Results. 100% of all cadavers in Tanzanian medical schools are unclaimed bodies of black population. Female cadavers accounted for 0–20%. About 9 days elapse before embalmment of cadavers. Conclusion. It is the time to jump onto body bequest wagon.
Hecker, Tobias; Hermenau, Katharin; Isele, Dorothea; Elbert, Thomas
The adverse effect of harsh corporal punishment on mental health and psychosocial functioning in children has been repeatedly suggested by studies in industrialized countries. Nevertheless, corporal punishment has remained common practice not only in many homes, but is also regularly practiced in schools, particularly in low-income countries, as a measure to maintain discipline. Proponents of corporal punishment have argued that the differences in culture and industrial development might also be reflected in a positive relationship between the use of corporal punishment and improving behavioral problems in low-income nations. In the present study we assessed the occurrence of corporal punishment at home and in school in Tanzanian primary school students. We also examined the association between corporal punishment and externalizing problems. The 409 children (52% boys) from grade 2 to 7 had a mean age of 10.49 (SD=1.89) years. Nearly all children had experienced corporal punishment at some point during their lifetime both in family and school contexts. Half of the respondents reported having experienced corporal punishment within the last year from a family member. A multiple sequential regression analysis revealed that corporal punishment by parents or by caregivers was positively related to children's externalizing problems. The present study provides evidence that Tanzanian children of primary school age are frequently exposed to extreme levels of corporal punishment, with detrimental consequences for externalizing behavior. Our findings emphasize the need to inform parents, teachers and governmental organizations, especially in low-income countries, about the adverse consequences of using corporal punishment be it at home or at school. Copyright © 2013 Elsevier Ltd. All rights reserved.
This paper presents an ongoing co-design study focusing on the application of Near Field Communication (NFC) technology in the area of voucher payment. The research that is described is conducted to a) gain a thorough understanding of the current context of use of paper vouchers, including user experience and user needs, and b) evaluate the potential of the concept of NFC-vouchers with endusers in an early stage. Several aspects of the context of use as well as the future NFC-vouchers will be...
... Rent and Housing Assistance Payment § 982.505 Voucher tenancy: How to calculate housing assistance... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Voucher tenancy: How to calculate housing assistance payment. 982.505 Section 982.505 Housing and Urban Development Regulations Relating to...
... Information Collection: Comment Request; Request Voucher for Grant Payment and Line of Credit Control System... Notice also lists the following information: Title of proposal: Request Voucher for Grant Payment and..., if applicable: 2535-0102. Description of the need for the information and proposed use: Payment...
... Special Housing Types Shared Housing § 982.617 Shared housing: Rent and voucher housing assistance payment... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Shared housing: Rent and voucher housing assistance payment. 982.617 Section 982.617 Housing and Urban Development Regulations Relating to...
... Special Housing Types Group Home § 982.613 Group home: Rent and voucher housing assistance payment. (a... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Rent and voucher housing assistance payment. 982.613 Section 982.613 Housing and Urban Development Regulations Relating to...
... Housing Types Congregate Housing § 982.608 Congregate housing: Voucher housing assistance payment. (a... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Congregate housing: Voucher housing assistance payment. 982.608 Section 982.608 Housing and Urban Development Regulations Relating to Housing and...
Green, Preston C., III
This article provides an overview of non-religion-based state constitutional challenges to educational voucher and tax credit/scholarship programs. The first section discusses litigation examining whether education voucher programs violate constitutional provisions requiring the legislature to provide an efficient system of public schools. The…
San Jose, Alyssa L.
School vouchers are defined as certificates of government funding that are allocated to students and intended to defer the cost of tuition at a private school of the student or the student's parents' choice. With strong views on opposing sides, the issue of school choice and the corresponding use of vouchers has certainly been catapulted into the…
Osipian, Ararat L.
Higher education in Russia is currently being reformed. A standardized computer-graded test and educational vouchers were introduced to make higher education more accessible, fund it more effectively, and reduce corruption in admissions to public colleges. The voucher project failed and the test faces furious opposition. This paper considers…
Ellen, Ingrid Gould; Horn, Keren Mertens; Schwartz, Amy Ellen
Housing choice vouchers provide low-income households with additional income to spend on rental housing in the private market. The assistance vouchers provide is substantial, offering the potential to dramatically expand the neighborhood--and associated public schools--that low-income households can reach. However, existing research on the program…
Hamza, O.J.M.; Beukel, C.J.P. van den; Matee, M.I.N.; Moshi, M.J.; Mikx, F.H.M.; Selemani, H.O.; Mbwambo, Z.H.; Ven, A.J.A.M. van der; Verweij, P.E.
Using the ethnobotanical approach, some Tanzanian plants reported to be used by traditional healers for the treatment of oral candidiasis and fungal infections of the skin were collected and screened for their antifungal activity against Candida albicans, Candida glabrata, Candida tropicalis,
Tuomi, Margaret Trotta; Lehtomäki, Elina; Matonya, Magreth
Globally, persons with disabilities are underrepresented in higher education. In sub-Saharan Africa, where opportunities for higher education are especially limited, women are unlikely to continue their education. This research investigates women in Tanzanian higher education with the double marginalisation of being a woman and having…
The aim of this study was to explore Tanzanian men\\'s experiences regarding their health and sex life after they had been diagnosed with HIV. In-depth interviews were performed with a purposive sample of ten men living in an urban area in Tanzania and who had been HIV positive for more than one year.
Mugonzibwa, E.A.; Eskeli, R.; Kuijpers-Jagtman, A.M.; Laine-Alava, M.T.; Hof, M.A. van 't
Occlusal characteristics and anomalies were studied among 869 (428 boys, 441 girls) Tanzanian Bantu children aged 3.5-16 years and 706 (319 boys, 387 girls) Finnish children aged 5-11 years during different emergence stages of the permanent dentition. Various occlusal variables were registered
Mugonzibwa, E.A.; Kuijpers-Jagtman, A.M.; Hof, M.A. van 't; Kikwilu, E.N.
The objective was to investigate the opinion of Tanzanian parents on dental attractiveness and to compare their opinion with that of their children. A prestructured questionnaire with 18 intraoral frontal photographs was given to 286 parents and their children aged 9-18 years. The photographs
Kisanga, Dalton H.
This survey research study presents the findings on determinants of teachers' attitudes towards e-learning in Tanzanian higher learning institutions. The study involved 258 teachers from 4 higher learning institutions obtained through stratified, simple random sampling. Questionnaires and documentary review were used in data collection. Data were…
Hermes, N.; Kihanga, E.; Lensink, B.W.; Lutz, C.
We use primary survey data to analyse the relationship between trade credit and customer switching in the context of trade transactions between wholesalers and retailers in the Tanzanian rice market. Results reveal a negative relation of trade credit and customer switching, that is, trade credit
Nyenyembe, Fabian W.; Maslowski, Ralf; Nimrod, Beatrice S.; Peter, Levina
This study explores the relationship between leadership styles applied by school heads and teachers' job satisfaction in Tanzanian secondary schools. Using a questionnaire, data in this study was collected from 180 teachers in ten secondary schools in Songea District in Tanzania. The most salient finding of this study revealed that teachers were…
Nyenyembe, Fabian W.; Maslowski, Ralf; Nimrod, Beatrice S.; Peter, Levina
This study explores the relationship between leadership styles applied by school heads and teachers’ job satisfaction in Tanzanian secondary schools. Using a questionnaire, data in this study was collected from 180 teachers in ten secondary schools in Songea District in Tanzania. The most salient
Wormnaes, Siri; Mkumbo, Kitila; Skaar, Bjørn; Refseth, Yngve
In this study, concept map activities were used to trigger group discussions about inclusive education, with a focus on learners with disabilities. The participants were 226 Tanzanian student teachers. This article reports and discusses how the maps were analysed and what they indicate about the students' thinking about certain aspects of…
Hermes, C.L.M.; Kihanga, E.P.; Lensink, B.W.; Lutz, C.H.M.
We use primary survey data to analyse the relationship between trade credit and customer switching in the context of trade transactions between wholesalers and retailers in the Tanzanian rice market. Results reveal a negative relation of trade credit and customer switching, that is, trade credit
... use of Small Area FMRs or voucher payment standards should be directed to the respective local HUD... programmatic impacts of changing the way voucher payment standards are set. The purpose of the demonstration... the Housing Choice Voucher Program for Small Area Fair Market Rent Demonstration Program Participants...
.... Any questions related to use of FMRs or voucher payment standards should be directed to the respective... Housing Choice Voucher program, the FMR is the basis for determining the ``payment standard amount'' used... for the Housing Choice Voucher Program and Moderate Rehabilitation Single Room Occupancy Program...
... Information Collection: Request Voucher for Grant Payment and Line of Credit Control System (LOCCS) Voice.... Description of the need for the information and proposed use: Payment request vouchers for distribution of.... A. Overview of Information Collection Title of Information Collection: Request Voucher for Grant...
... subject proposal. Payment request vouchers for distribution of grant funds using the automated Voice... Lists the Following Information Title of Proposal: Request Voucher for Grant Payment and Line of Credit... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-46] Request Voucher for Grant...
... after a pre-payment review. Interim vouchers not selected for a pre-payment review will be considered to... a pre- payment review. Interim vouchers not selected for a pre-payment review will be considered to... office after a pre-payment review. Interim vouchers not selected for a pre-payment review will be...
... provisional payment and sent to the disbursing office after the pre-payment review. Interim vouchers not... evaluation of selected interim vouchers on a pre-payment basis in lieu of the current direct submission authorization, which does not allow for the pre-payment evaluation of higher risk interim vouchers. It is...
... of FMRs are to determine payment standards for the Housing Choice Voucher (HCV) program, to determine... . Questions related to use of FMRs or voucher payment standards should be directed to the respective local HUD... Final Fair Market Rents for the Housing Choice Voucher Program and Moderate Rehabilitation Single Room...
... the flexibilities available in the voucher program, to set voucher payment standards at varying and... Voucher Program--Demonstration Project of Small Area Fair Market Rents in Certain Metropolitan Areas for... on October 1 of each year. The primary uses of FMRs are to determine payment standard amounts for the...
... provided on the same website noted above. Any questions related to use of FMRs or voucher payment standards... the Housing Choice Voucher Program and Moderate Rehabilitation Single Room Occupancy Program for... County, ND. Both areas were having significant problems administering the Housing Choice Voucher program...
Eduardo de Carvalho Andrade
Full Text Available This paper compares theoretically three alternative university systems: the current one adopted in Brazil, in which students who perform better in the entering exam obtain the right to attend the public university without paying the full tuition; a system of affirmative action quotas in public universities, to benefit low income students; and a targeted vouchers system that can be used either to pay private or public university tuiton. The comparison indicates that the last system leads to: (i a higher quality of the labor force; (ii a more efficient allocation of resources; and (iii a greater social mobility.Este trabalho compara, do ponto de vista teórico, três sistemas universitários alternativos: o atual adotado pelo Brasil, no qual os alunos das universidades públicas, que são praticamente gratuitas, são escolhidos através de um processo seletivo; um sistema de quotas nas universidades públicas para beneficiar estudantes de baixa renda; e um sistema de vouchers direcionados para estudantes de baixa renda que podem ser utilizados nas universidades privadas ou públicas. A comparação destes três sistemas indica que o último é o mais eficiente, pois gera: (i maior qualidade da mão de obra; (ii alocação mais eficiente dos recursos; e (iii maior mobilidade social.
Cherry, Mark J
The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: (1) What are the direct and indirect health care costs and benefits of such a voucher system in human organs? (2) Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? (3) Do vouchers contribute to the inappropriate commodification of human body parts? (4) Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges (e.g., organ exchanges, organ chains, and organ vouchers), would save more lives and further reduce human suffering. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Baginda Oloan Lubis
ABSTRAK - PT. Plaza Indonesia Realty Tbk. Jakarta dalam penjualan voucher yang transaksinya dimulai dari pencatatan voucher yang masuk, pencatatan data pelanggan, pembuatan faktur penjualan voucher, pencatatan serah terima voucher dengan pelanggan sampai pembuatan laporan masih dilakukan secara manual, sehingga memungkinkan pada saat proses berlangsung sering terjadi kesalahan dalam pencatatan, kurang akuratnya laporan yang dibuat dan keterlambatan dalam pencarian data pada saat dibutuhkan. Untuk itu dibutuhkan adanya suatu rancangan program yang akan menunjang kegiatan sistem penjualan voucher yang memudahkan user dan mempercepat transakasi dengan pelanggan dan pembuatan laporan. Model pengembangan sistem yang digunakan dalam pembuatan sistem informasi ini adalah SDCL (System Development Life Cycle air terjun (Waterfall atau alur hidup klasik atau classic life. Tahapan-tahapan yang dilalui dalam proses analisis dan perancangan sistem antara lain: analisa kebutuhan sistem, desain, kode generator, testing dan pendukung. Dari hasil penelitian ini diharapkan dengan adanya sistem informasi penjualan voucher ini dapat membantu user dalam hal ini disebut concierge pada PT. Plaza Indonesia Realty Tbk. Jakarta dalam melakukan transaksi penjualan sampai dengan pembuatan laporan terakomodasi Kata kunci: Sistem Informasi, Penjualan Voucher, SDLC
Full Text Available This study tests the group-level causal relationship between the expansion of Kenya's Safe Motherhood voucher program and changes in quality of postnatal care (PNC provided at voucher-contracted facilities. We compare facilities accredited since program inception in 2006 (phase I and facilities accredited since 2010-2011 (phase II relative to comparable non-voucher facilities. PNC quality is assessed using observed clinical content processes, as well as client-reported outcome measures. Two-tailed unpaired t-tests are used to identify differences in mean process quality scores and client-reported outcome measures, comparing changes between intervention and comparison groups at the 2010 and 2012 data collection periods. Difference-in-differences analysis is used to estimate the reproductive health (RH voucher program's causal effect on quality of care by exploiting group-level differences between voucher-accredited and non-accredited facilities in 2010 and 2012. Participation in the voucher scheme since 2006 significantly improves overall quality of postnatal care by 39% (p=0.02, where quality is defined as the observable processes or components of service provision that occur during a PNC consultation. Program participation since phase I is estimated to improve the quality of observed maternal postnatal care by 86% (p=0.02, with the largest quality improvements in counseling on family planning methods (IRR 5.0; p=0.01 and return to fertility (IRR 2.6; p=0.01. Despite improvements in maternal aspects of PNC, we find a high proportion of mothers who seek PNC are not being checked by any provider after delivery. Additional strategies will be necessary to standardize provision of packaged postnatal interventions to both mother and newborn. This study addresses an important gap in the existing RH literature by using a strong evaluation design to assess RH voucher program effectiveness on quality improvement.
Messer, Dolores; Wolter, Stefan C.
This paper presents the results of a randomized experiment analyzing the use of vouchers for adult training. In 2006, 2,400 people were issued with a training voucher which they were entitled to use in payment for a training course of their choice. User behavior was compared with a control group of 14,000 people. People in the treatment and in the control group were not aware at any time that they were part of an experiment. The experiment shows that the voucher had a significant causal impac...
Jan Horn Van Heerden
Full Text Available A Computable General Equilibrium model is used to find the effects of a food voucher scheme on the economy in South Africa. If firms consider the issuing of vouchers as increased remuneration, they will hire fewer labourers. The higher labour cost increases the total cost of production and lowers supply. Real Gross Domestic Product decreases and the economy becomes worse off. However, depending on the size of the government’s involvement in such a scheme as well as the tax policies that are used to fund it, a food voucher scheme could benefit the poor, and improve the distribution of wealth in the country.
Full Text Available There is an ever growing number of molecular phylogenetic studies published, due to, in part, the advent of new techniques that allow cheap and quick DNA sequencing. Hence, the demand for relational databases with which to manage and annotate the amassing DNA sequences, genes, voucher specimens and associated biological data is increasing. In addition, a user-friendly interface is necessary for easy integration and management of the data stored in the database back-end. Available databases allow management of a wide variety of biological data. However, most database systems are not specifically constructed with the aim of being an organizational tool for researchers working in phylogenetic inference. We here report a new software facilitating easy management of voucher and sequence data, consisting of a relational database as back-end for a graphic user interface accessed via a web browser. The application, VoSeq, includes tools for creating molecular datasets of DNA or amino acid sequences ready to be used in commonly used phylogenetic software such as RAxML, TNT, MrBayes and PAUP, as well as for creating tables ready for publishing. It also has inbuilt BLAST capabilities against all DNA sequences stored in VoSeq as well as sequences in NCBI GenBank. By using mash-ups and calls to web services, VoSeq allows easy integration with public services such as Yahoo! Maps, Flickr, Encyclopedia of Life (EOL and GBIF (by generating data-dumps that can be processed with GBIF's Integrated Publishing Toolkit.
Lugoe, W; Rise, J
This study examined whether perceived behavioural control predicted the intention to use condoms at next sexual intercourse above the components of the theory of reasoned action, as well as the sufficiency of the theory of planned behaviour (TPB) as a theory of intention among Tanzanian adolescents. Five hundred and twenty-eight students who were sexually active, from seven secondary schools in Arusha, Northern Tanzania, completed a questionnaire designed to measure the components of the TPB. Behavioural intentions were significantly predictable from attitudes (.11), subjective norms (.22) and perceived behavioural control (.48). The inclusion of past behaviour into the regression equation increased R(2) only marginally (2 percent) but significantly, suggesting that the TPB provides a fairly accurate explanation of intention to use condoms among Tanzanian adolescents. The implications of this finding in relation to theoretical and practical issues are discussed.
This study investigates women’s roles in the media: attitudes towards gender issues in six Tanzanian newspapers. Firstly, the study examines the situation of female journalists in the aspects of education, employment status, job position and working conditions. Differences between female and male reporters in sourcing women in general issues and women issues, as well as obstacles facing these reporters in sourcing women are analyzed. Further, the study investigates journalists’ attit...
... Tenant- Furnished Utilities, Inspections, Financial Reports, Request for Tenancy Approval, Housing...-Furnished Utilities, Inspections, Financial Reports, Request for Tenancy Approval, Housing Voucher... required to maintain financial reports in accordance with accepted accounting standards. The PHA is...
Sport support at the municipal level has a long tradition, especially in Europe. Youth involvement to the sport is usually one of the important aspects of grant policies. There are questions regarding how to allocate public resources more efficiently and how to increase youth participation in sport. We analyze the sport vouchers as a tool for increasing transparency and efficiency as well as the involvement of youth and their parents in sport policy at the local level. Vouchers typically tran...
Full Text Available Abstract Background Adolescents face many barriers to physical activity, demonstrated by the decline in physical activity levels in teenage populations. This study aimed to assess the feasibility of overcoming such barriers via the implementation of an activity-promoting voucher scheme to teenagers in deprived areas. Methods All Year 9 pupils (n = 115; 13.3 ± 0.48 years; 51 % boys from one secondary school in Wales (UK participated. Participants received £25 of activity vouchers every month for six months for physical activity or sporting equipment. Focus groups (n = 7, with 43 pupils, and qualitative interviews with teachers (n = 2 were conducted to assess feasibility, in addition to a process evaluation utilising the RE-AIM framework. Quantitative outcomes at baseline, five months (during intervention and twelve months (follow-up included: physical activity (accelerometer, aerobic fitness (12 min Cooper run and self-reported activity (PAQ-A. Motivation to exercise (BREQ-2 was measured three months post-baseline and at follow-up. Results Qualitative findings showed that vouchers encouraged friends to socialise through activity, provided opportunities to access local activities that pupils normally could not afford, and engaged both those interested and disinterested in physical education. Improvements in weekend moderate-to-vigorous physical activity and reductions in sedentary behaviour were observed in both sexes. Boys’ fitness significantly improved during the voucher scheme. ‘Non-active’ pupils (those not meeting recommended guidelines of 60 mins∙day−1 and those with higher motivation to exercise had higher voucher use. Conclusions Adolescents, teachers and activity providers supported the voucher scheme and felt the vouchers enabled deprived adolescents to access more physical activity opportunities. Voucher usage was associated with improved attitudes to physical activity, increased socialisation with
Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E
Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.
Boddam-Whetham, Luke; Gul, Xaher; Al-Kobati, Eman; Gorter, Anna C
In conflict-affected states, vouchers have reduced barriers to reproductive health services and have enabled health programs to use targeted subsidies to increase uptake of specific health services. Vouchers can also be used to channel funds to public- and private-service providers and improve service quality. The Yamaan Foundation for Health and Social Development in Yemen and the Marie Stopes Society (MSS) in Pakistan-both working with Options Consultancy Services-have developed voucher programs that subsidize voluntary access to long-acting reversible contraceptives (LARCs) and permanent methods (PMs) of family planning in their respective fragile countries. The programs focus on LARCs and PMs because these methods are particularly difficult for poor women to access due to their cost and to provider biases against offering them. Using estimates of expected voluntary uptake of LARCs and PMs for 2014 based on contraceptive prevalence rates, and comparing these with uptake of LARCs and PMs through the voucher programs, we show the substantial increase in service utilization that vouchers can enable by contributing to an expanded method choice. In the governorate of Lahj, Yemen, vouchers for family planning led to an estimated 38% increase in 2014 over the expected use of LARCs and PMs (720 vs. 521 expected). We applied the same approach in 13 districts of Punjab, Khyber Pakhtunkhwa (KPK), and Sindh provinces in Pakistan. Our calculations suggest that vouchers enabled 10 times more women than expected to choose LARCs and PMs in 2014 in those areas of Pakistan (73,639 vs. 6,455 expected). Voucher programs can promote and maintain access to family planning services where existing health systems are hampered. Vouchers are a flexible financing approach that enable expansion of contraceptive choice and the inclusion of the private sector in service delivery to the poor. They can keep financial resources flowing where the public sector is prevented from offering services
Mushi, Adiel K; Schellenberg, Joanna R M Armstrong; Mponda, Haji; Lengeler, Christian
During the last decade insecticide-treated nets have become a key strategy for malaria control. Social marketing is an appealing tool for getting such nets to poor rural African communities who are most afflicted by malaria. This approach usually involves subsidized prices to make nets and insecticide more affordable and help establish a commercial market. We evaluated a voucher system for targeted subsidy of treated nets in young children and pregnant women in two rural districts of southern Tanzania. Qualitative work involved focus group discussions with community leaders, male and female parents of children under 5 years. In-depth interviews were held with maternal and child health clinic staff and retail agents. Quantitative data were collected through interviewing more than 750 mothers of children under 5 years during a cluster sample survey of child health. The voucher return rate was extremely high at 97% (7720/8000). However, 2 years after the start of the scheme awareness among target groups was only 43% (45/104), and only 12% of women (12/103; 95% CI 4-48%) had used a voucher towards the cost of a net. We found some evidence of increased voucher use among least poor households, compared with the poorest households. On the basis of these results we renewed our information, education and communication (IEC) campaign about vouchers. Discount vouchers are a feasible system for targeted subsidies, although a substantial amount of time and effort may be needed to achieve high awareness and uptake - by which we mean the proportion of eligible women who used the vouchers - among those targeted. Within a poor society, vouchers may not necessarily increase health equity unless they cover a high proportion of the total cost: since some cash is needed when using a voucher as part-payment, poorer women among the target group are likely to have lower uptake than richer women. The vouchers have two important additional functions: strengthening the role of public health
Anamisa, D. R.; Yusuf, M.; Syakur, M. A.
Food vouchers are government programs to tackle the poverty of rural communities. This program aims to help the poor group in getting enough food and nutrients from carbohydrates. There are several factors that influence to receive the food voucher, such as: job, monthly income, Taxes, electricity bill, size of house, number of family member, education certificate and amount of rice consumption every week. In the execution for the distribution of vouchers is often a lot of problems, such as: the distribution of food vouchers has been misdirected and someone who receives is still subjective. Some of the solutions to decision making have not been done. The research aims to calculating the change of each partition matrix and each cluster using Fuzzy C-Means method. Hopefully this research makes contribution by providing higher result using Fuzzy C-Means comparing to other method for this case study. In this research, decision making is done by using Fuzzy C-Means method. The Fuzzy C-Means method is a clustering method that has an organized and scattered cluster structure with regular patterns on two-dimensional datasets. Furthermore, Fuzzy C-Means method used for calculates the change of each partition matrix. Each cluster will be sorted by the proximity of the data element to the centroid of the cluster to get the ranking. Various trials were conducted for grouping and ranking of proposed data that received food vouchers based on the quota of each village. This testing by Fuzzy C-Means method, is developed and abled for determining the recipient of the food voucher with satisfaction results. Fulfillment of the recipient of the food voucher is 80% to 90% and this testing using data of 115 Family Card from 6 Villages. The quality of success affected, has been using the number of iteration factors is 20 and the number of clusters is 3
Full Text Available The introduction of Next Generation Sequencing into the disciplines of plant systematics, ecology, and metagenomics, among others, has resulted in a phenomenal increase in the collecting and storing of tissue samples and their respective vouchers. This manual suggests standard practices that will insure the quality and preservation of the tissue and vouchers and their respective data. Although written for use by the Smithsonian Institution botanists it suggests a framework for collecting tissues and vouchers that other research programs can adapt to their own needs. It includes information on collecting voucher specimens, collecting plant tissue intended for genomic analysis, how to manage these collections, and how to incorporate the data into a database management system. It also includes many useful references for collecting and processing collections. We hope it will be useful for a variety of botanists but especially those who know how to collect plants and want to collect tissue samples that will be useful for genomic research, and those who are skilled in lab work and want to know how to properly voucher and record their tissue collections.
Sudfeld, Christopher R; McCoy, Dana Charles; Fink, Günther; Muhihi, Alfa; Bellinger, David C; Masanja, Honorati; Smith, Emily R; Danaei, Goodarz; Ezzati, Majid; Fawzi, Wafaie W
A large volume of literature has shown negative associations between stunting and child development; however, there is limited evidence for associations with milder forms of linear growth faltering and determinants of malnutrition in developing countries. The objective of this study was to assess the association between anthropometric growth indicators across their distribution and determinants of malnutrition with development of Tanzanian children. We used the Bayley Scales of Infant Development III to assess a cohort of 1036 Tanzanian children between 18 and 36 mo of age who were previously enrolled in a neonatal vitamin A trial. Linear regression models were used to assess standardized mean differences in child development for anthropometry z scores, along with pregnancy, delivery, and early childhood factors. Height-for-age z score (HAZ) was linearly associated with cognitive, communication, and motor development z scores across the observed range in this population (all P values for linear relation development z scores, respectively. The relation of weight-for-height z score (WHZ) was nonlinear with only wasted children (WHZ development z scores, respectively, relative to nonwasted children. Maternal stature and flush toilet use were associated with higher cognitive and motor z scores, whereas being born small for gestational age (SGA) was associated with a -0.16 (95% CI: -0.30, -0.01) z score deficit in cognition. Mild to severe chronic malnutrition was associated with increasing developmental deficits in Tanzanian children, whereas only wasted children exhibited developmental delays during acute malnutrition. Interventions to reduce SGA, improve sanitation, and increase maternal stature may have positive effects on child development. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN12610000636055. © 2015 American Society for Nutrition.
Ogbo, Felix Akpojene; Nguyen, Hillary; Naz, Sabrina; Agho, Kingsley E; Page, Andrew
Diarrhoea is a leading cause of child mortality in Tanzania. The association between optimal infant feeding practices and diarrhoea has been reported elsewhere, but the evidence has been limited to promote and advocate for strategic interventions in Tanzania. This study examined the association between infant and young child feeding (IYCF) practices and diarrhoea in Tanzanian children under 24 months. The study used the Tanzania Demographic and Health Survey data to estimate the prevalence of diarrhoea stratified by IYCF practices. Using multivariable logistic regression modelling that adjusted for confounding factors and cluster variability, the association between IYCF practices and diarrhoea among Tanzanian children was investigated. Diarrhoea prevalence was lower in infants aged 0-5 months whose mothers engaged in exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) compared to those who were not exclusively and predominantly breastfed. Infants aged 6-8 months who were introduced to complementary foods had a higher prevalence of diarrhoea compared to those who received no complementary foods, that is, infants who were exclusively breastfed at 6-8 months. Infants who were exclusively and predominantly breastfed were less likely to experience diarrhoea compared to those who were not exclusively and predominantly breastfed [adjusted odds ratio (AOR) 0.31, 95% confidence interval (CI) 0.16-0.59, P children, while the introduction of complementary foods was associated with the onset of diarrhoea. Strengthening IYCF (facility- and community-based) programmes would help to improve feeding behaviours of Tanzanian women and reduce diarrhoea burden in children under 2 years.
Salman A Rahman
Full Text Available Mathematical models predict an exponential distribution of infection prevalence across communities where a disease is disappearing. Trachoma control programs offer an opportunity to test this hypothesis, as the World Health Organization has targeted trachoma for elimination as a public health concern by the year 2020. Local programs may benefit if a single survey could reveal whether infection was headed towards elimination. Using data from a previously-published 2009 survey, we test the hypothesis that Chlamydia trachomatis prevalence across 75 Tanzanian communities where trachoma had been documented to be disappearing is exponentially distributed.We fit multiple continuous distributions to the Tanzanian data and found the exponential gave the best approximation. Model selection by Akaike Information Criteria (AICc suggested the exponential distribution had the most parsimonious fit to the data. Those distributions which do not include the exponential as a special or limiting case had much lower likelihoods of fitting the observed data. 95% confidence intervals for shape parameter estimates of those distributions which do include the exponential as a special or limiting case were consistent with the exponential. Lastly, goodness-of-fit testing was unable to reject the hypothesis that the prevalence data came from an exponential distribution.Models correctly predict that infection prevalence across communities where a disease is disappearing is best described by an exponential distribution. In Tanzanian communities where local control efforts had reduced the clinical signs of trachoma by 80% over 10 years, an exponential distribution gave the best fit to prevalence data. An exponential distribution has a relatively heavy tail, thus occasional high-prevalence communities are to be expected even when infection is disappearing. A single cross-sectional survey may be able to reveal whether elimination efforts are on-track.
Rahman, Salman A; West, Sheila K; Mkocha, Harran; Munoz, Beatriz; Porco, Travis C; Keenan, Jeremy D; Lietman, Thomas M
Mathematical models predict an exponential distribution of infection prevalence across communities where a disease is disappearing. Trachoma control programs offer an opportunity to test this hypothesis, as the World Health Organization has targeted trachoma for elimination as a public health concern by the year 2020. Local programs may benefit if a single survey could reveal whether infection was headed towards elimination. Using data from a previously-published 2009 survey, we test the hypothesis that Chlamydia trachomatis prevalence across 75 Tanzanian communities where trachoma had been documented to be disappearing is exponentially distributed. We fit multiple continuous distributions to the Tanzanian data and found the exponential gave the best approximation. Model selection by Akaike Information Criteria (AICc) suggested the exponential distribution had the most parsimonious fit to the data. Those distributions which do not include the exponential as a special or limiting case had much lower likelihoods of fitting the observed data. 95% confidence intervals for shape parameter estimates of those distributions which do include the exponential as a special or limiting case were consistent with the exponential. Lastly, goodness-of-fit testing was unable to reject the hypothesis that the prevalence data came from an exponential distribution. Models correctly predict that infection prevalence across communities where a disease is disappearing is best described by an exponential distribution. In Tanzanian communities where local control efforts had reduced the clinical signs of trachoma by 80% over 10 years, an exponential distribution gave the best fit to prevalence data. An exponential distribution has a relatively heavy tail, thus occasional high-prevalence communities are to be expected even when infection is disappearing. A single cross-sectional survey may be able to reveal whether elimination efforts are on-track.
Routledge, Michael N; Kimanya, Martin E; Shirima, Candida P; Wild, Christopher P; Gong, Yun Yun
The association between aflatoxin intake from maize-based weaning food and aflatoxin albumin adducts (AF-alb) was investigated in 148 Tanzanian children aged between 12 and 22 months, at 2 visits 6 months apart. At the first visit (storage season) there was a significant correlation at the individual level between AF-alb (geometric mean 43.2 pg/mg albumin) and aflatoxin intake (geometric mean 81.7 ng/kg b.w./d) through maize-based weaning food (r = 0.51, p aflatoxin intake from maize in weaning food. Exposure levels suggest children may be at risk from aflatoxin associated health effects.
Bositis, David A.
In 2002, a national opinion poll of 2,463 U.S. adults examined such topics as politics, education, crime and criminal justice policy, globalization, international relations, and race relations. The education poll focused on such issues as school quality, school safety, school vouchers, school violence, and same-sex education. The survey sample…
... publishes the FMRs for the Housing Choice Voucher, the Moderate Rehabilitation, the project-based voucher... rental units. The final FY 2014 FMR areas are based on Office of Management and Budget (OMB) metropolitan.... The final FY 2014 FMRs in this notice reflect several updates from FY 2013 to the methodology used to...
Rohsenow, Damaris J; Tidey, Jennifer W; Martin, Rosemarie A; Colby, Suzanne M; Sirota, Alan D; Swift, Robert M; Monti, Peter M
Residential drug treatment provides an opportunity to intervene with smokers with substance use disorders (SUD). A randomized controlled clinical trial compared: (1) contingent vouchers (CV) for smoking abstinence to noncontingent vouchers (NCV), crossed with (2) motivational interviewing (MI) or brief advice (BA), for 184 smokers in SUD treatment. During the voucher period, 36% of carbon monoxide readings indicated smoking abstinence for those receiving CV versus 13% with NCV (p drug use or motivation to quit smoking occurred. Thus, CV had limited effects on long-term smoking abstinence in this population but effects were improved when CV was combined with MI. More effective methods are needed to increase motivation to quit smoking and quit rates in this high-risk population. Published by Elsevier Inc.
Full Text Available Abstract Background Coverage of vulnerable groups with insecticide-treated nets (ITNs in Ghana, as in the majority of countries of sub-Saharan Africa is currently low. A voucher scheme was introduced in Volta Region as a possible sustainable delivery system for increasing this coverage through scale-up to other regions. Successful scale-up of public health interventions depends upon optimal delivery processes but operational research for delivery processes in large-scale implementation has been inadequate. Methods A simple tool was developed to monitor numbers of vouchers given to each health facility, numbers issued to pregnant women by the health staff, and numbers redeemed by the distributors back to the management agent. Three rounds of interviews were undertaken with health facility staff, retailers and pregnant women who had attended antenatal clinic (ANC. Results During the one year pilot 25,926 vouchers were issued to eligible women from clinics, which equates to 50.7% of the 51,658 ANC registrants during this time period. Of the vouchers issued 66.7% were redeemed by distributors back to the management agent. Initially, non-issuing of vouchers to pregnant women was mainly due to eligibility criteria imposed by the midwives; later in the year it was due to decisions of the pregnant women, and supply constraints. These in turn were heavily influenced by factors external to the programme: current household ownership of nets, competing ITN delivery strategies, and competition for the limited number of ITNs available in the country from major urban areas of other regions. Conclusion Both issuing and redemption of vouchers should be monitored as factors assumed to influence voucher redemption had an influence on issuing, and vice versa. More evidence is needed on how specific contextual factors influence the success of voucher schemes and other models of delivery of ITNs. Such an evidence base will facilitate optimal strategic decision making
Slesinger, D P; Ofstead, C
FAMILY HEALTH/LA CLINICA de los Campesinos, Inc., is a federally funded migrant health clinic in the heart of Wisconsin's farmland that has offered outpatient health care since 1973 and an accompanying "voucher" program since 1988. The charges for outpatient care are based on the ability to pay. The clinic issues vouchers not only to migrant workers living and working in remote parts of the State but also to patients needing services the clinic does not offer. Between 1 April 1992 and 30 Marc...
Skjelbo, E; Mutabingwa, T K; Bygbjerg, Ib Christian
S-Mephenytoin and chloroguanide (proguanil) oxidation was studied in 216 tanzanians. The mephenytoin S/R ratio in urine ranged from 0.9, were arbitrarily defined as poor metabolizers of mephenytoin. The chloroguanide/cycloguanil ratio ranged from 0.82 to 249. There was a significant correlation b...
Kisanga, Dalton; Ireson, Gren
Tanzanian Higher learning institutions (HLIs) are faced with challenges of adopting e-learning in education. This study involved experts in e-learning to examine barriers of adopting e-learning and the best strategies to address them. Data were gathered from a series of semi-structured interviews with e-learning experts from two HLIs in Tanzania.…
Mkumbo, Kitila A. K.; Ingham, Roger
Despite evidence that demonstrates the benefits of school-based sex and relationships education (SRE) in promoting and protecting young people's sexual health, there are still controversies regarding "what" should be covered in the SRE curriculum among different stakeholders, including parents. This study assessed Tanzanian parents'…
Thijs, HFH; Massawe, AW; Okken, A; Coenraads, PJ; Muskiet, FAJ; Huisman, M; Boersma, ER
In healthy cot-nursed Tanzanian neonates (n = 92, gestation 26-42 weeks) measurements of transepidermal water loss (TEWL) and weight change were performed during the first 24 h after birth at an average ambient humidity of 70% and an environmental temperature of 32 degrees C. Urine production on day
Rustenhoven-Spaans, I.; Melkert, P.; Nelissen, E.J.T.; van Roosmalen, J.; Stekelenburg, J.
Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home
Rustenhoven-Spaan, Ilona; Melkert, Peter; Nelissen, Ellen; van Roosmalen, Jos; Stekelenburg, Jelle
Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home
Full Text Available This research explored the awareness, usage and perspectives of Tanzanian researchers on open access as a mode of scholarly communication. A survey questionnaire targeted 544 respondents selected through stratified random sampling from a population of 1088 university researchers of the six public universities in Tanzania. With a response rate of 73%, the data were analysed using the Statistical Package for Social Sciences. The study reveals that the majority of the researchers were aware of and were positive towards open access. Findings further indicate that the majority of researchers in Tanzanian public universities used open access outlets more to access scholarly content than to disseminate their own research findings. It seems that most of these researchers would support open access publishing more if issues of recognition, quality and ownership were resolved. Thus many of them supported the idea of establishing institutional repositories at their respective universities as a way of improving the dissemination of local content. The study recommends that public universities and other research institutions in the country should consider establishing institutional repositories, with appropriate quality assurance measures, to improve the dissemination of research output emanating from these institutions.
Bles, P; de Mast, Q; van der Gaast-de Jongh, C E; Kinabo, G D; Kibiki, G; van de Ven, A; de Jonge, M I
To determine antibiotic susceptibility of colonising pneumococcal serotypes in HIV-exposed infants before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), because HIV-exposed infants are at increased risk of invasive pneumococcal infections. Antibiotic susceptibility of 104 pneumococcal isolates, cultured from the nasopharynx from Tanzanian HIV-exposed infants, was determined using the disc diffusion method and the E-test according to EUCAST version 4.0 (2014) criteria. A total of 69.2% of isolates were intermediately susceptible for benzyl penicillin (MIC 0.06-2 mg/l ); no high-level resistance was found. All isolates but one were susceptible to ampicillin. Regarding non-beta-lactam antibiotics, 19.2% of isolates were resistant to doxycycline, 3.8% to erythromycin and 97.1% to trimethoprim/sulfamethoxazole. A total of 15.4% of isolates were resistant to three antibiotic classes or more. There were no differences in antibiotic susceptibility between vaccine and non-vaccine serotypes. Reduced susceptibility of colonising pneumococcal isolates for commonly used antibiotics is common in HIV-exposed Tanzanian infants. High-dose penicillin and ampicillin remain appropriate first choices for non-meningeal pneumococcal infections in this group. © 2015 John Wiley & Sons Ltd.
Tanzanian hospitals suffer from underfunding and poor management. In particular, planning and strategic thinking need improvement. Cultural values such as subordination, risk aversion, and high time preference, together with a long history of socialist government, result in lack of responsibility, accountability, and planning. This has been addressed by the health sector reform with its focus on decentralization, strengthened by the introduction of basket funding facilitated by the Comprehensive Council Health Plans. As a consequence of this the next logical step is to improve the authority of regional and district hospitals in the use of their resources by introducing hospital development plans. These strategic plans were introduced as tools of strategic planning in 2001 by the Kreditanstalt für Wiederaufbau in close collaboration with the Tanzanian Ministry of Health, binding the release of rehabilitation funds to presentation of a strategic hospital plan. This study examines the rationale and content of hospital development plans. Initial experiences are discussed. The quality of presented plans has steadily improved, but there is a tendency for hospitals with a close connection to development partners to present well prepared reports while other hospitals have severe problems fulfilling the requirements. For many hospitals it is in fact the first time that they have had to define their functions and future role, thus breaking ground for strategic thinking.
Shaffer, Michael B.; Ellis, John G.; Swensson, Jeff
"Getting poor kids out of failing schools" sounds like an altruistic cause most Americans support. However, one policy mechanism utilized to achieve that result, parental choice vouchers, has a checkered past. This descriptive analysis explores the policy-bubble created when state legislators eschewed their constitutional responsibility…
In June 2015, the Colorado Supreme Court struck down a successful voucher program in Douglas County, invoking a provision of the state constitution that harks back to an era of widespread prejudice against Catholics. But because of the court's reliance on this discriminatory provision, its decision could well be overturned by the U.S. Supreme…
Pedroni, Thomas C.
Critical educational researchers in the United States and elsewhere are missing something essential in their inattention to considerable support among Black urban women for market-based educational reforms, including vouchers. While the educational left has engaged in important empirical and theoretical work demonstrating the particularly negative…
Ridley, David B; Sánchez, Alfonso Calles
Every year 1 billion people worldwide are affected by traditionally neglected diseases, such as malaria, tuberculosis, leishmaniasis, and lymphatic filariasis, which impose tremendous public health burdens. Governments, foundations, and drug manufacturers have, however, started to support development of new treatments. European Union Member States have been leaders in implementing so-called push mechanisms (payment for drug development) and pull funding (reward for output), such as the advance market commitment, which creates a market for vaccines by guaranteeing prices. We propose an additional step that could be taken to encourage development of medicines for neglected diseases. A priority review voucher scheme, as is already in place in the USA, would reward a manufacturer that developed a new medicine for neglected diseases with a voucher that could be redeemed for priority review of a future medicine, probably a potential blockbuster drug. Unlike the US system a European voucher would also accelerate pricing and reimbursement decisions. This scheme would be likely to provide substantial benefits to voucher holders, society, and public health organisations. Copyright 2010 Elsevier Ltd. All rights reserved.
Fung, Chanel Kit-Ho; Lam, Chi-Chung
The issue of education vouchers has been widely researched as they are seen by many people as an effective strategy for improving the quality of education services. Striving to enhance the quality of the kindergarten education service in Hong Kong, the government of the Hong Kong Special Administrative Region has committed a substantial sum of…
Li, Hui; Wong, Jessie Ming Sin; Wang, X. Christine
Hong Kong launched the "Pre-primary Education Voucher Scheme" (PEVS) in 2007 to promote the "3A's" of early childhood education (ECE): affordability, accessibility, and accountability. The PEVS has three unique features: discriminating against profit kindergartens, promoting teacher professional development, and limiting…
Universities UK, 2014
This factsheet, the first in a series on innovation and growth, provides an overview of the benefits of innovation vouchers, and gives some examples of how universities and Local Enterprise Partnerships (LEPs) are including them in their European Structural and Investment Funds (ESIF) strategies. [For the second factsheet in the series,…
Salisbury, David F.
By most measures, U.S. K-12 public schools continue on a path of mediocrity. To date, many states have implemented school choice programs, seeking to instill elements of competition and choice into their education systems. However, they all have limitations. An ideal school choice program would give every child a voucher or tax credit to be spent…
Hess, Frederick M.; McGuinn, Patrick J.
Examines how the introduction of the Cleveland voucher experiment in 1995 affected the administration and leadership of Cleveland's public schools. As of summer 2001, the program has produced virtually no visible effects. Results suggest that choice-based reform may not spur improvement in urban school systems, at least in the short term or when…
Coulson, Andrew J.
School voucher and education tax credit programs have proliferated in the United States over the past 2 decades. Advocates have argued that they will enable families to become active consumers in a free and competitive education marketplace, but some fear that these programs may bring a heavy regulatory burden that could stifle market forces.…
Coulson, Andrew J.
School voucher and education tax credit programs have proliferated in the United States over the past two decades. Advocates have argued that they will enable families to become active consumers in a free and competitive education marketplace, but some fear that these programs may in fact bring with them a heavy regulatory burden that could stifle…
In this NEPC Policy Memo, Professor Welner explains that the most honest and conscientious approach to reporting the fiscal impact of tax credit vouchers is to provide a range of outcomes and let the readers--not the legislative analysts themselves--speculate on which is most likely. If a bottom line is demanded, it should be couched in as many…
... initial PHA consolidated Annual Contributions Contract (ACC) to the receiving PHA consolidated ACC, in... the consolidated ACC for the receiving PHA voucher program on the effective date of the HAP contract... family is assisted with funds available under the consolidated ACC for the receiving PHA tenant-based...
Warner, M.; Gradus, R.H.J.M.
In the Netherlands, the USA and Australia, public funding has promoted parental choice by introducing a voucher scheme for child care, where parents are free to choose the provider. The policy experiments and the outcomes in these three countries provide useful information about the consequences of
A key component of current school reform efforts focuses on increasing parental choice through voucher systems and programs that provide tax benefits for contributions to scholarship programs for private school tuition. Indeed, proposals to adopt such programs have been or currently are being considered in four-fifths of the states, and about half…
Angrist, Joshua D.; Bettinger, Eric; Bloom, Erik; King, Elizabeth; Kremer, Michael
This paper examines the impact of Colombia's Programa de Ampliacion de Cobertura de la Educacion Secundaria (PACES), which provided over 125,000 poor students with private secondary school vouchers, many of which were awarded by lottery. Researchers surveyed lottery winners and losers to compare educational and other outcomes. Results showed no…
... effect through September 30, 2011, for applications submitted with a priority review voucher, and the... multiplier of 1.67 (10 months divided by 6 months) should be applied to non-priority review costs in estimating the effort and cost of a priority review as compared to a standard review. This multiplier is...
Hill, Katharine; Peyton, Larissa
Youths who have been in foster care face many challenges in accessing and completing postsecondary education. The Chafee Education and Training Vouchers (ETV) program is a federally funded program that assists current and former foster youths in accessing postsecondary learning opportunities by providing scholarship money for their education. This…
Witte, John F.
Parents and private schools are generally satisfied with Milwaukee's voucher program. Four results are fairly negative: loss of active parents from public schools; student attrition from private schools; closure of four private schools; and lower achievement-test scores. Also, proponents are using dubious findings to support unwarranted program…
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Housing certificate and housing voucher programs. 8.28 Section 8.28 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development NONDISCRIMINATION BASED ON HANDICAP IN FEDERALLY ASSISTED PROGRAMS AND...
Rohsenow, Damaris J; Tidey, Jennifer W; Kahler, Christopher W; Martin, Rosemarie A; Colby, Suzanne M; Sirota, Alan D
Identifying predictors of abstinence with voucher-based treatment is important for improving its efficacy. Smokers with substance use disorders have very low smoking cessation rates so identifying predictors of smoking treatment response is particularly important for these difficult-to-treat smokers. Intolerance for Smoking Abstinence Discomfort (IDQ-S), motivation to quit smoking, nicotine dependence severity (FTND), and cigarettes per day were examined as predictors of smoking abstinence during and after voucher-based smoking treatment with motivational counseling. We also investigated the relationship between IDQ-S and motivation to quit smoking. Smokers in residential substance treatment (n=184) were provided 14days of vouchers for complete smoking abstinence (CV) after a 5-day smoking reduction lead-in period or vouchers not contingent on abstinence. Carbon monoxide readings indicated about 25% of days abstinent during the 14days of vouchers for abstinence in the CV group; only 3-4% of all participants were abstinent at follow-ups. The IDQ-S Withdrawal Intolerance scale and FTND each significantly predicted fewer abstinent days during voucher treatment; FTND was nonsignificant when controlling for variance shared with withdrawal intolerance. The one significant predictor of 1-month abstinence was pretreatment motivation to quit smoking, becoming marginal (pmotivation to quit smoking. Implications for voucher-based treatment include the importance of focusing on reducing these expectancies of anticipated smoking withdrawal discomfort, increasing tolerance for abstinence discomfort, and increasing motivation. Published by Elsevier Ltd.
Mumghamba, E G S; Honkala, S; Honkala, E; Manji, K P
Females are generally more motivated with regard to oral hygiene practices and thus brush their teeth more frequently than males. To determine the prevalence of gingival recession, oral hygiene status, oral hygiene practices and associated factors in women attending a maternity ward in Tanzania. Cross-sectional descriptive study. Maternity ward of Muhimbili National Hospital, Tanzania. Four hundred and forty six women were interviewed on oral hygiene practices and maternal factors, and a full-mouth examination was done to determine the presence of plaque, calculus, gingival bleeding and gingival recession at six sites per tooth. The prevalence of gingival recession (GR) > or =1 mm was 33.6%, calculus 99.3%, plaque 100%, and gingival bleeding 100%. Oral hygiene practices included toothbrushing (98.9%), brushing frequency > or =2 times/day (61.2%), horizontal brushing method (98%), and using a plastic toothbrush (97.8%). Factors that were significantly associated with gingival recession were age (OR = 2.0, 95% CI = 1.3-3.2), presence of calculus (OR(a) = 3.8, 95% CI=2.5-7.1), and gingival bleeding on probing (OR = 4.2, 95% CI = 2.5-7.1). Tooth cleaning practices and maternal factors, especially the number of pregnancies or deliveries were not significantly associated with gingival recession. In this study population, oral hygiene was poor and gingival recession was associated with age, calculus and gingival inflammation rather than with tooth cleaning practices.
Simon Elison NM
Full Text Available Abstract Background In Tanzania, oral health services are mostly in the form of dental extractions aimed at alleviating acute dental pain. Conservative methods of alleviating acute dental pain are virtually non-existent. Therefore, it was the aim of this study to determine treatment success of emergency pulpotomy in relieving acute dental pain. Methods Setting: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania. Study design: Longitudinal study. Participants: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001. Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute. Results Of the patients with treated premolars, 25 (13.9% patients did not experience pain at all while 19 (10.6% experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31% did not experience any pain, 76 (42.2% experienced mild pain and the other 4 (2.2% suffered acute pain. Conclusion The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.
D'Acremont, Valérie; Kilowoko, Mary; Kyungu, Esther; Philipina, Sister; Sangu, Willy; Kahama-Maro, Judith; Lengeler, Christian; Cherpillod, Pascal; Kaiser, Laurent; Genton, Blaise
As the incidence of malaria diminishes, a better understanding of nonmalarial fever is important for effective management of illness in children. In this study, we explored the spectrum of causes of fever in African children. We recruited children younger than 10 years of age with a temperature of 38°C or higher at two outpatient clinics--one rural and one urban--in Tanzania. Medical histories were obtained and clinical examinations conducted by means of systematic procedures. Blood and nasopharyngeal specimens were collected to perform rapid diagnostic tests, serologic tests, culture, and molecular tests for potential pathogens causing acute fever. Final diagnoses were determined with the use of algorithms and a set of prespecified criteria. Analyses of data derived from clinical presentation and from 25,743 laboratory investigations yielded 1232 diagnoses. Of 1005 children (22.6% of whom had multiple diagnoses), 62.2% had an acute respiratory infection; 5.0% of these infections were radiologically confirmed pneumonia. A systemic bacterial, viral, or parasitic infection other than malaria or typhoid fever was found in 13.3% of children, nasopharyngeal viral infection (without respiratory symptoms or signs) in 11.9%, malaria in 10.5%, gastroenteritis in 10.3%, urinary tract infection in 5.9%, typhoid fever in 3.7%, skin or mucosal infection in 1.5%, and meningitis in 0.2%. The cause of fever was undetermined in 3.2% of the children. A total of 70.5% of the children had viral disease, 22.0% had bacterial disease, and 10.9% had parasitic disease. These results provide a description of the numerous causes of fever in African children in two representative settings. Evidence of a viral process was found more commonly than evidence of a bacterial or parasitic process. (Funded by the Swiss National Science Foundation and others.).
Canella, Daniela Silva; Martins, Ana Paula Bortoletto; Bandoni, Daniel Henrique
Food stamps and meal vouchers can determine workers' dietary choices. The study aimed to assess the coverage of these benefits in Brazil and their distribution according to the beneficiaries' socio-demographic and regional characteristics, using data from the Brazilian Household Budgets Survey, 2008-2009. Eligibility criteria were having an occupation and a private or government job, including domestic or temporary work in rural areas. Only 3.2% of eligible individuals reported receiving such benefits. Highest coverage rates were verified with the Southeast region, urban areas, male gender, employment in the private sector, and monthly earnings > five times the minimum wage. The mean monthly amount of such benefits was R$ 177.20 (US$ 100 at the 2009 exchange rate). After adjusting for other variables, the highest amounts were associated with male gender, higher salaries, the Northeast and Central regions, and employment in the public sector. This first analysis of the national coverage of food stamps and meal vouchers showed that a large share of Brazilian workers lack access or have unequal access to such benefits.
Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna
Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the
Hunter, Benjamin M.; Harrison, Sean; Portela, Anayda; Bick, Debra
BackgroundCash transfers and vouchers are forms of `demand-side financing' that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years.MethodsThis systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute appr...
Hanbury, Meagan M; Gomez-Camacho, Rosa; Kaiser, Lucia; Sadeghi, Banafsheh; de la Torre, Adela
Recent recommendations for US food assistance programs are intended to ensure foods provided through these programs help households consume a varied, healthful diet. From a policy viewpoint, it is important to examine the impact of economic incentives to purchase healthy foods across subpopulations, particularly low-income Latinos, who comprise 40% of the WIC program nationwide. Our aim was to determine how rural, Mexican-heritage households (N = 227) residing in California's Central Valley distributed fruit and vegetable (F/V) voucher spending among F/V subgroups and specific items over a 1-year period. Households contained at least one child who was between 3 and 8 years old at baseline and had a parent of Mexican-heritage. F/V voucher purchase data were collected via grocery store scanners. Expenditure and frequency shares of subgroups and individual items were analyzed to determine purchasing habits. Fruits were the most commonly purchased subgroup, representing 55% of spending and 45% of frequency. Households allocated low percentages of their voucher to dark green and red/orange vegetables-7 and 9% respectively. Approximately 20% of purchases were good potassium sources and 30% of purchases were good fiber sources. Many of the most frequently purchased items were of cultural significance (tomatillo, chayote, chili/jalapeño pepper, and Mexican squash). This study suggests that economic incentives can contribute important nutrients to participants' diets and targeted vouchers provided by food assistance programs should continue to include culturally important foods and be aware of the cultural values of their participants.
Chopra, Mohit P.; Landes, Reid D.; Gatchalian, Kirstin M; Jackson, Lisa C.; Buchhalter, August R; Stitzer, Maxine L.; Marsch, Lisa A.; Bickel, Warren K.
This study compared the relative efficacy of two contingency management (CM) interventions versus standard care. During a 12-week intervention, opioid dependent participants (N = 120) were maintained on thrice-a-week (M, W, F) buprenorphine plus therapist and computer-based counseling. They were randomized to receive: (a) medication contingencies (MC= thrice weekly dosing schedule vs. daily attendance and single-day 50% dose reduction imposed upon submission of an opioid and/or cocaine positive urine sample); (b) voucher contingency (VC=escalating schedule for opioid and/or cocaine negative samples with reset for drug-positive samples); or (c) standard care (SC), with no programmed consequences for urinalysis results. Voucher reinforcement resulted in better 12-week retention (85%) compared to contingent medication (58%; p=0.009), but neither differed from standard care (76% retained). The groups submitted a similar overall percentage of opioid and cocaine-free urines (MC = 79%, VC = 76%, SC = 69%). After adjusting for baseline differences in employment, the medication contingency group achieved 1.5 more continuous weeks of combined opioid/cocaine abstinence than standard care (p=0.030), while the voucher group had 2 more total weeks of abstinence than standard care (p=0.048). Drug use results suggest that the two interventions were both efficacious, with effects seen primarily in opioid rather than cocaine test results. Findings should be interpreted in light of the greater attrition associated with medication-based contingencies versus the greater monetary costs of voucher-based contingencies. PMID:19653788
Obare, Francis; Warren, Charlotte; Njuki, Rebecca; Abuya, Timothy; Sunday, Joseph; Askew, Ian; Bellows, Ben
This paper examines community-level association between exposure to the reproductive health vouchers programme in Kenya and utilization of services. The data are from a household survey conducted among 2527 women (15-49 years) from voucher and comparable non-voucher sites. Analysis entails cross-tabulations with Chi-square tests and significant tests of proportions as well as estimation of multi-level logit models to predict service utilization by exposure to the programme. The results show that for births occurring after the voucher programme began, women from communities that had been exposed to the programme since 2006 were significantly more likely to have delivered at a health facility and to have received skilled care during delivery compared with those from communities that had not been exposed to the programme at all. There were, however, no significant differences in the timing of first trimester utilization of antenatal care (ANC) and making four or more ANC visits by exposure to the programme. In addition, poor women were significantly less likely to have used safe motherhood services (health facility delivery, skilled delivery care and postnatal care) compared with their non-poor counterparts regardless of exposure to the programme. Nonetheless, a significantly higher proportion of poor women from communities that had been exposed to the programme since 2006 used the services compared with their poor counterparts from communities that had not been exposed to the programme at all. The findings suggest that the programme is associated with increased health facility deliveries and skilled delivery care especially among poor women. However, it has had limited community-level impact on the first trimester timing of antenatal care use and making four or more visits, which remain a challenge despite the high proportion of women in the country that make at least one antenatal care visit during pregnancy.
JOURNAL VOUCHERS FOR FY 2000 DEPARTMENT OF THE NAVY GENERAL FUND FINANCIAL REPORTING Report No. D-2001-122...the fourth and final report on the FY 2000 Department of the Navy (Navy) General Fund Financial Statements. The previous reports discuss accounting...entries supporting Marine Corps reporting and our endorsement of he Naval Audit Service disclaimer of opinion on the FY 2000 Navy General Fund financial
Pergamit, Michael; Cunningham, Mary; Hanson, Devlin
This study addresses whether providing housing vouchers through the Family Unification Program (FUP) to families involved in the child welfare system reduces child maltreatment and the need for child welfare services. The study uses child welfare administrative data on 326 children in Portland, Oregon, and 502 children in San Diego, California from the point at which their families were referred to the program through 18 months post-referral. Using a quasi-experimental waitlist comparison design, probit regressions show little impact of FUP on preventing child removal from home, but some positive impact on reunification among children already placed out of home. Hazard estimations show receipt of FUP speeds up child welfare case closure. Impacts on new reports of abuse and neglect are mixed, but point toward reduced reports. Low rates of removal among intact comparison families and high rates of reunification for children in out-of-home care suggest poor targeting of housing resources. Housing vouchers are being given to families not bearing the risks the program is intended to address. The presence of some positive findings suggests that housing vouchers might help reduce child welfare involvement if better targeting were practiced by child welfare agencies. © Society for Community Research and Action 2017.
Catherine L. Dotchin
Full Text Available Cognitive impairment is thought to be a major cause of disability worldwide, though data from sub-Saharan Africa (SSA are sparse. This study aimed to investigate the association between cognitive impairment and disability in a cohort of community-dwelling older adults living in Tanzania. The study cohort of 296 people aged 70 years and over was recruited as part of a dementia prevalence study. Subjects were diagnosed as having dementia or mild cognitive impairment according to the DSM-IV criteria. Disability level was assessed according to the WHO Disability Assessment Schedule, version 2.0 (WHODAS. A higher WHODAS score indicates greater disability. The median WHODAS in the background population was 25.0; in those with dementia and in those with mild cognitive impairment, 72 of 78 (92.3% and 41 of 46 (89.1%, respectively, had a WHODAS score above this level. The presence of dementia, mild cognitive impairment, hearing impairment, being unable to walk without an aid and not having attended school were independent predictors of having a WHODAS score above 25.0, though age and gender were not. In summary, cognitive impairment is a significant predictor of disability in elderly Tanzanians. Screening for early signs of cognitive decline would allow management strategies to be put in place that may reduce the associated disability burden.
In response to the growing HIV epidemic in Africa in the 1990s, microbicide technologies emerged from discourses of empowerment and imaginings of the sexual lives and agency of African women. This draws on an anthropological enquiry which explored narratives from Tanzanian women who participated in a microbicide clinical trial. In the context of the HIV epidemic in Tanzania, women's lives were full of uncertainty and insecurity and their sexual lives were situated in a wider discourse of urban women's sexuality linked to morality and power. Their narratives revealed that women participated in the trial to seek knowledge as well as to 'try' the gel. In relation to their concerns about sexual health, the gel was experienced as cleansing as well as enhancing sexual desire and pleasure. The idea of empowerment imbued in the gel and transported to the women through the clinical trial was meaningful to the women, and this and ideas of sexual health and pleasure suggest future and hopeful possibilities for such HIV prevention technologies. However, if made widely available the potential for enhanced inequalities and further intensified surveillance of women's sexual lives must be considered.
Villages under the escarpment of the Tanzanian plateau were surveyed for breeding of Aedes aegypti. In some places more than 27% of the water containers outside houses harboured A. aegypti larvae, while there was practically no breeding in containers inside houses. From 2% to 10% of tree holes contained A. aegypti larvae. In places, as many as 47 A. simpsoni larvae were collected from one pineapple plant, and the total mean number of larvae per pineapple was 6.6, while the percentage of plants with larvae was as high as 93.6. The total mean number of larvae per colocasia plant was 2.9, but the number per banana plant was only 0.3. The plant Crinum was discovered to be a breeding site of A. simpsoni. Eggs of A. simpsoni were found in 55-80% of ovitraps placed in four villages. Of 20 traps found to contain eggs of this species 30% were in the village, 60% in gardens, and 10% at the edge of forest. It was observed that A. simpsoni females lay their eggs at all levels up to 5 m, but prefer ground level.
Dotchin, Catherine L; Paddick, Stella-Maria; Gray, William K; Kisoli, Aloyce; Orega, Golda; Longdon, Anna R; Chaote, Paul; Dewhurst, Felicity; Dewhurst, Matthew; Walker, Richard W
Cognitive impairment is thought to be a major cause of disability worldwide, though data from sub-Saharan Africa (SSA) are sparse. This study aimed to investigate the association between cognitive impairment and disability in a cohort of community-dwelling older adults living in Tanzania. The study cohort of 296 people aged 70years and over was recruited as part of a dementia prevalence study. Subjects were diagnosed as having dementia or mild cognitive impairment according to the DSM-IV criteria. Disability level was assessed according to the WHO Disability Assessment Schedule, version 2.0 (WHODAS). A higher WHODAS score indicates greater disability. The median WHODAS in the background population was 25.0; in those with dementia and in those with mild cognitive impairment, 72 of 78 (92.3%) and 41 of 46 (89.1%), respectively, had a WHODAS score above this level. The presence of dementia, mild cognitive impairment, hearing impairment, being unable to walk without an aid and not having attended school were independent predictors of having a WHODAS score above 25.0, though age and gender were not. In summary, cognitive impairment is a significant predictor of disability in elderly Tanzanians. Screening for early signs of cognitive decline would allow management strategies to be put in place that may reduce the associated disability burden. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Elacqua, Gregory; Contreras, Dante; Salazar, Felipe; Santos, Humberto
There is persistent debate over the role of scale of operations in education. Some argue that school franchises offer educational services more effectively than small independent schools. Skeptics counter that large centralized operations create hard-to-manage bureaucracies and foster diseconomies of scale and that small schools are more effective…
Le Gall, B.; Nonnotte, P.; Rolet, J.; Benoit, M.; Guillou, H.; Mousseau-Nonnotte, M.; Albaric, J.; Deverchère, J.
A revised kinematic model is proposed for the Neogene tectono-magmatic development of the North Tanzanian Divergence where the axial valley in S Kenya splits southwards into a wide diverging pattern of block faulting in association with the disappearance of volcanism. Propagation of rifting along the S Kenya proto-rift during the last 8 Ma is first assumed to have operated by linkage of discrete magmatic cells as far S as the Ngorongoro-Kilimanjaro transverse volcanic belt that follows the margin of cratonic blocks in N Tanzania. Strain is believed to have nucleated throughout the thermally-weakened lithosphere in the transverse volcanic belt that might have later linked the S Kenya and N Tanzania rift segments with marked structural changes along-strike. The North Tanzanian Divergence is now regarded as a two-armed rift pattern involving: (1) a wide domain of tilted fault blocks to the W (Mbulu) that encompasses the Eyasi and Manyara fault systems, in direct continuation with the Natron northern trough. The reactivation of basement fabrics in the cold and intact Precambrian lithosphere in the Mbulu domain resulted in an oblique rift pattern that contrasts with the orthogonal extension that prevailed in the Magadi-Natron trough above a more attenuated lithosphere. (2) To the E, the Pangani horst-like range is thought to be a younger (< 1 Ma) structure that formed in response to the relocation of extension S of the Kilimanjaro magmatic center. A significant contrast in the mechanical behaviour of the stretched lithosphere in the North Tanzanian diverging rift is assumed to have occurred on both sides of the Masai cratonic block with a mid-crustal decoupling level to the W where asymmetrical fault-basin patterns are dominant (Magadi-Natron and Mbulu), whereas a component of dynamical uplift is suspected to have caused the topographic elevation of the Pangani range in relation with possible far-travelled mantle melts produced at depth further N.
Meuwissen, L.E.; Gorter, A.C.; Kester, A.D.M.; Knottnerus, J.A.
OBJECTIVES: To evaluate whether participation in a competitive voucher programme designed to improve access to and quality of sexual and reproductive health care (SRH-care), prompted changes in doctors' knowledge, attitudes and practices. METHODS: The voucher programme provided free access to
Miguel Ángel Gómez-Nieto
Full Text Available Because of the global economic turmoil, nowadays a lot of companies are adopting a “deal of the day” business model, some of them with great success. Generally, they try to attract and retain customers through discount coupons and gift cards, using, generally, traditional distribution media. This paper describes a framework, which integrates intelligent environments by using NFC, oriented to the full management of this kind of businesses. The system is responsible for diffusion, distribution, sourcing, validation, redemption and managing of vouchers, loyalty cards and all kind of mobile coupons using NFC, as well as QR codes. WingBonus can be fully adapted to the requirements of marketing campaigns, voucher providers, shop or retailer infrastructures and mobile devices and purchasing habits. Security of the voucher is granted by the system by synchronizing procedures using secure encriptation algorithms. The WingBonus website and mobile applications can be adapted to any requirement of the system actors.
Borrego-Jaraba, Francisco; Garrido, Pilar Castro; García, Gonzalo Cerruela; Ruiz, Irene Luque; Gómez-Nieto, Miguel Ángel
Because of the global economic turmoil, nowadays a lot of companies are adopting a “deal of the day” business model, some of them with great success. Generally, they try to attract and retain customers through discount coupons and gift cards, using, generally, traditional distribution media. This paper describes a framework, which integrates intelligent environments by using NFC, oriented to the full management of this kind of businesses. The system is responsible for diffusion, distribution, sourcing, validation, redemption and managing of vouchers, loyalty cards and all kind of mobile coupons using NFC, as well as QR codes. WingBonus can be fully adapted to the requirements of marketing campaigns, voucher providers, shop or retailer infrastructures and mobile devices and purchasing habits. Security of the voucher is granted by the system by synchronizing procedures using secure encriptation algorithms. The WingBonus website and mobile applications can be adapted to any requirement of the system actors. PMID:23673675
Borrego-Jaraba, Francisco; Garrido, Pilar Castro; García, Gonzalo Cerruela; Ruiz, Irene Luque; Gómez-Nieto, Miguel Angel
Because of the global economic turmoil, nowadays a lot of companies are adopting a "deal of the day" business model, some of them with great success. Generally, they try to attract and retain customers through discount coupons and gift cards, using, generally, traditional distribution media. This paper describes a framework, which integrates intelligent environments by using NFC, oriented to the full management of this kind of businesses. The system is responsible for diffusion, distribution, sourcing, validation, redemption and managing of vouchers, loyalty cards and all kind of mobile coupons using NFC, as well as QR codes. WingBonus can be fully adapted to the requirements of marketing campaigns, voucher providers, shop or retailer infrastructures and mobile devices and purchasing habits. Security of the voucher is granted by the system by synchronizing procedures using secure encriptation algorithms. The WingBonus website and mobile applications can be adapted to any requirement of the system actors.
Hunter, Benjamin M; Harrison, Sean; Portela, Anayda; Bick, Debra
Cash transfers and vouchers are forms of 'demand-side financing' that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years. This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637). Data from 51 studies (15 more than previous reviews) and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services) can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes. Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects.
Benjamin M Hunter
Full Text Available Cash transfers and vouchers are forms of 'demand-side financing' that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years.This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637.Data from 51 studies (15 more than previous reviews and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes.Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects.
Hunter, Benjamin M.; Harrison, Sean; Portela, Anayda; Bick, Debra
Background Cash transfers and vouchers are forms of ‘demand-side financing’ that have been widely used to promote maternal and newborn health in low- and middle-income countries during the last 15 years. Methods This systematic review consolidates evidence from seven published systematic reviews on the effects of different types of cash transfers and vouchers on the use and quality of maternity care services, and updates the systematic searches to June 2015 using the Joanna Briggs Institute approach for systematic reviewing. The review protocol for this update was registered with PROSPERO (CRD42015020637). Results Data from 51 studies (15 more than previous reviews) and 22 cash transfer and voucher programmes suggest that approaches tied to service use (either via payment conditionalities or vouchers for selected services) can increase use of antenatal care, use of a skilled attendant at birth and in the case of vouchers, postnatal care too. The strongest evidence of positive effect was for conditional cash transfers and uptake of antenatal care, and for vouchers for maternity care services and birth with a skilled birth attendant. However, effects appear to be shaped by a complex set of social and healthcare system barriers and facilitators. Studies have typically focused on an initial programme period, usually two or three years after initiation, and many lack a counterfactual comparison with supply-side investment. There are few studies to indicate that programmes have led to improvements in quality of maternity care or maternal and newborn health outcomes. Conclusion Future research should use multiple intervention arms to compare cost-effectiveness with similar investment in public services, and should look beyond short- to medium-term service utilisation by examining programme costs, longer-term effects on service utilisation and health outcomes, and the equity of those effects. PMID:28328940
Hendriksen, Ilse C E; Maiga, Deogratius; Lemnge, Martha M; Mtove, George; Gesase, Samwel; Reyburn, Hugh; Lindegardh, Niklas; Day, Nicholas P J; von Seidlein, Lorenz; Dondorp, Arjen M; Tarning, Joel; White, Nicholas J
Although artesunate is clearly superior, parenteral quinine is still used widely for the treatment of severe malaria. A loading-dose regimen has been recommended for 30 years but is still often not used. A population pharmacokinetic study was conducted with 75 Tanzanian children aged 4 months to 8 years with severe malaria who received quinine intramuscularly; 69 patients received a loading dose of 20 mg quinine dihydrochloride (salt)/kg of body weight. Twenty-one patients had plasma quinine concentrations detectable at baseline. A zero-order absorption model with one-compartment disposition pharmacokinetics described the data adequately. Body weight was the only significant covariate and was implemented as an allometric function on clearance and volume parameters. Population pharmacokinetic parameter estimates (and percent relative standard errors [%RSE]) of elimination clearance, central volume of distribution, and duration of zero-order absorption were 0.977 liters/h (6.50%), 16.7 liters (6.39%), and 1.42 h (21.5%), respectively, for a typical patient weighing 11 kg. Quinine exposure was reduced at lower body weights after standard weight-based dosing; there was 18% less exposure over 24 h in patients weighing 5 kg than in those weighing 25 kg. Maximum plasma concentrations after the loading dose were unaffected by body weight. There was no evidence of dose-related drug toxicity with the loading dosing regimen. Intramuscular quinine is rapidly and reliably absorbed in children with severe falciparum malaria. Based on these pharmacokinetic data, a loading dose of 20 mg salt/kg is recommended, provided that no loading dose was administered within 24 h and no routine dose was administered within 12 h of admission. (This study has been registered with Current Controlled Trials under registration number ISRCTN 50258054.).
Several research programmes and projects have addressed the possibilities for using agro-industrial residues for production of valuable products. Anyhow, no complete analysis of the potential for bio-energy generation from these resources, including ways to implement and utilise the potential has been made, nor has an analysis of the importance of the bio-energy potential, in relation to the energy generation capacity of the countries of tropical Africa. The current project should be seen as a supplement and extension of these studies. It has its main focus on the bio-energy potential of Malawi, and the Tanzanian sugar industry. Development of and measures to maintain know-how on implementation and operation of biogas and biomass incineration facilities in East Africa, is of great importance for the exploitation of these resources. The current project should also be seen in this context. The main conclusions of this survey are: The potential for biogas production from municipal organic waste in Malawi is scarce. Household waste is not appropriate for bio-energy generation and only the city of Blantyre has an exploitable bio-energy potential from markets and small food processing industries; The bio-energy potential of the Malawian agro-industries is large, with the main sources concentrated on few large units; Smaller bio-energy units for heat production may be feasible at coffee and tobacco curing facilities; The cane sugar industry and related ethanol production facilities have the largest single potential; One wood processing factory has a good potential for exploitation of its bioenergy potential using wood chip incineration CHP units. The sugar cane sector of Tanzania is the second largest producer of biomass waste, feasible for bioenergy production in biogas and biomass incineration units, only exceeded by the Sisal sector. The potential is concentrated on five large units which each have a considerable exploitable potential. (EHS)
A G Lim
Full Text Available Background. Emergency medicine (EM is a relatively new, but growing medical specialty in sub-Saharan Africa. African EM training programmes have used small-group learning (SGL modalities in their curricula. However, there is little knowledge of whether SGL modalities are perceived to be effective in these African EM training programmes. Objectives. To investigate the acceptability of SGL for physicians’ training in an academic Tanzanian emergency department using a novel EM curriculum. Methods. Using responses to a written questionnaire, we explored the perceived effectiveness of SGL compared with traditional didactic lectures among 38 emergency department physician learners in Dar es Salaam, Tanzania. Perceptions of SGL were identified from qualitative responses, and regression analyses were used to determine strength of association between quantitative outcomes. Results. Reported benefits of SGL included team building, simulation training, enhancement of procedural skills, and the opportunity to discuss opinions on clinical management. SGL scored more favourably with regard to improving clinical practice, enjoyment of learning, and building peer-to-peer relations. Lectures scored more favourably at improving medical knowledge. Preference towards SGL over lectures for overall training increased with years of clinical experience (95% confidence interval (CI 0.16 - 0.62, p=0.002, Spearman’s rho 0.51, and the perception that SGL reinforces learner-teacher relationships correlated with seniority within residency training (95% CI 0.14 - 0.86, p=0.007, Spearman’s rho 0.47. Conclusion. Techniques of SGL were perceived as effective at improving clinical practice in the emergency department setting. These modalities may be more favourably accepted by more experienced physician learners – therefore, new EM teaching programmes in Africa should consider these factors when targeting educational strategies for their respective regions and learner
Watson-Jones, Deborah; Baisley, Kathy; Ponsiano, Riziki; Lemme, Francesca; Remes, Pieter; Ross, David; Kapiga, Saidi; Mayaud, Philippe; de Sanjosé, Silvia; Wight, Daniel; Changalucha, John; Hayes, Richard
Background.We compared vaccine coverage achieved by 2 different delivery strategies for the quadrivalent human papillomavirus (HPV) vaccine in Tanzanian schoolgirls. Methods.In a cluster-randomized trial of HPV vaccination conducted in Tanzania, 134 primary schools were randomly assigned to class-based (girls enrolled in primary school grade [class] 6) or age-based (girls born in 1998; 67 schools per arm) vaccine delivery. The primary outcome was coverage by dose. Results.There were 3352 and 2180 eligible girls in schools randomized to class-based and age-based delivery, respectively. HPV vaccine coverage was 84.7% for dose 1, 81.4% for dose 2, and 76.1% for dose 3. For each dose, coverage was higher in class-based schools than in age-based schools (dose 1: 86.4% vs 82.0% [P = .30]; dose 2: 83.8% vs 77.8% [P = .05]; and dose 3: 78.7% vs 72.1% [P = .04]). Vaccine-related adverse events were rare. Reasons for not vaccinating included absenteeism (6.3%) and parent refusal (6.7%). School absenteeism rates prior to vaccination ranged from 8.1% to 23.5%. Conclusions.HPV vaccine can be delivered with high coverage in schools in sub-Saharan Africa. Compared with age-based vaccination, class-based vaccination located more eligible pupils and achieved higher coverage. HPV vaccination did not increase absenteeism rates in selected schools. Innovative strategies will be needed to reach out-of-school girls. Clinical Trials Registration. NCT01173900. PMID:22711908
Schellenberg, D.; Schellenberg, J. R. M. Armstrong; Mushi, A.; Savigny, D. de; Mgalula, L.; Mbuya, C.; Victora, C. G.
OBJECTIVE: To document the prevalence, age-distribution, and risk factors for anaemia in Tanzanian children less than 5 years old, thereby assisting in the development of effective strategies for controlling anaemia. METHODS: Cluster sampling was used to identify 2417 households at random from four contiguous districts in south-eastern United Republic of Tanzania in mid-1999. Data on various social and medical parameters were collected and analysed. FINDINGS: Blood haemoglobin concentrations (Hb) were available for 1979 of the 2131 (93%) children identified and ranged from 1.7 to 18.6 g/dl. Overall, 87% (1722) of children had an Hb <11 g/dl, 39% (775) had an Hb <8 g/dl and 3% (65) had an Hb <5 g/dl. The highest prevalence of anaemia of all three levels was in children aged 6-11 months, of whom 10% (22/226) had an Hb <5 g/dl. However, the prevalence of anaemia was already high in children aged 1-5 months (85% had an Hb <11 g/dl, 42% had an Hb <8 g/dl, and 6% had an Hb <5 g/dl). Anaemia was usually asymptomatic and when symptoms arose they were nonspecific and rarely identified as a serious illness by the care provider. A recent history of treatment with antimalarials and iron was rare. Compliance with vaccinations delivered through the Expanded Programme of Immunization (EPI) was 82% and was not associated with risk of anaemia. CONCLUSION: Anaemia is extremely common in south-eastern United Republic of Tanzania, even in very young infants. Further implementation of the Integrated Management of Childhood Illness algorithm should improve the case management of anaemia. However, the asymptomatic nature of most episodes of anaemia highlights the need for preventive strategies. The EPI has good coverage of the target population and it may be an appropriate channel for delivering tools for controlling anaemia and malaria. PMID:14576890
Wilkinson, A L; Pedersen, S H; Urassa, M; Michael, D; Andreasen, A; Todd, J; Kinung'hi, S M; Changalucha, J; McDermid, J M
HIV infection is associated with chronic systemic inflammation, with or without antiretroviral therapy. Consequences for foetal growth are not understood, particularly in settings where multiple maternal infections and malnutrition are common. The study was designed to examine maternal systemic circulating and umbilical cord blood cytokine concentrations in relation to birth anthropometry in a Tanzanian prospective cohort. A 9-plex panel of maternal plasma cytokines in HIV-positive (n = 44) and HIV-negative (n = 70) mothers and the same cytokines in umbilical cord blood collected at delivery was assayed. Linear regression modelled associations between maternal or cord blood cytokines and birth anthropometry. Health indicators (haemoglobin, mid-upper-arm circumference, body mass index) in HIV-positive mothers without considerable immunosuppression did not differ from HIV-negative women. Despite this, HIV-exposed infants had lower birthweight and length. Subgroup analyses indicated that HIV management using HAART was associated with lower plasma TNF-α, as were longer durations of any antiretroviral therapy (≥2 months). Greater maternal plasma TNF-α was associated with earlier delivery (-1.7 weeks, P = 0.039) and lower birthweights (-287 g; P = 0.020), while greater umbilical cord TNF-α (-1.43 cm; P = 0.036) and IL-12p70 (-2.4 cm; P = 0.008) were associated with shorter birth length. Birthweight was inversely associated with cord IL-12p70 (-723 g; P = 0.001) and IFN-γ (-482 g, P = 0.007). Maternal cytokines during pregnancy did not correlate with umbilical cord cytokines at delivery. Systemic inflammation identified in maternal plasma or umbilical cord blood was associated with poorer birth anthropometrics in HIV-exposed and HIV-unexposed infants. Controlling maternal and/or foetal systemic inflammation may improve birth anthropometry. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Recently a correspondence in Zootaxa (Ceríaco et al., 2016) with more than 450 signatories including taxonomists, curators and other taxonomy users from all continents has received wide attention and has stimulated extensive discussion (a true buzz) around the possible interpretations of the Code (ICZN) about photography in taxonomy (Researchgate website link). This short note was necessary to recall the necessity of preserved specimens as vouchers for taxonomy, in response to photography-based taxonomy (PBT) as defended by Pape et al. (2016), and in a broad sense, for all the life sciences. This had been widely discussed and argued by Dubois & Nemésio (2007) who concluded on the importance of vouchers in taxonomy. But if the subject of these papers and discussions are about photography as the only way to document a new species, none of them discussed really what photography could represent in enhancing knowledge in natural sciences based on collections of specimens including type series and in association with other media (video and sound).
Fabian, Flora M
This study was aimed at documenting the location, shape, and direction of the opening of the mental foramen in dry mandibles of adult black Tanzanian population. A hundred mandibles were available for studying. In 45% the mental foramen was located below the apex of the second premolar, 35% between the second premolar and the first molar, 12% between the first premolar and second premolar and 8% below the first molar. The mental foramen was asymmetrically located between the right and left sides in 78% of the mandibles. The shape of the mental foramen was oval in 54% and rounded in 46% of the mandibles observed. The direction of opening was superiorly in 44%, posterosuperiorly in 40%, labially in 10%, mesially (anteriorly) in 3%, and posteriorly in 3%. Unilateral double mental foramen was observed in 3% of the mandibles. In conclusion these results showed that the mental foramen in the dry mandibles of adult black male Tanzanians was located mostly below the apices of the second premolar or more posteriorly (80%) while only a small percentage was located between the first andsecond premolars. This is different from previous reports. In more than half the shape was oval and it was rounded in less than half of the mandibles. The opening was mainly superiorly and posterosuperiorly, with a small percentage opening labially, mesially (anteriorly) and posteriorly.
Meuwissen, L.E.; Gorter, A.C.; Kester, A.D.M.; Knottnerus, J.A.
Background: Little is known about how sexual and reproductive (SRH) health can be made accessible and appropriate to adolescents. This study evaluates the impact and sustainability of a competitive voucher program on the quality of SRH care for poor and underserved female adolescents and the
Fung, Kit Ho; Lam, Chi Chung
Voucher systems are based on the theoretical assumption that giving parents a choice of schools subjects institutions to the mechanism of market forces, which, in turn, pushes them to reform their services. While the ability of parents to make sound educational choices on behalf of their children is questioned by opponents of school choice,…
... for Policy Development and Research, HUD. ACTION: Notice of Final Fiscal Year (FY) 2013 Fair Market... URBAN DEVELOPMENT Final Fair Market Rents for the Housing Choice Voucher Program and Moderate... staff. Questions on how to conduct FMR surveys or concerning further methodological explanations may be...
... for Policy Development and Research, HUD. ACTION: Notice of Final Fiscal Year (FY) 2013 Fair Market... URBAN DEVELOPMENT Final Fair Market Rents for the Housing Choice Voucher Program and Moderate... standards should be directed to the respective local HUD program staff. Questions on how to conduct FMR...
Reichard, Joshua D.
This study was designed to determine whether parent religiosity is a statistically significant school choice factor. The Duke University Religion Index (DUREL) was administered to 215 parents in an urban, PreK-12 religious private school that participated in the Ohio Educational Choice (EdChoice) voucher program. The null hypothesis that there was…
Austin, Megan J.
Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…
Full Text Available Abstract Background Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Methods/Design Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. Discussion This is a quasi-experimental study which will investigate the impact of the voucher approach on improving
Mackenzie, Graham; Dougall, Angela
Poverty has a detrimental impact on health and wellbeing. Healthy Start food and vitamin vouchers provide support for low income families across the UK, but at least 25% of eligible women and children miss out. We set out to increase uptake, with an aim of 90% of eligible women and children (n~540 eligible, varying over time) receiving vouchers in the initial team's catchment area by December 2015. Starting with one midwife and one pregnant woman in March 2014 we used the model for improvement to identify ways to improve documentation, sign up, and referral. Weekly data on process measures and monthly data on voucher receipt were plotted on run charts. Comparing medians for January-June 2014 and March-August 2015 there was a 13.3% rise in voucher receipt in Lothian (increase from 313 to 355 women), versus an 8.4% decline for the rest of Scotland (fall from 1688 to 1546 women). Figures varied by team, influenced by staff, family, and area factors. The initial aim proved unrealistic, as signing up a woman for vouchers increases both the numerator and denominator. Accordingly, the percentage uptake has not increased at a regional level (remains at 75%), though the figure for the initiating team ("team 3" in graphs) has increased from 73.0% (January 2014) to 79.0% (November 2015). We have continued testing, achieving recent increases in the number of women referred for welfare rights advice on benefits, tax credits, employment rights, childcare, and debt, securing on average £4,500 per client during 2015/16 (£404k for 89 clients by mid September 2015). This improvement project, part of the Early Years Collaborative in Scotland, has had a measureable impact on pregnant women across Lothian. Success has relied on testing, an electronic maternity record, rapid dissemination of findings through direct engagement with clinical teams, and persistence. Our findings have relevance across the UK, particularly at a time of worsening finances for many families.
Khurram Azmat, Syed; Tasneem Shaikh, Babar; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Asghar, Jamshaid; Ishaque, Muhammad; Ahmed, Aftab; Bilgrami, Mohsina
Background Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society – a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan. Methodology We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11. Results Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers. Conclusion Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training
Full Text Available Perusahaan Listrik Negara (PLN has implemented a smart electricity system or prepaid electricity. The customers pay the electricity voucher first before use the electricity. The token contained in electricity voucher that has been purchased by the customer is inserted into the Meter Prabayar (MPB installed in the location of customers. When a customer purchases a voucher, it will get a receipt that contains all of the customer's identity and the 20-digit of voucher code (token to be entered into MPB as a substitute for electrical energy credit. Receipts obtained by the customer is certainly vulnerable to loss, or hijacked by unresponsible parties. In this study, authors designed and develop an android based application by utilizing QR code technology as a replacement for the receipt of prepaid electricity credit which contains the identity of the customer and the 20-digit voucher code. The application is developed by implemented waterfall methodology. The implementation process of the waterfall methods used, are (1 analysis of functional requirement of the system by conducting a preliminary study and data collection based on field studies and literature, (2 system design by using UML diagrams and Business Process Model Notation (BPMN and Entity Relationship diagram (ERD, (3 design implementation by using OOP (Object Oriented programming technique. Web application is developed by using laravel PHP framework and database MySQL while mobile application is developed by using B4A (4 developed system is tested by using blackbox method testing. Final result of this research is a Web and mobile applications for the sale of electricityvoucher by QR Code technology.
Syed Khurram Azmat
Full Text Available Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan.We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11.Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1% was recorded in the uptake of IUCDs, which were being promoted with vouchers.Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training, accreditation and branding of the
Azmat, Syed Khurram; Khurram Azmat, Syed; Shaikh, Babar Tasneem; Tasneem Shaikh, Babar; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Asghar, Jamshaid; Ishaque, Muhammad; Ahmed, Aftab; Bilgrami, Mohsina
Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan. We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11. Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers. Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training, accreditation and branding of the service providers
Plasman, M.; Tiberi, C.; Ebinger, C.; Gautier, S.; Albaric, J.; Peyrat, S.; Déverchère, J.; Le Gall, B.; Tarits, P.; Roecker, S.; Wambura, F.; Muzuka, A.; Mulibo, G.; Mtelela, K.; Msabi, M.; Kianji, G.; Hautot, S.; Perrot, J.; Gama, R.
Rifting in a cratonic lithosphere is strongly controlled by several interacting processes including crust/mantle rheology, magmatism, inherited structure and stress regime. In order to better understand how these physical parameters interact, a 2 yr long seismological experiment has been carried out in the North Tanzanian Divergence (NTD), at the southern tip of the eastern magmatic branch of the East African rift, where the southward-propagating continental rift is at its earliest stage. We analyse teleseismic data from 38 broad-band stations ca. 25 km spaced and present here results from their receiver function (RF) analysis. The crustal thickness and Vp/Vs ratio are retrieved over a ca. 200 × 200 km2 area encompassing the South Kenya magmatic rift, the NTD and the Ngorongoro-Kilimanjaro transverse volcanic chain. Cratonic nature of the lithosphere is clearly evinced through thick (up to ca. 40 km) homogeneous crust beneath the rift shoulders. Where rifting is present, Moho rises up to 27 km depth and the crust is strongly layered with clear velocity contrasts in the RF signal. The Vp/Vs ratio reaches its highest values (ca. 1.9) beneath volcanic edifices location and thinner crust, advocating for melting within the crust. We also clearly identify two major low-velocity zones (LVZs) within the NTD, one in the lower crust and the second in the upper part of the mantle. The first one starts at 15-18 km depth and correlates well with recent tomographic models. This LVZ does not always coexist with high Vp/Vs ratio, pleading for a supplementary source of velocity decrease, such as temperature or composition. At a greater depth of ca. 60 km, a mid-lithospheric discontinuity roughly mimics the step-like and symmetrically outward-dipping geometry of the Moho but with a more slanting direction (NE-SW) compared to the NS rift. By comparison with synthetic RF, we estimate the associated velocity reduction to be 8-9 per cent. We relate this interface to melt ponding
Full Text Available It is uncertain to what extent oral supplementation with zinc can reduce episodes of malaria in endemic areas. Protection may depend on other nutrients. We measured the effect of supplementation with zinc and other nutrients on malaria rates.In a 2×2 factorial trial, 612 rural Tanzanian children aged 6-60 months in an area with intense malaria transmission and with height-for-age z-score≤-1.5 SD were randomized to receive daily oral supplementation with either zinc alone (10 mg, multi-nutrients without zinc, multi-nutrients with zinc, or placebo. Intervention group was indicated by colour code, but neither participants, researchers, nor field staff knew who received what intervention. Those with Plasmodium infection at baseline were treated with artemether-lumefantrine. The primary outcome, an episode of malaria, was assessed among children reported sick at a primary care clinic, and pre-defined as current Plasmodium infection with an inflammatory response, shown by axillary temperature ≥37.5°C or whole blood C-reactive protein concentration ≥ 8 mg/L. Nutritional indicators were assessed at baseline and at 251 days (median; 95% reference range: 191-296 days. In the primary intention-to-treat analysis, we adjusted for pre-specified baseline factors, using Cox regression models that accounted for multiple episodes per child. 592 children completed the study. The primary analysis included 1,572 malaria episodes during 526 child-years of observation (median follow-up: 331 days. Malaria incidence in groups receiving zinc, multi-nutrients without zinc, multi-nutrients with zinc and placebo was 2.89/child-year, 2.95/child-year, 3.26/child-year, and 2.87/child-year, respectively. There was no evidence that multi-nutrients influenced the effect of zinc (or vice versa. Neither zinc nor multi-nutrients influenced malaria rates (marginal analysis; adjusted HR, 95% CI: 1.04, 0.93-1.18 and 1.10, 0.97-1.24 respectively. The prevalence of zinc
Gunaratna, Nilupa S.; Masanja, Honorati; Mrema, Sigilbert; Levira, Francis; Spiegelman, Donna; Hertzmark, Ellen; Saronga, Naomi; Irema, Kahema; Shuma, Mary; Elisaria, Ester; Fawzi, Wafaie
Objective Women’s nutritional status during conception and early pregnancy can influence maternal and infant outcomes. This study examined the efficacy of pre-pregnancy supplementation with iron and multivitamins to reduce the prevalence of anemia during the periconceptional period among rural Tanzanian women and adolescent girls. Design A double-blind, randomized controlled trial was conducted in which participants were individually randomized to receive daily oral supplements of folic acid alone, folic acid and iron, or folic acid, iron, and vitamins A, B-complex, C, and E at approximately single recommended dietary allowance (RDA) doses for six months. Setting Rural Rufiji District, Tanzania. Subjects Non-pregnant women and adolescent girls aged 15–29 years (n = 802). Results The study arms were comparable in demographic and socioeconomic characteristics, food security, nutritional status, pregnancy history, and compliance with the regimen (p>0.05). In total, 561 participants (70%) completed the study and were included in the intention-to-treat analysis. Hemoglobin levels were not different across treatments (median: 11.1 g/dL, Q1-Q3: 10.0–12.4 g/dL, p = 0.65). However, compared with the folic acid arm (28%), there was a significant reduction in the risk of hypochromic microcytic anemia in the folic acid and iron arm (17%, RR: 0.61, 95% CI: 0.42–0.90, p = 0.01) and the folic acid, iron, and multivitamin arm (19%, RR: 0.66, 95% CI: 0.45–0.96, p = 0.03). Inverse probability of treatment weighting (IPTW) to adjust for potential selection bias due to loss to follow-up did not materially change these results. The effect of the regimens was not modified by frequency of household meat consumption, baseline underweight status, parity, breastfeeding status, or level of compliance (in all cases, p for interaction>0.2). Conclusions Daily oral supplementation with iron and folic acid among women and adolescents prior to pregnancy reduces risk of anemia. The
Nilupa S Gunaratna
Full Text Available Women's nutritional status during conception and early pregnancy can influence maternal and infant outcomes. This study examined the efficacy of pre-pregnancy supplementation with iron and multivitamins to reduce the prevalence of anemia during the periconceptional period among rural Tanzanian women and adolescent girls.A double-blind, randomized controlled trial was conducted in which participants were individually randomized to receive daily oral supplements of folic acid alone, folic acid and iron, or folic acid, iron, and vitamins A, B-complex, C, and E at approximately single recommended dietary allowance (RDA doses for six months.Rural Rufiji District, Tanzania.Non-pregnant women and adolescent girls aged 15-29 years (n = 802.The study arms were comparable in demographic and socioeconomic characteristics, food security, nutritional status, pregnancy history, and compliance with the regimen (p>0.05. In total, 561 participants (70% completed the study and were included in the intention-to-treat analysis. Hemoglobin levels were not different across treatments (median: 11.1 g/dL, Q1-Q3: 10.0-12.4 g/dL, p = 0.65. However, compared with the folic acid arm (28%, there was a significant reduction in the risk of hypochromic microcytic anemia in the folic acid and iron arm (17%, RR: 0.61, 95% CI: 0.42-0.90, p = 0.01 and the folic acid, iron, and multivitamin arm (19%, RR: 0.66, 95% CI: 0.45-0.96, p = 0.03. Inverse probability of treatment weighting (IPTW to adjust for potential selection bias due to loss to follow-up did not materially change these results. The effect of the regimens was not modified by frequency of household meat consumption, baseline underweight status, parity, breastfeeding status, or level of compliance (in all cases, p for interaction>0.2.Daily oral supplementation with iron and folic acid among women and adolescents prior to pregnancy reduces risk of anemia. The potential benefits of supplementation on the risk of
Fischer, Sara Elisa; Strandberg-Larsen, Martin
Global health policy is created largely through a collaborative process between development agencies and aid-recipient governments, yet it remains unclear whether governments retain ownership over the creation of policy in their own countries. An assessment of the power structure in this relationship and its influence over agenda-setting is thus the first step towards understanding where progress is still needed in policy-making for development. This study employed qualitative policy analysis methodology to examine how health-related policy agendas are adopted in low-income countries, using Tanzania as a case study. Semi-structured, in-depth, key informant interviews with 11 policy-makers were conducted on perspectives of the agenda-setting process and its actors. Kingdon's stream theory was chosen as the lens through which to interpret the data analysis. This study demonstrates that while stakeholders each have ways of influencing the process, the power to do so can be assessed based on three major factors: financial incentives, technical expertise, and influential position. Since donors often have two or all of these elements simultaneously a natural power imbalance ensues, whereby donor interests tend to prevail over recipient government limitations in prioritization of agendas. One way to mediate these imbalances seems to be the initiation of meaningful policy dialogue. In Tanzania, the agenda-setting process operates within a complex network of factors that interact until a "policy window" opens and a decision is made. Power in this process often lies not with the Tanzanian government but with the donors, and the contrast between latent presence and deliberate use of this power seems to be based on the donor ideology behind giving aid (defined here by funding modality). Donors who used pooled funding (PF) modalities were less likely to exploit their inherent power, whereas those who preferred to maintain maximum control over the aid they provided (ie, non
Hellström, Andreas M; Almgren, Annette; Carlsson, Nils-Gunnar; Svanberg, Ulf; Andlid, Thomas A
The fermented cereal-based gruel togwa is used as weaning food for children in Tanzania. Togwa is rich in minerals but these are often not available for uptake in the human intestine due to natural inhibitors, such as phytate (IP(6)). The yeasts Pichia kudriavzevii TY13, Hanseniaspora guilliermondii TY14 and TY20, isolated from Tanzanian togwa, and selected for high phytase activity in complex yeast medium YPD, were now studied regarding their ability to degrade IP(6) in maize-based model togwa. A modified constitutively high-phytase producing Saccharomyces cerevisiae BY80 and commercial Aspergillus ficuum phytase were included for comparison. In addition, a strain of Lactobacillus plantarum was included in the model-togwa set-up. All yeasts in the study grew and reached final cell density 1.5-2 log units higher than the start value. S. cerevisiae BY80 degraded 85% of the IP(6) in 48 h; the same degradation level as with A. ficuum phytase (89%). Of the togwa-isolated yeasts, P. kudriavzevii TY13 and H. guilliermondii TY14 showed strong phytate degradation in the model-togwa; 95% or more of the initial IP(6) was degraded after 48 h. This corresponds to a remaining level of 0.4 and 0.3μmol IP(6)/g dw. Co-inoculation with L. plantarum did not increase IP(6) degradation. Moreover, fermentation with P. kudriavzevii TY13 yielded a successive increase in inorganic phosphate (P(i)), from 0.7 to 5.4 mM, suggesting a phytase production in TY13 which is fairly insensitive to P(i) repression. The study shows that phytate in a model togwa is available for yeast phytase enzymes, and addresses the importance of strain selection for effectively degrading the phytate. Certain yeasts originating from togwa seem to have developed a natural high phytase production, and P. kudriavzevii TY13 and H. guilliermondii TY14 seem particularly well adapted to phytate degradation in togwa, and is our choice for further studies and strain improvement. Copyright © 2011 Elsevier B.V. All rights
Gerrets Rene PM
Full Text Available Abstract Background Tanzania has a well-developed network of commercial ITN retailers. In 2004, the government introduced a voucher subsidy for pregnant women and, in mid 2005, helped distribute free nets to under-fives in small number of districts, including Rufiji on the southern coast, during a child health campaign. Contributions of these multiple insecticide-treated net delivery strategies existing at the same time and place to coverage in a poor rural community were assessed. Methods Cross-sectional household survey in 6,331 members of randomly selected 1,752 households of 31 rural villages of Demographic Surveillance System in Rufiji district, Southern Tanzania was conducted in 2006. A questionnaire was administered to every consenting respondent about net use, treatment status and delivery mechanism. Findings Net use was 62.7% overall, 87.2% amongst infants (0 to1 year, 81.8% amongst young children (>1 to 5 years, 54.5% amongst older children (6 to 15 years and 59.6% amongst adults (>15 years. 30.2% of all nets had been treated six months prior to interview. The biggest source of nets used by infants was purchase from the private sector with a voucher subsidy (41.8%. Half of nets used by young children (50.0% and over a third of those used by older children (37.2% were obtained free of charge through the vaccination campaign. The largest source of nets amongst the population overall was commercial purchase (45.1% use and was the primary means for protecting adults (60.2% use. All delivery mechanisms, especially sale of nets at full market price, under-served the poorest but no difference in equity was observed between voucher-subsidized and freely distributed nets. Conclusion All three delivery strategies enabled a poor rural community to achieve net coverage high enough to yield both personal and community level protection for the entire population. Each of them reached their relevant target group and free nets only temporarily
Eze, Ikenna C; Kramer, Karen; Msengwa, Amina; Mandike, Renata; Lengeler, Christian
To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007-2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria.
Yam, Carrie H K; Liu, Su; Huang, Olivia H Y; Yeoh, E K; Griffiths, Sian M
As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of
Full Text Available Abstract Background As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership. Methods This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program. Results 71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4% and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours. Conclusions Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The
Carder, Paula; Luhr, Gretchen; Kohon, Jacklyn
Affordable housing is an important form of income security for low-income older persons. This article describes characteristics of older persons waitlisted for either public housing or a housing choice voucher (HCV; previously Section 8) in Portland, Oregon. 358 persons (32% response rate) completed a mailed survey with questions about demographics, health and housing status, food insecurity, and preference for housing with services. Findings indicate that many waitlisted older persons experienced homelessness or housing instability, poor health, high hospital use, and food insecurity. Public housing applicants were significantly more likely to report lower incomes, homelessness, and food insecurity than HCV applicants. We conclude with policy implications for housing and health agencies that serve low-income older persons.
Giantsis, Ioannis A; Chaskopoulou, Alexandra; Bon, Marie Claude
Nondestructive techniques allow the isolation of genomic DNA, without damaging the morphological features of the specimens. Though such techniques are available for numerous insect groups, they have not been applied to any member of the medically important families of mosquitoes (Diptera: Culicidae) and phlebotomine sand flies (Diptera: Psychodidae). This study presents Mild-Vectolysis, the first nondestructive DNA extraction methodology for vouchering taxa of mosquitoes and sand flies, which provided sufficient amounts of DNA, tested in a verified barcode (cytochrome oxidase I gene), while preserving their morphological integrity. Application of the method to sand flies allowed successful insect identification post DNA extraction, as all basic taxonomical structures necessary for identification (pharynx, cybarium, and genitalia) remained intact. The development of the methodology was more challenging in mosquitoes, due to the fragility of key morphological characters (scales and color). A small modification of the lysis buffer concentration, in combination with the adjustment of the incubation time, a postlysis freezing stage, and the avoidance of ethanol, achieved the extraction of sufficient DNA quantity, while preserving the integument of the mosquitoes, although a small proportion of the scales and the color still appeared to have been lost. In addition to the practicality and efficiency of our methodology, preserving of the original insect specimen post DNA extraction is highly advantageous, as it allows for 1) utilization of the specimen for further analysis and 2) storage for vouchering. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: email@example.com.
Rumisha, Cyrus; Leermakers, Martine; Elskens, Marc; Mdegela, Robinson H; Gwakisa, Paul; Kochzius, Marc
The genetic diversity of giant tiger prawns in relation to trace metals (TMs) pollution was analysed using 159 individuals from eight sites at the Tanzanian coast. The seven microsatellites analysed showed high degree of polymorphism (4-44 alleles). The measured genetic diversity (H o =0.592±0.047) was comparable to that of populations in the Western Indian Ocean. Apart from that, correlation analysis revealed significant negative associations between genetic diversity and TMs pollution (ppollution. This suggests that TMs affect larvae settlement and it may account for the measured deficiency of heterozygosity. This calls for strengthened pollution control measures in order to conserve this commercially important species. Copyright © 2016 Elsevier Ltd. All rights reserved.
Rustenhoven-Spaan, Ilona; Melkert, Peter; Nelissen, Ellen; van Roosmalen, Jos; Stekelenburg, Jelle
Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home delivery that day. She presented with a 2 day history of fever, headache, general body malaise and vomiting. She was misdiagnosed as having severe malaria and was treated with quinine. The blood slide showed Borrelia duttoni. The patient continued treatment with procaine penicillin fortified for relapsing fever. Several hours later the woman died, probably due to JHR. This case of a patient with relapsing fever who died from a JHR stresses the importance of adequate diagnosis and treatment which should include careful monitoring, especially for the first hours after starting antibiotics.
Azmat, Syed Khurram; Shaikh, Babar Tasneem; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Asghar, Jamshaid; Ishaque, Muhammad; Ahmed, Aftab; Bilgrami, Mohsina
Background: Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor....
Bua, John; Paina, Ligia; Kiracho, Elizabeth Ekirapa
In spite of the investments made by the Ugandan Government, the utilisation of maternal health services has remained low, resulting in a high maternal mortality (438 maternal deaths per 100,000 live births). Aiming to reduce poor women's constraints to the utilisation of services, an intervention consisting of a voucher scheme and health system strengthening was implemented. This paper presents the lessons learnt during the setup and implementation of the intervention in Eastern Uganda, in order to inform the design and scale up of similar future interventions. The key lessons were synthesised from a variety of project reports, as well as qualitative data drawn from six focus group discussions and four in-depth interviews conducted in the Buyende and Pallisa districts during the implementation phase of the voucher scheme. To promote the successful implementation of interventions with demand and supply side initiatives, such as voucher schemes, the health system should be able to respond to the demand created by providing the additional required resources such as health workers, essential supplies and equipment. Involving a diverse, multi-sectoral group of stakeholders is important for addressing the different barriers experienced by women when seeking maternal health services. Voucher schemes should have a mechanism of detecting unintended consequences and mitigating them. Sustainability plans should be built into such interventions to maintain the gains achieved. Lastly, health policy planners can use this information to develop follow-up programmes to test modified versions that are more sustainable. Such programmes could use locally existing community structures for management and resource mobilisation for self-sustainment.
Kalous, L.; Šlechtová, Věra; Petrtýl, M.; Kohout, Jan; Čech, Martin
Roč. 26, č. 4 (2010), s. 614-617 ISSN 0175-8659 R&D Projects: GA ČR GA206/06/1371; GA ČR GP206/09/P266 Institutional research plan: CEZ:AV0Z50450515; CEZ:AV0Z60170517 Keywords : small fish * voucher * desktop scanner Subject RIV: GL - Fishing Impact factor: 0.945, year: 2010
Orphans and other vulnerable children (OVC) who grow up in institutional care often show communication and language problems. The caregivers lack training, and there are few language didactics programmes aimed at supporting communication and language development in OVC in institutional care in Tanzania. The purpose of the study was to adapt the German concept of relational communication therapy (RCT) as a support to language development in a Tanzanian early childhood education context in a culturally sensitive way. Following the adaptation of the concept, a training programme for Tanzanian caregiver students was developed to compare their competencies in language didactics before and after training. A convergent mixed methods design was used to examine changes following training in 12 participating caregiver students in a Tanzanian orphanage. The competencies in relational language didactics were assessed by a self-developed test and video recordings before and after intervention. Based on the results, we drew conclusions regarding necessary modifications to the training modules and to the concept of RCT. The relational didactics competencies of the caregiver students improved significantly following their training. A detailed analysis of the four training modules showed that the improvement in relational didactics competencies varied depending on the topic and the teacher. The results provide essential hints for the professionalisation of caregivers and for using the concept of RCT for OVC in institutional care in Tanzania. Training programmes and concepts should not just be transferred across different cultures, disciplines and settings; they must be adapted to the specific cultural setting.
Topp, Libby; Islam, M Mofizul; Day, Carolyn Ann
Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20-30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); χ(2)=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; ppayment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use.
Marlin, Robert W; Young, Sean D; Bristow, Claire C; Wilson, Greg; Rodriguez, Jeffrey; Ortiz, Jose; Mathew, Rhea; Klausner, Jeffrey D
Up to half of all new HIV cases in Los Angeles may be caused by the 20-30% of men who have sex with men (MSM) with unrecognized HIV infection. Racial/ethnic minority MSM are at particularly high risk for being sero-unaware and due to stigma and poor healthcare access might benefit from novel private, self-testing methods, such as the recently FDA-approved OraQuick® In-Home HIV Test. From July-November 2013, we undertook a pilot study to examine the feasibility of a voucher program for free OraQuick® tests targeting African American MSM in Los Angeles. We determined feasibility based on: (1) the establishment of a voucher redemption and third-party payment system, (2) the willingness of community-based organizations (CBOs) to disseminate vouchers, and (3) the collection of user demographics, test and linkage-to-care results with an anonymous telephone survey. We partnered with Walgreens® to create a voucher and third-party reimbursement system for free OraQuick® tests. Voucher distribution was divided into two periods. In total, 641 vouchers were supplied to CBOs: 274 (42.7%) went to clients and of those 53 (19.3%) were redeemed. Fifty (18.2%) of the 274 clients were surveyed: 44 (88%) were African American, 39 (78%) reported being likely to repeat voucher use, 44 (88%) reported reviewing pre-test information, and 37 (74%) the post-test information. Three (6%) of 50 survey respondents reported newly testing HIV-positive of whom all (100%) reported seeking medical care. Two withheld their results, both of whom also sought medical care. Developing and partnering with a commercial pharmacy to institute a voucher system to facilitate HIV self-testing with linkage-to-care was feasible. Our findings suggest the voucher program was associated with increasing the identification of new cases of HIV infection with high rates of linkage to care. Expanded research and evaluation of voucher programs for HIV self-test kits among high-risk groups is warranted.
Suresh K. PATEL
Full Text Available Occurrence of Isoetes coromandeliana L.f. in natural ponds of Harni, Savali and Tuwa (India is known since 1956 by earlier workers. Equisetum debile Roxb. ex Voucher was also reported in 1962 growing as wild at Savali. Available literature indicates that I. coromandeliana falls under the category of ‘near threatened’ in Asian continents and as an ‘endangered species’ at national (India level. In the current field work study, the authors could not locate the investigated species from the locations earlier documented by researchers. Few saplings of I. coromandeliana were observed at Talod and Vaktapur near Gandhinagar, a new location for the species. In contrast, E. debile appeared to be lost in wild from Gujarat. Their extinction from earlier reported locations is associated with anthropogenic pressure and thus legal action for their protection is needed. The present paper suggests further survey and habitat based studies and recommends conservation and management action plans based upon the ecology of the habitat.
Gorter Anna C
Full Text Available Abstract Background Little is known about how sexual and reproductive (SRH health can be made accessible and appropriate to adolescents. This study evaluates the impact and sustainability of a competitive voucher program on the quality of SRH care for poor and underserved female adolescents and the usefulness of the simulated patient (SP method for such evaluation. Methods 28,711 vouchers were distributed to adolescents in disadvantaged areas of Managua that gave free-of-charge access to SRH care in 4 public, 10 non-governmental and 5 private clinics. Providers received training and guidelines, treatment protocols, and financial incentives for each adolescent attended. All clinics were visited by female adolescent SPs requesting contraception. SPs were sent one week before, during (with voucher and one month after the intervention. After each consultation they were interviewed with a standardized questionnaire. Twenty-one criteria were scored and grouped into four categories. Clinics' scores were compared using non-parametric statistical methods (paired design: before-during and before-after. Also the influence of doctors' characteristics was tested using non-parametric statistical methods. Results Some aspects of service quality improved during the voucher program. Before the program started 8 of the 16 SPs returned 'empty handed', although all were eligible contraceptive users. During the program 16/17 left with a contraceptive method (p = 0.01. Furthermore, more SPs were involved in the contraceptive method choice (13/17 vs.5/16, p = 0.02. Shared decision-making on contraceptive method as well as condom promotion had significantly increased after the program ended. Female doctors had best scores before- during and after the intervention. The improvements were more pronounced among male doctors and doctors older than 40, though these improvements did not sustain after the program ended. Conclusion This study illustrates provider
Full Text Available Abstract Background Few studies in Africa have explored in detail the ability of output-based aid (OBA voucher programs to increase access to gender-based violence recovery (GBVR services. Methods A qualitative study was conducted in 2010 and involved: (i in-depth interviews (IDIs with health managers, service providers, voucher management agency (VMA managers and (ii focus group discussions (FGDs with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya. Results The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services. Conclusions The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers.
Njuki, Rebecca; Okal, Jerry; Warren, Charlotte E; Obare, Francis; Abuya, Timothy; Kanya, Lucy; Undie, Chi-Chi; Bellows, Ben; Askew, Ian
Few studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services. A qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya. The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services. The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers.
Gries, Corinna; Gilbert, Edward E; Franz, Nico M
We review the Symbiota software platform for creating voucher-based biodiversity information portals and communities. Symbiota was originally conceived to promote small- to medium-sized, regionally and/or taxonomically themed collaborations of natural history collections. Over the past eight years the taxonomically diverse portals have grown into an important resource in North America and beyond for mobilizing, integrating, and using specimen- and observation-based occurrence records and derivative biodiversity information products. Designed to mirror the conceptual structure of traditional floras and faunas, Symbiota is exclusively web-based and employs a novel data model, information linking, and algorithms to provide highly dynamic customization. The themed portals enable meaningful access to biodiversity data for anyone from specialist to high school student. Symbiota emulates functionality of modern Content Management Systems, providing highly sophisticated yet intuitive user interfaces for data entry, batch processes, and editing. Each kind of content provision may be selectively accessed by authenticated information providers. Occupying a fairly specific niche in the biodiversity informatics arena, Symbiota provides extensive data exchange facilities and collaborates with other development projects to incorporate and not duplicate functionality as appropriate.
Full Text Available We review the Symbiota software platform for creating voucher-based biodiversity information portals and communities. Symbiota was originally conceived to promote small- to medium-sized, regionally and/or taxonomically themed collaborations of natural history collections. Over the past eight years the taxonomically diverse portals have grown into an important resource in North America and beyond for mobilizing, integrating, and using specimen- and observation-based occurrence records and derivative biodiversity information products. Designed to mirror the conceptual structure of traditional floras and faunas, Symbiota is exclusively web-based and employs a novel data model, information linking, and algorithms to provide highly dynamic customization. The themed portals enable meaningful access to biodiversity data for anyone from specialist to high school student. Symbiota emulates functionality of modern Content Management Systems, providing highly sophisticated yet intuitive user interfaces for data entry, batch processes, and editing. Each kind of content provision may be selectively accessed by authenticated information providers. Occupying a fairly specific niche in the biodiversity informatics arena, Symbiota provides extensive data exchange facilities and collaborates with other development projects to incorporate and not duplicate functionality as appropriate.
Gehl, Anthony C [ORNL; Liu, Xiaobing [ORNL; Koopman, Gary [KCF Technologies; Fugate, David L [ORNL
This document is to fulfill the final report requirements for the Small Business Voucher (SBV) CRADA project with ORNL and KCF Technologies (CRADA/NFE-16-06133). Pumping systems account for nearly 20% of the world’s electrical energy demand and range from 25-50% of the energy usage in many industrial and building power plants. The energy cost is the largest element in the total cost of owning a pump (~40%). In response to a recent DOE mandate for improved pump efficiency pump manufacturers are preparing for the changes that the impending regulations will bring, including design improvements. This mandate also establishes a need for new low cost pump efficiency measurement systems. The standard industry definition of pump efficiency is the mechanical water horsepower delivered divided by the electrical horsepower input to the motor. KCF Technologies has developed a new sensor measurement technique to estimate fluid pump efficiency using a thermodynamic approach. KCF Technologies applied for a SBV grant with ORNL as the research partner. KCF needed a research partner with the proper facilities to demonstrate the efficacy of its wireless sensor unit for measuring pump efficiency. The ORNL Building Technologies Research and Integration Center (BTRIC) test resources were used to test and demonstrate the successful measurement of pump efficiency with the KCF sensor technology. KCF is now working on next steps to commercialize this sensing technology.
Posti-Ahokas, Hanna; Lehtomäki, Elina
In Tanzania, the national examinations are used as the primary tools for selection and transition from lower to upper secondary education. Female students are more likely to fail in the national exams and to drop out from education. This article examines the perspectives of female students concerning their advancement in secondary education. Two…
Full Text Available Background. Hypertension is increasingly common in sub-Saharan Africa where traditional medicine use is also common. We conducted a hospital-based, mixed-methods study to determine prevalence, pattern, and correlates of herbal and alternative medicine use in Tanzanian adults hospitalized with hypertension. Methods. A standardized questionnaire was administered. In-depth interviews were performed on a subset of participants. Factors associated with herbal medicine use were determined by logistic regression. The association between traditional medicine uses and allopathic medication adherence was determined using ordinal logistic regression. Qualitative data were analyzed according to grounded theory. Results. Of 213 adults enrolled, 52 (24.4% reported using herbs during the previous month and 47 (22.1% reported concurrent use of herbs and allopathic medicines. Lower educational level, nonprofessional employment, and lack of health insurance were significantly associated with herbal medicine use. Alternative medicines use was not associated with lower medication adherence. Qualitative interviews identified several important themes including reasons for herbal medicine use. Conclusion. The use of traditional medicines is very common among patients with hypertension. Adults from low socioeconomic status, those with misunderstandings about hypertension, and those without health insurance were more likely to take herbs. Open, nonjudgmental communication between healthcare workers and patients regarding use of traditional medicines must be encouraged in Africa.
Lazenby, Gweneth B; Taylor, Peyton T; Badman, Barbara S; McHaki, Emil; Korte, Jeffrey E; Soper, David E; Young Pierce, Jennifer
The goal of this study was to determine the prevalence of vaginitis and its association with high-risk human papillomavirus (HR HPV) in women undergoing cervical cancer screening in rural Tanzania. For the purpose of cervical cancer screening, cytology and HR HPV polymerase chain reaction data were collected from 324 women aged between 30 and 60 years. Microscopy and gram stains were used to detect yeast and bacterial vaginosis. Cervical nucleic acid amplification test specimens were collected for the detection of Trichomonas vaginalis (TV), Chlamydia trachomatis, and Neisseria gonorrhoeae. The majority of women were married (320 of 324) and reported having a single sexual partner (270 of 324); the median age of participants was 41 years. HR HPV was detected in 42 participants. Forty-seven percent of women had vaginitis. Bacterial vaginosis was the most common infection (32.4%), followed by TV (10.4%), and yeast (6.8%). In multivariable logistic regression analysis, TV was associated with an increased risk of HR HPV (odds ratio, 4.2 [95% CI, 1.7-10.3]). Patients with TV were 6.5 times more likely to have HPV type 16 than patients negative for TV (50% vs 13.3%) (odds ratio, 6.5 [95% CI, 1.1-37]). Among rural Tanzanian women who presented for cervical cancer screening, Trichomonas vaginitis was significantly associated with HR HPV infection (specifically type 16). © 2014 Published by Elsevier HS Journals, Inc.
Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus–Dieter; Spies, Claudia
Introduction Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. Methods All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Results Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, pimproved to then decline again (63.3% in 2009; 70% in 2010; 58.6% in 2011). In the control group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Conclusion Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach. PMID:26327392
Krishnan, Suneeta; Vohra, Divya; de Walque, Damien; Medlin, Carol; Nathan, Rose; Dow, William H.
Intimate partner violence (IPV) is widely prevalent in Tanzania. Inequitable gender norms manifest in men's and women's attitudes about power and decision making in intimate relationships and are likely to play an important role in determining the prevalence of IPV. We used data from the RESPECT study, a randomized controlled trial that evaluated an intervention to prevent sexually transmitted infections in a cohort of young Tanzanian men and women, to examine the relationship between couples' attitudes about IPV, relationship power, and sexual decision making, concordance on these issues, and women's reports of IPV over 12 months. Women expressed less equitable attitudes than men at baseline. Over time, participants' attitudes tended to become more equitable and women's reports of IPV declined substantially. Multivariable logistic regression analyses suggested that inequitable attitudes and couple discordance were associated with higher risk of IPV. Our findings point to the need for a better understanding of the role that perceived or actual imbalances in relationship power have in heightening IPV risk. The decline in women's reports of IPV and the trend towards gender-equitable attitudes indicate that concerted efforts to reduce IPV and promote gender equity have the potential to make a positive difference in the relatively short term. PMID:23320151
Roediger, Rebecca; Jaka, Hyasinta; Bougaila, Amina; Smart, Luke; Langwick, Stacey
Background Hypertension is increasingly common in sub-Saharan Africa where traditional medicine use is also common. We conducted a hospital-based, mixed-methods study to determine prevalence, pattern, and correlates of herbal and alternative medicine use in Tanzanian adults hospitalized with hypertension. Methods A standardized questionnaire was administered. In-depth interviews were performed on a subset of participants. Factors associated with herbal medicine use were determined by logistic regression. The association between traditional medicine uses and allopathic medication adherence was determined using ordinal logistic regression. Qualitative data were analyzed according to grounded theory. Results Of 213 adults enrolled, 52 (24.4%) reported using herbs during the previous month and 47 (22.1%) reported concurrent use of herbs and allopathic medicines. Lower educational level, nonprofessional employment, and lack of health insurance were significantly associated with herbal medicine use. Alternative medicines use was not associated with lower medication adherence. Qualitative interviews identified several important themes including reasons for herbal medicine use. Conclusion The use of traditional medicines is very common among patients with hypertension. Adults from low socioeconomic status, those with misunderstandings about hypertension, and those without health insurance were more likely to take herbs. Open, nonjudgmental communication between healthcare workers and patients regarding use of traditional medicines must be encouraged in Africa. PMID:28634545
Yu, Min; Jiao, Lichao; Guo, Juan; Wiedenhoeft, Alex C; He, Tuo; Jiang, Xiaomei; Yin, Yafang
ITS2+ trnH - psbA was the best combination of DNA barcode to resolve the Dalbergia wood species studied. We demonstrate the feasibility of building a DNA barcode reference database using xylarium wood specimens. The increase in illegal logging and timber trade of CITES-listed tropical species necessitates the development of unambiguous identification methods at the species level. For these methods to be fully functional and deployable for law enforcement, they must work using wood or wood products. DNA barcoding of wood has been promoted as a promising tool for species identification; however, the main barrier to extensive application of DNA barcoding to wood is the lack of a comprehensive and reliable DNA reference library of barcodes from wood. In this study, xylarium wood specimens of nine Dalbergia species were selected from the Wood Collection of the Chinese Academy of Forestry and DNA was then extracted from them for further PCR amplification of eight potential DNA barcode sequences (ITS2, matK, trnL, trnH-psbA, trnV-trnM1, trnV-trnM2, trnC-petN, and trnS-trnG). The barcodes were tested singly and in combination for species-level discrimination ability by tree-based [neighbor-joining (NJ)] and distance-based (TaxonDNA) methods. We found that the discrimination ability of DNA barcodes in combination was higher than any single DNA marker among the Dalbergia species studied, with the best two-marker combination of ITS2+trnH-psbA analyzed with NJ trees performing the best (100% accuracy). These barcodes are relatively short regions (<350 bp) and amplification reactions were performed with high success (≥90%) using wood as the source material, a necessary factor to apply DNA barcoding to timber trade. The present results demonstrate the feasibility of using vouchered xylarium specimens to build DNA barcoding reference databases.
Ohly, Heather; Crossland, Nicola; Dykes, Fiona; Lowe, Nicola; Hall-Moran, Victoria
To explore how low-income pregnant women use Healthy Start food vouchers, the potential impacts of the programme, and which women might experience these impacts and why. A realist review. Primary or empirical studies (of any design) were included if they contributed relevant evidence or insights about how low-income women use food vouchers from the Healthy Start (UK) or the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) programmes. The assessment of 'relevance' was deliberately broad to ensure that reviewers remained open to new ideas from a variety of sources of evidence. A combination of evidence synthesis and realist analysis techniques was used to modify, refine and substantiate programme theories, which were constructed as explanatory 'context-mechanism-outcome'-configurations. 38 primary studies were included in this review: four studies on Healthy Start and 34 studies on WIC. Two main outcome strands were identified: dietary improvements (intended) and financial assistance (unintended). Three evidence-informed programme theories were proposed to explain how aspects of context (and mechanisms) may generate these outcomes: the 'relative value' of healthy eating (prioritisation of resources); retailer discretion (pressure to 'bend the rules'); the influence of other family members (disempowerment). This realist review suggests that some low-income pregnant women may use Healthy Start vouchers to increase their consumption of fruits and vegetables and plain cow's milk, whereas others may use them to reduce food expenditure and save money for other things. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Muller, Patricia A.; Boone, William J.; Metcalf, Kim K.
In many settings, the issue of publicly funded vouchers for students is being discussed. This article presents the results of evaluating test data from students living within the city boundaries of Cleveland, Ohio. In Cleveland, a limited number of low - socioeconomic status students can receive publicly funded vouchers. Data were analyzed using multivariate and univariate techniques. The results suggest that (a) students who did not return to the scholarship program from third to fourth grade exhibited lower achievement levels than those who remained in the program, (b) scholarship students who continued in the scholarship program from third to fourth grade continue to be very much like their public school counterparts, and (c) the effects of the program on scholarship students' academic performance are slightly positive but are mediated by the schools they attend. This study is important because vouchers may or may not provide a mechanism by which the participation of underrepresented groups in science and mathematics can be increased.
Kingkaew, Pritaporn; Werayingyong, Pitsaphun; Aye, San San; Tin, Nilar; Singh, Alaka; Myint, Phone; Teerawattananon, Yot
Reducing child and maternal mortality in order to meet the health-related Millennium Development Goals (MDGs) 4 and 5 remains a major challenge in Myanmar. Inadequate care during pregnancy and labour plays an important role in the maternal mortality rate in Myanmar. A Maternal and Child Health (MCH) Voucher Scheme comprising a subsidization for pregnant women to receive four antenatal care (ANC), delivery and postnatal care (PNC) free-of-charge was planned to help women overcome financial barriers in addition to raising awareness of ANC and delivery with skilled birth attendants (SBA), which can reduce the rate of maternal and neonatal death. This study is part of an ex-ante evaluation of a feasibility study of the MCH Voucher Scheme. A cost-utility analysis was conducted using a decision tree model to assess the cost per disability-adjusted life years (DALYs) averted from the MCH Voucher Scheme compared with the current situation. Most input parameters were obtained from Myanmar context. From the base-case analysis, where the financial burden on households was fully subsidized, the MCH Voucher Scheme increased utilization for ANC from 73% up to 93% and for delivery from SBAs from 51% up to and 71%, respectively; hence, it is considered to be very cost-effective with an incremental cost-effectiveness ratio of 381 027 kyats per DALY averted (2010, price year). From the probabilistic sensitivity analysis, the MCH Voucher Scheme had a 52% chance of being a cost-effective option at 1 GDP per capita threshold compared to the current situation. Given that the Voucher Scheme is currently being implemented in one township in Myanmar as a result of this study, ongoing evaluation of the effectiveness and cost-effectiveness of this scheme is warranted. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
Full Text Available Background: Orphans and other vulnerable children (OVC who grow up in institutional care often show communication and language problems. The caregivers lack training, and there are few language didactics programmes aimed at supporting communication and language development in OVC in institutional care in Tanzania. Objectives: The purpose of the study was to adapt the German concept of relational communication therapy (RCT as a support to language development in a Tanzanian early childhood education context in a culturally sensitive way. Following the adaptation of the concept, a training programme for Tanzanian caregiver students was developed to compare their competencies in language didactics before and after training. Methods: A convergent mixed methods design was used to examine changes following training in 12 participating caregiver students in a Tanzanian orphanage. The competencies in relational language didactics were assessed by a self-developed test and video recordings before and after intervention. Based on the results, we drew conclusions regarding necessary modifications to the training modules and to the concept of RCT. Results: The relational didactics competencies of the caregiver students improved significantly following their training. A detailed analysis of the four training modules showed that the improvement in relational didactics competencies varied depending on the topic and the teacher. Conclusion: The results provide essential hints for the professionalisation of caregivers and for using the concept of RCT for OVC in institutional care in Tanzania. Training programmes and concepts should not just be transferred across different cultures, disciplines and settings; they must be adapted to the specific cultural setting.
Rosendal, Tove; Mapunda, Gastor
Tanzania's post-independence language policy has promoted Swahili as a means of achieving national and linguistic unity. This policy has affected the Ngoni language in south-western Tanzania. Today, Swahili has permeated communication all over Tanzania, even in rural and remote areas. This paper discusses lexical borrowing and especially borrowing…
Rosendal, Tove; Mapunda, Gastor
The codeswitching pattern is different in rural Tanzania compared to urban agglomerations around the world. Even in very rural areas people in Tanzania are bilingual in Swahili, the national and local lingua franca, and their own first language. The result of this language contact is understudied and has only recently been focused on. This paper…
McDonald, Christine M; Manji, Karim P; Kupka, Roland; Bellinger, David C; Spiegelman, Donna; Kisenge, Rodrick; Msamanga, Gernard; Fawzi, Wafaie W; Duggan, Christopher P
Infants born to HIV-infected women are at increased risk of impaired neurodevelopment, but little research has attempted to identify modifiable risk factors. The objective of this prospective cohort analysis was to identify maternal, socioeconomic, and child correlates of psychomotor and mental development in the first 18 mo of life among Tanzanian infants born to HIV-infected women. We hypothesized that child HIV infection, morbidity, and undernutrition would be associated with lower developmental status when taking into consideration maternal health and socioeconomic factors. Baseline maternal characteristics were recorded during pregnancy, birth characteristics were collected immediately after delivery, infant micronutrient status was measured at 6 wk and 6 mo, and anthropometric measurements and morbidity histories were performed at monthly follow-up visits. The Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Development, 2nd edition (BSID-II) were used to assess developmental functioning at 6, 12, and 18 mo of age. Multivariate repeated regression models with time-varying covariates were used to estimate adjusted mean MDI and PDI scores for each level of the variables. A total of 311 infants contributed ≥1 BSID-II assessments for 657 PDI and 655 MDI measurements. Of infants, 51% were male, 23% were born preterm, 7% were low birth weight, and 10% were HIV-positive at 6 wk. Preterm birth, child HIV infection, stunting, and wasting were independently associated with lower PDI and MDI scores. Strategies to lower mother-to-child transmission of HIV, prevent preterm birth, and enhance child growth could contribute to improved child psychomotor and mental development.
Bosse, Goetz; Abels, Wiltrud; Mtatifikolo, Ferdinand; Ngoli, Baltazar; Neuner, Bruno; Wernecke, Klaus-Dieter; Spies, Claudia
Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. All hospitals conducted quality assessments with a Hospital Performance Assessment Tool. Changes in immediate outcome indicators after one and two years were compared to final outcome indicators such as Anaesthetic Complication Rate and Surgical Case Fatality Rate. Immediate outcome indicators for Preoperative Care in the intervention hospital improved (52.5% in 2009; 84.2% in 2011, pcontrol group, preoperative care declined from 50.8% (2009) to 32.8% (2011, p hospital declined (1.89% before intervention; 0.96% after intervention, p = 0.006). Surgical Case Fatality Rate in the intervention hospital declined from 5.67% before intervention to 2.93% after intervention (pcontrol group was 4% before intervention and 3.8% after intervention (p = 0.411). Anaesthetic Complication Rate in the control group was not available. Immediate outcome indicators initially improved, while at the same time final outcome declined (Surgical Case Fatality, Anaesthetic Complication Rate). Compared to the control group, final outcome improved more in the intervention hospital, although the effect was not significant over the whole study period. Documentation of final outcome indicators seemed inconsistent. Immediate outcome indicators seem more helpful to steer the Continuous Quality Improvement program. Specific interventions as part of Continuous Quality Improvement might lead to sustainable improvement of the quality of care, if embedded in a multi-faceted approach.
Full Text Available The use of Interferometric Synthetic Aperture Radar (InSAR data has great potential for monitoring large scale forest above ground biomass (AGB in the tropics due to the increased ability to retrieve 3D information even under cloud cover. To date; results in tropical forests have been inconsistent and further knowledge on the accuracy of models linking AGB and InSAR height data is crucial for the development of large scale forest monitoring programs. This study provides an example of the use of TanDEM-X WorldDEM data to model AGB in Tanzanian woodlands. The primary objective was to assess the accuracy of a model linking AGB with InSAR height from WorldDEM after the subtraction of ground heights. The secondary objective was to assess the possibility of obtaining InSAR height for field plots when the terrain heights were derived from global navigation satellite systems (GNSS; i.e., as an alternative to using airborne laser scanning (ALS. The results revealed that the AGB model using InSAR height had a predictive accuracy of R M S E = 24.1 t·ha−1; or 38.8% of the mean AGB when terrain heights were derived from ALS. The results were similar when using terrain heights from GNSS. The accuracy of the predicted AGB was improved when compared to a previous study using TanDEM-X for a sub-area of the area of interest and was of similar magnitude to what was achieved in the same sub-area using ALS data. Overall; this study sheds new light on the opportunities that arise from the use of InSAR data for large scale AGB modelling in tropical woodlands.
Vissoci, Joao Ricardo Nickenig; Hertz, Julian; El-Gabri, Deena; Andrade Do Nascimento, José Roberto; Pestillo De Oliveira, Leonardo; Mmbaga, Blandina Theophil; Mvungi, Mark; Staton, Catherine A
To develop Swahili versions of the Alcohol Use Disorders Identification Test (AUDIT) and CAGE questionnaires and evaluate their psychometric properties in a traumatic brain injury (TBI) population in Tanzania. Swahili versions of the AUDIT and CAGE were developed through translation and back-translation by a panel of native speakers of both English and Swahili. The translated instruments were administered to a sample of Tanzanian adults from a TBI registry. The validity and reliability were analyzed using standard statistical methods. The translated versions of both the AUDIT and CAGE questionnaires were found to have excellent language clarity and domain coherence. Reliability was acceptable (>0.85) for all tested versions. Confirmatory factor analysis of one, two and three factor solution for the AUDIT and one factor solution for the CAGE showed adequate results. AUDIT and CAGE scores were strongly correlated to each other (R > 0.80), and AUDIT scores were significantly lower in non-drinkers compared to drinkers. This article presents the first Swahili and Tanzanian adaptations of the AUDIT and CAGE instruments as well as the first validation of these questionnaires with TBI patients. Both instruments were found to have acceptable psychometric properties, resulting in two new useful tools for medical and social research in this setting. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.
This article presents some unexpected findings from a study of the upper secondary school voucher system in Sweden. This publicly funded but relatively unregulated quasi-market offers a large number of alternatives to teenagers choosing an education. The choice situation is relatively complex and the stakes are high, but the youths themselves find…
Fung, Kit-Ho Chanel; Lam, Chi-Chung
School choice gives parents greater power over their children's education. But ever since the Pre-primary Education Voucher Scheme (PEVS) was introduced in Hong Kong in 2007, school choice has become a hotly debated topic. The scheme was introduced to empower kindergarten parents in choosing a school for their children by offering them direct fee…
Dickman, Anneliese; Schmidt, Jeffrey
For the first time since its 1998 expansion to include religious schools, enrollment in the Milwaukee Parental Choice Program (MPCP) did not grow in the 2010-2011 school year. Currently, 20,996 private school students receive taxpayer-funded tuition vouchers (of $6,442 per pupil), a decrease of 66 students over last year. Chart 1 shows program…
Full Text Available Abstract Background Since the mid-1970s, the dominant model for U.S. federal housing policy has shifted from unit-based programs to tenant based vouchers and certificates, intended to allow recipients a choice in their housing and neighborhoods. Surprisingly little research has examined the question of where those with Section 8 housing vouchers are able to live, but some research suggests that voucher holders are more likely to reside in distressed neighborhoods than unsubsidized renter households. Further, federal housing policy has limited drug users' access to housing subsidies. In turn, neighborhood disorder has been associated with higher levels of injection drug risk behaviors, and higher drug-related mortality. This paper explores rental accessibility and neighborhood characteristics of advertised rental housing in Hartford CT. Methods Brief telephone interviews were conducted with landlords or management companies with units to rent in Hartford to explore housing accessibility measured as initial move in costs, credit and criminal background checks, and whether rental subsidies were accepted. These data were supplemented with in-depth interviews with landlords, shelter staff and active users of heroin, crack or cocaine. Apartments for rent were geocoded and mapped using ArcGIS. We used location quotients to identify areas where low-income rental housing is concentrated. Finally, we mapped apartments in relation to drug and violent arrest rates in each neighborhood. Results High security deposits, criminal background and credit checks limit housing accessibility even for drug users receiving vouchers. While most landlords or management companies accepted housing subsidies, several did not. Voucher units are concentrated in neighborhoods with high poverty neighborhoods. Landlords reported little incentive to accept rental subsidies in neighborhoods with low crime rates, but appreciated the guarantee provided by Section 8 in high crime
Full Text Available This article begins with the assumption that the argument for the inclusion of children with disabilities in mainstream schools, championed by Sustainable Development Goal 4 and Article 24 of the UN Convention on the Rights of Persons with Disabilities, has largely been accepted nationally and internationally by policy makers, and is increasingly being accepted by teachers. In interrogating the complex craft of developing inclusive and equal learning environments for children with disabilities, this article draws upon Kershner’s ‘core aspects of teachers’ knowledge and knowing’, and in particular, ‘the school as a site for the development of teaching expertise and the creation of knowledge’. Data is presented from in-depth interviews following videoed lesson observations with experienced teachers in 15 rural, urban and coastal primary schools in four districts in Tanzania. Findings indicate that the teachers’ practice is moving unevenly towards disability equality, and involves processes of inclusions and exclusions. This involves teacher autonomy, agency and reflective practice in the context of material, attitudinal, structural, pedagogic and curricular barriers. The teachers’ expertise has potential to inform national and international policy developments, and so reduce the evident rhetoric-reality gap. In conclusion, it is argued that inclusive education needs to grapple with disability as a social construct, and lessons are drawn for the further fulfilment of the rights of children with disabilities to equal participation in education.
Alfonso, Y Natalia; Bishai, David; Bua, John; Mutebi, Aloysius; Mayora, Crispus; Ekirapa-Kiracho, Elizabeth
The maternal mortality ratio (MMR) in Uganda has declined significantly during the last 20 years, but Uganda is not on track to reach the millennium development goal of reducing MMR by 75% by 2015. More evidence on the cost-effectiveness of supply- and demand-side financing programs to reduce maternal mortality could inform future strategies. This study analyses the cost-effectiveness of a voucher scheme (VS) combined with health system strengthening in rural Uganda against the status quo. The VS, implemented in 2010, provided vouchers for delivery services at public and private health facilities (HF), as well as round-trip transportation provided by private sector workers (bicycles or motorcycles generally). The VS was part of a quasi-experimental non-randomized control trial. Improvements in institutional delivery coverage (IDC) rates can be estimated using a difference-in-difference impact evaluation method and the number of maternal lives saved is modelled using the evidence-based Lives Saved Tool. Costs were estimated from primary and secondary data. Results show that the demand for births at HFs enrolled in the VS increased by 52.3 percentage points. Out of this value, conservative estimates indicate that at least 9.4 percentage points are new HF users. This 9.4% bump in IDC implies 20 deaths averted, which is equivalent to 1356 disability-adjusted-life years (DALYs) averted. Cost-effectiveness analysis comparing the status quo and VS's most conservative effectiveness estimates shows that the VS had an incremental cost-effectiveness ratio per DALY averted of US$302 and per death averted of US$20 756. Although there are limitations in the data measures, a favourable cost-effectiveness ratio persists even under extreme assumptions. Demand-side vouchers combined with supply-side financing programs can increase attended deliveries and reduce maternal mortality at a cost that is acceptable. Published by Oxford University Press in association with The London School
Jennings, Larissa; Conserve, Donaldson F; Merrill, Jamison; Kajula, Lusajo; Iwelunmor, Juliet; Linnemayr, Sebastian; Maman, Suzanne
Impoverished men have lower rates of facility-based HIV counseling and testing and higher unknown HIV-positive status than women. Economic theory suggests that individuals will obtain an HIV test if anticipated benefits are greater than anticipated costs. Yet, few studies have investigated the range of financial preferences of HIV self-testing (HIVST) among poor men who decline testing or do not test regularly. Twenty-three interviews were conducted to qualitatively assess perceived costs saved and costs incurred from use of HIVST kits in infrequently- or never-tested Tanzanian men. All men were shown an HIVST kit and video. They were then asked about the costs associated with provider-led HIV testing, financial benefits and concerns of HIVST and willingness to pay for HIVST. Data were transcribed, coded and analyzed using inductive content analyses. We then grouped codes into perceived cost advantages and disadvantages and tabulated the range of prices men were willing to pay for a self-test kit. Perceived cost advantages of HIVST were avoidance of spending money to test in facilities, omission of follow-up fees, affordability relative to private clinics, and increased time for earning income and other activities. Men also discussed the imbalance of the financial benefit of accessing free, public HIV testing with the resources spent for transport, purchasing meals away from home and long wait lines. Perceived cost disadvantages of HIVST were prohibitive kit costs, required prior savings to purchase kits, expenditures relating to death and preferences for free provider-performed testing. Men were also concerned about the psychological costs of inaccurate results. HIVST willingness to pay varied among men. Men’s decisions to self-test for HIV takes into account expected financial gains and losses. Demand generation for HIVST among men should consider use of low fees or free HIVST, while emphasizing potential savings from reduced travel, clinical costs, or time way
Jennings, Larissa; Conserve, Donaldson F; Merrill, Jamison; Kajula, Lusajo; Iwelunmor, Juliet; Linnemayr, Sebastian; Maman, Suzanne
Impoverished men have lower rates of facility-based HIV counseling and testing and higher unknown HIV-positive status than women. Economic theory suggests that individuals will obtain an HIV test if anticipated benefits are greater than anticipated costs. Yet, few studies have investigated the range of financial preferences of HIV self-testing (HIVST) among poor men who decline testing or do not test regularly. Twenty-three interviews were conducted to qualitatively assess perceived costs saved and costs incurred from use of HIVST kits in infrequently- or never-tested Tanzanian men. All men were shown an HIVST kit and video. They were then asked about the costs associated with provider-led HIV testing, financial benefits and concerns of HIVST and willingness to pay for HIVST. Data were transcribed, coded and analyzed using inductive content analyses. We then grouped codes into perceived cost advantages and disadvantages and tabulated the range of prices men were willing to pay for a self-test kit. Perceived cost advantages of HIVST were avoidance of spending money to test in facilities, omission of follow-up fees, affordability relative to private clinics, and increased time for earning income and other activities. Men also discussed the imbalance of the financial benefit of accessing free, public HIV testing with the resources spent for transport, purchasing meals away from home and long wait lines. Perceived cost disadvantages of HIVST were prohibitive kit costs, required prior savings to purchase kits, expenditures relating to death and preferences for free provider-performed testing. Men were also concerned about the psychological costs of inaccurate results. HIVST willingness to pay varied among men. Men's decisions to self-test for HIV takes into account expected financial gains and losses. Demand generation for HIVST among men should consider use of low fees or free HIVST, while emphasizing potential savings from reduced travel, clinical costs, or time way
Mosha Frank W
Full Text Available Abstract Background Long-lasting insecticidal nets (LLINs are advocated by WHO for protection against malaria. Of the three brands of LLINs currently approved by WHO, Olyset® is the only one currently granted full recommendation. With this type of LLIN, the insecticide (permethrin is incorporated into the polyethylene fibre during manufacture and diffuses from the core to the surface, thereby maintaining surface concentrations. It has not been determined for how long Olyset nets remain protective against mosquitoes in household use. Methods Examples of Olyset nets, which had been in use in Tanzanian villages for seven years, were tested in experimental huts against naturally entering Anopheles gambiae and Anopheles funestus mosquitoes. Performance was compared with new Olyset nets, conventionally treated ITNs (either newly treated with alphacypermethrin or taken from local villages after 1.5 years of use and untreated nets. All nets were artificially holed except for the seven-year Olyset nets, which had developed holes during prolonged domestic use. Results Anopheles funestus and An. gambiae in NE Tanzania are susceptible to pyrethroids. The new Olyset nets caused high mortality against An. funestus (73.9% and An. gambiae (62.7% in experimental huts. The seven-year Olyset nets caused 58.9% mortality against An. funestus and 40.0% mortality against An. gambiae. The freshly treated alphacypermethrin nets also caused high mortality against An. funestus (70.6% and An. gambiae (72.0%; this decreased to 58.4% and 69.6% respectively after 1.5 years of use. The new Olyset nets inhibited blood-feeding by 40–50%. The 7 year Olyset nets showed no feeding inhibition over that shown by the untreated nets. The alphacypermethrin treated nets failed to inhibit blood-feeding after 1.5 years of use. However iHhhdn laboratory tunnel tests samples of all types of treated net including the 7 year Olyset inhibited blood-feeding by more than 95%. Conclusion After
Full Text Available The paper deals with the evaluation and financing of research and innovation projects. The paper analyzes and discusses the “Technological Vouchers and Cooperative Research” program in the Calabria Region (Southern Italy, as a program for financing R&D projects in a geographical area far behind in development. Three real cases of R&D projects are described. The program was effective as regards the stimulus to realizing R&D activities by Calabrian SMEs and furthermore in relation to the improvement of cooperation between SMEs, research centers, universities and technological laboratories. The weak points of the program mainly regard the evaluation phase that made it impossible to get a feedback useful for policy and for driving future agenda.
Sanchez Barreiro, Fatima; Garrett Vieira, Filipe Jorge; Martin, Michael David
, samples with degraded DNA are generally unsuitable for RRL methods. Given that ancient and historic specimens can provide key temporal perspectives to evolutionary questions, we explored how custom-designed RNA probes could enrich for RRL loci (Restriction Enzyme-Associated Loci baits, or REALbaits......). Starting with Genotyping-by-Sequencing (GBS) data generated on modern common ragweed (Ambrosia artemisiifolia L.) specimens, we designed 20,000 RNA probes to target well-characterized genomic loci in herbarium voucher specimens dating from 1835-1913. Compared to shotgun sequencing, we observed enrichment...... of the targeted loci at 19-151-fold. Using our GBS capture pipeline on a dataset of 38 herbarium samples, we discovered 22,813 SNPs, providing sufficient genomic resolution to distinguish geographic populations. For these samples, we found that dilution of REALbaits to 10% of their original concentration still...
Strong, Adrienne E
Based on mixed-methods, ethnographic research in government health facilities conducted in Rukwa, Tanzania over 23 months between 2012 and 2015, this paper explores the social implications of budget shortfalls in the healthcare system at the level of a regional hospital. Budget crises resulted from the late disbursal of funds and the failure of outside donors to meet aid commitments needed to subsidize healthcare at the national level. Healthcare administrators recounted specific donors who pulled out of commitments as a direct result of foreign government austerity measures enacted after the global financial crisis of 2008. In this environment of scarcity, partially due to years of reduced donor funds in the region, regional healthcare administrators circumvented bureaucratic fiscal procedures to ensure the continued functioning of facilities, and healthcare personnel struggled to provide pregnant women with high quality care in times of emergencies. Providers cited low morale and demotivation due to deteriorating physical infrastructure, lack of supplies, and poor relations with the community as key factors inhibiting their ability to care for the women who came to their facilities. Copyright © 2017 Elsevier Ltd. All rights reserved.
Mumghamba, E G S; Pitiphat, W; Matee, M I N; Simon, E; Merchant, A T
The only partial mouth index that has been validated against full-mouth examinations in the East African population is the CPITN (Community Periodontal Index of Treatment Needs). Since the Ramfjord index can potentially shorten the examination time by almost half, we evaluated Ramfjord teeth in predicting full-mouth periodontal status of an adult population in Tanzania. Pocket depth was measured for 192 consecutive patients aged from 15 to 77 years (36 years old on average); 86 (45%) females referred to the Department of Restorative Dentistry, Muhimbili National Hospital, Tanzania between January 1997 and December 1999, and the mean pocket depth for full-mouth and Ramfjord teeth was calculated. The correlation between the mean pocket depth calculated from the full-mouth and Ramfjord teeth was 0.96. The beta coefficient for the mean pocket depth measured by Ramfjord teeth to predict the full-mouth mean was 0.94, and was not affected by adjustment for age, missing teeth or sex. This overall high agreement between Ramjford teeth and full-mouth periodontal pocket situation confirms the epidemiological validity of Ramfjord's dental sample in our setting.
Cinderby, Steve; Bruin, Annemarieke de; Mbilinyi, Boniface; Kongo, Victor; Barron, Jennie
One of the keys to environmental management is to understand the impact and interaction of people with natural resources as a means to improve human welfare and the consequent environmental sustainability for future generations. In terms of water management one of the on-going challenges is to assess what impact interventions in agriculture, and in particularly different irrigation strategies, will have on livelihoods and water resources in the landscape. Whilst global and national policy provide the overall vision of desired outcomes for environmental management, agricultural development and water use strategies they are often presented with local challenges to embed these policies in the reality on the ground, with different stakeholder groups. The concept that government agencies, advocacy organizations, and private citizens should work together to identify mutually acceptable solutions to environmental and water resource issues is increasing in prominence. Participatory spatial engagement techniques linked to geographic information systems (commonly termed participatory GIS (PGIS)) offers one solution to facilitate such stakeholder dialogues in an efficient and consultative manner. In the context of agricultural water management multi-scale PGIS techniques have recently been piloted as part of the ‘Agricultural Water Management Solutions’ project to investigate the current use and dependencies of water by small-holder farmers a watershed in Tanzania. The piloted approach then developed PGIS scenarios describing the effects on livelihoods and water resources in the watershed when introducing different management technologies. These relatively rapid PGIS multi-scale methods show promise for assessing current and possible future agriculture water management technologies in terms of their bio-physical and socio-economic impacts at the watershed scale. The paper discusses the development of the methodology in the context of improved water management decision
Full Text Available Vaccine-induced HIV antibodies were evaluated in serum samples collected from healthy Tanzanian volunteers participating in a phase I/II placebo-controlled double blind trial using multi-clade, multigene HIV-DNA priming and recombinant modified vaccinia Ankara (HIV-MVA virus boosting (HIVIS03. The HIV-DNA vaccine contained plasmids expressing HIV-1 gp160 subtypes A, B, C, Rev B, Gag A, B and RTmut B, and the recombinant HIV-MVA boost expressed CRF01_AE HIV-1 Env subtype E and Gag-Pol subtype A. While no neutralizing antibodies were detected using pseudoviruses in the TZM-bl cell assay, this prime-boost vaccination induced neutralizing antibodies in 83% of HIVIS03 vaccinees when a peripheral blood mononuclear cell (PBMC assay using luciferase reporter-infectious molecular clones (LucR-IMC was employed. The serum neutralizing activity was significantly (but not completely reduced upon depletion of natural killer (NK cells from PBMC (p=0.006, indicating a role for antibody-mediated Fcγ-receptor function. High levels of antibody-dependent cellular cytotoxicity (ADCC-mediating antibodies against CRF01_AE and/or subtype B were subsequently demonstrated in 97% of the sera of vaccinees. The magnitude of ADCC-mediating antibodies against CM235 CRF01_AE IMC-infected cells correlated with neutralizing antibodies against CM235 in the IMC/PBMC assay. In conclusion, HIV-DNA priming, followed by two HIV-MVA boosts elicited potent ADCC responses in a high proportion of Tanzanian vaccinees. Our findings highlight the potential of HIV-DNA prime HIV-MVA boost vaccines for induction of functional antibody responses and suggest this vaccine regimen and ADCC studies as potentially important new avenues in HIV vaccine development.Controlled-Trials ISRCTN90053831 The Pan African Clinical Trials Registry ATMR2009040001075080 (currently PACTR2009040001075080.
National Oceanic and Atmospheric Administration, Department of Commerce — We studied young of the year sablefish Anoplopoma fimbria to collect basic life history information on their abundance, growth, and diet and to determine whether...
Full Text Available Abstract Background A law making all indoor workplaces including bars and restaurants smokefree became operational in New Zealand in December 2004. New Zealand has a national free-phone Quitline Service which has been operational since 1999. Previous work has shown that the number of calls to the Quitline are influenced by marketing of the service through media campaigns. We set out to investigate if the smokefree law increased calls to the Quitline. Methods For 24 months prior to the law, and 12 months after the law, data were collected on: (i Quitline caller registrations and the issuing of nicotine replacement therapy (NRT vouchers by the Quitline Service; (ii expenditure on Quitline-related television advertising; (iii expenditure on other smokefree television advertising; and (iv print media coverage of smoking in major New Zealand newspapers. These data were inputs to a time series analysis using a Box-Jenkins transfer function model. This used the law change as the intervention variable, with the response series being the monthly Quitline caller rates and monthly first time NRT voucher issue rates. Results The monthly rates of Quitline caller registrations and NRT voucher issues were observed to increase in the months after the law change. The increase in both these outcomes was even greater when considered in terms of per level of Quitline advertising expenditure (though these patterns may have partly reflected marked reductions in advertising expenditure at the time of the law change and hence are of limited validity. In the more robust time series analyses, the law change (intervention variable had a significant effect (p = 0.025 on increasing the monthly caller registration rate in December 2004. This was after adjusting for the possible effects of Quitline advertising expenditure, print media coverage, and other smoking-related advertising expenditure. Conclusion The new national smokefree law resulted in increased quitting
Singleton, Chelsea R; Opoku-Agyeman, William; Affuso, Ermanno; Baskin, Monica L; Levitan, Emily B; Sen, Bisakha; Affuso, Olivia
To examine cash value voucher (CVV) redemption behavior and its association with fruit and vegetable (FV) consumption among women who participate in the Supplemental Nutrition Program for Women, Infants, and Children (WIC). Cross-sectional. Jefferson County, Alabama. Between October 2014 and January 2015, 300 women (mean age: 27.6 years; 66.8% non-Hispanic black; 45.1% obese) who participated in the Birmingham WIC program were surveyed. Self-reported information on demographics, produce shopping behaviors, and residential access to fresh produce retailers (eg, supermarkets and farmers markets) was examined. Fruit and vegetable intake was collected via the Block Fruit-Vegetable-Fiber screener. Participants who self-reported redeeming the WIC CVV in each of the 3 prior months were classified as regular redeemers. Multivariable-adjusted regression models were used to examine associations between variables of interest and regular WIC CVV redemption. There were 189 (63.0%) study participants classified as regular WIC CVV redeemers. Regular redeemers and other participants (ie, irregular redeemers and nonredeemers) were similar with respect to demographics. Regular redeemers were more likely to use grocery stores to purchase FVs ( P = .003) and consumed significantly more servings of FVs per day (β = .67; standard error = 0.24; P = .007). Regular WIC CVV redemption was associated with some produce shopping behaviors and increased FV consumption and among WIC participants in Jefferson County, Alabama.
Bickel, Warren K; Jones, Bryan A; Landes, Reid D; Christensen, Darren R; Jackson, Lisa; Mancino, Michael
Delay discounting rates are predictive of drug use status, the likelihood of becoming abstinent, and a variety of health behaviors. Rates of delay discounting may also be related to other relevant behaviors associated with addiction, such as the frequency at which individuals redeem contingency management voucher earnings. This study examined the discounting rates of 152 participants in a buprenorphine treatment program for opioid abuse. Participants received up to 12 weeks of buprenorphine treatment combined with contingency management. Participant's drug use was measured via urine specimens submitted three times a week. Successive negative urine specimens were reinforced with increasing amounts of money. After each negative urine specimen, a participant could either redeem his or her earnings or accumulate it in an account. Analysis of the frequency of redemptions showed that participants with higher rates of delay discounting at study intake redeemed their earnings significantly more often than participants with lower rates of discounting. Age and income also predicted redemption rates. We suggest that delay discounting rates can be used to predict redemption behaviors in a contingency management treatment program and that these findings are consistent with the recent theory of the competing neurobehavioral decision systems. PsycINFO Database Record (c) 2010 APA, all rights reserved.
Erdman, Laura K.; D’Acremont, Valérie; Hayford, Kyla; Kilowoko, Mary; Kyungu, Esther; Hongoa, Philipina; Alamo, Leonor; Streiner, David L.; Genton, Blaise; Kain, Kevin C.
Background Diagnosing pediatric pneumonia is challenging in low-resource settings. The World Health Organization (WHO) has defined primary end-point radiological pneumonia for use in epidemiological and vaccine studies. However, radiography requires expertise and is often inaccessible. We hypothesized that plasma biomarkers of inflammation and endothelial activation may be useful surrogates for end-point pneumonia, and may provide insight into its biological significance. Methods We studied children with WHO-defined clinical pneumonia (n = 155) within a prospective cohort of 1,005 consecutive febrile children presenting to Tanzanian outpatient clinics. Based on x-ray findings, participants were categorized as primary end-point pneumonia (n = 30), other infiltrates (n = 31), or normal chest x-ray (n = 94). Plasma levels of 7 host response biomarkers at presentation were measured by ELISA. Associations between biomarker levels and radiological findings were assessed by Kruskal-Wallis test and multivariable logistic regression. Biomarker ability to predict radiological findings was evaluated using receiver operating characteristic curve analysis and Classification and Regression Tree analysis. Results Compared to children with normal x-ray, children with end-point pneumonia had significantly higher C-reactive protein, procalcitonin and Chitinase 3-like-1, while those with other infiltrates had elevated procalcitonin and von Willebrand Factor and decreased soluble Tie-2 and endoglin. Clinical variables were not predictive of radiological findings. Classification and Regression Tree analysis generated multi-marker models with improved performance over single markers for discriminating between groups. A model based on C-reactive protein and Chitinase 3-like-1 discriminated between end-point pneumonia and non-end-point pneumonia with 93.3% sensitivity (95% confidence interval 76.5–98.8), 80.8% specificity (72.6–87.1), positive likelihood ratio 4.9 (3.4–7
Full Text Available Abstract Background Many teenagers are insufficiently active despite the health benefits of physical activity (PA. There is strong evidence to show that inactivity and low fitness levels increase the risk of non-communicable diseases such as coronary heart disease (CHD, type 2 diabetes and breast and colon cancers (Lee et al. Lancet 380:219–29, 2012. A major barrier facing adolescents is accessibility (e.g. cost and lack of local facilities. The ACTIVE project aims to tackle this barrier through a multi-faceted intervention, giving teenagers vouchers to spend on activities of their choice and empowering young people to improve their fitness and PA levels. Design ACTIVE is a mixed methods randomised control trial in 7 secondary schools in Swansea, South Wales. Quantitative and qualitative measures including PA (cooper run test (CRT, accelerometery over 7 days, cardiovascular (CV measures (blood pressure, pulse wave analysis and focus groups will be undertaken at 4 separate time points (baseline, 6 months,12 months and follow-up at 18 months. Intervention schools will receive a multi-component intervention involving 12 months of £20 vouchers to spend on physical activities of their choice, a peer mentor scheme and opportunities to attend advocacy meetings. Control schools are encouraged to continue usual practice. The primary aim is to examine the effect of the intervention in improving cardiovascular fitness. Discussion This paper describes the protocol for the ACTIVE randomised control trial, which aims to increase fitness, physical activity and socialisation of teenagers in Swansea, UK via a voucher scheme combined with peer mentoring. Results can contribute to the evidence base on teenage physical activity and, if effective, the intervention has the potential to inform future physical activity interventions and policy. Trial registration ISRCTN75594310 (Assigned 06/03/2017.
Ohly, Heather; Crossland, Nicola; Dykes, Fiona; Lowe, Nicola; Hall-Moran, Victoria
Objectives To explore how low-income pregnant women use Healthy Start food vouchers, the potential impacts of the programme, and which women might experience these impacts and why. Design A realist review. Eligibility criteria for selecting studies Primary or empirical studies (of any design) were included if they contributed relevant evidence or insights about how low-income women use food vouchers from the Healthy Start (UK) or the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) programmes. The assessment of ‘relevance’ was deliberately broad to ensure that reviewers remained open to new ideas from a variety of sources of evidence. Analysis A combination of evidence synthesis and realist analysis techniques was used to modify, refine and substantiate programme theories, which were constructed as explanatory ‘context–mechanism–outcome’–configurations. Results 38 primary studies were included in this review: four studies on Healthy Start and 34 studies on WIC. Two main outcome strands were identified: dietary improvements (intended) and financial assistance (unintended). Three evidence-informed programme theories were proposed to explain how aspects of context (and mechanisms) may generate these outcomes: the ‘relative value’ of healthy eating (prioritisation of resources); retailer discretion (pressure to ‘bend the rules’); the influence of other family members (disempowerment). Conclusions This realist review suggests that some low-income pregnant women may use Healthy Start vouchers to increase their consumption of fruits and vegetables and plain cow’s milk, whereas others may use them to reduce food expenditure and save money for other things. PMID:28432063
James, Michaela; Christian, Danielle; Scott, Samantha; Todd, Charlotte; Stratton, Gareth; McCoubrey, Sarah; Halcox, Julian; Audrey, Suzanne; Ellins, Elizabeth; Brophy, Sinead
Many teenagers are insufficiently active despite the health benefits of physical activity (PA). There is strong evidence to show that inactivity and low fitness levels increase the risk of non-communicable diseases such as coronary heart disease (CHD), type 2 diabetes and breast and colon cancers (Lee et al. Lancet 380:219-29, 2012). A major barrier facing adolescents is accessibility (e.g. cost and lack of local facilities). The ACTIVE project aims to tackle this barrier through a multi-faceted intervention, giving teenagers vouchers to spend on activities of their choice and empowering young people to improve their fitness and PA levels. ACTIVE is a mixed methods randomised control trial in 7 secondary schools in Swansea, South Wales. Quantitative and qualitative measures including PA (cooper run test (CRT), accelerometery over 7 days), cardiovascular (CV) measures (blood pressure, pulse wave analysis) and focus groups will be undertaken at 4 separate time points (baseline, 6 months,12 months and follow-up at 18 months). Intervention schools will receive a multi-component intervention involving 12 months of £20 vouchers to spend on physical activities of their choice, a peer mentor scheme and opportunities to attend advocacy meetings. Control schools are encouraged to continue usual practice. The primary aim is to examine the effect of the intervention in improving cardiovascular fitness. This paper describes the protocol for the ACTIVE randomised control trial, which aims to increase fitness, physical activity and socialisation of teenagers in Swansea, UK via a voucher scheme combined with peer mentoring. Results can contribute to the evidence base on teenage physical activity and, if effective, the intervention has the potential to inform future physical activity interventions and policy. ISRCTN75594310 (Assigned 06/03/2017).
Full Text Available It is well accepted that aging and HIV infection are associated with quantitative and functional changes of CMV-specific T cell responses. We studied here the expression of Mip-1β and the T cell maturation marker CD27 within CMVpp65-specific CD4(+ and CD8(+ T cells in relation to age, HIV and active Tuberculosis (TB co-infection in a cohort of Tanzanian volunteers (≤ 16 years of age, n = 108 and ≥ 18 years, n = 79. Independent of HIV co-infection, IFNγ(+ CMVpp65-specific CD4(+ T cell frequencies increased with age. In adults, HIV co-infection further increased the frequencies of these cells. A high capacity for Mip-1β production together with a CD27(low phenotype was characteristic for these cells in children and adults. Interestingly, in addition to HIV co-infection active TB disease was linked to further down regulation of CD27 and increased capacity of Mip-1β production in CMVpp65-specific CD4+ T cells. These phenotypic and functional changes of CMVpp65-specific CD4 T cells observed during HIV infection and active TB could be associated with increased CMV reactivation rates.
Msafiri Y. Mkonda
Full Text Available Although various climate models, statistical crop models and economic simulations have been established to determine the level of farmers’ vulnerability, there has been little systematic assessment of farmers’ perception towards climate change in association with meteorological analyses and policy implications in Tanzania. The results from this assessment will enhance the formation of robust policies that improve resilient livelihoods and the capacity to adapt to climate change and variability. This paper seeks to (i reveal the farmers’ perception on variation, change of rainfall, and temperature in the Tanzanian semi-arid area; (ii depict meteorological evidence for the perceived rainfall and temperature changes; (iii assess the policy perception and responses for the changing climate; and (iv discuss the correlation between farmers’ perception and meteorological data. Household surveys, informative interviews and discussions were employed during data collection. The Mann-Kendall Test and SPSS (version 20 were used for climate data analyses, while qualitative data were thematically analyzed. The results showed that from 1980 to 2015 the mean annual rainfall decreased ( R2 = 0.21 while temperature increased (R2 = 0.30. Even though majority farmers agreed with these results, they had not yet taken serious measures to curb the situation. Besides, Agricultural Policy has lightly addressed and enforced the implementations of adaptation strategies to reduce climate impacts and vulnerability. Thereby, creation of awareness and intensification of climate adaptation strategies is needed at both farm and policy level.
Sager, M; McCulloch, C R; Schoder, D
Milk powder is a food for malnourished African children and for healthy infants of women with HIV/AIDS. High demand and low purchasing power has resulted in a huge informal, black market in Sub-Saharan Africa. Forty-three milk powder batches were analyzed for 43 chemical elements using ICP-MS One sample (2.3%) was contaminated at a lead concentration of 240 µg/kg dry weight exceeding the European threshold (130 µg/kg dry weight). Macroelement contents revealed a trend decreasing in concentration through skimmed, full cream products to infant formulae. Concentration ranges by dry weight differed in respect of uncertainty intervals of ±10%. Median Ca, K and P concentrations declined from 11.14 g/kg to 3.21 g/kg, 14.11 g/kg to 4.95 g/kg and 9.12 g/kg to 2.75 g/kg dry mass, respectively. Milk powder samples obtained from the Tanzanian black market were comparable in respect of nutritional and chemical content to international branded full cream products. Copyright © 2018 Elsevier Ltd. All rights reserved.
Andrew V Oleinikov
Full Text Available PfEMP1 proteins comprise a family of variant antigens that appear on the surface of P. falciparum-infected erythrocytes and bind to multiple host receptors. Using a mammalian expression system and BioPlex technology, we developed an array of 24 protein constructs representing 38 PfEMP1 domains for high throughput analyses of receptor binding as well as total and functional antibody responses. We analyzed the reactivity of 561 plasma samples from 378 young Tanzanian children followed up to maximum 192 weeks of life in a longitudinal birth cohort. Surprisingly, reactivity to the DBL5 domain of VAR2CSA, a pregnancy malaria vaccine candidate, was most common, and the prevalence of reactivity was stable throughout early childhood. Reactivity to all other PfEMP1 constructs increased with age. Antibodies to the DBL2βC2(PF11_0521 domain, measured as plasma reactivity or plasma inhibition of ICAM1 binding, predicted reduced risk of hospitalization for severe or moderately severe malaria. These data suggest a role for VAR2CSA in childhood malaria and implicate DBL2βC2(PF11_0521 in protective immunity.
Rumisha, Cyrus; Leermakers, Martine; Mdegela, Robinson H; Kochzius, Marc; Elskens, Marc
The coastal population in East Africa is growing rapidly but sewage treatment and recycling facilities in major cities and towns are poorly developed. Since estuarine mangroves are the main hotspots for pollutants, there is a potential for contaminants to accumulate in edible fauna and threaten public health. This study analysed trace metals in muscle tissues of the giant mud crabs (Scylla serrata) and the giant tiger prawns (Penaeus monodon) from the Tanzanian coast, in order to determine the extent of bioaccumulation and public health risks. A total of 180 samples of muscle tissues of S. serrata and 80 of P. monodon were collected from nine sites along the coast. Both species showed high levels of trace metals in the wet season and significant bioaccumulation of As, Cu and Zn. Due to their burrowing and feeding habits, mud crabs were more contaminated compared to tiger prawns sampled from the same sites. Apart from that, the measured levels of Cd, Cr and Pb did not exceed maximum limits for human consumption. Based on the current trend of fish consumption in Tanzania (7.7 kg/person/year), the measured elements (As, Cd, Co, Cu, Mn, Pb and Zn) are not likely to present health risks to shellfish consumers. Nevertheless, potential risks of As and Cu cannot be ruled out if the average per capita consumption is exceeded. This calls for strengthened waste management systems and pollution control measures.
Jeurink Prescilla V
Full Text Available Abstract Background Deficiencies in vitamins and mineral elements are important causes of morbidity in developing countries, possibly because they lead to defective immune responses to infection. The aim of the study was to assess the effects of mineral element deficiencies on early innate cytokine responses to Plasmodium falciparum malaria. Methods Peripheral blood mononuclear cells from 304 Tanzanian children aged 6-72 months were stimulated with P. falciparum-parasitized erythrocytes obtained from in vitro cultures. Results The results showed a significant increase by 74% in geometric mean of TNF production in malaria-infected individuals with zinc deficiency (11% to 240%; 95% CI. Iron deficiency anaemia was associated with increased TNF production in infected individuals and overall with increased IL-10 production, while magnesium deficiency induced increased production of IL-10 by 46% (13% to 144% in uninfected donors. All donors showed a response towards IL-1β production, drawing special attention for its possible protective role in early innate immune responses to malaria. Conclusions In view of these results, the findings show plasticity in cytokine profiles of mononuclear cells reacting to malaria infection under conditions of different micronutrient deficiencies. These findings lay the foundations for future inclusion of a combination of precisely selected set of micronutrients rather than single nutrients as part of malaria vaccine intervention programmes in endemic countries.
Full Text Available Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania.This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50% of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level.Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension.The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary healthcare system in Tanzania for better management of chronic diseases and curb their rising impact on health outcomes.
Bintabara, Deogratius; Mpondo, Bonaventura C T
Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary healthcare system in Tanzania for better management of chronic diseases and curb their rising impact on health outcomes.
Kutcher, Stan; Wei, Yifeng; Gilberds, Heather; Ubuguyu, Omary; Njau, Tasiana; Brown, Adena; Sabuni, Norman; Magimba, Ayoub; Perkins, Kevin
Mental health literacy (MHL) is foundational for mental health promotion, prevention, stigma reduction, and care; School supported information pertaining to MHL in sub-Saharan Africa is extremely limited, including in Tanzania. Successful application of a school MHL curriculum resource may be an effective way to increase teacher MHL and therefore help to improve mental health outcomes for students. Secondary school teachers in Tanzania were trained on the African Guide (AG) a school MHL curriculum resource culturally adapted from a Canadian MHL resource (The Guide) for use in Africa. Teacher training workshops on the classroom application of the AG were used to evaluate its impact on mental health literacy in a sample of Tanzanian Secondary school teachers. Pre-post training assessment of participant knowledge and attitudes was conducted. Help-seeking efficacy for teachers themselves and their interventions for students, friends, family members and peers were determined. Paired t test (n = 37) results demonstrate highly significant improvements in teacher's overall knowledge (p Teachers' stigma against mental illness decreased significantly following the training (p teacher's overall knowledge (p Teachers also reported high rates (greater than ¾ of the sample) of positive help-seeking efficacy for themselves as well as for their students, friends, family members and peers. As a result of the training, the number of students teachers identified for potential mental health care totaled over 200. These positive results, when taken together with other research, suggest that the use of a classroom-based resource (the AG) that integrates MHL into existing school curriculum through training teachers may be an effective and sustainable way to increase the MHL (improved knowledge, decreased stigma and positive help-seeking efficacy) of teachers in Tanzania. As this study replicated the results of a previous intervention in Malawi, consideration could be given to
Wilkinson, Amanda L; Pedersen, Sarah H; Urassa, Mark; Michael, Denna; Todd, Jim; Kinung'hi, Safari; Changalucha, John; McDermid, Joann M
Healthcare access and resources differ considerably between urban and rural settings making cross-setting generalizations difficult. In resource-restricted rural/semi-rural environments, identification of feasible screening tools is a priority. The objective of this study was to evaluate gestational anthropometry in relation to birth and infant growth in a rural/semi-rural Tanzanian prospective cohort of mothers and their infants. Mothers (n = 114: 44 HIV-positive) attending antenatal clinic visits were recruited in their second or third trimester between March and November, 2012, and followed with their infants through 6-months post-partum. Demographic, clinical, and infant feeding data were obtained using questionnaires administered by a Swahili-speaking research nurse on demographic, socioeconomic, clinical, and infant feeding practices. Second or third trimester anthropometry (mid-upper arm circumference [MUAC], triceps skinfold thickness, weight, height), pregnancy outcomes, birth (weight, length, head circumference) and infant anthropometry (weight-for-age z-score [WAZ], length-for-age z-score [LAZ]) were obtained. Linear regression and mixed effect modeling were used to evaluate gestational factors in relation to pregnancy and infant outcomes. Gestational MUAC and maternal HIV status (HIV-positive mothers = 39%) were associated with infant WAZ and LAZ from birth to 6-months in multivariate models, even after adjustment for infant feeding practices. The lowest gestational MUAC tertile was associated with lower WAZ throughout early infancy, as well as lower LAZ at 3 and 6-months. In linear mixed effects models through 6-months, each 1 cm increase in gestational MUAC was associated with a 0.11 increase in both WAZ (P anthropometry through 6-months despite maternal antiretroviral access. Routine assessment of MUAC has the potential to identify at-risk women in need of additional health interventions designed to optimize pregnancy outcomes and infant growth
Azmat, Syed Khurram; Mustafa, Ghulam; Hameed, Waqas; Asghar, Jamshaid; Ahmed, Aftab; Shaikh, Babar T
The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes the perspectives of Suraj clients, field workers mobilization (FWMs), and providers on various components of the Suraj model. A qualitative exploratory study was conducted in six randomly selected intervention districts in the Sindh and Punjab provinces. Data were collected using focus group discussions (FGDs) with clients and in-depth interviews (IDIs) with providers and FWMs. Data were manually analyzed using constant comparison and the thematic analysis approach. Clients showed positive attitudes towards modern contraceptive methods and identified Suraj FWMs and signboards as sources of information. Almost all clients reported IUCDs as effective methods as they have manageable side effects and require fewer visits to clinics. They spoke highly of voucher schemes as these enabled them to avail free IUCD services. Clients also appreciated many components of Suraj clinics, including cleanliness, privacy, confidentiality, the sterilization of instruments, and courteous Suraj providers and FWMs. Most Suraj providers said that IUCD insertion and infection-prevention training enhanced their ability to provide IUCD services and increased their standing in local communities. They reported that the role of FWMs was crucial in mobilizing the community and increasing their FP clientele. The FWMs said that attitudes
Full Text Available The malaria vaccine candidate, RTS,S/AS01(E, showed promising protective efficacy in a trial of Kenyan and Tanzanian children aged 5 to 17 months. Here we report on the vaccine's safety and tolerability. The experimental design was a Phase 2b, two-centre, double-blind (observer- and participant-blind, randomised (1∶1 ratio controlled trial. Three doses of study or control (rabies vaccines were administered intramuscularly at 1 month intervals. Solicited adverse events (AEs were collected for 7 days after each vaccination. There was surveillance and reporting for unsolicited adverse events for 30 days after each vaccination. Serious adverse events (SAEs were recorded throughout the study period which lasted for 14 months after dose 1 in Korogwe, Tanzania and an average of 18 months post-dose 1 in Kilifi, Kenya. Blood samples for safety monitoring of haematological, renal and hepatic functions were taken at baseline, 3, 10 and 14 months after dose 1. A total of 894 children received RTS,S/AS01(E or rabies vaccine between March and August 2007. Overall, children vaccinated with RTS,S/AS01(E had fewer SAEs (51/447 than children in the control group (88/447. One SAE episode in a RTS,S/AS01(E recipient and nine episodes among eight rabies vaccine recipients met the criteria for severe malaria. Unsolicited AEs were reported in 78% of subjects in the RTS,S/AS01(E group and 74% of subjects in the rabies vaccine group. In both vaccine groups, gastroenteritis and pneumonia were the most frequently reported unsolicited AE. Fever was the most frequently observed solicited AE and was recorded after 11% of RTS,S/AS01(E doses compared to 31% of doses of rabies vaccine. The candidate vaccine RTS,S/AS01(E showed an acceptable safety profile in children living in a malaria-endemic area in East Africa. More data on the safety of RTS,S/AS01(E will become available from the Phase 3 programme.
Norris, Alison H; Decker, Michele R; Weisband, Yiska L; Hindin, Michelle J
Physical intimate partner violence (IPV) and STIs, including HIV, are highly prevalent in east Africa. While we have some evidence about women's experience with physical IPV, little is known about men's experience with physical IPV, particularly in sub-Saharan Africa. Our objective was to examine, in Tanzanian male migrant plantation residents, the prevalence of, and associations among, experience and enactment of physical IPV and prevalent STI/HIV. Data from a cross-sectional survey of male plantation residents (n=158) in northern Tanzania were analysed to estimate prevalence of physical IPV experience and enactment. We assessed associations between IPV and sexual risk behaviours, and serodiagnosis of HIV, herpes simplex virus type-2 (HSV-2) and syphilis. Overall, 30% of men had experienced and/or enacted physical IPV with their main sexual partner: 19% of men had ever experienced physical IPV with their main sexual partner; 22% had enacted physical IPV with their main sexual partner. Considering overlaps in these groups, 11% of all participants reported reciprocal (both experienced and enacted) physical IPV. 9% of men were HIV seropositive, 51% were HSV-2 seropositive and 10% were syphilis seropositive-54% had at least one STI. Men who reported reciprocal physical IPV had increased odds of STI/HIV (adjusted OR (AOR) 8.85, 95% CI 1.78 to 44.6); the association retained statistical significance (AOR 14.5, 95% CI 1.4 to 147.0) with sexual risk behaviours included in the multivariate model. Men's physical IPV experience and enactment was common among these migrant plantation residents. Men reporting reciprocal physical IPV had significantly increased odds of prevalent STI/IPV, and we hypothesise that they have unstable relationships. Physical IPV is an important risk factor for STI/HIV transmission, and programmatic activities are needed to prevent both. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence
Athumani M. Ramadhani
Full Text Available Trachoma, caused by Chlamydia trachomatis, is the world's leading infectious cause of blindness and remains a significant public health problem. Much of trachomatous disease pathology is thought to be caused indirectly by host cellular and immune responses, however the immune response during active trachoma and how this initiates progressive scarring is not clearly understood. Defining protective vs. pathogenic immune response to C. trachomatis is important for vaccine design and evaluation. This study reports the baseline results of a longitudinal cohort of Tanzanian children, who were monitored for 4 years in order to determine the immunofibrogenic and infectious correlates of progressive scarring trachoma. In this cohort baseline, 506 children aged 6–10 years were assessed for clinical signs, infection status and the expression of 91 genes of interest prior to mass azithromycin administration for trachoma control. C. trachomatis was detected using droplet digital PCR and gene expression was measured using quantitative real-time PCR. The prevalence of follicles, papillary inflammation and scarring were 33.6, 31.6, and 28.5%, respectively. C. trachomatis was detected in 78/506 (15.4% individuals, 62/78 of whom also had follicles. C. trachomatis infection was associated with a strong upregulation of IFNG and IL22, the enrichment of Th1 and NK cell pathways and Th17 cell-associated cytokines. In individuals with inflammation in the absence of infection the IFNG/IL22 and NK cell response was reduced, however, pro-inflammatory, growth and matrix factors remained upregulated and mucins were downregulated. Our data suggest that, strong IFNG/IL22 responses, probably related to Th1 and NK cell involvement, is important for clearance of C. trachomatis and that the residual pro-inflammatory and pro-fibrotic phenotype that persists after infection might contribute to pathological scarring. Interestingly, females appear more susceptible to developing
Future climate projections indicate that a very serious consequence of post-industrial anthropogenic global warming is the likelihood of the greater frequency and intensity of extreme hydrometeorological events such as heat waves, droughts, storms, and floods. The design of national and international policies targeted at building more resilient and environmentally sustainable food systems needs to rely on access to robust and reliable data which is largely absent. In this context, the improvement of the modelling of current and future agricultural production losses using the unifying language of risk is paramount. In this study, we use a methodology that allows the integration of the current understanding of the various interacting systems of climate, agro-environment, crops, and the economy to determine short to long-term risk estimates of crop production loss, in different environmental, climate, and adaptation scenarios. This methodology is applied to Tanzania to assess optimum risk reduction and maize production increase paths in different climate scenarios. The simulations carried out use inputs from three different crop models (DSSAT, APSIM, WRSI) run in different technological scenarios and thus allowing to estimate crop model-driven risk exposure estimation bias. The results obtained also allow distinguishing different region-specific optimum climate risk reduction policies subject to historical as well as RCP2.5 and RCP8.5 climate scenarios. The region-specific risk profiles obtained provide a simple framework to determine cost-effective risk management policies for Tanzania and allow to optimally combine investments in risk reduction and risk transfer.
Thomsen, Robert Chr.
previously independent countries, are excellent examples of this. Building on theories of national identity-formation and nationalism, it traces the development of cultural and political nationalism, and changing images of the national self. With a focus on important fomenting factors and actors...
Smithson, Paul; Florey, Lia; Salgado, S. Rene; Hershey, Christine L.; Masanja, Honorati; Bhattarai, Achuyt; Mwita, Alex; McElroy, Peter D.
Background Mainland Tanzania scaled up multiple malaria control interventions between 1999 and 2010. We evaluated whether, and to what extent, reductions in all-cause under-five child mortality (U5CM) tracked with malaria control intensification during this period. Methods Four nationally representative household surveys permitted trend analysis for malaria intervention coverage, severe anemia (hemoglobin malaria endemicity. Prevalence of contextual factors (e.g., vaccination, nutrition) likely to influence U5CM were also assessed. Population attributable risk percentage (PAR%) estimates for malaria interventions and contextual factors that changed over time were used to estimate magnitude of impact on U5CM. Results Household ownership of insecticide-treated nets (ITNs) rose from near zero in 1999 to 64% (95% CI, 61.7–65.2) in 2010. Intermittent preventive treatment of malaria in pregnancy reached 26% (95% CI, 23.6–28.0) by 2010. Sulfadoxine-pyrimethamine replaced chloroquine in 2002 and artemisinin-based combination therapy was introduced in 2007. SAP among children 6–59 months declined 50% between 2005 (11.1%; 95% CI, 10.0–12.3%) and 2010 (5.5%; 95% CI, 4.7–6.4%) and U5CM declined by 45% between baseline (1995–9) and endpoint (2005–9), from 148 to 81 deaths/1000 live births, respectively. Mortality declined 55% among children 1–23 months of age in higher malaria endemicity areas. A large reduction in U5CM was attributable to ITNs (PAR% = 11) with other malaria interventions adding further gains. Multiple contextual factors also contributed to survival gains. Conclusion Marked declines in U5CM occurred in Tanzania between 1999 and 2010 with high impact from ITNs and ACTs. High-risk children (1–24 months of age in high malaria endemicity) experienced the greatest declines in mortality and SAP. Malaria control should remain a policy priority to sustain and further accelerate progress in child survival. PMID:26536354
Merville, Denis; Lechevin, Bruno; Mialot, Stephane; Lefeuvre, Katia
The National Energy Ombudsman is an independent administrative authority that was created by the law of 7 December 2006 relating to the energy sector, in preparation for the imminent liberalisation of the French gas and electricity markets. It has two legal roles: participating in the process of informing consumers about their rights, and recommending solutions for settling disputes. The Ombudsman reports directly to the French Parliament. This 2012 edition of the National energy ombudsman's activity report has adopted a somewhat original, but very informative, format: an abc which allows us to take a look back at the highlights of 2012 and to summarise the great energy challenges that the National Energy Ombudsman has worked on since 2007: Achievements, Activity, Amicable agreement, Billing decree, Consultation, Disconnections, Energy voucher, National debate on energy transition, help to consumers, lowering gas prices, best management of public resources, communicating gas meter project, Peak hours and off-peak hours, Unpaid bills, Commercially sensitive information, Disputes, Mediation, development of the European Network of Independent Energy Ombudsmen, Combat against energy poverty, Consumer protection, Back billing time limit, Supply quality, Complaint, Recommendations, Debt distress, rise in prices etc
Sonnichsen, André; Gad, Ulrik Pram
Is nationality the only way of organizing political community? Given the ubiquity of the national principle, one might think so. But, in practice, the national principle is constantly challenged by what can be termed non-national identities. This article looks at manners in which such deviating...... identities can be conceptualized, how contemporary European states have attempted to deal with them when they arise and to what extent non-national modes of organizing political community can point towards a challenge to the national principle itself. In its capacity as an introduction to the special issue...
Hunter, Benjamin M; Murray, Susan F
Demand-side financing (DSF) interventions, including cash transfers and vouchers, have been introduced to promote maternal and newborn health in a range of low- and middle-income countries. These interventions vary in design but have typically been used to increase health service utilisation by offsetting some financial costs for users, or increasing household income and incentivising 'healthy behaviours'. This article documents experiences and implementation factors associated with use of DSF in maternal and newborn health. A secondary analysis (using an adapted Supporting the Use of Research Evidence framework - SURE) was performed on studies that had previously been identified in a systematic review of evidence on DSF interventions in maternal and newborn health. The article draws on findings from 49 quantitative and 49 qualitative studies. The studies give insights on difficulties with exclusion of migrants, young and multiparous women, with demands for informal fees at facilities, and with challenges maintaining quality of care under increasing demand. Schemes experienced difficulties if communities faced long distances to reach participating facilities and poor access to transport, and where there was inadequate health infrastructure and human resources, shortages of medicines and problems with corruption. Studies that documented improved care-seeking indicated the importance of adequate programme scope (in terms of programme eligibility, size and timing of payments and voucher entitlements) to address the issue of concern, concurrent investments in supply-side capacity to sustain and/or improve quality of care, and awareness generation using community-based workers, leaders and women's groups. Evaluations spanning more than 15 years of implementation of DSF programmes reveal a complex picture of experiences that reflect the importance of financial and other social, geographical and health systems factors as barriers to accessing care. Careful design of DSF
Cheesbrough, Kate; Bader, Meghan
New clean energy and energy efficiency technology solutions hold the promise of significant reductions in energy consumption. However, proven barriers for these technologies, including the technological and commercialization valleys of death, result in promising technologies falling to the wayside. To address these gaps, NREL's Innovation & Entrepreneurship Center designs and manages advanced programs aimed at supporting the development and commercialization of early stage clean energy technologies with the goal of accelerating new technologies to market. These include: Innovation Incubator (IN2) in partnership with Wells Fargo: this technology incubator supports energy efficiency building-related startups to overcome market gaps by providing access to technical support at NREL; Small Business Voucher Pilot: this program offers paid vouchers for applicants to access a unique skill, capability, or facility at any of the 17 DOE National Laboratories to bring next-generation clean energy technologies to market; Energy Innovation Portal: NREL designed and developed the Energy Innovation Portal, providing access to EERE focused intellectual property available for licensing from all of the DOE National Laboratories; Lab-Corps: Lab-Corps aims to better train and empower national lab researchers to understand market drivers and successfully transition their discoveries into high-impact, real world technologies in the private sector; Incubatenergy Network: the Network provides nationwide coordination of clean energy business incubators, share best practices, support clean energy entrepreneurs, and help facilitate a smoother transition to a more sustainable clean energy economy; Industry Growth Forum: the Forum is the perfect venue for clean energy innovators to maximize their exposure to receptive capital and strategic partners. Since 2003, presenting companies have collectively raised more than $5 billion in growth financing.
Gutiérrez, Eliécer E.; Helgen, Kristofer M.; McDonough, Molly M.; Bauer, Franziska; Hawkins, Melissa T. R.; Escobedo-Morales, Luis A.; Patterson, Bruce D.; Maldonado, Jesús E.
Abstract The taxonomy of American deer has been established almost entirely on the basis of morphological data and without the use of explicit phylogenetic methods; hence, phylogenetic analyses including data for all of the currently recognized species, even if based on a single gene, might improve current understanding of their taxonomy. We tested the monophyly of the morphology-defined genera and species of New World deer (Odocoileini) with phylogenetic analyses of mitochondrial DNA sequences. This is the first such test conducted using extensive geographic and taxonomic sampling. Our results do not support the monophyly of Mazama, Odocoileus, Pudu, M. americana, M. nemorivaga, Od. hemionus, and Od. virginianus. Mazama contains species that belong to other genera. We found a novel sister-taxon relationship between “Mazama” pandora and a clade formed by Od. hemionus columbianus and Od. h. sitkensis, and transfer pandora to Odocoileus. The clade formed by Od. h. columbianus and Od. h. sitkensis may represent a valid species, whereas the remaining subspecies of Od. hemionus appear closer to Od. virginianus. Pudu (Pudu) puda was not found sister to Pudu (Pudella) mephistophiles. If confirmed, this result will prompt the recognition of the monotypic Pudella as a distinct genus. We provide evidence for the existence of an undescribed species now confused with Mazama americana, and identify other instances of cryptic, taxonomically unrecognized species-level diversity among populations here regarded as Mazama temama, “Mazama” nemorivaga, and Hippocamelus antisensis. Noteworthy records that substantially extend the known distributions of M. temama and “M.” gouazoubira are provided, and we unveil a surprising ambiguity regarding the distribution of “M.” nemorivaga, as it is described in the literature. The study of deer of the tribe Odocoileini has been hampered by the paucity of information regarding voucher specimens and the provenance of sequences
Eliécer E. Gutiérrez
Full Text Available The taxonomy of American deer has been established almost entirely on the basis of morphological data and without the use of explicit phylogenetic methods; hence, phylogenetic analyses including data for all of the currently recognized species, even if based on a single gene, might improve current understanding of their taxonomy. We tested the monophyly of the morphology-defined genera and species of New World deer (Odocoileini with phylogenetic analyses of mitochondrial DNA sequences. This is the first such test conducted using extensive geographic and taxonomic sampling. Our results do not support the monophyly of Mazama, Odocoileus, Pudu, M. americana, M. nemorivaga, Od. hemionus, and Od. virginianus. Mazama contains species that belong to other genera. We found a novel sister-taxon relationship between “Mazama” pandora and a clade formed by Od. hemionus columbianus and Od. h. sitkensis, and transfer pandora to Odocoileus. The clade formed by Od. h. columbianus and Od. h. sitkensis may represent a valid species, whereas the remaining subspecies of Od. hemionus appear closer to Od. virginianus. Pudu (Pudu puda was not found sister to Pudu (Pudella mephistophiles. If confirmed, this result will prompt the recognition of the monotypic Pudella as a distinct genus. We provide evidence for the existence of an undescribed species now confused with Mazama americana, and identify other instances of cryptic, taxonomically unrecognized species-level diversity among populations here regarded as Mazama temama, “Mazama” nemorivaga, and Hippocamelus antisensis. Noteworthy records that substantially extend the known distributions of M. temama and “M.” gouazoubira are provided, and we unveil a surprising ambiguity regarding the distribution of “M.” nemorivaga, as it is described in the literature. The study of deer of the tribe Odocoileini has been hampered by the paucity of information regarding voucher specimens and the provenance of
Gutiérrez, Eliécer E; Helgen, Kristofer M; McDonough, Molly M; Bauer, Franziska; Hawkins, Melissa T R; Escobedo-Morales, Luis A; Patterson, Bruce D; Maldonado, Jesús E
The taxonomy of American deer has been established almost entirely on the basis of morphological data and without the use of explicit phylogenetic methods; hence, phylogenetic analyses including data for all of the currently recognized species, even if based on a single gene, might improve current understanding of their taxonomy. We tested the monophyly of the morphology-defined genera and species of New World deer (Odocoileini) with phylogenetic analyses of mitochondrial DNA sequences. This is the first such test conducted using extensive geographic and taxonomic sampling. Our results do not support the monophyly of Mazama , Odocoileus , Pudu , M. americana , M. nemorivaga , Od. hemionus , and Od. virginianus . Mazama contains species that belong to other genera. We found a novel sister-taxon relationship between " Mazama " pandora and a clade formed by Od. hemionus columbianus and Od. h. sitkensis , and transfer pandora to Odocoileus . The clade formed by Od. h. columbianus and Od. h. sitkensis may represent a valid species, whereas the remaining subspecies of Od. hemionus appear closer to Od. virginianus . Pudu ( Pudu ) puda was not found sister to Pudu (Pudella) mephistophiles. If confirmed, this result will prompt the recognition of the monotypic Pudella as a distinct genus. We provide evidence for the existence of an undescribed species now confused with Mazama americana , and identify other instances of cryptic, taxonomically unrecognized species-level diversity among populations here regarded as Mazama temama , " Mazama " nemorivaga , and Hippocamelus antisensis . Noteworthy records that substantially extend the known distributions of M. temama and " M. " gouazoubira are provided, and we unveil a surprising ambiguity regarding the distribution of " M. " nemorivaga , as it is described in the literature. The study of deer of the tribe Odocoileini has been hampered by the paucity of information regarding voucher specimens and the provenance of sequences
Can food vouchers improve nutrition and reduce health inequalities in low-income mothers and young children: a multi-method evaluation of the experiences of beneficiaries and practitioners of the Healthy Start programme in England.
McFadden, Alison; Green, Josephine M; Williams, Victoria; McLeish, Jenny; McCormick, Felicia; Fox-Rushby, Julia; Renfrew, Mary J
Good nutrition is important during pregnancy, breastfeeding and early life to optimise the health of women and children. It is difficult for low-income families to prioritise spending on healthy food. Healthy Start is a targeted United Kingdom (UK) food subsidy programme that gives vouchers for fruit, vegetables, milk, and vitamins to low-income families. This paper reports an evaluation of Healthy Start from the perspectives of women and health practitioners. The multi-method study conducted in England in 2011/2012 included focus group discussions with 49 health practitioners, an online consultation with 620 health and social care practitioners, service managers, commissioners, and user and advocacy groups, and qualitative participatory workshops with 85 low-income women. Additional focus group discussions and telephone interviews included the views of 25 women who did not speak English and three women from Traveller communities. Women reported that Healthy Start vouchers increased the quantity and range of fruit and vegetables they used and improved the quality of family diets, and established good habits for the future. Barriers to registration included complex eligibility criteria, inappropriate targeting of information about the programme by health practitioners and a general low level of awareness among families. Access to the programme was particularly challenging for women who did not speak English, had low literacy levels, were in low paid work or had fluctuating incomes. The potential impact was undermined by the rising price of food relative to voucher value. Access to registered retailers was problematic in rural areas, and there was low registration among smaller shops and market stalls, especially those serving culturally diverse communities. Our evaluation of the Healthy Start programme in England suggests that a food subsidy programme can provide an important nutritional safety net and potentially improve nutrition for pregnant women and young
because they lack collateral and experience. Youth feel they are distrusted by both the older generation and by Tanzanian institutions including, besides the financial institutions, the state and the private sector generally. Young entrepreneurs attending the workshop, and those aspiring to become one, mentioned the hurdle ...
Weiss, Alexander; Wilson, Michael L.; Collins, D. Anthony; Mjungu, Deus; Kamenya, Shadrack; Foerster, Steffen; Pusey, Anne E.
Researchers increasingly view animal personality traits as products of natural selection. We present data that describe the personalities of 128 eastern chimpanzees (Pan troglodytes schweinfurthii) currently living in or who lived their lives in the Kasekela and Mitumba communities of Gombe National Park, Tanzania. We obtained ratings on 24 items from an established, reliable, well-validated questionnaire used to study personality in captive chimpanzee populations. Ratings were made by former and present Tanzanian field assistants who followed individual chimpanzees for years and collected detailed behavioral observations. Interrater reliabilities across items ranged from acceptable to good, but the personality dimensions they formed were not as interpretable as those from captive samples. However, the personality dimensions corresponded to ratings of 24 Kasekela chimpanzees on a different questionnaire in 1973 that assessed some similar traits. These correlations established the repeatability and construct validity of the present ratings, indicating that the present data can facilitate historical and prospective studies that will lead to better understanding of the evolution of personality in chimpanzees and other primates. PMID:29064463
Glass, Gene V.
In this article, the author discusses the demographic trends affecting America's public schools. As an expert on empirical evaluation of education, the author believes the major debates over vouchers, charter schools, bilingual education, and other issues are not really about preparing the next generation to compete with China or India, or about…
Jill S. Baron; Craig D. Allen; Erica Fleishman; Lance Gunderson; Don McKenzie; Laura Meyerson; Jill Oropeza; Nate Stephenson
Covering about 4% of the United States, the 338,000 km2 of protected areas in the National Park System contain representative landscapes of all of the nation's biomes and ecosystems. The U.S. National Park Service Organic Act established the National Park System in 1916 "to conserve the scenery and the natural and historic objects and...
U.S. Department of Health & Human Services — Payment measures – national data. This data set includes national-level data for the payment measures associated with an episode of care for heart attack, heart...
U.S. Department of Health & Human Services — Payment measures â national data. This data set includes national-level data for the payment measures associated with an episode of care for heart attack, heart...
U.S. Department of Health & Human Services — The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...
Johansson, K A; Jerene, D; Norheim, O F
To provide an ethical analysis of whether the Ethiopian and Tanzanian national HIV/AIDS treatment guidelines can be considered legitimate and fair rationing tools. Qualitative study and ethical analysis involving guideline documents and interviews with nine key members involved in the development of the guidelines. The analysis followed an editing organising style. The theoretical framework was a guideline-specific framework based on theories of just resource allocation in healthcare and conditions that ensure fair processes in guideline development. According to this framework, legitimate rationing requires reasons for patient selection to be explicit, public and relevant, and decisions must be open to question and revision. The only explicit rationing criteria that both guidelines recommended were clinical antiretroviral treatment indications. Explicit non-clinical rationing criteria were expressed in a separate Ethiopian implementation guideline. Neither of the guideline development processes fully satisfies minimal requirements of procedural fairness. There is a lack of transparency. The reasons for decisions are rarely given and are not publicly available. This reduces the opportunity for public questioning, debate and revisions. The guidelines were based on expert opinion and consensus. Recommendations from the WHO were copied without much discussion, disagreement or adjustment. The two national HIV treatment guidelines discussed are de facto mechanisms for rationing but were developed using methods that do not fully satisfy the requirements of fair processes.
Ferguson, Priscilla Parkhurst
Culinary consciousness raisers, cooking texts often serve as vehicles of national identification. From Pampille (Marthe Allard Daudet) and her cookbook, Les Bons Plats de France, in 1913 to the international culinary competitions of today such as the Bocuse d'or, culinary distinction promotes national interests. In contrast to the strident nationalism of the early twentieth century, culinary nationalism today operates in an increasingly globalized world. National culinary distinction defines the nation and sells its products in a highly competitive international arena. A recent culinary text, the South Korean film Le Grand Chef [Sik Gaek ] (2007), illustrates the phenomenon, subsuming national culinary promotion in a mega culinary competition, all in the service of Korean culinary achievement.
Rijs Antonius JMM
Full Text Available Abstract Background In Tanzania, little is known on the species distribution and antifungal susceptibility profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal candidiasis. Methods A total of 296 clinical oral yeasts were isolated from 292 HIV-infected patients with oropharyngeal candidiasis at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Identification of the yeasts was performed using standard phenotypic methods. Antifungal susceptibility to fluconazole, itraconazole, miconazole, clotrimazole, amphotericin B and nystatin was assessed using a broth microdilution format according to the guidelines of the Clinical and Laboratory Standard Institute (CLSI; M27-A2. Results Candida albicans was the most frequently isolated species from 250 (84.5% patients followed by C. glabrata from 20 (6.8% patients, and C. krusei from 10 (3.4% patients. There was no observed significant difference in species distribution between patients with primary and recurrent oropharyngeal candidiasis, but isolates cultured from patients previously treated were significantly less susceptible to the azole compounds compared to those cultured from antifungal naïve patients. Conclusion C. albicans was the most frequently isolated species from patients with oropharyngeal candidiasis. Oral yeast isolates from Tanzania had high level susceptibility to the antifungal agents tested. Recurrent oropharyngeal candidiasis and previous antifungal therapy significantly correlated with reduced susceptibility to azoles antifungal agents.
1880s, emphasizing the Confucian obligation of filial piety and the national obligation of loyalty. This, along with compulsory military drill...materialized in the form of kokutai ( the national essence; what it means to be Japanese) discussions, reactions against official Confucianism, classical ...feeling of loyalty to the imperial house. Kokugaku, or national learning, developed as a reaction against the dominating Chinese classics and philosophy
Department of Transportation — National Park Service unit boundaries (NTAD). These park boundaries signify legislative boundary definitions and local park names have been consolidated according to...
National Oceanic and Atmospheric Administration, Department of Commerce — Data for this project resides in the West Coast Groundfish Bottom Trawl Survey Database. Deep-sea corals are often components of trawling bycatch, though their...
Mwalongo, D.; Kileo, A.
Utilization of nuclear power has been escalating, hence the growing demand for Uranium for the world nuclear power worldwide and in particular Asia and Middle East. This has influenced uranium exploration, development and investment in different countries in the world. In 2007, Tanzania witnessed extensive uranium exploration investment and discovery of several sites with economically viable uranium deposits at Bahi, Manyoni and Mkuju River. The most advanced project is Mkuju River Project located in the Selous Game Reserve, which is a classified UNESCO World Heritage site. At a time of discovery, the country had no previous experience managing uranium production cycle, hence the necessity for cooperation with national and international stakeholders to ensure safe, secure and safeguarded Uranium mining. This development pressed a need to quickly and efficiently setting up of an internationally accepted best practice for uranium mining in the country. Preparations and stakeholder involvement in setting regulatory framework for uranium mining were initiated. Therefore, the request was submitted to International Atomic Energy Agency (IAEA) Uranium Production Site Appraisal Team (UPSAT) mission to review the country’s regulatory readiness for uranium governance. The review mission aimed at appraising the country’s preparedness for overseeing the Uranium Production Cycle in general and with emphasis on the planned Mkuju River Project (MRP) in the south of the country in particular. The mission comprehensively reviewed the regulatory system, sustainable uranium production life cycle, health, safety and environment, social licensing and capacity building and gave objective recommendations based on best practice. Therefore, this paper briefly reviews the impact of the first UPSAT mission in African soil for fostering sustainable best practice for uranium life cycle in Tanzania. (author)
Oyugi, Boniface; Kioko, Urbanus; Kaboro, Stephen Mbugua; Gikonyo, Shadrack; Okumu, Clarice; Ogola-Munene, Sarah; Kalsi, Shaminder; Thiani, Simon; Korir, Julius; Odundo, Paul; Baltazaar, Billy; Ranji, Moses; Muraguri, Nicholas; Nzioka, Charles
the variance explained by various models, is larger than 18% for implants and total or combined long-term family planning. The study showed that the voucher services in Kenya has been effective in providing long-term family planning services and improving access of care provided to women of reproductive age. Therefore, voucher scheme can be used as a tool for bridging the gap of unmet needs of family planning in Kenya and could potentially be more effective if rolled out to other counties.
In National Responsibility and Global Justice, David Miller defends the view that a member of a nation can be collectively responsible for an outcome despite the fact that: (i) she did not control it; (ii) she actively opposed those of her nation's policies that produced the outcome; and (iii......) actively opposing the relevant policy was costly for her. I argue that Miller's arguments in favor of this strong externalist view about responsibility and control are insufficient. Specifically, I show that Miller's two models of synchronic collective responsibility*the like-minded group model...
The foundation of a 'National Laboratory' which would support a Research center in synchrotron radiation applications is proposed. The essential features of such a laboratory differing of others centers in Brazil are presented. (L.C.) [pt
Kristensen, Helen Grundtvig; Stjernø, Henrik
Artikel om national database for sygeplejeforskning oprettet på Dansk Institut for Sundheds- og Sygeplejeforskning. Det er målet med databasen at samle viden om forsknings- og udviklingsaktiviteter inden for sygeplejen.......Artikel om national database for sygeplejeforskning oprettet på Dansk Institut for Sundheds- og Sygeplejeforskning. Det er målet med databasen at samle viden om forsknings- og udviklingsaktiviteter inden for sygeplejen....
Holod, Aleksandra; Johnson, Anna D.; Martin, Anne; Gardner, Margo; Brooks-Gunn, Jeanne
Background: The federal child care subsidy program, funded through the Child Care and Development Fund (CCDF), is the nation's largest public investment in early child care. However, little is known about whether and how subsidy payment mechanisms relate to the stability of subsidy receipt or the stability of children's care arrangements.…
Monitoring and evaluation pilots Energy Box and Energy vouchers. Measuring the success rate of two instruments for energy saving in households; Monitoring en evaluatie pilots Energiebox en Energiebon. Succesmeting van twee instrumenten voor energiebesparing bij huishoudens
Groot, M.I.; Koot, M.C.M.; Schepers, B.L.; Wielders, L.M.L. [CE, Delft (Netherlands); Jungblut, P. [Blauw Research, Rotterdam (Netherlands)
The Dutch government wants to incite energy saving behavior in households and increase the use of energy saving products. By means of the pilot projects of the Energy Box and the Energy Voucher the Dutch Ministry of Housing, Spatial Planning and the Environment wants to examine if these instruments can contribute to changing behavior and the corresponding CO2 reduction. This final report describes the results of the monitoring and evaluation study of the pilots with the aim of establishing how the actions are values in real life, which products are actually used and what the direct and indirect effects are of these actions on energy saving, CO2 reduction and changing behavior [mk]. [Dutch] De overheid wil Nederlandse huishoudens aanzetten tot energiebesparend gedrag en gebruik van energiebesparende producten. Met de uitgevoerde pilotprojecten van de Energiebox en de Energiebon wil het Ministerie van VROM onderzoeken of met deze instrumenten een bijdrage kan worden geleverd aan gedragsverandering en de daarmee samenhangende CO2-reductie. In deze eindrapportage worden de resultaten van de monitoring en evaluatiestudie van de pilots beschreven met als doel: Bepalen hoe de acties in de praktijk gewaardeerd worden, welke producten daadwerkelijk worden gebruikt en welk directe en indirecte effecten de acties hebben op energiebesparing, CO2-reductie en gedragsverandering.
This viewpoint paper examines environmental education policy in practice in Tanzania in the context of the primary school curriculum. This policy review stretches back to the mid-1960s, when major curricula changes were effected, to the present. The paper highlights efforts during this period to provide relevant education ...
Normal operations at the Kihansi power station in Tanzania may be endangering the spray toad (Nectophrynoides asperginis). The problem is that reduced water flows (as a result of abstraction for hydroelectricity) results in insufficient spray for the toads, but so far nobody knows what flow rate will ensure survival. Additional water sprays are provided to irrigate parts of the wetlands habitat. The problem has yet to be resolved
Background. The performance of clinical and immunological criteria to predict virological failure in HIV-infected children receiving antiretroviral therapy (ART) is not well documented. Objective. To determine the validity of clinical and immunological monitoring in detecting virological failure in children on ART. Methods.
John, Innocensia Festo; Egelyng, Henrik; Lokina, Azack
requirements for such creation or capturing to happen, including presence of export opportunities, are discussed. Geographical indication is believed to allow smallholders to create employment and build monetary value, while stewarding local food cultures and natural environments and resources, and increasing......As the world's population is constantly growing, food security will remain on the policy Agenda, particularly in Africa. At the same time, global food systems experience a new wave focusing on local foods and food sovereignty featuring high quality food products of verifiable geographical origin...... of food origin products in Tanzania that have potential for GI certification. The hypothesis was that there are origin products in Tanzania whose unique characteristics are linked to the area of production. Geographical indications can be useful policy instruments contributing to food security...
Micron sized polymeric particles were prepared from cashew nut shell liquid and subsequently functionalized to produce micron-sized carboxylated cation exchange resin (MCCER). By titrimetry and analytical procedures employing atomic absorption spectrometry, an assessment of the cation exchange capability of the ...
media that enhance a variety of learning styles and the acquisition of knowledge and new ideas (Healey, 2003) ... sports and news from around the world instead of using the Internet for academic matters. In the same vein ..... recreational purposes e.g. Music, sports, fashion and design, celebrities, etc., every day and two to ...
Based on a questionnaire survey of librarians and undergraduate students, the study found that the main IL teaching methods used include lectures, web pages and seminars, while content covered in IL sessions include information search skills, use of library facilities, information evaluation, and use of information sources.
MiniPrep Kit (ZYMO RESEARCH) according to manufacturer's instructions. Concentration and cleanliness of genomic. DNA were assayed by nanodrop spectrophotometer(THERMO SCIENTIFIC. NanoDrop 2000c) whereas DNA quality was checked by gel electrophoresis on 1% agarose gel stained with GelRed using λ.
In this study, ten wild saprophytic edible mushrooms samples, collected from Tanzania natural forests and planted trees, and their two domesticated forms were characterized by in-vitro/in-vivo amplification and sequencing of ITS/LSU regions. Mushroom genomic DNA was extracted by ZR Fungal/Bacterial DNA MniPrep Kit.
The grafted seedlings with graft union tied using grafting clips were healed in a dark chamber for three days and then in a transparent chamber for three days. The average temperature and relative humidity in both chambers were maintained at 21-30°C and 85-95 %, respectively. The grafted seedlings were hardened for ...
Happy Nation er et stykke eksperimentel teknologiformidling, der er udformet som en skønlitterær roman. Værket tager udgangspunkt i et fremtidsscenarie, hvor virtual reality er blevet en hverdagsteknologi, hvis sansedel bliver understøttet af implantater, der kan foretage dyb hjernestimulation...
... (ICR) entitled National Service Trust Voucher & Payment Request Form for review and approval in...: CNCS is seeking approval of the National Service Trust Voucher & Payment Request Form, which is used by...: Corporation for National and Community Service. Title: National Service Trust Voucher & Payment Request Form...
Okeke, Janice O; Ekanayake, Ruwani M; Santorelli, Melissa L
Purpose In 2014, the New Jersey Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began requiring WIC-authorized stores to stock at least two fresh fruits and two fresh vegetables. We aimed to evaluate the effect of this policy change on fruit and vegetable purchases among WIC-participating households and to assess variation by household access to a healthy food store such as a supermarket or large grocery store. Description Households with continuous WIC enrollment from June 2013 to May 2015 were included (n = 16,415). Participants receive monthly cash-value vouchers (CVVs) to purchase fruits and vegetables. For each household, the CVV redemption proportion was calculated for the period before and after the policy by dividing the total dollar amount redeemed by the total dollar amount issued. Complete redemption was defined as a proportion ≥90% and the change in complete redemption odds was assessed after adjusting for Supplemental Nutrition Assistance Program participation. Assessment We observed a small increase following the policy change [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04-1.17]; however, the effect varied by healthy food access (p = 0.03). The odds increased for households with access to at least one healthy food store (OR 1.13, 95% CI 1.06-1.20) while no effect was observed for households without such access (OR 0.91, 95% CI 0.76-1.10). Conclusion Policy change was associated with a small increase in purchasing, but only among households with healthy food access. The state is addressing this gap through technical assistance interventions targeting WIC-authorized small stores in communities with limited access.
Lee, Kyung Mi
Considering the importance of explaining how a nation brand is effectively managed and how nation branding aligns the nation's brand with country management so as to gain competitiveness, this research aims to assess the role of nation branding and to create a strategic management tool for nation branding to achieve sustainable competitiveness of nations. Focusing on performance in nation branding, the dissertation develops a brand management model towards a systematic and strategic applicati...
Lee, Kyung Mi
Considering the importance of explaining how a nation brand is effectively managed and how nation branding aligns the nation's brand with country management so as to gain competitiveness, this research aims to assess the role of nation branding and to create a strategic management tool for nation
International Annual Bazaar of the 22 November 2005Thank you for helping to make the 2005 UNWG Bazaar a success! All 10 000 Lottery Tickets were sold, thereby raising 100 000 CHF to be given to projects helping impoverished children all over the world. The winning lottery numbers are posted below. Please print this notice and post it as you see fit. Prizes may be claimed at the Villa Les Feuillantines on November 23 - December 9 from 11am-1pm. After January 9 phone No. 022 917 33 86 between 9am-11.30am. Last day Friday May 22, 2006. Special thanks to all our kind and generous donors! All air and cruise tickets are non-transferable. Restrictions and validity dates on air and cruise tickets, travel vouchers, and gift certificates as stipulated by the donor apply. Prizes may not be redeemed for cash or other merchandise. Any attempt to do so will result in automatic forfeiture. Thank you for your support and good luck to all! 00154 01175 02081 02950 03891 05117 05920 07123 08110 08834 ...
International Annual Bazaar of 22 November 2005 Thank you for helping to make the 2005 UNWG Bazaar a success! All 10 000 Lottery Tickets were sold thereby raising 100 000 CHF to be given to projects helping impoverished children all over the world. The winning lottery numbers are posted below. Please print this notice and post it as you see fit. Prizes may be claimed at the Villa Les Feuillantines November 23 - December 9 from 11am-1pm. After January 9 phone nr 022 917 33 86 between 9am-11.30am. Last day Friday May 22, 2006.Special thanks to all our kind and generous donors! All air and cruise tickets are non-transferable. Restrictions and validity dates on air and cruise tickets, travel vouchers, and gift certificates as stipulated by the donor apply. Prizes may not be redeemed for cash or other merchandise. Any attempt to do so will result in automatic forfeiture. Thank you for your support and good luck to all! 00154 01175 02081 02950 03891 05117 05920 07123 08110 08834 ...
International Annual Bazaar 21 November 2006 Thank you for helping to make the 2006 UNWG Bazaar a success! All the money will be given to projects helping impoverished children all over the world. The winning lottery numbers are posted below. Please print this notice and post it as you see fit. Prizes may be claimed at the Villa Les Feuillantines from November 22 - December 14 from 11am-1pm. After January 15 2007 please call 022 917 33 86 between 9 am-11.30 am. Last day for collection will be the May 22, 2007. Special thanks to all our kind and generous donors! All air and cruise tickets are non-transferable. Restrictions and validity dates on air and cruise tickets, travel vouchers, and gift certificates as stipulated by the donor will apply. Prizes may not be redeemed for cash or other merchandise. Any attempt to do so will result in automatic forfeiture. Thank you for your support and good luck to all! 111 1328 2466 3447 4478 6174 7323 8565 271 1374 2488 3502 4487 6237 7324 8623 ...
Birth weight differences between those offered financial voucher incentives for verified smoking cessation and control participants enrolled in the Cessation in Pregnancy Incentives Trial (CPIT), employing an intuitive approach and a Complier Average Causal Effects (CACE) analysis.
McConnachie, Alex; Haig, Caroline; Sinclair, Lesley; Bauld, Linda; Tappin, David M
voucher incentives. ISRCTN Registry, ISRCTN87508788 . Registered on 1 September 2011.
Overpopulation is dealt with differently in China, India, Nigeria, and the United States. In China since the last 1970s, policy has emphasized one child per family; the incentives and penalties in wages, housing, and health care were relaxed in 1988 due to international pressure. The one son rule applies now. China policy will be devoted to limiting births for all couples at least until the year 2000. The annual growth rate is 1.5% and population is 1.166 billion, with doubling expected by 2047. India's population stands at 883 million with an annual growth rate of 2.1%; doubling of population is expected by 2028. India was one of the first countries to offer birth control in 1921. Fertility has declined over the past 50 years by about 33%. Family planning policy during the 1970s promoted sterilization, but coercion and targets were stopped in 1977 by rioting. India's 16% of world population is confined to only 2.4% of the world's land resources. Family size desired is still high at 2 sons. The future prospects include a tripling of population, unless political determination is effective in combatting tradition and mistrust of government. Nigeria's population is 93 million with an annual growth rate of 2.9%; doubling is expected by 2018. Nigeria is the most crowded African country and has overpopulation and environmental problems. Family size is high at 5.6 people. The US has a population of 259 million and a growth rate of 1.1%; doubling is expected by 2058. Although the US is the third most populous country and US citizens consume almost six times the world's energy supply per capita, overpopulation seems to be other nations' problem. 30% of growth is due to immigration. Even the US may soon be exceeding its ability to sustain itself. The challenge will be for US citizens to lower consumption and set a world example.
Westbrooks, R.; Westbrooks, R.
Over the past 50 years, experience has shown that interagency groups provide an effective forum for addressing various invasive species issues and challenges on multiple land units. However, more importantly, they can also provide a coordinated framework for early detection, reporting, identification and vouchering, rapid assessment, and rapid response to new and emerging invasive plants in the United States. Interagency collaboration maximizes the use of available expertise, resources, and authority for promoting early detection and rapid response (EDRR) as the preferred management option for addressing new and emerging invasive plants. Currently, an interagency effort is underway to develop a National EDRR System for Invasive Plants in the United States. The proposed system will include structural and informational elements. Structural elements of the system include a network of interagency partner groups to facilitate early detection and rapid response to new invasive plants, including the Federal Interagency Committee for the Management of Noxious and Exotic Weeds (FICMNEW), State Invasive Species Councils, State Early Detection and Rapid Response Coordinating Committees, State Volunteer Detection and Reporting Networks, Invasive Plant Task Forces, and Cooperative Weed Management Areas. Informational elements and products being developed include Regional Invasive Plant Atlases, and EDRR Guidelines for EDRR Volunteer Network Training, Rapid Assessment and Rapid Response, and Criteria for Selection of EDRR Species. System science and technical support elements which are provided by cooperating state and federal scientists, include EDRR guidelines, training curriculum for EDRR volunteers and agency field personnel, plant identification and vouchering, rapid assessments, as well as predictive modeling and ecological range studies for invasive plant species.
Schmidt, Cecilia A.; Powell, Brian F.; Halvorson, William L.
Executive Summary We summarized inventory and monitoring efforts for plants and vertebrates at Organ Pipe Cactus National Monument (NM) in Arizona. We used data from previous research to compile complete species lists for the monument and to assess inventory completeness. There have been 1,031 species of plants and vertebrates observed at the monument. Most of the species on the list are documented by voucher specimens. There are 59 non-native species established in the monument: one mammal, three birds, and 55 non-native plants. Most non-native plant species were first recorded along roads. In each taxon-specific chapter, we highlight areas that contribute disproportionately to species richness or that have unique species for the monument. Of particular importance are Quitobaquito Springs and Pond, which are responsible for the monument having one of the highest number of bird species in the Sonoran Desert Network of parks. Quitobaquito also contains the only fish in the monument, the endangered Quitobaquito pupfish (Cyprinodon eremus). Other important resources for the plants and vertebrates include the xeroriparian washes (e.g., Alamo Canyon) and the Ajo Mountains. Based on the review of past studies, we believe the inventories of vascular plants and vertebrates are nearly complete and that the monument has one of the most complete inventories of any unit in the Sonoran Desert Network.
The objective is that the onus falls on national leaders to take ownership of the symbols so that these symbols can be internalised and a stronger national identity created. The use of national symbols must transcend issues of ethnicity, race and language. The method utilised assists in developing a conceptual approach to ...
... About ODPHP Food and Nutrition Physical Activity Health Literacy Health Care Quality Healthy People healthfinder health.gov About ODPHP National Health Information Center National Health Information Center The National Health ...
EPA reports information on the condition of our nation's waters using probabilistic surveys. The National Aquatic Resource Surveys assess the status of and changes in water quality of the nation's coastal waters, lakes, rivers and streams, and wetlands.
National Oceanic and Atmospheric Administration, Department of Commerce — Current convective hazards identified by the National Convective Weather Detection algorithm. The National Convective Weather Diagnostic (NCWD) is an automatically...
Minnesota Department of Natural Resources — Wetland area features mapped as part of the National Wetlands Inventory (NWI). The National Wetlands Inventory is a national program sponsored by the US Fish and...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Environmental Policy Act (NEPA) was the first major environmental law in the United States and established national environmental policies for the...
U.S. Department of Health & Human Services — National Health Expenditure Accounts are comprised of the following, National Health Expenditures - Historical and Projected, Age Estimates, State Health...
Federal Laboratory Consortium — For more than 60 years, Sandia has delivered essential science and technology to resolve the nation's most challenging security issues.Sandia National Laboratories...
Minnesota Department of Natural Resources — Linear wetland features (including selected streams, ditches, and narrow wetland bodies) mapped as part of the National Wetlands Inventory (NWI). The National...
of RSC on a national level shows, 950 vouchers were sent to the participating institutions in 2014. This means that about 60 % of all RSC articles with a German corresponding author could, in theory, be made open access, but in practice not all vouchers were used. The article also makes recommendations how the acceptance of open access vouchers can be raised.
Koefoed, Lasse Martin
One of the most important political issues today is the recent upsurge in identity politics and nationalism in Denmark and the western world. In a short period of time, Denmark has turned from being a relatively open, liberal and tolerant society into a nation marked by cultural racism, xenophobia...... of narratives constructions of nationalism conducted in a medium-sized Danish town, how nationalism is practised as part of everyday life stories in divergent ways. Fourth, I will make sense of how these banal narratives and very different perspectives on the nation can explain current forms of nationalism...
National Transportation Statistics presents statistics on the U.S. transportation system, including its physical components, safety record, economic performance, the human and natural environment, and national security. This is a large online documen...
... and Irma. Proceedings of the National Academy of Sciences (PNAS) PNAS is one of the world’s most- ... Exchange Evolution Resources Biographical Memoirs National Academy of Sciences About The NAS Mission History Organization Leadership and ...
... Sports National Buddy Walk® Program Athlete Ambassador Team Charity Racing Advocate National Advocacy and Public Policy NDSS ... journey started when her son, Marcus, was very young. Originally, it was something for her to do ...
... Living Tips About WIN NIDDK Information Clearinghouses National Diabetes Education Program Together with more than 200 partners ... type 2 diabetes. Learn more about NDEP . National Diabetes Month You are the center of your diabetes ...
U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...
U.S. Department of Health & Human Services — The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...
U.S. Department of Health & Human Services — Complications and deaths - national data. This data set includes national-level data for the hip/knee complication measure, the Agency for Healthcare Research and...
U.S. Environmental Protection Agency — This data exchange allows states to submit data to the US Environmental Protection Agency's National Emissions Inventory (NEI). NEI is a national database of air...
... ROPS Rebate Skin Cancer Screening Zika Virus National Farm Medicine Center The National Farm Medicine Center was established in 1981 in response to occupational health problems seen in farm patients coming to Marshfield Clinic. The center continues ...
U.S. Department of Health & Human Services — Value of care displays – national data. This data set includes national-level data for the value of care displays associated with an episode of care for heart...
U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...
... National Drug IQ Challenge 2017 Reto nacional del coeficiente intelectual (CI) sobre las drogas y el alcohol 2016 National Drug IQ Challenge 2016 Reto nacional del coeficiente intelectual (CI) sobre las drogas y el alcohol 2015 ...
Desai, B.N.; Kunte, P.D.; Bhargava, R.M.S.
Ocean study is inherently interdisciplinary and therefore calls for a controlled and integrated approach for information generation, processing and decision making. In this context, Indian National Oceanographic Data Centre (INODC) of National...
Iowa State University GIS Support and Research Facility — The National Register Historic District layer is a shape file showing the boundaries of Historic Districts that are listed on the National Register of Historic Places.
Minnesota Department of Natural Resources — This theme shows the USFS national forest boundaries in the state. This data was acquired from the GIS coordinators at both the Chippewa National Forest and the...
National Oceanic and Atmospheric Administration, Department of Commerce — NOAA publication dedicated to issues, news and recognition of observers in the National Weather Service Cooperative Observer program. Issues published regionally...
US Census Bureau, Department of Commerce — The 2015 TIGER Geodatabases are extracts of selected nation based and state based geographic and cartographic information from the U.S. Census Bureau's Master...
Kolstø, Pal; Blakkisrud, Helge
Assessing the transformation of Russian nationalist discourse in the 21st century Russian nationalism, previously dominated by ‘imperial’ tendencies – pride in a large, strong and multi-ethnic state able to project its influence abroad – is increasingly focused on ethnic issues. This new ethno-nationalism has come in various guises, like racism and xenophobia, but also in a new intellectual movement of ‘national democracy’ deliberately seeking to emulate conservative West European nationalism...
Gingrich, Chris D; Hanson, Kara G; Marchant, Tanya J; Mulligan, Jo-Ann; Mponda, Hadji
There has been considerable controversy about the most appropriate means of delivering insecticide-treated nets (ITNs) to prevent malaria. Household demand for ITNs is a key factor influencing the choice of delivery strategy, but evidence to date about price and income elasticities comes either from studies of hypothetical willingness to pay or small-scale policy experiments. This study estimates the price and income elasticities of demand for ITNs using nationally representative household survey data and actual consumer choices, in the context of a national scheme to provide vouchers for subsidized nets to pregnant women in Tanzania. Under this distribution system, the estimated price elasticity of demand for subsidized ITNs equals -0.12 and the income elasticity estimates range from zero to 0.47, depending on household socio-economic status. The model also shows a substantial decline in short-term ITN purchases for women whose household received a free ITN. These findings suggest that if the Tanzanian government continues to use a mixed public-private model to distribute ITNs, increasing the consumer subsidy alone will not dramatically improve ITN coverage. A concerted effort is required including an increase in the subsidy amount, attention to income growth for poor households, increases in women's and girls' education levels, and expansion of the retail ITN distribution network. Use of a catch-up campaign to distribute free ITNs would increase coverage but raises questions about the effect of households' long-term purchase decisions for ITNs.
Giri, Krishna Prasad; Kjær-Rasmussen, Lone Krogh
This paper investigates practices related to the ideology of infusing Gross National Happiness (GNH) into school curriculum, the effectiveness of the meditation and mind training and the implication of GNH for school environment. It also explores how GNH ambience has been managed and practiced...... of Gross National Happiness and Educating for Gross National happiness....
Music became a marker of national identity in nineteenth-century Europe. Western art music consists of tonal systems that are universally intelligible, but certain rhythms and musical idioms have been associated with national styles. How, when, and why does a musical phrase or piece become national?
The last book Anthony D. Smith wrote before he died, and which will be published in Spring 2017, has the title Nation and Classical Music. Smith had for a long time been intrigued by the intimate relationship between the nation and classical music. At the most manifest level it involves...... them into their compositions thus challenging the romantic musical style searching for an authentic national musical expression. Against the backdrop of the extensive research carried out by Anthony Smith into the relationship between the nation and classical music, the present paper seeks to add...... cultural centers. In doing this, the paper seeks to unfold how composers channeled musical inspiration embedded in cultural environments that cut across national boundaries into national musical traditions thus catering to specific national audiences. The paper is written as a tribute to a great mentor...
The national security strategy (NSS), National Security Strategy for a New Century, published in December 1999, categorizes national interests as vital, important, and humanitarian and other interests...
Despite repeating claims that Canadians are less nationalistic than members of other nations, English as a second language (ESL) textbooks often participate in banal repetitions of nation-ness and nationalism. This banal nationalism takes the form of the marking of nation through flags, maps, routine deixis, and nationalized symbols. This study…
Dr. Kevin A. Fenton, Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, discusses National HIV Testing Day, an annual observance which raises awareness of the importance of knowing one's HIV status and encourages at-risk individuals to get an HIV test. Created: 6/9/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Date Released: 6/9/2011.
Full Text Available Today, branding is such a strong force that hardly anything goes unbranded. Branding in global markets poses several challenges to the marketers. A key decision is the choice between global and nationals brands. This article gives the answers to the questions: what is, what is need for, what are the advantages, costs and risks of global and national brands? All go to the following conclusion: use global brands where possible and national brands where necessary.
surrounding refugees and migrancy in Australia and Europe (since this is what we are invited to do by the organisers), and how the deconstruction of such discourses might lead to more constructive ways of speaking through nation, might offer a way. I think Stan Grant’s book, Talking to My Country, through its...... combination of incisive criticism and insistence on constructive nation-(re)building offers an interesting launching pad. I am hoping to use Grant’s nation-rebuilding project to suggest ways that could open up similar spaces in equally exclusivist, the-nation-is-white-places in Europe. I am aware Grant has...
Full Text Available Taking an attention to promotion as operational variable in marketing effort, author focused on so called ways of creating national images. As a case of very interesting activity paper discuss an experience of regional chamber of Croatia with activities in upgrading international recognition of national products as well as country as destination in such context.
Illerup, J. B.; Lyck, E.; Winther, M.
This report is Denmark's National Inventory Report reported to the Conference of the Parties under the United Nations Framework Convention on Climate Change (UNFCCC) due by 15 April 2001. The report contains information on Denmark's inventories for all years' from 1990 to 1999 for CO2, CH4, N2O, CO...
US Department of Agriculture, 2009
The National School Lunch Program is a federally assisted meal program operating in over 101,000 public and non-profit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to more than 30.5 million children each school day in 2008. In 1998, Congress expanded the National School Lunch…
Illerup, J. B.; Lyck, E.; Winther, M.
This report is Denmark's National Inventory Report reported to the Conference of the Parties under the United Nations Framework Convention on Climate Change (UNFCCC) due by 15 April 2001. The report contains information on Denmark's inventories for all years' from 1990 to 1999 for CO2, CH4, N2O, ......, NMVOC, SO2, HFCs, PFCs and SF6....
U.S. Department of Health & Human Services — Value of care displays â national data. This data set includes national-level data for the value of care displays associated with an episode of care for heart...
Along with the processes of globalisation and the end of the cold war we have seen an upsurge in religious nationalism and an increasing focus on the role of religion as a legitimising force in democratic secular states. Holy Nations & Global Identities draws on the combined theoretical...
Ronald E. McRoberts; Erkki O. Tomppo; Klemens Schadauer; Göran. Ståhl
International agreements increasingly require that countries report estimates of national forest resources. The United Nations Framework Convention on Climate Change requires that countries submit annual reports of greenhouse gas emissions and removals by sources and sinks. The Convention on Biological Diversity requires that countries identify and monitor components...
-, 8 November (2010), s. 1-21 ISSN 2190-3328 Institutional research plan: CEZ:AV0Z80330511 Keywords : National Style * Czech architecture * Czech design Subject RIV: AL - Art, Architecture, Cultural Heritage http://www.riha-journal.org/articles/2010/hnidkova-rondocubism-versus-national-style
Liberal nationalists such as David Miller and Will Kymlicka have claimed that liberal principles have implausible implications with regard to the issue of immigration. They hold that nationality should play a normative role in this regard, and that this is necessary in order to justify restrictions...... on immigration. The present chapter discusses the envisaged role for considerations of nationality with regard to admission and residence, and examines the actual implications of arguments advanced by liberal nationalists as to why nationality should play this role. It is argued that the connection between...... nationality and immigration on liberal nationalist premises is not as straightforward as one might expect, and that the addition of considerations of nationality to liberal principles makes no practical difference with regard to reasons for restricting immigration or criteria of selection among applicants...
MusiClub United nations Orchestra www.ungenevaorchestra.ch An organizing committee has taken the initiative to create an Orchestra of the united nations at Geneva. In the context of this initiative, musicians in the following categories are invited to become members of the Orchestra and the Association: Active or retired staff of International organizations in Geneva; Active or retired employees of Permanent Missions to the United Nations at Geneva; as well as children and spouses of the above persons. For enrolment or for additional information, please contact: firstname.lastname@example.org
Fitzpatrick, L; Gregory, G; Harris, B
The National Rural Health Alliance, the Toowoomba Hospital Foundation and the Cunningham Centre have agreed to merge the two biennial conferences for rural and remote health that have been running in alternate years since 1991. This means that in March 2001, the National Rural Health Conference will, for the first time, incorporate 'Infront Outback', the Australian Rural and Remote Health Scientific Conference. There will, therefore, be one major biennial rural heath conference, dealing coherently with health scientific research and policy development. The recommendations to governments and national bodies that result should be even stronger and more highly regarded than has been the case to date.
Carswell, William J.
The National Geospatial Program (NGP; http://www.usgs.gov/ngpo/) satisfies the needs of customers by providing geospatial products and services that customers incorporate into their decisionmaking and operational activities. These products and services provide geospatial data that are organized and maintained in cost-effective ways and developed by working with partners and organizations whose activities align with those of the program. To accomplish its mission, the NGP— organizes, maintains, publishes, and disseminates the geospatial baseline of the Nation's topography, natural landscape, and manmade environment through The National Map
McCartney, Elizabeth; Craun, Kari J.; Korris, Erin M.; Brostuen, David A.; Moore, Laurence R.
Using crowdsourcing techniques, the US Geological Survey’s (USGS) Volunteered Geographic Information (VGI) project known as “The National Map Corps (TNMCorps)” encourages citizen scientists to collect and edit data about man-made structures in an effort to provide accurate and authoritative map data for the USGS National Geospatial Program’s web-based The National Map. VGI is not new to the USGS, but past efforts have been hampered by available technologies. Building on lessons learned, TNMCorps volunteers are successfully editing 10 different structure types in all 50 states as well as Puerto Rico and the US Virgin Islands.
America's national parks provide a wealth of experiences to millions of people every year. What visitors seelandscapes, wildlife, cultural activitiesoften lingers in memory for life. And what they hear adds a dimension that sight alone cannot p...
... Standards Act and Program MQSA Insights MQSA National Statistics Share Tweet Linkedin Pin it More sharing options ... but should level off with time. Archived Scorecard Statistics 2018 Scorecard Statistics 2017 Scorecard Statistics 2016 Scorecard ...
Compiled and published by the U.S. Department of Transportation's Bureau of Transportation Statistics (BTS), National Transportation Statistics presents information on the U.S. transportation system, including its physical components, safety record, ...
Since 1995 the Vineyard of Nations has honoured an international organisation. On 7 May, Robert Cramer, the Council of State, removed leaves from the vine at the side of Robert Aymar, Director of CERN (1 paragraph)
Kansas Data Access and Support Center — The National Hydrography Dataset (NHD) is a feature-based database that interconnects and uniquely identifies the stream segments or reaches that comprise the...
... at NTP Study Types Nominations to the Testing Program Study Results & Research Projects Areas of Research Data & ... on for decisions that matter. The National Toxicology Program provides the scientific basis for programs, activities, and ...
... History Day – Prepare for a Family Conversation About Genetics and Cancer November 08, 2017 Live Webinar on ... us here . Thanksgiving Day, November 23rd, is National Family ... Read ... Tree Display November 19, 2017 @ 10:00AM Hosted by ...
National Funding Assistance Program administers competitive grants for clean diesel projects. The Diesel Emissions Reduction Act (DERA) appropriates funds for these projects. Publication numbers: EPA-420-B-13-025 and EPA-420-P-11-001.
National Oceanic and Atmospheric Administration, Department of Commerce — This system collects bycatch data and fishery landings data from all five NOAA Fisheries Regions and automates the generation of the tables required to publish the...
Farm Service Agency, Department of Agriculture — The NAIP National Metadata Map contains USGS Quarter Quad and NAIP Seamline boundaries for every year NAIP imagery has been collected. Clicking on the map also makes...
This session considered the changing nature of citizenship in a global world by exploring relationships between individuals and the wider society at local, national and global scales, touching on issues of identity, belonging, empathy and responsibility.
...; since the days of George Washington many American leaders have believed universal service was vital to the nature of our country This paper will argue for the reinstatement of a national service...
U.S. Department of Health & Human Services — The Healthcare-Associated Infections (HAI) measures - national data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected...
The National Energy Balance - 1985 shows energy fluxes of several primary and secondary energy sources, since the production to the final consumption in the main economic sectors, since 1974 to 1984 (E.G.) [pt
... Department Nuclear Science and Technology Nonproliferation and National Security Nuclear & Particle Physics Collider-Accelerator Instrumentation Physics Superconducting Magnet RIKEN BNL Research Center Computational Sciences Computer Science and Mathematics BNL Scientific Data and Computing Center ...
... ART and Birth Defects ART and Autism 2013 Assisted Reproductive Technology National Summary Report Recommend on Facebook Tweet Share ... live-birth rate? [PDF - 1.37MB] Section 2: ART Cycles using fresh nondonor eggs or embryos What ...
Minnesota Department of Natural Resources — Wetland point features (typically wetlands that are too small to be as area features at the data scale) mapped as part of the National Wetlands Inventory (NWI). The...
US Census Bureau, Department of Commerce — The 2015 TIGER Geodatabases are extracts of selected nation based and state based geographic and cartographic information from the U.S. Census Bureau's Master...
National Oceanic and Atmospheric Administration, Department of Commerce — The CDNS was published from 1950 - 1980. Monthly and annual editions contain summarized climatological information from the following publications: Local...
U.S. Department of Health & Human Services — The National Outbreak Reporting System (NORS) is a web-based platform designed to support reporting to CDC by local, state, and territorial health departments in the...
US Census Bureau, Department of Commerce — The 2015 TIGER Geodatabases are extracts of selected nation based and state based geographic and cartographic information from the U.S. Census Bureau's Master...
Hulbert, S.L.; Lazarz, N.M.
This report discussion research being conducted at the National Synchrotron light source. In particular, this report contains operations summaries; symposia, workshops, and projects; NSLS highlights; and abstracts of science at the NSLS
Siim, Birte; Stoltz, Pauline
Feminist scholars have pointed out that constructions of gender and gender equality are embedded in national narratives and politics of belonging (Yuval-Davis 2011; Siim & Mokre 2013). This paper aims to explore gendered approaches to nationalism and to discuss how nationalism in Scandinavia...... is associated with ‘social democratic’ perceptions of welfare and gender equality. Brochmann and Hagelund (2010) have pointed towards a specific form of Scandinavian welfare nationalism which is challenged by globalization and increased migration. We add that gender equality is a key aspect of the Scandinavian...... politics of belonging and that this has implications for our understanding of the challenges which can be recognised in the contemporary politics of gender and welfare in Scandinavia. This point is illustrated by exploring the problematic ways in which contemporary nationalist parties in Sweden, Denmark...
U.S. Environmental Protection Agency — The National Assessment Database stores and tracks state water quality assessment decisions, Total Maximum Daily Loads (TMDLs) and other watershed plans designed to...
U.S. Environmental Protection Agency — The National Emission Inventory contains measured, modeled, and estimated data for emissions of all known source categories in the US (stationary sources, fires,...
U.S. Department of Health & Human Services — The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States...
EPA’s National Stormwater Calculator (SWC) is a desktop application that estimates the annual amount of rainwater and frequency of runoff from a specific site anywhere in the United States (including Puerto Rico).
U.S. Environmental Protection Agency — The National Lakes Assessment (NLA) is a first-ever statistically-valid survey of the biological condition of lakes and reservoirs throughout the U.S. The U.S....
EPA's National Pesticide Standards Repository collects and maintains an inventory of analytical “standards” of registered pesticides in the United States, as well as some that are not currently registered for food and product testing and monitoring.
The National Nursing Home Survey provides includes characteristics such as size of nursing home facilities, ownership, Medicare/Medicaid certification, occupancy rate, number of days of care provided, and expenses.
Kansas Data Access and Support Center — The U.S. Geological Survey has developed a National Elevation Database (NED). The NED is a seamless mosaic of best-available elevation data. The 7.5-minute elevation...
National Cyber Security Policy. Salient Features: Caters to ... Creating a secure cyber ecosystem. Creating an assurance framework. Encouraging Open Standards. Strengthening the Regulatory framework. Creating mechanisms for security threat early warning, vulnerability management and response to security threats.
The National Energy Balance - 1984 shows energy fluxes of several primary and secondary energy sources, since the productions to final consumption in the main economic sectors, since 1973 to 1983. (E.G.) [pt
The National Energy Balance - 1987 showns energy fluxes of several primary and secondary energy sources, since the production to final consumption in the main economic sectors, since 1971 to 1986. (E.G.) [pt
... Headache Topic Sheets (Spanish) Headache FAQ NHF Webinars Education Modules MigrainePro™ Children’s Headache Disorders New Perspectives on Caffeine and Headache War Veterans Health Resource Initiative National Headache Foundation Brochures ...
Networking and Information Technology Research and Development, Executive Office of the President — On July 1, NITRD released the National Privacy Research Strategy. Research agencies across government participated in the development of the strategy, reviewing...
... Our Crisis Centers Stories of Hope and Recovery Mental Health & Suicide Prevention Glossary Get Involved Participate Our Crisis Centers Social Media Hub Promote National Suicide Prevention Month Providers & Professionals ...
Kansas Data Access and Support Center — This is a polygon feature data layer of United States National Grid (1000m x 1000m polygons ) constructed by the Center for Interdisciplinary Geospatial Information...
U.S. Department of Health & Human Services — The National Death Index (NDI) is a centralized database of death record information on file in state vital statistics offices. Working with these state offices, the...
National Oceanic and Atmospheric Administration, Department of Commerce — The NCWF is an automatically generated depiction of: (1) current convection and (2) extrapolated signficant current convection. It is a supplement to, but does NOT...
U.S. Department of Health & Human Services — Use of medical imaging - national data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...
The structure and function of the National Invasive Species Council was presented below. The names and contact information for the USDA Invasive Species coordinators as of February 2006 were presented on the next page.
maintaining peace and tranquility within a society. National security strategy thus carries great responsibilities. The need for a national...for Analysis, 76. 43 Ataniyazova, Oral A. Health and Ecological Consequences of the Aral Sea Crisis, 1. 44 Buzan, Barry and Ole Waver. Security: A...Watch Institute). Vital Signs 2007-2008; The Trends that are Shaping Our Future. New York, NY: W.W. Norton & Company, 2007. Ataniyazova, Oral A
Tony G. Johnson; Ronald J. Piva; Brian F. Walters; al. et.
United Statesâ pulpwood production amounted to 89.2 million cords in 2008. Roundwood production totaled 63.0 million cords and accounted for 71 percent of the Nationâs total pulpwood production. The use of wood residue totaled 26.2 million cords. Georgia led the Nation in total production, with 11.6 million cords. In 2008, 146 mills were operating and drawing wood from...
The research focuses on two agro-ecological zones of the cattle corridor in Tanzania - Ngorongoro and Kibaha/Kilosa districts - and will be led by a regional scientific network, the ... They will look at interactions between human and animal health, environmental change, gender, and other socio-economic conditions.
Abstract. Purpose: To evaluate the antifungal and cytotoxic activities of four medicinal plants from Tanzania, namely, Mystroxylon aethiopicum ... The importance of medicinal plants in solving the healthcare problems of the world is gaining ... often with indefinite biological effects . Medicinal plants therefore, have been ...
on suspension polymerization of the same, to produce surface reactive materials. In this work, suspension polymerization of CNSL and its distillate product cardanol to produce spherical polymeric particles (SPP) and surface characterization of the latter is reported. EXPERIMENTAL. Materials. Technical CNSL was supplied ...
Micron-sized polymer particles (MSPP) were prepared by formaldehyde condensation polymerization of cashew nut shell liquid (CNSL) previously emulsified with sodium lauryl sulphate. The sizes of the MSPP were found to range from 0.1 to 4.4 mm. Increasing the emulsifier concentration had the effect of increasing the ...
Abstract—With the current increase in frequency of coral bleaching events, knowledge on the genetic diversity of symbiotic algae in the genus Symbiodinium harboured by reef-building corals is important to understand how coral reefs will respond to global climate change. This study was undertaken as very little is known.
Full Text Available Understanding the correlates of HIV shedding is important to inform strategies to reduce HIV infectiousness. We examined correlates of genital HIV-1 RNA in women who were seropositive for both herpes simplex virus (HSV-2 and HIV-1 and who were enrolled in a randomised controlled trial of HSV suppressive therapy (aciclovir 400 mg b.i.d vs. placebo in Tanzania.Samples, including a cervico-vaginal lavage, were collected and tested for genital HIV-1 and HSV and reproductive tract infections (RTIs at randomisation and 6, 12 and 24 months follow-up. Data from all women at randomisation and women in the placebo arm during follow-up were analysed using generalised estimating equations to determine the correlates of cervico-vaginal HIV-1 RNA detection and load.Cervico-vaginal HIV-1 RNA was detected at 52.0% of 971 visits among 482 women, and was independently associated with plasma viral load, presence of genital ulcers, pregnancy, bloody cervical or vaginal discharge, abnormal vaginal discharge, cervical ectopy, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, an intermediate bacterial vaginosis score and HSV DNA detection. Similar factors were associated with genital HIV-1 RNA load.RTIs were associated with increased presence and quantity of genital HIV-1 RNA in this population. These results highlight the importance of integrating effective RTI treatment into HIV care services.
Diversity was assessed based on morphological measurements and 29 microsatellite markers recommended by ISAG/FAO advisory group on animal genetic diversity. A principal component analysis (PCA) of morphological measures distinguished individuals most by body sizes and body weight. Morogoro Medium, Pemba ...
Mwaisumo, William Nathan
This paper focuses on the meaning, classification and types of support staff, their contributions towards conducive teaching and learning environments, conditions required/attributes required for support staff to be employed in temporally or permanent terms. It further identifies current situations and challenges in recruitment and recruited…
Adding amoxicillin to the treatment did not improve the end results. Hearing test performed before and after treatment showed that the hearing thresholds were the same or better after the treatment. The possible risk that boric acid in alcohol ear drops should lead to sensorineural hearing loss has not been confirmed.
Mar 1, 2000 ... schools: two boy-schools; two girl-schools; and one mixed gender-school participated by filling in a questionnaire. ... can utilise this information for the advertisement of their courses, ii) the same information can ... a sound advertising background, information on the attitude of potential applicants towards ...
grained and platey, plastic, nonabrasive and easy to form. In addition, the fine grained nature of these materials ... dissolution products were quantitatively transferred to a 50 ml plastic beaker containing 2.8 g of HBO3. ... done with the use of a hydraulic press at a pressure of 235.5 kg cm-2. The small bars were dried at room.
The websites also lack uniformity despite many similarities that university libraries possess. There is poor presentation of details on e-resources and library services. It is recommended that the design of library websites should be driven by the information needs and seeking behaviour of target users rather than technology ...
Jacobsen, P.; Dahi, Elian
were treated every day. The defluoridator could be manufactured locally in Ngurdoto village, Arusha Region Tanzania for a price of about 10 US $ per unit. The defluoridator is monitored as operated in 10 households. The defluoridator reduced the fluoride concentration from 10.5 mg/L to less than 1 mg....../L for periods between 4 and 13 months. The users expressed their acceptability of the defluoridator and its performance....