Users' reactions to the primer on tree registration policies: Lessons for designing extension materials and improving information flow

In the Philippines, only a few farmers and plantation owners register their tree farms with the Department of Environment and Natural Resources (DENR), the office in charge of tree registration. One of the major reasons is their lack of knowledge of government policy on tree registration. To help improve the flow of information and understanding of tree registration policies among smallholder tree farmers and other stakeholders, a Primer on Tree Registration, Harvesting, Transport and Marketing Policies on Private Land was developed. Produced through the participation of stakeholders, including tree farmers, the DENR and local government officers, police and timber dealers, the Primer is highly visual and has been released in English as well as Waray-Waray and Cebuano dialects. This paper reports findings of focus group discussions conducted to gauge user reactions to the Primer. The Primer was considered as a valuable source of information about tree registration policies. Aside from being comprehensible, FDG participants found it attractive, and perceived it to be intended for them and free from content that confused them. However, farmers suggested that illustrations need to be improved by making the persons portrayed more presentable and reflective of their actual tree farm operations. Participants said that aside from the Primer, the flow of information on tree registration policies could be improved through the use of multi-media including posters, radio broadcasts, and presentation of seminars for farmers

Can increased primary care access reduce demand for emergency care? Evidence from England's 7-day GP opening

Restricted access to primary care can lead to avoidable, excessive use of expensive emergency care. Since 2013, partly to alleviate overcrowding at the Accident & Emergency (A&E) units of hospitals, the UK has been piloting 7-day opening of General Practitioner (GP) practices to improve primary care access for patients. We evaluate the impact of these pilots on patient attendances at A&E. We estimate that 7-day GP opening has reduced A&E attendances by patients of pilot practices by 9.9% with most of the impact on weekends which see A&E attendances fall by 17.9%. The effect is non-monotonic in case severity with most of the fall occurring in cases of moderate severity. An additional finding is that there is also a 9.9% fall in weekend hospital admissions (from A&E) which is entirely driven by a fall in admissions of elderly patients. The impact on A&E attendances appears to be bigger among wealthier patients. We present evidence in support of a causal interpretation of our results and discuss policy implications

The Perceptions on Male Circumcision as a Preventive Measure Against HIV Infection and Considerations in Scaling up of the Services: A Qualitative Study Among Police Officers in Dar es Salaam, Tanzania.

\ud In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03) trial in Dar es Salaam, Tanzania. In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination program may increase its coverage at early childhood. The findings from this investigation provide contextual understanding that may assist in scaling-up male circumcision in Tanzania.\u

Convenient primary care and emergency hospital utilisation

Participation and utilisation decisions lie at the heart of many public policy questions. I contribute new evidence by using hospital records to examine how access to primary care services affects utilisation of hospital Emergency Departments in England. Using a natural experiment in the roll out of services, I first show that access to primary care reduces Emergency Department visits. Additional strategies then allow me to separate descriptively four aspects of primary care access: proximity, opening hours, need to make an appointment, and eligibility. Convenience-oriented services divert three times as many patients from emergency visits, largely because patients can attend without appointments

Frequency analysis of urban runoff quality in an urbanizing catchment of Shenzhen, China

Copyright © 2013 Elsevier. NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Hydrology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Hydrology Vol. 496 (2013), DOI: 10.1016/j.jhydrol.2013.04.053This paper investigates the frequency distribution of urban runoff quality indicators using a long-term continuous simulation approach and evaluates the impacts of proposed runoff control schemes on runoff quality in an urbanizing catchment in Shenzhen, China. Four different indicators are considered to provide a comprehensive assessment of the potential impacts: total runoff depth, event pollutant load, Event Mean Concentration, and peak concentration during a rainfall event. The results obtained indicate that urban runoff quantity and quality in the catchment have significant variations in rainfall events and a very high rate of non-compliance with surface water quality regulations. Three runoff control schemes with the capacity to intercept an initial runoff depth of 5 mm, 10 mm, and 15 mm are evaluated, respectively, and diminishing marginal benefits are found with increasing interception levels in terms of water quality improvement. The effects of seasonal variation in rainfall events are investigated to provide a better understanding of the performance of the runoff control schemes. The pre-flood season has higher risk of poor water quality than other seasons after runoff control. This study demonstrates that frequency analysis of urban runoff quantity and quality provides a probabilistic evaluation of pollution control measures, and thus helps frame a risk-based decision making for urban runoff quality management in an urbanizing catchment.Open Research Fund Program of State Key Laboratory of Hydroscience and EngineeringNational Natural Science Foundation of ChinaNational Water Pollution Control and Management Technology Major Project

Clinical trial simulation to evaluate power to compare the antiviral effectiveness of two hepatitis C protease inhibitors using nonlinear mixed effect models: a viral kinetic approach.

International audienceBACKGROUND: Models of hepatitis C virus (HCV) kinetics are increasingly used to estimate and to compare in vivo drug's antiviral effectiveness of new potent anti-HCV agents. Viral kinetic parameters can be estimated using non-linear mixed effect models (NLMEM). Here we aimed to evaluate the performance of this approach to precisely estimate the parameters and to evaluate the type I errors and the power of the Wald test to compare the antiviral effectiveness between two treatment groups when data are sparse and/or a large proportion of viral load (VL) are below the limit of detection (BLD). METHODS: We performed a clinical trial simulation assuming two treatment groups with different levels of antiviral effectiveness. We evaluated the precision and the accuracy of parameter estimates obtained on 500 replication of this trial using the stochastic approximation expectation-approximation algorithm which appropriately handles BLD data. Next we evaluated the type I error and the power of the Wald test to assess a difference of antiviral effectiveness between the two groups. Standard error of the parameters and Wald test property were evaluated according to the number of patients, the number of samples per patient and the expected difference in antiviral effectiveness. RESULTS: NLMEM provided precise and accurate estimates for both the fixed effects and the inter-individual variance parameters even with sparse data and large proportion of BLD data. However Wald test with small number of patients and lack of information due to BLD resulted in an inflation of the type I error as compared to the results obtained when no limit of detection of VL was considered. The corrected power of the test was very high and largely outperformed what can be obtained with empirical comparison of the mean VL decline using Wilcoxon test. CONCLUSION: This simulation study shows the benefit of viral kinetic models analyzed with NLMEM over empirical approaches used in most clinical studies. When designing a viral kinetic study, our results indicate that the enrollment of a large number of patients is to be preferred to small population sample with frequent assessments of VL

The timing of strike-slip shear along the Ranong and Khlong Marui faults, Thailand

The timing of shear along many important strike-slip faults in Southeast Asia, such as the Ailao Shan-Red River, Mae Ping and Three Pagodas faults, is poorly understood. We present 40Ar/39Ar, U-Pb SHRIMP and microstructural data from the Ranong and Khlong Marui faults of Thailand to show that they experienced a major period of ductile dextral shear during the middle Eocene (48–40 Ma, centered on 44 Ma) which followed two phases of dextral shear along the Ranong Fault, before the Late Cretaceous (>81 Ma) and between the late Paleocene and early Eocene (59–49 Ma). Many of the sheared rocks were part of a pre-kinematic crystalline basement complex, which partially melted and was intruded by Late Cretaceous (81–71 Ma) and early Eocene (48 Ma) tin-bearing granites. Middle Eocene dextral shear at temperatures of ~300–500°C formed extensive mylonite belts through these rocks and was synchronous with granitoid vein emplacement. Dextral shear along the Ranong and Khlong Marui faults occurred at the same time as sinistral shear along the Mae Ping and Three Pagodas faults of northern Thailand, a result of India-Burma coupling in advance of India-Asia collision. In the late Eocene (<37 Ma) the Ranong and Khlong Marui faults were reactivated as curved sinistral branches of the Mae Ping and Three Pagodas faults, which were accommodating lateral extrusion during India-Asia collision and Himalayan orogenesis

1988 Correspondence Committee.

Curriculum Guide

Oreodonts

498 p. : ill. ; 27 cm.pt. 1. Merycoidodontinae, Eporeodontinae, and Leptaucheniinae, three subfamilies of oreodonts, with an appendix to the revision of the Merycoidodontidae -- pt. 2. Summary and conclusions concerning the Merycoidodontidae.Includes bibliographical references (p. 473-490) and index