Transportation of water-based slurry in an open furrow, launder or stream

The transport of large boulders in a furrow from a mining area to a nearby pond was considered. The furrow is filled with a mixture of water and soil particles flowing down to the pond at a very high velocity. Due to operating constraints, the slope of the furrow is reduced progressively. A formula is derived, relating the slope of the furrow and the composition of the fluid to the maximum size and shape of the transported boulders. The characteristics of the boulders carried all the way down to the pond may then be determined

The Role of Informal Social Networks in Micro-Savings Mobilization

The influence of informal institutions on economic outcomes for low income individuals and households has received little attention in the United States. Yet, drawing on social capital theory and existing studies from developing countries where informal institutions have been widely used in promoting economic opportunities offamilies in poverty, one would expect these institutions to have positive effects on the economic outcomes of low income individuals in the context of an IDA program. Using a sample of 840 respondents who were enrolled in a community action program, this study assesses the effects of informal networks of social support on performance in a matched savings program. Results show partial support for the hypothesized relationship. Specifically, an increase in the amount of help a respondent gives to members of her community is inversely related to performance in an IDA program. This may imply that although informal networks have mutual benefits for both the individual and community, economically these benefits may be mixed. Among low income individuals saving in an IDA program, participating in such networks may constrain the economic resources available to them or their households; hence impacting their performance negatively

Assessing social engagement practices in unstable environments: An examination of collective action and community participation in Mexico

El estudio que se presenta utiliza la teoría de Capital Social, explora los efectos del capital social, la violencia, y el compromiso político en dos observables: acción colectiva y voluntad de ayuda a la comunidad en México. Se utiliza una encuesta recabada en 2011 (N=7,416) y procedimientos estadísticos (correlaciones y análisis de regresión usando mínimos cuadrados ordinarios (MCO) con modelos anidados). Los resultados muestran que los factores contextuales y políticos, particularmente el miedo y la violencia, influyen en la mobillización en acción colectiva. Se indican algunas implicaciones para las interacciones sociales en escenarios de conflicto prolongado e inestabilidad, en particular, para México

Using Individual Development Accounts for Microenterprise Development

This study examines whether there is a role for microenterprise development as an anti-poverty strategy in the United States. This question is important because skeptical views exist regarding whether, generally, poor Americans would have the enthusiasm to undertake the risk of dealing with small-businesses, especially given that the United States has a public welfare system to take care of the poor and “abundant jobs” for those with the skills—compared to most developing countries where the only alternative open for a family investing in a small-business may be starvation. Using data from 14 community-based programs promoting small-business investment through Individual Development Accounts (IDAs), this study finds that overall there is a considerable level of interest in saving for and investing in small-businesses among poor Americans, including those who are less advantaged in terms of income poverty and employment. Policy makers should thus consider promoting IDAs/subsidized savings for small-businesses development as a potentially viable strategy to address income poverty and inequality in the United States

Expanding global access to essential medicines: investment priorities for sustainably strengthening medical product regulatory systems.

Access to quality-assured medical products improves health and save lives. However, one third of the world's population lacks timely access to quality-assured medicines while estimates indicate that at least 10% of medicine in low- and middle-income countries (LMICs) are substandard or falsified (SF), costing approximately US$ 31 billion annually. National regulatory authorities are the key government institutions that promote access to quality-assured medicines and combat SF medical products but despite progress, regulatory capacity in LMICs is still insufficient. Continued and increased investment in regulatory system strengthening (RSS) is needed. We have therefore reviewed existing global normative documents and resources and engaged with our networks of global partners and stakeholders to identify three critical challenges being faced by NRAs in LMICs that are limiting access to medical products and impeding detection of and response to SF medicines. The challenges are; implementing value-added regulatory practices that best utilize available resources, a lack of timely access to new, quality medical products, and limited evidence-based data to support post-marketing regulatory actions. To address these challenges, we have identified seven focused strategies; advancing and leveraging convergence and reliance initiatives, institutionalizing sustainability, utilizing risk-based approaches for resource allocation, strengthening registration efficiency and timeliness, strengthening inspection capacity and effectiveness, developing and implementing risk-based post-marketing quality surveillance systems, and strengthening regulatory management of manufacturing variations. These proposed solutions are underpinned by 13 focused recommendations, which we believe, if financed, technically supported and implemented, will lead to stronger health system and as a consequence, positive health outcomes

Rethinking the construction of welfare in Mexico: Going beyond the economic measures

This study utilized a multidimensional measure of social welfare composed of 26 social indicators integrated in nine categories: education, employment and social protection, income, health, housing conditions, subjective wellbeing, social capital, use of technology, and culture and leisure to help understand social welfare in Mexico. We also compared the integrated measure with the Human Development Index. Estimation was performed using the DP2 method. Our analysis indicated that the health and housing conditions categories contributed the most to social welfare across the 32 Mexican States. In relation to the indicators, income and trust in other people were associated with welfare. Further, results on the welfare ranking of Mexican states revealed variations between the two indices ðDP2 and the HDI). Specifically, only four states occupied the same position on both indices, ten recorded different positions on DP2 moving up or down from their levels of social welfare. Implications of observed correlations are presented

Incorporating Public Insecurity Indicators: A New Approach to Measuring Social Welfare in Mexico

Social Welfare (SW) is a multidimensional and contextual concept. It is generally adjusted to reflect the prevailing social realities of a given context (Grasso & Canova, 2008). It consists of a material dimension, including economic indicators such as income, employment, level of schooling, and access to social security services (Di Pasquale, 2008; Mæstad & Norheim, 2012). The other dimension of social welfare is subjective and includes elements such as happiness and satisfaction with life (Diener, 1994, 2000).ITESO, A.C.Boston College, School of Social WorkUniversidad Iberoamericana Ciudad de Méxic

Defining Essential Childhood Cancer Medicines to Inform Prioritization and Access: Results From an International, Cross-Sectional Survey

PURPOSE: Access to essential cancer medicines is a major determinant of childhood cancer outcomes globally. The degree to which pediatric oncologists deem medicines listed on WHO's Model List of Essential Medicines for Children (EMLc) essential is unknown, as is the extent to which such medicines are accessible on the front lines of clinical care. METHODS: An electronic survey developed was distributed through the International Society of Pediatric Oncology mailing list to members from 87 countries. Respondents were asked to select 10 cancer medicines that would provide the greatest benefit to patients in their context; subsequent questions explored medicine availability and cost. Descriptive and bivariate statistics compared access to medicines between low- and lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs). RESULTS: Among 159 respondents from 44 countries, 43 (27%) were from LMICs, 79 (50%) from UMICs, and 37 (23%) from HICs. The top five medicines were methotrexate (75%), vincristine (74%), doxorubicin (74%), cyclophosphamide (69%), and cytarabine (65%). Of the priority medicines identified, 87% (27 of 31) are represented on the 2021 EMLc and 77% (24 of 31) were common to the lists generated by LMIC, UMIC, and HIC respondents. The proportion of respondents indicating universal availability for each of the top medicines ranged from 9% to 46% for LMIC, 25% to 89% for UMIC, and 67% to 100% for HIC. Risk of catastrophic expenditure was more common in LMIC (8%-20%), compared with UMIC (0%-28%) and HIC (0%). CONCLUSION: Most medicines that oncologists deem essential for childhood cancer treatment are currently included on the EMLc. Barriers remain in access to these medicines, characterized by gaps in availability and risks of catastrophic expenditure for families that are most pronounced in low-income settings but evident across all income contexts

Cancer Medicines: What Is Essential and Affordable in India?

PURPOSE: The WHO essential medicines list (EML) guides selection of drugs for national formularies. Here, we evaluate which medicines are considered highest priority by Indian oncologists and the extent to which they are available in routine practice. METHODS: This is a secondary analysis of an electronic survey developed by the WHO EML Cancer Medicine Working Group. The survey was distributed globally using a hierarchical snowball method to physicians who prescribe systemic anticancer therapy. The survey captured the 10 medicines oncologists considered highest priority for population health and their availability in routine practice. RESULTS: The global study cohort included 948 respondents from 82 countries; 98 were from India and 67 were from other low- and middle-income countries. Compared with other low- and middle-income countries, the Indian cohort was more likely to be medical oncologist (70% v 31%, P < .001) and work exclusively in the private health system (52% v 17%, P < .001). 14/20 most commonly selected medicines were conventional cytotoxic drugs. Universal access to these medicines was reported by a minority of oncologists; risks of significant out-of-pocket expenditures for each medicine were reported by 19%-58% of oncologists. Risk of catastrophic expenditure was reported by 58%-67% of oncologists for rituximab and trastuzumab. Risks of financial toxicity were substantially higher within the private health system compared with the public system. CONCLUSION: Most high-priority cancer medicines identified by Indian oncologists are generic chemotherapy agents that provide substantial improvements in survival and are already included in WHO EML. Access to these treatments remains limited by major financial burdens experienced by patients. This is particularly acute within the private health system. Strategies are urgently needed to ensure that high-quality cancer care is affordable and accessible to all patients in India

A Narrative Synthesis of Literature on the Barriers to Timely Diagnosis and Treatment of Cancer in Sub-Saharan Africa.

Poor cancer survival outcomes in sub-Saharan Africa (SSA) have been linked to delays in diagnosis and treatment. Here we present a detailed overview of the qualitative literature evaluating the barriers to receiving timely diagnosis and treatment of cancer in SSA. The PubMed, EMBASE, CINAHL, PsycINFO databases were searched to identify qualitative studies reporting on barriers to timely diagnosis of cancer in SSA published between 1995 and 2020. A systematic review methodology was applied, including quality assessment and narrative data synthesis. We identified 39 studies, of which 24 focused on breast or cervical cancer. Only one study focused on prostate cancer and one on lung cancer. When exploring factors contributing to delays, six key themes emerged from the data. The first theme was health service barriers, which included: (i) inadequate numbers of trained specialists; (ii) limited knowledge of cancer among healthcare providers; (iii) poor co-ordination of care; (iv) inadequately resourced health facilities; (v) negative attitudes of healthcare providers towards patients; (vi) high cost of diagnostic and treatment services. The second key theme was patient preference for complementary and alternative medicine; the third was the limited understanding of cancer among the population. The fourth barrier was a patient's personal and family obligations; the fifth was the perceived impact of cancer and its treatment on sexuality, body image and relationships. Finally, the sixth was the stigma and discrimination faced by patients following a diagnosis of cancer. In conclusion, health system, patient level and societal factors all influence the likelihood of timely diagnosis and treatment for cancer in SSA. The results provide a focus for targeting health system interventions, particular with regards to awareness and understanding of cancer in the region