Mechanisms underpinning interventions to reduce sexual violence in armed conflict: A realist-informed systematic review

Sexual violence is recognised as a widespread consequence of armed conflict and other humanitarian crises. The limited evidence in literature on interventions in this field suggests a need for alternatives to traditional review methods, particularly given the challenges of undertaking research in conflict and crisis settings. This study employed a realist review of the literature on interventions with the aim of identifying the mechanisms at work across the range of types of intervention. The realist approach is an exploratory and theory-driven review method. It is well suited to complex interventions as it takes into account contextual factors to identify mechanisms that contribute to outcomes. The limited data available indicate that there are few deterrents to sexual violence in crises. Four main mechanisms appear to contribute to effective interventions: increasing the risk to offenders of being detected; building community engagement; ensuring community members are aware of available help for and responses to sexual violence; and safe and anonymous systems for reporting and seeking help. These mechanisms appeared to contribute to outcomes in multiple-component interventions, as well as those relating to gathering firewood, codes of conduct for personnel and legal interventions. Drawing on pre-existing capacity or culture in communities is an additional mechanism which should be explored. Though increasing the risk to offenders of being detected was assumed to be a central mechanism in deterring sexual violence, the evidence suggests that this mechanism operated only in interventions focused on gathering firewood and providing alternative fuels. The other three mechanisms appeared important to the likelihood of an intervention being successful, particularly when operating simultaneously. In a field where robust outcome research remains likely to be limited, realist methods provide opportunities to understand existing evidence. Our analysis identifies the important potential of building in mechanisms involving community engagement, awareness of responses and safe reporting provisions into the range of types of intervention for sexual violence in crises

The evolution of strategic environmental assessment from the Law 20.417

La evaluación ambiental estratégica se incorporó el año 2010, como instrumento de gestión ambiental a través de la Ley N° 20.417, que creó el Ministerio del Medio Ambiente, el Servicio de Evaluación Ambiental y la Superintendencia del Medio Ambiente, la cual introdujo reformas importantes en la regulación del medio ambiente. Casi seis años más tarde, el reglamento para la Evaluación Ambiental Estratégica, fue aprobado mediante el Decreto 32/2015 del Ministerio del Medio Ambiente. Durante la ausencia de norma reglamentaria, Contraloría General de la República dio ciertas directrices a seguir por los Órganos Responsables al momento de evaluar ambientalmente los Instrumentos de Planificación Territorial, Planes y Políticas, estableciendo como ley supletoria para llevar a cabo el procedimiento administrativo a la Ley N° 19.880. Con ello se debió implementar abruptamente la EAE considerando ciertos vacíos legales que con la llegada del Reglamento se esperaban resolver.The strategic environmental assessment was incorporated in 2010 as an instrument of environmental management through the Law N° 20.417, that created the Ministry, the Environment Assessment Authority and the Superintendence, which made on the environment regulation, important reforms. Nearly six years later, the strategic environmental assessment regulation, was approved by Decree 32/2015 of the Environment Ministry. During the absence of regulatory standard, Contraloría General gave some guidelines to be followed by the responsible institutions that have to elaborate the strategic environmental assessment of the Territorial Planning Instruments, Plans and Public Policies, establishing as a suppletive law to this administrative procedure, the Law N° 19.880. This was an abrupt implementation, considering certain loopholes that are expected to be solved with the recently approved regulation

Aging Impact of Permanent Magnets in Synchronous Machines for Traction Applications

openWith the continuous electrification of the industrial and transportation systems, higher demanding specifications are being imposed on electrical motors, leading to higher degradation due to the aging of their components. This thesis focuses its attention on the study of the effect that the degradation of the magnetic properties of permanent magnets, as a result of exposure to elevated temperatures, has on the performance of the electrical machines in which they are applied. A comprehensive study was conducted, including an experimental part of data collection and a simulation part. Initially, a method for measuring magnetic flux density was designed, implemented, and validated. This exploits the induction law to obtain the average value of flux produced by permanent magnets from a voltage measurement. After that, aging tests at 140°C till 186 hours were performed on three samples of NdFeB magnets to observe changes in their magnetic properties, particularly the decay of magnetic flux density. The measurements showed no appreciable decay, so a fourth sample of another magnet grade was tested but again no aging was found. For this reason, it was decided to consider previously obtained data from a colleague to develop the simulation part. The experimental results were supplemented by a detailed finite element analysis to simulate the impact of the observed degradations on machine performance. The results show a decrease in magnetic flux density for prolonged periods. This is reflected in the torque produced by the motor in a negative way. In addition, effects, albeit marginal, were found on machine efficiency.With the continuous electrification of the industrial and transportation systems, higher demanding specifications are being imposed on electrical motors, leading to higher degradation due to the aging of their components. This thesis focuses its attention on the study of the effect that the degradation of the magnetic properties of permanent magnets, as a result of exposure to elevated temperatures, has on the performance of the electrical machines in which they are applied. A comprehensive study was conducted, including an experimental part of data collection and a simulation part. Initially, a method for measuring magnetic flux density was designed, implemented, and validated. This exploits the induction law to obtain the average value of flux produced by permanent magnets from a voltage measurement. After that, aging tests at 140°C till 186 hours were performed on three samples of NdFeB magnets to observe changes in their magnetic properties, particularly the decay of magnetic flux density. The measurements showed no appreciable decay, so a fourth sample of another magnet grade was tested but again no aging was found. For this reason, it was decided to consider previously obtained data from a colleague to develop the simulation part. The experimental results were supplemented by a detailed finite element analysis to simulate the impact of the observed degradations on machine performance. The results show a decrease in magnetic flux density for prolonged periods. This is reflected in the torque produced by the motor in a negative way. In addition, effects, albeit marginal, were found on machine efficiency

Appendix to: Efficient European and American Option Pricing Under a Jump-diffusion Process

When the underlying asset of an option displays oscillations, spikes or heavy-tailed distributions, modeling it with the lognormal diffusion process is inadequate. In order to overcome these real world difficulties, Merton proposed a jump-diffusion model, where the dynamics of the price of the underlying are subject to variations due to a Brownian process and also to possible jumps, driven by a compound Poisson process. There have been a lot of attempts to obtain a discretization of the Merton model with tree methods in order to price American or more complex options, e. g. Amin, the O(n3) procedure by Hilliard and Schwartz and the O(n2:5) procedure by Dai et al. Here, starting from the implementation of the seven-nodes procedure by Hilliard and Schwartz, we prove theoretically that it is possible to reduce the complexity of this method to O(n2 ln n) in the American put case. Our method is based on a suitable truncation of the lattice structure; the proofs provide closed formulas for the truncation limitations

Global Emergency Medicine: A Review of the Literature From 2013

Objectives The Global Emergency Medicine Literature Review ( GEMLR ) conducts an annual search of peer‐reviewed and grey literature relevant to global emergency medicine ( EM ) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners. Methods This year 8,768 articles written in six languages were identified by our search. These articles were distributed among 22 reviewers for initial screening based on their relevance to the field of global EM . An additional two reviewers searched the grey literature. A total of 434 articles were deemed appropriate by at least one reviewer and approved by an editor for formal scoring of overall quality and importance. Results Of the 434 articles that met our predetermined inclusion criteria, 65% were categorized as emergency care in resource‐limited settings, 18% as EM development, and 17% as disaster and humanitarian response. A total of 24 articles received scores of 18 or higher and were selected for formal summary and critique. Interrater reliability for two reviewers using our scoring system was good, with an intraclass correlation coefficient of 0.63 (95% confidence interval = 0.55 to 0.69). Infectious diseases, trauma, and the diagnosis and treatment of diseases common in resource‐limited settings represented the majority of articles selected for final review. Conclusions In 2013, there were more emergency care in resource‐limited settings articles, while the number of disaster and humanitarian response articles decreased, when compared to the 2012 review. However, the distribution of articles selected for full review did not change significantly. As in prior years, the majority of articles focused on infectious diseases, as well as trauma and injury prevention. Resumen Objetivos El grupo Global Emergency Medicine Literature Review (GEMLR) lleva a cabo una búsqueda anual de revisión por pares y de la literatura gris relevante para la Medicina de Urgencias y Emergencias ( MUE ) Global para identificar, revisar y divulgar las investigaciones recientes más importantes en este campo para la audiencia mundial de profesores universitarios y médicos clínicos. Metodología Se identificaron según nuestra búsqueda 8.768 artículos escritos en seis lenguas en 2013. Estos artículos se distribuyeron entre 22 revisores para un despistaje inicial basado en la relevancia para el área de la MUE Global. Dos revisores adicionales buscaron en la literatura gris. Un total de 434 artículos se consideraron apropiados por al menos un revisor y se aprobaron por un editor mediante una puntación formal de calidad e importancia. Resultados De los 434 artículos que cumplieron los criterios de inclusión predeterminados, un 65% se categorizó como atención urgente en escenarios de recursos limitados, un 18% como desarrollo de la MUE y un 17% como grandes catástrofes y respuesta humanitaria. Un total de 24 artículos recibió puntuaciones de 18 o más y se seleccionaron para el resumen formal y la crítica. La concordancia interobservador para los dos revisores usando nuestro sistema de puntuación fue buena con un coeficiente de correlación intraclase de 0,63 (intervalo de confianza 95% = 0,55 a 0,69). Las enfermedades infecciosas, los traumatismos y el diagnostico y tratamiento de las enfermedades comunes en escenarios de recursos limitados representaron la mayoría de los artículos seleccionados para la revisión final. Conclusiones En 2013, hubo más artículos de atención urgente en escenarios de recursos limitados, mientras que el número de artículos de grandes catástrofes y respuesta humanitaria disminuyó respecto a la revisión de 2012. Sin embargo, la distribución de los artículos seleccionados para la revisión total no cambio significativamente. Como en años anteriores, la mayoría de los artículos se centró en enfermedades infecciosas, así como en la prevención de los traumatismos y las lesiones.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108313/1/acem12414.pd

Efficient derivatives evaluation under a jump-diffusion process

Merton (1976) provides a jump-diffusion model, where the dynamics of the price of the underlying are subject to variations due to a Brownian process and also to possible jumps. Under the Black and Scholes (1973) assumptions on the Brownian component and considering a compound Poisson process for the jump part, the model admits a series solution for the European option pricing. Amin (1993) proposes a procedure for derivative pricing by discretising the distribution of the underlying allowing the jumps to have a random amplitude which must be a multiple of the Brownian move. Hilliard and Schwartz (HS, 2005) considering the independency of the two factors develop a multinomial lattice: one variable mimicking the diusion process and the second one the log-normal jumps in the compound Poisson process. HS procedure provides more accurate results than Amin and the weak convergence of the discrete price is ensured in the special case of deterministic jump amplitude and numerically justified otherwise. HS bivariate tree can be applied to the evaluation of American options. The time complexity of the HS backward procedure is O(n3). Dai et al. (2010) build on the HS procedure reducing complexity to O(n2:5) by dissolving the intermediate nodes on the tree introduced by the jumps in the nearest diffusion node, therefore providing a one-dimensional tree. Here, also starting from the HS technique we introduce a procedure which further reduces the complexity both in the European and in the American case. We prove this theoretically when the log-normal distribution is discretised by a variable with tree possible states (up, down and no jump). In the general case, our procedure is numerically justified as in the Hilliard and Schwartz paper

Screening women for intimate partner violence in healthcare settings.

Intimate partner violence (IPV) damages individuals, their children, communities, and the wider economic and social fabric of society. Some governments and professional organisations recommend screening all women for intimate partner violence rather than asking only women with symptoms (case-finding); however, what is the evidence that screening interventions will increase identification, and referral to support agencies, or improve women's subsequent wellbeing and not cause harm? To assess the effectiveness of screening for intimate partner violence conducted within healthcare settings for identification, referral to support agencies and health outcomes for women. We searched the following databases in July 2012: CENTRAL (2012, Issue 6), MEDLINE (1948 to September Week June Week 3 2012), EMBASE (1980 to Week 28 2012), MEDLINE In-Process (3 July 2012), DARE (2012, Issue 2), CINAHL (1937 to current), PsycINFO (1806 to June Week 4 2012), Sociological Abstracts (1952 to current) and ASSIA (1987 to October 2010). In addition we searched the following trials registers: metaRegister of Controlled Trials (mRCT) (to July 2012), and International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, Australian New Zealand Clinical Trials Registry and the International Standard Randomised Controlled Trial Number Register to August 2010. We also searched the reference lists of articles and websites of relevant organisations. Randomised or quasi-randomised trials assessing the effectiveness of IPV screening where healthcare professionals screened women face-to-face or were informed of results of screening questionnaires, compared with usual care ( which included screening for other purposes). Two review authors independently assessed the risk of bias in the trials and undertook data extraction. For binary outcomes, we calculated a standardised estimation of the risk ratio (RR) and for continuous data, either a mean difference (MD) or standardised mean difference (SMD). All are presented with a 95% confidence interval (CI). We included 11 trials that recruited 13,027 women overall. Six of 10 studies were assessed as being at high risk of bias.When data from six comparable studies were combined (n = 3564), screening increased identification of victims/survivors (RR 2.33; 95% CI 1.40 to 3.89), particularly in antenatal settings (RR 4.26; 95% CI 1.76 to 10.31).Only three studies measured referrals to support agencies (n = 1400). There is no evidence that screening increases such referrals, as although referral numbers increased in the screened group, actual numbers were very small and crossed the line of no effect (RR 2.67; 95% CI 0.99 to 7.20).Only two studies measured women's experience of violence after screening (one at three months, the other at six, 12 and 18 months after screening) and found no significant reduction of abuse.Only one study measured adverse effects and data from this study suggested that screening may not cause harm. This same study showed a trend towards mental health benefit, but the results did not reach statistical significance.There was insufficient evidence on which to judge whether screening increases take up of specialist services, and no studies included economic evaluation. Screening is likely to increase identification rates but rates of referral to support agencies are low and as yet we know little about the proportions of false measurement (negatives or positives). Screening does not appear to cause harm, but only one study examined this outcome. As there is an absence of evidence of long-term benefit for women, there is insufficient evidence to justify universal screening in healthcare settings. Studies comparing screening versus case finding (with or without advocacy or therapeutic interventions) for women's long-term wellbeing would better inform future policies in healthcare settings.</p

Priorities and strategies for improving disabled women's access to maternity services when they are affected by domestic abuse:a multi-method study using concept maps

BACKGROUND: Domestic abuse is a significant public health issue. It occurs more frequently among disabled women than those without a disability and evidence suggests that a great deal of domestic abuse begins or worsens during pregnancy. All women and their infants are entitled to equal access to high quality maternity care. However, research has shown that disabled women who experience domestic abuse face numerous barriers to accessing care. The aim of the study was to identify the priority areas for improving access to maternity services for this group of women; develop strategies for improved access and utilisation; and explore the feasibility of implementing the identified strategies. METHODS: This multi-method study was the third and final part of a larger study conducted in the UK between 2012 and 2014. The study used a modified concept mapping approach and was theoretically underpinned by Andersen’s model of healthcare use. Seven focus group interviews were conducted with a range of maternity care professionals (n = 45), incorporating quantitative and qualitative components. Participants ranked perceived barriers to women’s access and utilisation of maternity services in order of priority using a 5-point Likert scale. Quantitative data exploration used descriptive and non-parametric analyses. In the qualitative component of each focus group, participants discussed the barriers and identified potential improvement strategies (and feasibility of implementing these). Qualitative data were analysed inductively using a framework analysis approach. RESULTS: The three most highly ranked barriers to women’s access and utilisation of maternity services identified in the quantitative component were: 1) staff being unaware and not asking about domestic abuse and disability; 2) the impact of domestic abuse on women; 3) women’s fear of disclosure. The top two priority strategies were: providing information about domestic abuse to all women and promoting non-judgemental staff attitude. These were also considered very feasible. The qualitative analysis identified a range of psychosocial and environmental barriers experienced by this group of women in accessing maternity care. Congruent with the quantitative results, the main themes were lack of awareness and fear of disclosure. Key strategies were identified as demystifying disclosure and creating physical spaces to facilitate disclosure. CONCLUSIONS: The study supports findings of previous research regarding the barriers that women face in accessing and utilising maternity services, particularly regarding the issue of disclosure. But the study provides new evidence on the perceived importance and feasibility of strategies to address such barriers. This is an important step in ensuring practice-based acceptability and ease with which improvement strategies might be implemented in maternity care settings

Psychopharmacology

Psychopharmacology is the scientific study of the effects drugs have on mood, sensation, thinking, and behavior. Particularly it concerns the use of medications in the treatment of mental disorders. The goal of this chapter is to define the major classes of psychotropic drugs, introducing general pharmacological concepts, explaining the different mechanisms of action and the main clinical applications of the drugs used to treat psychiatric disorders. Psychotropic drugs are commonly categorized according to their major clinical applications: antidepressants, anxiolytics, antipsychotics, and mood stabilizers. However, almost every drug used in psychiatry has multiple therapeutic roles and many clinical applications. For example, SSRIs are considered the first-line pharmacological treatment for several disorders, such as depressive disorders, anxiety disorders, and OCD. Similarly, antipsychotics are indicated as first-choice drugs for psychotic disorders, but many guidelines recommend their use, in combination with mood stabilizers, also in the treatment of acute mania