A systematic review of the routine monitoring of growth in children of primary school age to identify growth-related conditions

Objectives: To clarify the role of growth monitoring in primary school children, including obesity, and to examine issues that might impact on the effectiveness and cost-effectiveness of such programmes. Data sources: Electronic databases were searched up to July 2005. Experts in the field were also consulted. Review methods: Data extraction and quality assessment were performed on studies meeting the review's inclusion criteria. The performance of growth monitoring to detect disorders of stature and obesity was evaluated against National Screening Committee (NSC) criteria. Results: In the 31 studies that were included in the review, there were no controlled trials of the impact of growth monitoring and no studies of the diagnostic accuracy of different methods for growth monitoring. Analysis of the studies that presented a 'diagnostic yield' of growth monitoring suggested that one-off screening might identify between 1: 545 and 1: 1793 new cases of potentially treatable conditions. Economic modelling suggested that growth monitoring is associated with health improvements [ incremental cost per quality-adjusted life-year (QALY) of pound 9500] and indicated that monitoring was cost-effective 100% of the time over the given probability distributions for a willingness to pay threshold of pound 30,000 per QALY. Studies of obesity focused on the performance of body mass index against measures of body fat. A number of issues relating to human resources required for growth monitoring were identified, but data on attitudes to growth monitoring were extremely sparse. Preliminary findings from economic modelling suggested that primary prevention may be the most cost-effective approach to obesity management, but the model incorporated a great deal of uncertainty. Conclusions: This review has indicated the potential utility and cost-effectiveness of growth monitoring in terms of increased detection of stature-related disorders. It has also pointed strongly to the need for further research. Growth monitoring does not currently meet all NSC criteria. However, it is questionable whether some of these criteria can be meaningfully applied to growth monitoring given that short stature is not a disease in itself, but is used as a marker for a range of pathologies and as an indicator of general health status. Identification of effective interventions for the treatment of obesity is likely to be considered a prerequisite to any move from monitoring to a screening programme designed to identify individual overweight and obese children. Similarly, further long-term studies of the predictors of obesity-related co-morbidities in adulthood are warranted. A cluster randomised trial comparing growth monitoring strategies with no growth monitoring in the general population would most reliably determine the clinical effectiveness of growth monitoring. Studies of diagnostic accuracy, alongside evidence of effective treatment strategies, could provide an alternative approach. In this context, careful consideration would need to be given to target conditions and intervention thresholds. Diagnostic accuracy studies would require long-term follow-up of both short and normal children to determine sensitivity and specificity of growth monitoring.

Children’s perspectives on their working lives and on public action against child labour in Burkina Faso

The majority of children in Burkina Faso undertake work and, compared to other West African countries, it has the highest rate of children involved in hazardous work (Diallo 2008; NISD 2008), which is one working child out of two. Based on a qualitative survey, this chapter presents the perspectives of Burkinabe children working in two of the hazardous sectors: a quarry and an artisanal mine. The findings show that children acknowledge very difficult working conditions in these sites. However a variety of reasons maintain them in work, which they perceive as a solution and thus challenging action against child labour in Burkina Faso.

A qualitative exploration of the underlying causes of preventable drug-related morbidity in primary care, resulting in hospitalisation

This study has explored the underlying causes of preventable drug-related admissions to hospital, from primary care through semi-structured interviews and review of patients’ medical records. Analysis of the data has revealed that communication failures between different groups of healthcare professionals and between healthcare professionals and patients contribute to preventable drug-related admissions, as do knowledge gaps about medication in both healthcare professionals and patients. In addition, working conditions for community pharmacists severely limit their ability to effectively act as a safety barrier to patients receiving inappropriate medication. Limitations include heavy workloads, lack of access to patients’ clinical information, poor relationships with general practitioners and time restrictions. The results of this study represent an important addition to our understanding of the contribution of human error as an underlying cause of preventable drug-related morbidity, and the factors which contribute to errors occurring in the primary healthcare setting.

Strengthening artisanal mining research and policy through baseline census activities

Over the past 10-15 years, several governments have implemented an array of technology, support-related, sustainable livelihoods (SL) and poverty-reduction projects for artisanal and small-scale mining (ASM). In the majority of cases, however, these interventions have failed to facilitate improvements in the industry's productivity and raise the living standards of the sector's subsistence operators. This article argues that a poor understanding of the demographics of target populations has precipitated these outcomes. In order to strengthen policy and assistance in the sector, governments must determine, with greater precision, the number of people operating in ASM regions, their origins and ethnic backgrounds, ages, and educational levels. This can be achieved by carrying out basic and localized census work before promoting ambitious sector-specific projects aimed at improving working conditions in the industry.

A new framework for understanding inequalities between expatriates and host country nationals

An interdisciplinary theoretical framework is proposed for analysing justice in global working conditions. In addition to gender and race as popular criteria to identify disadvantaged groups in organizations, in multinational corporations (MNCs) local employees (i.e. host country nationals (HCNs) working in foreign subsidiaries) deserve special attention. Their working conditions are often substantially worse than those of expatriates (i.e. parent country nationals temporarily assigned to a foreign subsidiary). Although a number of reasons have been put forward to justify such inequalities—usually with efficiency goals in mind—recent studies have used equity theory to question the extent to which they are perceived as fair by HCNs. However, since perceptual equity theory has limitations, this study develops an alternative and non-perceptual framework for analysing such inequalities. Employment discrimination theory and elements of Rawls’s ‘Theory of Justice’ are the theoretical pillars of this framework. This article discusses the advantages of this approach for MNCs and identifies some expatriation practices that are fair according to our non-perceptual justice standards, whilst also reasonably (if not highly) efficient.

Embedding arts and humanities in the creative economy: the role of graduates in the UK

The recent change in funding structure in the UK higher education system has fuelled an animated debate about the role that arts and humanities (A&H) subjects play not only within higher education but more broadly in the society and the economy. The debate has engaged with a variety of arguments and perspectives, from the intrinsic value of A&H, to their contribution to the broader society and their economic impact, particularly in relation to the creative economy, through knowledge exchange activities. The paper argues that in the current debate very little attention has been placed on the role that A&H graduates play in the economy, through their work after graduation, and specifically in the creative economy. Using Higher Education Statistical Agency data, we analyse the performance of A&H graduates (compared with other graduates) and particularly explore how embedded they are with the creative economy and its associated industries. The results highlight a complex intersection of different subdisciplines of the A&H with the creative economy but also reveal the salary gap and unstable working conditions experienced by graduates in this field.

Data stream mining in ubiquitous environments: state-of-the-art and current directions

In this article, we review the state-of-the-art techniques in mining data streams for mobile and ubiquitous environments. We start the review with a concise background of data stream processing, presenting the building blocks for mining data streams. In a wide range of applications, data streams are required to be processed on small ubiquitous devices like smartphones and sensor devices. Mobile and ubiquitous data mining target these applications with tailored techniques and approaches addressing scarcity of resources and mobility issues. Two categories can be identified for mobile and ubiquitous mining of streaming data: single-node and distributed. This survey will cover both categories. Mining mobile and ubiquitous data require algorithms with the ability to monitor and adapt the working conditions to the available computational resources. We identify the key characteristics of these algorithms and present illustrative applications. Distributed data stream mining in the mobile environment is then discussed, presenting the Pocket Data Mining framework. Mobility of users stimulates the adoption of context-awareness in this area of research. Context-awareness and collaboration are discussed in the Collaborative Data Stream Mining, where agents share knowledge to learn adaptive accurate models.

Travail des enfants et droit à l’éducation au Burkina Faso: L’exemple de la carrière de Pissy

Cet article décrit et analyse le travail des enfants dans une carrière de granit d’un quartier de la ville de Ouagadougou, interroge le rapport entre l’école et le travail du point de vue des acteurs du site pour apprécier l’argument de la scolarisation comme solution alternative au travail des enfants. Les données proviennent d’une enquête réalisée dans le cadre de notre recherche doctorale au Burkina Faso, de février à avril 2009, dont la carrière de Pissy a été un des terrains d’enquête1. Les enquêtés sont constitués de parents et de leurs enfants âgés de moins de 16 ans ayant des trajectoires différentes : non scolarisés,scolarisés, déscolarisés et à la fois écoliers et travailleurs. Les personnes ont été choisies aléatoirement selon leur accord et disponibilité, en variant leur emplacement. L’approche choisie privilégie le point de vue des différents acteurs du site,l’analyse de leurs discours et l’observation de leurs pratiques de travail. La prise en compte du point de vue des enfants s’appuie sur la perspective théorique développée par James & Prout (1997), où les enfants sont des acteurs compétents dans la sphère du travail et de la vie sociale. L’article présente d’abord le processus d’institutionnalisation de l’école et la situation du travail des enfants au Burkina Faso, puis décrit les logiques autour du travail des enfants dans la carrière en montrant que celui-ci n’est pas seulement lié à la nécessité économique. Enfin, il confronte les alternatives au travaildes enfants invoquées par les enfants et leurs parents aux solutions d’éducation proposées par l’état et la société civile. This article is about a particular case of children in working situation: children crushing the granite in the quarry of Pissy. Their working conditions are considered as dangerous by national and international legal texts. This article aims to grasp the experience of children who work in this frame in order to test the hypothesis according to which schooling would be an effective tool of struggle against child labour. The fieldwork reveals that child labour in the quarry is not only guided by economic aspects. The wish of the parents (and of some children and teenagers) to find another job for working children reopen the debate on “the right to work” for children.