The application of medical informatics to the veterinary management programs at companion animal practices in Alberta, Canada: a case study.

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.

Development of meta-representations: Procedural metacognition and the relationship to Theory of Mind

In several studies it was shown that metacognitive ability is crucial for children and their success in school. Much less is known about the emergence of that ability and its relationship to other meta-representations like Theory of Mind competencies. In the past years, a growing literature has suggested that metacognition and Theory of Mind could theoretically be assumed to belong to the same developmental concept. Since then only a few studies showed empirically evidence that metacognition and Theory of Mind are related. But these studies focused on declarative metacognitive knowledge rather than on procedural metacognitive monitoring like in the present study: N = 159 children were first tested shortly before making the transition to school (aged between 5 1/2 and 7 1/2 years) and one year later at the end of their first grade. Analyses suggest that there is in fact a significant relation between early metacognitive monitoring skills (procedural metacognition) and later Theory of Mind competencies. Notably, language seems to play a crucial role in this relationship. Thus our results bring new insights in the research field of the development of meta-representation and support the view that metacognition and Theory of Mind are indeed interrelated, but the precise mechanisms yet remain unclear.

Diagnosis of sexually transmitted infections in developing nations using syndromic management: Is it working?

Sexually transmitted infections (STIs) are a major public health problem, and controlling their spread is a priority. According to the World Health Organization (WHO), there are 340 million new cases of treatable STIs among 15–49 year olds that occur yearly around the world (1). Infection with STIs can lead to several complications such as pelvic inflammatory disorder (PID), cervical cancer, infertility, ectopic pregnancy, and even death (1). Additionally, STIs and associated complications are among the top disease types for which healthcare is sought in developing nations (1), and according to the UNAIDS report, there is a strong connection between STIs and the sexual spread of HIV infection (2). In fact, it is estimated that the presence of an untreated STI can increase the likelihood of contracting and spreading HIV by a factor up to 10 (2). In addition, developing countries are poorer in resources and lack inexpensive and precise diagnostic laboratory tests for STIs, thereby exacerbating the problem. Thus, the WHO recommends syndromic management of STIs for delivering care where lab testing is scarce or unattainable (1). This approach utilizes the use of an easy to use algorithm to help healthcare workers recognize symptoms/signs so as to provide treatment for the likely cause of the syndrome. Furthermore, according to the WHO, syndromic management offers instant and legitimate treatment compared to clinical diagnosis, and that it is also more cost-effective for some syndromes over the use of laboratory testing (1). In addition, even though it has been shown that the vaginal discharge syndrome has low specificity for gonorrhea and Chlamydia and can lead to over treatment (1), this is the recommended way to manage STIs in developing nations. Thus, the purpose of this paper is to specifically address the following questions: is syndromic management working to lower the STI burden in developing nations? How effective is it, and should it still be recommended? To answer these questions, a systematic literature review was conducted to evaluate the current effectiveness of syndromic management in developing nations. This review examined published articles over the past 5 years that compared syndromic management to laboratory testing and had published sensitivity, specificity, and positive predicative value data. Focusing mainly on vaginal discharge, urethral discharge, and genital ulcer algorithms, it was seen that though syndromic management is more effective in diagnosing and treating urethral and genial ulcer syndromes in men, there still remains an urgent need to revise the WHO recommendations for managing STIs in developing nations. Current studies have continued to show decreased specificity, sensitivity and positive predicative values for the vaginal discharge syndrome, and high rates of asymptomatic infections and healthcare workers neglecting to follow guidelines limit the usefulness of syndromic management. Furthermore, though advocate d as cost-effective by the WHO, there is a cost incurred from treating uninfected people. Instead of improving this system, it is recommended that better and less expensive point of care and the development of rapid test diagnosis kits be the focus and method of diagnosis and treatment in developing nations for STI management. ^

Effectiveness of healthcare waste management interventions in developing countries

Inefficiencies during the management of healthcare waste can give rise to undesirable health effects such as transmission of infections and environmental pollution within and beyond the health facilities generating these wastes. Factors such as prevalence of diseases, conflicts, and the efflux of intellectual capacity make low income countries more susceptible to these adverse health effects. The purpose of this systematic review was to describe the effectiveness of interventions geared towards better managing the generation, collection, transport, treatment and disposal of medical waste, as they have been applied in lower and middle income countries.^ Using a systematic search strategy and evaluation of study quality, this study reviewed the literature for published studies on healthcare waste management interventions carried out in developing countries, specifically the low and lower middle income countries from year 2000 to the current year. From an initially identified set of 829 studies, only three studies ultimately met all inclusion, exclusion and high quality criteria. A multi component intervention in Syrian Arab Republic, conducted in 2007 was aimed at improving waste segregation practice in a hospital setting. There was an increased use of segregation boxes and reduced rates of sharps injury among staff as a result of the intervention. Another study, conducted in 2008, trained medical students as monitors of waste segregation practice in an Indian teaching hospital. There was improved practice in wards and laboratories but not in the intensive care units. The third study, performed in 2008 in China, consisted of modification of the components of a medical waste incinerator to improve efficiency and reduce stack emissions. Gaseous pollutants emitted, except polychlorodibenzofurans (PCDF) were below US EPA permissible exposure limits. Heavy metal residues in the fly ash remained unchanged.^ Due to the paucity of well-designed studies, there is insufficient evidence in literature to conclude on the effectiveness of interventions in low income settings. There is suggestive but insufficient evident that multi-component interventions aimed at improving waste segregation through behavior modification, provision of segregation tools and training of monitors are effective in low income settings.^

Report on the practice based culminating experience as teaching assistant for "Pathology and Public Health" class taught at University of Texas School of Public Health, Houston

Objectives. The objectives of this report were to describe current best standards in online education, class competencies, class objectives, class activities and to compare the class competencies, objectives and activities undertaken with the current best practices in online teaching and to provide a list of recommendations based on the most efficacious practices. ^ Methods. Utilizing the key words- online teaching, national standards, quality, online courses, I: (1) conducted a search on Google to find the best standard for quality online courses; the search yielded National Standards for Quality Online Teaching as the gold standard in online course quality; (2) specified class objectives and competencies as well as major activities undertaken as a part of the class. Utilizing the Southern Regional Education Board evaluation checklist for online courses, I: (1) performed an analysis comparing the class activities, objectives, and competencies with the current best standards; (2) utilized the information obtained from the analysis and class experiences to develop recommendations for the most efficacious online teaching practices. ^ Results. The class met the criteria set by the Southern Regional Education Board for evaluating online classes completely in 75%, partially in 16% and did not meet the criteria in 9% cases. The majority of the parameters in which the class did not meet the standards (4 of 5) were due to technological reasons beyond the scope of the class instructor, teaching assistant and instructional design. ^ Discussion. Successful online teaching requires awareness of technology, good communication, methods, collaboration, reflection and flexibility. Creation of an online community, engaging online learners and utilizing different learning styles and assessment methods promote learning. My report proposes that online teaching should actively engage the students and teachers with multiple interactive strategies as evidenced from current best standards of online education and my “hands-on” work experience. ^ Conclusion. The report and the ideas presented are intended to create a foundation for efficacious practice on the online teaching platform. By following many of the efficacious online practices described in the report and adding from their own experiences, online instructors and teaching assistants can contribute to effective online learning. ^

Let their voices be heard: Understanding the barriers to seeking early prenatal care for low-income non-Hispanic Black women

Background: Receipt of early prenatal care, care during the first three months of pregnancy, is the standard in the United States. Sixty percent of non-Hispanic Black women who had a live birth in the Sunnyside community of Houston did not obtain early prenatal care in 2009. ^ This study's aims were to: 1) Describe the barriers to obtaining early prenatal care in non-Hispanic Black women who live in the Sunnyside community of Houston; and, 2) Describe the actions that could encourage non-Hispanic Black women who live in the Sunnyside Community to obtain early prenatal care. The goal was to provide information to organizations that promote early prenatal care use in non-Hispanic Black women in Harris County that may aid in developing interventions. ^ Methods: The Participatory Learning for Action rapid assessment qualitative method was used in a group setting to answer the research questions on behalf of women in the community. Women who participated in the group sessions also participated in an in-depth interview. Key informants who work in the community with pregnant women, or promote the use of prenatal care services, were also interviewed. An inductive analysis of the data was conducted to identify common themes that address the study's aims. ^ Results: Aim 1: Group participants identified fear of the reaction from family and/or the baby's daddy and shame, not having insurance or money, and lack of knowledge of the pregnancy and resources as the top three barriers to early prenatal care for women in the community. Aim 2: Group participants stated that to help women to overcome these barriers, communication, awareness and support; help, resources and services; and information and early education are needed. Participant in-depth interviewees echoed the themes of fear of the reaction from family and/or the baby's daddy and not knowing of the pregnancy. Key informants mentioned these themes as well, though not at the same priority level. Participants and key informants also mentioned similar themes for helping women to overcome barriers to early prenatal care. ^ Conclusion: A comprehensive approach is needed to improve early prenatal care use in the Sunnyside community. Education efforts must include all members of the community, young and old, to promote support for pregnant women. Community members must be a part of the process for developing education campaigns. Engaging the community builds a relationship with organizations that serve the community, which may promote use of the organizations' services, and build trust with the community. All efforts must be ongoing so that women and men of all ages in the community understand the importance of prenatal care and support women obtaining care early in the pregnancy.^

Identification and characterization of the vegetally localized Hermes mRNA

One way developing embryos regulate the expression of their genes is by localizing mRNAs to specific subcellular regions. In the oocyte of the frog, Xenopus laevis, many RNAs are localized specifically to the animal or the vegetal halves of the oocyte. The localization of these RNAs contributes to the primary polarity of the oocyte, the asymmetry that is the basis for patterning and lineage specification in the embryo. I have screened a cDNA library for clones containing the Xlsirt repeat, an element known to target RNAs to the vegetal cortex of the oocyte. I have identified seventeen cDNA clones that contain this element. One of these cDNAs encodes the RNA binding protein Hermes. The Hermes mRNA is localized to the vegetal cortex of the oocyte. Additionally, Hermes protein is also vegetally localized in the oocyte and is found in subcellular structures known to contain localized mRNAs. This suggests that Hermes might interact with localized RNAs. While Hermes protein is present in oocytes, it disappears at germinal vesicle breakdown during maturation. We therefore believe that the time period during which Hermes functions is during oogenesis or maturation prior to the time of Hermes degradation. To determine Hermes function, an antisense depletion strategy was used that involved injecting morpholino oligos (HE-MO) into oocytes. Injection of these morpholinos causes the level of Hennes protein to drop prematurely during maturation. Embryos produced from these oocytes exhibit cleavage defects that are most prevalent in the vegetal blastomeres. The phenotype can be partially rescued by injection of a heterologous Hermes mRNA and is therefore specific to Hermes. The Hermes expression and depletion results are consistent with a model in which Hermes interacts with one or more vegetally localized mRNAs in the oocyte and during the early stages of maturation. The interaction is required for cleavage of the vegetal blastomeres. Therefore, it is likely that at least one mRNA that interacts with Hermes is a cell cycle regulator. ^

Major element oxides, trace element content and isotopic ratios of dolerites from the Schirmacher Oasis

New results on the petrochemistry and geochemistry of dolerites from the Schirmacher Oasis shed light on the development of the Karoo-Maud plume in Antarctica. The basalts and dolerites are petrologically identical to the rocks of western Dronning Maud Land (DML), which were previously studied and interpreted as a manifestation of the Karoo-Maud plume in Antarctica. The spatial distribution of the dikes suggests eastward spreading of the plume material, up to the Schirmacher Oasis for at least 10 Ma. The geochemical characteristics of magmas from the Schirmacher Oasis reflect the influence of crustal contamination, which accompanied both the ascent and spreading of the plume. The magmas of the initial stage of plume activity (western DML) appeared to be the most contaminated in crustal components. It was found that the geochemical characteristics of Mesozoic magmas from the Schirmacher Oasis are identical to those of enriched tholeiites from the Afanasy Nikitin Rise and the central Kerguelen Plateau (Hole 749), which indicates that their enrichment was related to the ancient material of the Gondwana continent. This was caused by the opening of the Indian Ocean under the influence of the Karoo-Maud plume. This process was peculiar in that it occurred in the presence of nonspreading blocks of varying thickness, for instance, Elan Bank in the central Kerguelen Plateau, and was accompanied by the formation of intraplate volcanic rises, which are documented in the seafloor relief of basins around Antarctica. The geochemical characteristics of igneous rocks from the resulting rises (Afanasy Nikitin, Kerguelen, Naturaliste, and Ninetyeast Ridge) indicate the influence of processes related to crustal assimilation. The magmatism that occurred 40 Ma after the main phase of the Karoo-Maud volcanism at the margins of the adjacent continents of Australia (Bunbury basalts) and India (Rajmahal trapps) could be generated by the Karoo-Maud plume flowing along the developing spreading zone. The plume moved subsequently and was localized at the Kerguelen Plateau, where it occurs at present as an active hotspot.

Are Job Networks Localized in a Developing Economy? Search Methods for Displaced Workers in Thailand

Effects of localized personal networks on the choice of search methods are studied in this paper using evidence of displaced workers by establishment closure in Thailand Labor Force Survey, 2001. For the blocks/villages level, there is less significant evidence of local interactions between job-seekers and referrals in developing labor markets. The effects of localized personal networks do not play an important role in the probability of unemployed job-seekers seeking assistance from friends and relatives. Convincing evidence from the data supports the proposition that both self-selection of individual background-like professions and access to large markets determine the choice of job search method.

Evolution in the Concept of Development: How Has The World Bank's Legal Assistance Extended its Reach?

The World Bank's legal and judicial reforms programs have expanded considerably since it began to address the issue of governance in the early 1990s. Initially the Bank focused on legal reforms for inducing private investment. Currently, its legal assistance extends to include the criminal justice sector. Such activities cannot be directly construed from its Articles of Agreement. This paper will discuss how the Bank interpreted its Articles in order to ligitimize its expanding activities. The Bank has manoeuvred itself into the criminal justice sector by skillfully changing its concept of development without deviating from its mandate. The change can be described as an 'evolution' which has allowed the Bank to identify any area as target for its development assistance.

Re-examining "difference" and "development" : a note on broadening the field of gender and development in Japan

It is the author’s position that the framework for WID/GAD, as academic field and practice concerned primarily with developing countries should be broadened so as to incorporate Japan’s own gender and development issues in its scope. Unlike other developed countries, activists and scholars in Japan rarely connected, as was also the case with the fields of women’s/gender studies and WID/GAD. However, this was not due to any lack of interest among Japanese women regarding the lives of women in developing countries. Rather the points of fissure were the notions of ‘difference’ and ‘development’ held by Japanese women. These analytical concepts were narrowly defined, which resulted in limited interaction between discourse on women’s issues in Japan and WID/GAD related to ‘other’ women. By re-examining these notions and looking more deeply into perceived differences in the local context of ‘development’, not only can we strategize on ‘differences’ in such a way that we draw strength from the very fact of being different, but also prevent ‘differences’ from being used as grounds for discrimination. As a whole, we could gain substantially by broadening the field of Gender and Development and, as such, it is imperative that this field be broadened with urgency as development itself changes in this ever-interconnected world

Determinants of government consumption expenditure in developing countries : a panel data analysis

The paper focuses on the recent pattern of government consumption expenditure in developing countries and estimates the determinants which have influenced government expenditure. Using a panel data set for 111 developing countries from 1984 to 2004, this study finds evidence that political and institutional variables as well as governance variables significantly influence government expenditure. Among other results, the paper finds new evidence of Wagner's law which states that peoples' demand for service and willingness to pay is income-elastic hence the expansion of public economy is influenced by the greater economic affluence of a nation (Cameron1978). Corruption is found to be influential in explaining the public expenditure of developing countries. On the contrary, size of the economy and fractionalization are found to have significant negative association with government expenditure. In addition, the study finds evidence that public expenditure significantly shrinks under military dictatorship compared with other form of governance.

Diversified boundaries of the firm

We analyze diversification of boundaries of local firms in developing countries under the economic globalization. The globalization has an aspect of homogenization of the world economy, but also has another aspect of diversification through international economic activities. Focusing on boundary-level of the firm, this article shows that the diversification from a comparison with boundaries of foreign firms in developed countries is brought by a disadvantage of technology deficit and a home advantage as local firms.

Rethinking special and differential treatment in the WTO

Special and differential treatment (S&D) allows differentiated treatment for developing countries within the WTO system by justifying a deviation from the most-favoured-nation obligation. Since it was incorporated into the GATT (the predecessor of the WTO) in the 1960s, S&D has played a significant role in promoting the integration of developing countries into the multilateral trading system. However, S&D is undergoing complicated and entangled discussion at the current multilateral trade negotiations, the Doha Development Agenda. There are a number of reasons to make opposing arguments in developed and developing countries, among which this paper focuses on two elements: diversification of developing countries and instability of preferential schemes. In order to overcome these problems and in order to make S&D more effective and operational, this paper considers the following alternative approaches: differentiation among developing countries applying the common but differentiated responsibility (CBDR) principle by analogy and codification of a preferential scheme as a multilateral agreement in the manner of North-South RTAs with flexibility.

Does technological progress magnify regional disparities?

We study how technological progress in manufacturing and transportation to-gether with migration costs interact to shape the space-economy. Rising labor productivity in the manufacturing sector fosters the agglomeration of activities, whereas falling transport costs associated with technological and organizational in-novations fosters their dispersion. Since these two forces have been at work for a long time, the final outcome must depend on how drops in the costs of producing and trading goods interact with the various costs borne by migrants. Finally, when labor is heterogeneous, the most efficient workers of the less productive region are the first to move to the more productive region.