Biopsy case mix and diagnostic yield at a Malawian central hospital

Cancer is a major disease burden worldwide resulting in high morbidity and mortality. It is the leading cause of mortality in developed countries and is one of the three leading causes of death for adults in developing countries. Pathological examination of tissue biopsies with histological confirmation of a correct cancer diagnosis is central to cancer care. Without an accurate and specific pathologic diagnosis, effective treatment cannot be planned or delivered. In addition, there are marked geographical variations in incidence of cancer overall, and of the specific cancers seen. Much of the published literature on cancer incidence in developing countries reflects gross estimates and may not reflect reality. Performing baseline studies to understand these distributions lays the groundwork for further research in this area of cancer epidemiology. Our current study surveys and ranks cancer diagnoses by individual anatomical site at Queen Elizabeth Central Hospital (QECH) which is the largest teaching and referral hospital in Malawi. A retrospective study was conducted reviewing available pathology reports over a period of one full year from January 2010 to December 2010 for biopsies from patients suspected clinically of having cancer. There were 544 biopsies of suspected cancer, taken from 96 anatomical sites. The oesophagus was the most common biopsied site followed by breast, bladder, bone, prostate, bowel, and cervical lymph node. Malignancies were found in biopsies of the oesophagus biopsies (squamous cell carcinoma, 65.1%; adenocarcinoma, 11.6%), breast (57.5%), bladder (squamous cell carcinoma, 53.1%) and stomach (37.6%). Our study demonstrates that the yield of biopsy for clinically suspected malignancy was greater than 50% for the 11 most common sites and provides a current survey of cancer types by site present in the population reporting to our hospital.

Na expressão de um sonho: Barreiras da carreira em universitários com incapacidade

Este estudo teve como objetivo analisar a perceção de barreiras ao desenvolvimento da carreira num grupo de estudantes Universitários portadores de incapacidade. Participaram 19 estudantes de 3 estabelecimentos de Ensino Superior, com idades compreendidas entre os 19 e os 45 anos. Responderam a uma entrevista semiestruturada que avaliava a perceção de barreiras e de sistemas de apoio ao seu desenvolvimento da carreira no passado, no presente e no futuro. Os resultados obtidos evidenciam dimensões de estabilidade e de mudança na perceção de barreiras: as persistentes nos três momentos avaliativos e as específicas a esses momentos. Também revelam que as pessoas significativas e as ajudas pedagógicas são os tipos de apoio ao desenvolvimento da carreira mais referidos. Os resultados são discutidos quanto às suas implicações para a prática e às perspetivas que abrem à investigação do desenvolvimento da carreira desta população. ABSTRACT: The aim of this study is to examine barriers perception to career development in a group of disabled university students. Nineteen students of three institutions of colleges participated, aged between nineteen and forty-five years. they responded to a semi-structured interview that appraised support systems and barriers perception to their career development in past, present and future. The results show barriers perception’s change and stability dimensions: the persistent in the three analise moments and those specific to these moments. lt also reveals that the most said career development's types of support are significant persons and pedagogical aids. The results are discussed regarding their implications for practice and prospects that open for research career development of this population.

The effectiveness of technical assistance, socio-economic development and the absorptive capacity of competition authorities

Includes bibliography

Lane Closure Policy Development, Enforcement, and Exceptions: A Survey of Seven State Transportation Agencies, February 2007

Traffic volume increases and an aging infrastructure create the need for reconstruction, rehabilitation, and maintenance of existing facilities. As more motorists feel that delays should be minimal during highway renewal projects, lane closures that reduce capacity through the work zone should not create unreasonable delays. In order to facilitate the determination of when a lane closure is permitted during the day, some state transportation agencies (STAs) have developed lane closure policies, or strategies, that they use as guidance in determining daily permitted lane closure times. Permitted lane closure times define what times of the day, week, or season a lane closure is allowed on a facility and at a specific location or segment. This research addresses the lane closure policies of several STAs that were reputed to have good lane closures policies or strategies and that were selected by the project advisory committee for further research.

Competence Development and Capacity Building of Sawmill Enterprises in Kenya – A Human Resources Development Approach

The Kenyan forestry and sawmilling industry have been subject to a changing environment since 1999 when the industrial forest plantations were closed down. This has lowered raw material supply and it has affected and reduced the sawmill operations and the viability of the sawmill enterprises. The capacity of the 276 registered sawmills is not sufficient to fulfill sawn timber demand in Kenya. This is because of the technological degradation and lack of a qualified labor force, which were caused because of non-existent sawmilling education and further training in Kenya. Lack of competent sawmill workers has led to low raw material recovery, under utilization of resources and loss of employment. The objective of the work was to suggest models, methods and approaches for the competence and capacity development of the Kenyan sawmilling industry, sawmills and their workers. A nationwide field survey, interviews, questionnaire and literature review was used for data collection to find out the sawmills’ competence development areas and to suggest models and methods for their capacity building. The sampling frame included 22 sawmills that represented 72,5% of all the registered sawmills in Kenya. The results confirmed that the sawmills’ technological level was backwards, productivity low, raw material recovery unacceptable and workers’ professional education low. The future challenges will be how to establish the sawmills’ capacity building and workers’ competence development. Sawmilling industry development requires various actions through new development models and approaches. Activities should be started for technological development and workers’ competence development. This requires re-starting of vocational training in sawmilling and the establishment of more effective co-operation between the sawmills and their stakeholder groups. In competence development the Enterprise Competence Management Model of Nurminen (2007) can be used, whereas the best training model and approach would be a practically oriented learning at work model in which the short courses, technical assistance and extension services would be the key functions.

A reappraisal of Baskerville's Greek types

Ιn the eighteenth century the printing of Greek texts continued to be central to scholarship and discourse. The typography of Greek texts could be characterised as a continuation of French models from the sixteenth century, with a gradual dilution of the complexity of ligatures and abbreviations, mostly through printers in the Low Countries. In Britain, Greek printing was dominated by the university presses, which reproduced conservatively the continental models – exemplified by Oxford's Fell types, which were Dutch adaptations of earlier French models. Hindsight allows us to identify a meaningful development in the Greek types cut by Alexander Wilson for the Foulis Press in Glasgow, but we can argue that in the middle of the eighteenth century Baskerville was considering Greek printing the typographic environment was ripe for a new style of Greek types. The opportunity to cut the types for a New Testament (in an twin edition that included a generous octavo and a large quarto version) would seem perfect for showcasing Baskerville's capacity for innovation. His Greek type maintained the cursive ductus of earlier models, but abandoned complex ligatures and any hint of scribal flourish. He homogenised the modulation of the letter strokes and the treatment of terminals, and normalised the horizontal alignments of all letters. Although the strokes are in some letters too delicate, the narrow set of the style composes a consistent, uniform texture that is a clean break from contemporaneous models. The argument is made that this is the first Greek typeface that can be described as fully typographic in the context of the technology of the time. It sets a pattern that was to be followed, without acknowledgement, by Richard Porson nearly a century and a half later. The typeface received little praise by typographic historians, and was condemned by Victor Scholderer in his retrospective of Greek typography. A survey of typeface reviews in the surrounding decades establishes that the commentators were mostly reproducing the views of an arbitrary typographic orthodoxy, for which only types with direct references to Renaissance models were acceptable. In these comments we detect a bias against someone considered an arriviste in the scholarly printing establishment, as well as a conservative attitude to typographic innovation.

Learning for well being : Studies using the International Adult Literacy Survey

This thesis is a collection of five independent but closely related studies. The overall purpose is to approach the analysis of learning outcomes from a perspective that combines three major elements, namely lifelonglifewide learning, human capital, and the benefits of learning. The approach is based on an interdisciplinary perspective of the human capital paradigm. It considers the multiple learning contexts that are responsible for the development of embodied potential – including formal, nonformal and informal learning – and the multiple outcomes – including knowledge, skills, economic, social and others– that result from learning. The studies also seek to examine the extent and relative influence of learning in different contexts on the formation of embodied potential and how in turn that affects economic and social well being. The first study combines the three major elements, lifelonglifewide learning, human capital, and the benefits of learning into one common conceptual framework. This study forms a common basis for the four empirical studies that follow. All four empirical studies use data from the International Adult Literacy Survey (IALS) to investigate the relationships among the major elements of the conceptual framework presented in the first study. Study I. A conceptual framework for the analysis of learning outcomes This study brings together some key concepts and theories that are relevant for the analysis of learning outcomes. Many of the concepts and theories have emerged from varied disciplines including economics, educational psychology, cognitive science and sociology, to name only a few. Accordingly, some of the research questions inherent in the framework relate to different disciplinary perspectives. The primary purpose is to create a common basis for formulating and testing hypotheses as well as to interpret the findings in the empirical studies that follow. In particular, the framework facilitates the process of theorizing and hypothesizing on the relationships and processes concerning lifelong learning as well as their antecedents and consequences. Study II. Determinants of literacy proficiency: A lifelong-lifewide learning perspective This study investigates lifelong and lifewide processes of skill formation. In particular, it seeks to estimate the substitutability and complementarity effects of learning in multiple settings over the lifespan on literacy skill formation. This is done by investigating the predictive capacity of major determinants of literacy proficiency that are associated with a variety of learning contexts including school, home, work, community and leisure. An identical structural model based on previous research is fitted to the IALS data for 18 countries. The results show that even after accounting for all factors, education remains the most important predictor of literacy proficiency. In all countries, however, the total effect of education is significantly mediated through further learning occurring at work, at home and in the community. Therefore, the job and other literacy related factors complement education in predicting literacy proficiency. This result points to a virtual cycle of lifelong learning, particularly to how educational attainment influences other learning behaviours throughout life. In addition, results show that home background as measured by parents’ education is also a strong predictor of literacy proficiency, but in many countries this occurs only if a favourable home background is complemented with some post-secondary education. Study III. The effect of literacy proficiency on earnings: An aggregated occupational approach using the Canadian IALS data This study uses data from the Canadian Adult Literacy Survey to estimate the earnings return to literacy skills. The approach adapts a labour segmented view of the labour market by aggregating occupations into seven types, enabling the estimation of the variable impact of literacy proficiency on earnings, both within and between different types of occupations. This is done using Hierarchical Linear Modeling (HLM). The method used to construct the aggregated occupational classification is based on analysis that considers the role of cognitive and other skills in relation to the nature of occupational tasks. Substantial premiums are found to be associated with some occupational types even after adjusting for within occupational differences in individual characteristics such as schooling, literacy proficiency, labour force experience and gender. Average years of schooling and average levels of literacy proficiency at the between level account for over two-thirds of the premiums. Within occupations, there are significant returns to schooling but they vary depending on the type of occupations. In contrast, the within occupational return of literacy proficiency is not necessarily significant. The latter depends on the type of occupation. Study IV: Determinants of economic and social outcomes from a lifewide learning perspective in Canada In this study the relationship between learning in different contexts, which span the lifewide learning dimension, and individual earnings on the one hand and community participation on the other are examined in separate but comparable models. Data from the Canadian Adult Literacy Survey are used to estimate structural models, which correspond closely to the common conceptual framework outlined in Study I. The findings suggest that the relationship between formal education and economic and social outcomes is complex with confounding effects. The results indicate that learning occurring in different contexts and for different reasons leads to different kinds of benefits. The latter finding suggests a potential trade-off between realizing economic and social benefits through learning that are taken for either job-related or personal-interest related reasons. Study V: The effects of learning on economic and social well being: A comparative analysis Using the same structural model as in Study IV, hypotheses are comparatively examined using the International Adult Literacy Survey data for Canada, Denmark, the Netherlands, Norway, the United Kingdom, and the United States. The main finding from Study IV is confirmed for an additional five countries, namely that the effect of initial schooling on well being is more complex than a direct one and it is significantly mediated by subsequent learning. Additionally, findings suggest that people who devote more time to learning for job-related reasons than learning for personal-interest related reasons experience higher levels of economic well being. Moreover, devoting too much time to learning for personal-interest related reasons has a negative effect on earnings except in Denmark. But the more time people devote to learning for personal-interest related reasons tends to contribute to higher levels of social well being. These results again suggest a trade-off in learning for different reasons and in different contexts.

Best practices and innovative capacity development approaches in ARD programmes of ERA-ARD consortium members: Draft compilation of National Contribution

In the framework of the European Research Area for Agricultural Research for Development (ERA-ARD) project, a survey of innovative approaches in capacity development (CD) was undertaken. All Consortium members were asked to describe innovative approaches and best practices of CD mechanisms within their ARD programmes. A tabular overview of all the programmes or mechanisms can be found on page 4. Abstracts of the programmes or mechanisms are compiled in alphabetic order of the consortium members in this document. The intention of this catalogue of mechanisms is to give an overview of different approaches and practices and not to provide a comprehensive mapping of all the ongoing CD activities of the Consortium members. Thus, the programmes described represent only a fraction of all the ongoing CD programmes on the national level.

Capacity building in development projects

Development projects of different types mainly aim to alleviate poverty and ameliorate the livelihoods of local people. One of the strategies commonly used is to focus on organizations and build from their existing capacities in order to improve their living standards or try to build new organizations to work in a common project. Social and human capitals are two key components of these organizations and they might be crucial to the success of the actions that they accomplish. Both can be considered as part of the social capacity of the local organization. This capacity can be enforced with development projects through capacity building. This term means much more than training activities as it includes not only human resource development but also organizational and institutional development (UNESCO, 2010). Capacity and capacity building concepts, as well as capacity measurements in this context are explored to build a framework to evaluate the social capacity generated with the interventions and better plan the actions to be undertaken by the projects to succeed. The focus is set on rural development projects.

Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams:a mixed-methods approach

Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

Determinants of resource development strategies in nonprofit organizations: An analysis of children, youth and family services

This study is an exploratory analysis of an operational measure for resource development strategies, and an exploratory analysis of internal organizational contingencies influencing choices of these strategies in charitable nonprofit organizations. The study provides conceptual guidance for advancing understanding about resource development in the nonprofit sector. The statistical findings are, however, inconclusive without further rigorous examination. A three category typology based on organization technology is initially presented to define the strategies. Three dimensions of internal organizational contingencies explored represent organization identity, professional staff, and boards of directors. Based on relevant literature and key informant interviews, an original survey was administered by mail to a national sample of nonprofit organizations. The survey collected data on indicators of the proposed strategy types and selected contingencies. Factor analysis extracted two of the initial categories in the typology. The Building Resource Development Infrastructure Strategy encompasses information technology, personnel, legal structures, and policies facilitating fund development. The Building Resource Development Infrastructure Strategy encompasses the mission, service niche, and type of service delivery forming the basis for seeking financial support. Linear regressions with each strategy type as the dependent variable identified distinct and common contingencies which may partly explain choices of strategies. Discriminant analysis suggests the potential predictive accuracy of the contingencies. Follow-up case studies with survey respondents provide additional criteria for operationalizing future measures of resource development strategies, and support and expand the analysis on contingencies. The typology offers a beginning framework for defining alternative approaches to resource development, and for exploring organization capacity specific to each approach. Contingencies that may be integral components of organization capacity are funding, leadership frame, background and experience, staff and volunteer effort, board member support, and relationships in the external environment. Based on these findings, management questions are offered for nonprofit organization stakeholders to consider in planning for resource development. Lessons learned in designing and conducting this study are also provided to enhance future related research. ^

Pupal Development of Ceratitis capitata (Diptera: Tephritidae) and Diachasmimorpha longicaudata (Hymenoptera: Braconidae) at Different Moisture Values in Four Soil Types

This study aimed to evaluate adult emergence and duration of the pupal stage of the Mediterranean fruit fly, Ceratitis capitata (Wiedemann), and emergence of the fruit fly parasitoid, Diachasmimorpha longicaudata (Ashmead), under different moisture conditions in four soil types, using soil water matric potential Pupal stage duration in C capitata was influenced differently for males and females In females, only soil type affected pupal stage duration, which was longer in a clay soil In males, pupal stage duration was individually influenced by moisture and soil type, with a reduction in pupal stage duration in a heavy clay soil and in a sandy clay, with longer duration in the clay soil As allude potential decreased, duration of the pupal stage of C capitata males increased, regardless of soil type C capitata emergence was affected by moisture, regardless of soil type, and was higher in drier soils The emergence of D longicaudata adults was individually influenced by soil type and moisture factors, and the number of emerged D longicaudata adults was three times higher in sandy loam and lower in a heavy clay soil Always, the number of emerged adults was higher at higher moisture conditions C capitata and D longicaudata pupal development was affected by moisture and soil type, which may facilitate pest sampling and allow release areas for the parasitoid to be defined under field conditions.

Seed development, yield and quality of two palm species growing in different tropical forest types in SE Brazil: implications for ecological restoration

Natural forest remnants have been set as seed production fields to supply seeds of native tree species for tropical forest restoration, but the effect of different forest types on seed production has not been accessed to date for palm species. In this work, we studied seed development, yield, and quality of two palm species in different tropical forest types in SE Brazil. Seed production of palmiteiro (Euterpe edulis) and queen-palm (Syagrus romanzoffiana), which are largely used in restoration efforts due to their importance for vertebrate frugivores, were studied in natural remnants of Atlantic Rainforest, Restinga Forest, Seasonally Dry Forest, and Cerrado Forest. We studied seed development, yield, size, and germination of seed lots produced in some of these forest types, including seeds harvested in 2008, 2009, and both years. Seed yield and quality, as well as seed dry mass in 2009, were higher for palmiteiro seeds produced in the Atlantic Rainforest, while queen-palm seeds produced at the Restinga Forest showed the higher mass and yield, but the lowest physiological potential. Consequently, these natural differences of seed yield and quality have to be taken into account for establishing standards for seed commercialization and analysis, seed pricing, and seedling production in forest nurseries.