Accessibility, availability and affordability of anti-malarials in a rural district in Kenya after implementation of a national subsidy scheme.

BACKGROUND: Poor access to prompt and effective treatment for malaria contributes to high mortality and severe morbidity. In Kenya, it is estimated that only 12% of children receive anti-malarials for their fever within 24 hours. The first point of care for many fevers is a local medicine retailer, such as a pharmacy or chemist. The role of the medicine retailer as an important distribution point for malaria medicines has been recognized and several different strategies have been used to improve the services that these retailers provide. Despite these efforts, many mothers still purchase ineffective drugs because they are less expensive than effective artemisinin combination therapy (ACT). One strategy that is being piloted in several countries is an international subsidy targeted at anti-malarials supplied through the retail sector. The goal of this strategy is to make ACT as affordable as ineffective alternatives. The programme, called the Affordable Medicines Facility - malaria was rolled out in Kenya in August 2010. METHODS: In December 2010, the affordability and accessibility of malaria medicines in a rural district in Kenya were evaluated using a complete census of all public and private facilities, chemists, pharmacists, and other malaria medicine retailers within the Webuye Demographic Surveillance Area. Availability, types, and prices of anti-malarials were assessed. There are 13 public or mission facilities and 97 medicine retailers (registered and unregistered). RESULTS: The average distance from a home to the nearest public health facility is 2 km, but the average distance to the nearest medicine retailer is half that. Quinine is the most frequently stocked anti-malarial (61% of retailers). More medicine retailers stocked sulphadoxine-pyramethamine (SP; 57%) than ACT (44%). Eleven percent of retailers stocked AMFm subsidized artemether-lumefantrine (AL). No retailers had chloroquine in stock and only five were selling artemisinin monotherapy. The mean price of any brand of AL, the recommended first-line drug in Kenya, was $2.7 USD. Brands purchased under the AMFm programme cost 40% less than non-AMFm brands. Artemisinin monotherapies cost on average more than twice as much as AMFm-brand AL. SP cost only $0.5, a fraction of the price of ACT. CONCLUSIONS: AMFm-subsidized anti-malarials are considerably less expensive than unsubsidized AL, but the price difference between effective and ineffective therapies is still large.

Stability and Resolution in Electromagnetic Inverse Scattering - Part I

info:eu-repo/semantics/published

Pinter and style

This short article considers Harold Pinter’s dramatic style, looking at the ways in which it has been defined, imitated and parodied over the years, and concludes with an exploration of the way in which some of Pinter’s work may be seen as self-parody. [From the Author]

Postcolonial futures: postcolonial literature and the Obama moment

In an analysis of President Obama's Acceptance Speech, this article argues that postcolonial theory is now being re-formulated for a global, transnational sensibility.

Representations of multicultural identities in British Cinema

This paper explores the transnational and interstitial dimensions of cultural production in Britain today, and the representation of migrant and diasporic identities in contemporary mainstream British cinema. The box office success of films like Gurindha Chadha’s Bhaji on the Beach (1993) and Bend it Like Beckham (2002) and East is East (Daniel O’Donnell 1999) and their precursors My Beautiful Launderette (Stephen Frears 1985), Sammy and Rosie Get Laid (Stephen Frears 1987) and the TV mini-series Buddha of Suburbia (Roger Mitchell 1993) seem to celebrate and articulate a set of values around hybridity and alterity: a discourse of multiculturalism. This paper will engage with a series of key questions. Are there ideological values implicit within and common to all these texts? Can we map a rhetoric or discourse of multiculturalism within popular culture? Do mainstream representations of immigrant identities represent a discourse of resistance, a decolonising global culture or is this Western brand of multiculturalism still located within an Orientalising gaze? In what ways are multiculturalism and postcolonialism overlapping and yet opposing rhetorics? [From the Author]

Surrogate brands - the pull to adopt an 'other' nation; via sports merchandise

A growing number of consumers are choosing to wear sporting merchandise, from an‘other’ nation – whom they have no geographic or ethnic affiliation with. In addition, nation sports branding appears to have scaled pandemic heights; by reaching fever pitch, when actively carrying its message across boarders. Consumer preferences are being driven past simple behavioural characteristics; towards more transient psychographic and emotional constructs. In short, nation branded sporting uniform is no longer viewed as demanding restrictivemonogamous loyalty. Ownership of a uniform largely suggests exclusivity and encouraged competition. However, manufactures, national teams, athletes and sponsors are entering symbiotic brand relationships - where they are actively seeking publics, open to multiple adopted nationalities. This phenomenon draws consumers towards embracing temporal national identities, which are converted into an over-arching cross-border identity; ultimately gifting sports brands more significance. The following paper explores consumers’ entry into relationships with another nation, in preference to their own - in manner that has been likened to a form of surrogacy; by the authors. The aim is to stimulate further thinking in a field; which transcends national and cultural boundaries - in the interests of developing new insight, and to provide a platform for marketers to develop more effective communications.

Psychological bonds and their impact on behavioral loyalty in auditor-client relationships

Purpose – The purpose of this paper is to examine the effect of the psychological bond on behavioral loyalty (word-of-mouth, continuance and non-audit services) to audit firms providing services to companies listed on the Polish Stock Exchange. Design/methodology/approach – A model is proposed and tested using structural equation modeling with LISREL. Data were collected from top executives of companies listed on the Warsaw Stock Exchange. Findings – The psychological bond has a positive effect on word-of-mouth, continuance and non-audit services. Research limitations/implications – The current research is limited to the investigation of the psychological bond as an antecedent of behavioral loyalty in Poland. Future research should identify and assess other antecedents and replicate these across different countries. A longitudinal survey across different points in time might reveal more useful information about auditor-client relationships. Practical implications – Auditors need to consider ways in which they can develop the psychological bond with their clients. This bond is the basis for the client believing the audit firm is superior to others, which has been found to lead to behavioral loyalty in this study. In particular, management of the auditor brand and reputation, personal experience of the audit firm and alumni relations are discussed as ways of enhancing the psychological bond among client executives. Originality/value – This study is the first to examine the impact of the psychological bond on behavioral loyalty in auditor-client relationships.

Sustainability and local tourism branding in England's South Downs

This paper reports on a stakeholder consultation exercise that examined the tourism industry's perception of developing a local tourism branding scheme within the South Downs' protected areas in south-east England. The research shows that such schemes could offer potential benefits that are recognisable by the tourism industry, while helping to meet the statutory aims of the protected area. The paper records the perceptions of small tourism businesses, their fears, awareness of tourism impacts, perceptions of sustainable tourism and of local branding, and key criteria connected to the future organisation of a local tourism branding scheme. The conclusion lists the recommendations for the implementation of a local branding scheme, including grassroots stakeholder consultation that encourages ownership and participation, institutional frameworks that support capacity-building and the importance of developing core values within a local brand.

Amplifying applied game development and uptake

The established (digital) leisure game industry is historically one dominated by large international hardware vendors (e.g. Sony, Microsoft and Nintendo), major publishers and supported by a complex network of development studios, distributors and retailers. New modes of digital distribution and development practice are challenging this business model and the leisure games industry landscape is one experiencing rapid change. The established (digital) leisure games industry, at least anecdotally, appears reluctant to participate actively in the applied games sector (Stewart et al., 2013). There are a number of potential explanations as to why this may indeed be the case including ; A concentration on large-scale consolidation of their (proprietary) platforms, content, entertainment brand and credibility which arguably could be weakened by association with the conflicting notion of purposefulness (in applied games) in market niches without clear business models or quantifiable returns on investment. In contrast, the applied games industry exhibits the characteristics of an emerging, immature industry namely: weak interconnectedness, limited knowledge exchange, an absence of harmonising standards, limited specialisations, limited division of labour and arguably insufficient evidence of the products efficacies (Stewart et al., 2013; Garcia Sanchez, 2013) and could, arguably, be characterised as a dysfunctional market. To test these assertions the Realising an Applied Gaming Ecosystem (RAGE) project will develop a number of self contained gaming assets to be actively employed in the creation of a number of applied games to be implemented and evaluated as regional pilots across a variety of European educational, training and vocational contexts. RAGE is a European Commission Horizon 2020 project with twenty (pan European) partners from industry, research and education with the aim of developing, transforming and enriching advanced technologies from the leisure games industry into self-contained gaming assets (i.e. solutions showing economic value potential) that could support a variety of stakeholders including teachers, students, and, significantly, game studios interested in developing applied games. RAGE will provide these assets together with a large quantity of high-quality knowledge resources through a self-sustainable Ecosystem, a social space that connects research, the gaming industries, intermediaries, education providers, policy makers and end-users in order to stimulate the development and application of applied games in educational, training and vocational contexts. The authors identify barriers (real and perceived) and opportunities facing stakeholders in engaging, exploring new emergent business models ,developing, establishing and sustaining an applied gaming eco system in Europe.