An evaluation of Primary health care system in Kerala

The thesis entitled An Evaluation of Primary Health Care System in Kerala. The present study is intended to examine the working of primary health care system and its impact on the health status of people. The hypothesis tested in the thesis includes, a. The changes in the health profile require reallocation of resources of primary health care system, b. Rate of utilization depends on the quality of services provided by primary health centers, and c. There is a significant decline in the operational efficiency of the primary health care system. The major elements of primary health care stated in the report of AlmaAta International Conference on Primary Health Care (WHO, 1994)” is studied on the basis of the classification of the elements in to three: Preventive, Promotive, and Curative measures. Preventive measures include Maternal and Child Health Care including family Planning. Provision of water and sanitation is reviewed under promotive measures. Curative measures are studied using the disease profile of the study area. Collection of primary data was done through a sample survey, using pre-tested interview schedule of households of the study area. Multi stage random sampling design was used for selecting the sample. The design of the present study is both descriptive and analytical in nature. As far as the analytical tools are concerned, growth index, percentages, ratios, rates, time series analysis, analysis of variance, chi square test, Z test were used for analyzing the data. Present study revealed that no one in these areas was covered under any type of health insurance. Conclusion states that considering the present changes in the health profile, traditional pattern of resource allocation should be altered to meet the urgent health care needs of the people. Preventive and promotive measures like health education for giving awareness among people to change health habits, diet pattern, life style etc. are to be developed. Proper diagnosis and treatment of the disease at the beginning of the stage itself may help to cure majority of disease. For that, Public health policy must ensure the primary health care as enunciated at Alma- Ata international Conference. At the same time Public health is not to be treated as the sole responsibility of the government. Active community participation is an essential means to attain the goals.

Opportunities and constraints of peri-urban buffalo and dairy cattle systems in Faisalabad, Punjab, Pakistan

In the big cities of Pakistan, peri-urban dairy production plays an important role for household income generation and the supply of milk and meat to the urban population. On the other hand, milk production in general, and peri-urban dairy production in particular, faces numerous problems that have been well known for decades. Peri-urban dairy producers have been especially neglected by politicians as well as non-government-organizations (NGOs). Against this background, a study in Pakistan’s third largest city, Faisalabad (Punjab Province), was carried out with the aims of gathering basic information, determining major constraints and identifying options for improvements of the peri-urban milk production systems. For data collection, 145 peri-urban households (HH) engaged in dairy production were interviewed face to face using a structured and pretested questionnaire with an interpreter. For analyses, HH were classified into three wealth groups according to their own perception. Thus, 38 HH were poor, 95 HH well off and 12 HH rich (26.2%, 65.5% and 8.3%, respectively). The richer the respondents perceived their HH, the more frequently they were actually in possession of high value HH assets like phones, bank accounts, motorbikes, tractors and cars. Although there was no difference between the wealth groups with respect to the number of HH members (about 10, range: 1 to 23), the educational level of the HH heads differed significantly: on average, heads of poor HH had followed education for 3 years, compared to 6 years for well off HH and 8 years for rich HH. About 40% of the poor and well off HH also had off-farm incomes, while the percentage was much higher - two thirds (67%) - for the rich HH. The majority of the HH were landless (62%); the rest (55 HH) possessed agricultural land from 0.1 to 10.1 ha (average 2.8 ha), where they were growing green fodder: maize, sorghum and pearl millet in summer; berseem, sugar cane and wheat were grown in winter. Dairy animals accounted for about 60% of the herds; the number of dairy animals per HH ranged from 2 to 50 buffaloes (Nili-Ravi breed) and from 0 to 20 cows (mostly crossbred, also Sahiwal). About 37% (n=54) of the HH did not keep cattle. About three quarters of the dairy animals were lactating. The majority of the people taking care of the animals were family workers; 17.3% were hired labourers (exclusively male), employed by 11 rich and 32 well off HH; none of the poor HH employed workers, but the percentages were 33.7% for the well off and 91.7% for the rich HH. The total number of workers increased significantly with increasing wealth (poor: 2.0; well off:2.5; rich: 3.4). Overall, 69 female labourers were recorded, making up 16.8% of employed workers and one fourth of the HH’s own labourers. Apparently, their only duty was to clean the animals´ living areas; only one of them was also watering and showering the animals. Poor HH relied more on female workers than the other two groups: 27.1% of the workers of poor HH were women, but only 14.8% and 6.8% of the labour force of well off and rich HH were female. Two thirds (70%) of the HH sold milk to dhodis (middlemen) and one third (35%) to neighbours; three HH (2%) did doorstep delivery and one HH (1%) had its own shop. The 91 HH keeping both species usually sold mixed milk (97%). Clients for mixed and pure buffalo milk were dhodis (78%, respectively 59%) and neighbours (28%, respectively 47%). The highest milk prices per liter (Pakistani Rupees, 100 PKR @ 0.8 Euro) were paid by alternative clients (44 PKR; 4 HH), followed by neighbours (40 PKR, 50 HH); dhodis paid lower prices (36 PKR, 99 HH). Prices for pure buffalo and mixed milk did not differ significantly. However, HH obtaining the maximum price from the respective clients for the respective type of milk got between 20% (mixed milk, alternative clients) and 68% (mixed milk, dhodi) more than HH fetching the minimum price. Some HH (19%) reported 7% higher prices for the current summer than the preceding winter. Amount of milk sold and distance from the HH to the city center did not influence milk prices. Respondents usually named problems that directly affected their income and that were directly and constantly visible to them, such as high costs, little space and fodder shortages. Other constraints that are only influencing their income indirectly, e.g. the relatively low genetic potential of their animals due to neglected breeding as well as the short- and long-term health problems correlated with imbalanced feeding and insufficient health care, were rarely named. The same accounts for problems accompanying improper dung management (storage, disposal, burning instead of recycling) for the environment and human health. Most of the named problems are linked to each other and should be addressed within the context of the entire system. Therefore, further research should focus on systematic investigations and improvement options, taking a holistic and interdisciplinary approach instead of only working in single fields. Concerted efforts of dairy farmers, researchers, NGOs and political decision makers are necessary to create an economic, ecological and social framework that allows dairy production to serve the entire society. For this, different improvement options should be tested in terms of their impact on environment and income of the farmers, as well as feasibility and sustainability in the peri-urban zones of Faisalabad.

Optimising contributions of goat farming to household economic success and food security in three production systems in Ethiopia

The study aims to analyse factors affecting contributions of goat farming to household economic success and food security in three goat production systems of Ethiopia. A study was conducted in three districts of Ethiopia representing arid agro-pastoral (AAP), semi-arid agro-pastoral (SAAP) and highland mixed crop-livestock (HMCL) systems involving 180 goat keeping households. Gross margin (GM) and net benefit (NB1 and NB2) were used as indicators of economic success of goat keeping. NB1 includes in-kind benefits of goats (consumption and manure), while NB2 additionally constitutes intangible benefits (insurance and finance). Household dietary diversity score (HDDS) was used as a proxy indicator of food security. GM was significantly affected by an off-take rate and flock size interaction (P<0.001). The increment of GM due to increased off-take rate was more prominent for farmers with bigger flocks. Interaction between flock size and production system significantly (P<0.001) affected both NB1 and NB2. The increment of NB1 and NB2 by keeping larger flocks was higher in AAP system, due to higher in-kind and intangible benefits of goats in this system. Effect of goat flock size as a predictor of household dietary diversity was not significant (P>0.05). Nevertheless, a significant positive correlation (P<0.05) was observed between GM from goats and HDDS in AAP system, indicating the indirect role of goat production for food security. The study indicated that extent of utilising tangible and intangible benefits of goats varied among production systems and these differences should be given adequate attention in designing genetic improvement programs.

Self-organized sociopolitical interactions as the best way to achieve organized patterns in human social systems: going beyond the top-down control of classical political regimes

La monografía presenta la auto-organización sociopolítica como la mejor manera de lograr patrones organizados en los sistemas sociales humanos, dada su naturaleza compleja y la imposibilidad de las tareas computacionales de los regímenes políticos clásico, debido a que operan con control jerárquico, el cual ha demostrado no ser óptimo en la producción de orden en los sistemas sociales humanos. En la monografía se extrapola la teoría de la auto-organización en los sistemas biológicos a las dinámicas sociopolíticas humanas, buscando maneras óptimas de organizarlas, y se afirma que redes complejas anárquicas son la estructura emergente de la auto-organización sociopolítica.

The three systems for the protection of fundamental human rights in the European Union and exceptional measures against terrorism: the case of extraordinary extraditions (the CIA flights) with special reference to the Spanish case

This document is aimed first of all, make a small introductory reference on the three levels of protection of fundamental rights in Europe with the idea of helping to clarify and understand mainly to non-European systems that we are not talking. For that, based on this, going on to assess the impact generated in these systems suggest that the complaints alleged involvement of European countries in secret CIA flights to combat international terrorism, as well as investigate the responses that have given each protection of these areas to try to clarify them. 

Comparing meta-analysis and ecological-longitudinal analysis in time-series studies: a case study of the effects of air pollution on mortality in three Spanish cities

The objective of this paper is to introduce a diVerent approach, called the ecological-longitudinal, to carrying out pooled analysis in time series ecological studies. Because it gives a larger number of data points and, hence, increases the statistical power of the analysis, this approach, unlike conventional ones, allows the complementation of aspects such as accommodation of random effect models, of lags, of interaction between pollutants and between pollutants and meteorological variables, that are hardly implemented in conventional approaches. Design—The approach is illustrated by providing quantitative estimates of the short-termeVects of air pollution on mortality in three Spanish cities, Barcelona,Valencia and Vigo, for the period 1992–1994. Because the dependent variable was a count, a Poisson generalised linear model was first specified. Several modelling issues are worth mentioning. Firstly, because the relations between mortality and explanatory variables were nonlinear, cubic splines were used for covariate control, leading to a generalised additive model, GAM. Secondly, the effects of the predictors on the response were allowed to occur with some lag. Thirdly, the residual autocorrelation, because of imperfect control, was controlled for by means of an autoregressive Poisson GAM. Finally, the longitudinal design demanded the consideration of the existence of individual heterogeneity, requiring the consideration of mixed models. Main results—The estimates of the relative risks obtained from the individual analyses varied across cities, particularly those associated with sulphur dioxide. The highest relative risks corresponded to black smoke in Valencia. These estimates were higher than those obtained from the ecological-longitudinal analysis. Relative risks estimated from this latter analysis were practically identical across cities, 1.00638 (95% confidence intervals 1.0002, 1.0011) for a black smoke increase of 10 μg/m3 and 1.00415 (95% CI 1.0001, 1.0007) for a increase of 10 μg/m3 of sulphur dioxide. Because the statistical power is higher than in the individual analysis more interactions were statistically significant,especially those among air pollutants and meteorological variables. Conclusions—Air pollutant levels were related to mortality in the three cities of the study, Barcelona, Valencia and Vigo. These results were consistent with similar studies in other cities, with other multicentric studies and coherent with both, previous individual, for each city, and multicentric studies for all three cities

Materiality, subjectification, and government: the geographies of Britain's Motorway Code

In this paper I provide a critical discussion of Foucault's work on government and governmentality. I argue that geographers have tended to overlook the ways in which practices of self-government and subjectification are performed in relation to programmes of government, and suggest that they should examine the technical devices which are embedded in networks of government. Drawing upon these observations I suggest how geographers might proceed, tracing the geographies of a specific artefact: the British government's 1958 Motorway Code. I examine how the code was designed to serve as a technology of government that could shape the conduct of fairly mobile and distant subjects, enabling them to govern their conduct and the movements of their vehicles.

Computer modelling and estimation of recruitment patterns of non-branching coral colonies at three sites in Wakatobi Marine Park, S.E. Sulawesi, Indonesia; implications for coral reef conservation

We have studied growth and estimated recruitment of massive coral colonies at three sites, Kaledupa, Hoga and Sampela, separated by about 1.5 km in the Wakatobi Marine National Park, S.E. Sulawesi, Indonesia. There was significantly higher species richness (P<0.05), coral cover (P<0.05) and rugosity (P<0.01) at Kaledupa than at Sampela. A model for coral reef growth has been developed based on a rational polynomial function, where dx/dt is an index of coral growth with time; W is the variable (for example, coral weight, coral length or coral area), up to the power of n in the numerator and m in the denominator; a1……an and b1…bm are constants. The values for n and m represent the degree of the polynomial, and can relate to the morphology of the coral. The model was used to simulate typical coral growth curves, and tested using published data obtained by weighing coral colonies underwater in reefs on the south-west coast of Curaçao [‘Neth. J. Sea Res. 10 (1976) 285’]. The model proved an accurate fit to the data, and parameters were obtained for a number of coral species. Surface area data was obtained on over 1200 massive corals at three different sites in the Wakatobi Marine National Park, S.E. Sulawesi, Indonesia. The year of an individual's recruitment was calculated from knowledge of the growth rate modified by application of the rational polynomial model. The estimated pattern of recruitment was variable, with little numbers of massive corals settling and growing before 1950 at the heavily used site, Sampela, relative to the reef site with little or no human use, Kaledupa, and the intermediate site, Hoga. There was a significantly greater sedimentation rate at Sampela than at either Kaledupa (P<0.0001) or Hoga (P<0.0005). The relative mean abundance of fish families present at the reef crests at the three sites, determined using digital video photography, did not correlate with sedimentation rates, underwater visibility or lack of large non-branching coral colonies. Radial growth rates of three genera of non-branching corals were significantly lower at Sampela than at Kaledupa or at Hoga, and there was a high correlation (r=0.89) between radial growth rates and underwater visibility. Porites spp. was the most abundant coral over all the sites and at all depths followed by Favites (P<0.04) and Favia spp. (P<0.03). Colony ages of Porites corals were significantly lower at the 5 m reef flat on the Sampela reef than at the same depth on both other reefs (P<0.005). At Sampela, only 2.8% of corals on the 5 m reef crest are of a size to have survived from before 1950. The Scleractinian coral community of Sampela is severely impacted by depositing sediments which can lead to the suffocation of corals, whilst also decreasing light penetration resulting in decreased growth and calcification rates. The net loss of material from Sampela, if not checked, could result in the loss of this protective barrier which would be to the detriment of the sublittoral sand flats and hence the Sampela village.

The role of transgenic crops for sustainable development

The concept of sustainable development forms the basis for a wide variety of international and national policy making. World population continues to expand at about 80 M people per year, while the demand for natural resources continues to escalate. Important policies, treaties and goals underpin the notion of sustainable development. In this paper, we discuss and evaluate a range of scientific literature pertaining to the use of transgenic crops in meeting sustainable development goals. It is concluded that a considerable body of evidence has accrued since the first commercial growing of transgenic crops, which suggests that they can contribute in all three traditional pillars of sustainability, i.e. economically, environmentally and socially. Management of herbicide-tolerant and insect-resistant transgenic crops to minimize the risk of weeds and pests developing resistance is discussed, together with the associated concern about the risk of loss of biodiversity. As the world population continues to rise, the evidence reviewed here suggests it would be unwise to ignore transgenic crops as one of the tools that can help meet aspirations for increasingly sustainable global development.

Accounts of the English Crown with Italian merchant societies, 1272-1345

The credit arrangements between the three Edwards and Italian merchants were crucial for financing England’s ambitious foreign policies and ensuring the smooth running of governmental administration. The functioning of this credit system can be followed in detail through the well-kept but mostly unpublished records of the English Exchequer. This volume combines a transcription of the most important surviving accounts between the merchants and the Crown, with a parallel abstract presenting the core data in a double-entry format as credits to or debits from the king's account. This dual format was chosen to facilitate the interpretation of the source while still retaining the language and, as far as possible, the structure of the original documents. The wealth of evidence presented here has much value to add to our understanding of the financing of medieval government and the early development of banking services provided by Italian merchant societies. In particular, although the relationship between king and banker was, for the most part, mutually profitable, the English kings also acquired a reputation for defaulting on their debts and thus 'breaking' a succession of merchant societies. These documents provide an essential basis for a re-examination of the 'credit rating' of the medieval English Crown.

Cross-cultural comparison of three medicinal floras and implications for bioprospecting strategies

Ethnopharmacological relevance One of the major drawbacks of using ethnomedicinal data to direct testing of plants which may find pharmaceutical use is that certain plants without bioactivity might be traditionally used. An accepted way of highlighting bioactive plants is to compare usage in different cultures. This approach infers that presumed independent discovery by different cultures provides evidence for bioactivity. Although several studies have made cross-cultural comparisons, they focussed on closely related cultures, where common patterns might be the result of common cultural traditions. The aim of this study was to compare three independent ethnomedicinal floras for which similarities can be more robustly interpreted as independent discoveries, and therefore likely to be indication for efficacy. Materials and methods Data from the literature were compiled about the ethnomedicinal floras for three groups of cultures (Nepal, New Zealand and the Cape of South Africa), selected to minimise historical cultural exchange. Ethnomedicinal applications were divided in 13 categories of use. Regression and binomial analyses were performed at the family level to highlight ethnomedicinal “hot” families. General and condition-specific analyses were carried out. Results from the three regions were compared. Results Several “hot” families (Anacardiaceae, Asteraceae, Convolvulaceae, Clusiaceae, Cucurbitaceae, Euphorbiaceae, Geraniaceae, Lamiaceae, Malvaceae, Rubiaceae, Sapindaceae, Sapotaceae and Solanaceae) were recovered in common in the general analyses. Several families were also found in common under different categories of use. Conclusions Although profound differences are found in the three ethnomedicinal floras, common patterns in ethnomedicinal usage are observed in widely disparate areas of the world with substantially different cultural traditions. As these similarities are likely to stem from independent discoveries, they strongly suggest that underlying bioactivity might be the reason for this convergent usage. The global distribution of prominent usage of families used in common obtained by this study and the wider literature is strong evidence that these families display exceptional potential for discovery of previously overlooked or new medicinal plants and should be placed in high priority in bioscreening studies and conservation schemes.

Towards an improved understanding of farmers' behaviour: the integrative agent-centred (IAC) framework

An effective approach to research on farmers' behaviour is based on: i) an explicit and well-motivated behavioural theory; ii) an integrative approach; and iii) understanding feedback processes and dynamics. While current approaches may effectively tackle some of them, they often fail to combine them together. The paper presents the integrative agent-centred (IAC) framework, which aims at filling this gap. It functions in accordance with these three pillars and provides a conceptual structure to understand farmers' behaviour in agricultural systems. The IAC framework is agent-centred and supports the understanding of farmers' behavior consistently with the perspective of agricultural systems as complex social-ecological systems. It combines different behavioural drivers, bridges between micro and macro levels, and depicts a potentially varied model of human agency. The use of the framework in practice is illustrated through two studies on pesticide use among smallholders in Colombia. The examples show how the framework can be implemented to derive policy implications to foster a transition towards more sustainable agricultural practices. The paper finally suggests that the framework can support different research designs for the study of agents' behaviour in agricultural and social-ecological systems.

Microstructure of the Euro-area government bond market

This chapter highlights similarities and differences of equity and fixed- income markets and provides an overview of the characteristics of European government bond market trading and liquidity. Most existing studies focus on the U.S. market. This chapter presents the institutional details of the MTS market, which is the largest European electronic platform for trading government, quasi-government, asset- backed, and corporate fixed- income securities. It reviews the main features of high- frequency fixed- income data and the methods for measuring market liquidity. Finally, the chapter shows how liquidity differs across European countries, how liquidity varies with the structure of the market, and how liquidity has changed during the recent liquidity and sovereign crises.

Contrasting the responses of three different ground-based instruments to energetic electron precipitation

In order to make best use of the opportunities provided by space missions such as the Radiation Belt Storm Probes, we determine the response of complementary subionospheric radiowave propagation measurements (VLF), riometer absorption measurements (CNA), and GPS-produced total electron content (vTEC) to different energetic electron precipitation (EEP). We model the relative sensitivity and responses of these instruments to idealised monoenergetic beams of precipitating electrons, and more realistic EEP spectra chosen to represent radiation belts and substorm precipitation. In the monoenergetic beam case, we find riometers are more sensitive to the same EEP event occurring during the day than during the night, while subionospheric VLF shows the opposite relationship, and the change in vTEC is independent. In general, the subionospheric VLF measurements are much more sensitive than the other two techniques for EEP over 200 keV, responding to flux magnitudes two-three orders of magnitude smaller than detectable by a riometer. Detectable TEC changes only occur for extreme monoenergetic fluxes. For the radiation belt EEP case, clearly detectable subionospheric VLF responses are produced by daytime fluxes that are ~10 times lower than required for riometers, while nighttime fluxes can be 10,000 times lower. Riometers are likely to respond only to radiation belt fluxes during the largest EEP events and vTEC is unlikely to be significantly disturbed by radiation belt EEP. For the substorm EEP case both the riometer absorption and the subionospheric VLF technique respond significantly, as does the change in vTEC, which is likely to be detectable at ~3-4 TECu.

The role of subsidy in ensuring the sustainability of small-scale anaerobic digesters in Odisha, India

Small-scale anaerobic digester installation has been a development objective of the Indian government to provide rural households clean fuel. Anaerobic digester installation is heavily subsidised. Depending on caste, the rate of subsidy offered for the smallest system available (1m3) varies between 32.35% and 41.18% of the total installation price. Yet, there are gaps in knowledge regarding the usefulness of such subsidies from a sustainability perspective. A cost-benefit analysis was conducted to evaluate the circumstances required for digester sustainability. The analysis used household data collected from 115 cattle owning households in Odisha, India to evaluate profitability at three levels of subsidy (none, General caste subsidy, and Schedule Caste/Schedule Tribe subsidy). Additional analyses considered the effect of; taking a loan, replacing electric lighting with biogas lighting, and the wealth level of the household. The results indicated that access to subsidy improved profitability. Yet, profitability could be achieved without the use of subsidy. The level of benefit accrued by households was similar independent of wealth. However, the provision of subsidy was essential for ensuring profitability for those households required to take a loan to meet the expense of installation. Such findings highlight the importance of subsidy as a means of including the poor.