Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania : an open label prospective study

Background: Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. Methods: An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results: A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p <= 0.046). Conclusions: Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for scaling-up implementation of HMM with AL in Tanzania.

Must teachers be social workers, as well …? : Reflections on the current teacher role in the Swedish upper secondary school and how it affects teacher training

The Swedish upper secondary school has made a transition from a school for the elite to be a school for everybody. When almost every youth nowadays chooses to continue studying, for some of them this is not what they want to do most of all. However, as there in practice is no choice, there come up problems and many upper secondary school teachers experience a growing frustration. We will here discuss some aspects of the following questions: -  How do upper secondary schoolteachers handle their working-conditions in a new situation? - What possible consequences do this have on teacher education?

The association between the investment opportunity set and corporate financing and dividend decisions: some Australian evidence

Summarizes previous research on the investment opportunity set (IOS) using price-based and investment-based proxies and variance measures; and develops hypotheses on the relationship between IOS, debt/equity ratios and dividend policies. Tests them on 1990-1998 data from listed Australian companies and explains the methodology, which builds on Gover and Gover (1993) by including more recent proxy variables. Finds no significant results from low growth firms, although some high growth firms show lower debt/equity ratios and dividends. Questions the robustness of existing IOS proxies in the Australian context and calls for further research.

Integrated natural resource management in Australia: the opportunity offered by a national coastal policy

Under the Australian Constitution the management (and planning) of Crown Land is a State and Territory Government responsibility. When this is considered in conjunction with the Offshore Constitutional Settlement, which affirmed that coastal waters out to three nautical miles (in general) offshore were also the responsibility of State and Territory Governments, then clearly coastal management in Australia is largely a State/Territory responsibility.

Beyond three nautical miles it is a different story. Under the United Nations Law of the Sea Convention (UNCLOS), which Australia ratified in October 1994, Australia claims jurisdiction out to 200 nautical miles and beyond (Wescott, 2000). These waters cover an area including the Antarctic claim of over 15 million square kilometres or twice the land area of Australia.

Hence in marine and coastal terms we have the national (Commonwealth) Government managing the oceans and seven State and Territory governments largely in charge of coastal management (coastal land and coastal waters). Heading "up river", State and Territory Governments plan and manage catchments.

Given the uncoordinated relationships between Australian coastal management policy and both catchment management policy and Australia's Ocean Policy (Commonwealth of Australia, 1998a and b), the Commonwealth Government's commitment to a "National Coastal Policy" presents an opportunity to progress the integration of natural resources management for the first time in decades.

Tourism, guest workers, and resident immiserization

This paper analyses the impact of a boom in tourism on the welfare of the residents in the presence of guest workers. Guest workers are employed in the tourism industry and they consume non-traded goods and services. This consumption by guest workers converts non-traded goods into
exportables and creates guest worker generated monopoly power in trade in the home country. It is established that under certain plausible conditions a tourist boom (in the presence of guest workers) results in the immiserization of the resident population. This result arises due to an adverse movement in the terms-of-trade, specifically those associated with the guest workers consumption of non-traded goods. These results are based on a static model of trade and may not be necessarily
valid in a growth model with guest workers, tourism and labor shortages. It is not the object of the paper to be either anti-tourism or anti-guest worker, but only to show a possible source of resident immiserization that is associated with guest workers. This possibility may require correction via a suitable policy both in static and dynamic models.

Culture-based fisheries: an underutilised opportunity in aquaculture development

The reasons for considering culture-based fisheries as an aquaculture practice are presented. The need to develop culture-based fisheries, which are basically a nonconsumptive user of water compared to conventional aquaculture practices such as pond culture, to augment the aquatic food supplies, in the wake of increasing consumption of aquatic food, dwindling catches from the wild, and the decreasing rate of growth of conventional aquaculture is evaluated.

The well-documented culture-based fishery practices of a number of countries are reviewed, and the development of these is traced. It is suggested that successful practices occur in mainland China, where the production from culture-based fishery in reservoirs is estimated to be 1,165,075 tons (from a total area of 1,567,971 ha), approximating 743 kg ha⁻¹ year⁻¹, and which is reputed to have recorded a yearly growth of 52% from 1979 to 1997. General features of culture-based fisheries and factors responsible for increasing yields are discussed, and the importance of such practices to rural communities in developing countries is emphasised. The constraints facing the development of the practices and the importance of overcoming such constraints, especially in the wake of the increasing challenges the conventional aquaculture industry is encountering, are evaluated.

Attitudes and perceptions of workers to sexual harrassment

The authors investigated how individual factors (age, gender, gender role, past experiences of sexual harassment) and organizational factors (gender ratio, sexual harassment policies, the role of employers) related to workers' attitudes toward and perceptions of sexual harassment. In Study 1, participants were 176 workers from a large, white-collar organization. In Study 2, participants were 75 workers from a smaller, blue-collar organization. Individuals from Study 2 experienced more sexual harassment, were more tolerant of sexual harassment, and perceived less behavior as sexual harassment than did individuals from Study 1. For both samples, organizational and individual factors predicted workers' attitudes toward and experiences of sexual harassment. Individual factors—such as age, gender, gender role, past experiences of sexual harassment, and perceptions of management's tolerance of sexual harassment—predicted attitudes toward sexual harassment. Workers' attitudes, the behavioral context, and the gender of the victim and perpetrator predicted perceptions of sexual harassment. The authors discussed the broader implications of these findings and suggested recommendations for future research.

Winners or losers? Work/life balance and temporary agency workers

This article focuses upon temporary' agency workers' capacity to balance work/life needs. Two extremes are identified within the Victorian temporary agency labour market. On the one hand, there are skilled temporary agency workers employed in areas of high demand accompanied by labour shortages. Nurses are one such group. At the other extreme, there are skilled and semi-skilled temporary agency workers who face a shortfall in demand for permanent, direct hire employees. Drawing upon a survey and focus groups of temporary agency workers, their potential for achieving a satisfactory work/life balance is assessed in relation to control over working time, income and employment security, and a narrow band of employment conditions. The findings differ substantially between the two groups of agency workers, contributing to significantly different perceptions of the personal benefits of working through a temporary employment agency.

Mature workers, training and using TLM frameworks

Mature workers have been at the centre of policies aimed at encouraging higher workforce participation, longer working life and enhanced savings for retirement. Low mature age workforce participation rates reflect labour market withdrawal in the face of multiple barriers to participation for many. Their apparent voluntary joblessness conceals the fact that mature workers endure longer periods of unemployment, discrimination, redundancy and other barriers to employment (hence the drift to 'early retirement'). The policy dilemma is not just about addressing discrimination barriers, access to appropriate retraining or skills enhancement for mature workers, but what this tells us about lifelong learning as a means of managing and mitigating risk. The mismatch between work opportunities/skills shortages and the low education and skills base of many mature workers, means it is simplistic to think that working longer might be a short term way to address skills shortages; without an enormous investment in the current ageing cohort. Drawing on Transitional Labour Market (TLM) theory and European reform agendas, this article argues that the link between investment in lifelong education/ skills training and stronger labour market participation needs attention; not just for current cohorts of excluded or underemployed mature workers but to position strategically for future generations.

Equal channel angular pressing of metal matrix composites: effect on particle distribution and fracture toughness

An Al6061-20%Al₂O₃ powder metallurgy (PM) metal matrix composite (MMC) with a strongly clustered particle distribution is subjected to equal channel angular pressing (ECAP) at a temperature of 370 °C. The evolution of the homogeneity of the particle distribution in the material during ECAP is investigated by the quadrat method. The model proposed by Tan and Zhang [Mater Sci Eng 1998;244:80] for estimating the critical particle size which is required for a homogeneous particle distribution in PM MMCs is extended to the case of a combination of extrusion and ECAP. The applicability of the model to predict a homogeneity of the particle distribution after extrusion and ECAP is discussed. It is shown that ECAP leads to an increase of the  uniformity of the particle distribution and the fracture toughness.

Career progression, human capital and pay equity in Australian public sector labour markets

This study uses data from the Victorian Public Sector Census 2004 to identify the extent of equity in pay and career progression (promotion). A system of three equations is developed to capture the endogeneity between human capital and promotion and the interdependence between promotion, pay and human capital. The results indicate that there are substantial differences in the average wages earned by public sector employees in different Equal Employment Opportunity (EEO) groups. While some of these differences arise from factors beyond the control of the public sector employers, others arise from bias in the public sector employment system and procedures. The earnings of individual employees in the public sector are determined in a systematic way by the wage structures in the different sub-sectors, the skill base of the employee on recruitment, sub-sector specific promotion rates, acquisition of formal and informal training and the apparent bias within recruitment and promotion systems in dealing with particular groups. The apparent bias of recruitment and promotion systems is complex in makeup and varies within EEO groups as well as between EEO groups. Most of the difference in pay across employees can be explained as an outcome of individual choice and labour market conditions external to the public sector. After adjusting for sectoral wage differences, skill base when recruited, sectoral promotion rate differences, experience in the public sector, whether individuals are employed on a full-time or part-time basis and individual training decisions, the statistical evidence is consistent with the finding that public sector recruitment and promotion systems tends to be biased, on average, against females and those from culturally diverse backgrounds. Achievements in formal education are important for salary progression. This is particularly the case for women. The main drivers of participation in formal education were employer support in both financial and non-financial terms. Promotion rates were important factors in explaining wage differences. Women tended to receive slightly fewer promotions than men, but women received, on average, greater rewards for each promotion.

Productivity and the knowledge worker

The industrial age of Taylor and Ford transformed the landscape of office buildings. Office spaces were very uniform and highly supervised. People were units of production. Their work activities were routine. Work study, or "time and motion" studies measured outputs.

The current "information age" way of working, combined with major demographic shifts in the workforce (Gen-Xers, career-shifting Baby Boomers and a greater number of women and minority ethnic groups in the workforce), requires major changes in how to support service industry productivity. The motivations of knowledge workers are very different from those of the industrial age worker. Commitment to the organisation has gone as a result of business re-engineering processes that increased productivity but at the expense of job security. Workers are more likely to be "goal-focussed" rather than "prevention focussed" (Meyer et al 2004 2 ) meaning that instead of doing only what is necessary to retain their job, workers actively seek more meaningful work that matches their personal value systems. They even want to have fun at work!

What contribution can the workplace make to support this work and increase productivity? Surveys have indicated that workers spend more than 75% of their time in their own office space with more than half of that time spent in concentrated work. Concentrated work requires quiet with few distractions, yet workers report that distractions are probably the biggest problem hampering their productivity. What are the current workplace solutions to office space usage? Probably the worst option for distractions is frequently used – open-plan offices, which are a more cost-effective use of space, but at the potential expense of productivity. Visioning architects such as Duffy (1999)3 advocate quiet spaces ("dens") where workers can decamp to carry out their concentrated work. But is this workspace as efficient for the worker – who may have to transport materials back and forth?

Workers know what they need to support their productivity best. On the rare occasions when the staff have been given the opportunity to configure their work-settings, high productivity increases result. Besides noise, environmental quality is perceived as a key factor influencing productivity. Stuffy workplaces generate lethargy. Greater worker satisfaction with their workplace is reported when they have more individual control over the environment.

We need to seriously question the "one-size-fits-all" office building with cellular layouts. Workers need to be involved in the design and fit-out. They need personal control over their environment and an organisation that can support their individual aspirations and values. A number of interventions that could generate significant improvements in knowledge work productivity are proposed.