Rapid diagnostic tests for the home-based management of malaria, in a high-transmission area

Rapid diagnostic tests (RDT) are sometimes recommended to improve the home-based management of malaria. The accuracy of an RDT for the detection of clinical malaria and the presence of malarial parasites has recently been evaluated in a high-transmission area of southern Mali. During the same study, the cost-effectiveness of a 'test-and-treat' strategy for the home-based management of malaria (based on an artemisinin-combination therapy) was compared with that of a 'treat-all' strategy. Overall, 301 patients, of all ages, each of whom had been considered a presumptive case of uncomplicated malaria by a village healthworker, were checked with a commercial RDT (Paracheck-Pf). The sensitivity, specificity, and positive and negative predictive values of this test, compared with the results of microscopy and two different definitions of clinical malaria, were then determined. The RDT was found to be 82.9% sensitive (with a 95% confidence interval of 78.0%-87.1%) and 78.9% (63.9%-89.7%) specific compared with the detection of parasites by microscopy. In the detection of clinical malaria, it was 95.2% (91.3%-97.6%) sensitive and 57.4% (48.2%-66.2%) specific compared with a general practitioner's diagnosis of the disease, and 100.0% (94.5%-100.0%) sensitive but only 30.2% (24.8%-36.2%) specific when compared against the fulfillment of the World Health Organization's (2003) research criteria for uncomplicated malaria. Among children aged 0-5 years, the cost of the 'test-and-treat' strategy, per episode, was about twice that of the 'treat-all' (U.S.$1.0. v. U.S.$0.5). In older subjects, however, the two strategies were equally costly (approximately U.S.$2/episode). In conclusion, for children aged 0-5 years in a high-transmission area of sub-Saharan Africa, use of the RDT was not cost-effective compared with the presumptive treatment of malaria with an ACT. In older patients, use of the RDT did not reduce costs. The question remains whether either of the strategies investigated can be made affordable for the affected population.

Neonatal procedural pain exposure and pain management in ventilated preterm infants during the first 14 days of life

OBJECTIVES: Ventilated preterm infants are at high risk for procedural pain exposure. In Switzerland there is a lack of knowledge about the pain management in this highly vulnerable patient population. The aims of this study were to describe the type and frequency of procedures and to determine the amount of analgesia given to this patient group in two Swiss neonatal intensive care units. METHOD: A retrospective cohort study was performed examining procedural exposure and pain management of a convenience sample of 120 ventilated preterm infants (mean age = 29.7 weeks of gestation) during the first 14 days of life after delivery and born between May 1st 2004 and March 31st 2006. RESULTS: The total number of procedures all the infants underwent was 38,626 indicating a mean of 22.9 general procedures performed per child and day. Overall, 75.6% of these procedures are considered to be painful. The most frequently performed procedure is manipulation on the CPAP prongs. Pain measurements were performed four to seven times per day. In all, 99.2% of the infants received either non-pharmacological and/or pharmacological agents and 70.8% received orally administered glucose as pre-emptive analgesia. Morphine was the most commonly used pharmacological agent. DISCUSSION: The number of procedures ventilated preterm infants are exposed to is disconcerting. Iatrogenic pain is a serious problem, particularly in preterm infants of low gestational age. The fact that nurses assessed pain on average four to seven times daily per infant indicates a commitment to exploring a painful state in a highly vulnerable patient population. In general, pharmacological pain management and the administration of oral glucose as a non-pharmacological pain relieving intervention appear to be adequate, but there may be deficiencies, particularly for extremely low birth weight infants born <28 weeks of gestation.

High plant species richness indicates management-related disturbances rather than the conservation status of forests

There is a wealth of smaller-scale studies on the effects of forest management on plant diversity. However, studies comparing plant species diversity in forests with different management types and intensity, extending over different regions and forest stages, and including detailed information on site conditions are missing. We studied vascular plants on 1500 20 m × 20 m forest plots in three regions of Germany (Schwäbische Alb, Hainich-Dün, Schorfheide-Chorin). In all regions, our study plots comprised different management types (unmanaged, selection cutting, deciduous and coniferous age-class forests, which resulted from clear cutting or shelterwood logging), various stand ages, site conditions, and levels of management-related disturbances. We analyzed how overall richness and richness of different plant functional groups (trees, shrubs, herbs, herbaceous species typically growing in forests and herbaceous light-demanding species) responded to the different management types. On average, plant species richness was 13% higher in age-class than in unmanaged forests, and did not differ between deciduous age-class and selection forests. In age-class forests of the Schwäbische Alb and Hainich-Dün, coniferous stands had higher species richness than deciduous stands. Among age-class forests, older stands with large quantities of standing biomass were slightly poorer in shrub and light-demanding herb species than younger stands. Among deciduous forests, the richness of herbaceous forest species was generally lower in unmanaged than in managed forests, and it was even 20% lower in unmanaged than in selection forests in Hainich-Dün. Overall, these findings show that disturbances by management generally increase plant species richness. This suggests that total plant species richness is not suited as an indicator for the conservation status of forests, but rather indicates disturbances.

Strategy and Action Plan for Sustainable Land Management in the High Pamir and Pamir-Alai Mountains

This Strategy and Action Plan was written within the framework of the project on Sustainable Land Management in the High Pamir and Pamir-Alai Mountains (PALM). PALM is an integrated transboundary initiative of the governments of the Kyrgyz Republic and the Republic of Tajikistan. It aims to address the interlinked problems of land degradation and poverty within a region that is one of Central Asia’s crucial sources of freshwater and a location of biodiversity hotspots. The project is executed by the Committee on Environment Protection in Tajikistan and the National Center for Mountain Regions Development in Kyrgyzstan, with fi nancial support from the Global Environment Facility (GEF) and other donors. The United Nations Environment Programme (UNEP) is the GEF Implementing Agency for the project, and the United Nations University (UNU) is the International Executing Agency. This Strategy and Action Plan integrates the work of three main teams of experts, namely the Pamir-Alai Transboundary Strategy and Action Plan (PATSAP) team, the Legal Task Forces, and a team of Natural Disaster Risk specialists. The PATSAP team was coordinated by the Centre for Development and Environment (CDE), University of Bern, Switzerland. The Legal Task Force was led by the Australian Centre for Agriculture and Law of the University of New England (UNE), and responsibility for the Natural Disaster Risk assessment was with the Central- Asian Institute of Applied Geosciences (CAIAG) in Bishkek, Kyrgyzstan. The development of the strategy took place from June 2009 to October 2010. The activities included fi eld study tours for updating the information base with fi rst-hand information from the local level, coordination meetings with actors from the region, and two multi-level stakeholder forums conducted in Khorog and Osh to identify priorities and to collect ideas for concrete action plans. The baseline information collected for the Strategy and Action Plan has been compiled by the experts and made available as reports1. A joint multi-level stakeholder forum was conducted in Jirgitol, Tajikistan, for in-depth discussion of the transboundary aspects. In August 2010, the draft Strategy and Action Plan was distributed among local, national, and international actors for consultation, and their comments were discussed at feedback forums in Khorog and Bishkek. This Strategy and Action Plan is intended as a recommendation. Nevertheless, it proposes concrete mechanisms for implementing the proposed sustainable land management (SLM) activities: The Regional Natural Resources Governance Framework provides the legal and policy concepts, principles, and regulatory requirements needed to create an enabling environment for SLM in the High Pamir and Pamir-Alai region at the transboundary, national, and local levels. The priority directions outlined provide a framework for the elaboration of rayon-level strategies and for strategies on specifi c topics (forestry, livestock, etc.), as well as for further development of government programmes and international projects. The action plans may serve as a pool of concrete ideas, which can be taken up by diff erent institutions and in smaller or larger projects. Finally, this document provides a basis for the elaboration and signing of targeted cooperation agreements on land use and management between the leaders of Osh oblast (Kyrgyz Republic), Gorno Badakhshan Autonomous Oblast, and Jirgitol rayon (Republic of Tajikistan).

Modelling the system behaviour of wet snow avalanches using an expert system approach for risk management on high alpine traffic roads

The presented approach describes a model for a rule-based expert system calculating the temporal variability of the release of wet snow avalanches, using the assumption of avalanche triggering without the loading of new snow. The knowledge base of the model is created by using investigations on the system behaviour of wet snow avalanches in the Italian Ortles Alps, and is represented by a fuzzy logic rule-base. Input parameters of the expert system are numerical and linguistic variables, measurable meteorological and topographical factors and observable characteristics of the snow cover. Output of the inference method is the quantified release disposition for wet snow avalanches. Combining topographical parameters and the spatial interpolation of the calculated release disposition a hazard index map is dynamically generated. Furthermore, the spatial and temporal variability of damage potential on roads exposed to wet snow avalanches can be quantified, expressed by the number of persons at risk. The application of the rule base to the available data in the study area generated plausible results. The study demonstrates the potential for the application of expert systems and fuzzy logic in the field of natural hazard monitoring and risk management.

Understanding E-Bike Users' Behaviour, Motives, and Barriers to the Use - An Empirical Study with high Potential for Mobility Management

A representative study among e-bike owners and tenants in Switzerland (n = 1652) provides a deeper understanding of e-bike users characteristics, motives, values, usage behavior, and barriers to the use. In a micro simulation the implications of the findings for the energy demand and CO2 emissions are estimated.

Accident Management Actions In An Upper-Head Small-Break Loss-Of-Coolant Accident With High-Pressure Safety Injection Failed

Since the Three Mile Island accident, an important focus of pressurized water reactor (PWR) transient analyses has been a small-break loss-of-coolant accident (SBLOCA). In 2002, the discovery of thinning of the vessel head wall at the Davis Besse nuclear power plant reactor indicated the possibility of an SBLOCA in the upper head of the reactor vessel as a result of circumferential cracking of a control rod drive mechanism penetration nozzle - which has cast even greater importance on the study of SBLOCAs. Several experimental tests have been performed at the Large Scale Test Facility to simulate the behavior of a PWR during an upper-head SBLOCA. The last of these tests, Organisation for Economic Co-operation and Development Nuclear Energy Agency Rig of Safety Assessment (OECD/NEA ROSA) Test 6.1, was performed in 2005. This test was simulated with the TRACE 5.0 code, and good agreement with the experimental results was obtained. Additionally, a broad analysis of an upper-head SBLOCA with high-pressure safety injection failed in a Westinghouse PWR was performed taking into account different accident management actions and conditions in order to check their suitability. This issue has been analyzed also in the framework of the OECD/NEA ROSA project and the Code Applications and Maintenance Program (CAMP). The main conclusion is that the current emergency operating procedures for Westinghouse reactor design are adequate for these kinds of sequences, and they do not need to be modified.

Power management techniques in an FPGA-Based WSN node for high performance application

In this work, the power management techniques implemented in a high-performance node for Wireless Sensor Networks (WSN) based on a RAM-based FPGA are presented. This new node custom architecture is intended for high-end WSN applications that include complex sensor management like video cameras, high compute demanding tasks such as image encoding or robust encryption, and/or higher data bandwidth needs. In the case of these complex processing tasks, yet maintaining low power design requirements, it can be shown that the combination of different techniques such as extensive HW algorithm mapping, smart management of power islands to selectively switch on and off components, smart and low-energy partial reconfiguration, an adequate set of save energy modes and wake up options, all combined, may yield energy results that may compete and improve energy usage of typical low power microcontrollers used in many WSN node architectures. Actually, results show that higher complexity tasks are in favor of HW based platforms, while the flexibility achieved by dynamic and partial reconfiguration techniques could be comparable to SW based solutions.

El programa ERHIN y la gestión de embalses en áreas con alta precipitación nival = The ERHIN programme and reservoir management in areas of high nival precipitation

El programa de Evaluación Recursos Hídricos procedentes de la Innivación (ERHIN) ha desarrollado un modelo hidrológico con subrutinas que contemplan el proceso de acumulación/fusión de nieve que permite el seguimiento del manto de nieve y su fusión , esencial para la previsión de avenidas en embalses cuyas cuencas vertientes recogen altos porcentajes de precipitación solida. En determinados sectores del territorio español (Pirineos, Cordilleras Cantábrica e Ibérica, Sistema Central y Sierra Nevada) la precipitación nival alcanza valores significativos durante el invierno, que conducen a espesores de nieve persistentes en las cuencas alimentadoras de numerosos embalses y a la fusión rápida de esta nieve en períodos cortos de tiempo, directamente relacionados con la elevación de la isoterma de cero grados en primavera. Estos procesos condicionan la gestión de los mencionados embalses.

High risk : human capital in the federal government : hearing before the Oversight of Government Management, Restructuring, and the District of Columbia Subcommittee of the Committee on Governmental Affairs, United States Senate, One Hundred Seventh Congress, first session, February 1, 2001.

Shipping list no.: 2001-0303-P.

Efficiency in high schools : studies, 1911-14, in the application of the principles of scientific management to high school problems made by the High School Teachers' Association of New York City /

At head of title: H.S.T.A. Bulletins 29-46.

Long-term management of liquid high-level radioactive wastes stored at the Western New York Nuclear Service Center, West Valley : final Environmental Impact Statement.

"June 1982."