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Gender equity is imperative to the attainment of healthy lives and wellbeing of all, and promoting gender equity in leadership in the health sector is an important part of this endeavour. This empirical research examines gender and leadership in the health sector, pooling learning from three complementary data sources: literature review, quantitative analysis of gender and leadership positions in global health organisations and qualitative life histories with health workers in Cambodia, Kenya and Zimbabwe. The findings highlight gender biases in leadership in global health, with women underrepresented. Gender roles, relations, norms and expectations shape progression and leadership at multiple levels. Increasing women's leadership within global health is an opportunity to further health system resilience and system responsiveness. We conclude with an agenda and tangible next steps of action for promoting women's leadership in health as a means to promote the global goals of achieving gender equity.
The aims of this report are, firstly, to review the activities of Commission 5 during the period since the IAU General Assembly in Delhi in November 1985 and, secondly, to draw attention to other relevant activities. It is based mainly on contributions from the Chairmen of the working groups and other members of the Commission, but it also includes some items of general interest that have been taken from the Commission’s Newsletter. The Working Groups and their Chairmen are as follows:
The report period 1982-84 was characterized by an again increased volume of material processed in data and abstracting centers, and by a growing clientele particularly of online services. The Working Groups of Commission 5 seek continued consultation with research object commissions so that the advanced documentation technology be efficiently employed toward specific demands of subject areas as to indexing, tagging, comprehensive, selective and inter-discliplinary retrievals. The guideline library for these purposes has been augmented by the First Dictionary of the Nomenclature of Celestial Objects by A. Fernandez, M.-C. Lortet and F. Spite (Astr. Astrophys. Suppl. 52 no.4, 1983) and by the Guide to the Presentation of Astronomical Data by G.A. Wilkins (CODATA Bull.46 1982); a new draft of the IAU Style Manual is before the IAU EC.
This paper is a report from the Extreme Events Working Party. The paper considers some of the difficulties in calculating capital buffers to cover potential losses. This paper considers the reasons why a purely mechanical approach to calculating capital buffers may bot be possible or justified. A range of tools and techniques is presented to help address some of the difficulties identified.
We sought to estimate mortality and associated factors in HIV-hepatitis co-infected individuals in Michigan using a retrospective cohort study. For the study period of 1 January 2006 to 31 December 2009, all HIV-infected individuals were matched to hepatitis B and C cases. In the final Cox proportional hazards regression model, individuals of other [hazard ratio (HR) 2·2, 95% confidence interval (CI) 1·4–3·2] and black (HR 1·3, 95% CI 1·1–1·6) race had decreased survival compared to white race. Similarly, injecting drug users (IDUs) (HR 2·1, 95% CI 1·6–2·6), men who have sex with men (MSM)/IDUs (HR 1·5, 95% CI 1·1–2·2), individuals with undetermined risk (HR 1·5, 95% CI 1·2–1·9) and heterosexual practices (HR 1·4, 95% CI 1·1–1·8) had decreased survival compared to MSM. Additionally, an interaction was found between current HIV status and co-infection. Mortality in HIV-hepatitis co-infected individuals remains a continuing problem. Our study can help in planning interventions to reduce mortality in HIV-infected individuals.
A retrospective cohort study was conducted from 1 January 2006 to 31 December 2009 in Michigan to estimate the prevalence of HIV and hepatitis co-infection and identify associated factors. The prevalence of co-infection was 4·1% [95% confidence interval (CI) 3·8–4·5]. Multivariable logistic regression analysis revealed a significant association between co-infection and being male and: of Black race [odds ratio (OR) 2·0, 95% CI 1·2–3·6] and of Other race (OR 3·5, 95% CI 1·7–7·0) compared to Hispanic race. A significant association was found between co-infection and risk categories of blood products (OR 11·1, 95% CI 6·2–20·2), injecting drug user (IDU) (OR 3·6, 95% CI 2·7–4·8) and men who have sex with men/IDU (OR 3·4, 95% CI 2·4–4·9) in addition to two interactions; one between sex and current HIV status and the other between current HIV status and age at HIV diagnosis. Our results document the changing epidemiology of HIV–hepatitis co-infection which can guide preventive measures and interventions to reduce the prevalence of hepatitis co-infection.
Chlorine-36 has been identified as a potential source of radiological risk
in the disposal of nuclear fuel waste. The radioisotope 36Cl
(t1/2 = 3 × 1O5 a) is produced by neutron
activation of Cl impurities in UO2 fuel. The total average Cl
impurity level in four unirradiated CANDU UO2 fuel samples was
2.3 ± 1.1 ppm. ORIGEN-S calculations using a 5 ppm Cl impurity in a CANDU
fuel resulted in a 36Cl activity comparable to the activity of
129I and 14C produced in the fuel thus requiring
36Cl to be considered in disposal risk assessments. The
“instant release” of 36Cl from the gap and grain boundary regions
of the fuel to solution was measured by leaching both clad fuel and fuel
samples crushed to grain-sized particles. The 36Cl concentration
was measured by Accelerator Mass Spectrometry. The 36Cl releases
from fuel samples taken from 8 different fuel bundles ranged from 0.5% to
20.4% of the total 3 Cl inventory over a leaching period of 32
days. The 36Cl released was found to correlate with the stable Xe
gas release, the fuel burnup and the linear power rating (LPR). For a
typical CANDU fuel with an LPR of -42 kW/m, the “instant release” of
36Cl would be about 5% of the total inventory.
The dissolution behaviour of Zircaloy clad used CANDU fuel in aqueous solutions has been examined under mildly reducing conditions at 95°C for a period of 16 months. The effects of various container components and groundwaters on the dissolution of the fuel have been investigated. The components studied were titanium (container material), carbon steel (fuel bundle support basket) and soda-lime glass beads (container infill material). Leaching solutions included deionized water (DIW) and synthetic saline groundwaters.
The presence of glass beads or carbon steel did not appear to significantly affect solution concentrations of 137Cs, 90Sr, 99Tc, or 238U. Radionuclide concentrations were one to two orders of magnitude higher in saline groundwaters than in DIW. After about 30 days leaching, continued radionuclide release from the fuel was strongly inhibited in the absence of oxygen, and radionuclide concentrations in solution remained virtually constant. X-Ray photoelectron spectroscopy (XPS) measurements of the oxidation state of fuel fragments leached in groundwaters, showed a surface composition of less than UO2.33, below the postulated threshold for oxidative dissolution.
Future manned space travel will go beyond the Lower Earth Orbit into deep space exploration and providing protection from space radiation is a major challenge. It is essential to study the effects of the space environment on materials to ensure safe and successful missions.
This paper summarized the studies of two materials, in-site regolith composites and LTM 45 composites, for potential applications in space radiation environments. The effects of radiation on the mechanical and thermal properties of the composites were investigated. The radiation shielding effectiveness of in-situ composites and low temperature molding materials was analyzed. The work was part of the efforts in study and development of the multifunctiaonal materials for long-term radiation exposures to ensure effective radiation shielding and maintaining integrity of materials' mechanical and thermal properties for future space missions.
A portable air purifier significantly reduced mal odour in a small room. If the atmosphere was deliberately contaminated with Serratia marcescens the unit rapidly removed this organism. However, if incorrectly sited, the purifier could disperse organisms into the atmosphere.
A cross-sectional field study was performed to evaluate infection in dogs and cats living on farms with Mycobacterium bovis-infected cattle. The purpose was to determine pet infection status and assess their risk to farm families and/or tuberculosis-free livestock. Data and specimens were collected from 18 cats and five dogs from nine participating farms. ELISA testing for M. bovis and M. avium was conducted. Fifty-one biological samples were cultured; all were negative for M. bovis, although other Mycobacterium species were recovered. No radiographic, serological or skin test evidence of mycobacterial infection was found. These negative results may be due to the low level of M. bovis infection in the cattle and the limited duration of exposure of pets to infected cattle residing on the same farm. No evidence was found to indicate that pets residing on M. bovis-infected Michigan cattle farms pose a risk to humans or M. bovis-free livestock; however, precautionary advice for farm owners was provided.
This paper was written by the Derivatives Working Party, a permanent working party of the Life Research Committee of the Institute and Faculty of Actuaries. Our aim is to consider how life assurers may use, or may wish to use, derivatives, and if their use is unduly constrained, e.g. by regulation. This paper focuses on credit derivatives. We provide an overview of the credit derivatives market, and the strong growth in this market over recent years. We then focus on the two main traded credit derivative instruments — Credit Default Swaps (CDSs) and Collateralised Debt Obligations (CDOs). We explain how these instruments work and are priced, and clarify some of the more complex topics involved, such as the settlement of CDSs, basis risk and the relevance of implied correlation in pricing CDOs. We then consider how life insurers could make use of credit derivatives, for example to provide more efficient investment management in taking exposure to credit risk, or to hedge credit exposures, and consider the regulatory implications of so doing. Finally, in the Appendix, we discuss the credit spread puzzle, and the existence or otherwise of a liquidity premium in corporate bond spreads, with implications for the valuation of illiquid liabilities.
This paper describes the use of the Neurosign 100 Nerve Monitor and vagus nerve stimulation in the identification and assessment of the integrity of the recurrent laryngeal nerve (RLN) during thyroid and parathyroid surgery.
Vocal fold function was assessed pre- and post-operatively in all patients undergoing thyroid and parathyroid surgery. The nerve monitor, used in association with endotracheal electrodes, was used to confirm correct RLN identification and demonstrate its integrity at the completion of surgery.
There were 21 unilateral and 19 bilateral neck explorations. In these 40 patients, 57 of 59 RLNs were identified. The nerve monitor demonstrated RLN continuity in all but one case (equipment failure: electrode misplacement) after initial identification. Vagus nerve stimulation was performed in 21 patients without adverse sequelae. Damage to the RLN was identified in one of these patients, in whom direct RLN stimulation close to the larynx had failed to indicate discontinuity. Post-operatively this patient had a transient unilateral vocal fold palsy.
The use of the Neurosign 100 Nerve Monitor is no substitute for meticulous surgery. Stimulation of the vagus nerve may be a more sensitive means of assessing RLN integrity during thyroid and parathyroid surgery than stimulation of the RLN itself. Confirmation of RLN integrity allows the surgeon to proceed with confidence to the contralateral side of the neck during hazardous bilateral explorations.
True malignant mixed tumours (carcinosarcomas) of salivary gland origin are rare and not widely recognized lesions. These tumours account for approximately 0.2 per cent of all malignancies of the major salivary glands (Stephen et al., 1986). They usually occur in pre-existing pleomorphic ademonas of major salivary glands and have an aggressive and often rapidly fatal progression.
We report a case of carcinosarcoma in a minor salivary gland of the upper lip. Its management and the use of immunocy-tochemical stains to demonstrate the separate epithelial and connective issue components are discussed.
Huckle, Rook and Wilkins (1993) have reported elsewhere in this meeting the production responses of cows grazing grass-clover swards maintained at different heights with or without concentrate supplementation. In order to understand these responses more fully the ingestive behaviour of the animals was studied in detail.
Multlparous Holstein-Friesian cows with a mean calving date of 21 March were continuously stocked on mixed grass-clover swards. The cows were blocked by calving date, parity and milk yield in week two of lactation and randomly allocated to one of six treatments, 0 (U) or 4 kg (3.44 kg DM) (S) concentrate supplementation (180 g CP/kg DM, 12.8 MJ ME/kg DM) with swards maintained at 4, 6 or 8 cm compressed (rising plate) sward height by adjusting the grazed area. In order to avoid the possibility of social facilitation occurring between supplemented and unsupplemented animals, two paddocks were maintained at each sward height with the concentrate treatments alternating daily between the paddocks at each height. Jaw movements were recorded automatically over a 24 hour period for a different cow on each treatment for each of 6 days between 15 and 25 June 1992, using the apparatus described by Huckle, Clements and Penning (1989).
The aims of this study were to identify and trace all schizophrenic patients discharged from in-patient and day-patient psychiatric services in Harrow between 1 January 1975 and 1 January 1985, to examine the patients in terms of their mental state, cognitive functioning, extrapyramidal function and social disability, and to relate their current status in those terms to demographic, historical and treatment variables. The data collection was conducted between 1 February 1987 and 1 January 1990. The project was devised against the background of developing community care policies for psychiatric patients. In the UK, policies of closure of the mental hospitals have been advocated for a considerable time (Tooth & Brooke, 1961). In the US the plan of closing the mental hospitals and replacing in-patient care with care in the community was partially adopted (Scharfstein, 1978; Fink & Weinstein, 1979; Winslow, 1979). In Italy it was carried out in a much more complete way, at least in some areas (Jones & Poletti, 1985, 1986), but problems appear to have arisen in both of these countries (Donovan, 1982; Papeschi, 1985).