Suchergebnisse

AbstractRussian local governments now have primary responsibility for the administration of social assistance programmes thanks to a combination of decentralization of some responsibilities from higher levels of government and the transfer of certain administrative functions from state enterprises to municipalities. Over the past few years, there has also been a distinct shift to means‐testing of social assistance. This article reports on the results of a pilot project undertaken to improve the efficiency of programme administration conducted in the city of Arzamas (pop. 110,000). The municipal administration promotes it as a programme to ease client burden and improve access to benefits. Specifically, the pilot introduced a unified application form for all the major social assistance programmes in the city and required, regardless of how many programmes are applied for, that applicants visit only one office and supply one set of documents verifying their eligibility for assistance. Benefit processing is also consolidated. Staff efficiency improvements are substantial: under the one‐window system, 127 benefits are processed per month per staff member, while 85 benefits were processed per month per staff member under the old administrative system. Impressive time savings for clients were also observed: the statistically average client saves between 1.3 and 2.4 hours, depending on the degree to which a client was able to coordinate documentation collection and trips to the benefit agencies under the old system. The total potential time saved by clients as a result of the one‐window reforms is between 4100 and 7600 person hours per month. Copyright © 2002 John Wiley & Sons, Ltd.

Trinity Health and Education International Research Conference 2022 (THEConf 2022), Virtual Event, 8-10 March 2022 ; Background: The World Health Organisation (WHO) declared a global pandemic on the 11th of March 2020. The Irish government subsequently imposed the first national lockdown and stringent measures to curb the spread of COVID-19 between March-May 2020. Concerns were raised about whether women were fearful of accessing maternity services during the lockdown. Maternal perception of reduced fetal movements (RFM) in pregnancy is a common reason for self-referral to maternity services. International guidelines recommend that women perceiving RFM attend their maternity unit for fetal assessment. Objectives: We sought to determine the impact of the first global pandemic lock-down on attendances for reduced fetal movements (RFM) during pregnancy in a large urban maternity unit. Methods: All women with a singleton pregnancy, presenting to the emergency department (ED) of the National Maternity Hospital, Dublin with a primary presentation of perceived reduced fetal movements after 24 weeks' gestation between 1st January 2020 and 30th April 2020 were included. Findings: Between January 1 and February 29, 2020 there were 2135 total attendances to the ED; 264 of these were for RFM (12.4%). From March 1- April 30, we observed a significant decline in the number of attendances to ED, totalling 1458; 231 of these were for RFM (15.8%). During the first lock-down period (March-April 2020) overall attendances to the ED decreased by 31.7%, however referrals for RFM increased by 27.4%. Conclusions: There was a significant decrease in the number of attendances to the ED during the first lockdown of the COVID-19 pandemic, however referrals for RFM increased.

Participatory modeling is a potentially high‐impact approach for catalyzing fundamental sustainability transformations. We test if participation in a group system dynamics modeling exercise increases participants' agency through a novel method to evaluate potential behavioral change using expectation measures. A water‐energy‐food nexus—a functionally interdependent but underconceptualized system with low consensus and high scientific uncertainty—was mapped, and its evolution simulated by 46 participants in three interventions in a region undergoing hydropower infrastructure development in Northeastern Cambodia. Participants' system‐related expectations were measured before and after the interventions. Our results suggest that participants became significantly more optimistic about their individual agency to increase agricultural and fishing income and, interestingly, less likely to participate in local government development planning procedures. Findings also reveal how some uncertainties for multiple variables were reduced within and across the groups. Such converging expectations suggest that participatory modeling could contribute to making collective solutions and institutionalized agreements more likely. This research contributes to innovation in sustainability because it unpacks some underlying mechanics of how participatory processes can lead to new adaptive capacities, shared perspectives, and collective actions.

© 2018 Clarke et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in the Dhaulagiri region of Nepal. Pulse oximetry, and Lake Louise scores were also recorded on the morning and evening of each trek day. Data were compared between altitudes and relationships between pulse oximetry, Lake Louise score, and sway velocity were explored. Total sway velocity during standing balance with eyes open (p = 0.003, d = 1.9) and during Sharpened Romberg test with eyes open (p = 0.007, d = 1.6) was significantly greater at altitudes of 3619m and 5140m when compared with sea level. Anterior-posterior sway velocity during standing balance with eyes open was also significantly greater at altitudes of 3619m and 5140m when compared with sea level (p = 0.001, d = 1.9). Knee joint position sense was not altered at higher altitudes. There were no significant correlations between Lake Louise scores, pulse oximetry and postural sway. Despite a gradual ascent profile, exposure to 3619 m was associated with impairments in postural control without impairment in knee joint position sense. Importantly, these impairments did not worsen at higher altitudes of 4600 m or 5140 m. The present findings should be considered during future trekking expeditions when developing training strategies targeted to manage impairments in postural control that occur with increasing altitude.