Making aid effective at the community level: the AMREF experience

Effective use of donor aid is critical in achieving the sixth Millennium Development Goal –reversing the HIV/AIDS epidemic by 2015. The Paris Declaration of 2005 identified five key principles for aid effectiveness: ownership, alignment, harmonisation, mutual accountability and managing for results. As civil society organisations play a critical role in implementing HIV/AIDS interventions, it is important that they adhere to these principles. Often, however, they fail to implement interventions conforming with the principles, leading to duplication and inefficiency. Two case studies from AMREF in Kenya demonstrate how the principles of aid effectiveness can be applied to increase the impact of HIV/AIDS interventions.

Rendre l'aide efficace au niveau communautaire : l'expérience d'AMREF

L'utilisation efficace de l'aide apportée par les bailleurs de fonds est cruciale pour atteindre le sixième Objectif du Millénaire pour le développement – inverser l'épidémie du VIH/sida d'ici à 2015. La Déclaration de Paris de 2005 a identifié cinq principes clés pour l'efficacité de l'aide : l'appropriation, l'alignement, l'harmonisation, la redevabilité mutuelle et la gestion en vue de résultats. Comme les organisations de la société civile jouent un rôle crucial dans la mise en ?uvre des interventions en matière de VIH/sida, il est important qu'elles adhèrent à ces principes. Cependant, souvent, elles échouent à mettre en ?uvre des interventions conformes aux principes, ce qui aboutit à des doublons et à l'inefficacité. Deux études de cas d'AMREF au Kenya démontrent la manière dont les principes de l'efficacité de l'aide peuvent être appliqués pour accroître l'impact des interventions de lutte contre le VIH/sida.

Tornando a Ajuda Efetiva no Âmbito da Comunidade: A experiência da AMREF

O uso efetivo da ajuda dos doadores é crucial para se alcançar o sexto Objetivo de Desenvolvimento do Milênio – reverter a epidemia do HIV/AIDS até 2015. A Declaração de Paris de 2005 identificou cinco princípios-chave para a efetividade da ajuda: apropriação, alinhamento, harmonização, responsabilidade mútua e gerenciamento para resultados. Como as organizações da sociedade civil desempenham um papel crucial na implementação de intervenções relativas ao HIV/AIDS, é importante que elas tenham adesão a estes princípios. Frequentemente, porém, elas falham na implementação das intervenções de acordo com os princípios, levando à duplicação e ineficiência. Dois estudos de caso da AMREF no Quênia mostram como os princípios da efetividade da ajuda podem ser aplicados para aumentar o impacto das intervenções relativas ao HIV/AIDS.

Una ayuda más eficiente a nivel comunitario: la experiencia AMREF

Para alcanzar los Objetivos de Desarrollo del Milenio y conseguir que la epidemia del VIH/SIDA retroceda para el 2015, es de vital importancia que la ayuda de los donantes se utilice con más eficiencia. La Declaración de París de 2005 enunció cinco principios clave para que la ayuda sea eficaz: apropiación, alineación, armonización, rendición de cuentas mutua y gestión basada en los resultados. Debido a que las organizaciones de la sociedad civil desempeñan un papel fundamental en la lucha contra el VIH/SIDA, es necesario que éstas respeten los cinco principios. Sin embargo, a menudo éstos no se aplican en la práctica ocasionando duplicidades y falta de eficiencia. Dos estudios de caso de AMREF (siglas en inglés de la Fundación Africana de Medicina e Investigación) en Kenia muestran cómo estos principios de eficacia en la ayuda son útiles para aumentar el impacto de la lucha contra el VIH/SIDA.     

Fatalities Due to Failure of Continuous Subcutaneous Insulin Infusion Devices: A Report of Six Cases

Diabetes mellitus type 1 and type 2 are diseases characterized by impaired regulation of blood glucose due to decreased insulin production and insulin resistance, respectively. Management of diabetes mellitus often requires injection of exogenous insulin. Continuous subcutaneous insulin infusion (CSII or insulin pump) is a diabetes treatment modality utilizing a device to aid in regulation of glycemic control. Malfunctions in device components can have rare fatal consequences. Described in this report are six fatalities due to one such malfunction, the failure of plastic cannulas of CSII devices to penetrate the skin and deliver insulin, resulting in fatal diabetic ketoacidosis (DKA). The cases derive from four different death investigation systems. For each case, scene and autopsy findings are presented, as well as selected toxicology and histology findings. These cases illustrate the importance of careful examination of CSII devices in death investigations and introduce a discussion on discrepant manner of death classifications.     

‘It’s an invisible wound’: the disenfranchised grief of post-separation mothers who lose care time

This paper enriches understandings of the implications of contemporary custody law for mothers and their children. It does so through a discussion of mothers’ grief and emotional pain over involuntarily losing care time with children. Mothers involuntarily lose care time by becoming non-resident parents against their will or by having a shared care parenting order imposed on them. Both experiences of losing maternal care time are becoming more commonplace as a result of the gender neutrality of custody laws across the Anglo-West and the increased emphasis given to shared care parenting as a viable post-separation parenting arrangement. Yet investigations into the emotions engendered by mothers’ loss of care time are sparse. Exploratory qualitative research with twelve mothers who involuntarily lost care time reveals the intensity and durability of their grief, its entanglement with emotions like fear, and its significance, as a relational welfare approach emphasises, to children’s best interests.     

Two-dimensional linear analysis of dynamic bare footprints: A comparison of measurement techniques

In forensic intelligence-gathering, footprints have been shown to be valued evidence found at crime scenes. Forensic podiatrists and footprint examiners use a variety of techniques for measuring footprints for comparison of the crime scene evidence with the exemplar footprints. This study examines three different techniques of obtaining two-dimensional linear measurement data of dynamic bare footprints. Dynamic bare footprints were gathered from 50 students from a podiatric medical school using the Identicator® Inkless Shoe Print Model LE 25P system. After obtaining 100 bilateral footprints from the participants, the quantitative measurement data were collected by using three different measurement techniques: (i) a manual technique using a ruler (direct technique); (ii) an Adobe® Photoshop® technique; and (iii) a GIMP (GNU Image Manipulation Program) technique. The seven Reel linear measurement methodology was used for producing measurements using these three techniques.This study showed that all the mean bare footprint measurements on the right and left feet obtained using the direct technique were larger than those obtained using GIMP and Adobe® Photoshop® images. Differences were also observed in measurements produced using GIMP software and Photoshop images. However, the differences observed in the three techniques used for bare footprint measurements were not found to be statistically significant. The study concludes that there are no significant differences between the three measurement techniques when applied to two-dimensional bare footprints using the Reel method. It further concluded that any of these measurement techniques can be used when employing the Reel methodology for footprint analysis without significant difference.     

Quantifying Macrophages and Hemosiderin in Pediatric Dura Mater,

Determining the age of a subdural hematoma at autopsy is of great interest for medicolegal purposes. The appearance of pigment‐laden macrophages is often referenced as evidence that the subdural hematoma is 3–4 days old. However, understanding the significance of macrophages and hemosiderin requires understanding the histology of infant dura. Samples of grossly unremarkable dura taken from 17 pediatric autopsies were identified and histologically confirmed to lack subdural neomembrane. CD68 immunostaining and Prussian blue staining was performed. The CD68‐positive cells per high‐power field were quantified, and the presence of iron‐containing cells was recorded. CD68‐positive cells were present in all cases, even in the dural border layer. Iron‐containing cells were identified in 59% of cases, and in the dural border layer in 29%. Therefore, CD68‐positive and iron‐containing cells can be present in pediatric dura without neomembrane or macroscopic subdural hemorrhage, and this requires consideration when estimating the age of a subdural hematoma.     

The Global Adoption of National Policies Protecting Children from Violent Discipline in Schools and Homes, 1950–2011

With a focus on the relationship between women's and children's rights and theories of globalization, we conduct an event history analysis of more than 150 countries between 1950 and 2011 to assess the factors associated with policies banning corporal punishment in schools and homes. Our research reveals that formal condemnation of corporal punishment in schools is becoming a global norm; policies banning corporal punishment in the home, in contrast, are being adopted more slowly. We find that the percentage of women in parliament is associated with the adoption of anti‐corporal punishment policies in both schools and homes, suggesting a nexus between women's and children's issues. Countries with more ethnic diversity are slower to adopt home policies, however. We propose that minority groups in these countries may be resistant to laws because of the risk of selective or prejudicial enforcement. In terms of globalization, more aid is associated with both school and home policies, and countries that have ratified the Convention on the Rights of the Child are more likely to adopt home policies. Surprisingly, international nongovernmental organizations are not significantly associated with either type of policy adoption.     

Parental Denigration: A Form of Conflict that Typically Backfires

Parental denigration is a phenomenon characterized by disparaging comments made by one parent about the other parent in front of their children. It is an emerging area of research with implications that could either follow a parental alienation perspective or a conflict perspective. In two prior studies of 648 and 994 young adults, denigration was found to be (1) measured reliably and perhaps validly; (2) reciprocally occurring; (3) related to children feeling more distant from both parents, particularly the more frequent denigrator; and (4) associated with various measures of maladjustment. These results held in married and divorced families, for mothers and fathers, in group and individual analyses, across own and sibling reports, and across studies. In a new study, parents also showed agreement in reported denigration, with divorced (particularly litigating) parents appearing motivated to underreport their own denigration behaviors and overreport their co‐parent's denigration behaviors. Across all three studies, results consistently aligned with a conflict perspective and indicated that denigrating one's co‐parent appears to boomerang and hurt the parent's own relationship with the children rather than distance children from the co‐parent.