Protracted Refugee Situations: Parallel Health Systems and Planning for the Integration of Services

The international community typically responds to refugee situationsby establishing ‘care and maintenance’ programmesspecifically for refugees. Limited resources may also be directedto hosting communities, but donors often channel the bulk offunding through UNHCR and its implementing partner NGOs, whoin turn create service delivery structures that are operatedin parallel to local structures. Although there may be causefor this approach in a short-term emergency phase, particularlyif the host country systems are very weak, this eventually becomesfinancially problematic if refugees continue to live in exilefor years at a time. In the short term, it can also engenderan inequitable and inefficient use of scarce resources. Thispaper traces the evolution and impact of implementing refugeehealth services in parallel to local systems using observationsfrom Uganda, and offers Quality Design as a model for planningthe local integration of services.     

Histological correlates of post mortem mitochondrial DNA damage in degraded hair

We have assessed the histological preservation of naturally degraded human hair shafts, and then assayed each for levels of amplifiable mitochondrial DNA and damage-associated DNA miscoding lesions. The results indicate that as sample histology is altered (i.e. as hairs degrade) levels of amplifiable mitochondrial DNA decrease, but no correlation is seen between histology and absolute levels of mitochondrial DNA miscoding lesions. Nevertheless, amplifiable mitochondrial DNA could be recovered across the complete range of the histological preservation spectrum. However, when template copy number is taken into consideration, a correlation of miscoding lesions with histology is again apparent. These relationships indicate that a potential route for the generation of misleading mitochondrial sequence data exists in samples of poor histology. Therefore, we argue that in the absence of molecular cloning, the histological screening of hair may be necessary in order to confirm the reliability of mitochondrial DNA sequences amplified from hair, and thus represents a useful tool in forensic mitochondrial DNA analyses.     

An analysis of factors contributing to a series of deaths caused by exposure to high environmental temperatures

Autopsy reports at the Forensic Science Centre, Adelaide, South Australia, were reviewed for the 8 years from January 1991 to December 1998 for cases with unusual features in which deaths had been attributed to exposure to high environmental temperatures. Amphetamine-related hyperpyrexial deaths, anesthetic deaths caused by malignant hyperpyrexia, deaths of elderly incapacitated individuals during heat waves, and deaths of children trapped in the back of cars were excluded from the study. In 9 cases, where heat-related deaths had occurred (age range 21 to 77 years; M:F = 8:1). Predisposing factors included lack of familiarity with Australian environmental conditions, excessive clothing, prolonged sun exposure, acute alcohol intoxication, obesity, benztropine and trifluoperazine medication, and underlying dementia, alcoholic liver disease, and possibly epilepsy.     

Financing local government debt in Canada: pooled versus standalone issues - an empirical study

Abstract: Provincially legislated special-purpose bodies created to pool municipal bond requirements have operated in Canada for several decades. American states have also adopted this Albertan/Canadian innovation. The organizations use different titles, such as municipal bond authorities/corporations and bond banks; this paper uses the generic term municipal bond bank, or mbb. These banks are separate legal entities, and the paper discusses the use of internalization theory as an explanation for their creation and continued use. Several US. empirical studies comparing the cost of municipal borrowing under a pooled mbb issue versus stand-alone issues were undertaken in the 1980s. The American studies' results support the practice of pooling debt issuance through bond banks and conclude that savings from mbb participation are inversely proportional to unit credit rating and size. This paper presents the findings of the first Canadian empirical study that compares the cost of municipal funds for pooled versus stand-alone issues. The study uses data from the Province of Ontario, as it is a large province and quantitative data was available; Ontario does not currently have an mbb. The Canadian study results share some similarity with the results of previous American studies in that they show that pooled financing through an mbb results, in aggregate, in cost-savings to municipal borrowers, with the greatest savings to those units that are small and un rated and that borrow for longer periods. The Canadian study suggests that the few large, highly rated municipalities that would receive little or no benefit from mbb participation and certain small issuer units that have found economical, alternative methods of raising funds retain the option of issuing debt outside a provincial mbb. This paper concludes with a reference to the discussion on the impact of municipal borrowing arrangements on provincial credit ratings. Sommaire: Des organismes légiférés à des fins spéciales, au niveau provincial, offrant de mettre en commun les besoins d'émission d'obligations municipales, fonctionnent au Canada depuis plusieurs décennies. Des États américains ont également adoptécette innovation provenant de l'Alberta et du Canada. Les organismes portent des noms différents, tels que »Autorité/société de financement municipal« et banque d'obligations, et le présent article utilise l'expression générique » Banques d'obligations municipales « ou bom. Il s'agit en fait d'entités juridiques distinctes, et l'article se penche sur l'emploi de la théorie de l'intemalisation en tant qu'explication de leur création et de leur fonctionnement. Plusieurs études empiriques américaines comparant le coût d'emprunt municipal mis en commun dans le cadre d'une bom au coöt des émissions isolées ont été entreprises au cours des années 1980. Les résultats des études américaines justifient la pratique de mettre en commun l'émission de dette par l'entremise des banques d'obligations; selon elles, les économies qu'on peut réaliser en participant aux bom sont inversement proportionnelles à l'ampleur et à la cote de crédit de l'entité en question. Cet article présente les constatations de la première étude empirique canadienne qui compare le coöt des fonds municipaux pour les émissions mises en commun au coût des émissions isolées. L'étude utilise des données de la province de l'Ontario parce que c'est une grande province et que les données quantitatives étaient disponibles; l'Ontario n'a pas actuellement de bom. Les résultats de l'étude canadienne sont similaires, dans une certaine mesure, à ceux des études américaines précédentes, puisqu'ils montrent que le financement en commun par l'entremise d'une bom entraîne, dans l'ensemble, des économies de coût pour les emprunteurs municipaux, les économies les plus importantes étant réaliées par les entités qui sont petites et non cotées et qui empruntent pour des périodes prolongées. L'étude canadienne suggère que les quelques grandes municipalités bien cotées, qui n'auraient peu ou pas d'avantage à participer aux bom ainsi que certaines petites entités émettrices ayant trouvé des méthodes alternatives économiques pour recueillir des fonds, devraient se réserver l'option d'émettre des dettes sans faire appel à la bom provinciale. En guise de conclusion, l'étude mentionne le débat sur les répercussions que peuvent avoir les arrangements d'emprunt municipaux sur les cotes de crédit provinciales.