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ABSTRACT Background : Healing ability of nonhealing chronic ulcers can be assessed by estimating hydroxyproline, total protein and enzymatic antioxidants such as glutathione peroxidase (GPx), glutathione S-transferase (GST) in the granulation tissue. Materials and Method : A total of 34 patients were analysed from two groups: Limited access dressing (LAD) group ( n = 17) and conventional dressing group ( n = 17). Results : Patients treated with LAD that exerts combination of intermittent negative pressure and moist wound-healing had shown a significant increase in the hydroxyproline ( P = 0.026), total protein ( P = 0.004), GPx level ( P = 0.030) and GST level ( P = 0.045). Conclusion : Patients treated with LAD indicated significantly better anabolic effect on wound-healing compared to that of patients treated with conventional dressing.

The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria's neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees.

The private sector is the engine of economic growth, stimulating entrepreneurship and innovation and promoting competition and productivity. While many countries in Africa have developed private sector-driven growth strategies, private investment as a proportion of gross domestic product (GDP) is only 13 percent in Africa, significantly lower than in other regions, such as South Asia, with many low-income countries. The public sector still occupies the lion's share of economic activity in Africa. This study addresses how industrial clusters could be a springboard for the development of Africa's micro and small enterprise sector, which constitutes the bulk of the region's indigenous private sector. The successful development of industrial clusters in Asia illustrates how small enterprises can help to drive growth led by market expansion at home and abroad.

Background Inequalities in geographic access to health care result from the configuration of facilities, population distribution, and the transportation infrastructure. In recent accessibility studies, the traditional distance measure (Euclidean) has been replaced with more plausible measures such as travel distance or time. Both network and raster-based methods are often utilized for estimating travel time in a Geographic Information System. Therefore, exploring the differences in the underlying data models and associated methods and their impact on geographic accessibility estimates is warranted. Methods We examine the assumptions present in population-based travel time models. Conceptual and practical differences between raster and network data models are reviewed, along with methodological implications for service area estimates. Our case study investigates Limited Access Areas defined by Michigan’s Certificate of Need (CON) Program. Geographic accessibility is calculated by identifying the number of people residing more than 30 minutes from an acute care hospital. Both network and raster-based methods are implemented and their results are compared. We also examine sensitivity to changes in travel speed settings and population assignment. Results In both methods, the areas identified as having limited accessibility were similar in their location, configuration, and shape. However, the number of people identified as having limited accessibility varied substantially between methods. Over all permutations, the raster-based method identified more area and people with limited accessibility. The raster-based method was more sensitive to travel speed settings, while the network-based method was more sensitive to the specific population assignment method employed in Michigan. Conclusions Differences between the underlying data models help to explain the variation in results between raster and network-based methods. Considering that the choice of data model/method may substantially alter the outcomes of a geographic accessibility analysis, we advise researchers to use caution in model selection. For policy, we recommend that Michigan adopt the network-based method or reevaluate the travel speed assignment rule in the raster-based method. Additionally, we recommend that the state revisit the population assignment method.

Ciphertext Policy-Attribute Based Encryption (CP-ABE) is a secure one-to-many asymmetric encryption schemes where access control of a shared resource is defined in terms of a set of attributes possessed by a user. Key delegation service, where a user is able to temporally transfer its full or partial access rights, is an important requirement to make CP-ABE based systems practically useful. In existing CP-ABE delegation schemes, a delegator can delegate its entire or partial set of attributes such that all content accessible using those attributes becomes available to the delegatee also. Flexibility to delegate some specific content, which is a practical requirement, is not feasible with these schemes. Further, for a delegated resource, flexibility of fine grained delegation like delegating only a specific subset of read, write and update permissions is not yet available. In this work, CP-ABE key delegation has been enhanced to support specific content and specific permission delegation. The proposed scheme is fully flexible as it additionally supports limits on the number of times delegation can be done, delegatee revocation and traceability of forbidden delegation. Theoretical and practical analysis show that the proposed scheme achieves its objectives and is computationally efficient as well as secure against chosen plaintext and key abuse attacks.

Although popular, control accounts of privacy suffer from various counterexamples. In this article, it is argued that two such counterexamples—while individually resolvable—can be combined to yield a dilemma for control accounts of privacy. Furthermore, it is argued that it is implausible that control accounts of privacy can defend against this dilemma. Thus, it is concluded that we ought not define privacy in terms of control. Lastly, it is argued that since the concept of privacy is the object of the right to privacy if the former cannot be defined in terms of control, neither can the latter.

President Dwight D. Eisenhower is remembered by many as the originator of the American Interstate Highway System. He is also praised for restraining executive overreach, restoring the separation of powers, and presiding over an era of governmental equanimity and goodwill. In Dwight D. Eisenhower and the Federal Highway Act , Charles Zug contests all these assumptions. Through archival research, Zug shows that Eisenhower’s attempt to lead highway expansion during 1952–1955 ended in dismal failure. Far from championing the separation of powers, Eisenhower sought to marginalize Congress from the legislative process by secretly writing a transformative highway bill within the confines of his White House. And once it was announced, Eisenhower’s highway plan was almost universally panned: Ike’s own comptroller general deemed the plan’s funding mechanism “illegal” before a bipartisan majority laughed it out of the Senate in the spring of 1955. The highway bill that did eventually pass Congress in 1956, and that went on to launch the modern interstate system, was written by congressional Democrats and emphatically rejected Eisenhower’s basic approach to highway reform. Drawing on executive politics, American political development, and leadership studies, Zug uses the Federal Highway Act to argue for a foundational reassessment of Eisenhower’s legacy as highway founder, president, and political leader.

Although access to financing in Pakistan is expanding quickly, it is two to four times lower than regional benchmarks. Half of Pakistani adults, mostly women, do not engage with the financial system at all, and only 14 percent have access to formal services. Credit for small- and medium-size enterprises is rationed by the financial system. The formal microfinance sector reaches less than 2 percent of the poor, as opposed to more than 25 percent in neighboring countries. Yet it is the micro- and small businesses, along with remittances, that help families escape the poverty trap and participate in the economy. 'Bringing Finance to Pakistan's Poor' is based on a pioneering and comprehensive survey and dataset that measures the access to financial products by Pakistani households. The survey included 10,305 households in all areas of the country, excluding the tribal regions. The accompanying CD contains summary statistics. The authors develop a picture of access to and usage of financial services across the country and across different population groups, and they identify policy and regulatory priorities. Reform measures in Pakistan have been timely, but alone are not enough; financial institutions have lagged behind in adopting technology, segmenting customer bases, diversifying products, and simplifying processes and procedures. Gender bias and low levels of financial literacy remain barriers, as is geographical remoteness. However, the single strongest cause of low financial access is lack of income—not location, education, or even gender. 'Bringing Finance to Pakistan's Poor' will be of great interest to readers working in the areas of business and finance, economic policy, gender and rural development, and microfinance.

Limited access to obstetric care for pregnant women in rural areas increases the risk of maternal mortality. A geographic information system (GIS) was used to analyze spatial and temporal access to obstetric care in southeastern Morocco. The obstetric records of 1,304 pregnant women were examined to determine the diagnosis upon arrival and the duration of ambulance transport. According to maps generated by the GIS, 19 obstetric cases were more than 100 kilometers away from the regional hospital, and 16 cases required over two hours for transport to the regional hospital. Univariate binary logistic regression analysis confirmed that delays exceeding two hours between the sending hospital and the receiving regional hospital increased the likelihood of pregnant women arriving with hemorrhage (OR: 2.82 (1.38, 5.79), p = 0.005). The study revealed the consequences of restricted access to obstetric care on the health of pregnant women, highlighting the need for targeted strategies to improve access to obstetric services in this region.