Principal Recipient Research Articles

Flourishing among Canada’s outstanding principal award recipients: the critical role of resilience

ABSTRACT School leaders in Canada face increasing social, political, economic, educational, and professional demands, which often lead to increased workload, stress, burnout, decreased well-being, and lack of work-life balance. Research demonstrates that school principals with high levels of resilience are better at coping with stress and crisis, are generally more effective as leaders, are more connected to schools and districts, and have lower levels of compassion fatigue. Examining the challenges that school principals face can both prevent conditions that decrease their well-being and help understand coping strategies and resilience-building approaches necessary for successful school leadership. Drawing from the study of flourishing among the national award-winning principals in the Canada’s Outstanding Principals (COP) program, in this article we describe the participants’ perceptions regarding their resilience as school leaders, the conditions that discouraged school principals in their role, and the approaches that allowed them to develop their personal resilience. The article offers recommendations on how school administrators can overcome the challenges and flourish by fostering resilience and growing a resilient mind-set.

Centering School Leaders’ Expertise: Usability Evaluation of a Leadership-Focused Implementation Strategy to Support Tier 1 Programs in Schools

Although there are a growing number of implementation strategies to increase the adoption, fidelity, and sustainment of evidence-based practices (EBP), they are often complex and bulky, which can interfere with their widespread application. To address these challenges, the Helping Educational Leaders Mobilize Evidence (HELM) strategy was created as an adaptation of the evidence-based Leadership and Organizational Change for Implementation (LOCI) implementation strategy to enhance elementary school principals’ use of strategic implementation leadership to support the adoption and delivery of Tier 1 (i.e., universal social, emotional, and behavioral) EBP. In service of its iterative development, a human-centered design methodology was employed to increase the successful uptake and use of HELM. The Cognitive Walkthrough for Implementation Strategies (CWIS), a novel mixed-methods approach to evaluate implementation strategy usability, was applied to identify and test HELM strategy tasks of critical importance. A sample of 15 elementary school principals participated in group cognitive walkthrough testing as either school principal recipients or HELM coaches. Both user types rated the strategy as acceptable (principal M = 77.8, SD = 15.5; coach M = 87.5, SD = 7.9). Five usability issues were identified using a highly structured common usability issue framework and provided direction for the generation of redesign solutions to be incorporated in a subsequent version of the HELM strategy. The evaluation of the strategy’s usability improved its alignment with user needs, expectations, and contextual constraints, rendering a more usable strategy and broadly applicable information surrounding the development of psychosocial implementation strategies in real-world settings.

Current State and Trends of Openness of the Ukrainian Economy

The essence of openness of the economy as an object of theoretical study based on the analysis of publications and research of domestic and foreign scientists is explored in the article. On that basis, the authors give their interpretation of the concept. It is noted that the consistent expansion of economic openness is an important factor in modern economic development. Four groups of the division of national economies by the criterion of openness, namely by the share of exports in the country's GDP, are considered. The main conditions of an open economy are highlighted and the main tools (economic and political) with which it is possible to achieve the expansion of economic openness are given.
 An assessment of the current state and trends of openness of the national economy, based on the analysis of the main indicators of exports and imports of goods and services, as well as the geographical structure of Ukraine's foreign trade by recipient countries and donor countries of goods and services, has been made. It was found that in the current conditions of socio-economic instability, the openness of Ukraine’s economy remains at a fairly high level, which causes its close dependence on changes in external conditions. It is analyzed that the lion's share in the overall structure of Ukraine's foreign trade belongs to goods. The principal recipient countries of Ukrainian goods and services and donor countries in 2020 have been identified. The most common goods and services in the structure of exports and imports of Ukraine are also highlighted. In particular, it is noted that the most common goods for export were products of plant origin, base metals and articles base metals, fats and oils of animal or vegetable origin, and among services - transport services. At the same time, it was determined that the highest volume of imports in the general structure of Ukraine's foreign trade was achieved via machinery, equipment and machinery, electrical equipment and transport services import. It is generalized that the openness of Ukraine's economy is essential for its socio-economic development. Importantly to maximise the use of openness advantages that leads to productivity increasing and adaptation of production to growing competition that in turn is an important factor in improving the overall efficiency of the economy. It is recommended for ensuring the economic development of Ukraine, along with the foreign trade component of economic openness, it is also necessary to develop financial (including investment, technological, communicational) and political components.

Increased activity of the sterol branch of the mevalonate pathway elevates glycosylation of secretory proteins and improves antifungal properties of Trichoderma atroviride

Some Trichoderma spp. have an ability to inhibit proliferation of fungal plant pathogens in the soil. Numerous compounds with a proven antifungal activity are synthesized via the terpene pathway.Here, we stimulated the activity of the mevalonate pathway in T. atroviride P1 by expressing the Saccharomyces cerevisiae ERG20 gene coding for farnesyl pyrophosphate (FPP) synthase, a key enzyme of this pathway. ERG20-expressing Trichoderma strains showed higher activities of FPP synthase and squalene synthase, the principal recipient of FPP in the mevalonate pathway.We also observed activation of dolichyl phosphate mannose (DPM) synthase, an enzyme in protein glycosylation, and significantly increased O- and N-glycosylation of secreted proteins. The hyper-glycosylation of secretory hydrolases could explain their increased activity observed in the ERG20 transformants.Analysis of the antifungal properties of the new strains revealed that the hydrolases secreted by the transformants inhibited growth of a plant pathogen, Pythium ultimum more efficiently compared to the control strain. Consequently, the biocontrol activity of the transgenic strains, determined as their ability to protect bean seeds and seedlings against harmful action of P. ultimum, was also improved substantially.

Caveolin-1 selectively regulates microRNA sorting into microvesicles after noxious stimuli.

Emerging evidence suggests that extracellular vesicle (EV)-containing miRNAs mediate intercellular communications in response to noxious stimuli. It remains unclear how a cell selectively sorts the cellular miRNAs into EVs. We report that caveolin-1 (cav-1) is essential for sorting of selected miRNAs into microvesicles (MVs), a main type of EVs generated by outward budding of the plasma membrane. We found that cav-1 tyrosine 14 (Y14)-phosphorylation leads to interactions between cav-1 and hnRNPA2B1, an RNA-binding protein. The cav-1/hnRNPA2B1 complex subsequently traffics together into MVs. Oxidative stress induces O-GlcNAcylation of hnRNPA2B1, resulting in a robustly altered hnRNPA2B1-bound miRNA repertoire. Notably, cav-1 pY14 also promotes hnRNPA2B1 O-GlcNAcylation. Functionally, macrophages serve as the principal recipient of epithelial MVs in the lung. MV-containing cav-1/hnRNPA2B1 complex-bound miR-17/93 activate tissue macrophages. Collectively, cav-1 is the first identified membranous protein that directly guides RNA-binding protein into EVs. Our work delineates a novel mechanism by which oxidative stress compels epithelial cells to package and secrete specific miRNAs and elicits an innate immune response.

Региональная инновационная система как инструмент опережающего социально-экономического развития Дальнего Востока России

<span>Опережающий рост производства валового регионального продукта в Дальневосточном макрорегионе не приводит к ожидаемому улучшению социально-демографических показателей. Рост производства добавленной стоимости является результатом работы главным образом сырьевых отраслей, а не высокотехнологичных обрабатывающих. В динамике развития воспроизводственных секторов: инновационно-инвестиционного, потребительского, инфраструктурного и энергосырьевого наблюдается существенный дисбаланс в пользу последнего. Сырьевые отрасли являются основным реципиентом инвестиций, но не создают дополнительных рабочих мест. В результате применяемые меры проведения государственной социально-экономической политики не дают ожидаемого результата, исполнение правительственных планов по стабилизации и росту численности населения оказывается под угрозой срыва. В качестве метода решения проблемы предлагается переход к современному варианту государственной региональной политики на основе идей поляризованного развития</span><span class="myHorizontalScaleForEmDashSpaceBefore"> </span><span>–</span><span class="myHorizontalScaleForEmDashSpaceAfter"> </span><span>концепции региональной инновационной системы. Приведена оценка эффективности её практического применения в Дальневосточном регионе. Предлагаемые институциональные изменения позволят улучшить социально-экономическую ситуацию и начать переход к инновационному типу воспроизводства в макрорегионе.</span>

Promising potentials of Tibetan macaques in xenotransplantation.

Organ transplantation is a crucial medical procedure, as it is often the only treatment for patients suffering from end-stage organ failure. Unfortunately, the shortage of donor organs limits the number of patients whose lives can be saved. Carrying out research on xenotransplantation with the aim of eventually replacing human organ transplants with those of animals is very promising, as it could effectively bridge the shortfall in donor organs. Thanks to the success of cloned pigs and to the emergence of gene-editing techniques, genetically modified pigs have come to be considered ideal animal donors for human xenotransplantation and have been widely used in basic research. Such research focuses on pig-to-nonhuman primates transplantation, as the recipients are suitable for preclinical studies because both their genes and organ sizes are similar to those of humans. Chinese transplantation scientists have carried out several experiments on Tibetan macaques, including successful preclinical transplants of material from genetically modified pigs, as well as research on such topics as intraocular pressure, Parkinson's disease, advanced cancer, islet transplantation, and liver transplantation. This article reviews basic and applied research on Tibetan macaques in xenotransplantation, as well as the issues of immune rejection and ethical concerns. We aim to demonstrate the various advantages of Tibetan macaques as transplant recipients compared to other nonhuman primate species and to provide a perspective for the future establishment of Tibetan macaques as principal recipients in preclinical studies of xenotransplantation.

A social systems analysis of implementation of El Salvador\u2019s national HIV combination prevention: a research agenda for evaluating Global Health Initiatives

BackgroundGlobal Health Initiatives (GHIs) have been instrumental in the rapid acceleration of HIV prevention, treatment access, and availability of care and support services for people living with HIV (PLH) in low and middle income countries (LMIC). These efforts have increasingly used combination prevention approaches that include biomedical, behavioral, social and structural interventions to reduce HIV incidence. However, little research has evaluated their implementation. We report results of qualitative research to examine the implementation of a national HIV combination prevention strategy in El Salvador funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria.MethodsWe conducted in-depth interviews with principal recipients of the funding, members of the Country Coordinating Mechanism (CCM) and front line peer outreach workers and their clients. We analyzed the data using a dynamic systems framework.ResultsEl Salvador’s national HIV combination prevention strategy had three main goals: 1) to decrease the sexual risk behaviors of men who have sex with men (MSM), commercial sex workers (CSW) and transgender women (TW); 2) to increase HIV testing rates among members of these populations and the proportion of PLH who know their status; and 3) to improve linkage to HIV treatment and adherence to antiretroviral therapy (ART). Intervention components to achieve these goals included peer outreach, community prevention centers and specialized STI/HIV clinics, and new adherence and retention protocols for PLH.In each intervention component, we identified several factors which reinforced or diminished intervention efforts. Factors that negatively affected all intervention activities were an increase in violence in El Salvador during implementation of the strategy, resistance to decentralization, and budget constraints. Factors that affected peer outreach and sexual risk reduction were the human resource capacity of grassroots organizations and conflicts of the national HIV strategy with other organizational missions.ConclusionsOverall, the national strategy improved access to HIV prevention and care through efforts to improve capacity building of grass roots organizations, reduced stigma, and improved coordination among organizations. However, failure to respond to environmental and organizational factors limited the intervention’s potential impact.

Motor and emotional behaviours elicited by electrical stimulation of the human cingulate cortex.

The cingulate cortex is a mosaic of different anatomical fields, whose functional characterization is still a matter of debate. In humans, one method that may provide useful insights on the role of the different cingulate regions, and to tackle the issue of the functional differences between its anterior, middle and posterior subsectors, is intracortical electrical stimulation. While previous reports showed that a variety of integrated behaviours could be elicited by stimulating the midcingulate cortex, little is known about the effects of the electrical stimulation of anterior and posterior cingulate regions. Moreover, the internal arrangement of different behaviours within the midcingulate cortex is still unknown. In the present study, we extended previous stimulation studies by retrospectively analysing all the clinical manifestations induced by intracerebral high frequency electrical stimulation (50 Hz, pulse width: 1 ms, 5 s, current intensity: average intensity of 2.7 ± 0.7 mA, biphasic) of the entire cingulate cortex in a cohort of 329 drug-resistant epileptic patients (1789 stimulation sites) undergoing stereo-electroencephalography for a presurgical evaluation. The large number of patients, on one hand, and the accurate multimodal image-based localization of stereo-electroencephalography electrodes, on the other hand, allowed us to assign specific functional properties to modern anatomical subdivisions of the cingulate cortex. Behavioural or subjective responses were elicited from the 32.3% of all cingulate sites, mainly located in the pregenual and midcingulate regions. We found clear functional differences between the pregenual part of the cingulate cortex, hosting the majority of emotional, interoceptive and autonomic responses, and the anterior midcingulate sector, controlling the majority of all complex motor behaviours. Particularly interesting was the 'actotopic' organization of the anterior midcingulate sector, arranged along the ventro-dorsal axis: (i) whole-body behaviours directed to the extra-personal space, such as getting-up impulses, were elicited ventrally, close to the corpus callosum; (ii) hand actions in the peripersonal space were evoked by the stimulation of the intermediate position; and (iii) body-directed actions were induced by the stimulation of the dorsal branch of the cingulate sulcus. The caudal part of the midcingulate cortex and the posterior cingulate cortex were, in contrast, poorly excitable, and mainly devoted to sensory modalities. In particular, the caudal part of the midcingulate cortex hosted the majority of vestibular responses, while posterior cingulate cortex was the principal recipient of visual effects. We will discuss our data in the light of current controversies on the role of the cingulate cortex in cognition and emotion.

Physicians' self-assessed empathy levels do not correlate with patients' assessments.

BackgroundEmpathy is a fundamental humanistic component of patient care which facilitates efficient and patient-centered clinical encounters. Despite being the principal recipient of physician empathy little work on how patients perceive/report receiving empathy from their physicians has been undertaken. In the context of doctor-patient interactions, knowledge about empathy has mostly originated from physicians’ perspectives and has been developed from studies using self-assessment instruments. In general, self-assessment may not correlate well with the reality observed by others.ObjectivesTo investigate: 1—the relationship between physicians’ self-assessed empathy and patients’ measures of physicians’ empathy; 2 –Environmental factors that could influence patients’ perceptions; and 3 –the correlation between two widely used psychometric scales to measure empathy from the perspective of patients.MethodsThis is an observational study which enrolled 945 patients and 51 physicians from radiology, clinical, and surgical specialties. The physicians completed the Jefferson Scale of Physician Empathy (JSE) and the International Reactivity Index (IRI), and patients completed the Consultation and Relational Empathy scale (CARE), and the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE).ResultsWe did not observe any significant correlation between total self-assessed empathy and patients’ perceptions. We observed a small correlation (r = 0,3, P<0,05) between the sub-dimension Perspective Taking-JSE and JSPPPE. JSPPPE and CARE had a positive and moderate correlation (0,56; p<0,001). Physicians’ gender and sector influenced the JSPPPE score. Sector, medical specialty and the nature of the appointment (initial versus subsequent) influenced the CARE measure.ConclusionsThe lack of correlation between self-assessed empathy levels and patients’ perceptions suggests patients be included in the process of empathy evaluation.Practice implicationsTraining strategies aiming the development of empathy should include patients’ evaluations and perspectives.

From associations to action: mental health and the patient politics of subsidiarity in Scotland

In times of economic hardship public mental healthcare suffers a double disservice. On the one hand, it faces a diminution of existing resource, and on the other, it is met with vastly increased demand. The damage done to already hard-pressed public services during economic crises is often most keenly felt by those at the receiving end of statutory health and welfare provisions. When public services are deemed by its principal recipients to be no longer fit for purpose, it is unsurprising that they, along with others, look to agencies other than the state to meet their needs. In the final year of the 1970s, a decade in which Great Britain became the ‘sick man of Europe’, while Margaret Thatcher moved into 10 Downing Street, a new mental health organisation came into being in Scotland. Glasgow Association for Mental Health (GAMH) and a group of patients’ social clubs called LINK clubs joined to form LINK/GAMH. In a climate of great social and economic upheaval during the 1980s, LINK/GAMH received substantial Urban Aid funding to support those suffering from mental illness. Motivated by principles of voluntary association, self-help and mutual aid, LINK/GAMH sought to ‘cater for needs, and encourage aspirations, which are not and perhaps should not be met, or promoted by Statutory Welfare Agencies’. This article examines how the relationship between socioeconomic factors and mental health was understood by LINK/GAMH and how this informed the development of a resource centre, a rehabilitation programme and political campaigning by psychiatric patients. By focusing upon the activities of LINK/GAMH in the 1970s and 1980s, drawing on archival evidence and oral testimony, it will be argued that the concepts of solidarity and subsidiarity were embedded in the practices of patient associations. This study will show that through the development of relationships of solidarity and subsidiarity, across local, national and international boundaries, patient associations such as LINK/GAMH and their allies redefined a normative conception of the ‘sick role’, reclaiming civic selfhood and political agency for psychiatric patients.

Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC

Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Global fund in DRC with around 40000 people living with HIV/AIDS (PLWHIV) receiving ART in 129 health zones in the country. The continuous success of ART critically depends on sustained ART adherence. The objective of this study was to identify the determinants of adherence among PLWHIV in SANRU managed health zones in the Democratic Republic of Congo. Two thousand five hundred eighty-six PLWHIV’s files were extracted. Eighty-two percent (82%) were adherent to ART, while 85. 5% were alive after 12 months on anti-retroviral treatment, 5.2% were lost from follow-up and 2.2% were transferred. The average age was 37 years, and predominantly women formed 65.5% of the sample. The median distance between facilities and patient’s habitat was 5 kms. Close to three-fifth of the PLWHIV were living in urban settings (64.4%). Among 2586 patient’s files retrieved, 2495 (96, 5%) were followed up in facilities with at least an HIV-care trained physician and nurses, 1566 (60.6%) were followed up in facilities with at least one HIV care trained pharmacist; 1645 (63.6%) among the PLWHIV did not report ART stock run-outs. These findings highlight the relevance of healthcare providers’ training on HIV to improve HIV patient outcomes.

Community-Based Counterterrorism Policing: Recommendations for Practitioners

ABSTRACTThis article presents recommendations for practitioners of community-based counterterrorism policing. The recommendations are located and explained within two broad propositions: recognize the implications and limitations of policing by consent, and respect the legitimate religious beliefs of all communities. Highlighting tensions between high and low policing and between policing and government imperatives, the article helps illustrate how different aspects of counterterrorism policy and practice may sometimes be at odds with one another. The recommendations are aimed at recognizing and, where practicable, reconciling such tensions. They arise from the authors' engagement with the issues in London and are understood to have application in other towns and cities in the United Kingdom and the West, particularly in communities and neighborhoods where Muslim citizens are the principal recipients of this form of policing.

Partners or donors: The perceived roles of Global Fund Principal Recipient NGOs in HIV prevention programmes in Ukraine

Ukraine has one of Europe's fastest growing HIV rates and in 2003–2012 was one of the largest recipients of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF). Doctoral research recently completed by the author investigates the conduct and practice of international and national nongovernmental organisations (NGOs) as Principal Recipients (PRs) of GF grants in Ukraine from 2003 to 2012. An ethnographic enquiry including 50 participant interviews was conducted in three oblasts in Ukraine, and in its capital, Kyiv. The paper presents some of the findings that emerged from the analysis. Discussing the PR NGOs roles and practices in delivering HIV prevention programmes funded by GF, the author argues that the anticipated benefits of NGO partnerships between PR NGOs and their Sub-Recipients (SRs) have not been achieved. Rather, PRs acted as donors and ran highly discretionary policies in channelling GF funding to SRs that installed competition and vertical relations between NGO-grantors and NGO-grantees. The outcome was a servile civil society that is dependent on external funding and is unable to genuinely represent their communities. With an anticipated GF phasing out from Ukraine, there is a critical lack of advocacy potential of the civil society to articulate and defend the needs of PLHIV when transferring HIV services into state funding.

Capacity and readiness of civil society organisations to implement community case management of malaria in Kenya.

IntroductionCivil Society Organizations (CSOs) contribute to achieving development goals through advocacy, social mobilisation and provision of health services. CSO programming is a key component of Global Fund (GF) grants; however, CSOs face technical and governance capacity challenges in grant utilisation leading to missed opportunities for improving health at community level. Amref Health Africa was appointed Principal Recipient of a GF grant aimed at scaling up community case management of malaria through CSOs as sub-recipients in western Kenya. To identify potential risks and strengthen grant management, Amref Health Africa and the Ministry of Health conducted a capacity needs assessment to determine the capacity of CSOs to effectively utilise grants.Methods26 selected CSOs participated in this study. Document reviews and on-site assessments and observations were conducted using structured tool. The five main assessment areas were: governance and risk management; strategic and operational planning; monitoring and evaluation; programme management; and financial management. Overall performance was grouped into four categories: 3.0-2.5 (excellent), 2.0-2.4 (good), 1.5-1.9 (fair), and 1.0-1.4 (poor). Data were collected and analysed using Excel software.ResultsTwenty five out of 26 CSOs were legally compliant. 14(54%) CSOs were categorized as good; 7(27%) as excellent; 3(12%) as poor and 2(8%) as fair. Most CSOs had good programme management capacity but monitoring and evaluation presented the most capacity gaps.ConclusionMore than 75% of the CSOs were rated as excellent or good. A capacity building plan, programme risk management plan and oversight mechanisms were important for successful grant implementation.

NGO Hybridisation as an Outcome of HIV Services Delivery in Global Fund-Supported Programmes in Ukraine

Ukraine has one of the world’s fastest growing HIV rates and was one of the largest recipients of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF). Doctoral research recently completed by the author investigates the conduct and practice of international and national nongovernmental organisations (NGOs) as Principal Recipients of GF grants in Ukraine from 2004 to 2012. The study aimed to understand how NGO-based services were implemented in the context of a state-owned health care system. An ethnographic enquiry including 50 participant interviews was conducted in three oblasts in Ukraine, and in its capital, Kyiv, between 2011 and 2013. The paper is based on a doctoral research and presents some of the findings that emerged from the analysis. The author argues that the accent on NGO-run services promoted by GF has rendered the original grass roots, community-based NGOs, to be undermined or replaced by ‘quasi’, hybrid NGOs created by health officials and AIDS centres head doctors. The outcome of such hybridization is a weakened civil society that is dependent on external funding and is unable to genuinely represent their communities.

Progenitors of secondary crest myofibroblasts are developmentally committed in early lung mesoderm.

Development of the mammalian lung is predicated on cross-communications between two highly interactive tissues, the endodermally derived epithelium and the mesodermally derived pulmonary mesenchyme. While much attention has been paid for the lung epithelium, the pulmonary mesenchyme, partly due to lack of specific tractable markers remains under-investigated. The lung mesenchyme is derived from the lateral plate mesoderm and is the principal recipient of Hedgehog (Hh) signaling, a morphogenetic network that regulates multiple aspects of embryonic development. Using the Hh-responsive Gli1-cre(ERT2) mouse line, we identified the mesodermal targets of Hh signaling at various time points during embryonic and postnatal lung development. Cell lineage analysis showed these cells serve as progenitors to contribute to multiple lineages of mesodermally derived differentiated cell types that include parenchymal or interstitial myofibroblasts, peribronchial and perivascular smooth muscle as well as rare populations of cells within the mesothelium. Most importantly, Gli1-cre(ERT2) identified the progenitors of secondary crest myofibroblasts, a hitherto intractable cell type that plays a key role in alveolar formation, a vital process about which little is currently known. Transcriptome analysis of Hh-targeted progenitor cells transitioning from the pseudoglandular to the saccular phase of lung development revealed important modulations of key signaling pathways. Among these, there was significant downregulation of canonical WNT signaling. Ectopic stabilization of β-catenin via inactivation of Apc by Gli1-cre(ERT2) expanded the Hh-targeted progenitor pools, which caused the formation of fibroblastic masses within the lung parenchyma. The Gli1-cre(ERT2) mouse line represents a novel tool in the analysis of mesenchymal cell biology and alveolar formation during lung development.

Implementing Global Fund programs: a survey of opinions and experiences of the Principal Recipients across 69 countries

BackgroundPrincipal Recipients (PRs) receive money from the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) to manage and implement programs. However, little research has gone into understanding their opinions and experiences. This survey set out to describe these, thereby providing a baseline against which changes in PR opinions and experiences can be assessed as the recently introduced new funding model is rolled out.MethodologyAn internet based questionnaire was administered to 315 PRs. A total of 115 responded from 69 countries in Africa, Asia, Eastern Europe and Latin America. The study was conducted between September and December 2012.FindingsThree quarters of PRs thought the progress update and disbursement request (PU/DR) system was a useful method of reporting grant progress. However, most felt that the grant negotiation processes were complicated, and that the grant rating system did not reflect performance.While nearly all PRs were happy with the work being done by sub-Recipients (92%) and Fund Portfolio Managers (86%), fewer were happy with the Office of the Inspector General (OIG). Non-government PRs were generally less happy with the OIG’s work compared to government PRs.Most PRs thought the Global Fund’s Voluntary Pooled Procurement system made procurement easier. However, only 29% said the system should be made compulsory.When asked which aspects of the Global Fund’s operations needed improvement, most PRs said that the Fund should re-define and clarify the roles of different actors, minimize staff turnover at its Secretariat, and shorten the grant application and approval processes. All these are currently being addressed, either directly or indirectly, under a new funding model. Vigorous assessments should nonetheless follow the roll-out of the new model to ensure the areas that are most likely to affect PR performance realize sustained improvement.ConclusionsOpinions and experiences with the Global Fund were varied, with PRs having good communication with Fund Portfolio Managers and sub-Recipients, but being unhappy with the grant negotiation and grant rating systems. Recommendations included simplifying grant processes, finding performance assessment methods that look beyond numbers, and employing Local Fund Agents who understand public health aspects of programs.

The Macroeconomic Consequences of Remittances

This paper examines two important channels which influence the dynamic absorption of remittances at the macroeconomic level: (i) the presence of borrowing constraints, and (ii) the distribution of remittances across recipient households. Using an open economy DSGE model with heterogeneous households, we show that remittances accruing to hand-to-mouth households (with no capital ownership or access to credit markets) generate a dynamic response that is inherently contractionary for the recipient economy. On the other hand, credit-constrained households with ownership of capital respond in a way that is inherently expansionary, when they are the principal recipients. The ability of countercyclical remittances to smooth business cycle shocks also depends critically on their distribution across households. We use data for Philippines to calibrate the internal distribution of remittances, and show that this calibrated distribution and the presence of binding credit constraints play an important role in improving the model's fit to the data. The welfare consequences of the distribution of remittances are also analyzed.

Thailand’s HIV/AIDS program after weaning-off the global fund’s support

Background Although the number of smokers has declined in the last decade, smoking is still a major health problem among youngsters and adolescents. For this reason, there is a need for effective smoking prevention programmes targeting primary school children. A web-based computer-tailored feedback programme may be an effective intervention to stimulate youngsters not to start smoking, and increase their knowledge about the adverse effects of smoking and their attitudes and self-efficacy regarding non-smoking. Methods & Design This paper describes the development and evaluation protocol of a web-based out-of-school smoking prevention programme for primary school children (age 10-13 years) entitled 'Fun without Smokes'. It is a transformation of a postal mailed intervention to a web-based intervention. Besides this transformation the effects of prompts will be examined. This web-based intervention will be evaluated in a 2-year cluster randomised controlled trial (c-RCT) with three study arms. An intervention and intervention + prompt condition will be evaluated for effects on smoking behaviour, compared with a no information control condition. Information about pupils' smoking status and other factors related to smoking will be obtained using a web-based questionnaire. After completing the questionnaire pupils in both intervention conditions will receive three computer-tailored feedback letters in their personal e-mail box. Attitudes, social influences and self-efficacy expectations will be the content of these personalised feedback letters. Pupils in the intervention + prompt condition will - in addition to the personalised feedback letters - receive e-mail and SMS messages prompting them to revisit the 'Fun without Smokes' website. The main outcome measures will be ever smoking and the utilisation of the 'Fun without Smokes' website. Measurements will be carried out at baseline, 12 months and 24 months of follow-up. Discussion The present study protocol describes the purpose, intervention design and study protocol of 'Fun without Smokes'. Expectations are that pupils receiving tailored advice will be less likely to smoke after 24 months in contrast to pupils in the control condition. Furthermore, tailored feedback letters and prompting is expected to be more effective than providing tailored feedback letters only. Trial Registration Dutch Trial Register NTR3116