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Objective To conduct a systematic review of the effectiveness of facial exercise therapy for facial palsy patients, updating an earlier broader Cochrane review; and to provide evidence to inform the development of telerehabilitation for these patients. Data Sources MEDLINE, EMBASE, CINAHL, Cochrane Library, PEDro and AMED for relevant studies published between 01 January 2011 and 30 September 2020. Methods Predetermined inclusion/exclusion criteria were utilised to shortlist abstracts. Two reviewers independently appraised articles, systematically extracted data and assessed the quality of individual studies and reviews (using GRADE and AMSTAR-2, respectively). Thematic analysis used for evidence synthesis; no quantitative meta-analysis conducted. The review was registered with PROSPERO (CRD42017073067). Results Seven new randomised controlled trials, nine observational studies, and three quasi-experimental or pilot studies were identified ( n = 854 participants). 75% utilised validated measures to record changes in facial function and/or patient-rated outcomes. High-quality trials (4/7) all reported positive impacts; as did observational studies rated as high/moderate quality (3/9). The benefit of therapy at different time points post-onset and for cases of varying clinical severity is discussed. Differences in study design prevented data pooling to strengthen estimates of therapy effects. Six new review articles identified were all rated critically low quality. Conclusion The findings of this targeted review reinforce those of the earlier more general Cochrane review. New research studies strengthen previous conclusions about the benefits of facial exercise therapy early in recovery and add to evidence of the value in chronic cases. Further standardisation of study design/outcome measures and evaluation of cost-effectiveness are recommended.

Background Error detection and analysis alone cannot create or sustain a culture of safe, high-quality, compassionate care for patients. Some experts have endorsed a unit-based approach to improving quality, but there are few examples and those rarely focus on reducing all preventable harms and engaging frontline clinicians, patients, and families. Approach: We implemented a unit-based approach comprising seven building blocks for creating a comprehensive approach to detect and prevent harm at the unit level within a hospital: (1) unit quality council and stakeholder buy-in, (2) parent engagement and advisory council, (3) frontline clinician and parent quality improvement training, (4) measurement of organizational contextual factors, (5) electronic health record trigger development and synthesis of harm measures, (6) subcommittees to review harm, and (7) quality improvement teams. Challenges and Lessons Learned: Challenges include conceptualizing triggers for a unit unfamiliar with this methodology, establishing unit resources for collecting and analyzing data, and creating processes to integrate parents in unit quality efforts. The seven essential building blocks helped overcome these challenges and could be adopted by other healthcare organizations. Conclusion These building blocks create a generalizable foundation for establishing a unit-based approach to detecting and preventing harm.

The global economy has been transformed dramatically in the period following the demise of the Soviet Union. What we now see is a shift from the North to the South, the emergence of Asia, a pace of liberalization that is unprecedented and a recalibration of trade flows that had not been seen earlier. Investments move seamlessly across continents as sentiment shifts happen almost overnight and trace emerging patterns of growth and development. What this has resulted in is a pressure on the services sector, more importantly on the knowledge economy to provide the human resource required in this changed world. With the manufacturing sector changed beyond recognition, with transportation and communication getting revolutionized and a services sector that does not respect legacy and tradition, the world demands a rethinking in skilling and training. How has the academic community responded to these challenges? What is it about globalization that needs to be examined and taught? What do global managers need to ...

Millions of households are pushed into poverty every year because of high out-of-pocket (OOP) expenditure on health care. Globally, each year more than 150 million people face financial catastrophe and around 100 million suffer destitution due to OOP payments made for health care. More than 90 per cent of these people reside in low-income countries. In South Asia, impoverishment due to health payments is significant with at least 32 million people in India alone being pushed into poverty annually due to OOP expenditures on health care. In most health care systems in this region, the role of public spending on health and prepaid schemes, such as tax and social insurance, is limited as is the extent of financial risk protection. The problem is compounded by the large informal sector which is a major challenge to attaining universal health coverage in South Asian countries. Recent literature points to the role of public–private partnerships (PPP) in health care as a viable solution for ensuring equitable access to health care especially for the poor. This article seeks to review the major components of health care financing and reform including financial risk protection, resource generation and pooling, and PPPs in procurement and payment in South Asia. It identifies key lessons across the health financing systems of Asian countries that have attempted to reduce dependence on OOP expenditures, expanded health service delivery and increased pooled health financing mechanisms. It analyses the role and importance of PPPs in mitigating the impoverishing effects of OOP health expenditure in South Asia.

International audience; Early detection of leakages in hydraulic infrastructures is important to ensure their safety and security. Significant flow of water through the dike can be an indicator of internal erosion and results in a thermal anomaly. Temperature measurements are therefore capable of revealing information linked to leakage. Optical fiber-based distributed temperature sensors present an economically viable and reliable solution for recording spatio-temporal temperature data over long distances, with spatial and temperature resolutions of 1m and 0.05 C, respectively. The acquired data are influenced by several factors, among them water leakages, heat transfer through the above soil depth, seasonal thermal variations, and the geomechanical environment. Soil properties such as permeability alter the acquired signal locally. This article presents leakage detection methods based on signal processing of the raw temperature data from optical fiber sensors. The first approach based on source separation identifies leakages by separating them from the non-relevant information. The second approach presents a potential alarm system based on the analysis of daily temperature variations. Successful detection results for simulated as well as real experimental setups of Electricité de France are presented.

The second-generation reforms in India are ones where the focus shifts to a large extent from the Centre to the States. All big infrastructural areas and important subjects like land, labour and agriculture are state issues, just as health and education are. It is important indeed to highlight that in the reform process in India, the main protagonist has been the Central Government. However, going forward, apart from issues related to competition, foreign direct investment and the broad functioning of the legal system, almost all other issues that this article discusses fall squarely on the shoulders of state governments. Building constituencies for reform in states, with entrenched interest groups and smaller constituencies, is certainly going to be more difficult than it has been to push for reform at the centre. However, if inclusive growth is important, rural development critical and agriculture growth crucial, it stands to reason that the unfinished business of India’s reforms must be carried on at state capitals. The process seems to have begun, as states compete increasingly for investments and not any longer for central subsidies and grants.

The recent economic downturn and the ensuing reordering of the global economic order has underlined beyond doubt the value of innovation in driving sustained growth. India now is firmly established as a player in the knowledge economy. Since the economic reforms began nearly two decades ago, the Indian economy has been undergoing an important transition—from a closed to an open one; to one where knowledge-based production of goods and services is commanding a significant portion of the output. India has also moved away from a static economy that was characterised by a status quo-ist government control to one where economic liberalism is the driving force, and one where innovation in products, processes, technologies and systems is critical for the profitable sustenance of productive entities. This structural transformation of the Indian economy is the result of many factors, and each has involved the interplay of international forces, influences, domestic abilities and efforts. The role of government, domestic industry, international firms, research institutions, non-government organisations, and, of course, private individuals has changed significantly in the past few years, and one expects this to continue in the future. The direction is towards lower government command and control in all sectors and the greater role of the market-place in creating the right set of incentives. All this is in the context of an economy that is becoming more and more integrated with the international economy, and where free movement of knowledge and technology goes hand in hand with the flow of financial and human capital. This article aims to look at the role that intellectual property rights play in promoting innovation and driving growth in the knowledge economy.

Labour market efficiency is often a function of the degree to which labour is mobile and the market flexible. In India labour markets are integrated but continue to be rigid on account of the legal system that has traditionally viewed labour markets as skewed in favour of employers. Labour dispute resolution, trade union laws, minimum wage stipulations and other laws have ensured that labour often is over protected. This article looks at how existing labour law plays its part in making labour markets less than efficient.