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Robust evidence is lacking for community initiatives to prevent first presentation acute rheumatic fever (ARF) by group A streptococcal (GAS) pharyngitis treatment.We measured the effect of introducing a sore throat clinic program on first presentation ARF into 61-year 1-8 schools with students 5-13 years of age (population ≈25,000) in Auckland, New Zealand. The study period was 2010-2016. A generalized linear mixed model investigated ARF rate changes before and after the staggered introduction of school clinics. Nurses and lay workers treated culture-proven GAS sore throats (including siblings) with 10 days of amoxicillin. ARF cases were identified from a population-based secondary prophylaxis register. Annual pharyngeal GAS prevalence was assessed in a subset.ARF rates in 5-13 year olds dropped from 88 [95% confidence interval (CI): 79-111] per 100,000 preclinics to 37 (95% CI: 15-83) per 100,000 after 2 years of clinic availability, a 58% reduction. No change in rate was demonstrated before the introduction of clinics [P = 0.88; incidence risk ratio for a 1-year change: 0.98 (95% CI: 0.63-1.52)], but there was a significant decrease of first presentation ARF rates with time after the introduction of the sore throat program [P = 0.008; incidence risk ratio: 0.61 (95% CI: 0.43-0.88)]. Pharyngeal GAS cross-sectional prevalence fell from 22.4% (16.5-30.5) preintervention to 11.9% (8.6-16.5) and 11.4% (8.2-15.7) 1 or 2 years later (P = 0.005).ARF declined significantly after school-based GAS pharyngitis management using oral amoxicillin paralleled by a decline in pharyngeal GAS prevalence.

Purpose The purpose of this paper is twofold: primary, to argue that the profits method, specifically a discounted cash flow (DCF)-based profits method, should be the preferred method of valuation when valuing specialised property. Secondary, to make technical recommendations in the application of the method. Design/methodology/approach Literature was reviewed on the theory of the profits method as well as physical valuations performed in practice. Improvements for the profits method are suggested from the review of six valuations conducted in South Africa in the specialised property sectors. A qualitative approach is followed in the research as broad principles are extracted from the valuation reports as implications and improvements for the profits method. Findings The profits method is more flexible and sophisticated than the cost approach in taking into account systematic and unsystematic risk. The profits method is more accurate than the cost approach in delivering a true reflection of the value of specialised property for any purpose but specifically for mortgage lending purposes and reduces the credit exposure risk of financial institutions. It also decreases pricing inefficiencies to be exploited by buyers and sellers. Practical implications Three improvements to the profits method are suggested. First, revenue could be forecasted based on a probability-weighted approach. Second, a modified capitalisation rate is suggested to the capitalisation rate formula in the calculation of G. Third, a market rental aggregation anchoring and judgement-based approach is suggested as rationale for determining the hypothetical rental split. Originality/value There seems to be a general lack in literature on the profits method of valuation and its application to specialised properties, specifically a DCF-based approach, with this paper being a technical contribution to the body of knowledge on this topic.

In February 2011, aBundesgerichtshof[BGH—Federal Court of Justice] decision caused a great media echo. The court convicted Germany's largest bank to pay about half a million Euros in damages for the breach of advisory duties. In the aftermath of the financial crisis, banking law evolved fast in German courts. The recent decision raises new questions concerning the advisory duties of a bank, when offering financial products to its clients. The article gives an insight to various factual backgrounds, which, as financial products of today, are somewhat complex. Another interesting aspect to this case is that there are numerous decisions of lower courts that dealt with the same product as the BGH did. The ruling is considered to be far-reaching and groundbreaking. This case note will look into the question how far this is true.

Indonesia is not often considered a state where security management is well conducted. The dominant perception appears to be that law enforcement and security institutions cooperate poorly. In part, this trend is informed by academic works on the past behaviour of security forces in some of Indonesia's troubled areas, like Ambon, Papua and Central Sulawesi, to name a few. (1) Some authors argue that in these cases, unclear boundaries of jurisdiction and poor internal command and control, frustrated efforts to coordinate security forces. However, we can perhaps question whether conflict zones provide a sound basis for our impressions of the relationships among police and military forces. Much of the best evidence that demonstrates poor inter-institutional cooperation occurs in the years after 1998, at a time of acute crisis in Indonesia and in the institutions themselves. This fact prompts us to consider how state security actors interact today when managing security problems. Scholars contributing to the debate about security sector reform in Indonesia have offered potential explanations for why Indonesia's police and military forces do not interact well. Part of the security sector reform literature has discussed the problem of "grey areas" or a supposed lack of clarity in the job descriptions of the police and the Indonesian military. The literature also identifies another potential problem with the high autonomy between security and law enforcement actors. To the contrary however, this article finds that while agencies at the sub-national level are indeed highly autonomous, autonomy does not vitiate inter-institutional cooperation. In the case studies examined government security actors also respect one another's jurisdictional boundaries. Where inter-institutional cooperation does take place, regional government plays an important role as a facilitator. Regional government is able to use mechanisms under its own authority (particularly joint agency committees) to involve national government agencies in resolving local problems. This system in turn depends on broad consensus over the job descriptions of the different actors. Accordingly, the Indonesian police are the lead agency in combating most threats to order and stability. The police possess statutory and normative supremacy, while the military and regional government act to back up the police. This article outlines the relations between the three law enforcement and security actors--the National Police (Polri), regional government and its own law enforcement agents, the Polisi Pamong Praja or civil service police (Pol.PP) and the territorial units of the Indonesian military (TNI)--in three district case studies in Yogyakarta. These districts are Sleman, the city municipality of Yogyakarta and Bantul. This article begins with an examination of the historical development of these institutions, highlighting in particular the integration and separation of the police from the Indonesian military. This history provides a basis for understanding how the police have become the lead agency in managing security today. We then review some of the reasons for the widespread perception that security institutions in Indonesia have problematic relations. Finally we examine the data from the case studies that outlines the existence of inter-institutional, cooperation. It is acknowledged, however, that this article is not the last word on the behaviour of security and law enforcement agencies in Indonesia. Other sources have investigated many negative practices perpetrated by such actors, ranging from corruption to abuses of human rights. This article does not, for example, touch on one of the other probing questions on the topic--competition in the black economy--as this is something rarely seen in the case studies. The purpose of this article therefore is not to deny the existence of serious misdeeds by security actors. Rather this article seeks to focus on one specific part of the picture: how state security actors inter-relate in managing security. …

Throughout the world, particularly in colonized countries, the health status of indigenous people and the unequal representation of indigenous people within the health workforce is of concern. In 2002, as part of a national health workforce development strategy, a qualification was developed to provide Maori (Indigenous New Zealander) health professionals with the skills and confidence to teach and supervise students on clinical placements in Maori health environments. This project required close collaboration between two education providers, one a Maori private education provider and the other a traditional government-funded tertiary institution; and for both organizations to work cooperatively with Maori communities and Maori health providers. The Christchurch College of Education (CCE) and Mauri Ora Associates are jointly involved in the administration, design and delivery of the programme, recruitment of guest lecturers, and ongoing curriculum updates. The content for the programme is mainstream, international and interprofessional but the pedagogy is Maori, with Maori customs, values and traditions upheld and practised. A national Maori health workforce development organization contracts independently with both organizations and provides an oversight and quality monitoring role. Together, the three organizations work with other Maori health professional groups and Maori elders to deliver the qualification. This paper describes how this course was designed, how it is delivered within a Maori paradigm, and how the outcomes are achieved. It also describes the cooperation between Maori and Pakeha (white New Zealanders) across health, community and educational organizations that was required to sustain this programme over five years and identifies some themes that may be applied in a global context. In sharing our experiences, we hope to inspire others to consider ways they can meet the needs of indigenous learners within their mainstream programmes.

Engineers, renowned for poor communications skills, can become effective public speakers by following a rational sequence of problem solving techniques. Engineers have a head start in public speaking because they are already considered among the most credible and trustworthy professionals. They can capitalize on their advantage by learning how to present information in a clear and logical sequence, then learning how to use listening techniques to understand and answer questions from an audience. Audiences vary, and speakers must understand the different presentational styles needed for the media, political officials, professional peers and civic groups. Body language and humor also help convey a speaker’s message; used appropriately, they can diffuse or even prevent difficult situations.