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Trachoma, caused by repeated ocular infection with Chlamydia trachomatis (Ct), is targeted for elimination as a public health problem. Serological testing for antibodies is promising for surveillance; determining useful thresholds will require collection of serological data from settings with different prevalence of the indicator trachomatous inflammation—follicular (TF). Dried blood spots were collected during trachoma mapping in two districts each of Togo and Democratic Republic of the Congo. Anti-Ct antibodies were detected by multiplex bead assay (MBA) and three different lateral flow assays (LFA) and seroprevalence and seroconversion rate (SCR) were determined. By most tests, the district with > 5% TF (the elimination threshold) had five–sixfold higher seroprevalence and tenfold higher SCR than districts with

Brick-manufacturing is an intensive water-consuming industry that requires a sustainable and integrated water management strategy to reduce reliance on freshwater consumption. This study aims to develop a rigorous analytical tool based on water footprint principles and water pinch analysis techniques that can be used to manage and optimise water consumption. By performing thorough water audits, the water consumption footprint (the sum of blue and green water footprints) and the theoretical water pollution footprint (grey water footprint) were quantified. The total water consumption footprint of a brick is determined as 2.02 L, of which blue water is identified as 1.71 L (84.8%) and green water as 0.31 L (15.2%). The theoretical grey water footprint of a brick was found to be 1.3 L, a value that would have been higher if in-situ wastewater treatment had not been operated before effluent discharge. In order to reduce the water footprint of a brick, water pinch analysis techniques were applied for the brick-manufacturing processes. Two water recovery schemes were explored, i.e. direct re-use/recycle and water regeneration. For the former, water targeting was first carried out using the material recovery pinch diagram. Next, an algebraic technique was utilised for the targeting of water regeneration, where an interception unit is used to partially purify the water sources for further re-use/recycle. The network that fulfils the water flow rate targets was then designed using the nearest neighbour algorithm. The calculation indicates that direct re-use/recycle scheme reduces with the standard water consumption footprint reduced only by 15.6%. Water regeneration scheme, on the other hand improved the current value (which relies on an unsystematic water regeneration scheme) by 56.4%. The analysis clearly shows that the water consumption footprint of a brick is improved when the brick-manufacturing industry operates sustainable water management strategies. This study, a first of its kind, demonstrates that integration of water pinch analysis coupled with water footprint concepts, provides a robust and effective tool for the manufacturing industries that aim for sustainable water consumption.

Private organizations are deeply entrenched in fulfi lling the responsibilities of government through the provision of public services. In this context, we must question the conceptual coherence of drawing sharp distinctions between public and private functions. In YL v Birmingham City Council, however, the House of Lords had to determine which of the various functions contracted out by public authorities retain their public character for the purposes of the United Kingdom’s Human Rights Act 1998. This article analyzes the complex public/private division set up by the Human Rights Act and argues that the decision of the House of Lords has led to a gap in human rights protection and has weakened public accountability. Public functions and services traditionally carried out by public entities have been transferred increasingly to the private sector. 1 In the United Kingdom, policies such as privatization, outsourcing, and public/private projects under the Private Finance Initiative 2 have altered dramatically the way in which public services are delivered. Although these policies cover a variety of activities and varying arrangements, they typically share three features: the transfer of public functions, with the associated delivery risk, to private entities; the use of market-style competition to select the supplier; and a shift in the measurement of performance — from a concern with process to the achievements of outputs. “ Internal markets ” have been introduced into the provision of such fundamental public services as health and education, organized around a separation between “ purchasers ” and “ providers ” and governed by sophisticated commercial contracts. 3 Prisons and immigration centers are managed by

only against public authorities.2 The issue of whether a body is a public authority has proved highly controversial. The hiving-off of many traditional governmental functions through policies such as privatisation, outsourcing and projects under the Private Finanace Initiative (PFI) has led to a blurring of the traditionally understood publicprivate distinction.3 The changed nature in the way that public services are delivered has led to sharply divergent views among the judiciary about which functions are those of a public nature for the purposes of the Human Rights Act. This is evident in the YL judgment itself: a split decision, with two dissenting judgements.4 The division in the House reflects different understandings of the operation of the Human Rights Act, the public-private distinction and, perhaps more fundamentally, competing ideological stances. The decision also suggests that the ghost of Dicey still haunts the development of public law in our legal tradition. Dicey's premise that the Rule of Law admits of no separation between public and private law and that all people were subject to the ordinary laws of the realm inhibited the development of public law.5 The first inkling of change occurred during the 1960's.6 Influenced no doubt by EC and human rights law, gradually the judiciary began to establish substantive public law rules and principles. It is ironic that just as public law became more established and effective in the control of government power, the state began to shrink and the pattern of government to change. The transformation of the delivery of public services poses a serious threat to public law values, to ensuring public accountability and to the

Disrupted sleep is considered a patient outcome sensitive to oncology nursing care and can lead to a variety of physical and psychologic dysfunctions, such as insomnia, chronic pain, respiratory distress, obesity, stress, and anxiety. Although sleep disturbances have been studied in recipients of hematopoietic stem cell transplantations (HSCTs), these studies have not examined the acute phase of transplantation. The current study aimed to identify the level of sleep disturbance in this patient population, identify factors contributing to decreased ability to sleep for hospitalized recipients of HSCT, and compare the differences in sleep disturbance between age, gender, type of transplantation, and initial stem cell transplantation versus readmission for transplantation-associated complications. Among the 69 patients studied, 26% reported clinical insomnia, as measured by the Insomnia Severity Index, and 74% had some degree of insomnia. Patient characteristics were not significantly associated with insomnia scores. Patients reported bathroom use as the most frequent reason for sleep disruption (85%). These findings suggest that sleep disturbances are common in hospitalized patients undergoing HSCT, and strategies to reduce disruptions are needed to improve patient outcomes.