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This paper examines the role of participation, co-production and community management in a random sample of 50 rural and urban water systems under the Water and Sanitation Extension Programme (WASEP) in Gilgit-Baltistan, Pakistan. It looks at the role of an NGO (the Aga Khan Agency for Habitat) in co-production, and how this model of community-based water management (CBWM) contributes to the discussion in the literature. Specifically, the paper considers whether the largely rural WASEP model can be successfully scaled up and scaled out to urban centres, drawing on evidence from a survey of over 2,500 rural and urban households. The findings illustrate the importance of participation in the successful delivery of water systems. However, higher levels of rural participation are related to specifically rural features, including the smaller size and more limited diversity of communities. The paper concludes that new methods may be required for the transfer of CBWM to urban centres with much larger, more diverse and growing populations.

This article seeks to explain the failure of industrial upgrading in Malaysia in terms of the state’s capacity to allocate and manage rents to promote learning and accumulation, and to withdraw ren...

Purpose The aim of this study was to quantify the prevalence of Fear of Cancer Recurrence (FCR) in patients with a prior haematology malignancy surviving more than one year post allogeneic haematopoietic stem cell transplantation (HSCT), and to identify the demographic, medical and psychological factors associated with FCR occurrence. Method Participants were adult allogeneic HSCT recipients who had undergone the procedure for acute leukaemia or other haematological malignancy between the years 2000–2012 in Sydney, Australia. They completed a purpose designed survey and six other validated instruments which assessed FCR, psychological functioning, quality of life, demographic, social and clinical variables. Results Of the 364 respondents, approximately 11% of the sample lived with severe FCR while only 5% of subjects reported having no FCR. Variables significantly associated with higher FCR included unemployment, a shorter time (years) post-transplant, not attending to health screening (PAP smear), a secondary diagnosis of skin cancer, younger age, referral to a psychiatrist and taking psychotropic medication. Higher psychological distress (depression, anxiety, stress) and lower quality of life made a significant contribution to the prediction of FCR. Conclusions Post HSCT follow-up care should include an assessment and discussion regarding FCR to balance both realistic and unrealistic cancer recurrence risks. Managing FCR is one of the most ubiquitous unmet needs of survivors of haematological disease and it is important that HSCT nurses are both aware of the fear, and are equipped with knowledge on how to help patients navigate it with realistic expectations.

The aim of this qualitative study was to gain a rich understanding of the impact that haematopoietic stem cell transplantation (HSCT) has on long-term survivor’s quality of life (QoL). Participants included 441 survivors who had undergone HSCT for a malignant or non-malignant disease. Data were obtained by a questionnaire positing a single open-ended question asking respondents to list the three issues of greatest importance to their QoL in survivorship. Responses were analysed and organised into QoL themes and subthemes. Major themes identified included the following: the failing body and diminished physical effectiveness, the changed mind, the loss of social connectedness, the loss of the functional self and the patient for life. Each of these themes manifests different ways in which HSCT survivor’s world and opportunities had diminished compared to the unhindered and expansive life that they enjoyed prior to the onset of disease and subsequent HSCT. HSCT has a profound and pervasive impact on the life of survivors—reducing their horizons and shrinking various parts of their worlds. While HSCT survivors can describe the ways in which their life has changed, many of their fears, anxieties, regrets and concerns are existential in nature and are ill-defined—making it exceeding unlikely that they would be adequately captured by standard psychometric measures of QoL post HSCT.

The aims of this study were to describe the long-term nutrition, body weight and body image issues facing survivors of Allogeneic Blood and Marrow Transplant (BMT) and their impact on quality of life. It also describes survivors’ perception of enteral feeding during BMT. Four hundred and forty-one survivors who had undergone a BMT in NSW, Australia between 2000 and 2012 (n = 441/583) completed the Sydney Post BMT Study Survey (SPBS). Forty-five percent of survivors less than 2-year post-transplant reported a dry mouth, 36 % reported mouth ulcers and 19 % had diarrhoea. This was consistent across all survivor groups, regardless of time since transplant. Patients with one or more gastrointestinal (GI) symptoms had significantly lower quality of life scores. There was a significant difference in quality of life scores when comparing those with no GI symptoms to those with one or more symptoms (P =

Allogeneic Blood and Marrow Transplant (BMT) survivors are at high risk of secondary cancers. Although current guidelines endorse survivors following Country‐specific general population screening recommendations to mitigate this risk, little is known about cancer screening adherence in Australian BMT survivors. We conducted a cross‐sectional survey of 441 BMT survivors who were >1 year post transplant, to explore rates of screening for secondary cancers and to identify barriers to cancer screening recommendations. Survey instruments included the Sydney Post‐BMT Survey, FACT‐BMT, DASS 21, The Chronic Graft versus Host Disease (GVHD) Activity Assessment–Patient Self‐Report (Form B), the Lee Chronic GVHD Symptom Scale, Fear of Cancer Recurrence Scale, and The Post Traumatic Growth Inventory. Fifty‐seven percent of respondents were male, median age 54 years, and 40% were >6 years post‐BMT. Rates of cancer screening adherence were as follows: cervical 63.4%, breast 53.3%, skin 52.4%, and bowel 32.3%. Older BMT survivors and those >2 years post transplant were more likely to undergo cancer screening. Improved quality of life was associated with screening for skin, breast, and cervical cancer. Fear of cancer recurrence negatively impacted on cervical screening. For those who had not undergone screening, the majority reported not being advised to do so by their treatment team. This study is the largest and most comprehensive to date exploring cancer screening adherence in BMT survivors in Australia. These data provide the basis for health service reform to better meet the needs of BMT survivors and provide evidence to support counseling and education of both patients and professionals.

This paper examines the ongoing promotion of infrastructure and water privatization in Malaysia despite the failure to increase capital investment and improve efficiency. It locates privatization within the process of capital accumulation, with rents and rent-seeking as an integral part of this. In this context, water privatization provides opportunities for the creation of entrepreneurs through the allocation of rents in the form of water-related contracts. The paper provides preliminary evidence, drawing from privatized water and sewerage projects in the state of Selangor to illustrate how this offers rents for both bumiputera (Malay) and non- bumiputera entrepreneurs. Rent-seeking is driven by changes in social formations and specifically the emergence of a Malay middle class that needed to be politically accommodated.

New insights into electrochemical kinetics of the flavin adenine dinucleotide (FAD) redox center of glucose-oxidase (GlcOx) immobilized on reduced graphene oxide (rGO), single- and multiwalled carbon nanotubes (SW and MWCNT), and combinations of rGO and CNTs have been gained by application of Fourier transformed AC voltammetry (FTACV) and simulations based on a range of models. A satisfactory level of agreement between experiment and theory, and hence establishment of the best model to describe the redox chemistry of FAD, was achieved with the aid of automated e-science tools. Although still not perfect, use of Marcus theory with a very low reorganization energy (≤0.3 eV) best mimics the experimental FTACV data, which suggests that the process is gated as also deduced from analysis of FTACV data obtained at different frequencies. Failure of the simplest models to fully describe the electrode kinetics of the redox center of GlcOx, including those based on the widely employed Laviron theory is demonstrated, as is substantial kinetic heterogeneity of FAD species. Use of a SWCNT support amplifies the kinetic heterogeneity, while a combination of rGO and MWCNT provides a more favorable environment for fast communication between FAD and the electrode.

This article examines the process of deindustrialisation in developing countries, looking at the case of Malaysia. It provides a framework to examine how industrial structure and domestic technological capabilities are affected by the wider challenges of late industrialisation, changes in global accumulation and domestic class formations. It discusses the emerging evidence of Malaysia’s premature deindustrialisation, and how this is the result of broader accumulation strategies that were primarily driven by internal factors related to the emergence of a Malay middle class and supported by changes in global accumulation processes related to the development of global production networks and financialisation.

The separate study of Islam prioritises religion and culture over other factors that may influence economic development. This approach ultimately focusses on the individual as the starting point and has much in common with the methodological individualism of neoclassical economics. This paper argues that there is nothing exceptional about religion and culture, or essential about Islam that warrants their separate analysis in relation to the process of economic development. It adopts a comparative approach which does not prioritise religion and culture, or essentialise Islam. Instead it seeks to explain the problems of development in Muslim countries in terms of class formations related to the nature of capitalist development, secularisation and social transformations.

In addition to prescribed conventional medicines, many allogeneic hematopoietic stem cell transplant (HSCT) survivors also use complementary and alternative medical therapies (CAM), however, the frequency and types of CAMs used by allogeneic HSCT survivors remain unclear. Study participants were adults who had undergone an allogeneic HSCT between 1st January 2000 and 31st December 2012. Participants completed a 402‐item questionnaire regarding the use of CAM, medical complications, specialist referrals, medications and therapies, infections, vaccinations, cancer screening, lifestyle, and occupational issues and relationship status following stem cell transplantation. A total of 1475 allogeneic HSCT were performed in the study period. Of the 669 recipients known to be alive at study sampling, 583 were contactable and were sent study packs. Of 432 participants who returned the completed survey (66% of total eligible, 76% of those contacted), 239 (54.1%) HSCT survivors used at least one form of CAM. These included dietary modification (13.6%), vitamin therapy (30%), spiritual or mind–body therapy (17.2%), herbal supplements (13.5%), manipulative and body‐based therapies (26%), Chinese medicine (3.5%), reiki (3%), and homeopathy (3%). These results definitively demonstrate that a large proportion of HSCT survivors are using one or more form of CAM therapy. Given the potential benefits demonstrated by small studies of specific CAM therapies in this patient group, as well as clearly documented therapies with no benefit or even toxicity, this result shows there is a large unmet need for additional studies to ascertain efficacy and safety of CAM therapies in this growing population.

Summary This paper examines why private participation in infrastructure (PPI) in water continues to be promoted despite poor results in developing countries. It argues that the main characteristics of infrastructure discourage private investment and necessitate state subsidies which dilute private risks and incentives and facilitate rent-seeking. As a result, PPI is characterized by public financing, selective private investments and inconclusive efficiency gains. This is reflected globally and in Malaysia where PPI continues to be promoted because it provides captive rents. The political factors that drive PPI invariably compromise institutional solutions as Malaysia’s water sector reforms illustrate.

The objective of this study was to determine if intubation using larger endotracheal tube sizes in mechanically ventilated patients with thermal burn injury adversely affects voice and swallowing function. This prospective, observational study was conducted in patients with thermal burn injuries, who were mechanically ventilated via an endotracheal tube. The primary outcome measures were changes in voice and swallowing function, assessed using the Australian Therapy Outcome Measures (AusTOMS), immediately before the burn injury, and 12 months after the removal of the endotracheal tube. Of 101 patients screened, 20 male patients were followed for 12 months. Patients intubated with size 8.0 or larger endotracheal tubes were compared to patients with size 7.5 endotracheal tubes or smaller. Patients with the larger endotracheal tubes had a signifi cant 1.8-point (9%) decline in their AusTOMS voice score (p � .01) using the paired t-test, but there was no signifi cant difference between the two groups using the independent samples t-test. There was no signifi cant difference in swallowing outcome between the two groups. Male patients with thermal burn injuries, mechanically ventilated using size 8.0 endotracheal tubes or larger, had a statistically signifi cant decline in voice outcome; however, interpretation of this result is limited by methodological considerations.

Background Clinical emergency response systems such as medical emergency teams (MET) are used in many hospitals worldwide, but the effect that these systems have in mental health facilities is unknown. This study examined the rate and nature of MET calls to a mental health facility that had relocated to the campus of a tertiary referral hospital. Methods This study was a prospective, observational study of MET calls to a newly constructed 170 bed mental health facility. Data were collected on the number and nature of MET calls to the facility. Results Over 24 months, there were 66 MET calls to the mental health facility, and 1217 MET calls at the main hospital. The mean MET call rate was 14.2 calls per 1000 admissions (95% confidence interval (CI) 10.8–17.7) at the mental health facility, and 14.7 calls per 1000 admissions (95% CI 13.9–15.5) at the main hospital. Neurological and cardiovascular problems were present in 61% and 41% of MET calls. Conclusion The rate of MET calls to a new mental health facility can be similar to that of a tertiary hospital. Staff attending MET calls need to be prepared to manage predominantly neurological and cardiovascular problems.

Background This cross-sectional survey aimed to establish the prevalence of infectious diseases and vaccination uptake in long-term allogeneic hematopoietic stem cell transplants (HSCT) survivors in New South Wales, in order to reduce long-term post-HSCT morbidity and mortality and enhance long-term care. Patients and methods Hematopoietic stem cell transplants survivors aged over 18 years and transplanted between 2000-2012 in New South Wales (NSW) were eligible to participate. Survivors self-completed the Sydney Post BMT Study survey, FACT-BMT (V4), Chronic Graft versus Host Disease (cGVHD) Activity Assessment Self Report, Lee Chronic GvHD Symptom Scale, DASS21, Post Traumatic Growth Inventory, and the Fear of Recurrence Scale. Results Of the 583 HSCT survivors contacted, 441 (78%) completed the survey. Respondents included 250 (57%) males and median age was 54 years (range 19-79 years). The median age at the time of transplant was 49 years (Range: 17-71), the median time since HSCT was 5 years (Range: 1-14) and 69% had cGVHD. Collectively, 41.7% of survivors reported a vaccine preventable disease (VPD) with the most common being influenza-like-illness (38.4%), varicella zoster/shingles (27.9%), pap smear abnormalities (9.8%), pneumococcal disease (5.1%), and varicella zoster (chicken pox) (4.6%). Only 31.8% had received the full post-HSCT vaccination schedule, and the majority (69.8%) of these had received the vaccines via their General Practitioner. cGVHD was not found to be a significant factor on multivariate analysis for those who were vaccinated. There was a trend toward lower vaccination rates in patients in a lower income strata. Conclusions Vaccinating post-HSCT survivors to prevent infections and their consequences have an established role in post-HSCT care. Improving rates of post-HSCT vaccination should be a major priority for BMT units.

Infrastructure privatisation aimed to finance capital investment and improve efficiency, but the results have been disappointing because of the mismatch between privatisation theory and the characteristics of infrastructure and utility projects in developing countries. This article reviews the evidence and seeks to explain the results in terms of the high capital costs and low revenues that have necessitated public financing and risk-sharing, diluting private incentives and requiring regulation. However, it argues that the emphasis on strengthening weak regulatory capacities in poor countries is misplaced, because these are the outcome of the development process, and are constrained by technical capacities, informational problems and the resources available. In this context, infrastructure privatisation is argued to be inappropriate for developing countries.

This paper explains a new procedure for the direct measurement of wave resistance from the measurement of ship-wave height on a patch of surface water near the hull. The optical instrumentation used and the newly developed method for numerical calculations are explained. Internal consistency tests and a comparison with well-known longitudinal wave height cut methods, LCM, are provided. This numerical procedure does not require any truncation correction and uses all of the data collected by an optical system described in the paper. This procedure could be more attractive to narrower tanks, as the requirement for tank beam to model length ratio for successful truncation correction b/L > 5 is removed. This formulation can also be used in connection with data collected by a series of wave probe records.

Four hundred and twenty-one adult allogeneic haematopoietic stem cell transplant (HSCT) survivors participated in a cross-sectional study to assess sexual dysfunction and infertility post-transplant. Survey instruments included the Sydney Post-Blood and Marrow Transplant (BMT) Survey, Functional Assessment of Cancer Treatment (FACT) - BMT, the Depression, Anxiety, Stress Scales (DASS 21), the Chronic Graft-versus-Host Disease (cGVHD) Activity Assessment- Patient Self Report (Form B), the Lee cGVHD Symptom Scale and The Post-Traumatic Growth Inventory. Most HSCT survivors reported sexual difficulties (51% of males; 66% of females). Men reported erectile dysfunction (79%) and decreased libido (61·6%) and women reported loss of libido (83%), painful intercourse (73%) and less enjoyment of sex (68%). Women also commonly reported vaginal dryness (73%), vaginal narrowing (34%) and vaginal irritation (26%). Woman had much higher rates of genital cGvHD than men (22% vs. 5%). Age and cGVHD were significantly associated with sexual dysfunction. Few survivors had children following transplant (3·3%). However, for those of reproductive age at HSCT, 22% reported trying to conceive, with 10·3% reporting success. This study is the largest to date exploring sexual function in survivors of allo-HSCT. This data provides the basis for health service reform to better meet the needs of HSCT survivors, including evidence to support counselling and education both pre- and post-transplant.

In this paper, a novel theoretical paradigm of evolving trust is presented which aims to enforce secure operations within a computing system through the proper allocation, enforcement, validation, and proliferation of trust as a metric for all operations. The focus is on defining a conceptual model which can envision this approach for lower level operations within a system, thereby ensuring system security is maintained at all times. Allowing trust to either increase or decrease over time based on historical operations allows for the definition of trust as a deterministic metric rather than a subjective one. Lastly, the theoretical model is supported with a conceptual evaluation of the overall security achieved vs. the trade-off in performance.

To determine whether palliative care teams can improve patient, family and staff satisfaction for patients receiving end-of-life care in the intensive care unit and reduce surrogate markers of health care costs.Randomised controlled, feasibility study.14-bed general ICU over 29 months in 2006-2008.Patients admitted with a terminal or preterminal condition, for whom the treating intensivist considered that escalating or continuing treatment was unlikely to achieve significant improvement in the patient's clinical condition.A consultation from a palliative care team, in addition to usual ICU end-of-life care.ICU and hospital length of stay, and changes in composite scores of satisfaction obtained from questionnaires administered to families, nursing staff and intensivists.The study was constrained by significant logistical and methodological problems, including low recruitment and questionnaire completion rates, and the lack of an available validated questionnaire. From a total of 2009 admissions over a 29-month period, 20 patients were enrolled, 10 in each group. There were significant differences in baseline characteristics. There were no statistically significant differences between those who had a consultation with the palliative care team and those who did not in median ICU length of stay (3 days v 5 days, P=0.97), median hospital length of stay (5 days v 11 days, P=0.44), or changes in overall composite satisfaction scores reported by families (-6% v -6%, P=0.91), nursing staff (+5% v +15%, P=0.30), and intensivists (-2% v +2%, P=0.42).This feasibility study was difficult to conduct and did not generate any robust conclusions about the utility of involving palliative care teams in end-of-life care in the ICU. Larger studies are technically possible but unlikely to be feasible.Australian Clinical Trials Registry ACTRN012606000110583.

Background Clinical emergency response systems such as medical emergency teams (MET) have been implemented in many hospitals worldwide, but the effect that these systems have on injuries to hospital staff is unknown. The objective of this study was to determine the rate and nature of injuries occurring in hospital staff attending MET calls. Methods This study was a prospective, observational study, using a structured interview, of 1265 MET call participants, in a 650 bed urban, teaching hospital. Data was collected on the number and the nature of injuries occurring in hospital staff attending MET calls. Results Over 131 days, 248 MET calls were made. An average of 8.1 staff participated in each MET call. The overall injury rate was 13 (95% confidence interval (CI) 7–20) per 1000 MET participant attendances, and 70 (95% CI 38–102) per 1000 MET calls. One injured participant required time off-work, an injury requiring time off-work rate of 1 (95% CI 0–4) per 1000 MET participant attendances, or 4 (95% CI 0–27) per 1000 MET calls. The relative risk of sustaining an injury if the MET participant performed chest compressions, contacted patient body fluids on clothing or protective equipment, without direct contact to skin or mucosa, or lifted the patient or a patient body part was 11.0 (95% CI 4.2–28.6), 8.7 (95% CI 3.4–22.0) and 5.5 (95% CI 2.1–14.2), respectively. Conclusion The rate of injuries occurring to hospital staff attending MET calls is relatively low, and many injuries could be considered relatively minor.

The removal of DNA interstrand cross-links (ICLs) has proven to be notoriously complicated due to the involvement of multiple pathways of DNA repair, which include the Fanconi anemia/BRCA pathway, homologous recombination and components of the nucleotide excision and mismatch repair pathways. Members of the SNM1 gene family have also been shown to have a role in mediating cellular resistance to ICLs, although their precise function has remained elusive. Here, we show that knockdown of Snm1B/Apollo in human cells results in hypersensitivity to mitomycin C (MMC), but not to IR. We also show that Snm1B-deficient cells exhibit a defective S phase checkpoint in response to MMC, but not to IR, and this finding may account for the specific sensitivity to the cross-linking drug. Interestingly, although previous studies have largely implicated ATR as the major kinase activated in response to ICLs, we show that it is activation of the ATM-mediated checkpoint that is defective in Snm1B-deficient cells. The requirement for Snm1B in ATM checkpoint activation specifically after ICL damage is correlated with its role in promoting double-strand break formation, and thus replication fork collapse. Consistent with this result Snm1B was found to interact directly with Mus81-Eme1, an endonuclease previously implicated in fork collapse. In addition, we also show that Snm1B interacts with the Mre11-Rad50-Nbs1 (MRN) complex and with FancD2 further substantiating its role as a checkpoint/DNA repair protein.

Entrepreneurship is central to innovation and hence industrialisation. However, the innovation process is cumulative, increasingly undertaken within formal organisations, and characterised by uncertainty. The technological challenge facing developing country entrepreneurs attempting to 'catch up' is considerable in this context and can be supported by the appropriate institutions and policies. The efficacy of these will depend on the nature of the government – business relationship and whether the state can ensure such support is contingent upon learning taking place. Malaysia's attempts to create domestic entrepreneurs demonstrate the difficulties involved, and the importance of accounting for political factors.

Autologous haematopoietic SCT (AHSCT) is increasingly used to control severe and refractory autoimmune diseases (AD). Many patients are women of reproductive age with a potential desire for children. We present a multicentre retrospective analysis of pregnancy and childbirth in patients who underwent AHSCT for AD. The databases of the European Blood and Marrow Transplantation and University of Sao Paulo, Ribeirão Preto, Brazil were searched for female patients aged 18-50 years who had received AHSCT for AD between 1994-2011. In 324 adult female patients, 22 pregnancies were reported in 15 patients between 1997-2011. Indications for AHSCT included multiple sclerosis (n=7), systemic sclerosis (n=5), rheumatoid arthritis (n=1), juvenile idiopathic arthritis (n=1) and Takayasu disease (n=1). Of the 22 reported pregnancies, 20 followed natural conception. 15 pregnancies (68%) resulted in healthy life births, whereas 7 (32%) failed. Exacerbations of AD occurred in two patients during second pregnancies. No maternal mortality was associated with pregnancy or postpartum. There were no reports of congenital, developmental or any other disease in the children. This retrospective analysis confirms the possibility of pregnancy and childbirth following AHSCT for severe AD. The outcome of pregnancy is generally good and most led to the birth of a healthy child.