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Background: Orphan-hood is a major consequence of the Acquired Immune Deficiency Syndrome (AIDS) pandemic globally. In South Africa most children who are AIDS orphans live in township communities. They are often uncared for and unsupported by the community, and experience recurrent psychological trauma and much personal suffering. Identifying the "barriers to" and "recommendations for" providing care and support to these vulnerable children is vital to enable the development of comprehensive implementations to meet these children's unique care and support needs. Objective: Using empirical data from health and social care professionals and cluster analysis to identify "barriers to" and "recommendations for" providing care and support to children living as AIDS orphans in township communities in Nelson Mandela Bay South Africa. Design: Data was collected using a descriptive phenomenology research design incorporated an exploratory, contextual and descriptive approach. In-depth unstructured interviews were used to collect data from participants. Participants: The primary health care nurses (PN) (n = 10) and social workers (SW) (n = 8) were selected using criterion-based purposive sampling, whilst snowball sampling was used to select psychologists (Psy) (n = 6). Participants are referred to as health and social care professionals. Setting: Participants were selected using purposive sampling (nurses and social workers) and snowball sampling (psychologists) from four primary health care clinics and twelve satellite health care clinics, all located in township communities in Nelson Mandela Bay, South Africa. The participants were all caring for and supporting children who are AIDS orphans living in these communities. Methods: In-depth individual interviews occurred between April and Nov 2013 which were recorded and transcribed verbatim. All data was then analysed using cluster analysis to identify "barriers to" and "recommendations for" providing care and support to these vulnerable children as identified by these research participants. Results: All "barriers to" and "recommendation for" are represented in this cluster analysis. There were six identified clusters illustrating "Barriers to" and four visualised clusters illustrating "Recommendations for". The barriers can be identified using the following broad themes; B1, fundamental barriers; B2, primarily related to legislative and policy frameworks, B3, lack of human and financial resources also included stigma and communication. B4, grief, high risk behaviours and cumbersome bureaucratic processes and included loss of trust in adults; B5, barriers related to poverty B6, barriers related to poverty also included non-disclosure of HIV status. Regarding the "recommendations for" these can be identified using the following broad themes; R1, developing the resilience of health and social care professionals. R2, developing interventions, to meet the unique needs of these AIDS orphans. R3, developing, empowering and capacitating professionals and R4, facilitating an empowering working environment for professionals. Conclusions: Significant clusters emerged and the "barriers to" and "recommendations for" were identified in this research which could be used to inform the development of an intervention to provide "best practice" care and support to these vulnerable children living in these township communities.

Policy dialogs are deliberative dialogue that gather policy makers and relevant stakeholders from across disciplines to discuss a topic of mutual interest. They typically serve as a single element in a broader policymaking cycle, either informing the content of new policy or forming a component of policy evaluation and review. In the joint action CHRODIS PLUS, national policy dialogs were conducted in fourteen EU Member States. The aim of the dialogs was to identify new policies or changes to existing policies and legislation that are capable of tackling major risk factors for chronic disease, to strengthen health promotion and prevention programs and to ensure health systems are equipped to respond to priority issues within the chronic diseases field. In this paper, we present the CHRODIS PLUS policy dialog methodology, as well as results and lessons learnt from three national policy dialogs held in Ireland, Portugal and Spain. After discussion of the results, we conclude that the CHRODIS PLUS methodology is an effective mechanism to provoke deliberative discussion around chronic disease prevention and management in different countries. However, it is essential to ensure adequate human and financial resources—as well as political commitment—to accomplish objectives set out during the policy dialogs. We argue that priority-setting across sectors can improve the resilience of health systems and opportunities for investment in Health in All Policies (HiAP), both at European Union and Member State levels

The European Union aims for a 40% reduction in greenhouse gas emissions by 2030, compared to 1990 levels, and recognizes the opportunities of Liquefied Natural Gas (LNG) as an alternative fuel for transportation to reach this goal. The lack of a mature supply chain for LNG as a fuel results in a need to invest in new (satellite) terminals, bunker barges and tanker trucks. This network design problem can be defined as a Two-Echelon Capacitated Location Routing Problem with Split Deliveries (2E-CLRPSP). An important feature of this problem is that direct deliveries are allowed from terminals, which makes the problem much harder to solve than the existing location routing literature suggests. In this paper, we improve the performance of a hybrid exact algorithm and apply our algorithm to a real world network design problem related to the expansion of the European supply chain for LNG as a fuel. We show that satellite terminals and bunker barges become an interesting option when demand for LNG grows and occurs further away from the import terminal. In those situations, the large investments associated with LNG satellites and bunker barges are offset by reductions in operational costs of the LNG tanker trucks.

The article argues that closer attention to how solidarity is understood and expressed in different European contexts can shed light on the conditions for establishing a social and solidarity economy. Drawing on data collected within the H2020 SOLIDUS project, which explores current expressions of European solidarity, the comparative analysis covers three social economy initiatives, each representing a country with different political and economic context. The analysis focuses on solidarity as reciprocity and, in particular, how it is affected by such factors as actor motivations, internal participatory functioning, resource mix and political legitimacy. While further empirical work is needed, the findings suggest that solidarity as reciprocity produced by social and solidarity economy organisations thrives where political institutions are both supportive and trusted, where public funding is accessible, and where partnerships with relatively autonomous social and solidarity economy organisations are genuinely collaborative.

We explore aquaponics in the Scandinavian countries (Norway, Sweden and Denmark) through policy analysis, a review of the historical context, and semi‐structured case study interviews. The semi‐structured case study interviews are conducted with relevant actors that have a stake in the future development of aquaponics. These actorsinclude: (1) large scale commercial salmon producers, who are currently moving a larger proportion of the smolt production on land to counter problems with sea lice; (2) small‐scale aquaculture farms; (3) small‐scale hydroponic vegetable growers; (4) hobby‐scale aquaponics enthusiasts, (5) demonstration‐scale aquaponic producers; (6) aquaponics support organizations and (7) relevant policy makers. All of these actors have the potential to be key players in the transition to where aquaponics production systems contribute a substantial share of food to regional markets. We analyze the incentive structures and roles of the various actors and potentials for synergies. We also explore possible pathways for the expansion of aquaponics in the near future from a global value chain perspective (Gereffi, 2005). We find that there remain geographic co‐location barriers, as well as barriers related to an unequal production scale by the current regime actors. These issues, along with the dominant institutional legacies from fisheries and agriculture, result in a regulatory landscape in Scandinavian countries that hinder the development and transition to a more sustainably produced food source. We also find the regulatory landscape for aquaponics in respective countries has emerged in reaction to historical precedentsin aquaculture and agriculture, and specific legislation on aquaponics has been slow to develop. Aquaponics operations typically must meet disparate sets of regulations. As such, it creates a complex barrier to commercial scaling up and the transition to a more sustainable circular economy. We conclude with specific policy suggestions for aquaponics, but also note larger lessons for the regulatory challenges that occur when the circular economy application attempt to bridge two or more different areas of policies.

The human papillomavirus (HPV) can cause a range of cancers as well as genital warts and recurrent respiratory papillomatosis in men and women. Most cases can be prevented by vaccination in adolescence. Many countries vaccinate girls and an increasing number, although still a minority, vaccinate both boys and girls. The case for vaccinating boys is based on arguments of public health, equity, ethics, and cost-effectiveness. The selective vaccination of females does not protect males sufficiently and provides no protection at all for men who have sex with men. In the United Kingdom (UK), the government's vaccination advisory committee (Joint Committee on Vaccination and Immunisation [JCVI]) began to consider whether boys should be vaccinated as well as girls in 2013 and made clear in draft statements that it considered this not to be cost-effective. A campaign group, HPV Action, was established to advocate gender-neutral vaccination. This group became a coalition of over 50 organisations and used evidence-based arguments, political advocacy and media campaigning to make its case. One of its members initiated legal action against the government on the grounds of sex discrimination. In July 2018, the government agreed that boys in the UK should be vaccinated. The lessons for other campaigns in the men's and public health fields include: be prepared for the long haul, focus on clear and specific goals, build alliances, align the objectives with existing policies, make a financial case for a change of policy, and use all legitimate means to exert pressure.

Background Risk assessment is central to primary prevention of cardiovascular disease (CVD), but there remains a need to better understand the use of evidence-based interventions in practice. This study examines: (i) the policies and guidelines for risk assessment in Europe, (ii) the use of risk assessment tools in clinical practice and (iii) the barriers to, and facilitators of, risk assessment. Methods Data were collected from academics, clinicians and policymakers in an online questionnaire targeted at experts from all European Union member states, and in 8 in-depth country case studies that were developed from a targeted literature review and 36 interviews. Results The European Society of Cardiology (ESC) produces European guidelines for CVD risk assessment and recommends the Systematic COronary Risk Evaluation tool, which is the most widely used risk assessment tool in Europe. The use of risk assessment tools is variable. Lack of time and resources are important barriers. Integrating risk assessment tools into clinical systems and providing financial incentives to carry out risk assessments could increase implementation. Novel biomarkers would need to be supported by evidence of their clinical effectiveness and cost-effectiveness to be introduced in clinical practice. These findings were consistent across Europe. Conclusions Efforts to improve the assessment of CVD risk in clinical practice should be carried out by or in collaboration with, the ESC. Increasing the use of existing risk assessment tools is likely to offer greater gains in primary prevention than the development of novel biomarkers.

Today, the Indian government is emphasising more on cash less transactions in order to eliminate black money activity in the market. In supporting to this internet and mobile banking is also one of the initiations steps taken by the nationalized banks. Even there are money private sectors banks are also coming up with innovative products of service to facilitate the customer in cashless transactions either in shopping, banking, payment of bills, recharges etc. This venture may be successful in the urban part of the India but making it reachable to the rural part is a big challenge. In this background, current study is focusing on the issues related to the internet and mobile banking usage and its impact on the consumers and their satisfaction towards the facilities offered by the nationalized banks in the rural part of the India especially in the Belthangady taluk, Dakshina Kannada district, Karnataka.

This article engages in an experiment that aims to push critical/post-structuralist thought beyond its comfort zone. Despite its commitment to critiquing modern, liberal ontologies, the article claims that these same ontologies are often tacitly reproduced, resulting in a failure to grasp contemporary structures and histories of violence and domination. The article brings into conversation five selected critical scholars from a range of theoretical approaches and disciplines who explore the potential of the notion of 'fracture' for that purpose. The conversation revolves around political struggles at various sites – migrant struggles in Europe, decolonial struggles in Mexico, workers and peasant struggles in Colombia – in order to pintpoint how these struggles 'fracture' or 'crack' modern political frames in ways that neither reproduce them, nor lead to mere moments of disruption in otherwise smoothly functioning governmental regimes. Nor does such 'fracturing' entail the constructing of a 'complete' or 'coherent' vision of a politics to come. Instead, we detail the incoherent, tentative and multiple character of frames and practices of thought in struggle that nevertheless produce an (albeit open and contested) 'whole'.

The Danish government has set ambitious targets regarding the future exploitation of renewable energy in the Danish energy system. In many respects, the prospective increase in renewable energy resources (RES) will substantially impact the entire future Danish energy system. Renewable gas is a fuel that can contribute to the sustainable transition towards an energy system independent of fossil fuels in the longterm. This study investigates the role of renewable gas production in a renewable based Danish energy system. To facilitate the modelling of renewable gas, improvements of the structure in the spatiotemporal optimization model OptiFlow is carried out. The OptiFlow model is hard-linked to the existing energy system model Balmorel, allowing modelling the gas chain from up-stream renewable gas production, through storage facilities to end consumers. Balmorel is a bottom-up, deterministic, partial equilibrium model, which minimizes systems costs under perfect market conditions. The developments in OptiFlow enable modelling of various processing technologies, e.g. biological- and thermal- gasification as well as electrolysis technologies. The co-simulation of OptiFlow and Balmorel leads to the socio-economic optimal system, where investments and operations optimization is facilitated for the integrated electricity, district heating, and gas system. The results of this study show that production of RE-gas is socio-economically attractive in all the investigated scenarios. Furthermore, the results show that RE-gas directly injected into the natural gas pipeline network is preferred. The analysis show that geographical allocation of resources has an impact on the results. Moreover, it was shown that hydrogen was not produced in periods with high electricity prices.

Background: To avoid exposure to mercury, government advice on fish consumption during pregnancy includes information on fish species to avoid and to limit, while encouraging consumption of least two portions of fish per week. Some women may, however, chose to avoid fish completely during pregnancy despite potential benefits to the fetus. Objectives: Our aims were to evaluate the effects of blood mercury levels in pregnant women on birth outcomes in the UK, and to compare outcomes in those who ate fish with those who did not. Methods: Pregnant women were enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples for singleton pregnancies with a live birth were analysed for Hg by inductively coupled plasma dynamic reaction cell mass spectrometry (n=4044). Fish intake was determined by a food frequency questionnaire during pregnancy. Data collected on the infants included anthropometric variables and gestational age at delivery. Regression models were adjusted for covariates using SPSS v18. Results: There were no significant associations of maternal blood Hg level with birthweight, head circumference or crown–heel length in adjusted linear regression models. Similarly, there were no increased odds of low birthweight or preterm delivery in adjusted logistic regression models. When the models were repeated after stratification into fish-eaters and non-fish eaters there were no associations except for a negative association with birthweight in non-fish eaters (unstandardised B coefficient –58.4 (95% confidence interval –113.8, –3.0) g, p=0.039). Conclusion: Moderate mercury levels in pregnancy were not associated with anthropometric variables, or on the odds of low birthweight or premature birth. Fish consumption may have a protective effect on birthweight. Consumption of fish in line with government guidelines during pregnancy should be encouraged.