Computer simulation of the structure and stability of forsterite surfaces

The aim of this paper is to demonstrate that atomistic simulations can be used to evaluate the structure of mineral surfaces and to provide reliable data for forsterite surfaces up to a plane index of 2 using the code METADISE. The methods used to calculate the surface structure and energy which have more commonly been used to study ceramics are briefly explained as is a comparison with experimental data, most notable the crystal morphology. The predicted morphologies show that all the methods (Donnay-Harker, Attachment energies and equilibrium) show most of the surfaces that are expressed in observed crystals. The equilibrium morphology calculated from the relaxed surface energies is the only method which expresses the {201} surfaces and the {101} surfaces, which appear only upon relaxation. The more stable surfaces are shown to be those which have the highest surface density and more closely resemble close packed structures with highly coordinated surface ions and silicon as far from the surface as possible. The most stable surfaces the {100} which has alternating layers of MgO and SiO₂ terminating with an MgO layer. The structure is similar to the MgO {100} surfaces and has a similar energy (1.28?Jm^?2 compared to 1.20). The second most stable are the {201} which have a stepped surface topology, but is also compact with a relaxed surface energy of 1.56?Jm^?2. The results indicate that atomistic simulation is well suited to the prediction of surface structure and morphology although care must be taken in choosing potentials which model the structure and elastic properties accurately.     

Private non-degree practitioners and spatial access to out-patient care in rural India

Most rural areas in the developing countries lack access to qualified out-patient (OPD) care. The gap in health services provision arises, due to lack of qualified doctors and is oftentimes filled by unqualified doctors who are also known as private non-degree practitioners (PNDPs). Despite their dominance, their presence is often neglected in access to health care studies. This leaves a scenario which lacks informal, but predominant, care. This paper uses a mix-method approach, combining exhaustive quantitative census of all health care providers along with location details in Geographic Information System to address the accessibility to PNDP. Longitudinal quantitative as well as spatial surveys were conducted for 3 years (2010, 2012 and 2013) in districts of Pratapgarh and Kanpur Dehat in state of Uttar Pradesh and Vaishali in Bihar state. The results of this study show that PNDPs account for 25 % of the all health care providers active across the study areas. The PNDPs are active in a radius of 2–5 km and are main workforce for the OPD care. Considering all health care providers PNDPs provide best potential accessibility to OPD care. If the PNDPs are removed from the scenario; remote areas will be the most affected ones, leaving them with almost no OPD care.     

Researching the geography of health and health care: Connecting with the Third World

In the context of doing research on the geography of health and health care, ‘connecting’ takes on multiple meanings. First, there are the connections between research topics although the political and socio-economic realities of the various geographical contexts can lead to foci on different aspects and social and geographic processes. There are then the connections between researchers from developed and developing countries who share an interest in the geography of health and health care, who perhaps transfer or refine research methods to look at the different contexts and even different topics. Finally, in this context, there are the connections between researchers and the IGU Commission on Health, Environment and Development (HED) promoted by the HED for the past eight years through its activities. This paper uses examples from the literature and the activities of HED to illustrate these various connections. It argues that if the geography of health and health care is to continue to develop, these three sets of connections must continue to grow and strengthen. This revised version was published online in July 2006 with corrections to the Cover Date.     

The geography of medical care delivery: an historical perspective

A weakness of research into urban service delivery has been its ahistorical approach. Historical geographers, on the other hand, have neglected the issue of urban service delivery. This paper illustrates the influence and interaction of urbanization, professionalization and public policy on urban service delivery using the example of medical care in Britain.     

The future relevance of medical geography for health planning,health and development in the third world

Conclusions: the Future Relevance of Medical Geography in the Third World This article has deliberately ranged widely and suggested various research themes to which medical geographers interested in health and development might turn their attention. The International Geographical Union Commission on Health and Development established in 1988 suggested a research agenda which includes many of them (see IGU Commission on Health and Development, Circular Letter No. 1 published in GeoJournal 17, 4, 659–660 (1988)). The achievement of even part of such an agenda will call for close international collaboration in research amongst medical geographers and allied disciplines.Increasingly, medical geographers are gaining applied experience in health and health care in the developing world. They are obtaining breadth and depth of knowledge and are now, for example, cogniscant of financial matters such as those involved in the cost explosion in health care worlwide which has particularly sinister implications for the health of Third World countries (Josephg and Phillips 1984). They, too, are now increasingly comfortable in dealing with epidemiological and demographic data. Geographers now no longer focus solely on phenomena such as distance decay or environments for disease. They are aware that human resources, intelligence, aspirations, attitudes and finance are all potent variables influencing successful health care and health in populations.In the future, therefore, the wide-ranging ambit of medical geography will increasingly become relevant to health and health care research in the Third World. Contributions of value will emerge both from those geographers adopting more socio-political stances and those adopting a more empiricist approach. However, it is the holistic nature of geography, with its wide academic links, and the courage of geographers to research in new topics and gain sound understanding of them which will increasingly be recognized. The days of extempore contributions to political, policy and practical debates on health and development are now largely past. Well researched, solid and sound medical geography contributions will, it is hoped, forge ahead.     

Social provision and service delivery: Problems of equity,health, and health care in rural Australia

A neglected area of Australian geographical research relates to the issue of how to ensure an equitable provision of services to inhabitants of rural areas. Equity, however defined, is a procedural concept, requiring the implementation of rules about how to allocate and distribute scarce resources. Equity, as a distributional principle, is an important consideration both in determining the actual amount and nature of resources available and in deciding who will get how much of what is available. Compared with other social goods, there is a particular insistence on equity with respect to health care services. This article outlines the problems characterizing health care provision in rural Australia. It evaluates fiscal equalization as one means by which the Federal Government attempts to ensure at least some equity in the provision and distribution of health care resources to areas of dispersed population. The findings reveal that fiscal equalization alone is unable to ensure equity. This is because of problems of how to assess the needs for and costs associated with providing health care services in areas of dispersed population, confusion between equality and equity, problems related to the differentiation of government functions in a federal system, and inadequacies associated with using hospital services as the basis for resource allocation. This article concludes that equity is more likely to be achieved when policy is oriented to health care rather than medical care and when provision and distribution of resources relates more to service outcomes than to service inputs.     

Placing voluntarism within evolving spaces of care in ageing rural communities

Guided by a theorisation of voluntarism as a critical process shaping local outcomes of changes underway in health care systems and in rural communities, this paper re-analyses qualitative results from previous case studies of rural ageing to deconstruct the multifaceted role of the voluntary sector in facilitating the emergence of homes and communities as ‘new’ spaces of care. The specific focus is on the lived experience of voluntary sector care providers from the perspectives of non-profit organisations, community groups and families as well as elderly residents of rural communities in Canada and New Zealand. The findings confirm the local dynamics of voluntarism as a crucial yet neglected component of sustainable rural services and communities. More importantly, they reveal the voluntary sector as a major source of resistance to both the short-term changes mandated by restructuring and longer-term changes associated with rural ageing and service decline. It is through resistance that voluntary organisations and volunteers are seen to be engaging most intensely with the challenge of ageing in place within evolving spaces of care. A more nuanced understanding of their complex role is a prerequisite for developing informed policy on rural ageing and care provisioning.     

Noise pollution and its effects on medical care workers and patients in hospitals

The objectives of this study are to investigate the levels of noise pollution in some hospitals in Taiwan and to study the effects of noise pollution on the physiological and psychological reactions and annoyance response of medical care staff, patients and visitors in these hospitals. An instrument for the measurement of sound level was used and a self-answered survey questionnaire on noise pollution was administered. Results showed that the daily average sound levels measured inside these hospitals during daytime were between 52.6 and 64.6 decibels. These are higher than the current daytime environmental noise limit of 50 decibels in Taiwan. Most nursing staff members expressed that “talking of visitors or patient’s family members” is the major source of noise inside the wards, whereas “talking of visitors or patient’s family members” and “children playing” are the two major noise sources outside the wards. However, most patients or visitors claimed that “doors opening or closing” and “patients moaning or crying” are the two major sources of noise inside the wards. “Footsteps,” “renovation of hospitals,” “talking of visitors or patient’s family members,” “shouting of nursing staff” and “doors opening or closing” are the five major noise sources outside the wards. To conclude, noise pollution inside and outside the wards either directly or indirectly affects, in a simultaneous manner, the subjective perception of noise, emotions, physiology and experience of noise inside and outside the wards of both the medical care staff and the patients and visitors.     

AIDS-affected children,family collectives and the social dynamics of care in Ethiopia

Many programmes for AIDS-affected children pursue resource-intensive and external interventions of care, and often place such children at the receiving end of the care continuum. The aim of this article is to explore from a socio-spatial perspective the capacities of families and children experiencing orphanhood and the policy significance of empowering both to address the growing challenge of orphan care in rural and urban Ethiopia. Drawing on participatory research (involving in-depth interviews, focus group discussions, story writing, photo essays, ranking, observation and household visits), the complex social dynamics of care and spatial diversities in the manifestations of the vulnerabilities, capacities, strengths, and potentials of children and their families are discussed. It is argued that rather than the lack of biological parents it is the combination of the absence of a carer and the presence of acute poverty and economic marginality that explain various forms of vulnerability in orphans and non-orphans. The article further argues that effective and sustainable care needs to be informed by identification and empowerment of ‘family collectives’ as sites of interventions. In doing so, it draws analytical attention to the importance of examining the socio-temporal processes of orphanhood and care, children’s changing circumstances, and family collectives’ variances in the capacity to provide support for them. Strategies for sustainable care should recognise the specific needs of AIDS-affected children and the resourceful ways in which they contribute to enhance the care-giving capacities of family collectives in the light of broader socio-cultural and political–economic contexts.     

Retail geography and social well-being: A note on the changing distribution of pharmacies in Scotland

Dispensing Chemists represent an important component in the organization of primary medical care in the United Kingdom, as well as providing a basic retail service. Over the past 30 years, the number of dispensing chemists' shops in Scotland has fallen by 40%, a withdrawal of services which has important spatial welfare implications. In this paper the locational dynamics of pharmaceutical retailing are examined, and the pattern of change between 1950 and 1980 is described. It is shown that the major trend, at both regional and intra-urban levels, is centralization. This trend is only weakly related to patterns in population change. Rather, it is the product of a general restructuring of retailing, reinforced by changes in the structure of the health care delivery system.     

International migration and health: Sickle cell and thalassaemia health care in the United Kingdom

Human migration has contributed to the redistribution of diseases from regions where they were endemic, thereby creating new areas where the task of control and management has become necessary. This is the case with respect to the major haemoglobinopathies — sickle cell anaemia and thalassaemia — in the United Kingdom since World War II. On the one hand, the great cultural diversity of the immigrant population presents an important challenge in delivering health care to the populations at risk of the diseases. On the other hand, the spatial concentration of these populations is one of the greatest advantages in the management of the disorders, since access to centrally located services can be optimized.The case of health care relating to the major haemoglobinopathies in the United Kingdom raises practical and theoretical questions about the most effective health care delivery models for ethnic minority needs. In turn, this issue has important implications for decisions concerning national and regional budgetary priorities in the health service and the position of minority medicine in the allocation of resources.     

Recasting diaspora strategies through feminist care ethics

The diaspora-centred development agenda holds that migrants lead transnational lives and contribute to the material well being of their homelands both from afar and via circular migration. Concomitant with the ascendance of this agenda there has arisen a new field of public policy bearing the title ‘diaspora strategies’. Diaspora strategies refer to proactive efforts by migrant-sending states to incubate, fortify, and harness transfers of resources from diaspora populations to homelands. This paper argues that diaspora strategies are problematic where they construe the diaspora–homeland relationship as an essentially pragmatic, instrumental, and utilitarian one. We suggest that a new generation of more progressive diaspora strategies might be built if these strategies are recast through feminist care ethics and calibrated so that they fortify and nurture caring relationships that serve the public good. Our call is for an approach towards state–diaspora relationships that sees diaspora-centred development as an important but corollary outcome that arises from prioritising caring relationships. To this end we introduce the term ‘diaspora economies of care’ to capture the derivative flow of resources between diasporas and homelands that happens when their relationship is premised on feminist care ethics. We introduce three types of diaspora economies of care, focusing on the emotional, moral, and service aspects of the diaspora–homeland relationship, and reflect upon the characteristics of each and how they might be strengthened later by foregrounding care now.     

Rethinking responsibility and care for a postcolonial world

Both responsibility and care have much to offer in thinking through the relationalities that make up a postcolonial world. Although contemporary political systems often posit responsibility and care within the context of individuated and autonomous selves, geographers have done much to relocate responsibility and care within narratives of interdependency - spatially and temporally. They have argued that both terms offer a route for thinking about ethical geographical relations between myriad places. In this article we take this project further, by looking at how the nature and shape of these relationships might be construed in a postcolonial world. We suggest that, through a more critical engagement with postcolonial thinking, any exploration of existing practices of responsibility and care will not only reveal the enormous potential of imagining these geographies as forms of existing and evolving relationalities, but will also lead us to interrogate the deployments of these terms in the context of past and present inequalities. We show that routing care and responsibility through postcolonial geographies moves us towards a more pragmatic responsiveness, one that involves a ‘care-full’ recognition of postcolonial interaction.     

Storm surge prediction with management information systems: A case study of estimating value and observations system

A natural disaster is a major adverse event resulting from the earth’s natural forces. We can now take advantage of information technology (IT) devices to make migration decisions and hazard analysis. The range of IT applications is very wide, and could include robot manufacturing, remote exploration, fuzzy Lyapunov techniques, artificial intelligence, intelligent devices, tension leg platform design, consumer and service quality, and management information systems. Management information systems are especially helpful to medical personnel when carrying out the treatment and medication of patients. Sometimes, though, hospital staff might not have immediate access to a patient’s records such as response to treatments, medication status, or examination results because the computer equipment is not easily portable. In such situations, it is only possible to keep written records, with the data being cataloged or referred to only after returning to the nursing station or office. If the hospital could implement a computerized medical service cart for use in the wards, the above problems would be solved. These computers could use a wireless network system, linked with the central server to access information. The technology now exists and the era of the smart phone has now been entered. Smart phones/tablet PCs could be applied for clinical medical care. For the elderly and patients with chronic diseases, smart health devices designed for home care service are necessary and should be applied as soon as possible. This study designs a wireless physiology signal monitoring system that uses a smart phone with a wireless network apparatus to provide convenient monitoring for patients in the home care service system. The wireless care system is designed for patients who need long-term home care services or assistance with chronic diseases. This paper provides important suggestions to develop ways to connect patients to medical care institutions through the internet.     

Long‐term landscape evolution in the Darwin region and its implications for the origin of landsurfaces in the north of the Northern Territory

The development of landsurfaces in the north of the Northern Territory has traditionally been attributed to successive episodes of uplift, erosion and weathering. The lower and younger two of the four landsurfaces attributed to such development, the Wave Hill and Koolpinyah surfaces, dominate the landscape in the Darwin region. Investigations of the relationship between the Cretaceous stratigraphy and the nature of deep weathering in the Darwin region show that these surfaces are structurally controlled. A bioturbated bed in the Darwin Member of the Cretaceous Bathurst Island Formation has limited the depth of weathering in this region mainly to the level of the Koolpinyah surface. A silicified horizon in the deeply weathered Cretaceous strata has controlled the level of the Koolpinyah and Wave Hill surfaces elsewhere. Furthermore, the presence of detrital laterite profiles, being the main form of evidence used for the identification of both of these surfaces, is challenged; in many localities these detrital profiles are in fact in situ, discounting the idea that these surfaces developed as a result of successive episodes of pediplanation. Similarities are drawn between the origin of these surfaces and the development of equivalent surfaces in the Daly River Basin to the south of Darwin. The practice of extrapolation between surfaces across widely separated regions of northern Australia has been previously shown to be based on tenuous grounds. The same degree of tenuity must now be placed upon such extrapolations in the north of the Northern Territory.     

Bridging the gap between employment and social care for people with learning disabilities: Local Area Co-ordination and in-between spaces of social inclusion

This paper identifies the growing gap between the spheres of paid employment and social care for people with learning disabilities. Social inclusion and independence remain closely associated with paid employment; social exclusion and dependency with receipt of care. The paper argues that, as employability and supported employment programmes increasingly select only the most able, and social care is ever more restricted to those in most need, an expanding number of people with learning disabilities are occupying a third or in-between sphere where the opportunities for work or care are limited. The paper draws on research undertaken for Scottish Government and interviews with policy makers and practitioners at national and local scales. The paper presents a critique of the array of employment programmes, arguing that their narrow and outcome-focused approach excludes most people with learning disabilities from opportunities for employment. ‘Local Area Co-ordinators’ present in many areas in Scotland provide personal support and ‘brokerage’ to facilitate access to, in some cases, employment and, perhaps more importantly, to other ‘work’ experiences (including voluntary work) and community capacity building. The ‘progressive localist’ network building work of Local Area Co-ordinators can potentially bridge the gap between the spheres of employment and social care, and in doing so contest the deterministic relation between social inclusion and paid employment.     

Modelling the effect of water on the surface structure and stability of forsterite

 We describe the application of atomistic simulation techniques to investigate the effect of associative and dissociative adsorption of water on the structures and stabilities of the low-index surfaces of forsterite. All surfaces are amenable to associative adsorption of water, while dissociative adsorption is energetically favourable on all but the non-dipolar {1 0 0} surface. Often, otherwise unstable (dipolar) surfaces are stabilised to a large extent by hydration, e.g. the dipolar {0 1 0} surface. However, on thermodynamic grounds we do not expect associatively adsorbed water to dissociate on all surfaces, as the energies released for dissociative adsorption of water on the non-dipolar {0 1 0} and {1 0 0} surfaces are less than those released for associative adsorption. As such, there is no energetic incentive for the associatively adsorbed water molecules to dissociate. The stabilities of the two terminations of the {0 1 0} surface, the main cleavage plane of forsterite, are reversed when hydroxylated, indicating that some dissolution of the magnesium ions may occur upon hydration, which is shown to be an exothermic process for both surface terminations. The equilibrium morphology was calculated as a way of assessing the change in surface energies. The experimental morphology of forsterite is adequately reproduced, suggesting that the relative stabilities of the surfaces, both unhydrated and hydroxylated, are calculated correctly. Received: 4 August 1999 / Revised, accepted: 11 October 1999     

Analyzing spatial disparities in access to health care: A methodology with application in Bangladesh

This paper develops a methodology for analyzing spatial disparities in access to health care in situations where the data base is limited, and applies it in the context of Bangladesh. The proposed indirect measures of inpatient and outpatient service utilization, and of quality of available services, seem to provide reasonably accurate, consistent, and interpretable results; these indices are combined into a composite index of relative access to health care. The form of the composite index and its components permits the incorporation of Sopher's disparity index into the methodology for measuring urban-rural disparities in relative access to health care. The empirical analysis based on subdivision level data revealed that Bangladesh's health care delivery system is, in general, characterized by extremely low level of access and a high degree of disparity in favor of urban areas, especially in terms of inpatient services. Spatial patterns of relative access and urban/rural disparity were perused through cartographic and statistical analyses; although clear-cut regional patterns did not emerge, the considerable spatial variations could be explained largely with reference to urbanization and density of population. Assuming improved level of access and minimal urban/rural disparity as basic policy goals a method to prioritize spatial units for future allocation of health sector resources is recommended.The author gratefully acknowledges the helpful comments on an earlier draft of this paper by Dr. S. M. Bhardwaj, Professor of Geography, Kent State University.     

Erosion and planation surfaces in the Machakos-Kitui area of Kenya

Geomorphologically, Africa is renowned for widely developed erosion surfaces. Details of these surfaces, including how they have come to be, are only imperfectly understood. This paper gives the results of a detailed study of the planation surfaces in the small part of Kenya situated just to the immediate east of Nairobi. An outline of the denudation chronology of Kenya is proposed with specific examples for each suggested cycle. The findings are correlated with results from adjacent parts of East Africa and with the outline for Africa following the work of L.C. King. Six cycles of erosion are mapped and it is shown that of these, it is the Kamba Summit plain and the Masii-Kangondi surfaces that marked major phases of long protracted uninterrupted erosion. The surfaces are interpreted as being mainly the results of scarp recession and pedimentation. All the surfaces are still being actively reduced by these processes. The Summit Plain is shown to be a bicyclic surface of late Jurassic age and is a prominent skyline surface at 1950–2134 m above sea level. The Masii-Kangondi surface (from 1219–1453 m) is the equivalent of the African cycle of some authors. It is confirmed to be of early Tertiary age.The work shows that more detailed studies must be undertaken in order to improve our understanding of the erosional and other related problems in Africa. This is particularly important if we are to give correct solutions to the challenging issues of landuse in the continent.     

The determinants of primary health care utilization: a comparison of three rural clinics in Southern Honduras

Primary health care utilization is poorly understood in many parts of the developing world. This is especially true in rural places, such as Santa Lucia, Intibuca, Honduras, where there are only three primary health care facilities servicing almost 12,000 people, and generally speaking access to care is limited. This study examines the factors that can be used to explain primary health care utilization, and aims to improve the understanding of patient utilization behavior. A better understanding of utilization can be used by health service planners to improve primary health care delivery in this and similar locations. The findings of this research indicate that utilization can be explained, to a large extent, by factors relating to economic status and walking time to clinic. These findings are consistent with findings from prior research. In addition, a home territory variable is used to examine spatial variations of utilization behavior. This variable has not been considered in previous utilization research, and is found to be a very significant determinant of health facility utilization in the study area.