Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.

We report the complete X-ray crystallographic structure as determined through single-crystal X-ray diffraction and a thorough theoretical analysis of the green gold Au30(S-tBu)18.\ud While the structure of Au30S(S-tBu)18 with 19 sulfur atoms has been reported, the crystal structure of Au30(S-tBu)18 without the μ3-sulfur has remained elusive until now, though matrix-assisted laser desorption ionization mass spectrometry (MALDI-MS) and electrospray ionization mass spectrometry (ESI-MS) data unequivocally show its presence in abundance. The Au30(S-tBu)18 nanomolecule not only is distinct in its crystal structure but also has unique temperature-dependent optical properties. Structure determination allows a rigorous comparison and an excellent agreement with theoretical predictions of structure, stability, and optical response

Polymethylmethacrylate-augmented pedicle screw fixation reduces the likelihood of pedicle screw loosening and pullout in patients with osteoporosis requiring instrumented arthrodesis.

Here we report the synthesis and size-dependent optical study of a series of bulky t-butyl thiolated monodisperse nanomolecules (NMs): Au23(S-tBu)16, Au30(S-tBu)18, Au46(S-tBu)24, and Au65(S-tBu)29. We further employ this series of NMs to address how the NM core size affects electrocatalytic oxygen reduction reactivity of these NMs in alkaline media. Though Au23(S-tBu)16 and Au30(S-tBu)18 have been reported before, the expansion of this series is brought about by the discovery, through the synthesis and characterization, of two new and larger species, in the bulky t-butyl thiolated NM series: namely Au46(S-tBu)24 and Au65(S-tBu)29. Furthermore, we take an in-depth look at the ligand effects in the bulky thiolated NM series and ligand dictation over the gold atoms to surface ligands. Assignments of molecular formulae are based on results obtained in high-resolution nanoelectrospray ionization mass spectrometry (nESI-MS). Purity was confirmed with matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Further analysis of the new bulky thiolated NMs, Au46(S-tBu)24 and Au65(S-tBu)29, was conducted using UV–vis-NIR spectroscopy to observe their unique optical properties. With the expansion of this series, we conclude that the bulky t-butyl thiolated series is unique from those observed with aliphatic and aromatic ligands; that is, how the bulky ligands dictate the size, composition, and structure of the NM is distinct from those of aliphatic and aromatic ligands. This provides insight into the tunability and core size manipulation of gold thiolate NM (i.e., we can make different sizes of NMs using specific types of ligands by varying the gold to thiol ratio). The largest NM Au65(S-tBu)29 was found to facilitate 80% OH– production, while the smallest size NM Au23(S-tBu)16 produced 53% OH–. From the optical measurements we determined that the excited state lifetimes of this series of t-butyl thiolate protected gold NMs follow the energy gap law except for Au30(S-tBu)18 which can be ascribed to its symmetry.