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In this paper, a novel education framework for a gender-inclusive, development oriented approach is investigated within the context of a non-formal vocational education and training programme implemented in rural India. Analysis of the two-year intervention that delivered vocational and life skills education to women in rural India has led to a framework that combines theories of women's empowerment and transformative learning. The results from this analysis indicate that by fusing women's empowerment with transformative learning, the objectives of VET can more effectively be achieved, while also making such programmes more accessible and supportive of marginal groups. Insights from this study hold potential for informing a scalable education intervention design geared towards women's empowerment and development.

In this paper, a novel education framework for a gender-inclusive, development oriented approach is investigated within the context of a non-formal vocational education and training programme implemented in rural India. Analysis of the two-year intervention that delivered vocational and life skills education to women in rural India has led to a framework that combines theories of women's empowerment and transformative learning. The results from this analysis indicate that by fusing women's empowerment with transformative learning, the objectives of VET can more effectively be achieved, while also making such programmes more accessible and supportive of marginal groups. Insights from this study hold potential for informing a scalable education intervention design geared towards women's empowerment and development. [ABSTRACT FROM AUTHOR]

This paper presents a theoretical framework of women's empowerment developed from an intervention in South India. The framework is unique in that, in addition to common empowerment indicators, it emphasizes the relational aspect of empowerment including the role of men, family, and gendered power structures—and the flexibility of these to change. This is especially pertinent to India, which has struggled to meet global targets for indicators of improved gender equality. The mixed-methods study found evidence that women who felt they had more support from their husbands and family also had more success in the project, and that family support was an overall indicator for empowerment. This paper's contribution is in reframing women's empowerment to better represent the often overlooked structural factors that could intrinsically resist or counter the establishment of new states of social equality and stability, specifically the integral role of men and the wider family in the women's empowerment process. [ABSTRACT FROM AUTHOR]

It may be possible to shorten the hospital stay of patients with pneumonia without compromising their health. Researchers used measurements of heart rate, breathing, blood pressure, blood oxygen levels and body temperature to determine when 686 pneumonia patients became stable enough to be discharged from the hospital. The median time to stability ranged from 3 to 7 days depending on the definition of stability. Most of the patients remained in the hospital 3 to 4 days after they stabilized, indicating that their hospital stay could have been shortened., Context.--Many groups have developed guidelines to shorten hospital length of stay in pneumonia in order to decrease costs, but the length of time until a patient hospitalized with pneumonia becomes clinically stable has not been established. Objective.--To describe the time to resolution of abnormalities in vital signs, ability to eat, and mental status in patients with community-acquired pneumonia and assess clinical outcomes after achieving stability. Design.--Prospective, multicenter, observational cohort study. Setting.--Three university and 1 community teaching hospital in Boston, Mass, Pittsburgh, Pa, and Halifax, Nova Scotia. Patients.--Six hundred eighty-six adults hospitalized with community-acquired pneumonia. Main Outcome Measures.--Time to resolution of vital signs, ability to eat, mental status, hospital length of stay, and admission to an intensive care, coronary care, or telemetry unit. Results.--The median time to stability was 2 days for heart rate ([is less than or equal to] 100 beats/min) and systolic blood pressure ([is greater than or equal to] 90 mm Hg), and 3 days for respiratory rate (524 breaths/min), oxygen saturation ([is greater than or equal to] 90%), and temperature ([is less than or equal to] 37.2 [degrees] C [99 [degrees] F]). The median time to overall clinical stability was 3 days for the most lenient definition of stability and 7 days for the most conservative definition. Patients with more severe cases of pneumonia at presentation took longer to reach stability. Once stability was achieved, clinical deterioration requiring intensive care, coronary care, or telemetry monitoring occurred in 1% of cases or fewer. Between 65% to 86% of patients stayed in the hospital more than 1 day after reaching stability, and fewer than 29% to 46% were converted to oral antibiotics within 1 day of stability, depending on the definition of stability. Conclusions.--Our estimates of time to stability in pneumonia and explicit criteria for defining stability can provide an evidence-based estimate of optimal length of stay, and outline a clinically sensible approach to improving the efficiency of inpatient management. JAMA. 1998;279:1452-1457

The guidelines for treating community-acquired pneumonia (CAP) recommended by the American Thoracic Society appear to be acceptable for patients under the age of 60 but not acceptable for those over 60 or those with co-existing diseases. Researchers compared drug costs and medical outcomes in 864 patients with CAP treated at hospitals that did or did not follow the guidelines. The guidelines reduced drug costs about one-third in the young patients without compromising their outcome. However, drug costs were 10 times higher in the elderly group treated under the guidelines with no improvement in outcome., Context. -- The American Thoracic Society (ATS) published guidelines based on expert opinion and published data -- but not clinically derived or validated -- for treating adult outpatients with community-acquired pneumonia. Objective. -- To compare medical outcomes and antimicrobial costs for patients whose antimicrobial therapy was consistent or inconsistent with ATS guidelines. Design. -- Multicenter, prospective cohort study. Setting. -- Emergency departments, medical clinics, and practitioner offices affiliated with 3 university hospitals, 1 community teaching hospital, and 1 health maintenance organization. Participants. -- A total of 864 immunocompetent, adult outpatients with community-acquired pneumonia: 546 aged 60 years or younger with no comorbidity and 318 older than 60 years or with 1 comorbidity or more. Main Outcome Measures. -- Patients' antimicrobial therapy was classified as being consistent or inconsistent with the ATS guidelines. Mortality, subsequent hospitalization, medical complications, symptom resolution, return to work and usual activities, health-related quality of life, and antimicrobial costs were compared among those treated consistently or inconsistently with the guidelines. Results. -- Outpatients aged 60 years or younger with no comorbidity who were prescribed therapy consistent with ATS guidelines (ie, erythromycin with some exceptions) had 3-fold lower antimicrobial costs ($5.43 vs $18.51; P is less than] .001) and no significant differences in medical outcomes. Outpatients older than 60 years or with 1 comorbidity or more who were prescribed therapy consistent with ATS guidelines (ie, second-generation cephalosporin, sulfamethoxazole-trimethoprim, or [Beta]-lactam and [Beta]-lactamase inhibitor with or without a macrolide) had 10-fold higher antimicrobial costs ($73.50 vs $7.50; P [is less than] .001); despite trends toward higher mortality and subsequent hospitalization, no significant differences in medical outcomes were observed. Conclusion. -- Our findings support the use of erythromycin as recommended by the ATS guidelines for outpatients aged 60 years or younger with no comorbidity. Although the antimicrobial therapy recommended in outpatients older than 60 years or with 1 comorbidity or more is more costly, this observational study provides no evidence of improved medical outcomes in the small subgroup who received ATS guideline-recommended therapy.

Some patients with community-acquired pneumonia may be predicted to have a lower risk of death and could be treated on an outpatient basis. Researchers analyzed the records of 14,199 adult hospital inpatients with community-acquired pneumonia to develop a prediction rule for the risk of death within one month. Patients who are under 50 and have no history of cancer, heart failure, stroke, kidney or liver disease, and who have stable vital signs and mental status have the lowest risk of death. The prediction rule includes a total of five risk groups.